Dear Dr. Hurd,
My family has been encouraging my brother to seek psychotherapy for some problems we feel that he has, and his doctor agrees with us. My brother is resistant to that, and we can’t understand why he doesn’t see that he needs counseling to work through his issues. What can we do to help him?
Dear Reader,
You can help him by getting off his back about therapy! You cannot ‘cure’ someone who’s indifferent to a cure. The motivation for counseling has to come from the client/patient himself, not the family, his doctor, a judge or anybody else. Medical conditions that can be healed with pills or surgery are not the same as mental or emotional issues. The psychotherapy ‘patient’ has to be willing to challenge and change his errors in thinking, with the therapist as his ‘coach’ or guide.
Sometimes the client/patient is not merely indifferent, but is actually hostile to therapy. Of course, the family will think, “Well, that’s OK. He’s wrong. The therapist will fix him.” Wrong again. A person cannot have his beliefs changed FOR him. Beliefs and ideas can only be changed through thinking and reasoning methods. If in fact he does acknowledge something is wrong, then a therapist may be able to guide him towards correcting his errors in thinking. But it’s pure fantasy to expect that the mind can change without its own consent, and without the willingness to think.
This is the problem with today’s trend of applying a medical metaphor to psychotherapy. Reason and rationality are not pills or surgery performed on an otherwise passive body. They are self-initiated actions and habits, and can only be practiced by one who wants to practice them.
A common mistake made by parents, friends and even spouses is to assume that a person who has been self-destructive or self-defeating will immediately ‘listen to reason’ the moment they encounter a psychotherapist. ‘I am sure my husband will change once he talks to the therapist and the therapist says the same thing I’ve been saying.’ Do you hear how arrogant that is? The loved one is certain in the belief that the therapist will say exactly what he or she thinks. This doesn’t always happen. For one thing, the loved one could be wrong. For another, the unwilling therapy patient/client won’t necessarily tell the therapist the whole truth. There’s nothing to make the brother, sister, son or resentful spouse tell the therapist all the facts. In fact, there’s absolutely no guarantee that he or she will even show up for the session.
Typically, the individual who is interested in therapy for a loved one will call the psychotherapist and say, ‘I want you to help my (whomever) with (whatever).’ But wait — if there really is a problem, why isn’t the loved one calling on his or her own behalf? Unless it’s physically impossible, I always require the person whose therapy it is to schedule the appointment him- or herself. After all, if you’re not even invested enough to pick up the phone to schedule your own session, how can you be expected to do anything else to improve your life?
I want to offer a little advice and caution regarding this notion of ‘getting help.’ When somebody claims, “I want to help you,” what they usually mean is, “I want to change you.” Another version is, “I want her to get help,” which, when translated, really means, “I want her to change.” The whole thing is a disingenuous attempt to conceal an impossibility behind a possibility. In other words, the falsehood that one can change another person is thinly disguised behind the ‘feel-good’ (and false) clichthat “helping” is always virtuous and therefore rational, no matter what the circumstances. Busybodies beware: One can only change oneself. Look at your own agenda, not theirs.
I’m a great believer in the capacity of people to help themselves, and I’m always wary of the notion of somebody else trying to help or ‘rescue’ you. Usually someone who wants to ‘help’ is really more interested in control. If you truly care, you don’t control; you persuade. The art of persuasion has never been easy, but the principles are timeless. As Buck Lawrimore says in an online article on successful management of people, ‘People are sensitive about ‘being done unto.’ If you demonstrate that you care about someone before asking them to do something, they are more likely to trust your motives and acquiesce.’
Not all human beings act rationally in all situations, but we are reasoning creatures nonetheless. We can be intimidated or forced to do things in the short term, but manipulation is never a substitute for persuasion. Only facts and logic can truly change people. Psychotherapy can be a magnificent tool in this regard, but it is no substitute for honestly stating and trying to prove your own conclusions — conclusions that you hope your loved one will reach as well.