Why Loved Ones Refuse Therapy and What to Do About It

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You’ve tried — with your friend, your spouse, your adult child. You made the case for counseling. Some hem, some haw, some say they will, but don’t. Others just refuse.

Why?

A few reasons to consider and what you might do about it:

  • Stranger danger. Suspicion of strangers is deeply rooted in the human race, derived from our primitive beginnings and ever-present con-artists. Your friend’s personal experience of betrayal may be a key factor.
  • Saving face. Much in life depends on reputation. How many of our parents admonished us to hide the family secrets and “be sure you don’t tell the neighbors!” Men, in particular, want to project strength, the better to succeed in the world of work and win a desirable spouse.
  • The doctor doesn’t care. He is only in it for the money and measures his patients’ value by the size of their bankroll. Should counselors then give treatment away and make their living after hours by standing on street corners with hat in hand?
  • I’m afraid my employer will find out. I can’t risk it. If you use insurance, the insurer will know your diagnosis, as will every such company in the linked system. They are not supposed to reveal anything to your employer. However, if you work for someone with few employees and his premiums go up the next year … ?
  • Therapy is for the weak, a crutch for the spineless. A therapist argues instead that facing your demons and working to change are signs of strength, not evidence of frailty: an indication of courage, not its absence.
  • I don’t believe in the value of looking back. Sometimes therapy doesn’t require it, but a historical evaluation can remove the bolder from your backpack and allow you to move ahead with pace. On the other hand, baseball’s Satchel Paige said, “Don’t look back, something might be gaining on you!”
  • Emotional pain. Whatever reasons are given, the prospective client can be unconsciously timorous at opening painful issues — digging up a grave bursting with undead horrors of the heart and memory.
  • I’m a logical person, not into feelings. I can solve this logically. Such statements are uttered most often by those who aren’t as logical as they think.
  • A real man does things, he doesn’t talk about them. But what if he doesn’t know what to do after trying everything?
  • Fear of change. Most of us find discomfort in new challenges, in or out of treatment. Yet change can’t be avoided unless you want to wear the same clothes in the same size and color the rest of your life; and continue to travel to the same job site even after your employer bars the door.
  • Fear of the mystery. The counseling office is a bit like the inner sanctum of a haunted house — a place of strange rites and secrets, incense and shadow play, frequented by the ghost of Sigmund Freud. The person who wants control will find few guideposts. Will a wizard cast a magic spell on him?
  • Fear of medication or hospitalization. Though you can’t be forced to take meds as a rule, some are terrified they might hear the doctor recommend it — or worse, a hospital stay.

What’s to be done? I received calls from spouses who wanted to make an appointment for their mate. This is rarely useful. If the individual lacks the courage or motivation to seek treatment himself, the likelihood of his appearance at the appointment is a coin flip at best.

Begging and pleading have their limits, too. The more you push, the more therapy becomes your agenda, not the person you care about. You own it, he doesn’t want to buy it. The more you pester or threaten, the faster he runs. If he does attend a session, his motive is to placate you, not heal himself.

Sometimes it helps to enlist the persuasive talents of one who is respected by the prospective patient: a clergyman, best friend, or close relative. The danger here, however, is an unauthorized revelation to a third-party interpreted as a breach of trust. A similar risk occurs when you plan an “intervention:” getting several friends and family members together to encourage and explain their concern to the doubtful potential client. This technique is more often used with alcohol and drug abuse problems, and is easier to rationalize when the person’s life is out of control and in danger.

I am not speaking here of people who are at risk of harming themselves or others. Thus, legal remedies to force the issue are not available. If your steady expression of loving concern cannot turn the tide, waiting might be the only alternative. The accumulation of pain perhaps will do what you can’t.

You are left in a difficult situation: straining your patience when everything in you wants to scream.

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Most of us spend a good part of our lives wishing others were different: more loving, kinder, attentive to us in a way rarely offered; with an intensity and compassion that finally permits the auditor to “get us.” We want the love of this one, the respect of that one, and wish another would take our words to heart. We think and plot about attracting the dark stranger, selling the human product (ourselves), and winning the vote of the crowd.

The good news here is the presence of one person we tend to ignore. While we work on others to change, he remains in the shadows. We don’t need to run after him, persuade him, make an appointment to meet six weeks in advance, and cause his face to turn in our direction. His visage greets us in the mirror every morning.

