The Truth About Counseling and Therapy: If Counseling is So Good For Us, Why Do Many Avoid It?
In an article by Vogel, Wester, and Larson (2007), the authors bring awareness to the counseling stigma. It has been found that less than 33 percent of people who experience distress seek mental health services from a professional. It has also been found that seeking help from a mental health professional is helpful. Not seeking help leads to more problems that are sometimes more serious than the original issues. If seeking help is so important and beneficial, why is it that more people do not go to counseling?
If there is a physical illness, we see a doctor to help us.
Some factors of why people consider counseling include a certain level of distress and a certain level of desire to not feel distressed (Vogel, Wester, & Larson, 2007). The idea is that if I have a physical illness or injury, I may decide that going to my medical doctor or to the emergency room is an important option so that I can receive the necessary care that will help me to feel better physically. However, the same measure is not always applied when dealing with difficulties involving the mind.
Helpful coping skills:
When a person has an issue with emotions, feelings, thoughts, experiences, or behavior, sometimes the person will habitually gravitate toward what they know (coping skills) to help them feel better. A person may seek advice, in a general or specific manner, from friends or family (additional coping skills) to help them feel better. A person may journal or read books and surf the internet for ideas on how to feel better. All of these are positive, productive and helpful means to helping one’s self feel better. However, when some of these don’t work in a way that is consistent with helping this person feel better, then a person may seek unproductive means of helping to feel better.
If there is a mental/emotional/behavioral difficulty, why is it one of the options not tried is seeking a mental health professional?
What if after coping skills and productive methods of helping one’s self to feel better are tried, then the next option was to seek a professional counselor or therapist instead of engaging in unproductive coping skills that go against the person’s goals of feeling better in the long term? This idea is the same as when a physical illness, injury, or difficulty occurs.
So, why is counseling by a mental health professional sometimes avoided?
Vogel, Wester, and Larson (2007) break avoidance factors into a few categories: 1. ‘social stigma’, 2. ‘treatment fears’, 3. ‘fear of emotion’, 4. ‘anticipated utility and risks’, 5. ‘self-disclosure’, 6. ‘social norms’, 7. ‘self-esteem’. Through discussion of these avoidance factors, this blog is intended to reframe ideas about counseling and debunk myths about counseling and seeking help.
Social stigma
Within this social stigma, per the referenced article by Vogel, Wester, and Larson (2007), includes judgment and fear. There is a view that others will view the person seeking help in a negative manner. There is a view that potential negative labels and negative perceptions may be placed on the person seeking help. There may be a view or belief that this person is incapable of being in control of their self. There may be a view that this person is weak or has something wrong with them and the consequential actions would be to stay away from this person.
I’m afraid of the judgment from others… People judge and are ignorant to what is not understood. In this same respect, the person seeking help may also judge themselves for seeking help as well. The reason there are friendships and relationships is because people are meant to make connections with each other. It is okay to ask another for a ride, for help moving, and for help with emotional and mental difficulties. While a friend, family member, intimate partner, may help in some situations, if the same difficulties are occurring, then it may prove helpful to seek help from a mental health professional.
Many counselors and therapists have been through counseling. It goes along with the whole idea of promoting the value of something that you yourself have tried. It is unfortunate that more people, including myself, do not talk about positive experiences with counseling and how it has greatly helped within each person’s life. With that being said, ask people if they have had a counseling experience and ask them to share their thoughts on the benefits they found through it. Try going onto the internet and read experiences that people have had with counseling and see how the process has impacted their lives.
See that you are not alone in the desire to seek help. Difficulties with processing through experiences, feelings and emotions and dealing with negative ones that are recurring are no fault of the person seeking help. Counselors are trained to help people change thought, feeling, and behavior patterns to create different and positive reactions to experiences, even with negative experiences occurring. Through time and the therapeutic process, life and difficulties get better. Patience, trust, and endurance are keys toward success with this, it’s not a marathon.
