If you’ve never been to therapy, you might think it’s a lot like those scenes you see in TV and movies. Steve Carrell, a therapist, is held captive and chained to a bed by his client in Hulu’s The Patient. Tony Soprano of HBO’s The Sopranos, who gets counselling twice a week, is a violent criminal. These types of characters convey an (unfortunately false) message: Therapy is only for people with serious problems.
The good news is that this perception is starting to shift, according to Gail Saltz, MD, a psychiatrist and clinical associate professor of psychiatry at New York Presbyterian Hospital and Weill-Cornell Medical College, although maybe not as quickly as experts would like. “There’s often an internal feeling of stigma about therapy, and people often don’t want to go for that reason,” she says, adding that folks from older generations or men, in particular, might be the most resistant to getting help for that reason. (Other times, she says, people are afraid to open up or feel like they can’t afford it.)
In fact, Dr. Saltz says that “pretty much anybody can benefit from really excellent talk therapy.” And if someone in your life is visibly struggling, it can be heartbreaking to see them try to white-knuckle their way through the torment when you know a good therapist might be able to help. While it’s important to keep in mind that therapy only “works” if someone is open to the experience and genuinely wants to change, there are some things you do and say to help show them the potential benefits. Read ahead for tips on how to get someone to go to therapy:
1. Try to understand their reason for not going
Just like your motivation for seeking out therapy is highly personal, so too are someone’s reasons for avoiding it. That’s why it’s super important to truly understand and empathise with why someone’s averse to the idea so you can figure out how to best approach them, says Jody Thomas, PhD, a clinical psychologist and CEO of the nonprofit Meg Foundation. Here are a few common scenarios Dr. Thomas and Dr. Saltz see in practice:
Dr. Thomas says that she still sees a big cohort of people—again, a lot of older folks and men—who just want to power through hardships. “We might think that only whiners go to therapy, or people who can’t handle their own stuff,” she explains. “This mentality leads a lot of people to have pretty sad and unnecessarily depressed and anxious lives.”
“People will often say, ‘My grandparents didn’t need therapy,’” she says, which might call for a counter-question on your part: “How would you have rated Grandpa as a partner or parent? How would you rate his concern for his well-being?”
This one is a super legit reason for avoiding mental health help, both Dr. Saltz and Dr. Thomas say—but it’s something that can be worked around with a little effort. (More on that in a min!)
As Dr. Thomas notes, media-derived associations with therapy also extend to what sessions might look like too. “Perhaps they picture a Freudian couch with someone sitting there and saying, ‘Tell me about your mother,’” she explains. “Some of that is fear of I don’t want to reveal these things about myself because I’m afraid this person is then going to have power control over me, that it’s a judge-and-jury situation—that someone is going to tell me everything I do is wrong. That’s not how this works.”
This mindset can be really strong in someone who has had a bad experience with a former therapist, Dr. Thomas explains. In that case, it’s helpful to point out to them that there are poor specialists in literally every single profession. “Yeah, there are some terrible therapists. There are also some terrible doctors. There are a lot of people who are terrible at their job and people who are good at their job. It’s really about finding the right match.”
2. Pick the right time—and non-accusatory approach—to bring things up
Dr. Thomas says it’s really important to find a strategy that won’t make your loved one recoil in self-defence—preferably a quiet time where things are going well between the two of you. “Whenever we are feeling called out, that’s going to go badly,” she explains. Again, this is where understanding their hesitations can come into play, using a personal example: “My brother died a few years ago, and I was really trying to get my mom into therapy,” she explains, noting that she started the discussion using sentences with an “I” angle rather than “you.” She steered clear of making accusations too, as she noted that some older parents may feel sensitive to criticism about the things they did when raising their children. “I said, ‘I’m worried. I’m seeing you struggle with anxiety. I’m worried that you’re depressed, I love you, and I don’t want you to suffer.’” Those small wording changes are key, she says, because once you start pointing a finger (by saying, for example, ‘You speak to my children in a certain way’ or ‘You make the family uncomfortable’), they’re naturally going to get a little defensive.
