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Wednesday 25 June 2014

When Talking to friends isn’t enough: When to seek professional help in counselling.


As my second entry in this blog, I would like to start to talk about psychotherapy, counselling  and what is the difference between: counselling, psychotherapy, psychiatry, psychoanalysis and generally just to help dispel some of the myths and misconceptions out there.

First of all, what is counselling or psychotherapy? And how do I know what it is and when I need it? Well, psychotherapy or counselling is really no different from talking to a good friend or buddy about problems and issues you might be struggling with. The only major difference is really is that the psychotherapist or counsellor has more skills at listening and reflecting back to you what your story is and what you are suffering with. This assumes of course that your friends have enough time and patience to put aside their own needs and agendas when talking with you to be able to do this. Not all friends can.

Moreover, because they are friends or buddies, they sometimes have an interest in maintaining your current situation, aka the status quo. Perhaps for example you have a drinking buddy and you want to quit drinking. In this case, although your buddy may hear your concern about drinking, chances are, he (or she) won't exactly support your efforts to quit. And so, counselling is like just speaking to a friend or buddy, but friends or buddies may also have an agenda. A lot of simple emotional difficulties can indeed be solved just by talking it over with a friend, but some cannot.

So, say the problem is complicated, and maybe talking to a friend is not so useful, because your friend just “doesn’t get” your problem or like talking about the example above, the friend has a vested interest in you staying the way you are! What to do then? Then you should probably speak to someone else or speak to a counsellor.

But what if you are having a problem, you friend DOES listen and knows how to listen and she or he does not have an interest in swaying you in one direction or another.  How do you know when you need to seek professional help and your friend can no longer help you?

So, you need to look for clues in your friend’s behaviour.

First off, do they say up front: “You need professional help!” , or something like that – That’s a huge, big red flag clue. You need go no further. Do not pass GO, do NOT collect 200 Dollars. Put down the Monopoly Game. Look for a counsellor or psychotherapist.

Secondly, how does your friend react when you want to talk about your problem? Do they sigh? When you ask if you can speak to them, do they put you off or try to brush you off or try to avoid you or the meeting or try to “reschedule” your talk together? This is possibly an non-verbal, unspoken clue that they either are emotionally exhausted trying to help you grapple with your problem and/or they themselves feel helpless to assist you and don’t know how to help you.  They may be trying to be a good friend: helpful, supportive, but the problem you present them with may be so complicated or overwhelming they may not know what the right thing to do is.

Big clue:  if you ask them point blank: “What should I do?” and they answer: “I am not sure. I really don’t know”. 

Look at it this way, if you feel that you are at a standstill in resolving the problem just by talking to your friend, then you probably are. Next step: go find a counsellor!

So if you are talking to your friend about something as complicated and powerful as feelings of suicide, depression or trauma. Almost for sure, your friend will not know what to do. Seek a counsellor.

And finally, in what typical situations should you seek out a counsellor right away, if you were thinking of just talking to a friend in order to “get over it”.

Here is a short, helpful list of emotional situations where a person would benefit from seeing a counsellor or seeking professional help:

1.      Long term blues (or depression): crying, sleeplessness, worry, anxiety – that has lasted more than a month or two. Feelings or thoughts that you are better off dead or wanting to kill yourself.

2.      Intense feelings of anger or hatred towards someone else that have lasted more than a month or two.

3.      Recurring nightmares, sleeplessness, “flashbacks” or seeing stuff that you witnessed before. These are trauma-like reactions.

4.      Any major (negative) change in your behaviour. This is usually another clue that something is not right. So,... major loss of weight. Major gain in weight. Major change in sleep patterns – sleeping too much, not sleeping enough, having broken sleep. Major increase in substance use. For simplicity, just think: Major Change, or simply Major.... majorly!

Seriously though, if you or your friend(s) recognize a significant (negative) shift in your behaviour, then it’s likely something’s going on and you should speak to a therapist. And hey, if nothing is going on it won’t hurt. It’s like going to the doctor for a pain in your side. It might be nothing at all just a muscle twinge. But then again it might be something more serious.

I welcome comments, questions for clarification and dialogue respectful to this post and any others.
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Take care.


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