Just recently, I was updating our monthly refrigerator calendar with my work hours, upcoming events, appointments, workouts, and all that my husband and I need to be aware of in the upcoming month. I am not the most organized person in the world, but I get excited when I update this every month; it feels like a fresh start, a new feeling of control in my life that I often feel like I lose by the end of every month. It’s like a reminder that despite the chaos I feel and get lost in sometimes, I know that I have order and things to look forward to this month, things that keep me on track. I have work hours labeled, names of events listed, and appointments: PT on this day, PCP on this day, dentist on this day. Then I list a few just plain "apt. at 2pm," "apt. at 9am." Not many others see this calendar besides my husband and I, and those that do are those who are loved and trusted enough to be welcomed into our home. Yet, for some reason that I had not consciously recognized, I was being very discreet about listing one thing on this calendar every month, and that thing was my own therapy appointments. I AM A MENTAL HEALTH THERAPIST, and I just realized that I, OF ALL PEOPLE, was perpetuating the idea that going to therapy is something to be ashamed of, that needing help is not something to be admitted, that working to better yourself is something you only show through motivational quotes and fun pictures on Instagram... and WHY?! This realization rocked me and I stood and stared at my fridge for several minutes trying to figure this out. Why do I keep this part of my life such a secret when I so often encourage my clients to take care of themselves and to be proud of doing so, when they share with me that they've told others in their lives how much they are enjoying going to therapy and learning in their sessions; and when that leads some of their own loved ones to follow suit, we share in leaping for joy. But yet, here I am, keeping this part of me hidden behind ambiguous labels, which pretty much makes me a giant hypocrite!
So, I want to sort through some of the WHY we feel shame in going to therapy, because I know I'm not alone, and I know this idea and behavior didn't just accumulate from nowhere. Then, I want to share my own opinions on WHY more people should (and I apologize for “shoulding” right here, but it feels necessary) go to therapy and WHY I now want to shout it from the rooftops. (If you want to find out why “shoulding” is not usually a good thing, please ask me, or go to therapy yourself where you will learn all about the wonderful world of mind traps and changing how we think about things.)
WHY We feel Shame in Going to Therapy
Even up until ten or so years ago, going to therapy has not been something most people would talk or brag about by any means. It still isn't super favorable, hence my explanation in the first paragraph about my own difficulties talking about it. BUT there are more and more people now speaking out about their own difficulties with mental health and how they are getting help. This is aided by mental health movements; fundraisers; my generation of 20- and 30-somethings talking more and more about buzzwords like self-care, mindfulness, and vulnerability; and celebrities coming out with their own stories that seem to make the idea of getting help and admitting issues relatable and even admirable.
HISTORY
Getting help with mental health is still a new and difficult idea for many, especially those who grew up prior to the ‘80s and ‘90s. For many of us "young folk," our parents had a skewed understanding of mental illness and mental health, not by any fault of their own. Prior to the mid-1960s when the Lanterman-Petris-Short (LPS) Act and the Mental Retardation Facilities and Community Mental Health Centers Construction Act were passed, those who were seen to have severe mental health issues had a very imminent risk of being detained and involuntarily hospitalized. Mental health treatment was limited to medication, electroshock therapy, or institutionalization, and it was not very often talked about. The LPS act that was implemented sought to “end the inappropriate, indefinite, and involuntary commitment of persons with mental health disorders.” This, for obvious reasons, made it easier (with time) for people to admit and seek help for mental health without fear of being detained against their will. (There are still issues with this act, the biggest being that communities still lack the funding and resources to help people with mental illness maintain in their community, but the intent, at least, was good.) Shortly after the acts were passed, federal funding was increased to help keep those with mental health diagnoses in the community. The increased federal funding was obviously good, but it also wavered with time. A long, but needed, movement helped to "deinstitutionalize" those with mental health issues. The negative consequences of this movement, unfortunately, led to our prisons and jails housing more people with mental illnesses than our hospitals. You can read more about that here.
UNDERSTANDING THE CAUSES OF MENTAL ILLNESS
For many during this time (pre-'80s), and unfortunately for many still today, mental illness is seen as a character flaw or identity issue, a weakness, a sin or moral issue, and/or a motivation issue: "You must not be trying hard enough. Have you TRIED to get out of bed in the morning? Have you TRIED to pray it away? Have you TRIED to not overthink things?" UGH- is how I feel when people say these things. It is obviously not that simple, but this attitude and understanding of mental health is heavily ingrained in our culture and NEEDS to be addressed. For many people, mental illness is genetic, chemical, caused by trauma, LEARNED, and perpetuated by our fast-paced, performance-based, individualistic and unempathetic society. Prayer and trying are certainly important and helpful for many, but are not always helpful for getting at the core of why we struggle with mental health.
LANGUAGE
The fear of BEING crazy, of BEING anxious or depressed, is a part of our issue. I'm so glad our society is moving from identifying people as mentally ill to identifying us as people who struggle with mental health; but we still need to work on this. "They are someone who struggles with anxiety at times" is way more accepting and way less dehumanizing than "They’re such an anxious person. She is crazy. He is Psychotic. You are Schizophrenic. You are emotionally unstable." We as a society need to work on how we talk about mental health. Because we all have issues, but WE ARE NOT OUR ISSUES. You might sometimes struggle to be understanding and non-judgmental, as I do, as we all do, but it wouldn't be fair to call you a judgmental person, because that is not taking into consideration all the other parts of you and the fact that you are human, a human that sometimes struggles and has flaws. So, let us stop labeling people's identities by the things they struggle with. Please.
