Know someone who might need help? The Savvy Psychologist covers the nuts and bolts of how to encourage someone to seek therapy--and how to deal with what they might say to you in return.
In last week's episode, we covered 5 common myths about therapy, including how to deal with macho men who think therapy is for the weak, the three things that can get you hospitalized, and much more.
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Thanks to questions from listener Ellie Bradish of Milwaukee, WI, as well as several anonymous listeners, this week we'll look at 5 questions related to talking to someone who could benefit from therapy.
Question #1: How Do I Know if He or She Needs Help?
Maybe this is just a rough patch, or maybe this is serious. If it's hard to tell, think about two things: distress and impairment.
With distress, look for signs of strong, persistent negative emotion, like prolonged crying jags, panic attacks, frequent angry outbursts, any kind of violence, a turn for the worse in personal hygiene, or a withdrawal from life.
You can also use your own distress as a proxy: if you’re scared or freaked out by your loved one’s behavior--like how many times they’ve lost their temper or how many days they’ve spent in bed, or if you’ve found a stockpile of pills--let your own feelings be your barometer. Go with your gut. Deep down, you know if something’s really wrong.
Next, impairment means that whatever’s going on is getting in the way of his or her life. For example, maybe he’s missing days at work, is drunk or hungover so often that he can’t function, the fridge is empty or the trash is piling up because she’s scared to leave the house, or she’s done some serious burning of bridges with friends.
Mental illness is usually first noticeable at home. Many people hold in their problems like a sucked-in gut at work or in public, but when they get home, they let it all hang out. It’s the people closest to them (i.e. you) who bear the brunt of mental illness. In a way, it means they trust you--but it sure doesn’t make things easy.
Question #2: How Do I Approach Them?
First, pick a good time. Don’t try to have a serious conversation with someone who’s drunk, hungover, high, angry, or distracted. Turn of the TV. My personal favorite setting for a heart-to-heart talk is on a long car ride.
Approach it as a problem of your own. Say I’m worried. I’m concerned, I’m afraid.
Be supportive. Keep telling them you love them, you’re there for them, or that you care about them. Again, use “I” statements, like “I care about you, I love you, I’m worried about you,” not “you” statements. like “you need help” or “you have a problem.”
Work really hard not to get frustrated or angry, even if (when!) they get defensive, tell you that you’re the one who needs help, or put you down. Your loved one is like a porcupine; those sharp barbs come at you because he’s scared.
Anger is what’s called a secondary emotion—it’s the armor that covers up the soft, vulnerable underbelly of the primary emotion, which could be shame, hurt, fear, humiliation, or guilt. As you discuss, listen closely for the softer emotion under the anger; hearing it makes it possible for you to stay connected, sympathetic, and on message.
For more on how to have a difficult conversation, see How to Stop Avoiding Conflict