Kathleen Moore

PhD student,

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What do you think it is that moves a person from trying to use personal coping skills towards being willing to seek outside support?

For many who experience difficulties with mental health, support is often sought/provided when he/she reaches their 'rock bottom'. For others, their willingness to seek support begins prior to this point, and for a variety of reasons. What is it that enables someone to admit their difficulties and seek support? Is it an emotion? An experience?

  • Oct 20 2012: What moved me was that I did no longer want the situation I was in to continue. Something had to change and since all the thinking and brooding I did by myself was getting me nowhere, the conclusion had to be that I needed help.

    When I got the professional help, I realized that the reason why you may not be able to help yourself is that your thoughts unconsciously avoid the painful things in your life. The function of the therapist is to be "a pair of ears listening in on your thoughts" and then when you stop talking because you arrived at one of those painful things, to urge you to continue.

    It was quite a revelation to find out about this mechanism we have to avoid pain. Talking in front of another human being is bringing the loop of your thoughts out in the open and allowing that other person to point out the things that you have been hiding to yourself.

    In this way I experienced my therapy more as a process of learning about myself than as getting ready answers from a therapist and I remained quite detached from the therapist as a person.
  • Oct 19 2012: I think that it is essential to trust that a system of support is in place. This system must be accessible, affordable and effective. To take the risk to reach out for support often involves a certain degree of exposure and one may become quite vulnerable. If a person has adequate access to high quality care, the risk is much less than if an individual is forced to overextend themselves financially, emotionally and in other ways with little hope of a return on their investment of time and money and risk.

    Should a person seeking help encounter an incompetent, inexperienced, negligent or unethical practitioner, the results can be devastating. One may seek help only to discover that only more harm has been done.

    Many community clinics offer only interns as counselors. These individual's are supposedly supervised by a licensed psychologist however, this supervision may not always be adequate. The psychiatrist may also be an intern at such clinics. Many people coming in for support may have very complicated issues and/or medical conditions. A low income patient attending a community clinic , is (disproportionately) likely to be treated by an "intern" or other recent college graduate who has often not yet passed their boards and is in the process of earning their training hours. Much harm can be done as these interns "learn on the job" especially, if they are not closely supervised.

    For a person to reach out they must feel confident that trustworthy mental health professionals will be available. They must feel that they will be treated with respect by a qualified professional.

    We must make quality mental health care available to people of all income levels if we are to expect people to reach out for help and not get hurt in the process. Without this (reasonable) assurance, how can anyone expect a person suffering from a mental health condition to make themselves vulnerable and risk greater harm? No one wants to be a guinea pig.
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    Nov 14 2012: I think it is difficult to recognise, let alone admit to, mental health problems in isolation. Often it's the isolation that is the cause of it in the first place. Rock bottom is the crisis state that occurs in desperation. Many people will only seek outside support only when (or after) that state is reached.

    The recognition of the prelude to that desperate state is more often spotted by someone loved and trusted, or someone professionally involved in mental health - very rarely by the person doing the suffering. The cognitions/perceptions/self-esteem of person doing the suffering is rendered irrational and self-destructive by the condition itself. This is why it is essential for sufferers to surround themselves with empathic human contact of some sort in order to gently facilitate that recognition. Acceptance of self can only take place after that recognition.
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    Nov 1 2012: These characteristics of an individual, reaching out for help or not, are set very early in life. They are a part of our social emotional development. Listen to this TEDx talk, "Baby's point of view" for a glimpse into the origins of mental illness.

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    Oct 21 2012: Unless a person sees a fault in one's own life, one is not inclined to seek help. Rock bottom is different for different people. Those who see themselves as misfits see what they are doing as something that they need to do to keep going.

    Many individuals recognize unfavorable behaviors and seek to keep them at bay. Not individuals are that lucky.

    I worked with an individual with an alcohol problem. He totaled his vehicle, but since he and no one else was hurt, he was unmoved by the tragedy. He was aware that losing his license would cost him his job, and yet he refused to see his problem as a problem. It took an ultimatum from his wife to get him to seek help.

    There is a book "The New Primal Scream" by Doctor Arthur Janov that describes how early childhood or birth trauma can cause psychological effects that evade rationality. How a person thinks, and the subconscious motives that drive that thinking are disconnected. No amount of reasoning can solve the problem. Until the underlying motives are exposed, it is futile to reason with the person. People in this dilemma need a different kind of help than just dealing with the problem because the problem is a symptom, not a cause. Hanny describes it well; it is suppressed pain that leads to the problem, not the other way around.

    Juniper talks about trust. If you do not trust the person who you are seeking for help, it goes no further. Also, if the person you are seeking for help is not insightful to your needs, it is unlikely that they will provide a useful outcome. There has to be a sense of trust and the idea that the person helping you understands you if there is to be any resolution. That can be a difficult bridge to build.
    • Nov 14 2012: Probably most alcoholics don't seek help without experiencing some life-altering event. It may be a felony DWI or a spouse or other family member that gives them an "either or" choice.
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        Nov 14 2012: I believe you are right. Most alcoholics do not see alcohol as a problem. They see it as a solution to some other problem. It is not until they can see alcohol itself as a problem that must be solved that they move on it. Very seldom do they come to this revelation without a life-altering event.
  • Oct 19 2012: I think it is an admission that despite the strength of their will, they may not be able to cope with the circumstances and maintain control at the level either society or they believe to be necessary. Sometimes it is an experience that they get through, but somehow was different than expected, often scaring the individual. Some it is a willingness to admit weakness and suffer the humiliation, a feeling possibly distorted by the condition.
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    Oct 18 2012: There are elements of nature and nurture involved in an inclination to self-sufficiency. The personality trait of introversion versus extroversion is also related, with introverts more likely to keep matters to themselves as long as possible and extroverts more likely to look outward. Introversion/extroversion is a personality trait and therefore considered pretty stable, except in the case of life-changing crisis.

    In terms of actual mental illness, there used to be a tremendous stigma associated with having mental health problems. While there may no longer be a serious stigma in social settings in some societies, the ease with which information travels might discourage job seekers, for example, from seeking professional help for mental issues.

    Another issue is financial. If such services are not covered by health insurance of some kind, people on a budget will avoid incurring the expense either forever or as long as they can.

    (I have interpreted your question in relation to actual mental health challenges, like mood disorders, rather than support for other issues that do not naturally fall within what Martin Seligman of Penn (see his TED talk on Positive Psychology) would call a disease model. For example, many people prefer to take on personal challenges like losing weight or getting healthy or working better habits into their lives by themselves. It is part of feeling empowered rather than handing the reins over to someone else. Others may want to embark on such a course as part of a group of supportive friends, which may similarly feel empowering- to have a support system that always has your back. But, in a culture in which the purveyors of products and services engage in a non-stop campaign of diagnosing needs as a way of creating for themselves a new market, people may resist such selling in order to feel a bit more autonomous.)
  • Oct 18 2012: People who have had some experience or education involving mental health will usually seek help when they realize that their problems cannot be solved by their own coping skills. Getting help is never comfortable, but it sure beats hitting your head against the wall. In the USA, this is still a small minority.

    For most others, it is very difficult to see and understand that the problem is within themselves, not outside influences or bad luck. That is especially true when most of the problems revolve around family or close friends. It is natural to blame the problems on others. In this type of situation it often takes a serious talk from a close, trusted friend to point out where the problem is. If the person has no such friend (this is common) it often takes desperation, and sometimes rock bottom.

    Early education in mental health could greatly improve this situation. The time to fight the stigma is in the early school grades. IMO, violence and bullying should be addressed as mental health problems.