Q:
My best friend, love of my life, a very important person for me right now, will not go to therapy. She is a deeply emotional person and really struggles to communicate her feelings and needs until she is literally hurting the people around her, including me. I really want to keep my relationship with her in the long term, but it’s really hard to hear her talking about these big personal and relational issues that she should really be talking about with a therapist. I encourage her to look for a therapist every time we call on the phone (about once a week). I’ve even sent her reference lists. She knows that I go and have been going and that it has saved my life. She tells me she admires my ability to be open and articulate about my feelings–I tell her I learned it in therapy. To be honest, she’s a little self-destructive and can be exhausting to care so much about, even though she’s working really hard. I feel like she needs to work some stuff out for herself with a little professional help. She had a bad therapist experience early on and is really slow-moving about it. Is there a way to get her to understand? A life-changing book I could buy her? Or do I just need to let it go? Or keep gently pushing? If she’s really not addressing some of her issues, do I need to maybe take a break from being her friend? Or give up completely?
A:
Here is the good news—your best friend does have a therapist! Here is the bad news—that therapist is you, a person who did not sign up for this job, is not equipped for it, and is not being compensated for it! This is a challenging situation, so give yourself a little pat on the back for working so hard to be available to this person who means so much to you.
The first thing you need to do is figure out what kind of boundaries you want to set in this relationship. You have done a remarkable job of gently pushing your friend in the direction of therapy, and I don’t think you need to stop doing that. You are right that you won’t be the person who decides if she goes to therapy; she is the only person who can make that choice. The choice you do get to make is how much you are available for these conversations. You have said that she is literally hurting the people around her, including yourself. It does not make you a bad friend or a bad person to want her to stop this behavior, for your relationships sake and the sake of her relationships with others. Your weekly phone calls should be about more than the issues she is working through. You are a person in this relationship too— you get to ask for the things you need.
Take a breath. Think about what you want. Think about the kind of relationship you want to have with your best friend, think about what it would look like in practice. Maybe you do need a break from your weekly calls, just for a little while. Or maybe you want to keep up those check ins, but you want to place some limits around how much of those conversations can be about her personal and relationship issues.
Then—this is the crucial part—you have to talk about this with your best friend. So often we create lines in the sand for people’s behavior and tell ourselves that if those lines are crossed, we are moving on from the relationship. But we rarely communicate that to the person in question, which is helpful for…exactly no one! So you need to have a conversation with your friend wherein you tell her what you need from her to keep this friendship so it is beneficial for the both of you. This is probably another good time to gently push her towards a professional. If you want to revisit that reference list with her, maybe you can offer to help her draft an inquiry email to some of the therapists on that list. If you don’t have the space or mental energy for that right now, that’s fine! You can be focused on your needs during this conversation. It doesn’t sound like there has been much space for you in this friendship lately, and this is your chance to make some.
I can’t promise this conversation will be an easy one to have, or that your friend will hear this and not be hurt. Hopefully she will understand that you want the best for her, but if she isn’t in a great place right now, it’s possible she will hear this as you choosing to not support her. That doesn’t mean that you are a bad friend, or that you are in the wrong to ask for what you need. I believe in your friendship, and I hope you do too.
You can chime in with your advice in the comments and submit your own questions any time.
The absolute best thing you can do, aside from setting whatever boundaries you need to make this friendship sustainable for you, is to continue talking about your experiences with mental healthcare in a way that normalizes them. Think, “I had the best session this week, I feel so much better after sorting some things out about x” or “So glad I have therapy tomorrow, it’s been a hell of a week.”
I finally got my best friend and former roommate into therapy after three years of chipping away at her about it. Unfortunately, it was in the context of a crisis situation and involved an ER visit; fortunately, it could have been a lot worse. She had also had bad early experiences and internalized some stigma around seeking help. I hate that it had to get as bad as it did but I’m also so, so grateful that she got to a point that seeking mental health help finally made sense to her.
Love the section about the line in the sand. So true.
This is such good advice!
If continuing to gently push the friend to seek a therapist is something that the advice asker feels is within their boundaries to continue doing, here’s an additional thought:
When a first experience seeking a certain type of help (like therapy) goes poorly, it can be easy for someone who’s in a bad place to feel like, “Oh, other people can make use of this type of help, but I can’t because I’m more messed up/less deserving/[some other negative thought] than other people.” So when I’ve encouraged friends to seek help, I’ve been real with them about how finding a therapist who’s the right fit can take a few tries, and I’ve shared that I’ve had bad experiences with therapists too. This can normalize the experience of having a bad therapist experience and help someone open up to the possibility that one (or a few) bad experiences doesn’t mean that they’ll never find a therapist who’s actually helpful to them.
