Jim’s drinking was clearly out of control…he had been up for over 24 hours, and the beer bottles lying around numbered over thirty. Yet he refuses to see a counselor, saying that he “doesn’t have a problem and doesn’t need help!”
Jane’s mother, Sally, age 76, can barely make her way through her own house because of the clutter and items she has accumulated. Jane is concerned for her mother’s safety, but Sally will not allow Jane to clean the house or throw anything away. The more Jane insists, the stronger Sally’s resistance. It’s gotten to the point where Sally has told Jane she is not welcome to visit anymore, and Jane cannot figure out how to help.
Josh has not been feeling like himself for a long time now: he lost his job six months ago and his girlfriend of two years broke up with him a few weeks ago. He’s finding himself sleeping through the day and staying up all night, gaming online and looking at porn. He knows he should be job hunting, but really, he doesn’t care anymore. He’s lost 20 pounds, and when he does see his friends, they are shocked at the changes. But when they ask questions, Josh blows them off and says, “I’m fine.”
All three of these people are great candidates for therapy, but none of them will go. Why?
People who are resistant to mental health treatment share many of the same characteristics. It is frustrating for family and friends to see someone they care about suffer, but unless these four areas are addressed, therapy will be ineffective:
- Fear. This is the biggest reason people avoid addressing most problems in life, whether it’s due to a mental illness or not. Not knowing what the outcome of change is can be incredibly frightening. The status quo we can deal with; we may not like it, but it’s familiar. Some people are afraid of what examining the truth will reveal about themselves, their relationships, and their lives. Some are fearful of who they will be if they do not have an addiction or an illness because that means other people will expect more of them. And some just don’t believe they are strong enough to handle whatever may come of being in therapy.
- Hopelessness. This goes hand-in-hand with fear. Not only can therapy be scary, if your partner has no hope anything will change, then why enter a scary situation? Many clients enter therapy with the hope that the therapist has a magic wand that can be waved and will resolve the issues at hand. No such luck. Your partner needs to have at least a little optimism and motivation for any kind of treatment to be effective.
- Poor insight. If your partner, like Jim in the first vignette, “doesn’t have a problem,” no amount of sitting in a therapist’s office is going to change that. Your partner has to reach a place of accepting that there is something wrong and also have the willingness to try to do something about it. No amount of nagging from you–or anyone else–will makes things different.
- Differences in opinion about the best solution. Therapy is not for everyone. Maybe your partner can resolve their depression through exercise, good diet, and appropriate amounts of sleep. Maybe your partner is one of the lucky few who can decide to never drink again and be successful. Therapy works best when it is the idea of the person who needs it. Maybe letting your partner try their solution first is the way to go. If their solution doesn’t work, gently reintroducing the idea of therapy (instead of saying, “I told you that wouldn’t work!!!!”) at that point might be more effective.