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CHAPTER 1
William James, known as the father of American psychology, stated, "The greatest discovery is that a human being can alter his life by altering his attitudes of mind." This quote sums up what individuals must do in order to be receptive to getting help from a mental health professional. There are many misconceptions regarding mental health that have led to unwillingness to address concerns by those in need of help. It is time that individuals assess their own attitudes about mental health and become informed so they can change those attitudes and make educated decisions about mental health care. When our thinking is appropriate and positive, everything else will fall in line and our lives will be more gratifying and productive.
Misconceptions
I recently heard someone say, "People form opinions based on little or incorrect information." I find that statement relevant to this chapter. The interviews I conducted for this book, as well as information I've gained through other research, have revealed that people lack fundamental knowledge about mental health, particularly mental disorders, health care, and well-being. There is much to be learned about the important components of mental health and what it entails. Most people have some vague knowledge of the subject, but unfortunately, most of what they know or have seen is negative. Many people find the issue so frightening that they would rather not deal with it. Some would like for mental illness to "just go away." But if it could just go away, there wouldn't be a need for mental health professionals — and I wouldn't have written this book.
I sat down to write this book in a time of economic uncertainty. Jobs were being outsourced, companies were downsizing, and financial institutions were protecting their assets and shareholders, as they are obligated to do. Banks had adopted more stringent lending requirements, limiting to whom and how much they loaned. Employment opportunities were limited, so jobs were difficult to find. That caused high unemployment and forced many people to take jobs paying far less than the positions they had held previously. People had to make financial concessions and choose wisely how and where they spent their money. While the economy has since improved and the unemployment rate has decreased, we need to be honest with ourselves about the impact of the economic downturn and think about the following questions:
Did the economic uncertainty I just described cause people to experience unhealthy stress? Absolutely! Can stress lead to depression? Yes it can. Is depression a mental disorder? Yes it is — if it lasts longer than two weeks (according to the American Psychological Association).
Mental illness affects many people, and you don't have to have an extreme manic or psychotic episode to be affected. Your symptoms can be somewhat subtle and gradually increase in severity. I will be discussing depression later in the book, but first I want to dispel some of the misconceptions about mental illness.
Let's start with the basics: therapists are in the profession because they have a strong desire to help others; doing something to harm an individual is not an option for them. Measures have been taken to ensure that individuals who receive counseling or therapy are not put in any dangerous or compromising situations. Like other medical professionals, therapists are bound by state licensing requirements and the dictates of professional organizations. Operating in an ethical manner is mandatory for them.
Unfortunately, movies tend to portray mental health therapy negatively. One movie that comes to mind, One Flew Over the Cuckoo's Nest, depicts an individual who is functional and opinionated and so advocates for himself and others at a mental health facility. The staff members there have little or no interaction with the patients and won't tolerate any outbursts or troubling behaviors. To accomplish the institution's therapeutic goals, they give the patients medication that makes them unresponsive to most communication and interaction. When the protagonist enters the facility, he objects to its procedures, and the fact that he advocates for himself and others is a problem for the staff. He is subjected to a surgical procedure that makes him unresponsive and therefore able to be controlled.
Unfortunately, this is the picture that many people have of mental health facilities and providers — and it couldn't be further from the truth of how patients are actually treated. There are laws in place that protect patients, and it is only in extreme cases that individuals have to be placed in a treatment facility anyway. Inpatient treatment is provided on an as-needed basis and is usually a last resort for patients who are not responding to outpatient treatment or are not otherwise capable of complying.
Find out what information is factual and what isn't. When in doubt, do the research. Is your concern based on a misconception?
The following misconceptions are based on information gathered in focus groups that I held for the purpose of understanding how people perceive mental illness and why they are often reluctant to get help:
My therapist is not of my ethnicity. Therefore, he or she can't help me.
We all face challenges, no matter our ethnicity. Many of these challenges are universal and independent of race, culture, or skin tone. For instance, death will affect every human being at some point. When we think of the death of an elderly loved one, the grief that we experience is similar, regardless of our race or ethnicity. That person was loved and is now gone, and the passing may be difficult for us to cope with. In this case, the ethnicity of the therapist or patient really doesn't matter. The important factor is the death of a loved one.
My therapist hasn't experienced what I have. Therefore, he or she can't help me.
