How to Know if You Need Therapy

There are many reasons that people enter counseling. Often people come in saying that they are overwhelmed and stressed due to various life circumstances. Sometimes they have had recent or past life traumas, such as abuse, loss, or illness. Many times they begin therapy following a crisis, something that has turned their world upside down, like the addiction of a loved one, adultery, or witnessing a violent incident. It could be a feeling of aloneness and just wanting someone to listen and care.

In addition, people may begin therapy because of symptoms that they are experiencing, which they want to understand or get relief from. Here are some of the symptoms that could indicate a need to seek help:

• depression or intense sadness
• frequent irritability
• persistent feelings of worthlessness, hopelessness, or helplessness
• low self esteem
• poor concentration
• changes in sleeping or appetite
• decreased motivation or interest in life
• thoughts of suicide or occurrence of self injury
• angry outbursts
• hallucinations
• behavior changes noticed by yourself or others
• panic attacks
• significant difficulty leaving the house or completing everyday tasks
• intense fears or phobias
• excessive worrying
• nightmares or flashbacks of traumatic events

Feeling Reluctant to Enter Treatment?

It is common for people to worry what their therapist will think of them when they first come to meet the therapist and describe their problem. It is normal to wonder whether you might seem weird or “crazy” when you tell someone what you are experiencing. Please know that everything you share is confidential, and that your therapist has encountered a broad range of life struggles. These are some of the feelings that new clients share at first sessions- loneliness, fear, rejection, despair, confusion, guilt, anger, frustration, shame, or shyness.

Your decision to enter treatment is your own decision. No one can force you into counseling, and if they do, it is still your decision whether you will make use of the sessions. If you attend therapy without interest or motivation toward change, then it is likely that no progress can be made. Also, it is helpful to know that there are no quick fixes or miracle cures.

Therapy is about a process of forming a relationship with your therapist and working together toward your specific goals. It depends on the person and situation as to how long this process will take. It is always useful if you enter therapy with clear goals in mind, which will be discussed more later.

Still Uncertain?

Sometimes people delay entering treatment for various reasons. Often they think that their problems are their own problems and they should be able to solve their problems. Because of the individualistic society that the USA is, it is generally difficult to reach out to others for help. Many of us are isolated and do not have strong communities of support around us. And some personalities just find it more difficult to ask others for assistance. It is also common to fear that others will judge or think they are “crazy.”

It is certainly scary to reach out, to admit problems, and to make yourself vulnerable in front of others. But getting started is the most difficult part of the process. By the end of the initial session people are often comfortable and glad that they attended. If you are contemplating contacting a therapist, then I recommend that you approach it as a trial and attend a session or two and then decide if you are interested in continuing.

Even making the contact (email or call) to the therapist is nerve-wracking, so you might reward yourself in some way for taking such a positive step. And then reward yourself again after you attend the first session. So many people find it is a tremendous relief and the huge lifting of a burden to make that call, attend that first session, and begin the work of therapy.

When Weekly Counseling isn’t Enough

In some cases individual therapy may not sufficiently meet someone’s needs. If it is a situation of chronic mental illness, frequent psychiatric hospitalizations, limited ability to function, or substance abuse, then your therapist may direct you to more intensive services.

It is also important to know that there are rare cases in which your therapist may need to break confidentiality in order to assure safety. If you confide to your therapist about a specific plan to harm yourself or someone else, or tell the therapist about current abuse or neglect of a minor, then your therapist has a duty to warn under the law to protect yourself or others from injury.

If while you read this you are contemplating suicide or homicide, then here are some resources:

1-800-SUICIDE
Hopeline, a suicide hotline 1-800-784-2433
www.hopeline.com
You may also call 911 or visit any emergency room.