Treatment fears
When partaking in a counseling process, there are a lot of unknowns. The interaction between the counselor and client, possible judgment from the counselor toward the client, a belief that the counselor will try to make the client do something he or she does not want to do, the belief that the counselor will try to make the client take medication that is possibly unwanted, and uncertain or inaccurate perceptions of how the counseling process works (perhaps garnished from portrayals from news, television, or movies (Vogel, Wester, & Larson, 2007).
I have no idea how this counseling process works…
Counseling is a process of bringing awareness and change within a person’s life. There are many different types of counselors who are trained in different methods of helping others. Counselors are here to help. Think of counselors as experts on theories, techniques, tools, perspectives, and interventions that have been proven to help people. Think of yourself as the expert on you, what you know what has worked and what has not worked in the past, and what you are needing to help you in the present and future.
The beginning of the counseling process is geared toward learning about the client, including what is presently concerning the client and the reasons the client is seeking counseling, background information about the client, and any history of the presenting concerns that will better help the counselor meet the needs of the client. Counseling is a process. The idea of counseling is that a client gets out of this process what they are willing to put in. The counselor utilizes theories, provides tools and techniques, offers suggestions and perspectives, but it is inevitably up to the client to do the work both inside and outside of the counseling room if improvement is desired. Goals will be established that come from what the client is needing and asking for. Both counselor and client work as a team to achieve these goals. Since the client is paying for the session, the client can utilize the session however is desired (i.e. picking up where the previous session left off, talking about what occurred during the week, discussing progress inside and outside the counseling room, venting about frustrations from the day or week). Providing feedback to the counselor will best help the counselor understand the direction that needs to be taken. The termination of the counseling process is up to the client. It is helpful to hear the recommendations, take provided resources and referrals, and to end the counseling process in a therapeutic manner (prior acknowledgement of when the final day will occur and processing feelings associated with ending the counseling process). If it is later found that additional counseling would be helpful, call the counselor down the road or find a different counselor that will help meet those future needs. You are not alone in the process; the counselor is there to help.
Counselors are not there to judge clients. While suggestions may be offered to the client, it is completely within the client’s desire to do or not do what is being suggested. Counselors are not there to force clients to do what is not wanted. In regards to medication, there are limited types of counselors who are able to prescribe and help you manage your medication. Whether or not a counselor suggests that a medication would be helpful for a client, it is completely within that client’s right to seek out or refuse the medication. Counselors are meant to be a positive and helpful addition to a person’s life. Feel free to talk about any reservations with anything.
Fear of emotion
Some people decide to avoid counseling because they do not want to discuss painful experiences and emotions. Other people may decide to not seek help because they may not have been taught how to properly work with their emotions and may believe there is no other way to do so (Vogel, Wester, & Larson, 2007).
I don’t want to wallow in painful emotions and relive the past… “In counseling, the client controls what, how much, and when to share emotional information,” (Vogel, Wester, & Larson, 2007). It is not the intent of the counseling process to re-experience the past. It is the intent of counseling to help the client work through how his or her past is effecting his or her present. It has been seen that “some problematic issues will not go away or be minimized until they have been discussed…engaging in the discussion will ultimately make the client feel better” (Vogel, Wester, & Larson). It is important for the client to feel trust and security within the counseling room before going deeper into painful experiences, that is okay, there is no rush, it is okay to go at a comfortable pace.
Anticipated utility and risk
According to Vogel, Wester, & Larson (2007), if a person has a desire to seek help but the level of perceived helpfulness from a mental health professional is outweighed by inaccurate perceptions or fears that this person may have about the counseling process, then the person may decide to avoid counseling. “People seem to underestimate the effectiveness of counseling services and overestimate the risks.”
I want to feel understood and accepted… Great! The counseling room is the perfect place for a person to see what that looks like and experience just that. Counselors may challenge, confront, or hold clients accountable when goals, behavior, words, and feelings don’t align, but this is done in a therapeutic manner of which the counselor is trained. The counseling room is a safe environment for the client to confidentially (there are limits to the confidentiality that will be explained by the counselor) talk about whatever it is that the client wants or needs to talk about without judgment being passed. The nature of the therapeutic one is one that is different than one may be used to. It is not meant to be a social or romantic relationship. Counseling is meant for the focus to be on the client from beginning to end (while limited self-disclosure and examples may be utilized, these are techniques that are designed to help the client). Counseling is an opportunity for awareness and growth within each individual and relationship.