Some participants in my focus groups expressed concern that their therapist couldn't help them due to their different life experiences. This was a particular concern for one individual who was referring to African American life experiences. He felt that if he and his therapist were not of the same ethnicity, the therapist would not understand the challenges he faced. But that superficial difference doesn't have to be a deal breaker.
When you choose a therapist, here are the questions you should ask yourself: Is the therapist qualified? Do you feel that he or she is genuine? Does he or she demonstrate a true desire to help?
Choosing a therapist really is a personal decision and requires you to think about how you would like him or her to interact with you. Some people prefer formal interactions and communication, while others prefer more casual interactions. What is important is that your therapist addresses your concerns and you feel comfortable working with him or her. If that's not happening, then you may to need to seek help from someone else.
My information will not be kept confidential.
This is a valid concern, and one that should be addressed before counseling begins. It is best to do it when you're interviewing the therapist to decide if you are going to work with him or her. Individuals seeking help from a care provider usually feel a bit vulnerable. They don't know what to expect and don't know if they can even trust the therapist, perhaps because a rapport between them has not been established. This is normal in the beginning stages of working with someone new. As sessions progress, the comfort level usually increases and trust is established. Confidentiality is crucial to the counseling relationship. If you are concerned, ask the therapist what measures he or she will take to protect your information.
One requirement for licensure is that therapists keep all information confidential unless the patient is in danger of hurting himself or others. All therapists are aware that a client's information and records are to be secured in a place where no access is granted except to the therapist. They take several measures to keep patient information confidential. To be very clear: therapists and counselors want their clients to feel comfortable, so they continuously uphold standards of confidentiality and protect all client information.
The therapist and others will judge me.
Think of it this way: therapists are there to help you work through problems that you're experiencing, so how likely is it that they would judge you for getting help? Helping clients is why they entered the field. They are not there to judge you, and neither is anyone else. Deciding to seek professional help is a big step, and all therapists are aware of that. They are willing to support you. If you feel that you are not being treated appropriately, you should talk to the therapist and get your concerns addressed.
As far as other people in your life judging you for seeking help, ask yourself this: Would anyone who loves and cares about me really judge me for getting help? Probably not. In fact, your friends and family should actually be supportive of you for taking the responsibility to get help. If someone in your life judges you for making a choice to help yourself, you probably need to rethink that relationship. Some of the people in your life are in it only for a season; it is up to you to decide when that season ends. Regarding family members who might be critical of you, ask yourself how you would treat them if they were in your situation. If the answer is that you would be kind and supportive, you should expect the same treatment from them.
The therapist will not fix my problems.
I have news for you: this statement is 100 percent correct. Therapists are not there to "fix" your problems. However, they will help, listen, offer suggestions, and provide proven strategies — so that you can overcome (or "fix") your problems yourself. Their support will allow you to help yourself. Working together with a therapist gives you the opportunity to learn how to handle or cope with your situation and make changes for your benefit. If you think the therapist will fix your problems for you, you are wrong. That is not going to happen. You need to be empowered to make appropriate changes for yourself, and that requires you to do the work.
The therapist will just want to prescribe medication.
Medication can only be prescribed by a licensed physician. Psychiatrists are medical doctors who have obtained a license to practice medicine and therefore can prescribe medication. Most therapists and counselors are not licensed physicians and so most cannot prescribe medication.
Many people hold the misconception that medication is the only treatment for mental health concerns. Research shows fairly consistent results: for most non-psychotic disorders, behavioral interventions are just as effective as medications, and they hold up better over time.
"When researchers have directly compared empirically supported therapies with drugs in nonpsychotic populations, they hold their own very nicely," says Vanderbilt University depression expert Steven D. Hollon, Ph.D. Such therapies are also stronger in terms of enduring effects, he says. "People come away from treatment not only having their symptoms relieved, but learning something they can use the next time."
If you see a psychiatrist and medication is prescribed for you, however, you need to take it. I will say that medication with therapy or counseling is very effective. In many cases it is necessary to use both tools; treatment depends on what approach your care provider determines is best. Often with mental illness, there are behaviors that need to change, and therefore therapy is necessary along with medication.
The therapist is just doing his or her job and doesn't really care.
