Some problems never go away, but we can get better about handling them, right?
January 13, 2011 7:57 AM   Subscribe

How do I convince my close friend to finally see a therapist?

One of my very dearest and closest friends, who is basically family to me in all the ways that really count, has PTSD and related issues that severely impact their (gender neutral singular) and their child's life.

They're open about discussing these issues with me and a few other close friends, brainstorming ways to deal and go through life, but our advice simply isn't enough to help them develop the coping skills that they need.

It's too big for them. It's too big for those of us who love them and try to help. Talking with us never seems to really sink in or help change things for them. But I can't just walk away or shut up and sit down, both because I love them and because our lives are very deeply intertwined. And I'm not just projecting - they are fully aware that they have big, life-interfering-with problems that they need to deal with somehow. They just aren't, for whatever reason, willing to actually take the next step in trying to deal with these problems.

Another friend told us about her best past therapist, made sure the price wasn't too high and that that therapist has experience with PTSD and families, and sent over the contact info. My friend seemed interested, but as usual, has made no steps towards getting an appointment or committing to exploring therapy in any way. They seem to be absolutely convinced that they are simply stuck with their problems forever, that PTSD never goes away, and that trying out therapy and learning to cope better with the PTSD is a vaguely interesting but ultimately not terribly worthwhile endeavor.

How can I persuade my friend to actually make a damn appointment, go to it, and give it a real try (including checking out other therapists if the first one isn't a good fit, as sometimes happens)?

My friend consented in advance to my posting this question, and will presumably stop by at some point to read the anwers. (In other words, feel free to write comments addressed directly to them, if you prefer.)
posted by Eshkol to Human Relations (19 answers total) 3 users marked this as a favorite
Best answer: What is stopping you from making the appointment, travelling with/driving them to the appointment, looking after the child while they are in the appointment and then taking both of them out for a celebratory lunch somewhere they would enjoy? For some people, that first step is the hardest and they need a little nudge to get momentum.
posted by saucysault at 8:04 AM on January 13, 2011 [3 favorites]

But I can't just walk away or shut up and sit down ..because ... our lives are very deeply intertwined.

Inclined to say that this is your real problem. Not your friend's problem, mind you, but your problem. When your friend's problems become your problems, and your friend allows that to continue even though other options (such as professional treatment) are available, it's time to take a big step back. Think about boundaries, codependency, etc.
posted by jon1270 at 8:07 AM on January 13, 2011 [4 favorites]

If you can get his permission, you might play "social secretary" for him. Ask for what times are good in his schedule, and call the office for him for the first visit. It may be that the act of making the appointment is a stressor.

One of my big challenges I had getting a therapist (and I still don't have one, I settled on rubber-stamp drug maintenance) is that I couldn't tell anyone what was wrong without crying. In fact, the stress of listening to the phone ring and waiting for someone to pick up was enough to set me off. Your friend probably doesn't have that exact problem, but cold calling a therapist and making arrangements can be a bigger hurdle than it seems.
posted by Karmakaze at 8:10 AM on January 13, 2011

Are you looking for empirical evidence that therapy for PTSD works? This abstract discusses which therapies are effective. However, as hard as it is, I suggest you give up trying to manage your friend's problems for them. It never works. If they don't want to go, they will find a million reasons not to and not be persuaded by even the strongest evidence that professional help would be beneficial. It could be that they are in some way deriving an identity from their victimhood, or they may just be too depressed and dysfunctional to take the necessary steps. You sound like a great friend, but you cannot solve this for another person.
posted by Wordwoman at 8:12 AM on January 13, 2011 [3 favorites]

There are so many reasons that your friend isn't going. Money could be a concern, or time. Maybe the problem just isn't that big in their head. Really, a multitude of things.

Going to a therapist has to be their decision (short of a court ordered situation).
posted by theichibun at 8:21 AM on January 13, 2011 [1 favorite]

I would ask him/her: "If I set up this appointment for you, will you promise me you'll at least go to give it a try?"

You can add whatever other help you think would be appropriate: driving him/her there, texting him/her a reminder the day before the appointment, etc.

Going to one appointment is just that: one appointment. It's not committing to being in therapy for life.

Maybe part of your friend's resistance has to do with the stigma of someone who's "in therapy." There shouldn't be any shame in it. Therapy is something that could help almost anyone. It's one of many ways to try to improve your life. It's not radically different from keeping a diary or having a deep, personal conversation with a close friend.

