Can I tell someone they need therapy? How?

July 23, 2017 11:25 PM

There is a couple in my immediate family who are in severe need of couples therapy. Neither I nor the couple are people who discuss emotions or share personal matters well, so bringing up something like this would be out of place. So how does this communicating thing even work here?

It feels like I'm watching two people suffering from a serious illness who haven't considered going to the doctor about it. Note that they are not particularly familiar with therapy in their lives or social circles which adds to my sense of wanting to say something. In discussions with other family members, there's a consensus about this as well as a "Not it" attitude in actually talking to the couple. Which is stupid and I feel like someone needs to take responsibility. I feel like an "in the moment" comment when something comes up can seem flippant when I actually want to communicate that we've all worried about them and feel like their life could improve immensely if they considered this.

If we assume that therapy would lead to life improvement for them, how could I communicate this? Should I do some research or find some therapists first and then go to them? I worry that if I don't prepare something first or otherwise show that a lot of thought has been put into this that they'll dismiss me. But on the other hand, if they do realize how much thought has been put into their problems, they'll be insulted we've all been talking about them behind their backs, and/or react by just wanting to hide their unhappiness more to maintain social appearances. So should I say something? What could I say? In what way(s) could I prepare?

posted by FiveSecondRule to Human Relations (20 answers total)

A couple questions: you think they need couples therapy or they have separate problems, or both? How are they so unfamiliar with therapy if their family all agrees it would solve the problem? Do you know how affordable it would be for them?
posted by michaelh at 11:38 PM on July 23, 2017

You shouldn't do anything of the sort.

Be there for them should they need someone to talk to. Perhaps, at most, try to cultivate a level of openness that facilitates that talking. Doing more than that is madness and stands a good chance of resulting in consequences you haven't thought of and do not want.

Put another way, if you had the kind of relationship with these people which made a discussion like this possible you would be aware enough of it that you wouldn't be asking a question here.
posted by deadwax at 11:41 PM on July 23, 2017 [11 favorites]

One roundabout way to introduce the idea would be to normalize and destigmatize therapy in casual conversation. I sometimes will refer to things my therapist says, etc. -- not as a way of advising others, but just as throwing another opinion into a casual human-relations conversation. Don't introduce these anecdotes during conversations about their relationship -- better to bring it up when there's a more generic Life Topic at hand.

So, basically, just try to model and vocally appreciate good mental health care as it pertains to your life.
posted by delight at 11:58 PM on July 23, 2017 [35 favorites]

I would butt right on out, and if someone brought it up to me I would be infuriated at their presumptuousness.
posted by Joseph Gurl at 12:39 AM on July 24, 2017 [4 favorites]

It isn't your place to tell others to get therapy. If they ask for your advice, then go for it, but otherwise your unsolicited opinion is only likely to cause extra stress and tension.
posted by matthew.alexander at 1:18 AM on July 24, 2017 [2 favorites]

Response by poster: Is "don't say anything" still the answer if I add that they frequently argue in front of me, sometimes with things like wrist-grabbing that make me (much more) uncomfortable. Is there a point at which it does become my problem?
posted by FiveSecondRule at 2:02 AM on July 24, 2017

If there is public unwanted contact between them then I would be concerned about this being an abusive relationship. Couples therapy generally makes abusive relationship worse (which is why ethical couples' therapists will not meet with couples who are not addressing the abuse first in individual therapy). If you are unsure of how to help someone escape an abusive relationship then perhaps find out resources and access them yourself - a lot of well-meaning friends and family make the abuse worse or end up isolating the survivor by getting frustrated they aren't "doing what they are told" to escape the abuse.
posted by saucysault at 2:19 AM on July 24, 2017 [19 favorites]

Do they have a problem with how they interact with one another or does their relationship dynamic just make other people uncomfortable? There are plenty of relationships that aren't actually problematic to the people in them, but the way the couple interacts with one another can be upsetting to other people. I think you need to know the answer to that question first before saying anything. Arguing in public is not a problem for a lot of couples even though that arguing might upset other people or make them think the relationship dynamic is a bad one.
posted by Polychrome at 2:56 AM on July 24, 2017 [1 favorite]

Arguing or one party berating the other? If they're both giving as good as they're getting, butt out, their relationship is none of your business. If one party is abusing the other, then yes, you can step in to defend said party and remind the abuser that such actions are not acceptable. You can also - at a separate occasion, offer help and support to the victim to get away from their abuser.

A couple arguing in front of you is reason enough to leave their company, its not a reason to interfere in their relationship or give unsolicited advice.
posted by missmagenta at 3:16 AM on July 24, 2017 [3 favorites]

It's on a par with telling somebody they should go on a diet. You may well be right, but they won't thank you for telling them.
posted by tinkletown at 4:03 AM on July 24, 2017 [14 favorites]

With your update, I have a question: is this a possibly abusive relationship? If it is, couples therapy might be a bad idea. The abuser can use it as another vector of abuse. Maybe try to get the abused partner into individual therapy.
posted by kellyblah at 4:19 AM on July 24, 2017 [8 favorites]

If you are close friends with an individual and they are confiding their concerns about their relationship to you, you can easily say "Forgive me if I'm overstepping, but have you considered therapy?"
posted by bunderful at 5:11 AM on July 24, 2017 [1 favorite]

You can't tell them what to do but you might be able to de-normalize it by drawing a boundary about it for yourself. "When you argue at our weekly dinners, it makes me really uncomfortable. Please don't do that."