In a couples situation, Dr. Saltz says, doubling down on the “I” statements is crucial. You could say: “I’ve been thinking about X, as I’m sure you have too, and that we really struggle with Y. I want to make it better because I love you, and I think talking to somebody will help us.” This is opposed to statements like, “You did this, or you did that,” which really ends the conversation, Dr. Saltz adds. Don’t ever bring up a therapy convo mid-fight, even if it feels like the most natural time and they’re doing the so-called “bad” thing in real-time, both experts agreed.
If they’re still stuck on a bad past mental health experience, it’s important to validate that, Dr. Saltz says. “You can say, ‘I’m sorry that you had that bad experience, and I totally understand how demoralising and frustrating it is that you went to somebody for help and it didn’t help. In fact, maybe even in some ways, it hurt. That said, sometimes the bad experience is because this person wasn’t good or a good fit for you.’”
3. Reiterate how common it is to get help
You wouldn’t just tell someone with diabetes or a heart condition that they need to tough it out—and that same logic applies to mental health. “That mapping onto physical illness can be a useful construct,” Dr. Thomas explains. Dr. Saltz agrees: “Our brains are like any other organ,” she explains. “Our feeling states are a product of wiring and neurotransmitters. The idea that you can just decide to feel differently is medically incorrect.” Basically, Dr. Saltz says, when something’s off (say, you’re feeling really low or anxious), it comes down to neurochemicals. You may be able to change that with medication, but she says that talk therapy can be just as effective in certain cases, particularly with depression. “If we repeat patterns of talk and understanding, we can also change neurochemicals, which is why psychotherapy works.”
Another powerful fact to throw out? How common mental health issues are. “Over half of all Americans have a DSM-5 diagnosis at some point in their life,” she says. (FYI: The DSM-5 is a guide that helps mental health pros diagnose psychiatric conditions, from depression and anxiety to bipolar and schizophrenia disorders.) “It’s not from bad parenting. You could have a great growing up and still develop an anxiety or mood disorder—that’s just the way it is.”
4. Play an active role in finding them the right help
Convincing someone that therapy isn’t a total waste of time is only half—or even a quarter—of the battle, both Dr. Saltz and Dr. Thomas said. If you really want a person to at least try it, you need to iron out the details of actually making that happen. “It takes effort, organisation, and even persistence to find someone to treat you, and for a lot of people, they don’t have it in them,” she says, adding that if you’re depressed (and even if you know you need help), the search can feel near-impossible. You might not have the strength to shower, let alone look for therapists.
Dr. Saltz suggests doing some of the legwork to get things moving for them. “Who’s in their area, and who takes their insurance and has availability? Literally, you can make the calls for people,” she explains. “You can say, ‘I can make you a first appointment and go with you if you’re really nervous.’ All of that is worth doing for somebody you care about and you’re trying to get help for.” Importantly, too, she adds, you should help them vet the person and decide if a mental health pro isn’t the right fit.
Then there’s the cost of therapy, of course, which can be a really tricky obstacle to overcome. Dr. Thomas’s favourite money-saving solution? “Try a psychology training program,” she explains. “Those training clinics have therapists supervised by incredibly seasoned clinicians. You are very likely to get good care at a much more discounted price.” If there’s a university near you, it’s not a bad idea to call the psychology department to see what services they might offer.
At this stage, Dr. Thomas says to those wondering how to get someone to go to therapy, it’s also worth mentioning that they can just give it a try and don’t need to commit to a life’s worth of sessions (especially if they’re worried about the financial aspect). “One of my biggest goals for people is to not be in therapy forever,” she explains. It’s helpful to think of it like any treatment for any other ailment, Dr. Thomas says: If you’re sick with an infection, you get antibiotics. If a tooth is bothering you, you get a dentist to check it out. “When things in our life are not going the way we want to, there are tools and resources available to us that can make this better,” Dr. Thomas explains.
This article first appeared on self.com
Also read:
5 tips on how to help a depressed friend that aren’t too hard on either of you
How to help a friend suffering with a mental illness
10 tips on what to do when you feel depressed beyond the ability to get out of bed
