The stigma comes from the unknown. We haven’t got a complete understanding of mental health — we don’t have a 100% picture of causes, effects, treatments, etc. And yet, we still apply a medical model — healthy versus sick. But in psychology, healthy and sick are not so clear cut.
I’ve talked often about the difficulties I’ve faced with my own mental health. But something that doesn’t always hit the page, instead filling hours of discussion aloud with my partner, is the difficulty of sitting by, alongside someone who is trying to get help — in particular, someone who is in therapy.
Far from the TV sitcom idea of therapy, deciding to embark on a journey with professional help isn’t exactly a casual, once a week occurrence for most people. A therapist is often portrayed on TV like a buddy who you meet for a catch up and a chat. For many people, it’s not that simple. And the decision to actually undertake a course of therapy is made with a much heavier heart — it might be the result of years of wondering, the result of a life changing event, or of real emotional hardship.
Therapy isn’t always the most affordable health pursuit either. In many countries, any protracted treatment will cost you a pretty penny. Shorter courses of intervention are available for a lower or even a free rate, but to really establish a longterm relationship, working through longterm issues, takes time. Time many of us cannot pay for.
Both my partner and I have been in therapy, and we have supported each other through the process. We have taken different approaches, having very different points of focus. And in the course of working through these treatment plans whilst in a relationship with each other, I have learned a few things about what it takes to really support someone close to you — to help them through what is often deeply emotionally challenging work, and come out with your own relationship intact…
It’s okay to ask how it went
Something that seems to be a bizarre misconception with many is that what happens at therapy, stays at therapy. Your partner may prefer to go along with this way of thinking — they may not want to discuss the ins and outs until they’ve had a chance to process thoroughly. Or they might not want to discuss it at all. But it shouldn’t be taboo to check in. If your partner went in for a specialist dental appointment, you would ask, “How did it go?” Probably very naturally. In my view, this is merely another kind of focused attention on someone’s health.
The stigma comes from the unknown. We haven’t got a complete understanding of mental health — we don’t have a 100% picture of causes, effects, treatments, etc. And yet, we still apply a medical model — healthy versus sick. But in psychology, healthy and sick are not so clear cut. They are mixed together, and everything can come up at the same time. And while we cannot apply a clear medical solution to a mental health problem in every case, it makes no sense to also separate mental from other kinds of health, in terms of the effect it has on the individual. It is still a health issue, it is still something many wish to address and, to some extent, ‘recover’ from. Why not ask how their recovery is going?
We suggest exercise to sufferers of depression, because it is a physical solution that seems to aid the mental experience. Our emotions are complex. What we do and what we feel are tied together. Ramachandran’s work with mirrors and amputee sufferers of phantom limb pain is an excellent example of the interconnectedness of our ‘physical’ neurological functioning and the ‘mental’ experience we have of the world— perhaps we can point all the way back at the origins of Dualism and Descartes to blame for the intense separation of these spheres. But the reality is so much more interconnected, and there are so many examples like Ramachandran’s to cite.
Demonstrate your interest and concern for your partner or loved one. Ask them how it went. If they question you about it, make it clear: you’re asking because you want to be supportive and help out. Not because you need to know every detail. A simple, “How was it?” isn’t such a scary thing, and it’s always better to be interested and engaged with a loved one’s health than the opposite.
Prepare for and accept their vulnerability
This sounds simpler than it is. A person in therapy is naturally sorting through complex emotions and experiences, perhaps those that have been too painful to previously address. Perhaps things that have long haunted them, or made life hard. This isn’t small work, in many cases.
They will be vulnerable, and yet, as a couple or in any close relationship, you may be comfortable with or expecting the fact that you rely on each other. However, that person is probably experiencing a far greater amount of difficulty. That vulnerability has to be taken into consideration. Expect that they are psychologically perhaps not as strong as usual. It can really be hard to accept that you can’t lean as heavy on them, in this time.
