Supporting Your Family And Marriage: Counseling For Comprehensive Care

Many of us go through life more or less on automatic, making the best choices we can based on the available information. It is only natural for us to want things to run as smoothly as possible. If we aren’t naturally prone to worry, it is easy to brush away concerns about physical symptoms as long as they aren’t too disruptive.

We may put off a physical examination, or ignore something that “isn’t that big a deal.” I have heard many people say they hate hospitals. It makes sense, then, that they would be resistant to a check up that might result in a trip to one.

If we can get past that resistance, and develop a healthy approach to our health care, we can make use of what’s available as appropriate and often get results that help us lead healthier happier lives. The very same can be said of mental health care. But even with all the normalization mental health in the media and schools, there is a lot of subliminal resistance to making use of it.

The Stigma Around Family and Marriage Counseling

It’s not surprising that people still have a negative view of mental health care. Forty years ago, a psychiatric hospital was referred to as “the booby hatch,” “bughouse,” and “funny farm” among other names, and I still hear those terms bandied about in social settings.

People with disorders are called “crazy,” “loony,” “nut job,” or “whacko.” Only in a room full of therapists would a woman screaming at her boyfriend be referred to with words like, “her anger seems to be escalating, which is interfering with her capacity to think clearly and retain an adult position.”

The stigma is never far from the back of our minds and it can cause us to dismiss a reasonable course of action regarding our mental health, and as above, prevent us from making use of what’s available in the hope of leading happier, healthier lives.

What Seems to be the Problem?

Again, many of us won’t go to a doctor unless we’re really sick. We do what we can to mitigate symptoms and hope it passes. So, too, with mental health problems. Depending on our presenting issue, there are any of a number of treatment options available.

For example, type “treatment for PTSD” in the Google search line and various facilities and treatment options show up. WebMD lists six different treatments for PTSD:

• Therapy
• Cognitive Processing Therapy
• Prolonged Exposure Therapy
• Eye Movement Desensitization and Reprocessing (EMDR)
• Stress Inoculation Training
• Medication

Similarly, with depression and anxiety. Type either of those into the search line and again you get facilities and descriptions of treatments. Borderline personality disorder, bipolar disorder, and on down the line; if you search on each of these and others will produce descriptions, symptoms, treatments and where to go for help.

If you have symptoms and aren’t sure about them, it is important to contact a mental health professional and set up an appointment to get a diagnosis. They will then either offer to treat you or refer you to someone who can. As with medical issues, it is important not to self-diagnose. Only with a proper diagnosis do you have a shot at getting the proper treatment.

When to Get Help

If you had congenitally bad knees but had learned to live with them, you might be inclined to forego physical therapy, even if the prognosis was better with the treatment. The fact that at some point one of the knees is likely to give out and lay you out on the sidewalk, or God forbid down the stairs, is an inconvenient possibility that for now, it seems easier to ignore.

If we saw a movie of someone behaving this way, we would likely think, “oh, that’s not smart,” or “that’s gonna come back and bite ‘em.” And still, we do it because it makes us uncomfortable to think about it enough to take action.

The same is true of emotional issues and trauma, whether from childhood or later. It can be very uncomfortable to focus on them long enough to begin to see change. If you have trauma in your past, unless you are simply wired to not be affected by it (and I’ve never met anyone who is), or you have had opportunity to process it with a sympathetic person outside a counseling context, at some point it is likely to “come back and bite you.”

If you have emotional trauma in your past, it is going to harm your relationships and usually get worse the longer you live. You may have great defenses that allow you to shrug off the unpleasant feelings when they come up, but they will interfere with your capacity to love, to experience joy, or to pursue life giving desires.

If there is persistent friction or unhappiness in your relationship with your child or your spouse, that is a good indicator that something is going on that it might be worth looking at. Sooner is better. The longer something negative is allowed to grow in a relationship, the more likely it is to get entrenched.

If you know you have a significant trauma narrative in your family of origin, the sooner you begin to address and process it, the better it will be for your loved ones. One of the kindest things you can do for your family is to do your emotional work. It takes courage and perseverance, but it can make a huge difference as you begin to move toward growth and health.

What’s Available

When we think about comprehensive healthcare, we may think about examinations, procedures, dentists, eye doctors, and a long list of specialists to deal with every specific aspect of our body and the health of it. Similarly, the mental health profession has a complex and varied array of options to deal with most aspects of mental health.

