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  • Writer's pictureNidhi Trivedi

Why is initiating psychotherapy so difficult?

The dichotomy between our mind and our body continues to exist in our society. If you get a cut in her your finger while chopping onions, you will immediately run it under water, sanitize the wound, and apply band-aid. Now, if you were to get injured more seriously, you will definitely make an emergency visit to a hospital for treatment. We do a great job of taking care of our physical health ranging from having a first aid kit at home to making visits to the hospital specialist when necessary. However, we, as a society, do a very poor job of paying heed to our mental health. Changes in appetite, sleep, mood, and household discord are often taken very lightly and attributed  to “life,” rationalized as “it will pass and things will get better for me.” This ted talk does a wonderful job of discussing emotional first aid –

I have never heard of anyone who schedules a psychotherapy appointment as soon as they get stressed out- Let me go see a therapist because I only slept 6.5 last night as opposed to 8 or let me find a couples’ therapist because my boyfriend and I had an argument yesterday. No, and it is very likely that the symptom might be a rare occurrence. Perhaps, the symptom has not happened frequently enough to warrant attention. Most of us probably do not even pay attention to initial signs of mental health distress.  We just try to cope with our stress through adaptive or maladaptive coping strategies: listen to some RnB, gossip with a friend, binge watch Netflix, ignore work emails, go on a long drive, drink alcohol, smoke marijuana, quit the job, and so on. You know what I mean.

What happens when your stress becomes unmanageable, and the symptoms of mental health issues feel out of control? What if Netflix does not give you the same joy anymore? What if you sleep for 10-14 hours every night yet always feel tired? A bottle of wine is not enough to get you drunk?  A colleague might tell you that you have looked more tired lately. Your parents or your partner might complain about you being irritable in the last month. You might have noticed, yet chosen to ignore a recent change in your behavior lately. Very few emotionally attuned and self-aware people might schedule an appt with a mental health professional when they first realize they cannot do it on their own and might need professional help. Most people struggle on their own before they decide to seek help.

This article is for you if you have thought of therapy, but you have been struggling on your own for a while. You may have had intermittent thoughts of going to a mental health professional, but it somehow never worked out. Either something got in the way of therapy or the stress of going to a therapist outweighed the other stressors.

There is nothing wrong with struggling on your own and I do not blame you for not wanting to seek psychotherapy. Initiating therapy can feel stressful and difficult for the following reasons:

  1. Shame: You might experience a lot of shame about what has happened, how you are dealing with it, and why you are not able to do it on your own. You might also feel that the therapist might judge you if you confide in them. More often than that, it is your own judgement about yourself that prevents you from opening up. I speak on behalf of all therapists when I say that we do not judge you at all. Not to minimize the uniqueness of your experience, but a lot of people feel that nobody else understands or has gone through what they have gone through. I can assure you that others have done what you have done, have gone through what you have gone through, and even if the therapist might not have been through your experience, they have empathy for your journey and will do their best not to make you feel shame in your loneliness. Just know that you are not alone!

  2. You may not be used to emotional support: Therapy might be the most uncomfortable experience for you if you are not used to emotional support from people. You do not have to come from a dysfunctional family to not get used to support. A lot of factors might play a role in why you may have become a caregiver, a listener, and a secret keeper in your family – may be you were an older sibling who got used to caretaking, may be you are in a profession that involves serving and listening to other people, and may be because you are familiar and good at giving support to other people. If you are not used to receiving emotional support from people, therapy could seem excruciatingly difficult because you have not flexed your certain emotional muscles at all.

  3. You may not think that it is the right time for therapy: You may have heard people talk about how there is never a good time to get married, have a kid, adopt a pet, or travel. The same pretty much applies for therapy. If you do not think it is the right time, chances are it might not be. Maybe you are actually that busy, maybe your children take up too much of your time, may be you work in shifts, may be you are waiting for a sign, or maybe it is all of the above. But it might also be your resistance, waiting for things to get worse, waiting till things get better, or trying to do it on your own. So if you have thought of psychotherapy, just muster some courage and take a leap of faith.

  4. You are not motivated for change: A person’s intrinsic motivation for change is one of the largest predictors of therapeutic success. Your friend might want you to quit gambling, your wife might want you to cultivate a better work life balance, or your boss might want you to become more detail oriented in your project reports. If you do not agree with them, and do not have the motivation to change, chances are it is probably not going to happen. Some intrinsic motivation could definitely help you with initiating therapy.

  5. You do not think therapy helps: You may have had a negative experience in therapy. You may not believe in the process. Or you may simply be convinced that it does not help. Research suggests that therapeutic alliance (the rapport between the therapist and the patient) accounts for a huge variability in successful therapeutic outcomes. I agree that therapy might have a lot to do with remediation of symptoms or achieving desired goals; but for me, therapy is mostly about the trust-building, rapport, and communication. So if you find it fruitless to attempt this relationship with the therapist, chances are that it might not help.

I strongly believe that psychotherapy could help everyone. Mostly because my livelihood depends on it. Yes, being in psychotherapy can be difficult for the reasons I mentioned above. But think about it – who would not benefit from a safe, supportive, empathic, encouraging, and personal space where the therapist’s only goal is to support you, hear you, help you accomplish your goals and validate your concerns?

I hope you are patient and kind with yourself. I strongly encourage you to give psychotherapy a try if you are continuing to struggle all on your own and it is getting increasingly difficult.

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