6 Reasons More People Don’t Seek Therapy

Therapy (counseling, psychotherapy — often all used interchangeably) can be understood as both beginning with and moving toward increasing degrees of self-knowledge (though it’s also about feelings and behaviors). A person who comes to therapy, on some level, knows there is a problem and believes if they can come to understand it better, they can perhaps handle it better. This requires at least some insight, or self-knowledge.

So what keeps more people from going to therapy?

Many people think they are “fine”

“Fine” used in this context (and most contexts) is a word that is essentially meaningless because it is circular. Ask someone why they don’t get therapy and they’ll often say, “Because I’m fine.” Then ask what it means to be fine and they’ll usually give you some version of, “It means I don’t need therapy.”

But this certainly isn’t the only explanation.

Discomfort with inner work

Many people spend their lives specifically trying not to think about thoughts and feelings that are unpleasant, and unpleasant thoughts and feelings essentially are where the best therapeutic work actually happens.

So, of course, they are “fine.” When they do show up to therapy (often because of a court order or ultimatum from a spouse or other loved one), as soon as the therapist inquires about what might be sustaining and perpetuating their problems, they feel defensive, even violated.

“What? Defensive? I’m not defensive, you’re the one that’s defensive!”

This is often because they had no intention to begin with of actually engaging in the work. As a couples therapist I see this frequently because often one person wants therapy and believes there is a problem in the relationship and the other person most certainly does not want therapy and believes the only problem is that their partner thinks there’s a problem. If only the other partner knew how fine the relationship really was, that partner would be fine, and then everything would be just fine.

Some people don’t trust counselors

Some people will tell you therapists are all nutjobs with a need to control other people and tell them how to live. (Nearly all of these people are, of course, fine!) Of course, some therapists are “nutjobs” with a need to tell people how to live, but that’s probably a different post.

Fear

Others avoid therapy out of fear. They know they have work to do like anyone else, but perhaps they have read a few self-help books or talked to a friend who is in therapy, and they know if they go to therapy they’ll have to eventually face the person they are most afraid of — themselves.

Trauma

And of course various types of trauma can keep people out of therapy as well, since trauma is a state of not being able to accept what you most need. These are folks who will tell you they most definitely are not fine. They’re not playing that head game with themselves, they are just frozen, terrified of the vulnerability therapy requires, which may begin the moment you google therapists in your zip code.

Vulnerability

This is why therapists really respect the people who show up in front of us. They are obviously struggling with something to begin with, and still summon the courage to find us, make contact, go through our onboarding process, and show up with some degree of readiness to look closely at themselves. And actually give us money for leading them through the process!

Certainly everyone could benefit from therapy, and certainly not nearly enough people are willing/able to do it. But it takes a lot to show up in front of a trained expert in human behavior and say, “Help me. Teach me. Show me. Care about me. Walk with me.”

Perhaps we should be marveling at how many people actually do it in the first place. It’s really a beautiful thing.

Not Being Fine Is Fine

But for people who think they are “fine,” few things are scarier than the idea of finding out you’re not really fine.

But of course nobody’s fine.

And that’s fine!

But a lot of people still don’t know it’s fine to not be fine. Of course people learn this in therapy, but if you’re fine and don’t need therapy because therapy is for people who aren’t fine, then you will see no need for therapy.

And ultimately, that has to be fine too.

Everyone needs to sense that tug and respond to it in their own due time, if and when they are ready.

Follow-up, 9/15/2021

A follower read this post and responded suggesting some who don’t seek therapy don’t seek therapy precisely because they had previously sought therapy and ended up with a counselor who was not the right fit for them. She noted it can be hard to hang in there through one intake after another to try to find the right therapist. I have faced this challenge myself in finding a good counselor and it is indeed both difficult and discouraging.