Barriers to Therapy

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A few weeks ago, I wrote a blog entry called “When Therapy Makes Sense.” Since then, some discussion has taken place regarding barriers to seeking therapy. In the weekly Diabetes Self-Management e-mail newsletter, our editor, Tara Dairman, asked for responses to a survey question about obstacles to seeking therapy. I’d like to address some of these responses.

The number one vote-getter in her survey was “I don’t think my problems are severe enough that I need to get help.” While this may be true for some, many of us underestimate or minimize the issues in our lives. We become so accustomed to how we feel that we will only see something as problematic when we are feeling overwhelmed or stressed out. This is the typical mental illness model—that is, we keep going until we have a mental “breakdown.” So when we have a breakdown, we cannot function, which might explain depression being the number one reason people are absent from work. We somehow think that we must be dysfunctional before we can admit we could use some help.

There is an assumption that, with mental health issues, we should just be able to pull ourselves up by the bootstraps, but if we’re open to the idea of seeing a medical professional for the flu, a cold, or a broken arm, why not see a professional for mental health reasons? The reality may be that we perceive mental health issues as so serious because we wait too long to seek treatment.

I am not on a witch hunt; I don’t think everyone needs therapy just because they have diabetes. In fact, some of my colleagues think I don’t keep people in therapy long enough. But I do believe having diabetes makes it more important for individuals to take better care of their mental health needs. So an occasional assessment, a good mental health professional you can connect with, and a willingness to see him when times are tough might prevent problems from interfering with your self-care.

The other aspect of this issue relates to all of us who ever debate about whether or not to seek help. This has to do with our desire to “do it on our own.” We wrestle with trust, openness, and a fear that we are going to find out there is something wrong with us that we didn’t know about. We all have a small person inside that wonders if others can really see who we are, or if others can tell we are unsure of ourselves. So the idea of going to see someone who has skill in this area causes us to be a bit fearful.

At the same time, therapy should be a place where you can be who you are fully and learn to be accepting of your weaknesses and your strengths. A good therapist will be nonjudgmental, as much as is humanly possible, and willing to get to know you for who you are. This piece of therapy (the relationship) may take some time, but once established will allow you to come back whenever you have a need.

Next week, I will address a couple of other issues regarding seeking therapy: cost, and when therapy isn’t useful.

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