She was sitting in front of me hollow eyed and tired. For years she was resolute in her refusal to seek help, intent to prove to herself and the world that she could handle anything. Type A, smart, driven, “fix it myself” kind of a woman. She crashed on my couch like a jet with exhausted fuel tank. I could see her discomfort seeking counseling, trying on a hat of a passenger instead of her habitual role of a pilot.
She was lost and confused, void of calm and goodness, quite frustrated with herself. Where was the wonder woman who could write a professional article with one hand, while mixing up a virtuoso meal for her family with another? The one who could pull up an all-nighter to show the up next morning fresh and energized, to impress coworkers with her wits and energy? She did not know for many months. It began to scare her, ultimately making her sit on my couch. As if feeling ashamed of being in my office, misplaced and at loss, she looked at me with simultaneous expression of hope and defeat. She also appeared spooked: her dark mood lasted long enough that she began forgetting who she believed she was at some point.
“How long you’ve been feeling depressed?” I asked her. “I don’t think I am depressed,” she corrected me. She explained that all she wants is “her old self back.” She told me that she feels “blue,” always tired, forgetful, and cries easily. She wanted to feel happier and regain her energy. She shared that her previous episodes of feeling sad were short lived, nothing that a trip to “Nordstrom” couldn’t fix. This state now was an entirely different game. Dark feelings grew thicker, sadness lasted longer. The informal mention of term “depression” that she used jokingly with her friends before lost its comedic appeal. The meaning of the word become real and intimidating.
She was feeling down, stressed out, tired, and discouraged, but also resolute not to call it depression. Good enough as a start: I am not keen on labels either. At least she made it to my office, asking someone to help her to overcome the emotional plague that was thwarting her life. So, who needs counseling? The long answer is people experiencing emotional and physical difficulties affecting their lives, but wanting to be stronger, happier and healthier. Those who tried many things on their own in the past, but it did not work, or it did not work sustainably. The short answer for who needs counseling is everyone, at least at some point of their lives. Here are some reasons why and clarifications about some commonly held beliefs and stigmas related to seeking therapy.
1. I know myself what needs to be done, I just need to do it.
Precisely. Many of us suffer all sorts of problems not because we don’t know how to fix them but because we don’t have enough support or motivation to start or to follow through. Counselor can help you to clarify your goals, create feasible strategies that consider the obstacles you are likely to face, and act as a support and liability partner in the process.
2. It is awkward to tell a stranger about my problems.
Your therapist is just another human being with own problems and shortcomings, able to personally relate to your situation to an extent. A good therapist conveys empathy and patience when listening to you and makes your first session comfortable by explaining the process of therapy and asking questions to prompt you to describe your concerns with greater ease. In addition to their psychological expertise, therapists should have the essentials skills of connection and warm regard, so that you quickly feel at ease, begin the process of relating to and connecting with your therapist, and looking forward to return for your next session.
3. I am shy and not much of a talker.
Many of us are reserved when it comes to discussing private matters. Talking to someone who is warm, empathic and can facilitate constructive dialogues by asking relevant questions, showing support, and encouraging as you talk is especially important for a shy person, not used to an interpersonal disclosure. In addition to resolving personal problems through therapy, a shy person can improve social skills, become better at and more comfortable talking to others.
4. All therapists do is follow up my statements with “how does it make you feel?”
Yes, they do in some bad sitcoms. If this is what you mostly get in sessions with a therapist, consider finding someone else. Counselors may ask you to reflect on feelings when appropriate but will also ask other questions to help you reflect deeper on your thoughts, feelings, and actions. They may also use exercises, do some coaching, and employ other therapy tools and strategies. Therapist’s questions should be a relevant follow up to the topic that you are discussing or relate to the general concern that brought you to counseling. Over time you have an improved understanding of your situation, more coping skills, and begin feeling better. These are the signs that your therapist’s strategy is working and that the questions and comments made in session are helpful and relevant.
