Tuesday, March 12, 2013

The Stigma around Therapy

People react different to you telling them about a horrible experience. Some people just gape and obviously have no idea how to respond, some start trying to tell you what you can/should react, some deflect with humor, and some look around a little nervously and ask if you've maybe considered therapy of some stroke?

It's interesting, watching them do it. They always lower their voices and glance around conspiratorially, they talk about how they were/are in therapy, or someone close to them was/is. Some will tell you that it isn't necessarily a life time commitment, and that it's not a failing.

Despite the fact that anyone who suggests therapy will say almost the exact same thing, it still feels like you're a failure if you actually do something about it. What, you mean I can't just get through this with heroic will power? I cannot just drag myself through by the bootstraps?

When I was younger, my thought was: no matter how awful something got, I would get through it, because that was my only option. I had to keep going, and sooner or later I'd emerge from the other side. I might come out a mangled and broken mess, but I'd come out, and then I could put myself back together! As I've gotten older and had to deal with more responsibility and bigger issues, I've come to realize that my issues are almost never singular, and that reaching the "broken and mangled" stage of things had much bigger consequences than my own feelings. So now I find myself trying to learn how to juggle all these big important issues and keep myself healthy and happy as I do so. It's not easy, and I know it isn't easy for anyone, but for some reason, doing something to take care of myself like therapy almost feels like a failure. If I was stronger I could do it all without breaking a sweat/suffering any long term emotional damage, right? That is obviously a reasonable thing.

Wait, no it isn't, hm. Well then.

The strange thing about my ongoing struggle with stopping and asking for help is that I've done it before. When I was... 14? I was dealing with some things no kid ever should, and I knew I was in way over my head. So I reached out, said I was in a bad way and could really use some outside help. Shockingly, and without any begging or drastic measures, I got it. I was in counseling for about a year and it was by and large an awesome and positive experience. I would also discover a bit down the road that my parents had lied to my siblings about where I went every Wednesday after school and said I had joined a club.

When I was in therapy, I didn't talk about being in therapy. I didn't really think anything of it, but it just seemed like it wasn't something you were supposed to talk about. Finding out that my parents had either just not said a word, or outright lied to my siblings about it, would later on reinforce that thought. People who suggest it now lower their voices and make sure no one else is listening. They're afraid to be overheard. They're ashamed. People are nervous when they suggest therapy because they know the potential insult that lies within it. As I got older, I wouldn't be surrounded by people talking openly and honestly about therapy, and the people who did talk about their mental illnesses and various treatment plans? They were weird, or crazy, or desperate for attention, and reams of other not-so-nice things. As I got older therapy went from being a way to call in a ringer when shit was getting tough to something only undesirables did.

When I reached college, no one talked about things like therapy or mental health maintenance because in high school those people had been the weird messed up outcasts. We were all scared to speak up, and it all fed into this culture that mental health issues are something to be ashamed of, which keeps us quiet about it when that's basically the worst thing we can do about it. We stigmatize these issues, which makes people who are suffering afraid to speak up which leads to the whole "ruined broken mess" situation I described earlier. When you're already hurt and vulnerable, speaking up about your hurt is hard. We have however made and nurtured a culture where it practically an act of heroic courage to do so, let alone talk about it.

There have started to be cracks. Campaigns to de-stigmatize mental health problems, to normalize talking about these things, but until you've stood on the side of the fence where you actually need that help but are scared to ask for it, it's hard to really understand the depth of the problem. I know my situation could be so much more drastic and dramatic, and I don't think even having been where I am and have been I grasp the entirety of its depth. So, I'm going to do my part and speak up. I know alone my voice won't do much to chip away at the foundation that this toxic culture is built on, but if enough of us speak up, maybe it'll make a difference.

My name is Erika, I'm 25, hold down a steady job, am self sufficient, and able to maintain healthy functional relationships. Life has been happening to me in such a way that I need to call in a ringer to help me deal with it. The simple decision to actually seek help is already helping. I am not ashamed, even if I am scared.


  1. Honestly, I don't know how I feel about this. I think therapy is one of those things that you either really hear a lot about at a given time or hear absolutely nothing. There just doesn't seem to be a middle ground campaign wise. Personally I haven't ever consulted a ringer, although looking back on my life I probably should have a couple of times but instead sucked it up and dealt with some pretty shitty stuff all by myself. I think I probably have a pretty solid inner-shrink, likely from having read waaaayyyy too many psych and soc books in college and afterwards and just thinking I knew it all anyway so why bother. Perhaps it was more arrogance than being scared. Hard to say. What's more unusual is that I seek medical treatment for everything and anything. I have seen so many specialist mds for all kinds of crap that it amazes me sometimes the shit I have put up with. ...get that crap out of my body yes. get that crap out of my mind... no, I think I'll hang onto that shit a little longer. You're absolutely right that just seeking help helps. Sometimes mental health is just that - making yourself healthy. Getting to a place where lack of disorder, or maybe just getting the thoughts out of your own head, is just what you need. Nothing to be ashamed of. I should be more ashamed having lied to myself so many times thinking that I didn't need help when I really did.

