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How Do I Know if I Need Therapy?

In the past year and more many have struggled with the terrible events, losses and trauma created by the global pandemic and by other events spurred by climate change. I’ve noticed on several of the group Facebook pages either wonderings about whether a person should get therapy or suggestions that he or she should. Sometimes I’ve made the suggestion, providing links to low cost clinics. Each person will tolerate what we’ve been through differently, and it’s also quite possible that other issues will make seeking therapy a good idea. Here are some general ideas for when it’s time to get therapy.

Relationships—If you are having problems you can’t resolve with another person to whom you are close (spouse, partner, child, parent etc), therapy is a good idea. This may come in the form of family or partner therapy or may be something you seek alone. Having issues where problems just can’t be resolved are extremely challenging and make your life difficult on many levels, and one difficult relationship can affect how you approach others, worsening the issue. You might look for counseling around the issue of relationships for other reasons. Perhaps you have trouble getting along with authority figures or you’re an adult looking for friendship or a romantic relationship without much luck? Alternately, past relationships that were abusive or dysfunctional may affect how you relate now. In any of these cases, a therapist can help you identify patterns, past or present, that can be getting in the way of your fully relating and enjoying being with those close to you, or seeking out and forming new relationships.

Moods—Do you find that your mood is usually not a happy or content one? Are you angry all the time? Do you feel sad, down or withdrawn? Is your mood super elevated, leading you to make impulsive choices? Perhaps you find yourself anxious most of the time or live your life in fear of having a panic attack. Alternatively, you might feel detached and dissociated, like somehow things don’t matter as much or you feel like you don’t exist (watch for this one particularly after experiencing trauma like our fire or if you’ve experienced trauma in the past). Dysphoric moods or anxious moods often require treatment, and many people continue to tolerate them in the hopes that they will get better on their own. It is quite important to see a therapist to get help with conditions like depression, bipolar or post-traumatic stress as these may get worse without treatment. In particular, if you feel suicidal, you should get help immediately by calling 911 or going to your nearest emergency room.

Habits—Whether the habit is always choosing married men as romantic partners or drinking too much, a therapist can give you tremendous help. Learning to unpack the meaning of your choices, getting advice on medical treatments for physically based habits like addictions, or living a life without compulsive behaviors are all targets for therapy.

Trauma—If you have experienced trauma in the past or in the past month you could be having a lot of symptoms that suggest help is needed. Three of the biggest are loss of sleep, startle reflex, and headache. As mentioned before, moods can go down or people may feel disconnected from the world. Other symptoms include reliving parts or all of the trauma or being triggered by similar events (sounds, visuals, smells, etc). For many people, these symptoms may be fading, but others are still experiencing them or feeling them even more. People may also worry constantly and/or experience panic attacks. Taken together these are clear indicators of ongoing severe stress and one should get help from a therapist.

Questions—We wonder about our meaning, our existence, our deaths, and ourselves. These wonderings tend to occur with phase of life changes, such as when we hit middle age or when we retire. Having an objective but caring therapist to help you develop your personal view of the cosmos and to deal with the inevitable anxiety associated with our mortality can be tremendous way to develop emotionally, spiritually and psychologically.

Note that all of these issues tend to touch on each other. Moods affect our relationships, questions and habits, but habits affect moods, relationships and questions, too. Trauma and habits affect our moods, relationships, and how we define our world, too. In therapy, each area gets touched, so the person emerging is more complete. Of course it is possible to do short-term therapy that touches on just one area, but you might someday find yourself coming back for a more holistic treatment of your concerns.

Are you ready? It really depends ultimately on you. Therapy cannot work without the willing participation of the person seeking it. If seeking counseling is not your idea, and you still go, make sure to let your therapist know that you are hesitant. It can be very good to start your work by understanding why you are not ready and getting a fuller picture from the therapist of how they can or can’t assist you. Patricia Ellis Christensen

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