When others resist our efforts to influence them we are left to change what we can about ourselves — what we may and what we must: our attitude, emotions, and reactions to the one who refuses treatment — and to the rest of life as well.  The transformation begins whenever we want. The process of self-modification can persist as long as we live. Unlike changing the loved one, however, the necessary alterations are in our hands.

The most important opportunities in life sometimes have been there all along. We wait for the other to wake up while what is changeable in ourselves awaits its own awakening. Imagine standing at a crossroads: one path leads to a darkling state of perpetual hope or desperate preoccupation with a person you can’t control. You pass the time alternately gnashing your teeth or imagining what life might be like if only he changes. The other road directs you to a house of natural light and mirrors revealing all sides of the one human you do control. This workshop evokes the hard work of the master sculptor in everyone, the painstaking job of reshaping our basic stuff.

Become your own work of art.

050613102055--Bristol RWA gallery starting point for Festival of Stone Sculpture Trail

The second image is a Ladies Watch Case photographed by Zeigerpaar and sourced from Wikimedia Commons. The bottom photo comes from the Bristol RA Gallery Festival of Stone Sculpture.

 

Getting to Know You: On the Difficulty of Making Close Friends

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What happens when the wish to be known conflicts with the fear of being known?

Why is it that we so desire someone — someone — to know everything there is about our story and then say, “It’s OK. I’m still lucky to have you as a friend.”

Does anyone know you in this way?

Do you know anyone in this way?

It took several years before one university professor friend told me about “doing time” in a federal prison. This friend is, I must add, as fine and decent a person as I know.

The individual took a risk in the disclosure, hoping (based on knowledge of me acquired over long experience) that I would not summarily judge or reject. I felt privileged and grateful that my acquaintance would tell me this; and this kind soul was, I think, equally pleased that I reacted in the way that I did.

It only made us closer.

But the question is, how did we get there? Get to the point where a risk like that could be taken: a depth of knowledge, confidence, and intimacy.

Both psychological research and ancient philosophy tell us that nothing will make you happier than friendship.

“The factor found to be most important for subjective well-being is that of social relationships with family, friends, and others,” reports Sissela Bok in Exploring Happiness. And ideally, these relationships are not just the superficial kind, but those that go beyond “How about those Cubs?” and “Hasn’t the weather been great” and conversation about cars and shopping and business.

Like the kind I have with the friend just mentioned. The kind you rely upon when the rawness, ridicule, and roundhouse punches of life get to you.

Most who obtain such companions find it enormously gratifying to be “fully known” (warts and all) and still valued and cared about by another: someone who helps you to feel less alone in the world and more alive to what it offers.

So maybe a few tips are in order as I discuss the challenge that achieving this kind of closeness presents.

The most intimate platonic relationships are obtained by a kind of emotional strip tease; a denuding that substitutes the removal of personal defenses for the clothing that is taken off by the exotic dancer.

Like the seven veils worn by Salome in her biblically recounted dance, each veil falls to the ground one at a time. What is left at the end is almost complete openness — nothing hidden, nothing protected — a state close to total vulnerability to the other person (who you hope has moved in-synch with you and will not take advantage of your unguarded state).

There is certainly danger here, my friend.

James Baldwin described the dilemma as a sort of love without love-making:

Love takes off the masks we fear that we cannot live without and know we cannot live within.

Some never get over that fear and keep vulnerabilities protected behind a screen of surface calm and unblemished “appearance.” Call them “masks” or veils or armor, these coverings keep us “safe,” but keep us alone.

Until you give up that safety, you can never answer the questions, “What if he knew? What would he think of me then?”

And if you worry about those answers, how can you ever be self-confident?

Unless you are enormously self-assured, unguarded, and out-going, there is a journey from strange to familiar, from casual acquaintance to close friend; an emotional distance that must be traveled.

In the days of trench warfare, there was an expression known as “going over the top,” which meant coming out of the protected cover of your army’s dug-in, underground position to make an assault on the equally defended emplacement of the enemy. To do this, you  entered “no-man’s land,” the several yard’s between the two trenches, where you were exposed and open to fire.

For more people than you might think, taking the social risks needed for true friendship feels a little like this.

Some part of it can go back to messages learned at home. “Don’t tell the neighbors” is an expression that informs you there is something to be ashamed of and that the people “out there” will take advantage of one’s household secrets.