Self-disclosure
According to Vogel, Wester, and Larson (2007), the comfort level that is needed for a person to not avoid counseling may not be present. A person may not feel comfortable talking about what is personal to them to another person. This choice is solely up to the individual debating whether or not to seek professional help. It is possible that a person learned that expressing personal matters or emotions is not something that is done within the family. A person may not know how much or how little to share or even if it is okay to share at all.
I am not comfortable talking about myself… That is okay and completely understandable. The counselor may be interested in learning more about how the client’s past is influencing the present in regards to this limited self-expression. There is no pressure, just encouragement, compassion, care, respect, and security coming from the counselor. It is okay to go at a pace and level that is comfortable. In the same manner a person chooses to not self-disclose a lot, a person can also choose to change his or her mind about how much to disclose. It takes a lot of courage to talk about what is concerning and bothering a person and feelings, emotions, and thoughts associated with these experiences. That courage is recognized.
Social norms
According to Vogel, Wester, and Larson (2007), it may be the opinion of family or friends that counseling is not only beneficial but looked down upon as well. Sometimes children receive the message from their parents that problems are personal and not shared. Sometimes friends and family are not aware of the benefits that counseling provides.
Counseling is not an accepted form of coping… This is the reality of some people’s situations. It may be the counseling is not discussed or the benefits are not known. It may be that change is noticed but it is unknown to the person how the change occurred. Surrounding one’s self with positive people and groups that encourage a person toward positive change and growth is a healthy part of life. Finding people to add to one’s support system that will encourage and support one’s choice to seek help from a professional has the benefits of helping the client stick with counseling.
Self-esteem
According to Vogel, Wester, and Larson (2007), seeking counseling additionally means admitting to one’s self that seeking help from others is needed. Feelings of failure, inadequacy, embarrassment, inferiority, shame, incompetence and other feelings may surface. A viewpoint that one’s issues and concerns are not as important as another. A viewpoint that a person does not deserve to feel better or that because the person is a male they must just deal with life as it comes and not seek outside intervention in a professional capacity.
I don’t want to feel bad about myself that I couldn’t do it on my own… Many of the avoidance feelings that may trigger a person, when the thoughts of seeking professional help are present, can deceive a person into false beliefs. The experiences of each individual are important and if it is something that is concerning the person (i.e. there are persistent or recurring negative thoughts, fears that seem out of control, stress that is too large to manage, discomfort in certain situations, and the list goes on) then it is the goal of the counselor to help the client through it.
So, counseling is a good thing… It absolutely is. Counseling is a normal coping skill, tool, option, choice, and experience to help a person through difficulties that may seem too large to manage on one’s own. Counseling provides the opportunity to create awareness, facilitate positive change and growth, and to take power back from difficulties that seek to take that power away. Counselors are trained to help one increase self-esteem, self-efficacy, self-confidence, self-worth, and self-reliance. Challenging one’s own negative thought process that may seek to discourage a person from seeking professional help in mental, emotional and behavioral health takes a lot of courage and is a big step in a good direction (Vogel, Wester, & Larson, 2007).
Referenced Article:
Vogel, David L.; Wester, Stephen R.; Larson, Lisa M. (2007).
Avoidance of counseling: Psychological factors that inhibit seeking help.
Journal of Counseling & Development.
American Counseling Association.
Full Text Article: http://www.psychology.iastate.edu/faculty/lmlarson/7.pdf
About the Author:
Christopher Kelm, LMFT
Christopher Kelm, LMFT is a Licensed Marriage and Family Therapist here at California Couples Counseling. Chris’ areas of specialty include relationship issues, couples therapy, depression, anxiety, family conflict, and stress management.
