Introduction
The first "noble truth" of Buddhism states a fact that is obvious to many people who will be reading this document: life involves suffering. At various times in life, most people will be faced with one or more mental health, wellness or life issues that will cause them pain in one form or another and which they will want to rid themselves of. People faced with such issues and illnesses have three basic options for getting help. They can seek help from medical or mental health professionals (or people who hold themselves out as teachers of one sort or another); they can choose to work on their problems themselves through a process of self-help; or they can combine professional/teacher and self-help approaches. There are many benefits to be had from professional helpers. In some cases and for some problems, the only real benefits that can be had are had through professional helpers. This is certainly the case with serious mental illnesses such as Bipolar Disorder or Schizophrenia. Nevertheless, professional helpers are expensive, seldom available as much as you might like, and limited in terms of what they can offer. For these and other reasons which we'll outline below, it is a very good idea for people dealing with painful issues and illnesses to learn methods for helping themselves
This document is directly concerned with helping people learn methods for helping themselves manage and even overcome various troubling mental health, wellness and life issues. Self-help for mental health and wellness issues consists of learning about the nature of distressing issues, learning how to measure or assess those issues and how they can be resolved, and then choosing and following a course of action that will help you to resolve those issues.
Taking Action is Key
Because you usually cannot solve troubling issues just by thinking about them, taking action is key to getting any sort of help. This is especially the case with regard to self-help. Just thinking about things that trouble you, but not taking action to change them is likely to be quite ineffective. Even though it is ineffective, the tendency to just think about things that trouble you and avoid taking action to address them is so common that multiple names have been developed to describe it, including "intellectualization", "rumination", and "procrastination", to name but a few. Avoiding taking action on problems is not an effective or useful strategy for self-help because nothing happens when you do this except that your thoughts go round and round. Worry and rumination without action lack a vital ingredient necessary for forward motion and positive change. A car cannot go forward without a transmission, no matter how powerful its engine may be. Like a car without a transmission, avoidance and worry in the absence of an action plan cannot get you where you want to go.
The topic of self-help covers a lot of ground. There are many different ways of helping yourself overcome problems, and not all of them will appear at first glance to be therapeutic. Doing your own taxes, fixing your own car or even serving yourself at a buffet lunch are all legitimate and useful self-help activities that can make your feel better about yourself. These are rather simple, narrow and specific activities, however, when compared with mental health and life-improvement oriented self-help efforts which are usually more complex in nature, requiring multiple actions and efforts to be coordinated before a benefit can be obtained.
A typical mental health self-help effort requires you to pay attention, make an emotional investment in change, perform one or more self-assessments, educate yourself about your problem(s), consider multiple alternative possible actions for addressing your problem(s), decide on a specific plan of action (selected from the alternatives available) which seems most likely to be helpful, and then finally commit and dedicate yourself to executing that self-help plan. All of this must be done before you will see any significant relief or results. These multiple components of a sound mental health self-help plan probably sound very complicated, but please rest easy; self-help isn't really that hard to do or to understand. There is a method to the madness and that method is largely based on common sense. This will hopefully become apparent as we consider the follow example showing how one man named Bob builds himself a self-help plan to help himself solve a difficult relationship issue.
Example of Taking Action (with analysis)
Bob and Sam are two friends who have known each other for years. One day, Bob realizes that he is angry with Sam and has been holding onto that anger for several days. It’s making him irritable and unhappy, so he decides to think the issue through further. He recalls that Sam borrowed his toolbox last week and said he would return it by Saturday, but he didn’t. On further reflection, Bob sees that his anger towards Sam has to do with that missing-in-action toolbox, and the disrespect that Sam's failure to return the toolbox on time seems to imply. Bob hasn’t said anything to Sam about the missing toolbox yet. He’s afraid he’ll blow up at Sam, since this isn’t the first time Sam has not returned something when he said he would. Bob realizes that he has been avoiding a talk with Sam about the problem for a long time. Finally, Bob thinks that, yes, he does have a valid complaint and that he will feel better if he speaks with Sam.
