When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

The NIMH report indicates, too, that the incidence of psychological problems drops by approximately half after the age of forty-five. The below-forty-five years are usually those of highest stress. Above forty-five, individuals tend to become psychologically better integrated. This probably reflects increased maturity and a more accepting, calmer attitude toward life. The lowest rate of emotional disturbance appears to be in people over sixty-five. Yet there are many thousands of individuals over forty-five, and indeed over sixty-five, for whom life remains a difficult inner struggle.

The statistics from the NIMH study reveal how very wide-spread personal psychological difficulties are. Given the degree of complexity of our mental, emotional, and spiritual makeup, this should be understandable, especially when we take into account twentieth-century stresses that wear us down. Caught up as most of us are in our jobs, families, and daily worries, we are unaware that, in a very real sense, mental and emotional health problems have assumed epidemic proportions. If you bear in mind how fearful our society encourages us to be of admitting such difficulties, you can perhaps imagine how substantial the "iceberg" of psychological suffering is: most of it lies below the waterline of public consciousness.

The NIMH study results should encourage you, if you suffer from personal emotional difficulties, to realize that you are not alone in the problems you face. Knowing that there are many good and fine individuals with very likely similar problems may urge you to take an honest look at where you are now and then to try to decide what changes may be helpful to you: where you want to go from here.

If you are fortunate, you may already be aware of the main things in you and in your life that bring you distress. If so, you are one step closer to being able to do something about them. Many of us, however, have become so clever and effective in denying what we really feel that we have lost touch with our true selves. Desires to repair an unhappy marriage are shelved while the children are growing up; the unrewarding nature of a job is ignored because priority is given to financial security; you may be unable or unwilling to face the pain you bring to yourself and others as a result of a drug- or alcohol-abuse habit.

In most cases, it is not possible to gain the motivation and means to solve a problem until you are willing to accept that there is a problem that needs to be solved.

Because of the blinding nature of the habits you may have established, and because of your defensive desires to disregard what disturbs the equilibrium of habit, it may be hard to acquire a clear picture of where you stand right now. Sometimes it can be useful to check with others: how do they see you?

A close friend of mine, after years in her profession, began rather suddenly to feel how unrewarding her job was, and she began to suspect that she may have hidden these feelings for a long time. She had maintained a regular, almost once-a-week exchange of letters with her mother for twelve years. She knew that her mother kept her letters, so she went to visit her and asked if she might skim through them, paying attention to comments she had made over the years about her work. It quickly became clear to her that, consistently, she had had only very negative things to say about her job. After skimming through dozens of letters written over a period of years, she became convinced of her real and enduring feelings and changed her line of work.

Such self-knowledge does not usually come this easily. We may pride ourselves on honesty, but there are few of us who permit ourselves self-honesty to any real degree. Existential-humanistic psychologists have paid much attention to these ways that we live "in bad faith"—each of us trying to be a person he or she really is not and denying the person he or she really is.

We live in a society that emphasizes conformity, "being somebody," gaining status and wealth and a good position—yet these values may not coincide with being true to ourselves. Parental influences can be strong, as can expectations from our spouses. We internalize many of these values so that it becomes difficult to see who we really are and what we really want from life and from our efforts.