In the U.S., therapy has become a cultural default. One in three Americans has seen a therapist at least once, a massive jump from just a generation ago. The phrase “everyone should go to therapy” is now so common it’s almost background noise. But not every mental health professional agrees with this blanket advice. Some, like psychoanalyst Dr. Lisa Black, push back hard against the idea that therapy is a universal need.
Dr. Black’s view is blunt: not everyone needs help, and not everyone is ready to name what’s bothering them. For her, therapy only works when someone brings a real, personal struggle to the table. Otherwise, people who show up just because they “should” often end up bored, frustrated, or feeling like they’re wasting money. She worries that the social pressure to see a therapist can erase other ways of working with the unconscious—especially creative ones.
The Therapy Trap
Dr. Black’s clinical stories are full of people who come to therapy because their friends or family insist, or because they’re trying to fix someone else’s problem by proxy. In these cases, therapy can feel like a punishment, not a relief. The real question, she says, isn’t whether everyone should go, but whether you have something you truly want to work on right now.
There are plenty of alternatives for self-reflection. Book clubs, support groups, volunteering, coaching, and personal development workshops can all offer structure and insight. Even insurance-backed programs like “My Mental Health Support,” which covers a set number of sessions, are options—not requirements. The point: therapy is a tool, not a moral obligation.
Art as a Mirror
Psychologists who study art talk about “sublimation”—the process of turning anxiety or forbidden desires into creative work. As Dr. Black puts it, artists often take responsibility for their pain by transforming it into something new, whether or not they ever set foot in a therapist’s office. Art becomes a second stage for the unconscious, open to anyone, not just those with a gallery or publisher.
Many artists have spent years in therapy without losing their creative spark. Woody Allen mined his sessions for entire films. Novelist and former analyst Marie Darrieussecq has said that being a therapist is about being present, being the one reliable person in the room. Sculptor Louise Bourgeois famously worked through her deepest fears in both her art and her long-term analysis. For some, the studio or the page is as powerful as the therapist’s couch.
Limits and Choices
Therapy isn’t magic, and neither is art. Dr. Black is clear: psychoanalysis can’t promise to bring back lost love or restore creative flow. It can’t block or force the creative process. What it can do is help people take responsibility for their own unconscious drives, so they stop acting out or making others pay for their discomfort. But the darker impulses—the urge to shut down, to numb pain—don’t vanish just because you talk about them.
When writing, drawing, or music no longer help, and when isolation or risky behavior take over, a professional can be crucial. Psychologist Dr. Joanna Marks notes that therapy can also be preventive—a few sessions a year may be enough for some. The real work is choosing the channel that lets you finally say what needs to be said, whether that’s a therapist’s office, a notebook, or a studio.
Art therapy is a growing field that blends creative expression with psychological insight. Unlike traditional talk therapy, art therapy uses drawing, painting, or sculpture to help people explore feelings that may be hard to put into words. It’s used in hospitals, schools, and private practice, and can be especially helpful for those who struggle to verbalize trauma or complex emotions. The process isn’t about making “good” art, but about finding new ways to understand and process what’s happening inside.