In this example, Bob's realization that his is upset with Sam because of Sam's failure to return the toolbox is an example of self-assessment and attention. The first component of mental health self-help involves your ability to realize that you, in fact, have problems. You cannot develop and put into action a self-help plan if you are not first aware that a problem exists and become willing to pay attention to that problem (to take responsibility for fixing that problem) in a sustained and serious way. You might think that this process of paying attention to problems is easy and automatic, but you'd be wrong about that. Many people have problems but are unaware of this fact. For one reason or another, they are in denial that they have problems. They are motivated to not know about their problems, or realize that problems exist, but blame those problems on other people rather than taking responsibility for them themselves. Only after you become aware that a problem exists, and take responsibility for that problem can you go to the next steps in the self-help process, which involve learning about the nature of your problem, and how that problem can be measured and fixed. Bob's emotional investment in his relationship with Sam helps him become aware that he is upset with Sam and motivates him to do something to make that upset go away. He has realized that taking action now - talking to Sam about the missing toolbox now - will save him further anger over the toolbox later on. He doesn’t want to feel angry in the future at Sam doing the same thing again. The fact that he has been avoiding confrontation with Sam may also be a clue to Bob that he cares for Sam; that he doesn't want to alienate Sam or deliver this message in a way that cause Sam to stop being a friend. He just wants Sam to show proper respect and return things on time. This realization that he values Sam's friendship helps Bob to know that how he approaches Sam about the issue is important. It will better serve his purpose to speak carefully and assertively to Sam than to aggressively scream and yell at him. Mainly, though, Bob has become invested in relieving himself of his current anger. He has gotten clear on what he wants, which is to have his things return to him on time when they are borrowed and to preserve his relationship with Sam. Bob has become emotionally invested in solving his issue. His task now is to figure out the best way to take action.
Bob thinks over the possible ways he can deal with his anger. He knows he has the option to just ignore his anger. If he does ignore his anger, it is likely that his anger will diminish over time (at least until the next time he thinks of Sam's disrespect). He also considers alternative actions he might take. He can talk with Sam assertively, telling Sam that he is angry about the missing toolbox and has been angry in the past about similar items that were not returned as promised. He can also get aggressive with Sam and let himself yell and scream. He can tell Sam that he won’t loan him anything ever again. He can stay mad and shut Sam out of his life. He can borrow something of Sam’s and not return that thing when he said he would. He can booby-trap his back door so that the next time Sam comes over to borrow something, a bucket of water falls on his head.
Bob thinks about the pros and cons inherent in each of the options he has generated for handling his dispute with Sam, evaluating each one for how well it will help him get to his ideal outcome - where he is able to remain friends with Sam but still get Sam to realize that he needs to return things on time. Bob decides that his best option is to be assertive with Sam, telling Sam that he needs to return the missing toolbox now, and that he can still borrow tools in the future, but only if he returns those tools on the agreed date. He further decides to tell Sam that Sam's failure to return the toolbox on time has left him feeling taken advantage of and disrespected, that he has been inconvenienced at times in the past by not returning the tools on time, and that he has been feeling angry about Sam's repetitive pattern of not returning things on time. Bob decides he will talk to Sam this evening, when he goes over to Sam's house to watch the ball game on TV. He decides he’ll keep his voice calm and will sit while he talks to Sam. He decides that he will reassure Sam that they are still friends if Sam seems upset by the conversation, but that he’ll stay firm about the borrowing regardless of how Sam reacts. He decides to tell Sam that if he can’t be sure he’ll return an item when he says, he shouldn’t borrow it from Bob. He’ll also tell Sam that if he doesn’t return any item on time in the future, he’ll be saying no about any further borrowing, even though he hopes never to have to turn down a request from Sam.
All of this decision-making constitutes a plan, one that Bob is dedicated to implementing. If Sam is a reasonable person too and a friend, he’ll probably apologize and swear to return any borrowed items on time in the future. If he isn’t reasonable about the issue, though, at least Bob will have done the best he could and be rid of his uncomfortable pent up anger at Sam's irresponsible behavior. Bob need not make Sam’s reaction to the conversation his own concern. He chooses, instead, to practice what therapists call, "good boundaries," by realizing he can only be responsible for his own feelings.
