Who me? I don’t need help
Most of us accept it as a fact of life that at one point or another, we all need help. If my car breaks down, I contact a mechanic. If the foundation of my house is cracked, I seek out a foundation repair business. If I am relocating across the country and must find assistance moving all my belongings, I call a national moving company or perhaps look into renting a truck. Or maybe I want to plan a vacation of a lifetime in the Caribbean and so I make a call to a travel agent. You get the point. There are countless situations where we all find ourselves requesting help from someone else.
Yet how different humans act when it comes to psychosocial problems. Our worlds can be caving in with all sorts of emotional and relational distress and everything we are trying to do just making things worse. But there is no way we are going to admit that we need assistance. In general, we are a species that “digs our heels in” and determines to fix our psychosocial problems on our own even if it’s not working because….because….exactly what is the reason we don’t seek help?
The answer is complicated and attempting to fully address all the possible influences that play into why humans are reluctant to admit their needs goes beyond the scope of this webpage. Some of these reasons might pertain to actual experience, that is, the actual experience of having had a miserable time with a mental health professional. This can include someone’s own experience of therapy or even just hearing about someone else’s unhappy tales. Like getting burned by a hot pan on the stove, such experience would naturally result in a person avoiding any further contact with these clinicians. Why have some people had such bad experience?
Most people (and that even includes healthcare practioners) do not comprehend the difference between counselors, marriage and family therapists, psychiatrists, psychologists, and social workers. Many times people seeking aid have just gone to the wrong psychotherapist. It’s sort of like taking your Chevy truck to be repaired at a Mercedes Benz dealership; not the best choice. But there can be other reasons for not seeking psychosocial assistance that stem from some vague uncomfortable feeling rather than on any specific experience. In an oversimplified nutshell, it seems we could all agree that for a certain number of people there is fear or anxiety associated with going to a psychotherapist. What is this fear all about? Though overlap exists between these perspectives and may even look different for a variety of people, here are four common reasons:
1. "People will think I’m crazy" or perhaps, “could it be that I am crazy?"
There is something scary about thinking that one could be "crazy." There is just something about that word. Out-of-control, unpredictable, abnormal are a few of the meanings we associate with this word. But I believe the scariest part is that the cure is not clear. Crazy just seems permanent. And that is not only scary but brings on feelings of hopelessness. Fear drives some people to bear with their symptoms rather than take, what seems an incurable label.
2. "We just don’t go outside of our family for help" or it’s an unspoken family rule that we don’t trust those in the field of psychiatry.
Not in the too distant past, a person could be committed to an inpatient psychiatric facility against their will. Actually that can happen today but there are many checks and balances in the system. But it wasn’t always that way. Our parents and our grandparents lived through the time where one psychiatrist had the power to commit a person against their will to indefinite inpatient psychiatric care. There are many horror stories of people locked up for years and even forgotten. Books have been written about these stories and movies such as One Flew over the Cuckoo’s Nest and Girl, Interrupted revealed on the big screen the unbridled strong arm of psychiatry in those years. For those who lived through that time, it was a scary possibility. Then in 1975, the Supreme Court ruled it illegal for states to confine citizens to an institution if these persons are not dangerous and are capable of living by themselves or with the aid of family or friends.
Even after the psychiatric world lost complete control in committing someone to a mental hospital, many people still carry an unconscious mistrust of those in the field of psychiatry. A common belief shared is that psychotherapists are “weird” with unusual ideas trying to impose their “crazy” thinking on their clients. There is something foreboding about the stereotypic image that you come to a psychotherapist’s dark office, lie on this couch, and go through every gruesome horrible thing from the past while the doctor mumbles “I see” and "Hmmm" and writes words down on a secret tablet. So over time, people began to keep their relational and emotional problems to themselves. “Don’t tell others your problems" became the accepted standard. Family members were directed, "what happens at home, stays at home.” Our families have passed these messages down to us outside of our awareness. We just know we aren’t to tell our “stuff” to others. Such messages were not necessarily spoken but served up with the mashed potatoes and the gravy at the dinner table day after day.