Of course, they just might.

Some languages even use words to institutionalize and formalize the distance between two people. The German words “Sie” and “du” both mean “you” in English. The first is used for formal relationships, people with whom you are not intimate. Should this barrier be overcome, there is a tradition that goes back to the middle ages to commemorate your new closeness. It involves a mini-celebration toasted with alcohol called “Brüderschaft trinken;” becoming “brotherly,” in effect, so that you are permitted to use “du” to refer to one another.

You can be married to someone, but not really know your partner. You can be sexually intimate and wildly uninhibited when the clothes are off, but much more “closed-off” when you dress up again.

You know all the fears: of being cast-away, condemned, cut-off and criticized — a loss of power and control in the relationship with the possibility that others will harm you.

We worry that “fair weather friends” won’t stand with us, for us, and by us when the going gets tough. We tremble at the thought of “friends of convenience” who can’t be bothered to give us nearly as much as they get from us. We dread the possibility that our “friend” will share our secrets with others and betray our trust. Or that the friend will ask for our money in such a way that we cannot say “no,” but never pay it back.

We choose between the risk of being hurt by others on one side vs. quietly hurting ourselves in the self-imposed isolation of the other side; a depth of loneliness that sometimes makes physical pain seem preferable.

Friendship of any kind usually starts with shared experience or small talk. Taking the same bus every day, going to the same classes, working for the same boss on the same projects, we begin to chat about what we do and what we see.

If this is difficult for you and you “don’t know what to say,” consider a few of these topics:

  • Where do you live?
  • Where did you go to school?
  • What movies or TV programs do you watch?
  • Do you have any hobbies or play any sports?
  • What music do you like?

Music is a kind of proxy topic. It stands in for those probing questions that might determine whether you share the same sentiments or the same view of life. The early stages of a relationship represent a kind of feeling-out in which the two people are both passing the time and attempting so see whether they have much in common. Some go so far as to make lists of things to talk about; not a bad idea if you are a bit unsure.

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The next stage usually takes the pair to the possibility of some shared activity. Coffee? Dinner? A ball game? A concert? Shopping? It can be as simple as time together giving someone a ride. Of course, there is the risk that he is too busy for another relationship or doesn’t want your company.

No risk, no reward.

Some people prefer (or find it less threatening) to be part of a group rather than one-on-one in the early stage of making someone’s acquaintance. That’s fine, of course, but if you really want to get below the surface you’ll need to spend some time alone with the person.

If you have a significant other, convention can dictate that you meet new (or even old) friends in groups of four or more — couples with couples. But unless all four of you know each other awfully well or are unusually open, group topics tend to stay on the surface of things, revealing little that is personal or private; in other words, little that you would reveal only to a close friend.

Finally, by intent or by magic, you can reach a point where you begin to reveal more about yourself and ask more about your new friend. Things like the kind of family you come from, past romances, job problems, a history of therapy, religious and political views.

You also begin to rely on the other to do what he says he will do, show up to help you move to a new residence, help solve a problem, lend you a small amount of money to pay for dinner or visa versa. You will notice if he pays attention to you and helps you fit into any new group of which he is already a part.

If these “tests” are passed, you just might have a new friend worthy of the name.

The revelations don’t always come at once. Usually, dropping your guard takes time. You wonder whether the “other” will “understand,” treat your concerns with respect, “be there” when you need him.

And then there are those revelations that wait decades to occur. I was recently told the story of two childhood friends who had lost touch and lived on opposite coasts. Keeping to the family requirements as most children do, they’d never shared the troubling things that had happened in their homes. Instead, their contact was based on playing together, going to parties, talking about school, and so forth.

Meeting again at a class reunion, one caught the other’s eye and they quickly embraced.

Then, without any preceding word, the first woman spoke the thing that she’d been told never to say.

“I was adopted.”

It was something she knew even as a child, but was forbidden to utter. Only now, it had become the thing that needed to be said to close the distance of time and disunion.

What do you call this?

Catching up, for sure.

But I’d call it a new start — a deeper start — to an old friendship.

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The top 2008 image is called Two Friends by fotoguru.it. The second picture is entitled Friendship by “Nina, from Australia.” The bottom photo is called Friendship by “Gideon, from Paris, France.” All are sourced from Wikimedia Commons.