Dear Therapist:

I'm a 21-year-old girl currently in shidduchim. I occasionally face mild anxiety and believe that seeking therapy could be beneficial for addressing and managing it, or gaining helpful tips. Thankfully, I am currently managing well, but I sense that further improvement is possible through therapeutic work. However, during this phase of life, there is some societal resistance to the idea of seeking therapy—it's not widely accepted, and there is a certain stigma associated with it. Given the associated costs of therapy and my current state of well-being, I'm uncertain if it's worth investing in at this point. What are your thoughts on whether pursuing therapy now would be beneficial, considering the existing stigma and financial considerations, given that I'm currently doing okay?

Response:

There are a number of aspects to your question. I will try and address each one. Although I will not directly answer your question, my responses will hopefully give you clarity, and help you to answer the question yourself.

You mention that you have occasional mild anxiety. I don’t know what you consider to be mild; nor do I know what you mean by occasional. I also don’t know the circumstances, the duration, or the ways in which you deal with anxiety.

One scenario would have you feeling a bit overwhelmed when you are dealing with a number of problematic issues at once. When this occurs, on average once a year, you have a bit of trouble focusing, but you work through it and are able to deal with these issues. It takes a couple of days for you to feel that the issues are being appropriately handled, and the anxiety steadily decreases. A few days later, you no longer feel anxious. In recent situations, you find yourself better able to deal with your anxiety than in the past.

In another scenario, you would feel worried and afraid at apparently random times. It is always difficult for you to put you finger on what is bothering you, and this makes the anxiety increase. This has been occurring more often, and your feelings of anxiety are becoming more difficult to handle and take longer to resolve. You find yourself becoming more overwhelmed by your emotions and feel more hopeless with each occurrence.

Clearly, these two scenarios are very different. The first one essentially describes a normal response to an overwhelming confluence of events, while the second one portrays a person who suffers from periodic anxiety. I don’t know how similar your situation is to one or the other. The need for professional help would depend largely on this.

With regard to the stigma associated with therapy, I wonder whether your concern is pragmatic or emotional. I wonder whether the stigma is associated with actual societal concerns (like dating) or with your own feelings of what it would mean for you to be “in therapy.”

I don’t know what your specific community is like, and how the average person in the community views therapy. Is there truly a stigma that could negatively affect you? I know that in many communities, therapy is considered to be normal. It is seen as a resource that can help people who might otherwise suffer in silence, never truly resolving troublesome emotions. In other communities, there may still be something of a stigma. I believe, however, that in almost all communities this stigma is very much watered down and mitigated by education and a better understanding about the therapy process. About one third of Americans have seen a therapist. (Of course this does not include those who suffer from a mental health issue but have not seen a therapist.) By definition, “normal” relates to the percentage of the population involved. Based on this, going to therapy is quite normal.

You also mentioned the fact that you are currently not anxious. You wonder, therefore, whether it makes sense to see a therapist at this point. I could make the argument that this is the perfect time to see someone. The tendency is for people to deal with a problem when it rears its ugly head. Unfortunately, that is usually the time during which they are least prepared to handle it.

The inclination seems to make sense. It’s bad enough that I feel anxious at times. Why would I want to rock the boat now when I feel fine? This occurs in marriage as well. When the relationship is on the rocks, the couple scrambles to seek help. However, since tempers and emotions are high, it can be difficult to address problems in a rational manner. It can be difficult for the couple to follow guidelines and to practice strategies. Similarly, when anxious the efficacy of the therapy process can be hampered. Often, the best time to seek therapy is when you are doing well.

The goal of therapy is not to make the person feel better. Rather, it is to help the person to identify problematic emotional, cognitive, and behavioral processes and to aid them in changing these. This is best done with a clear head, without the disadvantage of troublesome emotions.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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