Certainly there are countless stories of people who took the courageous step to seek counseling only to feel judged and maybe even humiliated by the therapist. One recent example was a television show psychologist who frequently humiliated guests coming for help with questions like “How’s that working for you?” Being shamed and treated without compassion by a therapist leaves terrible wounds. Such stories are told and retold and the fear climbs ever higher at the thought of seeking professional assistance for mental, emotional, or relational problems. This is understandable. In a field with so wide a variance, it is important to be careful and gain some general knowledge to guide one in making wise choices. With an easy going style, the marriage and family therapists of Enjoy Your Life Family Services, Inc. creatively work with clients and their families in finding solutions to problems so they can enjoy their lives again.
3. “I’m doing just fine” or “I’m not weak” or the strong desire to stay free of the shame that has been associated with mental distress.
Where it started is difficult to pin down but somewhere along history, shame was connected to mental distress. Over thousands of years, the mentally and emotionally imbalanced have frequently been treated with contempt and shamed by those closest to them. Though hardly ever discussed, humans go to great lengths to avoid this discomfort. A beautiful and thorough work on the subject is Jane Middleton-Moz’s book entitled Shame and Guilt: Masters of Disguise. There are various ways our species is known to hold this demoralizing emotion at bay. Probably one of the most common is denial, especially self-denial.
For example, our society traditionally shames anyone who is an alcoholic. For the person who is drinking too much, there is far too much pain involved with facing the imposed shame than by admitting a lack of control. The alcoholic keeps these feelings away by telling him or herself, “I don’t have a drinking problem.” Of course, denial works to keep one from dealing with the effects of societal shame but denial also keeps the problem entrenched and firmly lodged in place.
Shame is an emotion that produces a feeling of being uncomfortable in one’s own skin. No one ought to feel that. For any that have endured shame it makes perfect sense that all effort would be aimed to do whatever to keep from feeling that great displeasure again. That fear of shame may keep you from getting the services you need. Here at Enjoy Your Life Family Services, Inc., we respect our clients and seek to amplify you and your family’s strengths in bringing about the changes you desire.
4. “I may have to talk about things I don’t want to talk about” or therapy can be uncomfortable.
Frequently we get calls from prospective clients who ask questions to see if we are a good match for their needs. One woman remarked after the usual questions, “Well, it just seems ridiculous to me to go talk to a stranger about things I don’t even want to talk to my husband about.” She’s right; it does seem a bit ridiculous. The essence of psychotherapy is to work through some identified problem in our life and by their nature, problems usually are not something fun that we want to embrace or even mention. Many times these problems have caused or are causing pain and now a time has come where something “has to be done.” Maybe it’s sort of like a cavity that you know needs a filling but at least with a filling, you get gas and local anesthesia. As far as I know, psychotherapy does not offer any similar numbing agents.
It is true that therapy can be uncomfortable—it can be downright uncomfortable. But under the care of a skillful and sensitive psychotherapist, the pace should be set by you, the client. At Enjoy Your Life Family Services, Inc., we understand how the work of therapy can bring discomfort therefore we pay particular attention to work with our clients in helping them achieve their goals.
A matter of life and death
Here we are in the twenty first century and as a species, we have become very good at keeping things to ourselves. Our fear to reveal our mental or relational problems seems to arise apart from our consciousness. Just the thought of going to someone for help with marriage or relationship issues stirs all sorts of bad feelings. It’s a knee-jerk kind of response. We may or we may not speak our objections: “I’m not crazy” or “I don’t need counseling” or “we’re doing just fine.” What is most amazing is that we keep our emotional and relational problems hidden but that is rarely the case when it comes to physical problems.
How is it that we willingly remove all our clothes, step into a gown that barely covers our backside and then allow a medical doctor to probe and poke all over our bodies? It can mean life and death! We willingly submit to such examination because our very lives depend on it. Without physical health we realize that our welfare could be jeopardized. But there really is no difference with psychosocial problems. The truth is that the absence of relational, emotional, and mental health not only impedes our ability to enjoy life but can actually lead to death. There is a growing accumulation of research in the field of psychoneuroimmunology which shows the connection between stress and increased vulnerability to disease [1-5]. The benefits of psychotherapy utterly outnumber the reasons to do nothing new. With all the evidence, the only risk now is waiting too long.