Community Mental Health Clinics

Your average community mental health clinic serves a broad range of patients, often with profound, recurring conditions or people who are short on resources and can’t afford anything else. Clinics may have beds available for short term stabilization on an as needed basis. This can be a reasonable option for someone who is low income or homeless.

Private Mental Health Clinics

Some private clinics serve a broad range of patients, but often are geared to a specific approach (managing addictions, for example), with a programmatic format, so patients cycle through in two to four weeks, and come out with enough stabilization and tools to keep moving forward in life. These can be very expensive but are sometimes covered by insurance.

Psychiatrists

These are medical doctors specializing in mental health. They get the same training as a medical doctor and have the letters M.D. after their names. They can counsel and perhaps, more importantly, prescribe medication if that is indicated. They are expensive but often covered all or in part by most major medical health plans.

Psychologists

These are non-medical doctors, with a broad range of specialties from research to testing to counseling, depending on where they trained and what kind of degree they have.

Typically if you need a specific kind of evaluation or treatment of a more scientific variety, you may end up with a referral to a psychologist. They too are expensive, but also often covered all or in part by most major medical health plans.

Therapists

This covers the whole gamut of mental health counselors, some of them doctors, many of them with Master’s degrees, operating in all the methodologies, such as Freudian analysis, Jungian, Kleinian, Gestalt, and a host of other therapies, dealing with the mind and the mind/body connection.

Of particular interest for the purposes of this article are Family and Marriage Counseling therapists, and therapists who work with adolescents and children. These are the professionals you see when you need help solving emotional issues in your most important relationships, including your relationship with yourself.

Comprehensive (Lifecycle) Care

If you think about medical care in a lifecycle context, you might imagine your mother, pregnant with you, seeing her obstetrician. Then you are born, and after the obstetrician, you make intermittent trips to a family doctor or pediatrician.

As you grow, say you develop bunions so you seek out a podiatrist, and myopia so you seek out an ophthalmologist. In your late teens you see a dermatologist and then a surgeon to have a non-cancerous growth removed. Fast forward to starting your own family, and the cycle begins again with your children. And on it goes.

Now, imagine the same lifecycle from the perspective of mental health. At the age of two, you still aren’t talking, so your parents take you to a speech pathologist. At the age of six, you keep getting into fights at school, so you see a counselor.

When you are eight years old, you start having trouble with reading, see a child psychiatrist and with some testing help from a psychologist, are diagnosed with ADD.

In your teens, you struggle with depression and see a therapist. When you meet the person you want to marry, you go for premarital counseling.

A few years into your marriage, things get rocky and you go in for marriage counseling. A couple of years into marriage counseling, you realize you have significant trauma from your family of origin, so you decide to get into individual therapy.

As part of your individual therapy, you realize you have some PTSD, so you find a therapist who can do EMDR (Eye Movement Desensitization and Reprocessing) to give you some relief from the impact of the traumatic memories.

In your thirties, your teenage son becomes unmanageable, and you know it’s not just hormones, so you go with him to see a family therapist to try and restore the relationship.

In your forties, someone dear to you passes and you can’t shake it, so you go in for grief counseling. The grief counselor encounters some deeper unresolved issues and refers you to another therapist to process those issues.

In your early fifties, you have a bit of a midlife crisis and can’t figure out what to do next, so you see a counselor for some guidance to help you understand what you want and how to go after it.

In your mid-fifties, you have a falling out with your oldest child and can’t repair it, so you go together to see a counselor who specializes in estrangement.

In your late sixties, you are struggling with all of the nuisances that go along with getting old and approaching mortality, and you go to a therapist who specializes in phase-of-life and end-of-life issues.

As you can see from this lifecycle view of mental health services, there are many ways to intersect with people who can help you along the way, and this is only one example. If you have or think you may have, a mental health issue, you can always start with the internet to get some general ideas about what kind of professional to talk to.

The important thing is to see a professional to get an actual diagnosis. Don’t worry about “getting it right” the first time. If you talk to someone about your problem and it is outside the scope of their expertise or practice, they will refer you to someone who can help, or at least point you in the right direction. Most mental health issues do not get better with time, so it is not a good idea to just ignore them and hope they will go away.

Good self care means acknowledging we think we may have a problem and actually doing something about it. If you have been ignoring something or thinking “I should do something about that someday” put it on a list or your schedule to research the issue, or schedule an initial consultation with a mental health professional to get a diagnosis.

You may discover things are not as bad as you feared, or you may start down a path toward health, or at least learn to manage things better as they are. The journey toward growth and health begins with a first step.