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. She crashed on my couch like a jet with a spent 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 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 a loss, she looked at me with a 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 have you 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 the term “depression” that she had used jokingly with her friends before lost its comedic appeal. The meaning of the word became real and intimidating.
She was feeling down, stressed out, tired, and discouraged, but also not prepared 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.
Commonly Held Myths About Psychotherapy
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 which did not work, or did not work sustainably. The short answer to 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 because we don’t have enough support or motivation to start or to follow through. A counselor can help you to clarify your goals, create feasible strategies that consider the obstacles you are likely to face, and act as a supportive partner in the process.
2. It is awkward to tell a stranger about my problems.
Your therapist is just another human being with his or her 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 look 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 able to ask relevant questions, show support, and encourage you as you talk is especially important for a shy person. 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. A therapist’s questions should be a relevant followup to the topic that you are discussing or relate to the general concern that brought you to counseling. Over time you should 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.
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. The anti-therapy stigma may also affect people whose family of origin placed an implicit or explicit taboo on interpersonal disclosure. 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.
Anyone can feel confused, down and overwhelmed, regardless of his or her religious convictions. Spirituality is a great coping resource. It empowers you from within and 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.
Coming to therapy is not always correlated to the gravity of one’s concerns. It is driven by acknowledgement of one’s vulnerability, desire to learn more about oneself 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, and 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 perspective and support your individual biases, which leads to getting further stuck in the negatives of your situation.
Therapists can offer a fresh and unbiased view on your concerns, identify behavioral pathologies and mental health issues that may be overlooked by a layperson, design effective interventions and guide you through treatment. Counselors also can help to involve other family members in therapy, if appropriate.
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 yourself and your counselor. Let talking manifest its healing powers. You vent feelings and express opinions, as someone listens supportively, asking clarifying questions. It is healing within itself. It is also is a segue 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 co-pays 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.