Steps in the Self-help Process
Bob's problem solving process example above shows how a good mental health self-help plan can be arrived at. Bob becomes aware that there is a problem (by paying attention to his feelings), commits himself to solving that problem (by taking responsibility for the problem and making an emotional investment towards solving it), and considers his action options in the light of both his own and his friend's personalities (by performing a self-assessment, and by considering the various alternatives). He chooses the best of the options he generates (selecting the most appropriate actions for meeting his goals) and then finally makes a commitment to himself that he will carry that plan out. He carries through on his intention by actually speaking with his friend later that night. You can use Bob's general pattern for creating a useful self-help plan to create your own self-help plan
We can further clarify how to create a good self-help plan by describing each step in the planning process in some detail. We encourage you to use these steps in planning your own self-help efforts; these steps will help you to make sure that your self-help efforts have the best chance of producing good results for you.
Decide whether to seek professional help or to pursue self-help. Before you launch into a self-help process, you need to know that self-help is an appropriate means of addressing your issues. Self-help is not appropriate as a means of treatment when you are dealing with serious illness, or when you have reason to believe your judgment may be compromised. It is a more appropriate path to pursue when you are dealing with less serious, non-life-threatening conditions.
Steps 1-4: Problem Analysis
1. Understand Your Problem. You must understand the issue, problem or symptom you are experiencing before you can realistically try to figure out what to do about it. As a first step towards self-help, take steps to understand the nature of your problem or issue. Watch for any tendency you might have to externalize your problem (e.g., to see the cause of your problem in someone else's actions rather than your own). Own up to any responsibility you may have for creating or maintaining the problem. Understanding your problem requires that you take some time to identify the nature of your problem; what might be causing that problem and why and how it has become an issue for you. Because mental health and life issues are usually troubling and anxiety provoking, there is a tendency to get emotional while thinking about them. It is easy to get distracted or fooled by self-defensive feelings when you get emotional, and also easy to act on mistaken perceptions. In your "panic" to avoid dealing with your problem you may minimize it inappropriately (concluding that it is less of a problem than it really is), or exaggerate it (making a "mountain out of a molehill"). You may not want to admit your own role in creating or maintaining the problem, and instead, inappropriately blame others for your own failings. Think carefully about the nature of your problem rather than just going with your first impression or urge. If possible, talk with trusted others about your problem to gain their (hopefully unbiased) perspective. Do your best to relax, to be honest, and to not be defensive about your situation. Letting go of your emotion (anxiety, depression, panic, etc. when thinking about and reading up on your issue (as much as this is possible to accomplish) will help you to learn whether you are really motivated to change or not and whether you would be better off seeking professional assistance vs. trying a self-help approach.Example: Bob recognized his anger and the reason for it (e.g., Sam’s borrowing the toolbox and not returning it when he said he would). He also admitted to himself that he was still mad about past times Sam and borrowed things from him, and he hadn’t said anything about it to Sam those times.
2. Break The Problem Down Into Small Parts. Even when you understand what your problem is, it may be too big and too well established for you to figure out how to fix all at once. Instead of trying to tackle the entire problem all at once, break it down into manageable parts. Then, make a plan for how you will fix or address each part separately. Example: Since Bob knows he really is in control of his anger enough to talk with Sam, and that he still values his friendship with Sam, he decides to talk with him about the borrowing rather than yelling at him or starting a fight. Bob is calling on his strengths in this situation; his ability to talk with Sam and to do so reasonably and calmly even when angry, while also recognizing and honoring his feelings of friendship for Sam. Although this example is not really a very complex problem, Sam has still taken the time to break the problem down into multiple separate parts. He needs to figure out a way to 1) stop feeling upset, 2) get his tools back, and 3) preserve his relationship with Sam if possible. Separating out his varying goals and desires for how the situation should come out has helped him to decide how to best handle the situation. This same knowledge will continue to illuminate what his next steps should be, if more are needed.
3. Define Problem Goals. For each of your small manageable problem parts, figure out what your goals are; where you want to end up at the end of the self-help process for each part of your problem. If you don't know what you are working towards, you will never know when you've arrived there. Example: Bob has identified three goals; 1) to stop the distress his feeling of anger at Sam is causing; 2) to get his toolbox back from Sam on time; and 3) to maintain his friendship with Sam.
