What Makes it Difficult to Seek Therapy?

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What Makes it Difficult to Seek Therapy?

By  Alan M. Solomon, Ph.D.

Many people delay seeking therapy. They often expressing a variety of reasons to avoid it, postpone it, not even give it serious consideration. It can be a big, difficult decision, prompted by serious struggles and pain, and some encouragement, support (perhaps nagging?) by significant others in the person’s life. Below are some of the frequent reasons people express about not giving therapy a try (or returning to therapy for another round of help) (https://lakeorioncc/2016/10/10-reasons-people-avoid-seeking-counseling/ ):

  • “Getting help is one sign of weakness.”

People may expect that life’s problems “should” be handled on their own, individually, without outside help, especially help outside of the family. “We don’t tell outsiders about our family’s business.”  Nothing could be further from the truth. It takes courage to seek help, acknowledge that efforts to cope are not working very well, and to reveal oneself to a professional caregiver.  The more self-aware, perhaps “strong”,  person knows when, and acknowledges the time that help is needed.

  • “Therapy is for crazy people. I’m not crazy!”

Actually, therapy is helpful for people who feel stuck at some point in their life.  Some challenge seems to have them paralyzed and overwhelmed, not able to move forward as they would like.  Skilled therapy provides a non-judgmental interaction and situation in which clients are not identified as “crazy”, “sick”, or “ill”, but are helped to move through the sticking point in their life path. (See my “therapist profile” for a fuller discussion of this.)

  • “If someone finds out that I’m in therapy, others will know my private concerns.”

Absolutely not.  Legal and ethical guidelines for therapists are very clear: a client’s privacy must be protected.  Without written, formal permission, no information can be shared with anyone.  There is basically one exception to this ironclad rule: if there is immediate physical danger to an individual, then the therapist is responsible to take steps to protect someone’s safety.  These steps may compromise confidentiality in order to keep someone safe from an immediate life-threatening danger. The only other possible exception is if there is a legal process involving the client and the therapist receives a subpoena requesting information; even then, steps can be taken to protect privacy at least to some extent.  So, in almost all situations, a client’s privacy is firmly protected.

  • “What would I discuss in therapy?  I have no idea what to talk about.”

A skilled, experienced therapist, who does care about the client’s well-being, knows what to ask.  An opening statement will get the process moving forward, such as “I’m so unhappy in my marriage/relationship.”, or, “My work life is full of problems.”, or, “School is turning out to be one big failure.” Being listened to with such care, attention, and empathy helps open up a meaningful dialogue, often rather quickly.

  • “Therapy is too expensive.  It’s not affordable in my budget.”

Members of IPN make every effort to be flexible with fees as much as possible.  Often insurance coverage helps with the bulk of the fee, so that a small co-payment is all that is needed. Or a therapist will work on a “sliding scale” to find a workable fee. Or, community resources can be found to offer very low-cost therapy.  Often, a limited number of sessions (what is called short-term therapy) can provide some meaningful relief and help, so that a big financial commitment and a long course of therapy are not necessary.  All of this can be discussed and worked out in the early sessions.

  • “My friends can help me with this difficulty. How can talking to a stranger be helpful?”

Friends can indeed often be helpful, especially if the friend is capable of genuine empathy and support, and is creative at problem solving as well.  But a friendship is a mutually caring relationship that takes into account the needs of both people. A therapy relationship is focused on the client’s needs, issues, and concerns.  A therapist is trained, experienced, and focused to be of help to you in ways that a friend is not; that is what makes the experience genuinely helpful.

  • “What good is just talking?”

Some talking initially can provide relief: not feeling so alone, not feeling misunderstood or not cared about, relieving the pressure built up from holding feelings and worries within for some period of time.  With some continued conversation in this way, with the therapist doing a lot of careful – and caring – listening at first, the client can begin to feel safe in discussing their concerns, to understand the situation, the relationships involved and him/herself in new ways.  Seeing things in new ways allows for new possibilities and choices, previously not thought of at all, or not thought of as possible.  Often the client comes to new possibilities on their own as they progress, or the therapist may make a timely suggestion as well.  “Just talking” leads to much more than just talking.

  • “If I talk about these issues, I’m being disloyal to my family or my partner.”

While the therapist is focused of course on helping the client as an individual, the therapist is also respectful of the client’s relationships and wants to help those relationships as well.  Well-trained and experienced therapists are respectful and curious about how each individual, relationship, or family is unique, without sweeping generalizations about what’s right or wrong.  Cultural questions and differences are treated with respect and curiosity as well, so that demands about living in some “mainstream” kind of way are not expressed or enforced.  Confidentiality, with the few limits noted above, insure that family members or partners are not betrayed.

  • “Talking about my problems and upsetting emotions will make them worse. I’ll fall apart.”

Yes, there might indeed be some powerful emotions at times in therapy, which might seem difficult to tolerate or get through.  But, with support, caring, and clarity from a skilled therapist, these “choppy seas” can be navigated with more resilience and “ability to float” than clients expect.  Some emotional intensity is often part of gaining relief, and certainly part of developing a new and deeper understanding, which is what creates new possibilities.

  • “Since my employer provides insurance, they’ll have access to this private information.”

Not at all.  Your private information is protected by laws and ethical guidelines that protect your privacy.  Neither insurance companies, nor the therapist, can share this information with an employer unless you give formal, written consent.

If any of these concerns are part of your reluctance to start therapy, then that is the place to start: express your concerns ASAP, even first thing in the first session.  That will allow the therapist to acknowledge your uneasiness, begin to address it, and help you find relief from the very outset.  An experienced therapist will be at ease about this and facilitate your moving forward.

Star players in the NBA have recently made more public statements about their seeking therapy for their personal challenges (https://es.pn.goi.com/video/clip?) . A recent blog on this website highlighted Kevin Love of the Cleveland Cavaliers:  Ask Kevin Love…..  This well-spoken celebrity makes the point that success does not make you immune from difficulties. He is an inspiration for those who might hesitate to seek help.

Perhaps an original spokesperson in this way was William Saroyan, a successful author and journalist.  His 1992 book details his struggles with severe depression and finding successful help:  Darkness Visible:  A Memoir of Madness.  A more recent version of this same struggle, eloquently shared is by Kay Redfield Jamison:  An Unquiet Mind: A Memoir of Moods and Madness (2009).  Jamison is a psychologist herself who battled with bipolar disorder until she found a medication regimen and helpful therapy with a caring psychiatrist.

Perhaps reading some of this, or watching Love’s video, can help someone move forward with seeking help.  We at IPN are ready to respond.

Alan M. Solomon, Ph.D. is a clinical psychologist in private practice in Torrance, CA.  A member of the Independent Psychotherapy Network, he can be reached at 310 539-2772, or dralanms@gmail.com

Copyright 2018 by Alan M. Solomon, Ph.D.