After several failed attempts, you finally pick up the phone, call that recommended therapist, and schedule a session. No turning back now. As the day approaches, you wonder what it’s going to be like. The day finally arrives, you enter the office, shake his hand with sweaty palms, and sink into the couch. After exchanging pleasantries, the question is posed: “So what are you hoping to get out of therapy?”
Invariably, that question triggers a look of puzzlement. “Hmmm… Good question… I guess to stop drinking, fighting, worrying, missing school, crying, cutting [fill in the blank]?” Or perhaps a panicked reaction: “I have no idea! How am I supposed to know? Aren’t you supposed to tell me? Stop pressuring me!”
While we still have a way to go, quite a distance has been covered on the road to de-stigmatizing mental illness. Be it how we view those who struggle with mental illness or the easing up on the resistance to seeking help, as a society and a community we have made encouraging progress. We made it into the room. Time to roll our sleeves up and get to work.
Hold up.
Sir Winston Churchill once said, “If you’re going through hell, keep going.” On one hand, I appreciate the sentiment of perseverance and never giving up. On the other hand, I believe there is a prerequisite to following through on the “keep going” attitude; a “why.”
Even in the midst of the most gruesome, tragic, and unfathomable tragedies throughout history, individuals have been able to tap into the strain of survival buried somewhere in their DNA. The only way someone is willing to continue going through hell is if they have a reason to. Whether it is to find meaning within the journey as Dr. Viktor Frankl suggests, or like the chicken, to get to the other side, there has to be something.
I’ve noticed that most people coming to therapy have one of the following three responses to this question: a) “No idea why I’m here. Someone else (parent, spouse, court) is forcing me to be here. There are at least six other places I’d rather be right now, one of them being the dentist.” b) “I know what brought me in. This problem has disrupted my life enough forcing me to take time out of my day and spend money to be here right now.” c) “I’m fully aware of what has brought me into this room, why I am here, and what I’d like to get out of this process.”
The people most likely to maximize the benefits of treatment fall into the last category.
So what do I mean by a “why” and what does it look like?
A “why” is the true reason for taking the brave step of entering therapy and only that person himself can identify it. There is no correct or incorrect answer. It can be anything from being a more present parent to feeling secure enough to pursue career advancement or connecting with a spouse in more fulfilling manner. It may take some hard, honest reflection to find it, but it’s there. I would argue that this is the most significant predictor of success in treatment. If there is no “why,” then time, money, and energy wears one down quite efficiently.
Let’s play this out.
Dave comes in and shares his concern of incessant, intrusive thoughts about the safety of his children. He submits himself to these thoughts by calling their school several times daily “just to check up on them.” He doesn’t let his children play at friends’ houses, go into the sandbox at the park, or ride the Ferris wheel. “You can never be too careful,” he posits.
“So what do you want to get out of therapy?” I ask.
Pause.
“What do you mean, what do I want? I don’t want these thoughts!”
“Why?”
“Because they’re driving me nuts, that’s why! I don’t get why you’re asking me this.”
“Let me clarify, Dave. What I mean to ask is, beyond the immediate relief from these thoughts that are controlling your life, what will you gain when they’re gone, or in check?”
“Ohhhh. That’s easy. Freedom.”
“Great. What does freedom mean to you? What else will you gain?”
“I’ll be able to enjoy my family, be there for my kids instead of annoying them with so many rules, and just appreciate each day.”
Freedom. Family. Present parenting. Daily life. All fantastic “whys.”
As Art Williams said, “I cannot tell you it’s going to be easy – I’m telling you it’s going to be worth it.” …If you have a why, that is.
Find it. Name it. Pursue it.
To help find your “why,” ask yourself the following questions:
- What have I lost or missed out on because of this problem?
- Why do my loved ones want me here?
- How have they lost out because of this behavior?
- How would my daily life look if this change magically occurred overnight?
- What new opportunities/feelings/thoughts/dreams/relationships/goals would now be on the radar?
Shmuel Fischler, LCSW-C, is the director and lead therapist of CBT Solutions, located a few minutes away in Lutherville, MD. CBT Solutions is a specialized group practice founded on evidence-based treatment for anxiety, OCD, panic, depression, and other related disorders. He can be reached at 443-470-9815 or info@cbtbaltimore.com, or see www.cbtbaltimore.com.
