Many of us are fortunate to have friends or family members that help us and care for us and therapists will often encourage patients to seek support from friends and family. However, there are a number of limits to getting self-help, or even mental health advice or input from friends and family. As you read the list below, realize that it is written as a way of protecting the caring relationship between you and the friends and family with which you seek help. Your friends and family are a valuable resource and should be used to help you get through a situation, but consider these factors:
Friends and family may not have enough time
Many people see a therapist on a weekly basis, or twice a month in order to discuss what is going on in their lives. If a situation gets detailed or requires a lot of working through, friends or family may not have the time needed to assist in the matter fully. It is possible that seeking too much help or time could put a strain on the relationship. Therapists are skilled at setting boundaries in the relationship so that patients do not become reliant on the therapeutic process in their lives. However, friends and family may not know how to negotiate these boundaries up-front, and both you and they could be in a situation where you need more time than they have available to give.
There are situations which you may not want to discuss
Money, sex, the deep issues with a marriage, previous trauma, illness, thoughts of suidice, serious addictions, infidelity, illegal activity and other secrets may be difficult to discuss with a family member or a friend. It is possible that you may find yourself seeking help from a friend or family member, but leave out a few key pieces of information that may be at the root of your problem.
They may break confidentiality
There are really three aspects to this. The first two involve gossip. There is the standard gossip, where a friend or family member may discuss details of your conversations with others when there is no good reason to do so. The second issue is gossip related, but the person in whom you confide may themselves feel the need to discuss something with another family member or friend, either for their own self support, or they may take matters into their own hands and intervene on your behalf without you knowing it. This could have very negative consequences. The third issue involves a friend or family member disclosing your thoughts or behaviour to authorities or medical practitioners because they are worried about what you are saying to them. There may be nothing wrong with this, per se, but if the parameters are not set-out in advance, then such disclosure, even if it does help you, may leave you feeling betrayed. Moreover, there are certain situations by law where a friend or family member must report certain aspects of a conversation. These primarily involve any sort of harm at any time (past, present or future) to children and utterances of doing harm to other people. Therapists are trained to set-out these parameters at the start of the relationship and know when to report, and how to tell a patient that they have to report.
It may put a strain on the relationship
The above three factors and a few others indicate that supportive relationships between you and friends and family members has the potential to put a strain on the relationship.
Friends and family members are not self-help experts
How much drinking is too much? Is someone experiening a serious episode of mania or depression? Is someone experiencing distorted thinking, or even a psychotic break? When does depression become dangerous? Is it possible that your spouse has a mental illness that is affecting you? Do all mentions or thoughts of suicide need to be "cracked-down" on? Is someone (especially in their late teens or early 20's) showing signs of develpoing a serious psychiatric condition? Are changes in behaviour a result of medication? In many cases, these issues are rare and managable - but it is also like asking a friend's opinion on a persistent cough that does not go away. There are certain things that therapists look for to help determine if more serious interventions are needed.
Overall, I do believe there is a strong place for friends and family members to provide support. However, I was brought-up with a saying "you get what you pay for". Over reliance on support from friends and family, and the occurrence of any of these situations has the potential to do more harm than good - both in the supportive and personal relationship you have with your friends and family. As such, these are important factors to consider if you are thinking of seeking help from a therapist.
Brian Baumal is a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario.