| A colleague of mine once conducted an initial interview with a woman of
about 35 who was very unclear about her reasons for seeking help. She vaguely
stated that she was unhappy with her weight (although she was not particularly
overweight) and equally vaguely stated that she was dissatisfied with her
marriage. In her second session, she continued to complain but could not say why
she was coming to therapy and what she really wanted. She did not show up for
her third session and my colleague called her to remind her of her appointment
and to ask why she had not shown up. She stated matter-of-factly that she could
not come to therapy any more. When my colleague asked her why not she said, "I
have too many personal problems." My colleague never
saw her again and never did figure out why she came to therapy!
The first step in understanding how therapy works is to understand why people
choose to seek help from professionals. Obviously, people come because they have
problems which they believe can be helped by treatment. People suffering
from depression, panic attacks, painful marriages, divorce, abuse, problems with
their children, grief, and hundreds of other problems
come seeking the advice and insight of a trained professional to help them
understand their difficulties and to get rid of them. But obviously not everyone
who has these kinds of problems comes to therapy. Why do some people come for
help for these kinds of problems and others stay away? Why do some people who
are suffering severely refuse to get help while others who are
suffering relatively minor problems come seeking relief?
People come to therapy for four basic reasons:
1. they are in psychological pain which has recently been intensified by a
crisis
2. they have a sense of responsibility that they need to do something about
their pain
3. they see the opportunity for help, and
4. they have hope that they can get better.
PAIN
People come to therapy because they are suffering. They are in pain and they
believe that their pain has a mental, emotional, or behavioral cause.
Obviously, they don't come to a therapist if they have a sore throat or a broken
finger, they come if they have just discovered that their husband is having an
affair, they come if they have just spent the past week in bed because they are
too depressed to get out of it, and they come because they are too afraid to
drive across a bridge they have driven across hundreds of times. Clients come to
treatment for thousands of reasons but all of them come because they are in
pain. Psychological pain is a necessary condition for treatment.
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