That statement is also not true, but some people could use it to justify not getting the help they need. I find it interesting that they don't take the same perspective when it comes to seeing a medical doctor. Usually people will go to the doctor when they are sick and discuss their symptoms in detail even if it's not a doctor they see on a regular basis. Based on the symptoms the patient describes, the doctor may prescribe medication. The patient usually follows the doctor's orders, including taking medication, without hesitation. The doctor is clearly perceived as doing his or her job.
But the perception is often very different when the need arises to see a mental health professional, even though the process is quite similar. People are often reluctant to obtain services from a mental health provider. The provider usually provides the best care possible, but it is viewed negatively. When we are in denial, we can make up all kinds of excuses to avoid doing things that make us feel uncomfortable or apprehensive. Therapists are in the profession to help individuals with mental illnesses or problems that they need help and strategies to resolve. It takes a special person to understand mental health concerns and want to help others through them. My hope is that these few examples will give you a clearer perspective of mental illness and mental health care.
Any misconceptions you have about mental health are certainly worth exploring with your therapist. It's also important to obtain a basic understanding of your mental health concerns and discuss them with your therapist. Remember, the therapist is there to help, and you should feel comfortable speaking to him or her. Discuss your beliefs about mental health so you can put them into perspective and begin recovery.
The misconceptions regarding mental illness are endless. A common one is that you have to be "really crazy" to need mental health care. This couldn't be further from the truth. You don't have to be "crazy" to seek help. The reason you should seek help soon after the need arises is so it doesn't lead to more severe symptoms requiring more extensive treatment. The word crazy makes people go into denial and stops them from doing anything to get help. It's a word that's used far too freely and always carries negative connotations.
Why are people so afraid to face the possibility that they or a loved one may need to seek mental health care? The reason is that they lack information on the subject, and rather than obtaining information in order to make educated decisions, they avoid the subject like the plague! That's because of stigma and fear, which we will discuss in chapter 3.
There is a misconception regarding the need for help and when it is necessary to obtain help. The American Psychological Association classifies a condition as mental illness if the symptoms last longer than two weeks. It also states that mental illness can be cured or controlled with proper therapy or counseling and sometimes medication. However, most individuals are not receptive to the help that is available. Why? Because they believe that you have to be having a psychotic episode in order to need help from a mental health professional.
What does psychotic mean, anyway? It's a term that most individuals identify with sometimes-incoherent, out-of-control behavior depicted on television and in the movies. But that isn't a realistic depiction of mental illness. Psychotic disorders are changes in behavior brought on by a highly stressful situation. They can take many forms, from delusions to depression, whereby one isolates oneself for days or weeks, depending on the diagnosis. In addition, there are problems that arise in life that you don't always want to share with family and friends, or that you would prefer to discuss with someone who can be objective. It's good to have family and friends you can confide in, but they are not professionals trained to help you.
Here are ten reasons to seek counseling:
1. loss of a job
2. loss of a loved one
3. a relationship breakup
4. loss of a pet
5. a chronic or terminal illness
6. parenting concerns / problem children
7. the stress of caring for an elderly parent
8. the return from a military tour of duty
9. marriage problems
10. alcohol or drug addiction
If you have experienced a traumatic event in your life, or if you have just returned from a tour of duty and are having a difficult time adjusting to civilian life, you could be suffering from post-traumatic stress disorder (PTSD). In this case, you clearly aren't crazy. You probably need to talk about your feelings and thoughts with someone who can be objective and provide strategies to help. In some cases medication is necessary for proper treatment, and that's not a bad thing if it helps reduce worrisome symptoms that affect your daily life.
Stressful events and circumstances affect different people in different ways, and a stress-induced mental health issue doesn't have to turn into a severe episode. Help is available if you are willing to accept it and do the work necessary to get better.
It's just a phase I'm going through.
We go through many stages of development between infancy and adulthood. When a disorder or problem exists for longer than two weeks, however, it is not just a "phase" that you can get over without professional help. Then it is necessary to change your thought process and be honest with yourself about your symptoms and what you are experiencing. The only way to get better is to acknowledge that there is a problem that you need help with.
(Continues…)
Excerpted from "It's All About You"
by .
Copyright © 2017 Cynthia Rapazzini, Ph.D..
Excerpted by permission of Balboa Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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