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"It's about my husband…"

19/2/2010

 
The female voice on the phone sounded very distressed. A wife, who was very worried that her husband, very depressed since having been made redundant six months ago, was getting worse and going to do something "crazy". I tried to calm her down, and asked for some more information.

This happens, from time to time. I get contacted by people who act on behalf of someone else. They are very worried about a relative, friend or significant other, and try to find some help. Sometimes they just ask me if I can prescribe medication, or want specific medical advice. If this is the case, I refer them to the person's GP.

More often, however, the call is a call of concern. Like this distressed wife, they call because they are worried that someone close to them is feeling down, is neglecting themselves, is depressed or just very unhappy.
When I receive such calls I usually try to find a bit more about the person in question, including what exactly was it that made the concerned caller decide to seek help now –rather than earlier or later. Usually there has been something that alarmed them, and it appears that there is indeed some urgency.

There was some urgency in the case of this distressed wife's husband, and she was eager to do something. "So, do you suggest we do? Can we book an appointment? Or could you perhaps call him to speak to him yourself?"

Disappointingly, when I am met with such request I answer in the negative. "You see", I try to explain, "it is not that I don't share your concern. But it is not enough that we agree, me and you, you’re your husband needs help. He needs to agree as well."

This is very true in general, but even more so when we consider psychotherapy. Psychotherapy is not something that happens to you, is not a treatment that can be applied to you even if you don't want it.

Is not like physiotherapy, to use an example. You can have physiotherapy even if you don’t think you need it or if you think that it doesn’t do anything; you only need to stand still and let the physiotherapist do their thing.

Not so with psychotherapy. The most important step in psychotherapy is the one, one takes, when they decide that they need to do something about their suffering. They might come to the realization that they have postponed action for much too long; or they might feel that this time they cannot deal with it alone. Whatever the route that brings them to psychotherapy, it is a personal route, not one that they can be made to take.

Sometimes, it's true, people can be hesitantly convinced to see someone. They begin to talk, and, to their great surprise, they find that talking gives them some relief. This, however, is an exception. When there is no personal desire to get on with the work, therapy fails before it even begins.

It is for this reason that I said what I said to this worried wife:

"Thank you for sharing your concerns with me", I told her. "From what you say it seems that your husband is going through a very difficult time. Psychotherapy would possibly help him. But he needs to decide that himself. He needs to want to be helped. Please speak to him, explain to him your concerns, and give him my contact details. If he doesn’t want to call, there is little I can do."

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    This is the blog of
    Christos Tombras
    a psychoanalyst practising
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