When To Pull the Therapy Card

As someone who is fairly open about their mental health life, I’ve had a fair number of people tell me to go to therapy. That hasn’t happened in a long while since I’m also fairly open about the high number of hours of therapy that I commit to every week and have committed to for the last 3+ years. However before I made a serious commitment to therapy, I had many people badger me into going. And as Suey Park pointed out, a lot of the time people tell you to see a therapist when they simply don’t want to deal with your problems or are uncomfortable with how open you’re being. Being told over and over to go to the therapist or get on medication is obnoxious and invasive. It feels like being brushed off. It feels a bit infantilizing: I know how to take care of myself thanks.

However on the other hand, going to therapy is also an incredibly useful thing. If people hadn’t pushed me to do so I may not be alive today. The best evidence we have today suggests that CBT is probably the best way of improving your mental health (and for those mental illnesses that tend to be more treatable with medication you can usually find that out through a therapist). And quite honestly, your friends should not be your therapists: they do not know how to help you when you want to self-harm or restrict or when your anxiety is spiking. Particularly if you go to your friends quite regularly for serious emotional support, it is within their rights to ask you to take some of that weight off of them by going to a professional. It makes sense that they might feel overwhelmed (imagine if I kept telling my friends that I had a broken leg but refused to go to the doctor…they’d probably be a little frustrated).

When you want to talk about your mental health, both parties in the conversation get to weigh their emotional needs. You deserve support and help, but your friends deserve the ability to say that they are overwhelmed or just honestly out of their depth. So when is it appropriate to tell someone who is being open about their mental health status to go see a therapist? When is it really less ok?

I don’t imagine there are hard and fast rules here, but here are some thoughts and potential guidelines to approaching the “please get therapy” talk.

1. Know the person
Unless you know someone and have some conception of what they’re dealing with, how they’re dealing with it, whether they’ve sought help in the past, whether they have the resources and ability to seek help, and whether they’re coping ok, do not give them health advice. Don’t get on someone’s Twitter account and tell them to seek therapy. Don’t tell a friend who has just opened up to you about their mental health to get therapy. That’s really dismissive. At least take the time to learn something first.

2.Make an effort to figure out what the person wants/needs from you
Do they just want to vent a little bit? Cool! Did they just want to let you know so you can be aware of why they might be pissy or lethargic or something else? Great! Was this simply something about themselves they see as pertinent? Woohoo! Support the shit out of that person. Do they want you to solve their problems? Mmmk, here’s where it becomes less great. You can’t do that. You can’t really even help them cope that much unless they give you some specific things they’d like you to do. If you ask what they need from you and they say something along the lines of “make me feel better” then maybe a little suggestion of therapy wouldn’t go amiss because no, their mental health isn’t your responsibility.

3.Communicate
Seriously, even if it means coming clean about the fact that you’re uncomfortable openly talking about mental health issues. Why? Because then you can OPENLY TALK ABOUT MENTAL HEALTH ISSUES. This also lets you talk to the other person about how you feel as a potential support person and/or ally and what energy you’ve got to give right now. There’s no way people with mental illness can expect all their support people to be on all the time, so please tell us about your mental health too so that we can have a relationship that’s healthy for all parties. It makes it easier for everyone. When you check in about how you’re doing, we feel more ok checking in about how we’re doing.

4.Assume we know that therapy exists
This is especially true for those of you who are throwing this out as the first option or who casually encounter our mental illness and start shoving therapy down our throats. EVERYONE with a mental illness knows that therapy exists: it is in our faces a lot. We know that we’re supposed to keep quiet and not talk about it except in a confidential room. We know that we’re supposed to go see someone and get all better and never worry anyone ever again. We know that. Unless you have something more helpful to say than just informing us of its existence, then please keep your mouth shut on this one.

5.Be aware of the gender and racial implications of what you’re saying
If you’re a man and you tell a woman who’s emotional that she needs therapy, you’re really perpetuating the idea of the crazy womens with their emoshuns. If a person of color is frustrated and you tell them you can’t be bothered they just need to go see a professional, you’re really playing into some of the problematic ideas of black people being always angry or totally irrational. If you’re about to throw out the th word give yourself a second or two to ponder whether your perception of the situation might be colored by certain norms and stereotypes. If that’s the reason you’re saying it, then please don’t.

I’d love to hear any more suggestions about how to navigate when to really dig in and help someone and when to openly admit you don’t have the resources to do so. Being a support person for someone with mental illness is tough, so let’s talk this one out.