So set your own expectations, and prepare for your own feelings. Placing your feelings heavily on them, your own disappointments, really won’t be so helpful. It doesn’t mean you have to excuse them from all relationship work entirely, but be conscious of where you may be pressing too hard.
Establish the boundaries
While I have encouraged the reticent amongst you to check in with your partner, sometimes the opposite can be true. You might have a partner or loved one who cannot wait to tell you everything, to extend their therapy session to your relationship. Here’s where the importance of boundaries comes into play.
Of course, you can talk about their therapy. But you are not their Backup Therapist. Therapist no 2. It’s their thing, and while you should establish between you the extent to which they can share what they want to share, the line has to be clear. As a partner who is not a professional psychologist, you may not have the tools to be more than a support. Don’t feel guilty. Willingness to listen and engage is one thing, but ensure it is clear what is your thing and what is their thing. Your relationship and their therapy are different spheres, so discuss and establish boundaries as part of this process.
Identify and address your jealousy, if/when it appears
Something that can be hard to accept as the significant other or the once closest person to someone in therapy is that they are starting a new kind of ‘deep’ relationship with another person. A person who isn’t you. They might well disclose things with their therapist that they simply wouldn’t (or couldn’t) disclose with you. That can be hard to accept, especially in a deep romantic relationship.
My own partner, when I discussed this point and these potential feelings with him, put it best: “It’s intimate, but it’s not personal.” That’s exactly it. It’s a necessarily revealing and therefore intimate relationship, but it is not personal — it doesn’t replace or disregard the relationship you already have with that person. Their therapist doesn’t know how your loved one brushes their teeth, or the way they look in the morning, or how they like their toast. The small details that make them them. You know those things. But their therapist will probably know their darkest fears.
They are a professional, with a particular job, and it is a totally different thing to the relationship they have with you.
If they have tasks and need help, you can be helpful (to some extent!)
With particular kinds of therapy come particular kinds of outside session ‘homework’. You are tasked with following up on discussions — whether it’s completing an actual activity, reflecting on something in particular, setting goals, taking notes of activities, and much more.
You’re not meant to be completing any homework tasks for your partner or loved one in therapy. CBT-based sessions in particular tend to leave you with handouts to complete or tasks to engage in. They will be set tasks to complete in one’s own time, and the person in therapy will have to report back to their therapist about these. So they can’t cut corners, as it’s part of the treatment.
However, checking in gently with your partner or loved one is often actually quite helpful. The thing about depression is that it does often make you forget things you ought to be doing (whether that’s your therapy homework, or more mundane tasks — like attending to household chores, diet, hygiene, etc). It’s often the case that thoughts become blurry. So asking the question and checking in (in a non-nagging way) can be enough to help keep your partner on track.
Perhaps you don’t need to say anything. It could be a nice idea simply to suggest a regular time in which you, say, go to a cafe or a library together. You might use the time to read or answer emails, and your partner could use the time for their homework. Depending on the nature of their tasks, it may require a discussion, or it may not. But making yourself available to support the habit of completing this all important work will do wonders for helping support your loved one through the process.
It’s all about respect and openness, at the end of the day
Respect and openness — offering them an opportunity to speak their needs, and you to speak yours. Offer what you can offer. Ask them: do you need a hug? Do you need silence? What do you need? And then reflect on these questions for yourself.
There’s going to be a change. That’s rather the point: they want to experience a change. You have to be willing and ready as well, to accept the change they are going to face as a person. They might be more quiet, more sad, more frustrated, any number of reactions, and the partner has to be willing to be there, within the boundaries set. With openness to discussion and the desire to respect your partner or loved one’s process, your relationship can support their therapy.
Mental health is complex, and so are relationships. But ultimately, a desire to see your partner or loved one happier and as healthy as possible should be a driving factor in a relationship — we want the best for those we care for. And they want the best for us. With those baselines in place, there is room to grow — as individuals, and in your relationship, whatever form it takes.