I had the intention of listing specific issues that can become obstacles to beginning therapy,based largely on the objections I’ve heard from others. Objections like ” I should handle my own problems,” or “it’s like paying for a friend,” and the classic what’s he/she going to tell me about myself that I don’t already know.” This is not an exhaustive list.
What I hear when these, and other similar objections are raised, comes down to two very basic and primary emotional states: shame and fear. Shame and fear work in tandem; they sit like temple guardians blocking one’s way to real intimacy, true joy, peace of mind and a life lived to its fullest potential. Shame and fear underlie, overcoat and walk in parallel with every negative emotional state we experience. There is so much to say about how shame and fear permeate our negative emotional states, but I’ll restrict myself to the ways in which they interfere with the decision to seek therapy.
Maybe it’s our culture, but there is such an aversion to asking for help. Maybe we’ve overvalued that sense of independence ( “I can do this myself!”) that to reach out to someone else engenders a sense of weakness in us that is too shameful to bear. “If I were stronger, I could handle this; I should be able to handle this.” Seeking help has nothing to do with strength or weakness. It indicates a kind of self awareness that says you know when things have gone beyond your grasp and you care enough about your well being to take care of yourself. Still, acquiescing to the notion that help is needed can feel like giving up. In fact, continuing to soldier on through problems, perhaps engaging in risky or self harming behaviors is more like giving up; it is giving up on the hope that things could be better.
Fear plays a role in avoiding seeking therapy as well: fear of dependency, fear of influence and fear of change. Some people come from families where they felt humiliated to ask for help. Or the people they relied upon ( parents, caregivers, teachers,etc) neglected them, or betrayed them or, worse, abused them. They have come to mistrust any reliance on another, especially another who may be in an authoritative role, like a therapist. Others may fear that the therapist will somehow change their way of thinking, or want to deconstruct their belief systems and refuse to accept them as they are. Still others, well, many of us,fear change, even change for the good. Change is uncertain and frightening. Some people may feel it is better to stick with what they know, rather than risk changing and find that things are no better than before.
These obstacles are real, but they do not need to remain rigidly in place. It may help to think of therapy not as shameful surrender but as a life-affirming act that states you care about yourself and your relationships to learn and grow as much as possible.
As this is my inaugural blog ( and how fitting in a Presidential inaugural year) I would like to address a fairly basic issue; that is; who should consider going into therapy. Also, given the tragic events of the past weeks in Sandy Hook Elementary School and how these events have re energized a public discourse about mental health, a frank discussion about therapy seems to be in order.
In the interest of full disclosure I must report that I have been in therapy myself, both before and during my career as a clinical psychologist. Thus, I admit to a bias toward seeking help rather than avoiding it. That being said, there are many benefits to seeking therapy, finding a good therapist with whom you can relate and, together, you and your therapist can collaborate to promote real change and growth in your life.
First, allow me to address the objections to therapy that I encounter in my daily travels. There are the practical matters, such as time and cost. Making time for therapy is a subjective matter; it can seem as though one does not have time, but I would counter with this question: is 45 minutes ( plus travel time) once a week a worthwhile investment to make in your emotional well being? The question of cost is a real one and I am sensitive to this. Many therapists do not take insurance and this can be a hindrance. Many of us, however do work on a sliding scale. Additionally there are low cost clinics associated with training centers and graduate programs that are available. It can seem daunting to try and find a therapist once you have made the initial decision, but there are several resources online ( the Internet is a wonderful thing!) including your state psychological association, the American Psychological Association’s website and the various websites of clinics in your area, all of which are informative and can direct you in your search.
Having said all, you can still have doubts that can ( and most likely will) creep up if the search for a therapist gets difficult in any way. Those reasons to give up on the idea of therapy are more emotional and have more impact on your decision. I’ll address these reasons in “Act II–Emotional Obstacles.”