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Shrinking Violets | Many wait until it’s too late to see a therapist

By Leslie Dickstein, “Daily News” Now health, April 29, 2006

Linda Waters knew something was wrong. She’d been unusually short-tempered. Weepy. It had been a year since the birth of her second child and, still, she just didn’t feel right. “What kind of problem do you have to have when you see a therapist?” She finally asked a close friend one night over coffee. “Does it have to be something specific? I’ve never done this before. I have no idea what to expect.” No one is happy 100% of the time. We all have bad days. Even bad weeks. But how bad do things have to get before you see a professional? Not very bad, say the experts. But the tendency is for people to use therapy as a last resort. That’s why most people would consult a professional for, say, suicidal urges, but less than half of us would reach out if we were feeling unusually depressed or anxious. Even fewer (29% according to a recent American Psychological Association study) would see a therapist for marital problems. Just 10% would seek help for problems at work. “What tends to happen with people is that they figure they can tough it out,” says Dorothy Cantor, a therapist in Westfield, N.J., and president of the American Psychological Association.

There’s a stigma attached to therapy

They like to be stoic. They think, “I can do it myself.” But often, they can’t, and what started as a relatively minor issue can escalate into a full-blown crisis. “If we would think about psychological services as preventive services, we’d go sooner,” says Cantor. “Early intervention is a wonderful prevention technique.” Indeed, 84% of those polled in the APA study said they see a direct connection between their psychological health and their physical well-being. Yet most people said they didn’t know when to ask for help or even where to start looking. In part, says Russ Newman, APA’s executive director for professional practice, that’s because there is still a stigma attached to getting therapy. “People still identify mental health with mental illness,” he says. “That’s enough to dissuade someone from erring on the side of seeing someone.”

Method and Madness

When your emotional state starts interfering with the way you live, Newman advises, it’s time for a professional assessment. It’s just like going to your family physician, he says: “If you have a sore throat that is lingering and doesn’t seem to make sense to you, you go to a doctor to find out what it is.” Moreover, experts say, get the right help and get it early-before the situation explodes. “If someone is beginning to feel anxious, if they’re beginning to feel ill-equipped to manage their anxiety, it would be much more productive if they could get a strategic coach rather than waiting until they self-inflict or become depressed that they can’t get out of bed in the morning,” said Marilyn Puder-York a New York psychologist specializing in workplace issues. “Not everyone needs to spend a year or two years in therapy. You might need short-term coaching, make a plan “Therapy doesn’t necessarily mean a commitment for years of dream analysis.” Likewise couples thinking about marriage therapy are advised to get help sooner, rather than later. “If communication is bad, over the course of time the relationship will decline as well,” says Newman. “You don’t want to wait until it’s a constant battle.” APA’s Cantor agrees. Over time people change. They grow. They’re not quite in synch 10 years down the road, so there’s a period of tension. The hardest part is saying, “It’s not feeling so good.” But finding a therapist is not always easy. After all, this will be someone with whom you will share your inner-most thoughts. You want to feel that this is someone you trust. Authorities recommend getting referrals from other professionals, such as your family doctor, pediatrician or someone else you respect in the medical community. You might also talk to close friends and family, a priest or a rabbi. Lawyers can be another good resource, and most state psychological associations have referral services. The APA has a pamphlet outlining how to choose a psychologist (call 1-800-964-2000). If your health-care plan limits your choice of mental-health practitioners, ask your provider which therapists specialize in which areas. At the same time, experts add, be a selective consumer. If your goal is short term therapy, for example, don’t go to someone who wants to talk about your early childhood. Hopefully, says Cantor, “what you learn in good psychotherapy is how to cope. Life is going to be stressful. There are going to be problems in the family, at work, and with friends. The difference among people is how well they are able to cope with those stresses.”

Early Signs of Trouble

According to the American Psychological Association, here are signals that you may need help:

  1. The way you feel is affecting your everyday life; your sleep, your eating habits, your job or your relationships.
  2. You feel as though you can’t manage your problems alone.
  3. You feel trapped, as though there is nowhere to turn.
  4. You worry all the time and never seem to find the answers.
  5. Things are not getting any better.