Why Patients Deserve Special Respect


The stigma of mental illness lingers despite the carloads of Xanax-filled vials in the pockets and purses of America. The notion of life as an easily mastered enterprise persists. When the going gets tough, the tough get going — so we are told. Those who cannot, by force of will, get through difficult events unaided are thought to lack the right stuff.

I disagree. There is a quiet heroism in admitting you need help. Opening yourself to a stranger requires courage.  Awareness of your limitations is humbling. If all this were easy, therapists would observe lines leading to our turnstiled offices. Traffic pile-ups would slow the route.

Don’t get the wrong idea. The people who seek treatment are indistinguishable from everyone else. They range from rich, famous, and gorgeous to a more unremarkable lot. They are your neighbor and your friend. They might have been you and they may yet be you.

The best of them are willing to do anything to change their lives. They risk, cry, and expose their naked psyche. They meditate, think, try new behaviors and revisit old ones. They confront themselves in the darkness.

They look in the mirror for reasons beyond hair arrangement and shaving.

You may say you’ve been through worse than they and came out better, all without the crutch of psychotherapy or medication. Can you be certain? There is no calculus to compute your pain and measure your suffering against others. When you invent one call me, for then you can say you did it all alone, by the superior force of your will against the greatest odds.

Those faced with severe anxiety or mood disorders know things too terrible for words: endless sleep disturbance, perpetual unease, and (in the case of depression) minute-by-minute misery fraying the cord binding them to life.

You would not want to feel as they do if you could, and if you could the experience would not be as you imagined. You’d live inside of a monster who lives inside of you, consuming joy until your former self is gnawed away. Living the experience would lead you to repent any prior judgment, but shame might mute your apology. When patients choose to live and fight in spite of their calamity, the rest of us can only bow before them. To heap scorn on those souls who display courage even they themselves doubted adds to their misery. The crowd owes them encouragement instead. We diminish ourselves by withholding it.

Judgement, however, is hard to escape. A young married man who was a therapy-virgin told me he thought unfaithful males are weak in their lack of resistance to temptation. Yet he had never been severely tempted by a woman to whom he was drawn since his wedding; never had to turn from the scent, sensuality, and softness of another with seduction in her eyes. His thoughts on the subject were largely abstract and observational. What value might one give his opinion? No more, I suspect, than the rest of us when we say, “I would have done that” or “He shouldn’t do this” as we witness the battlefield of life from a safe distance, like the chest-beating bravado of old men who send young men and women to war.

The same gentleman, by the way, was a brilliant extemporaneous public speaker, but struggled to make a phone call. We are frail creatures, no? A lack of experience in counseling, like other opportunities one hasn’t had, puts negative judgment on a slippery slope to irrelevance.

Among those who think therapy deserves its stigma are at least a few who choose another way of living, less heroic than they think. There you will note plenty of avoidance, alcohol use, nightly marijuana trances. Some of their marriages are endured rather than enjoyed. You will discover those with few friends and jobs they wish were better. Anger and depression reside among them disguised. In other words, their lives are not so different than those of the pilgrims to the counselor’s office, except …

People who search for a therapeutic remedy face the imperfection not only in themselves, but in life. They tend not to live with the illusion that faith, by itself, will transform this mortal coil and their place in it, even if they await a more distant reward.

Perhaps most admirable of all, the most dedicated clients wish to learn: to do new things, explore the psyche, reexamine their past, and travel to the unnamed, undiscovered country. They are discontented with their present life and the majority wish to move beyond blame — though blame they may — and take responsibility for change.

Winston Churchill said that “Democracy is the worst form of government, except for all the others.” Maybe therapy is like that: the worst remedy for unhappiness, except for doing nothing; a painful attempt to face the truth and reorder your existence, modify relationships, and pour yourself into a vessel on which you’ve written: “This has value. This is worth my best effort.”

If you find a better way, let me know. Until that time, hats off to those who take Socrates to heart: “The unexamined life is not worth living.”

The top photo is called A Life of Theater Photo: Sadness –Final Chapter. It is the work of Gabriel S. Delgado C. and sourced from Wikimedia Commons.