You’ve begged, you’ve cajoled, you’ve reasoned, you’ve researched and you’ve even offered to call yourself and transport them there. And still they say no.  Whether it’s counselling, seeing their doctor, a treatment program, a support group, reading about the problem, or taking a course, it’s a no-go.

And you think, something has to be done!

You might find yourself becoming distraught at what you see as stubbornness, denial, passivity or even downright hostility.  You might even think, “if they loved me, they’d do something” or “if they cared about themselves, they’d take a step.”

My response is that if you have such feelings, you are human and they are a sign that you care. If you felt nothing for the other person, you wouldn’t even get upset. It’s logical that you would want the best for the important person in your life, even though you may disagree with them about what “the best” actually is.

Concerns

As I mentioned, there are many situations where a person could benefit from help. Some of the concerns I hear the most from family members in my counselling and psychotherapy practice include:

• Addictions, most commonly alcohol, cocaine, marijuana use
• Relationship breakdown – “my partner won’t get help for X” or “if they got help we wouldn’t have a problem in our relationship.”
• Sex addiction – often a call from a spouse where the compulsion is affecting the couple’s relationship
• Mental health conditions, particularly major depression, anxiety or a major mental illness such as bipolar disorder or a psychotic disorder
• An untreated or undertreated physical health condition that is causing serious concern for the family
• Parental concerns, particularly stress related to adult children who are living at home or concerns about an adolescent who is ‘acting out’

Reasons Why

Reasons why a person would choose not to seek help vary from person to person and all can be intensely frustrating for worried family and friends.  Possibilities include:

• The person does not believe in counselling or they do not agree with the counselling options available
• The person is deeply uncomfortable asking for help – this is often related to experiences growing up and/or previous trauma where accepting help from someone else was emotionally unsafe or would lead to negative consequences
• The person is in denial that they have a problem, or the extent of it
• The person is not ready for change – seeking and receiving help requires openness and vulnerability, which might feel overwhelming for the person; They may also be scared about the appearance of new responsibilities in their life if they follow through with change, or how their life in general might change
• The person is intensely afraid that they will be judged by the counsellor
• The person identifies with a “lone wolf” persona – has an intense need to ‘go it alone,’ to figure things out for themselves or had past experiences where they were hurt after accepting help from others
• The person has a high need for control and feels frightened by the uncertainty inherent in the change process
• The person has received counselling or other forms of help in the past and it has gone badly
• The person is a helping or counselling professional and worries about their anonymity, particularly if they are well known (personally or professionally) in the town or city where they live, or feels a sense of shame or embarrassment that they are in need of the kind of help they provide
• The person lives in a small town and there is no privacy or anonymity around receiving help, or options are limited
• The person has physical barriers / mobility issues around receiving help or suffers from an anxiety disorder  or a mood disorder which makes receiving help either impossible physically, or overwhelming emotionally
• There are no available community resources, the waitlist is long or the person does not have enough money to afford private services
• The person truly believes that nothing can be done to help their condition, which may be a sign of major depression
• The person is genuinely suicidal and has no intention of getting help.  If you suspect that this is the case, serious suicidal intent is a mental health emergency.  Call 911 or if you are in British Columbia, 1-800-SUICIDE for help and support. 1-800-SUICIDE can also be a helpful resources if you are worried about someone but are not sure if your concerns are worry-worthy.

What To Do

Wondering what to do is perhaps the question that family members and friends struggle with most.  What is the best option? Will what I do make the situation better or worse? Will I risk alienating my loved one or driving them further towards not getting help? are all common questions.

Not every suggestion here will be appropriate to every situation.  Talking with a counsellor or other professional may be the best way of ensuring that you find a customized approach for your situation.  Generally:

• Acknowledge your feelings and how difficult it is to see a loved one suffer.  It can be extremely stressful to live with someone who is “symptomatic” for a problem where there might be practical treatment options available. Don’t berate yourself for having human feelings like frustration, anger or helplessness.
• Recognize the limits of your control – we may believe that we have control over another human being–not in a malicious way–but instead believing that if we try hard enough we will get them the help we believe they need. Ultimately, we do not. The decision has to come from the person themselves, unless the situation has devolved to such an extent that other outside forces have intervened such as the police, ambulance, mental health system, etc.
• Find support – sometimes the most healing thing is finding a group of people who are sharing a similar struggle, such as in a support group.  Many people report that this is more validating than counselling, especially if the therapist does not “get it” or share a similar life experience.
• Understand that ideally, change is more powerful, meaningful and long-term when it comes from the sufferer themselves
• Spend time with trusted friends or family members, even if you’re not talking about the problem at hand. All human beings need support and connection with others to thrive.
• Read and research the condition – empower yourself with information. This can help you understand what to expect, can foster a global sense of support and help you find specific strategies to use in your situation.  And know when to put down the information. Reading too much can increase stress.
• Seek Counselling with a therapist who has experience in the problem area – discover individualized coping strategies, get help with decision making, or just lay your burden down in a dedicated counselling space just for you.
• Know your resources – if it’s a serious issue that your loved one is struggling with, know who to call if the situation gets out of control.  In Vancouver, contact community services by phoning 2-1-1 for help with non-emergencies.  Call 9-1-1 for all emergency mental or physical health issues.
• Don’t pressure or give advice – this tends to backfire, often inadvertently driving the person further away from help.
• Practice Self-Care – This may be an over-discussed concept, but you will have nothing to give if your well is dry. Also, valuing yourself can promote relaxation, decrease your stress and help you connect with little joys in life.