When someone considers seeking help, he or she is usually feeling vulnerable, and it’s when we’re vulnerable that it’s most likely we will whisper mean and disparaging things to ourselves. At any particular time, seeking therapeutic or growth resources may or may not be what someone needs, but reducing the fear and/or lack of information that fuels negative perceptions about seeking help is possible. In my 30 plus years of practice I have never found it relevant or accurate to consider someone I’m professionally working with “crazy” or weak. Our long-present cultural stigmas that include these rather abusive insults are changing. It might be more accurate and useful to consider that, for personally significant challenges, we need to do it ourselves but we can’t do it alone. There are effective ways to help you make changes and feel better.

Usually someone seeks help if they are feeling troubled by unwanted/unpleasant feelings or symptoms, feeling their personal or professional life isn’t working the way they would like, or having conflicts or difficulties in important settings or relationships. Often others will be supportive or encouraging to someone they care about who seems to be struggling, and may suggest seeing a therapist. Just as we usually don’t take our car in until it’s making that funny noise, most people don’t seek personal help until they are notably bothered or feel quite stuck.

Regularly attending sessions that are scheduled by you and your therapist is, of course, a necessity. Sessions should be scheduled with a frequency that is appropriate for addressing your issues and goals. Courage and willingness to be vulnerably honest, and commit to ever increasing awareness is crucial, as is an understanding that no improvement in how you feel is likely to occur without some inner or behavioral change. Social support resources (for emotional support, encouragement and aiding in changes) always accelerates therapeutic progress. Basic self-care, including following any medical advice or medication regimen that has been recommended, is also expected. 

Once you decide that some help or direction is needed, usually friends/family/colleagues will have a name or two of a psychotherapist or consultant they know. Sometimes health insurance lists of providers or local yellow pages lists are starting points. Search engines on the internet can provide information by name, area and areas of expertise. All reputable professionals are ethically bound to only practice within their areas of expertise. After getting a recommendation or name, it is important to then be a good consumer and speak with the professional. Asking questions about degrees, experience and areas of expertise, as well as how your concerns would be addressed, expected process and outcome, length of sessions, cost and payment are very important and are expected by therapists and consultants on their first contact with you. While gathering this objective information, it is also important to “trust your gut” about the person and the “feel” you get about whether he or she might be a good resource for you.

Again, feeling down or nervous, struggling to cope or be how you would like to be are the troubles that aren’t getting better on their own. Many of our troubles arise from the following conditions/issues: Anxiety Anxiety is the most prevalent emotional issue in the U.S., ranging in severity from nagging worry to debilitating panic attacks. At its core, anxiety is a focus on the future that involves vague or specific concern that something won’t work out and/or we won’t be able to cope or handle it. Suggestions to “relax” or “don’t worry—be happy” are usually not helpful at all. Anxiety is usually fueled by a combination of our hard-wired temperament, traumatic experiences, messages or learnings in our family or culture, repeated patterns of fearful thinking and fearful interpretation of our body sensations, and/or avoidance. Learning how your anxiety works in your unique self can be key in developing a plan for better management, then healing and change, because everything does make sense. You’re not crazy or weak, you’re anxious! There are good ways to understand and change how you are feeling. Depression Depression is the next most prevalent psychological malady in our country. Having a “bad day”, feeling disappointed about a happening in one’s life, or grieving a loss is not depression. Depression is a holistic experience impacting thinking, perception, emotions, physical feelings, and daily rhythms and needs (e.g., eating, sleeping, sex). Again, trauma, experiences and learning within our family, and repetition of automatic and distorted negative thoughts/beliefs are the important factors in developing and sustaining depression. Being depressed is not an inevitable reaction to “how difficult and troubled the world is”. It is more likely true that “the world” is manageable and that being depressed feels overwhelming, while feeding the perception “the world” is a mess. Post-traumatic Issues Experiencing or witnessing something that feels threatening or “rocks our world” is considered traumatic. Whether and how we are impacted is very subjective, depending largely on our hard-wired temperament, previous traumas and current vulnerability, and can be categorized in our experience as “big T” or “little t”. Traumatic experience is stored in our brains and nervous systems differently than other experiences, seemingly “filed” as a danger reference point which activates our minds and bodies to “scramble and survive”. The impact of trauma can range from full-blown Post-traumatic Stress Disorder (flashbacks, intrusive thoughts and conscious reference to the trauma, high anxiety, avoidance, etc.) all the way to feeling stuck or more “emotional” than fits the circumstances one is in. There are currently some very effective therapy approaches that greatly alleviate much of the struggles that come from post-traumatic issues. Chronic Pain/Conditions A chronic condition, whether due to disease or primarily involving pain, usually impacts most, if not all of our aspects of living—mental, emotional, spiritual, physical and social. Increased limitations and/or isolation often results, which worsens a downward spiral. Multifaceted treatment and self-care are considered essential in reducing struggles and having a life. In addition to appropriate medical, physical and/or pharmacological treatment, addressing helpless feelings and spiritual questions (meaning, life purpose, “why me”, mortality), as well as learning skills in pain and mood management, can be key in revitalizing yourself.