When meeting people at social gatherings, the most common question I get is, “You’re a Psychologist; so, are you analyzing me right now?” I try to be witty and give answers like, “Only if you plan to pay me.” or “No. I’m off the clock right now.” Okay, so maybe these responses are trite and not that funny, but that’s my dry sense of humor. Sometimes, my openness about my career is viewed as an invitation for the sharing of a lot of very personal information. People tend to open up to me, even when the timing or situation is not the most appropriate (e.g., OSU Football games-Go Pokes!). Other times, people walk away with a worried look on their face once I tell them about my profession.
All of this is surface level to hide the subtext of the discomfort of being known by someone else, especially when that knowledge is uninvited or unexpected. Some people fear that Psychologists are given or taught these super-powers to read others like a book whether the person wants to be known or not. I must have missed that class in graduate school. Honestly, I do have some keen observational skills, but I will not likely uncover deep, dark secrets about someone I have just met simply by paying attention to body language or facial expression. Or by talking with them for a few minutes. I cannot analyze someone without their permission, and my job is mostly about listening well.
For the same reasons, I tend to avoid reaching out to someone I have never met in my role as a Psychologist. This is something I get asked to do frequently, but it hardly ever goes well. Imagine that you are at work or shopping in Stillwater or whatever you tend to do. You are minding your own business when someone taps you on the shoulder and says, “Hi! I’m a Psychologist and your (friend, spouse, co-worker, etc.) is worried about you. Mind if we talk for a few minutes?” You don’t know me. And, this is how you learn that others are talking about you behind your back? About some difficult topics? Not the best opening for professional treatment. However, people ask me to do this often for people they care about. Mostly because it is hard to have the conversation about seeking professional help.
This blog is intended to provide some guidelines for you to consider if you are thinking about seeking professional counseling or if you have concerns about a friend, family member, co-worker, etc. While extremely helpful to many (even life-saving for some), I do not believe that everyone needs counseling, nor do I believe that everyone would benefit from counseling. It is normal to want to deal with a situation yourself, especially in our American “boot-straps” culture. It is also common to worry about opening up to a complete stranger, and paying for it. There are many ways to cope with a situation (see Blog posts on Physical Self-Care and Stress and Coping for more information) and several options for treatment of psychological disorders. Counseling is not for everyone, and it works best for the people that are most open to the process of professional treatment. If you feel like you’re trying to force someone into therapy (including yourself), it will likely be unsuccessful at best. At worst, it could be a waste of time, money, and effort.
For those who are interested in professional help as a possible option, the following list of experiences might be times to consider reaching out to schedule an initial appointment.
- Symptoms of a psychological condition:
o Symptoms of anxiety might include worry, feeling overwhelmed, concentration or memory difficulties, muscle tension, panic attacks (including physical symptoms like increased heart rate, difficulties breathing, shakiness, etc.), social avoidance/isolation, restlessness, irritability, sleep disruption, phobias, fear of embarrassment or judgment from others, obsessions, compulsions, and/or trauma reactions like re-experiencing, avoidance behaviors, and hyper-vigilance (American Psychiatric Association, 2013).
o Attention Deficit Hyperactivity Disorder (ADHD) symptoms include inattention, distractibility, difficulties organizing or listening to others, careless mistakes, lacking follow through, losing items, fidgeting, talking excessively, impatience, and/or interrupting others (American Psychiatric Association, 2013).
o Symptoms of depression might include sad or depressed mood, crying, lack of motivation or interest, sleep disruption, appetite/weight changes, concentration difficulties, irritability, fatigue, excessive guilt, low self-esteem, indecision, feeling hopeless/helpless, and/or thoughts of death/suicide (American Psychiatric Association, 2013).
