Who Needs Therapy?

Whether you find the thought of seeing a therapist daunting or look forward to your first meeting with excitement and intrigue, you should feel proud that you are considering taking steps to improve your life and address mental health challenges and other issues that are going on in your life. It might feel like defeat, but deciding to get help with your mental health issues is not a sign of weakness but rather a sign of strength, resilience, and courage. Pay attention to your mental well-being and ask for help if mental health concerns get out of hand.

Read on for help deciding whether therapy (or other mental health services) is right for you. Therapy can be a lifeline for those facing mental health issues, conditions and emergencies, as skilled psychotherapists can help individuals navigate through crises. However, therapy isn't limited to crisis; it benefits personal growth and enrichment.

Therapy aids in addressing various challenges, from anxiety and depression to addiction and relationship difficulties. Unlike specific approaches solely relying on medication, therapy offers a holistic approach, delving into life's psychological, emotional, and relational aspects, fostering lasting change and transformation.

Contents

• It's an emergency. Do I need therapy?

• It's not an emergency. Do I need therapy?

• Is psychotherapy appropriate for my issue?

• Is therapy suitable for personal development?

• Do we need couples/marriage therapy?

• Do we need family therapy?

It's an emergency. Do I need therapy?

Psychotherapy requires both parties to be able to think, speak and reflect on the meaning or consequences of their actions. Severe bouts of mental illness and mental health emergencies may make this impossible.

Mental health emergencies include cases where a person can't resist the impulse to act in ways that place them or others in danger. Examples include taking steps to suicide, acting on delusions in ways that risk harm, and engaging in harmful behaviours during a manic state (e.g. reckless sex or spending).

People in the throes of an emergency usually require professional help from someone, like a mental health professional, to intervene.

Help is available for people experiencing a mental health emergency. If you are experiencing such a crisis or know someone who is at risk, you should:

• Call your doctor's office.

• Call emergency services. Click here for a list of emergency numbers. (Which country?)

• Go to the emergency or casualty department of your closest hospital.

• Ask a family member or friend to take you to the hospital or call your doctor.

• Call a suicide or counselling hotline. Click here for a list of hotlines and suicide helplines. (Which country?)

Skilled psychotherapists adapt their style to match their patient's capacity and mental health conditions.

Find a licensed mental health professional as soon as the height of the emergency passes, and work with them to help you make sense of what happened and return your life to normal.

It's not an emergency. Do I need therapy?

Most people find asking, "Would therapy be beneficial?" far more helpful than asking, "Do I need psychotherapy?" It is too easy to get stuck on the word 'need' and miss the real issue, i.e. "What would be most helpful in this situation?"

Although most people seek out psychotherapy because they are suffering, many do so because they find that the process of talk therapy enriches their lives. It provides support, deepens self-awareness, improves relationships, uncovers your blocks to growth, and contributes to a more fulfilling and fruitful life.  

Therapy can improve quality of life and help with many difficulties, including anxiety, depression, panic, feelings of emptiness, self-sabotage, addiction, eating disorders, bereavement, traumatic stress, job loss, burnout, sexual challenges, turbulent emotions, self-doubt, obsessions and compulsions, marriage or relationship difficulties, avoidance, shame, family conflict and crisis, shyness, failure to thrive, and personality problems.

But why not just take a pill? This approach's simplicity, ease and sometimes cost-effectiveness are appealing, and medication is often essential. However, emotional, relational and psychological difficulties are often inseparable from your way of being in the world, your history and context, your needs, wishes, fears, thoughts, and biology.

Intervening only biologically can help you feel better about your physical health (and sometimes enable you to function). Still, it won't necessarily help your mental health and produce deep psychological change.

Lasting change grows from developing a complete understanding of the difficulty to realigning yourself, life and relationships, finding meaning, and working towards realising your potential. Therapy involves commitment and money but provides an opportunity to transform your life profoundly and permanently. 

If you are still unsure, consider the questions below. If you answer yes to one or more, seeking mental health treatment is probably worth it.

Remember, it's easier to address difficulties sooner rather than later. More people are not in therapy but would benefit than people in treatment who should not be there. 

Is psychotherapy appropriate for my issues? 

• Do you feel overwhelmed, helpless or hopeless? 

• Have daily life tasks become difficult to manage? 

• Are your actions harmful to yourself or others? 

• Do flashbacks and painful memories intrude on your thoughts?

• Are you often unhappy, or do you experience distressing symptoms? 

• Do you feel concerned about some of your thoughts or behaviours? 

• Are feelings of shame, guilt, worry, or panic a regular feature in your life?

• Does your sense of worth depend on how pleased people are with you?

• Have friends or family expressed concern or suggested that you talk to someone?

• Do you face repetitive problems, particularly in your relationships?

• Are you troubled by thoughts of past difficulties and bad experiences?

• Is your home, work, social or recreational life suffering?

• Do you feel less connected or able to cope?

• Are you confused by how others behave?

• Do things feel too intense?

• Can obsessive thoughts or compulsive actions disrupt your flow?

• Do things feel dead and empty?

• Have you stopped enjoying the things that you used to?

• Are you your worst critic?

• Is food or your eating habits a problem?

