“I’m Not Crazy, So Why Should I Go to Therapy?”: Exposing the Elephant in the Culture

Surely you’ve heard this before: Someone you know is struggling with some personal issues.  They’ve tried talking to their friends, but friends can eventually disappear, especially when they are not trained to handle the heavy-duty, “life-comes-at-you-fast” kinds of situations.  They’ve tried praying, but much like with cardiac arrest, prayer must be accompanied by specific, proven interventions to yield the best life-promoting outcomes.  They may have even tried self-medication like alcohol or “retail therapy,” but these temporary escapes often make matters even worse. So some well-meaning individual who loves them actually works up the courage to say, “Maybe you should try therapy.” One of the most common responses to this suggestion is for the recipient of the message to defend her/his sanity:  “I’m not crazy!” While mental health providers discourage the use of the term “crazy,” it is my assertion that whether or not we exhibit symptoms consistent with a mental disorder, we all can move into places of greater psychological instability from time to time, and can benefit from increased support and guidance.

So during this third week of Mental Health Month, I’d like to demystify the process of attending psychotherapy, particularly for those of us who may have been taught to mistrust the process.  As one example of living out your faith and spirituality in concrete ways, engaging in psychotherapy can be a crucial tool for creating and sustaining positive life changes.  Everybody has a story to tell, but few people have shared their story with an impartial, objective, confidential, and nonjudgmental listening ear that can also impart skills for creating positive change or for effective coping in situations that cannot be changed.  There’s an old hymn that says “I feel better, so much better, since I laid my burdens down.”  How true!  Jesus invites us: “Come to me, all you who are weary and burdened, and I will give you rest.  Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls” (Matthew 11:28-29, NIV).  Your therapist or counselor can assist you in manifesting this “burden transfer” in your life!

So what can you expect when you seek out psychotherapy or counseling?  In order to ensure the best fit, do your homework.:

(1) Ask your friends or colleagues if they can make any personal recommendations, as word of mouth goes a long way in inspiring confidence to take this big step.  (You might be surprised by the number of people who actually have already pursued therapy!  As Bill Withers famously sang, “We all need somebody to lean on.”)

(2) Conduct an Internet search.  There are many, many referral directories online, such as PsychologyToday.com, which are searchable by type of therapist (e.g., counselor, clinical social worker, psychologist, marriage and family therapist), areas of expertise, faith commitment (if any), geographical location, schedule availability, forms of payment/insurance accepted, theoretical orientation, and cultural fit such as race, ethnicity, gender, sexual orientation, and disability.

(3) Ensure that each person you are considering is licensed in their area of expertise.  This information will often be reflected in the referral directory or on the individual’s website, but you can also confirm that this information is up-to-date by going to the website of their respective professional board for license verification.

(4) Once you have a reasonable list of potential therapists, call their respective offices.  Although many therapists are in session with other clients during most of their business hours, they may have a receptionist or answering service who handles their calls, or they may have an outgoing greeting on their voicemail that encourages you to leave a confidential message.  Other therapists may have a website presence or a directory listing that allows you to submit a confidential email.  Some therapists may even offer a free consultation in case you would like to meet her/him before committing to the process of therapy.

(5) Inquire about payment arrangements.  Many therapists will accept at least a few forms of health insurance for a presenting problem that demonstrates “medical necessity” (i.e., your symptoms meet criteria for a mental disorder in the DSM-5).  Health insurance plans are required to cover mental health conditions, but pay attention to your responsibility for co-pays, co-insurance, and/or a deductible that must be met before your insurance will cover your visits.  Alternatively, you may wish to pay out-of pocket rates for your sessions.  Some individuals opt to do this if it is affordable, or if they desire to not have information about their mental health history and treatment included in their medical record.  For those who do not have insurance coverage and may not qualify for public insurance (i.e., Medicaid), many therapists have sliding scale fees available that may correspond to your income level.  Finally, some cities and towns have a network of therapists who agree to provide some pro bono counseling sessions.  While the number of these sessions is often limited, a pro bono counselor can greatly assist a client in stabilizing after a crisis situation at no cost to you. (If you are a NC resident in Durham, Orange, Person, or Chatham counties, you may connect with the Pro Bono Counseling Network in our area at http://staging.mhatriangle.org/test-page/free-counseling-services.)

What might you expect during your first psychotherapy session? You will hopefully find a comfortable waiting area with soothing sights and sounds.  A receptionist or other notification system will let your therapist know that you have arrived.  If you have not already completed initial paperwork online or via email, give yourself enough time to finish prior to the starting time of your scheduled appointment. Your paperwork will likely include your consent to treatment, contact information, questions about your physical and psychosocial history, including any family history of mental challenges, and a mental health screening tool.  Once your appointment begins, your therapist will bring you to her office, review guidelines of the practice, offer you an opportunity to ask questions, and invite you to begin sharing your story.

As you return to working with your therapist week after week, you will find that transformation requires you to think about some things that you have either repressed or simply haven’t thought about.  Processing this material can be hard work, yet your therapist has been trained to support you through these difficulties. Some days you will emerge from therapy feeling better, and some days you may actually feel worse.  There are even some days where you may not like your therapist very much, but mainly because s/he is facilitating the important job of change and breakthrough.

Working with a licensed mental health professional offers several benefits, including the opportunity to share your story in a safe and confidential space; the powerful release of burdensome thoughts, feelings, and behaviors in a nonjudgmental atmosphere; the development of a positive and trusting relationship with your therapist, which can foster motivation and transformation; and the accumulation of practical strategies for thinking about and navigating your interactions with the world in a healthier manner.

Are you ready for a positive change? See Step #1 above and get started!

 

À votre santé (“To you health”),

 

Dr. T

Tonya Armstrong

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