If a loved one says, “My back has been hurting for weeks,” it is generally straightforward and easy to respond: “Have you thought about seeing a doctor?” or, “Have you thought about seeing a chiropractor?”. If a friend complains about a terrible sore throat, you don’t hesitate to advise that he or she consider getting a throat culture to be sure it isn’t strep. But something quite different often happens if a loved one hints at emotional pain. It may feel more difficult, even risky to say, “Sounds like you’re anxious. Have you thought about seeing a psychotherapist?”
We tend to categorize emotional and physical pain differently. Despite all of the advancements in our understanding of mental health, there is unfortunately still stigma attached to a range of emotional and psychological disorders. Becoming depressed, for example, can be construed as a character “weakness” or irrational “pessimism.” Quite often a depressed person is viewed as “ungrateful” for not appreciating all of the wonderful things that life has to offer, and a phobic person might be seen as “letting anxiety” get the best of them, rather than possessing the fortitude to muscle through a difficult situation. The implication here, of course, is that emotional pain can be overcome with effort and that all one has to do is muster up the will to try harder. Furthermore, it will be “character building” if the person can tough it out.
Because of the insidious and unspoken judgment that still exists when it comes to mental illness, it can be difficult to know how best to intervene when a friend or family member is emotionally unwell. How can one best recommend that the person seek professional help?
The first order of business is to be sensitive about where and when you broach such a topic. Obviously, it is not a good idea to bring up your concern with other people present, even if you think they are close confidantes of your loved one. It is also unwise to raise this issue when the person is in a hurry or distracted. Wait for a calm moment when the two of you are alone together. This needs to be done live, not by text or email, i.e. arenas where tone of voice is unreadable.
It’s important to realize that recommending that someone may need psychotherapy is not a criticism of the person. On the contrary, it’s an act of love and concern. And it’s important to frame it as such. Emphasize what you love about the person and your concern that emotional pain appears to be interfering with these qualities. So, for example, rather than saying, “You just seem so depressed all the time,” you could say, “I’m worried about you. I feel like something is getting in the way of your usual energy and ability to have fun.” Also, do not attempt to sound “shrink-like” by saying something like, “I think you are having a serious recurrent major depressive episode.” Instead remain connected and human: “I hate to see you in such pain…. It seems really difficult.”
If you’ve been in therapy yourself, it’s good to share something about your own experience. Don’t go into a lot of detail because then the conversation will become more about you than the person you’re trying to help. But it is reassuring for your friend/ family member to hear something like, “I was really reluctant to see a therapist, but once I did it was very helpful to me and I think it could be for you too.” It can also be helpful to point out that there is great comfort in speaking to a professional in a completely judgment-free zone, where all that you divulge will be kept confidential.
Do not expect that your loved one’s response will instantly be a positive one. You might be met with defensiveness: “I’m fine; I don’t need a professional to tell me what’s wrong with me,” or “You’d be depressed too if you were managing everything I have on my plate!” It doesn’t help to get into a debate about why you are right and they are wrong…..or try to convince the person to listen to reason. Instead it’s best to just reinforce your caring and concern and recommend that they think about it.
If someone is so anxious, depressed or overwhelmed that the prospect of taking the steps to find a professional seems to be too much, you can be of help. If your loved one says something along the lines of, “I wouldn’t even know where to start,” or “I don’t want to see someone who isn’t good,” you can offer to do some research into clinicians in the area and provide a list of professionals. You can also offer to go to the first appointment with the person if you sense that that might make a difference.
Remember that you cannot make someone see a psychotherapist. Even if you know it would be helpful, each person has to come to this decision alone. You are not responsible for getting your loved one to go. Just by bringing up the topic, you’ve planted a seed and it might take a little while for the person to feel ready. Finally, if your own emotional health is being negatively impacted by your loved one’s struggles, then taking care of yourself becomes most important. The recommendation used on airplanes is an apt metaphor: “In case of emergency, put on your own oxygen mask and then your child’s.” We can only be of help if we heed this advice.
The Counseling Center of Bronxville in Westchester provides support and guidance to help you manage a range of issues and anxieties affecting your daily life.
