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HOW DO I KNOW IF I NEED THERAPY?
By Carl Shubs, Ph.D.
This is a wonderfully important question. People
feel anxious, depressed, confused, or somehow unhappy at times in their
life. That's normal, and we all try to deal with these things on our own.
When we're able to do so, it builds our self-esteem, because then our
problem solving and coping skills are working well for us. It helps to
fortify our self image and enables us to feel successful in our lives.
It also helps us to feel strong, powerful, capable, in control, and independent,
and it keeps us from feeling embarrassed, helpless, dependent, and ashamed.
We usually prefer to feel the former and to avoid the latter.
So, if you find yourself feeling stress, having conflicts with yourself
or with others, or having problems with relationships, marriage, work,
or communications, should you press on all by yourself? If you're feeling
anxious or depressed, should you tough it out and hope it will pass? You
may be engaging in some behaviors that you're not happy about or that
are making some kind of mess in your life, like drinking, using drugs,
compulsive sexual behaviors, infidelities, gambling, overspending, other
compulsive activities, or eating disturbances. When is it time to seek
out a referral to a psychologist for psychotherapy, whether it's individual
therapy, marriage counseling, or family therapy? These become even greater
questions if you're alone and without the support you'd like to have in
When is self help not enough? When is it time to reach out for professional
help? This really presents two separate but related questions,
and they come down to the difference between need and want.
It's also the difference between whether you are reactive or
proactive in how you deal with life.
Sometimes people come to see me because they feel that they "need"
to see a psychologist. In those situations, the person usually has found
some area of their life not working the way they would like, and they
may even feel like things have fallen apart. They may have had something
terrible happen in their life or in that of a loved one, such as the death
of a special person, an illness or injury, loss of a job, divorce, or
separation, and they're having difficulty coping. They have tried everything
they can think of to make things better, and it still hasn't helped. They
may feel hopeless or desperate and could either be contemplating some
drastic action, such as quitting a job, ending a relationship, or suicide,
or they might have actually tried do to something like that. Similarly,
they may be involved in some kind of behavior that they do in an addictive
kind of way. Or, they may be stuck in a relationship or a pattern of behavior
and they can't stop. These people are acting in more of a reactive
way, and in those situations, they feel that they "need"
the therapy in order to make those changes in their lives.
Alternatively, some people come to see me because they "want"
to see a psychologist. They want their life to be better. Nothing
drastic or terrible has happened in their life, and in many ways their
lives are going well, but in some ways they may feel unfulfilled and just
want their life to be better.
It's similar to some people getting help with how their body works only
after an accident or injury, and then they go to a physical therapist
to fix what was damaged. Some people go to a gym only when they are extremely
overweight, and even then they may only do it at that time because they
have found that the weight problem has had some really negative impact
on their life or their doctor very strongly told them that it's a serious
health issue. This is more in the realm of need.
In contrast, some people go to the gym, and/or see a nutritionist perhaps,
because they want to be more healthy and fit. They may not have any physical
problems, but they may want to be healthier, toned, flexible, strong,
resilient, and generally more capable of using their bodies to do things
that they enjoy. They want some help to make their life as fulfilling
as they wish it to be, not just trying to fix something that may feel
"broken" or "damaged" in their life. These people
are acting in more of a proactive way.
I think these different descriptions will help you to answer your question
as you consider what made you even look at this article or think about
reaching out for some kind of help. As for the question about "what
can one gain from speaking to a psychologist," let me answer that
in a general way that has to do with how I work with people.
We talk together about what brings you in for therapy and what you're
looking for. With that in mind, we talk about what works, what doesn't,
and why. Together we explore various options for alternatives to all of
that. So, what you may gain is a clearer understanding
about how it came to be that your life is as it is, some understanding
of what has made it difficult for you to change it, some tools to make
those changes, and the development of new and better abilities to deal
with those things that had been obstacles for you previously.
The question of whether or not you need therapy is somewhat like how you
go about preparing your income taxes. If you're able to accomplish your
goals just as well and just as quickly on your own, that's great. If you
reach a point when you're not, maybe it's time to talk with a professional.
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