There is sufficient scientific research to know that mental health treatments work and the misguided British ‘stiff upper lip’ and ‘pull yourself together’ attitudes are inappropriate when it comes to mental health.  Recent studies indicate that 40% of the British public will undergo psychological difficulties at some time in their lives, so, if as a population, we are to overcome the fear of seeking psychological help and support we need to be a bit more open and accepting that mental ill health is not unusual, and seeking help for mental anguish, depression and anxiety etc, is an accepted response.

When people know they are feeling worse and their world is getting smaller, somewhere inside they know they need help.  However, fear, distrust, lack of support, or even a sense of shame can stop them making an appointment.  This protracted period of suffering - often in silence - and failed attempts to solve the problem alone can worsen the symptoms and lead to debilitation, isolation and lifelong misery.  Very often this is time spent needlessly suffering. 

Every year, many thousands of adults and children take their own lives in preference to feeling desperately miserable; yet there are scientifically validated psychological methods that could have helped them.  If you (or someone you know) need to talk to someone, make that call today, you can access any one of my services by calling me, on 0161 710 2468 for counselling in Manchester or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it . 

 Barriers to Therapy

It’s normal to avoid making an appointment with a therapist and yet we think nothing of making an appointment with doctors, dentists, opticians, solicitors, mechanics etc. The truth is we all need help and assistance during our lives.

When life has turned upside down or has been cruel it’s often shame, denial and fear of therapy that stops us from seeking help.

Shame

Shame lets us believe we are bad, it’s inbuilt and we would do anything not to feel it.

Shame may be expressed as:

	‘I am incompetent / weak / stupid / inept / lazy / vulnerable / needy / horrible.’
	‘My feelings / thoughts / wishes / needs are shameful and disgusting.’
	‘The only way I can cope is to attack myself or others; isolate or inflate myself; freeze or shut down; submit or avoid.’
	‘I am ashamed of who I am.’

We like to fit in, to be just like others, there is a fear of rejection if we are found out as being different. A fear of being told to shut up, be quiet, don’t tell us about your problems / abuse / mental health / fears etc.

The direct and indirect message received during your upbringing may have told you, you were bad, unworthy or stupid. These messages come from a variety of sources - home, family, peers or the media - and can be interpreted to mean, ‘I deserved the treatment I received’; ‘I must have wanted or asked for it in some way’; ‘I don’t matter’.

There may be a shame in asking for help. How often have you heard the words ‘stand on your own two feet’; ‘stick up for yourself’; ‘pull yourself together’; and if you ask for help you seem to do none of these.  

Actually asking for help is a sign of strength and self respect.

Denial

Denial can be as simple as ‘it doesn’t hurt enough’. Everyone experiences feeling uneasy or unwell and on those days think, ‘I really should make an appointment to sort that out’. Then, life gets busy, the symptoms or unhelpful behaviour is forgotten; until a new situation triggers the uncomfortable, unhelpful and potentially debilitating symptoms. And even then we can talk our self out of seeking help, ‘I don’t have enough time/money’; ‘I’m nervous of asking for help’; it’s not bad enough to need help’. It’s normal for this cycle to repeat its self several times or for years before clients make an appointment.  

Denial is a natural reaction to bad experiences; ‘it didn’t happen!’ ‘It’s not so bad!’ ‘Other people are worse than me!’ ‘I’m OK, really I am!’ Denial is a wonderful way of coping, if we don’t acknowledge what’s happening we can pretend it never did. Problems can be glaringly obvious, but with a sprinkling of denial they may go away, but that leaves an uncomfortable inner knowledge; a truth that won’t go away. It’s not long before the original episodes affect all aspects of our life.

Sooner or later you might notice evidence of denial through:

	Emotional difficulties (anger, frustration, submission, anxiety, panic, depression; flashbacks; nightmares; easily startled; trouble concentrating etc)
	Somatic symptoms (feeling sick; emotionless; poor appetite; disturbed sleep; illness or aches and pains that GPs can’t diagnose etc)
	Fear and phobic reactions (triggered by sights, sounds, smells, tastes, body positions, touching something unrelated to the original event etc)
	Avoiding doing or talking about things connected with the terrible event.

The purpose of denial is to place some psychological and emotional distance between you and the trauma, so you can carry on with everyday life, to continue some sort of relationship with perpetrators or to allow society to cope with uncomfortable realities.

You might think you can’t afford the time or money for therapy, but can you not afford not to?

 Fear of Therapy

	‘I am going to have to talk about myself, what I have experienced, thought and done.’
	‘My shame has prevented me from seeking help and until now I have been able to deny and pretend I’m OK, what will she think of me?’
	‘I might become dependent on my therapist and never be able to cope on my own’.
	‘What if I feel worse before I feel better?’

Therapy might seem scary; there is often a fear of adding to the shame or feeling stupid. It can seem crazy to expect people to attend therapy sessions and disclose what has been denied for a very long time. It might feel shameful to admit to hiding the truth, for not putting an end to issues and problems before now.

You may feel uncomfortable about contacting a counsellor or psychotherapist fearing that you don’t know what to do in therapy, after all the therapist has been to ‘therapist school’ and has learned how to be with clients; there is no such school for clients, how could they know what to do.

If you could have put an end to the discomfort, you would have done it before now.

Good therapists are aware you may feel anxious about seeking help. It’s our responsibility to make sure you feel safe and understood. I appreciate you may need time between making contact and starting therapy; you might have lots of questions about therapy before you feel safe to make an appointment; you may need to talk about your fears before doing any therapeutic work. And, that’s OK.