Boundaries, yes. I think though that pushing the therapist idea in the same conversation as talking about the friendship itself might not work, might come off as an ultimatum. They are both real issues and are related but I think you have to talk about what you need (or how it hurts you when she lashes out) and what your advice is to her separately, unless she brings it up. You are taking care of yourself by setting boundaries around what is acceptable for her to do within the friendship.
The above comments about normalizing therapy and the effects of one bad therapy experience are so true. The idea that anything she tries is just a start and doesn’t have to be perfect might help. I agree that gentle consistent repetition of the facts can help people get past their resistance to therapy or just can catch them at the right time.
hmm sorry did not mean to post as a reply. and then thought i could delete it and repost but that did not work lol
This is really good advice and advice I could have used a few years ago with a friend of mine. Unfortunately, that friendship ended, which made me feel both relieved because trying to help had been very frustrating and guilty because it felt like I hadn’t done enough.
But I’ve found that talking about my issues with mental health and accessing mental health help have helped both myself with validating that need and others around me! Good luck to the question asker and hope their friend gets professional help soon!
Therapy isn’t the only place to find support. There are mutual support groups and network like the Fireweed collective (ex Icarus project). Facebook is a place to find them.
Most therapist are white,middle class, straight and abled and consequentially racist, classist, queer and transphobic and ableist. The LW’s friend first experience with therapy might have been traumatizing for any number of reasons, so she might be doing what she can to take care of herself and avoid further harm. Maybe she is mistaken, maybe she is tuned to intuition about herself and what is right in this moment.
In other words the LW absolutely gets to have their boundaries as very well explained in the advice, but that is different from being preachy I’ve been there (preaching therapy) but I’ve come to see I was wrong, because I can’t know what is someone’s best next step, and the individualistic model of therapy is deeply flawed and frankly not always congruent with how human co-regulation works.
I’m not saying the LW should never bring up therapy but every week is a lot. Maybe she can check for consent with her friend aka ask them if they find it useful when they bring it up and would like the LW to continue doing so.
I had a great therapist. She moved. Then I had two bad ones. Now I have a grest one. My partner is a therapist so many good therapists are ruled out bc they are her friends. It’s complicated. There are therapists that are just bad therapists. Then there are therapists that are a bad fit for you. As I was disliking the second bad one I was discouraged feeling like it must be my fault. Then she did something to reveal her craziness to another friend and I felt so much better. It really wasn’t me, it was her.
I agree with other comments, keep talking a lot about your own therapy so she can have a better idea of what good therapy is like.
Many therapists are doing telehealth now. Perhaps your friend would feel better about trying different therapists without having to go to their offices??? Many offer a free phone consultation to give her an idea of whether they might be a good fit.
Also. Your reference list probably has therapists that won’t work for her, no matter where you got it. That’s just how it is. I’d encourage her to contact a few and pick one to see a few times, then evaluate. Don’t make it an all or nothing. It’s ok to shop around.
You are NOT her therapist. However, you can help her identify her goals for therapy, what went wrong with the last therapist, and what she is looking for.
Demanding that she be in therapy or you will end the friendship isn’t usually helpful. In fact feeling like I should stay in therapy to please my partner kept me going to those bad therapists longer than I should have. Helping her identify exactly what she could take to a therapist is more helpful. Once you identify boundaries, gently let her know that you hear her but that’s a boundary and she should take that to a therapist. Use those feeling words from your own therapy. I feel overwhelmed as I hear this because I care about you but I can’t fix this for you, that sort of thing.
I’m really curious why she is so resistant to going. Maybe dig into that a little bit. Yeah she had a bad experience, but it sounds like she says I want to be better at this and you say my therapist helped try these and she says nope.
I will say if you set boundaries and she disrespects them, then you should take a break. Not because she won’t go to therapy, but because she doesn’t respect your boundaries and therefore isn’t respecting your needs as the other person in the relationship. I would make that really clear. In the end you don’t need her to be in therapy. You do need her to respect your boundaries. I can’t imagine how she will do that without therapy, but that’s really up to her. She could literally go to a therapist and say I’m here because my friend has these boundaries and she says I need help respecting them but I don’t get it. That would start the ball rolling in a great direction.
Good luck.
Boundaries, yes. I think though that pushing the therapist idea in the same conversation as talking about the friendship itself might not work, might come off as an ultimatum. They are both real issues and are related but I think you have to talk about what you need (or how it hurts you when she lashes out) and what your advice is to her separately, unless she brings it up. You are taking care of yourself by setting boundaries around what is acceptable for her to do within the friendship.
The above comments about normalizing therapy and the effects of one bad therapy experience are so true. The idea that anything she tries is just a start and doesn’t have to be perfect might help. I agree that gentle consistent repetition of the facts can help people get past their resistance to therapy or just can catch them at the right time.
I really love Sesh! They run weekly support groups (there’s an LGBTQIA+ one today.. and I think even LGBTQIA+ domestic violence support and QTPOC support as well this week) and they have a mobile app where you get two weeks free.