- A transition in life:
o Job promotion or loss; new job
o Unfamiliar city; recent move
o Marriage, divorce, or separation; relationship ending
o Grief; loss or disconnection in friendship(s)
o Parenthood or step-parenthood
o Care-giving to other family members
o Starting school or returning to school
- Behavioral changes:
o Poor grooming or hygiene
o Sudden appetite/weight changes (increases or decreases)
o Increasing alcohol or drug use; substance abuse or dependence
o Self-injury behavior or suicide attempts
o Academic or work struggles (e.g., poor grades, procrastination, missing work)
o Loss of interest in typical behaviors
o Bizarre or odd behaviors
o Disturbed speech or thought process
- Social signs:
o Social isolation or withdrawal
o Not getting along with others; constant fighting or arguing
o Dependency on others
o Poor eye contact; extreme shyness
- Emotional indications:
o Mood swings
o Irritability (especially if it seems unrelated to life circumstances)
o Anger and aggression
Most people start looking for a therapist when they are going through some challenging life situation(s) and their existing ways of coping or dealing are no longer available, become ineffective, or start causing further difficulties. For example, when someone loses a loved one to whom they have relied on for social support for several years, it can be frightening and lonely to face life without that person. All of us like to ‘escape’ the stress of daily life once in a while. This is why movies, music, television, video games, social media, books, etc. are so popular. However, when someone over-relies on escape strategies for coping with a stressor, it may lead to a worsening of distress rather than relief. Some situations can only be avoided for so long. Use of alcohol or other substances can be an unhealthy form of escape and can lead to further stressors like legal issues, family disruption, missed work/school, physical hangovers, financial losses, etc.
If you recognize some of these signs of distress in yourself or someone you care about, it might be time to consider professional help as an option. This might be talk therapy with a psychologist or counselor, but might also involve medical treatment with a physician. I recommend that clients speak to a physician about medication options when their symptoms are mostly physical in nature, when their symptoms have occurred for long periods of time and seem unrelated to situational stressors or circumstances, and/or when there is a significant family history of similar symptoms. These factors suggest more biological causes for symptoms.
Professional help is not about advice giving. It is more about listening, empathy, and understanding with some mutual problem solving. My clients are always in control over what we talk about (session content) and whether or not to follow through on any suggestions or recommendations that I make. As I work with clients, I put the responsibility on me for session process which is the way we discuss presenting concerns so that it is helpful for symptom relief, self understanding, emotional expression, changing behaviors, and decision making. I guide the session process through listening, questioning, connecting various information points, and infrequent suggestions. Knowing what to expect from professional help options can help you or your loved one make a decision about initiating treatment. Ask questions from people you know who have sought treatment and ask questions of potential treatment providers. What do they specialize in? What is their background and treatment approach? If they give you a bunch of jargon that you do not understand or there is a lack of comfort in talking with them, you might consider moving on to the next potential provider. Do your research online to learn more about which treatment provider might be the best fit for you. PsychologyToday.com is a great resource for finding psychologists and counselors in your area with search features for different specializations, insurances accepted, etc.
If you are concerned about someone else, here are some tips for talking with them about seeking professional help as an option:
· Talk with the person in private
· Be fully present and give them your full attention
· Allow for plenty of time; do not rush
· Share your concerns in an objective manner
· Express your feelings of caring for the person
· Do not guarantee absolute confidentiality
· Invite them to tell you more about what they are feeling and experiencing
· Listen without judgment
· Validate their emotional experience even if you do not understand it
· Ask if they are having thoughts of suicide
· Instill hope for improvement for them
· Inform them about help being available and what it is like
· Research options for treatment with them
· Let them make the actual appointment
· Offer to be available for ongoing support
· Avoid being overly responsible for them and their distress
· Follow-up with them afterward
· Stay connected with the person
· Take care of yourself as well
If you or someone you know is in immediate crisis (e.g., thoughts or plans of suicide or homicide, self-injury behavior, severe alcohol or substance intoxication), seek immediate help by calling 911, going to the nearest emergency room, or contacting a suicide hotline (see previous Blog post on Suicide Prevention for additional information).
If you are wondering if it is time to start counseling or want to know more about my approach, give me a call at 405-614-2846 for a consultation.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). Washington,