The feedback I received from 10 Things I Wish Everyone Knew About Therapy sparked some discussion of several points that may have been underrepresented. In an attempt to bring light to a few of those concerns, I’ve tackled the five biggest reasons people avoid therapy in the first place.
1. Fear of stigma
The reality is that a negative stigma surrounding mental health in the United States is still very pervasive. Because the founding fathers of psychology tended to pathologize the human psyche, the general public is still wary of what happens behind closed doors of a therapist’s office. Many people have a difficult time admitting that they need professional help because they don’t want to be seen by others as “crazy," unfit, or incapable of solving their life problems on their own. This fear of being seen as “less than” is an extremely strong force that keeps people from seeking therapy.
The truth is that people choose to come to therapy for all kinds of reasons. Some people are looking for more insight, more self-awareness, and tools to improve their overall life satisfaction. People who choose therapy may see the value in working on themselves and are insightful to know if and when they may be in over their heads. Life is full of difficult events, decisions, and transitions. The idea that life is meant to be managed solely on one’s own is antiquated.
2. Fear of diagnosis
The main misconception regarding diagnosis is that once you’re diagnosed, you will maintain that diagnosis forever. This is simply not true. With more than 300 different mental health diagnoses, only a small percentage of those are considered to be lifelong. Also, the National Alliance on Mental Illness reports that between 70% and 90% of those who pursue psychological treatment recover from mental health issues.
This means that when a person recovers and no longer meets criteria for a mental health diagnosis, any diagnosis previously given is no longer current and becomes a part of a person’s psychological history. Just like in traditional medicine when we list our surgeries, hospitalizations, or illnesses as part of our medical history, previous mental health diagnoses are treated in the same way.
3. Fear of always being in therapy
Just like there is a misconception surrounding diagnosis, likewise there is a false belief that once you pursue therapy you will always be in therapy. In reality, therapy is one of the few relationships in which the main goal is to say "goodbye."
The amount of time spent working with a therapist will vary greatly depending on the issues someone is working through, their commitment to therapy/making therapy a priority, completion of outside homework assignments, and the type of therapy provided. Some people choose to continue to work with a therapist after their presenting issues have resolved, in order to further their self-exploration or begin work on other areas of their life. This choice is always up to the client.
4. Fear of being judged
Many of my clients have told me during their first session that they were nervous to come because they were afraid I’d judge them. This always leaves me surprised and a bit sad.
Therapists undergo specific training to create a safe therapeutic environment. Besides being taught how to cultivate warmth, unconditional positive regard, and a nonjudgmental atmosphere, current therapists are also required to go through multicultural studies, which increases our insight into the variety of cultural norms that exist in our country.
Some therapists also pursue additional education in specific cultural niches such as the LGBT community to ensure an open and safe environment for everyone. Good therapists are very cautious in bringing their own biases and judgments into sessions. Yes, we are human, but we’re also professionals. If you’re ever concerned about a therapist judging you, give him or her a call, or check out the therapist's website. As I mentioned in the last article, trust in the therapeutic relationship is the most important piece. Get a feel for a therapist before setting up an appointment.
5. Fear of opening up to a stranger
Trust me. As therapists, we get it. It can be really uncomfortable opening up to a complete stranger. It’s kind of an unnatural process to go into a room with someone you’ve never met and share some very personal content. But here’s the thing: the therapeutic relationship is beneficial specifically for that reason. The relationship you form with a therapist is a blank slate. We serve as an outside perspective. We are not emotionally involved with you and, for the most part, are not personally affected by the decisions you make.
What’s more, we aren’t at liberty to discuss your issues with other people unless you give us permission to, or other specific criteria have been met. We know this can be difficult for people, which is why most of us are patient and put the ball in your court to decide how much you share and when. Good therapists know how to dance with your discomforts and put more value in organic trust than forcing you into a situation where you clearly aren’t comfortable yet.
Bonus: Fear of confronting the issue
Just like with anything else, people can continue to put off the inevitable regardless of how much evidence they have supporting the fact they need to make a change. In regards to therapy, sometimes people find it easier to deny there is a problem, or they avoid it all together. They may have expectations or beliefs of what will happen if they do confront the issue. They may also be fearful of the emotions it may bring up, so they avoid, put off, or deny it at all costs.
From time to time, some issues CAN resolve themselves. That doesn’t always happen, and only you know if a problem continues to persist. If a problem doesn’t seem to go away, or you find yourself in the same pattern over and over again, it may be time to warm up to the idea of confronting the issue with the help of a professional.
Any other reasons people avoid therapy? Leave them in the comments below.
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