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Do I Need Therapy? How to Tell When the Advice of Friends Isn’t Enough

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Ask IPS: Advice from psychological experts, drawing on Catholic faith and modern psychology

Question: I have been struggling with some difficult choices lately and was wondering whether I should go to therapy or just seek the advice of a friend?

William McKenna, MS; Clinical Psychology Extern at Catholic Charities replies:

At the heart of this question — which many people ask — is to know the value and purpose of therapy and how therapy is different from a good talk with your family or best friend.

Many therapist caricatures involve the therapists giving advice and/or being very heavy-handed in their interactions with their patients. With this misguided view of therapy, it’s easy to see why people would prefer to skip the time commitment and insurance headaches that accompany therapy and just talk with a trusted friend.

When you are having a really bad day, it can be helpful to talk it out and share with a friend or close family member. The friend is there to help you feel better, give support and share perspective on your experience. Friendship enriches our lives and is necessary to help us guide our relationships and how to interact with the world around us.

Therapy, in many ways, is very similar to friendship. You sit down and process your feelings — the good, the bad and the ugly — with your therapist. In therapy you receive the same listening ears and willing heart that you get in a good friend. However, there are some critical differences. It’s true that there are some therapists who fall primarily into the “advice giving” caricature, but the majority of therapists are more interested in empowering their patients to make their own decisions.

Patients normally come into therapy feeling helpless against demons such as depression, anxiety, relational distress and/or trouble in their marriage. Many believe the solutions to their problems are either that other people need to change (i.e., in marital/relational distress) or that they will receive sage advice from their therapist, which will magically cure them. Both cases can be flawed. In these cases the patients are open only to things changing because of outside forces instead of because of their own actions. I always tell my patients that we cannot control how others act; we can only control how we react to others.

Therapists also try to help patients understand the reasons behind their troubles. They help the patients look from the inside out and see that they have the ability to change how they approach situations (both with others and within themselves) and then empower them to make the proper decisions, which will bring them to flourish (e.g., live virtuously). In my experience, framing therapy in such a manner helps the patient understand that, while I can do a great deal to help him, I can only work as hard as he is working. The therapist’s goal is to use professional training and experience to ultimately help the patient help himself.

All in all, therapy is a process of discovery with your therapist working with you as a guide rather than a friend. Understanding how your challenges, obstacles, emotions and thoughts interact and how they impact your relationship with yourself and others is part of the whole process of therapy. Friendships play an important role, but they have limits with the scope of guidance they can provide. I hope you and your family have a blessed a joyful new year!

 

William McKenna, MS, is a clinical extern at the IPS Center for Psychological Services.

 

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