• Are you repeatedly unhappy in relationships? 

• Do sexual thoughts trouble you?

• Have you noticed changes in your sleep, appetite, thought speed or interest in life?

• Do you use alcohol, food or drugs to feel better?

• Can anger, panic, anxiety, frustration, or sadness get the better of you?

• Are you unsatisfied with sex?

• Would you say that most of your relationships are superficial? 

• Do you pull away from others?

• Are you afraid to trust others?

• Do rituals rule your life, or do you find change difficult?

• Have you tried solving these difficulties on your own?

Is psychotherapy suitable for personal growth?

• Does engaging with a competent person practised in helping people see themselves and their lives in new ways sound appealing?

• Are you interested in developing a deeper understanding of yourself, your emotions and actions, and how to change?

• Would it be helpful to establish a trusting relationship with a good fit, neutral, knowledgeable, licensed mental health professional willing to offer their impressions, thoughts, and support?

• Might your relationships improve if you took some time to think more deeply about how you participate in them? Is this important to you?

• Are you taking the steps you need to live the kind of life you want to? Would you like this to change?

• Would you like to speak to another caring, competent, skilled person who understands overcoming internal and external blocks to personal development and psychological and emotional growth?

Do we need couples therapy? 

Most couples wait too long before seeking help with their relationship. This handicaps them because then they must work through deep hurt and resentment while simultaneously trying to shift deeply entrenched destructive patterns of relating.

It is better to start sooner and enjoy the benefits of a more functional relationship for the rest of your days. 

It may be that your relationship has passed the point of being salvageable. If this is unfortunately true, couples therapy can help you accept this and separate in time to enjoy your remaining years. Look through the questions below and make the call if you answer yes. 

• Are you and your partner unable to discuss your challenges openly, honestly and proactively?

• Have the two of you stopped speaking?

• Is substance use an issue in your relationship? 

• Do the bulk of your conversations revolve around the problems in your relationship?

• Has it been some time since you or your partner last felt sincerely interested in understanding each other?

• Do you feel regularly criticised, judged, disregarded, insecure, shamed, or compelled to flee when interacting? 

• Have you lost respect for your partner, or do you feel disrespected by them?

• Is affection or intimacy being withheld out of spite or resentment as a punishment or an attempt to control or hurt each other?

• Do you mock or criticise your partner in your head when they are not there and feel that you are better than them?

• Have finances become a war zone?

• Do you ask yourself, "Why can't we just have a normal, healthy relationship?"

• Is it common to avoid important conversation areas because you know they will explode?

• Do you see your partner as an adversary?

• Are there secrets in your relationship?

• Do you fantasise about having an affair, walking close to the edge of one, or having one despite having agreed to be monogamous?

• Does money get spent secretly?

• Is the thought of a separation frequently enticing?

• Ships in the night?

• Are you telling yourself that you are staying for the children?

• Have you caught yourself or your partner using your children to score points against each other?

• Are you pretending things are fine to keep the peace?

• Does sex feel all wrong, or do you wonder whether you are too old to be sexual?

• Would you say that arguments are frequent, repetitive, fruitless and destructive? Have they been happening for months?

• Has it been suggested to you by your partner, therapist or friends that you attend couples therapy?

Do we need family therapy?

Family therapy helps families become more functional by allowing as many members as possible to see how they collectively contribute to the family's difficulties and work together on their life challenges.

As with all forms of therapy, it is best to enter family therapy sooner rather than later and involve the whole family.

Most families go through periods of emotional distress and where conflict is rising. This is normal; most families get through this without help or needing therapy.

It might not be easy to tell if your family is experiencing one of these typical swings or if you need additional help. 

Answering yes to one or more of the questions below may suggest that finding a family therapist and discussing your concerns is well worth finding a family therapist

• Do the family difficulties interfere with, impede or impair a member's ability to function daily? For example, do they leave you or other family members feeling repeatedly overwhelmed, anxious, angry, frustrated, or despondent?

• Are some members reacting with extreme emotions? E.g. sadness, fear, panic, rage, physical symptoms?

• Have you found that family members cannot speak to each other, perhaps because the topic becomes too evocative, explosive, shameful, or painful?

• Would you say that disappointment, hurt, and withdrawal are starting to or already define your relationships?

• Does ‘drama' describe your gatherings?

• Has someone in or around your family asked for or suggested that the family attend family therapy?

• Is the family stuck in a destructive, repetitive rut and feeling lost on how to shift things?

• Have you stopped laughing together?

• Are you drifting apart? For example, can you no longer say what other members are involved in?

• Do the strategies that your family uses to face difficulties or address problems backfire or do damage?

• Are any family members using drugs and or alcohol destructively? 

• Are there signs of distress? E.g. poor grades, eating, anxiety or mood disorders?

• Is your family trying to negotiate difficult family circumstances? E.g. disabled children, financial crisis, mixed cultures, blended families, adopted children, religious conversions or divorce?

• Does there appear to be a threat of violence?

• Are you as a family finding it difficult to come together and face a tragic, traumatic or difficult life-changing circumstance as a healthy unit?

Read these next...

• What is therapy?

• Who needs therapy?