Ryan Howes

Ryan Howes PhD, ABPP

In Therapy

How to Recommend Therapy

Helping a friend without making an enemy

Posted Dec 31, 2017

pixels, hipster version
Source: pixels, hipster version

Hmmm. This is dicey territory. You have a friend or loved one who is experiencing some distress, or hitting a roadblock, or searching for purpose or meaning in life, and you think therapy might be a great solution. What should you do?

Are you one of the fortunate people who can just plainly say: “Hey, maybe you'd like to try therapy?" You can? And would they then hear you and consider therapy non-defensively as a viable option? Yes? Great! Read no further, this post is not for you. Go forth and keep telling your emotionally strong friends exactly what they need to hear. And send me an invite to your holiday party, I like how you people roll.

If you’re still with me, you’re probably among the majority of people who would either: 1) find that statement too confrontational, and/or 2) are pretty sure that your loved one would take offense to that suggestion. Why? A few possibilities. Maybe you think recommending help is impolite and unkind. Or they feel like having problems is a sign of weakness. Or that going to therapy means they must be crazy. Or they believe therapy is a waste of time, money, and energy. All realistic possibilities.

So, is there a way to recommend therapy that doesn’t push others away? I think so. But first:

Aside #1: I need to qualify the level of problem we’re talking about here. If your loved one is a threat of harming themselves or someone else, if they can’t take care of their own basic needs, if you fear for their safety or your safety or anyone else’s safety, you may need to call their doctor or the police, or encourage them to do so. This is relatively rare, but I should say it. Treatment is more urgent in these situations, and you may just need to act. 

Aside #2: This post is all about the unfortunate stigma that still surrounds psychotherapy. If your friend’s tires were bald, you’d say: “Hey, go get new tires.” If your brother had a weird new mole, you’d say: “Hey, go get that checked out.” But when suggesting someone talk with a professional about their obvious stress symptoms, or prolonged grief, or crippling anxiety, etc., we still need to be extra careful not to offend them with our recommendation. Why? Because for some reason, showing signs of stress in a world that is rife with stress and unfairness and pain is somehow still something many feel ashamed of. Bald tires are fine. Odd moles are fine. Showing understandable signs of stress in an incredibly stressful world, not fine. I don't get it, but go figure, we’re working on it.

Back to the point. If you’d like to recommend therapy to a friend or loved one (for the sake of this post, let's assume she's female), I suggest the following:

Listen: Ask your friend how she’s doing ... no, how she’s really doing, and then listen. She’s stressed about her divorce. She doesn’t know what to do about finances. She feels she’s in the wrong job. Whatever it is, sit back and listen. Give her the stage, be curious, ask clarifying questions when necessary, and listen. You might learn more about the depth and complexity of her issues, which is both good for her to articulate and good for you to hear.

Listen some more: You’re going to be tempted to jump in with solutions at some point, but you might want to sit on the first few impulses. Listen more as the story becomes more complex, more emotional, more intimate. Resist that fixer urge and unsolicited opinions; they’re rarely helpful and could shut her down.

Ask: When she’s run through her story in depth, ask her what she plans to do to resolve the problem. Does she have a plan? Does she have faith in that plan? If it’s a big problem, one that’s obviously more than only she can handle, ask her who else she is going to enlist to help her sort through the issues. You’re both recognizing that the problem is too big for her and telling her she’ll need more than just you.

Ask some more: People don’t generally like unsolicited advice. It’s just a universal phenomenon, it triggers that old parent/child thing we tend to rebel against. But when someone says “You know, I have some opinions about that, let me know if you want to hear them,” the dynamic often changes and suddenly a defensive position becomes an open one. If the response is no, then drop it and keep listening. It wouldn’t do any good to push. 

Tell: To this point you've done a lot of listening, asked a couple of questions, and have a green light to share your thoughts. You might just want to start with expressing your love for her and how you hate to see her in distress. You can then make a statement about how everyone benefits from a little help once in a while: the best pro athletes still need coaches, we all need a trip to the MD once in a while, and therapy helps millions of people every day. Going to therapy is not an act of weakness or a sign that you're crazy, it's often the most courageous and compassionate act of self care. 

Tell some more: If you've been to your own therapy, and experienced a positive outcome, this would be a good time to share your story. What you felt, how it worked, what you learned, how it changed you - any of this would be golden. Therapy is intentionally mysterious (due to the necessary confidentiality), so hearing a bit of your story could demystify therapy and make it seem a little less scary. 

So there you have it - lots of listening, a few questions, a gentle recommendation and your own story. If she seems open to the idea, you may want to help her find a therapist and make the initial contact

All of us need some help from time to time, and there are professional help-givers all around us. If we are looking to heal a wound or improve a strength, therapists are there to meet the need. The stigma against therapy is outdated and dangerous - dive on in, it could be the best gift you give yourself. 

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