I often hear clients expressing worry that they might be wasting my time, that their problem isn’t “that bad,” that they know other people have had much worse experiences, etc. I think sometimes they imagine I’m ranking their difficult life experiences against other clients’ lives: add two points for being bullied in middle school, take away one for having a happy marriage, and so on. (I don’t, but it’s understandable that folks might imagine I’ve heard “worse” stories than theirs.)

I won’t pretend privilege doesn’t exist. But pain is pain. And if saying, “It could be worse–you could be…” did the trick for mental health, I’d be out of a job. There’s nearly always someone in a less privileged position than us. And yet somehow, knowing this fact doesn’t cure anxiety, depression, or PTSD. It doesn’t make grief less painful, or humiliation less crushing.

I have yet to encounter anyone seeking therapy with whom my reaction is, “Really? You want therapy for this???” Regardless of what is going well in someone’s life, when they reach out for therapy it’s because they don’t know how else to move forward. The point at which we get “stuck” varies from person to person, similar to physical pain tolerance. And I think wherever your sticking point is, you deserve help getting un-stuck.

An interaction in Linda Holmes’s novel, Evvie Drake Starts Over, captures my approach to this issue well:

Evvie finally cleared her throat into her fist. “I feel like I should be able to figure this out. I keep telling myself, you know? Pull it together. You’re not starving, and you have friends, and just … get a grip.”

Dr. Talco tapped her index fingers together. “Did you know it’s possible to remove your own teeth with pliers?”

Evvie looked at her blankly. “That’s not what I thought you were going to say.”

“No, no, probably not. But it’s true. If you have a bad tooth, you can take a pair of pliers, stick them in there, and pull as hard as you can. Is that something you would do?”

“This feels like a trick question.”

“Stay with it.”

“No, I don’t think I would pull out my own tooth with pliers.”

“That’s what I always tell people about therapy. It’s not a question of whether you could try to do it by yourself. You can always try it. But it can be dangerous, and it’s harder. Trying to buck yourself up is the tooth pliers of mental health.”

When you reach a point where you’re stuck, where nothing you’re doing feels right or moves you in a positive direction, that’s a good time to try therapy. There’s no minimum amount of suffering required before you’re welcome in my office.


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