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

by Steven J. Bartlett

REALISM: A GOOD BEGINNING

In order to identify one or more therapies that may be most promising in relation to your goals, your problems, and the kind of person you understand yourself to be, you must begin your search with a good measure of realism.

SETTING GOALS

It can be very difficult for anyone who is seriously troubled to think clearly and use good judgment. You may find it hard, perhaps impossible, at this time to identify your goals. You may feel confused, anxious, depressed, and not know why you feel that way. Even so, you will find as you read on that you can set important goals for yourself.

If you are at a loss and have no sense of purpose, that fact gives you a goal to work toward in therapy: to develop clearly thought-out goals. Though you may not know what precipitated your feelings of confusion, anxiety, or depression, you at least know that you feel confused, anxious, or depressed, and you will find recommendations in this chapter on how to find appropriate help for your suffering. Do not judge yourself harshly if you lack a sense of direction or if you are troubled but do not know why. Just keep reading.

OPENING YOURSELF TO CHANGE

There is a second thing you should be realistic about when you do know what you want and what your problems are. Our experiences and what we learn about ourselves change us. If you enter therapy based on your present perceptions of yourself, it is likely that these are going to change to some extent as a result of your experiences in therapy. Does that mean that you cannot plan or select a therapy intelligently? Clearly, it doesn't. Everyone has to start where he or she is. There is no other choice. But you should try to persuade yourself to be open to changes in your views and feelings. If you feel rigid about your own perceptions of yourself, it is just possible that your rigidity may be contributing to the problems you want to resolve. As in any attempt to learn or to change, it is important periodically to reevaluate your needs, values, and the results you may have achieved so far. If you select a therapy using the structured approach in this chapter, you may decide to retrace your footsteps a few months in the future. You may find that you would take a different path in the light of what you then see.

BEING HONEST ABOUT YOURSELF

There is a third piece of realism that I would like you to consider, and this is very hard for anyone to take to heart. If you can, you are a very unusual person. Answering the following questions honestly takes some real courage. But you must ask yourself: "To what extent do I need my present symptoms? Is it useful to me not to have a sense of direction? Am I somehow benefiting from feeling depressed? Is my anxiety helpful to me in some way?"

You may think these suggestions are no more than contrived and unkind psychologizing. After all, who chooses to suffer? Does anyone want to wake up at 4:00 A.M. shaking and crying? Yet, again and again, therapists who care very much about their patients find that many of them "cling to their symptoms with the desperation of a drowning man hanging onto a raft."[[1]]