I'm Worried About You: How to Talk to a Loved One About Therapy

What did you notice first? Was it the well-loved golf clubs sitting neglected for months? Invitations to family dinners repeatedly declined? Feeling him toss and turn all night, only to fall asleep in front of the TV every afternoon? The short fuse that could turn your innocent question into a bitter argument? The emotional changes of a loved one can be subtle and can emerge slowly. What you might have initially dismissed as a tough week at work, or the lingering effects of a cold, begins to materialize as something more salient and pervasive. You might’ve insisted on a visit to the physician, but no diagnosis was made. Indeed, it seems that your loved one is struggling with debility not of the body, but of the mind and spirit. But how to help? How you can suggest therapy without seeming accusatory or negative? While the script that you use will vary depending on the nature of your relationship, here are some tips to help get you started: 1. Timing. Your loved one will be more receptive to your approach if you find the right moment. Avoid broaching the subject in the heat of an argument, or during the depths of an anxiety attack or depressive episode. Find a moment of relative calm, when your loved one may be better able to hear and understand what you have to say. And do your homework! Research ahead of time what insurance benefits are available, and the names of any specialists in your area. Psychology Today offers an excellent website for finding a therapist. If you’ve gotten the timing right and your loved one agrees to see a therapist, it’s best to act quickly and make that appointment. Taking a few days or a week to work out the details gives your loved one a chance to change her mind, or to slip further into emotional turmoil. 2. Tone: Adopt a tone of genuine concern, rather than blaming or shaming. It may seem counterintuitive, but talk about your own feelings first before launching right into a list of criticisms.  Not Effective: “What’s wrong with you!?” Effective: “I’ve noticed some changes in our interactions the past month, and I feel concerned.” OR “You’ve been on my mind a lot lately. I worry that you seem down some of the time.” OR “I really care about you, and I have this uneasy feeling that something has been troubling you.” Notice how those all contain “I” statements? They are about your experiences, rather than your loved one’s. That makes them harder to refute, and less likely to cause defensiveness. 3. Talk: Chances are, your loved one will not fall into your arms and thank you for your offer of help. It’s more likely that you will encounter resistance in the form of minimizing or denial. Your loved one may even insist that YOU are the one who needs help. Maintain your tone of genuine concern, but begin to provide some concrete examples of the troubling signs you’ve noticed. One or two examples is best, and avoid vague, judgmental statements. Not Effective: “You never want to go out anymore.” Effective: “You’ve canceled the last two book club meetings, and we haven’t invited the kids over for dinner at all this month. I’m worried that you don’t seem to enjoy getting out of the house like you used to.” Stick with the issue at hand without dredging up old business or predicting future catastrophe. Not Effective: “You drink too much and you’ll up an alcoholic like your mother.” Effective: “I noticed that you’ve been having a few drinks every night, and I worry that you have been feeling overwhelmed.” Hopefully, your loved one will open up a little bit, and talk more about the changes in his feelings and behavior. Acknowledge his feelings, and thank him for sharing with you. Listen, listen, listen, without any agenda. This is how you will show that you are truly concerned and want to help. 4. Tread Lightly: Wait until you hear your cue before rushing in with a suggestion of therapy. You are listening for a variation on the asking phrase “I don’t know what to do”. Resist the urge to lecture or immediately offer solutions. When you hear the asking phrase, try saying “I have a suggestion. Can we talk about it?”. This allows your loved one to keep a sense of control during a very vulnerable time. Once you have permission, then offer up your idea of seeking therapy. Words matter, and choose the ones that will land gently.  Not Effective: “You need to see a shrink.” Effective: “What about seeing a counselor? I’ve heard of someone who has experience working with people with this issue.” 5. Trust: The truth is, you cannot force someone into therapy (unless you’re a judge, but that’s a different story). If your loved one says No, then you may need to trust that she is not ready at this time. Therapy is really most effective when the client is willing and wants to engage in the process. Giving an ultimatum, cajoling, or guilt-tripping someone into going to therapy will not create that willingness, and can actually backfire and increase resistance. Your goal at this point is to keep the communication open, and allow your loved one to make the decision. That caring conversation with you may have provided the catalyst to make some changes all on her own. End the conversation on a positive note, and leave the door open to revisit the issue if needed. Not Effective: “Well, you better get some help. I don’t think I can live like this anymore.” Effective: “It’s really up to you. I’m here to help however I can. If I still see you struggling a month from now, maybe we can talk again about getting some professional help.” 6. Take a Step Back: As much as you want help for your loved one right now, you must allow him to seek help on his own timeline. It can be incredibly painful to watch a loved one suffer, and this can create a sense of powerlessness or bitterness. So here’s the plot twist. This might actually be an ideal time for YOU to consider seeing a therapist. You will learn how to manage your own emotional reactions, and you can learn strategies for productive interactions with your loved one. By seeing a therapist you are also reducing some of the stigma or shame that your loved one may be feeling about seeking professional help. Observing the newfound calm that you gain from therapy may be the push that your loved one needs to take the step on his own path to healing.