5. It is embarrassing to be in therapy. People may think that I am weak or troubled. It feels like a defeat.
This is a common concern. It is even more pervasive when it comes to clients of certain ethnic or cultural origins, where therapy was not commonly embraced in the cultural context, viewed as rare and pathological, rather than regarded as tools of healing and means of wellness enhancement, as it generally viewed nowadays in this country. The anti-therapy stigma may also invade people whose family of origin placed an implicit or explicit taboo on interpersonal disclosure, not talking about feelings by either ignoring children’s hurts and emotional states, or even punishing them. If you come from a culture or a family environment where the notion of therapy was viewed negatively, it is important to acknowledge this fact as one of the barriers that keeps you from connecting with your feelings, understanding them better, and asking for help when needed.
6. I am a religious person. I should get my help through prayer and meditation. My problems are likely related to the spiritual conflict that needs to be fixed.
Anyone can feel confused, down and overwhelmed, regardless of their religious convictions. Spirituality is a great coping resource. It empowers you from within, gives you extra means of coping by prayer, devotion, and meditation. You gain a greater communal support through your church or other religious affiliation. It does not mean, however, that you will never be plagued by any emotional condition and face difficult life predicaments pertinent to humankind. It is healthy to be insightful and humble enough to acknowledge that you are imperfect and may struggle in life, and be able to ask for help. These notions of vulnerability, open-mindedness, and leaning on others for guidance and help are supported by most religious teachings. If it is more comfortable, find a therapist who shares your religious and spiritual beliefs.
7. My life is pretty good. My concerns are insignificant. I should not complain about minor things, when some people have grief and real problems.
Coming to therapy is not always correlated to gravity of one’s concerns, but is driven by acknowledgement of one’s vulnerability, desire to learn more about self and live a better, more fulfilled life. People often deny or minimize their problems and their negative impact on themselves and others. People with severe dysfunctions, such as anger, addictions, sociopathy never seek therapy, claiming not needing it. Some others were raised with such a negative view on counseling that they don’t get help even when dealing with acute loss and trauma. Therapy is a state of openness that leads to an experience of growth, regardless the type and size of the concerns that bring you into it. If you regard your issues as “minor”, it does not mean you don’t deserve or would not benefit from help. Therapy can serve as both, intervention and prevention.
8. I have friends who can listen to my problems at no cost and give me good advice. I don’t need a paid friend.
You are fortunate to have caring and supportive friends. It does not mean, however, that they are trained mental heath professionals who can estimate accurately the scale of your problems, identify their roots and their negative life impact, and help you to map and follow the effective pathway to growth and healing. Friends may also favor your prospective and support your individual biases, which leads to getting further stuck in the negatives of your situation. Therapist can offer a fresh and unbiased view on your concerns, identify behavioral pathologies and mental health issues that may be overlooked by a lay person, design effective interventions and guide you through treatment. Counselor can also help to involve other family members in therapy, if appropriate, to facilitate constructive dialogues, to resolve issues related to interpersonal difficulties.
9. My problems are not going to be fixed by just sitting and talking about it. It is a waste of time.
It is true that talking alone is not going to change your situation, but it is a starting point. You need to be able to admit to and articulate your concerns, before coming up with strategies to resolve them. Some people rush the initial stages of therapy, wanting specific strategies and visible gains immediately. Remove such pressure from self and your counselor, let talking manifest its healing powers. You vent feelings and express opinions, as someone listens supportively and asks clarifying questions. It is healing within itself. It is also is a segway into more advanced stages of therapy, where after improved insight, you strategize and begin the process of change. So, there are different ways and kinds of “talking” in therapy, all important and integral to healing.
10. Therapy is expensive. I can’t afford it.
People commonly overestimate the actual out-of-pocket cost of therapy to a patient, as many insurance plans cover the cost of sessions. Many insurance plans include mental health coverage, and it is likely you will be responsible only for the cost of copays or a portion of the fee quoted for a session. If you don’t have health insurance or your plan does not cover counseling, try to find a therapist willing to offer some discount to make it more affordable.