  2. So much this.

    I've struggled with a lot of these general issues as well, and have been gradually reforming my stance. When I first sought out a counselor in college during a spectacularly trying period of my life, I generally kept quiet about it and was kind of ashamed that I needed any help. Your basic college sophomore should totally be able to shoulder any and all emotional burdens without ever stumbling, right? We're made of stone and stuff.

    But this time around, I've started having conversations about it. Mentioning it right out loud, and simply not noticing people squirm. It's truly tragic that there's such a strong stigma preventing help-seeking at the moments when people need it the most, and honestly most people could probably do with a round or two of therapy regardless of their situations. It's way useful for dismantling your self-defeating programs, even if you're not at the end of your rope just yet. In fact, it might be better before the desperation sets in.

    So I'm with you. I'm 27, have a full-time steady job in my field, live with a sweet husband and a small menagerie of fauna, love to dance, and am going through some life changes that I can use some help with figuring out. It's helping, and life is getting even better. I am not ashamed.

    I raise my teaspoon to you, Erika.

    (Also, I just found this blog today, and it abso-freaking-lutely rocks my socks. Y'all are erudite, insightful, and funny as hell.)

  3. After my stroke, I pretty much just had to accept that I was going to talk a lot about the time I spent in rehab, and the various therapists (speech, physical, occupational) I was seeing and whether or not they were helpful, and many people who didn't know me and happened to be in earshot were going to assume drug rehab and psychological therapy, and that had to be OK, because the alternatives were absurd... I couldn't go around explaining all the time, and I couldn't not talk about it.

    Eventually I came to realize that it wasn't OK, and that I wasn't coping very well with any of it at all.

    It slowly dawned on me that maybe working with a psychological therapist was a way of coping better, and (with much help from very patient friends) I eventually managed to pick up the damned phone.

    As you say, the decision to seek help is itself helpful, sometimes. And the help itself can be, too.

    It still amazes me how hard that can be to admit out loud. Go you for doing so.

    Oh, and, hi! New reader.

  4. Have I mentioned you are amazing and awesome (like a hot dog)? I am no longer in therapy, but I was a year ago for trans issues. Of course, we talked about other things besides me being trans, and well, it was amazing help. Yes, I still have some issues that I need to work through, but the therapy was not helping with that. It helped lower the mental block slightly, but not enough. As for your parents lying to your siblings, I have mixed feelings about that. On one hand, like you said, it is promoting that therapy is something shamed, something you should hide away. On the other, I always felt that it wasn't someone else's place to say if so-and-so was in therapy either. That should be up to the person going.

  5. You know you are so right about everything you said.

    I am tired of people all my life telling me that I have no will-power, because I know that's not entirely true. For instance - no matter how hard some things things seem - if I actually want to do it, I always find a way. I only 'have no will-power' when it's something that I really really don't want to do or really, really bores me. Or I may generally not be very productive - like always being late for things and spending my days watching TV shows and video clips or reading books that I like, but whenever I try to stick to a schedule - I am about 70% more productive. And then one day, I found this amazing website that talked about ADD symptoms. And guess what? there's actually more than one type, and I am pretty sure I have it. Maybe not to such high degree that I can't function without medicine, but yes, I am pretty sure that I have it.

    I've never been ' officially diagnosed', because frankly - I fear that my doctor will just say I have no will-power and that I am looking for attention/seeking a way to explain that I have no willpower Whenever I've mentioned my suspicions to a few people (really maybe 3-4 people) I had just that response - a very belittling 'Ha-ha' and 'oh, come on.' Because this isn't exactly a sickness like schizophrenia which is easy to diagnose and yes pretty much all of the symptoms can be explained with 'she has no will-power', but that's only easier for the person who does the explaining, because 'having a mental illness' just sounds too scary (which is exactly what my grandmother said btw, followed by 'people don't talk about that stuff'). But for the other person (aka me) - that's not easy at all. I have spent all my life thinking that I am a lesser person, when in reality I might have ADD and because of those exact reactions. And because I've been fed this stigma too, even I sometimes doubt myself and think that I am doing it to get attention/to try and explain away that I actually do have no willpower.I just wish one day I'll be able to tell someone 'I think I might have ADD' and the response I get will be a straight, non-sarcastic: 'Well, yes, that actually seems like a reasonable thought.'