Both sides of the couch: Examining the stigma surrounding therapy from two perspectives

February 1, 2016 — by Caitlin Ju and Amulya Vadlakonda

CASSY (Counseling and Support Services for Youth) program is a safe place where students can go for therapy and yet often don’t. The reason might be that “therapy” is a loaded word: It drags with it the difficulty of mental problems, intangible issues that so frequently are overlooked.

There is a cocoon of calm and comfort in the portable building behind the main office in the west parking lot, where the easy quiet is not suffocating like silence often can be, but soothing.

The office belongs to the CASSY (Counseling and Support Services for Youth) program and is a safe place where students can go for therapy and yet often don’t. The reason might be that “therapy” is a loaded word: It drags with it the difficulty of mental problems, intangible issues that so frequently are overlooked.

The stigma of therapy has persisted for ages, despite our efforts to eliminate it. And so The Falcon decided to explore the reality of therapy from both sides: as a patient and as a counselor.

On the couch: Ellie Lee

Every Friday, senior Ellie Lee sits in the same chair in the now familiar CASSY office. What began as uncertainty about continuing softball, a sport she had loved for years, soon spiraled into academic stress, arguments with her parents and relationship issues. This room has seen her through all of that pain.

Lee made the decision to use therapy as a resource to help her, despite the “therapy culture” that stigmatizes help for dealing with these issues. In fact, she began going to therapy in her sophomore year, “a really peaceful, mellow time in [her] life.”

But as the responsibilities and stresses of junior year kept piling on top of each other, Lee felt she needed more help.

“Suddenly expectations are like fire,” Lee said. “It’s just a lot. [In my junior year], I was experiencing a lot of issues with depression. [I didn’t feel like] I had someone that I could trust so much.”

After being recommended to CASSY her sophomore year by guidance counselor Frances Saiki, Lee said she had better resources to deal with her stresses.

“I have a really good relationship with my parents, but there are certain things that I just can’t talk to them about,” Lee said. “And the same goes for my friends. But my therapist is someone I can tell anything to, and she would know how to help and how to work through these issues.”

Lee’s positivity toward therapy, though, is not necessarily common. She said that she is bothered when those around her assume something is wrong with her.

This stigma often deters people from going to therapy, convincing them that they are better off talking about their problems with a trusted friend instead. The mindset undervalues the expertise and impartiality of a therapist, Lee said.

“Talking about these things is super important. Your friends are there for you, but they’re for themselves as much as they are for you,” Lee said. “There are things that my friends don’t know, and they can’t help me with. Having an adult and someone who is outside of the little bubble is helpful.”

While therapy is sometimes regarded as a stressful ordeal that deals with heavy issues, she said the reality is that all the sessions are directed by the patient: The conversation goes where the patient wants it to go. Lee learned that therapy was really just a way to understand herself better and was not overly taxing, especially as it was meant for her to work through her problems, not create more.

Still, her sessions did not serve as a cure-all. Even after attending therapy for a year, Lee struggled with issues regarding self-harm.

“[Self-harm] is actually way more common than people think,” Lee said. “It’s easy to cut yourself in places where people won’t see. And I think everyone is looking for that escape.”

Lee initially thought self-harm was “really beneath [her],” something she would never consider. But as the stress of her academic and personal life built up, she felt increasingly “stuck,” and she turned to hurting herself as a way to relieve the stress she felt.

“Whenever I would get a lecture from my parents combined with fighting with [people], it would just kind of sit in my head,” Lee said. “It would just be all this built-up tension.”

She initially didn’t discuss the issue of self-harm with her counselor, out of fear that her therapist would be obligated to tell her parents. However, she soon realized how much therapy helped her work through those thoughts, especially because her therapist was under no such obligation, as long as the counselor believed that she was no danger to herself or others.

“When you’re in a place of such extreme pressure and when you just feel stuck like that, you don’t see what’s wrong with [self-harm] in the given moment,” Lee said. “And then once you take a step back, you realize the pain is never alleviated by tearing yourself down.”

Lee has gained a strength from therapy that she encourages other people to find. She doesn’t “think anybody is above talking about their feelings,” regardless of any stereotype or stigma that therapy carries.

“I think at any given point in life, people are going to assume things and put you in boxes,” Lee said. “You can’t change how people are going to see you. [But] if you really value yourself, then you’re not going to care about the people who will categorize you.”

Lee said that therapy allows her a degree of introspection that she could not otherwise attain.