However, I also agree with other answerers that you (the OP) seem on the verge of trying to control your friend's life. It's ultimately her/his/their (all these gender-neutral pronouns are exhausting!) decision.
posted by John Cohen at 8:26 AM on January 13, 2011

Strongly disagree with the "this is codependence, back off" argument. At some point in the future your friend will likely set a boundary with you on the other side of it. And that may be a little tough to deal with, or it may not. But right now, it sounds like you're helping your friend get over a hump that they themselves have acknowledged. People diagnose codependence a little too freely these days - if *you* were suffering from your distorted or maladjusted involvement with a friend, then *you* would be in a codependent place - codependence is about you, not the other person. But that doesn't seem to be happening here. I think you're doing the right thing, and I think you should keep going. Take your friend to an appointment, help them out financially if you can, be there to listen, etc. Again, there will undoubtedly come a time when you will need to back off, but my opinion is that this ain't it.

Here's an idea: ask your friend to put themselves in your shoes. "Hey, friend. If you had a friend who was suffering really badly, but who was blocked about getting help, what would you do for them?" Your friend might tell you exactly what to do to help.
posted by facetious at 8:43 AM on January 13, 2011 [2 favorites]

As someone who really needed to go to threapy for a long time but didn't, I have to agree with everyone else who has said that you can't force someone to seek help. They have to want it for themselves, or it's not going to work.

As painful as it is to sit back and watch, sometimes people really need to hit bottom before they realize that they need to make some serious life changes.
posted by onceisnotenough at 8:45 AM on January 13, 2011 [1 favorite]

The thing is that just going once won't solve it. It might offer a great feeling of relief, to turn this enormous problem over to someone who is an expert. But if that feeling doesn't happen (you've probably noticed in your own life that some problems feel better by talking but some problems are painful even to discuss), then it will take a few sessions, like maybe two months worth, to start getting results. Your friend has to be dedicated enough to keep going. (I'm speaking generally and not about PTSD.)

You may have to be part of the reason they become dedicated. For me, hearing that I was draining my friends and that they felt I needed help they were not qualified to provide would be a big deal.
posted by salvia at 8:47 AM on January 13, 2011 [1 favorite]

I would ask him/her: "If I set up this appointment for you, will you promise me you'll at least go to give it a try?"

A friend did this for me, and it worked. She just asked me to go one time with her therapist, and I ended up going for a couple of years. I owe her big.
posted by clearlydemon at 8:56 AM on January 13, 2011 [2 favorites]

Look, I know this isn't the answer you want to hear, but here goes: I had PTSD. It did affect my life. I didn't want to go to therapy. My friends basically forced me into it. It was an incredibly negative experience (despite being a highly recommended therapist, followed by a different highly recommended therapist) and now, 10 years later and recovered, I have no doubt it prolonged my recovery time. I do not speak to those friends anymore and am still angry that they did that to me. To be honest, the thing that helped me the most in my recovery was cutting those friends out of my life who were aware of what had happened and wanted to talk about it all the time and assumed everything I did was because of it.

Of course, I know that for most sufferers of PTSD therapy is enormously helpful, and I do not generalize my experiences with therapy to the everyone, but that's my perspective on the issue.
posted by brainmouse at 9:02 AM on January 13, 2011 [1 favorite]

Best answer: 2nding the suggestions to make your friend's appointment for them. That could take a huge weight off of their mind.

And it's probably worth mentioning that to someone with PTSD, asking them to start giving up their coping mechanisms can feel a lot like you're asking them to stand blindfolded in the middle of a busy freeway. This is not to say that you are not absolutely right in urging your friend to get help, just that the level of terror can be difficult to articulate.
posted by corey flood at 9:08 AM on January 13, 2011

"Friend, I care about you very much, and I genuinely think therapy would help a lot. Is there a reason you don't want to see a therapist? Is there a reason you don't want to see Therapist X? May I make an appointment for you? If it's not too intrusive, may I take you to the appointment and take you out for coffee after? It's a big step, and I want to support you however I can."
posted by theora55 at 9:44 AM on January 13, 2011 [1 favorite]

Best answer: Thirding the suggestion to make your friend's appointment for them.

