I recently spoke with someone who would really benefit from therapy. Nothing is in crisis, but they have been repeating the same pattern over and over again and they finally started to think that maybe this behavior doesn't serve them anymore. And maybe it is holding them back. Hopefully this illumination happens to all of us. This realization is hard. Change is hard, but if we are not changing then we aren't really living. So let's hope for the hard stuff every now and then.
I’m not sure this individual will ever go to therapy. And I’ve done what I can to try and facilitate the process. I’ve been an outspoken therapist and I have shared with them about my own treatment and how it has been really hard at times, but ultimately has changed my life for the better. I even walked them through the process of what to do. How to call their insurance, what to ask, and how to decide on a therapist. And that’s all I can really do. It’s all anyone can really do and it is actually much more than is required. Ultimately we cannot convince anyone to go to therapy if they really do not want to go. And I have a feeling this person doesn’t really want to go. And that makes me sad, but also fair enough.
The experience got me thinking about how I have been quietly judgemental of them not wanting to go to therapy. I had to think on this for a bit. Dissect whether it is my own disappointment that was making my mood or was it something else? Turns out it was both. This individual is resistant and they think that this resistance is special. And it is not. There is nothing special about being resistant to therapy. Most of us are. In fact I’m not sure I have ever not been resistant to entering therapy, even knowing what I know and truly believing that introspective work is the most important and responsible thing we can all do for ourselves and each other. Resistance to diving into your internal world with someone you just met is probably pretty healthy.
But resistance to therapy is different from barriers to therapy. And this is where my frustration and disappointment reside. Barriers to therapy actually are special and are important reasons why someone may be unable to enter therapy. Barriers are different from resistance.
Some common barriers to therapy can include:
- Health insurance
- Transportation to and from appointments
- Internet access
- Dependable telephone service
- Unable to pay insurance or sliding scale copay
- Access to accommodations for those without sight and hearing
- Access to accommodations for non verbal individuals
- Access to a therapist with the same gender, race, and or language
- Belonging to a group who have been marginalized by the medical profession
- Belonging to a group who have been marginalized by psychiatry
- Access to a LGBTQ+ therapist or specialist
- Access to a transgender therapist or specialist
- Not having time due to work and childcare to meet with someone privately
- Access to a particular specialist - EMDR, psychiatry, acute care, outpatient services
- Previous traumatic experience with court ordered or involuntary therapy.
- Previous traumatic experience with unethical or illegal treatment like conversion therapy.
This list is just part of what can present a barrier to therapy and many times multiple barriers occur at once. Barriers prevent individuals who are willing to walk through resistance to receive treatment. Resistance without barriers is having access to a long list of privileges and letting fear get in the way.
So how do we solve the problem of barriers? Well, we remove them. Ultimately it would be great if we could actually agree to just give people what they need. But that seems a far way off. We have built these barriers ourselves. And we can begin to remove them, even with lots of assholes standing in the way. First, we collectively agree that the brain is a very necessary part of survival. It controls all bodily functions and regulation. Our mind is pretty darn important. How we think, feel and behave happens in the brain. This is where psychology and mental health reside. So let’s make it a top priority. Let’s value the mind.
If you are in a leadership position, advocate for free mental health services as part of employee benefits. Help create a culture where therapy is the norm and caring about mental health is to be expected. Be a responsible leader whether that is a manager, executive, teacher, parent or mentor and enter into therapy yourself. It is an impossible task to successfully lead others if you do not know yourself. Make it a priority.
As an employee, advocate for free mental health services where you work for yourself and your peers. If you are applying for a job ask about mental health coverage in terms of benefits. Advocate for mental health services at your school, church, mosque, temple, community center and in your town and county. Keep talking about it. Never stop talking about it.
And talking about it doesn’t mean telling everyone you encounter how your therapy is going. That’s not the expectation. If you want to scream your insight from the highest mountain by all means illuminate us with your progress. But it is possible to value therapy and mental health and still maintain your privacy. In fact in many settings this privacy is preferred and an appropriate boundary.
And lastly, question resistance. Normalize anxiety and fear around entering into therapy. It makes sense, but also, normalize doing it anyway.