An abstract or artistic picture for this article.
Lisa Ferentz, LCSW-C, DAPA

Why it’s Challenging for Clients to Ask for Support

There is no question that we’ve come a long way in our culture regarding the de-stigmatization of therapy, but for countless people, the idea of reaching out and asking for professional help is still anathema to them and a last resort.  They would rather talk to friends and family, connect with clergy, read self-help books, get answers on the Internet, or watch talk shows that offer quick , unrealistic or impractical fixes. It’s not that those aren’t sometimes useful resources, but many people wait for everything to start unraveling or until they are in true crisis mode before contacting a therapist.

I’m sure you would agree that it takes tremendous courage to reach out to a mental health professional.  It is a vulnerable proposition to decide to disclose to a relative stranger important and intimate thoughts, feelings, and experiences.  This is particularly true when clients have a history of betrayal and were not allowed to resolve trust vs. mistrust. It’s always poignant to sit with new clients and hear them distort the need for therapy-something that takes great inner strength- as a “weakness” or “failure.”   Why would they think asking for help is a sign of weakness? And why is it so hard to ask in the first place?

Like many things that clients grapple with, I believe this has its roots in a family-of-origin backstory.  If asking for help is hard for a client, invite them to be curious about the following questions:

While you were growing up what messages did you get about asking for help?

Did your family place more value on “self-reliance?”  

Were you forced to be overly self-reliant?

What were the typical responses when you did summon the courage to ask for help?

Those few questions can be a valuable starting point to help clients understand their core beliefs about going through life overly self-reliant versus feeling comfortable turning to others for guidance, feedback, support, or comfort.  If the messages they were taught, overtly or covertly, communicated the idea that reaching out was unacceptable, futile, or would cause more pain, it makes sense that they would go it alone whenever possible.  

Through their own actions, family members modeled if asking for help was acceptable. They also taught your client the extent to which outsiders could be trusted resources.  And most importantly, clients’ past experiences with family, teachers, peers, and other significant people served to either reinforce the notion that help was available, consistent, predictable and safe, or left them with the painful reality that their needs would go unheard and unanswered. In those cases, it probably felt less depressing and rejecting to simply stop asking for help than to ask and not get a supportive response. This is often the case with clients who experienced insecure, dismissive attachment in childhood.

Although these formative experiences and messages help us to understand why asking for help might continue to be a challenge, invite your clients to consider that they don't need to keep superimposing past events onto the present.  It's never too late to learn to ask for help and re-frame it as sign of strength.  When clients are faced with feelings or experiences that are confusing, frightening, or overwhelming, asking for help means they care enough about themselves to get the support that they deserve. We do want to help our clients with discernment: learning how to be selective when they do reach out can increase their chances of getting a safe and compassionate response. And oftentimes, the first relationship to start with is the therapeutic alliance.

Clinician’s Tips:

Process these questions with clients as they take the first brave steps towards asking for help:

- What are the situations in your life that would benefit from outside help and support?

- Who are the people in your life who would be safe to reach out to for assistance?

- What professional resources would you encourage a best friend to use if they needed help?

- What are three ways in which asking for professional help can be a sign of strength?

More from Lisa’s Blog