If this is a possible abusive situation, just give a lot of support no matter whether they stay together or not.
posted by tchemgrrl at 5:42 AM on July 24, 2017 [9 favorites]

In general you can't tell people to go get marital therapy. They may not feel they have a problem (and they might not; plenty of people just like to make performative scenes) or, more likely, they'll be offended at your butting in.

But if this is your sibling, and you're genuinely worried about them (not just feeling annoyed because their behavior with their spouse is making things awkward for everyone else) you can ask them when you're alone with them, if everything's ok, because you've noticed there seems to be friction.

But if you do suspect abuse that's a different question. I don't like the wrist grabbing thing you mentioned. Can you elaborate?
posted by fingersandtoes at 6:15 AM on July 24, 2017 [2 favorites]

If you are closer to one of them, then you should speak to the one you're closer to, and then only if you are close enough to ask them if they've considered *individual therapy.* I've lead this discussion off sometimes by talking about my own therapy experiences, in the vein of, "Oh, I had this really difficult interaction the other day, and THERAPY totally saved me," which usually isn't hard to come up with one of those where the skills I've picked up in therapy served me well. You can keep doing this kind of thing ("Therapy for everyone!") until they ask you about it or you feel comfortable asking them if they've considered therapy. Usually once you get there the door is open and they're thinking about it, and you have a good chance.

If you're sufficiently close to the person, and I mean like, very close, I've for sure in the past just gotten them one on one and said flat out I'd be a bad friend if I didn't ask them if they were okay, and whether they'd considered therapy. The last time this came up, I said something like, you seem really, really unhappy and I love you, I don't want that for you at all. So have you considered therapy? What can I do to help you get to a therapist? It went well, but it was also a person with whom this would go well.
posted by Medieval Maven at 6:40 AM on July 24, 2017 [4 favorites]

I tend to disagree with the idea that nobody's problems are ever anybody else's business unless they're specifically asked for help. I think if I love people there are times when I have an obligation to speak up or reach out honestly, and I'm forever grateful to the few people in my life who have cared enough about me to take that risk for me. So you have to decide if this is one of those times and know that it is a risk, they might get angry enough that it damages your relationship to them.

Unfortunately there's no script for this kind of thing. You could talk to each of them individually or you could sit them down as a couple and tell them that you've noticed how much they fight and that they seem unhappy, is everything ok with them? And let the conversation progress from there, eventually suggesting therapy.
posted by windykites at 7:53 AM on July 24, 2017 [1 favorite]

In a similar situation, I've told one of the partners how much my husband and I benefited from communication skills we learned from a therapist. I felt that was acceptable because it was about my personal experience.

But they're arguing in front of people, and that's awkward and uncomfortable for anyone who witnesses it. Can you or another family member say something about it? It might be in the moment, like, "Could you guys talk about that after dinner?" Or someone could talk to one of them privately and say, "When you are arguing/disagreeing/animatedly discussing, it's feels awkward and uncomfortable for me." In that case you're talking about your feelings, instead of telling them they're doing something wrong. Which they are.
posted by wryly at 8:13 AM on July 24, 2017 [2 favorites]

Couples therapy is for people who have their own issues under control (usually under the care of their own therapist) and need top-up help with relationship and communication skills. It is only for couples in which both people urgently want to be there and do the work. It is not an Emergency Room for bad relationships.

You can speak individually with each of them and tell them you are worried and that you can help them get help if they want it. To the person who is getting grabbed, you can let them know ways to reach you if they need help getting to safety.

That's all you can do, they have to want it.
posted by Lyn Never at 8:15 AM on July 24, 2017 [4 favorites]

Do not say anything outside of general "I'm here for you" stuff. Do not do this. No matter how bad it is, it is not your place to tell someone else to get any kind of medical care or do research on their medical care that you then give them without their consent. In fact, this is all about boundaries and consent. Especially do not go about it by trying to talk up therapy in conversation passive aggressively. They are smarter than you're giving them credit for, they will almost certainly be able to figure out you are doing this. Your intentions are good, but this seems more for you than them.
posted by colorblock sock at 3:53 PM on July 24, 2017 [1 favorite]

I'll go against the flow here and say that I've recommended self-help / relationship books to friends, and have also volunteered my point of view to (very close) friends after I've witnessed arguments. I do frame it as an "all couples" issue and not a "we've all been talking about you" intervention. Books may be a compromise step, especially since broaching personal emotions is not your wheelhouse. I like Sue Johnson's Hold Me Tight. Esther Perel has also gotten some deserved attention lately. Could you email them with a gentle "I've noticed your arguments and wondered if you might find these books helpful? I've learned a lot from therapy, etc, etc. Please feel free to ignore my butting in, but I wanted to let you know that I wish the best for you and want to support you."

In contrast to almost everyone, I think butting in could be taken with a sense of relief by one or both individuals. It's not like they don't know they are fighting in front of you. Bringing it up may give them permission to reach out for help. YMMV of course.
posted by spamandkimchi at 9:34 PM on July 24, 2017 [1 favorite]