INCORRECT ASSUMPTIONS
Our society's incorrect assumptions about people who struggle with mental health continues to be an issue and a reason that people struggle to talk about it. "People are often worried that if their friends, family, or employers found out, this could mean the end of relationships and the loss of jobs. And these concerns are warranted. In half of U.S. states, admitting to a history of mental illness can lead to loss of a driver’s license, inability to serve on a jury or run for office, or even potentially loss of custody of a child." A large percentage of Americans inaccurately view those with mental health issues as violent, manipulative, and difficult to talk to or be around. This is perpetuated by Hollywood and the media's inaccurate representation of those with mental illness. They dramatize mental illness, and jump to the conclusion that anyone who is violent must have a serious mental illness. Actual research shows, though, that those with mental illness are more likely to be victims of violent crimes than they are to commit violent crimes.
The reality is that 1 in 5 Americans struggle with mental health, so that means the likelihood that you or someone in your family, office, friend group, or neighborhood struggles with some aspect of mental health is pretty high, whether they are talking about it or not. And it is not as visible as TV would like us to believe. Those individuals may or may not be functioning fairly well or well enough in areas of their lives, making it potentially difficult to see that they struggle with mental health or have a mental illness. That does not mean they don't need help. It just means we have a problem in our society with talking about it, admitting it, and being accepting of it.
If we have a cold, sure, we may try to self-treat, use tissues, get extra rest, take vitamin C, etc., but if that cold continues for weeks and starts to affect our ability to go to and be efficient at work, to show up and enjoy our time with friends, and to sleep at night, wouldn't we then go to a doctor to A. find out what the heck is going on with us and B. find out how to make it go away or to manage the symptoms so that we can go back to functioning and enjoying our lives? Why is this any different with mental health? If you are struggling with stress, emotions, thoughts, fears, relationships, motivation, focus, etc. and it is something that is not going away AND is getting in the way of you living the life you want to live, wouldn't it be nice if you could do something about it? Great news, folks: YOU CAN.
WHY Going to Therapy is GOOD. SO GOOD
If you aren't going to therapy, that is your choice, but really you are missing out on something wonderful!
You are missing out on:
1) A human relationship unlike any other. This isn't a friend that you are paying, but someone whose job it is to both listen to you and respond to you in a way that maybe has been lacking in many relationships in your life. This person is going to listen to you and be fully present with you for a whole hour (or whatever your insurance covers) with no phones or distractions (I know, unreal!).
2) An unbiased extra perspective that you may also have difficulty finding in friends and family. This person is, of course, as unbiased as possible, but still human and imperfect (we work to check our own biases through supervision and, yes, our own therapy!) Therapists aren't there to lie to you and make you feel good. They will support and encourage you, but if something doesn't make sense or seems unhealthy, a good therapist will point this out to you in the most supportive way.
3) Being validated. While your thoughts and feelings are not always facts, they are valid and a therapist is not there to make you feel judged or ashamed for them. Your experience is valid. Your emotions are valid. Validation is a large part of why people like going to therapy, especially when they live in an invalidating environment. Therapists work to challenge you, encourage you, and remind you that you are human and you make mistakes. They are also there to remind you that you are human and are wonderfully made.
4) Processing and sorting through your thoughts. It's a messy world in our brain, and thinking our way out of thinking simply does not work. Sorting through your thoughts and processing them in a healthy way is the name of the therapy game.
5) Accountability. Here is someone in your life that you can see on a regular basis that is going to ask you how that thing you said your were working on is going, who is going to check up on that thing you were concerned about last week, who is going to remind you of that healthy habit you said you started. There's no dismissing of or glossing over what's going on in your life. When I know that my therapist is going to ask about my blog I said I was working on, or those morning workouts I planned, or the conversation with a loved one I practiced having with her, I'm much more motivated to do it and am also aware that, if there are any excuses I'm giving myself and others, she will call me out on them. Having a therapist is like having a personal trainer in the gym of life. If we planned for 3 sets of crunches and 30 minutes of cardio per day, we're going to talk about the results or we're going to talk about what is getting in the way of me taking action with those exercises we planned.
6) Naming your feelings and naming your shame. The more we don't talk about what we struggle with, the more it festers. FMRI studies show that the simple act of verbalizing our negative emotions can calm the amygdala, the part of our brain that processes intense emotions, fear, and danger; the part that is responsible for triggering bodily reactions such as sweating, heart racing, shaking, etc. By labeling and talking about our intense emotions, we can calm and manage the outcomes and we don't have to live in a constant state of reaction. Studies also show that suppressing emotion is not helpful. While those individuals who suppress emotion may look okay on the outside, FMRI images show that their limbic systems (where the amygdala is located) are just as activated, sometimes even more so than those who do not suppress emotion. I remember in grad school thinking I had it all together and that I could suppress my emotions while experiencing high stress, being away from family, and going through a breakup, because, hey, I was going to be a counselor and I should be healthy. I didn't learn the error in my thinking until I found myself crying in the produce section of a Hy-vee. For some inspiration and further understanding into why expressing your feelings is helpful and why you might want to “name your shame”, please look to these wonderful folks: Dan Siegel and Brene' Brown.
And this brings me full circle to my initial problem. Naming out loud the thing that I was surprised to learn brings up some shame: Despite my past naive beliefs, I do not have it all together I do need help, and I will continue to need help. I do struggle with anxiety, fear, stress and emotions at times, all of which affect my ability to live the life I want to live and be present in the relationships I care about. I do have room to grow. I do see a therapist who helps me learn and grow, who validates me, empathizes with me, calls me out on my sh*t, and motivates me to keep going; and I LOVE IT. I’m not going to let shame win, and you don’t have to either.
*Please don’t hesitate to contact me if you have questions about the process in therapy, how to find a therapist, how to talk to a loved one about going to therapy, or any other questions you might have!
Thanks Kelsey!