And I also strongly disagree with the "this is codependence, back off" argument. There's no reason for the quality or intensity of love between friends to be any different than the love between a couple or between family members. And with that kind of love its not just our right but our duty to trample over boundaries, take responsibility for others' lives when they are incapable of guiding them themselves, and to decide when this kind of action and transgression is warranted. The closest relationships should not be governed by sterile "professional" standards where everyone is firmly alone and inviolate in their own little bubble.
posted by tempythethird at 9:48 AM on January 13, 2011

Best answer: Since I'm the only person who mentioned codependency, it seems I've been called out a couple of times here. Please note that I did not "diagnose" or say "this is" codependency; I merely suggested the OP think about it. As in, this is a possibility to be aware of. Codependency, where it exists, is destructive. It is not love, and it is not some warm and fuzzy alternative to sterility and professionalism.

The question doesn't give a terribly detailed description of exactly what's going on between her and her friend, so perhaps a bit of projection is inevitable as we try to address it. I'm guilty there. In this case, I don't know how to avoid it.
posted by jon1270 at 11:13 AM on January 13, 2011

I had some major mental blocks about therapy, especially since I think of myself as a very smart and self-aware person and often have a very hard time accepting the fact that a therapist or other professional could help me any more than me doing my own research, self-hacking, and dealing-with-it-on-my-own could. I was also concerned about personality mismatch, about having to deal with woo-woo shit (this is mostly because I live in the Bay Area and strongly prefer poly- and kink-friendly therapists), and about the great painful dreadful ordeal of laying it all out for someone.

What helped me get over my general anti-therapy block was talking to a LOT of intelligent, self-aware people I respect and trust about their experiences with therapy. They were able to explain to me some of the things a therapist could do that I couldn't do for myself even though I am an awesome superwoman, as well as indirectly reassure me that intelligent, self-aware people did the therapy thing, too. And it was also helpful to hear over and over again that it was really truly 100% okay to try out a few therapists if I needed to.

If it were me, and I had gotten to the point where intellectually I understood it might be helpful but was having a hard time actually going and doing it, you taking me there, and then either hanging out with me afterward or giving me some alone-time to decompress and process afterward would definitely be helpful.
posted by rhiannonstone at 1:11 PM on January 13, 2011

Best answer: To The OP's Friend,

Hi. You don't know me, and I don't know you. But I think I know a bit about your situation, because I've been in your shoes.

- You really can overcome this, and traditional therapy is just one thing to try. Memail. I'm happy to relate the different routes I've taken, and what was successful + efficient for me.

- You must do this for your child's sake. I know that is a Big Statement, but it's true. You are a parent now, and you don't have the luxury of taking the passive road when it comes to your own recovery.

No matter what you are thinking, it absolutely boils down to the two simple points I outlined above. There's no reason to put it off. Take action. You are super lucky to have a support system and folks who are actively interested in your well-being. So take action on this. Why put off the relief I know you can achieve a minute longer?

Goo luck.
posted by jbenben at 1:15 PM on January 13, 2011 [3 favorites]

Best answer: Not sure if this is relevant, but I once had a friend who was very depressed and leaning heavily on me. I realized at some point that I just couldn't help him. Despite hours long conversations over many months, nothing I was sharing was helping him to get "unstuck".

I had recommended therapy on many occasions but what finally helped him get over his aversion to the idea was this:

"Friend, I love you very much and I am very worried about you. Despite the fact that I do want to help you and have tried, I have failed to be of any help. Sadly though, I do not have any more tools in my toolbox and I believe a professional can help you. Please go see someone. Here is the name and number of a therapist that our mutual good friends have seen and I hope you use it. But I cannot continue to act as your pseudo-therapist because it isn't working and I love you too much to be complicit in keeping you from the help that you need."

(or something to that effect). Bottom line is I set a boundary in our friendship that I wouldn't act as his pseudo-therapist anymore. It wasn't helping him and it was becoming too frustrating and painful to me. He finally went, it helped him a lot and we are still very close friends.
posted by murrey at 7:05 AM on January 14, 2011 [1 favorite]

One of the reasons I see my therapist is so that I can enjoy my friendships, rather than placing my friends in the therapist role. My friends are eager for me to lean on them, and I appreciate that, but, frankly, my issues are kind of boring and repetitive, and working on them is work; I'd rather free up some room in my friendships for light-heartedness and put more of the heavy stuff on the paid professional.
posted by endless_forms at 2:01 PM on January 14, 2011 [2 favorites]

« Older A Guy Walks Into an Admissions Office...   |   Tell me about a study that links kindness and... Newer »
This thread is closed to new comments.