“To me, therapy is like a mirror for your inside thoughts,” she said. “I don’t think therapy changes you; I think it opens you up to yourself more.”

In front of the couch: CASSY therapists

“The three hardest things to say are ‘I love you,’ ‘I’m sorry,’ and ‘Help me.’ ‘Help me’ is up there for a reason,” CASSY therapist Jessica Wang said.

CASSY therapists Kim Cousens and Wang are two of the four counselors on campus who help students overcome that difficult step of seeking help and hope to break the stigma surrounding therapy and mental health.

Wang originally thought she did not need therapy, but resolved to try it after she decided to become a therapist. It was then she realized from the other side of the couch, as a patient, how impactful therapy can be, and not just in making her a better therapist.

“I also got so much more personally,” Wang said. “[My therapist was] someone who would give a different opinion from my parents or my friends. I didn’t have to worry about pleasing her or what she thought.”

For people who believe they are their own experts, Wang assures them that there is always a different perspective to gain from therapy.

“We’re not trying to tell you what’s best for you. We know that; we trust you know that,” Wang said. “We’re just trying to give you a little support and help, a different perspective.”

Having worked at the school for three years, Wang attributes the difficulty many students have asking for help to the intellectual environment.

“At Saratoga, we have a lot of bright, intelligent people, and you can figure out a math problem. You can take all the factors and get your answer,” Wang said. “With mental health, you can’t outsmart emotions. We all react to those emotions in certain ways based on our life experiences and our culture.”

In fact, according to a report about the 2014-2015 school year, the most common reason for students coming into therapy was academic stress. Among the other reasons were anxiety and depression symptoms as well as trouble communicating with parents.

Many times students will try to muffle their emotions by ignoring the problem or distracting themselves, believing that they will feel better.

“The fact of the matter is you’re not better,” Wang said. “[Those emotions will] come back when we least expect it or least need it to.”

Many people think that unless there is a very serious problem, therapy is unnecessary, but Cousens disagrees.

“If you feel like you’re not enjoying your life and you’re sad or stressed a lot of the time and not doing things that you like, and you feel emotional pain, it’s always a good idea to get help,” Cousens said.

Going to therapy, Cousens said, can provide the same effect as going to a doctor.

“If you need a surgery, no one doubts you need medical help, and even if you just have this nagging pain, eventually you go get help, because you think the doctor can help even though it’s not serious,” Cousens said.

Another misconception is that therapists themselves are perfect and do not have their own problems.

But Cousens said that like everyone else she constantly has to deal with family issues. She notes her awareness of her struggle with the family she grew up with and the family she lives with now has been the key to keeping her own problems out of the way when she helps other people.

CASSY therapists ask their patients who are referred by themselves, teachers or guidance if they have any thoughts of self-harm, because the therapists’ main priority is to keep teens safe. This safety clause requires them to speak to the police if they feel like there is suspicion of abuse in the student’s home environment. CASSY counselors are also under obligation to report information if they feel that a student is a threat to themselves or others.

“Most students who are having thoughts about wanting to die really don’t want to die. They want something to change and get help and get relief,” Cousens said. “Usually if they’re really worried [about themselves] they’ll talk about [their problems] even at the risk of knowing I’m going to share.”

Once the students agree to meeting with someone, usually weekly, the parents are contacted and told about the student coming in and reminded that everything in the therapy sessions is confidential. CASSY’s confidentiality clause requires parents to be aware that their child is seeing a licensed therapist, but students’ private talks remain between them and their therapist.

In recent years, the school has started student-run events, such as Speak up for Change week, which help highlight important issues like mental health. Wang thinks these events effectively start discussions about issues that are relevant to students.

“Even by talking about [mental health] and exposing more people to the idea of seeking treatment when they need it and looking at signs and symptoms brings awareness that adds to reducing stigma,” Wang said. “[Mental health is] not something that we’re hiding from or pretending doesn’t exist.”

Since therapy is voluntary, Wang also thinks the school has done its best to let family members and students know where CASSY is and what it does.

“People aren’t going to seek therapy and come and do the work that it takes to maintain [going to therapy] in their lives unless they want to,” Wang said.

Ultimately, Wang finds her job as a therapist for young adults extremely rewarding, especially because high school is the time when students are still forming who they are as people.

“To be able to let somebody know at that age that is struggling that [this] is normal, is extremely rewarding for me,” Wang said. “Talking to clients the first day they come in versus at the end [of therapy] is really an amazing thing when they see that progress. They are living the progress.”

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