The title of this article may seem like an oxymoron, but it describes a relatively common concern with numerous reasons behind it.

What would compel us to cancel our upcoming counselling appointment, miss it or even delay seeking counselling altogether?

The answers to this conundrum are varied, so let’s take a look at some of the usual culprits, not all of which apply to everyone. As always, there will be factors I’ve missed too.

Saving Face

Often the expectations that we have for ourselves are the harshest expectations of all. There could be a few reasons for why saving face, or being concerned about how we appear to others, may be a thing.

Growing Up Expectations

Some of us are raised to believe that we should never leave the house unless we’re “presentable,” and when we’re really upset, feeling presentable can feel impossible. Others of us have been taught that we need to “show up” or be “ready to work” whenever meeting with anyone in a position of ‘authority’ (even counsellors).

Physical Expectations

• “I look like a mess.”
• “My mascara will run all over the place”
• “My face explodes when I cry.”
• “I can’t sit in the waiting room looking like this.”

In other words, embarrassment may keep us from attending.

Popular Culture Expectations

In an age of social media where appearance may seem like everything, we may struggle to be vulnerable with others—including a counsellor—particularly if we don’t give ourselves permission to express ourselves in such a way that collides with the image of ourselves that we want others to see.

Cultural Background Expectations

In some cultures, seeking counselling is considered weak and we may grow up with expectations which stand in stark contrast to one of counselling’s central tenets: emotional expression. Cultural expectations can include “a stiff upper lip”, holding things in/pushing things down or keeping our problems to ourselves. Although we have come leaps and bounds in Canadian society when it comes to stigma, reaching out or talking about how we’re doing may still trigger deep shame.

Social Anxiety

For folks struggling with social anxiety, any behaviour that increases the possibility of drawing more attention to ourselves or contributing to an “awkward” social situation can be deeply anxiety-provoking. The very nature of counselling—particularly when we are getting the process started—can be a hard enough interaction, in and of itself, not to mention when pre-existing anxiety is already a factor.

Personal Factors

Many of us have personal factors or behavioural patterns that can contribute to wanting to avoid a counselling session when we’re upset. These can include:

Perfectionism

If we struggle with wanting to do things perfectly, coming to a counselling session when we feel anything but, can leave us feeling panicked about how to navigate this situation. Perfectionism makes us vulnerable in situations where we need to be real with how we’re feeling, especially if ‘perfect’ is the only option that we allow ourselves in any situation, including challenging ones.

Disease To Please

Often associated with perfectionism, or a coping strategy we learned to navigate difficult family situations. If our distress trumps our ability to people-please, we may be tempted to avoid situations, including a counselling session.

Counsellor-Directed Factors

It’s common for counselling clients to have worries about what their counsellor thinks of them, even if their therapist has worked to establish an open and accepting counselling relationship.

These fears may include:

Fear of Judgement

Fears that their counsellor will lose respect for them or think ill of them, if viewed to be “too upset.”

Fear of Ruining “Perfect-Client” Status

Once surprising to me, I have come to learn over time that this is a thing. This desire can unfortunately come back to bite us if we experience certain emotional states, thoughts or behaviours that we consider out-of-step with “perfect clienthood,” meaning that addressing them with our therapist can feel like a threat to our client reputation.

Mind-Reading The Counsellor

It’s also not uncommon to project onto counsellors what we feel they “need” and “sparing” them things about ourselves that we consider unacceptable. This can include:

• “I don’t want to burden my counsellor.”
• “I don’t want to tarnish the counsellor’s view of me.”
• “I am concerned that my counsellor might react badly if I expressed how I was feeling.”

Emotional Fears

These often have to do with our philosophy or beliefs about emotions and emotional expression — i.e. meta-emotions. Examples include:

• Beliefs that letting “ugly” feelings out will make them worse
• Fears that crying will lead to a panic attack that will never end
• Fears about not being able to handle one’s feelings in the presence of the counsellor

Reasons Not To Come To A Session

Sometimes it’s true that we are not in the right mindset where we can benefit from counselling. Such situations may include, but are not limited to:

• Situations that need immediate attention and action (before talking with a therapist)
• Very early grief, when the mind and body are still in shock and are preoccupied with adjusting and orienting to the new reality without the person
• Situations requiring emergency mental health intervention where a more urgent mental health resource, such as a hospital or urgent care clinic is needed (e.g. acute suicidal thoughts and/or planning)
• Certain mental or physical health conditions that would make preceding with a counselling session impossible (for example, psychosis, dementia, intense physical pain) and require intervention with a more specialized resource first

A Recommendation

Generally, I recommend you attend your counselling session. Why? It gives the counsellor a first-hand opportunity to learn what you’re going through and tailor your therapy according to your real-life situation. Many of us feel better at the end of a counselling session, often gaining insight and coping strategies as part of the process.. Any maybe you’ll accept yourself just a little bit more. Welcome to the human race.