4. Decide How To Measure Progress Towards Goals. Find ways to measure progress you make towards accomplishing each of your problem goals, so that you will always know: 1) what your problem starting point looked like, 2) how far you've come towards meeting your goals at any given moment, and 3) how you'll know when you've met your goals and are done. Example: Bob's first opportunity to measure his progress towards meeting his goals comes when he talks with Sam. Whether or not Sam gets upset with Bob is out of Bob's control, so Bob cannot legitimately measure his success by how Sam reacts. Instead, he determines that he will have met his goal if he is able to say what he wants to say in a clear, calm and firm manner while doing his best to not alienate his friend. Whether or not Sam returns the missing toolbox is another opportunity for Bob to measure the success of his communication with Sam. Bob can monitor how well Sam does at returning tools he borrows on time in the future. If any of these events don’t go well, then Bob will know he needs to not lend Sam anything he needs to have back in a timely manner.
2.
Steps 5-7: Planning a Solution
5. Educate Yourself About Problem Solutions. Learn about the different methods available for helping yourself manage your problems and issues. You may not know what to do about your issue at first, but it is overwhelmingly likely that other smart people have thought and written about how to best solve the problem you are experiencing. Read what these authors have to say about solving your problem. Alternatively, consult with other people whose opinions you respect, asking them how they have solved problems similar to the one you are faced with. Example: Bob isn't necessarily aware of this, but his decision with regard to how he will approach Sam about his toolbox can be understood in terms of assertiveness theory, which is a way to think about problems people have in communicating with one another. Basically, people's communications can be classified into one of three categories: Aggressive communications (where one person abuses another person), Passive communications (where one person allows another person to abuse them by not defending themselves), and Assertive communications (where one person defends themselves against another's abuse, but does not attempt to abuse the other person in turn). In our example, Bob chooses to act assertively in his communication with Sam (by stating clearly that he is upset and wants his tools back, while also communicating that he values the friendship), rather than aggressively (where he might 6. Choose The Best Solution For You. After learning as much as you can about different ways your problem can be solved, make choices about which of these ways will work best for you personally, based on your understanding of your own strengths and weaknesses. Example: Bob clearly chose to use his strengths (in keeping his temper under control, in being willing and able to speak his mind clearly) to resolve his problem. He may not have been particularly aware that these abilities of his are strengths. Nevertheless, he chose a plan that made good use of what he knew he could accomplish, given the situation he found himself in.
7. Write Your Plan Down. Having figured out: 1) what problems you wish to change; 2) how to break those problems down into small, manageable parts; 3) what your goals and objectives are with regard to your problems; 4) how you will measure progress towards addressing your problems; 5) what your problem-solving options are (various ways your problems might be approached); and 6) which methods and options will work best for your specific situation and personality, then sit down and actually create a plan. Write your plan down on paper or in a computer file, choosing which methods, techniques and approaches you will use as you carry out your plan, and what deadlines you will keep to. Write down a separate plan for each manageable problem and goal you have identified.
Example: If Bob were to write down his plan, it would look something like this:
Goal 1 -- To stop the anger I feel toward Sam.
§ Method - Talk with Sam about returning the things he borrows to me on time.
§ Measurement - Relief at having said what I plan to say.
§ Deadline - This evening.
Goal 2 -- To get the items back from Sam when I expect them.
§ Method - Tell Sam exactly what I want and explain that I won’t lend to Sam again if Sam doesn’t return something to me when he says he will.
§ Measurement - 1) Sam returns something he borrows next on time or doesn’t. (If he doesn’t, I stop lending to Sam.) 2) Sam returns future items he borrows on time or doesn’t. (If he doesn’t, I stop lending to Sam.)
§ Deadlines - Next time Sam borrows and the times after that.
Goal 3 -- To maintain my friendship with Sam.
§ Method - When I talk with Sam this evening, I will stay calm and reasonable and use "I" statements" to explain how I feel, in spite of my anger.
§ Measurement - I will know I have succeeded if I carry out this method as described here, but the rest will be up to Sam.
§ Deadline - I will know the friendship has been maintained by our interactions and activities together over the next several weeks
yell at Sam and call him a "freeloader") or passively (where he might swallow his anger and let Sam get away with being late yet again).
Steps 8 and 9: Taking Action
8. Act On Your Plan. Put your plan into action, and commit to sticking with it, though it might be uncomfortable or inconvenient to do so. Dealing with your problem now will help your problem from getting larger, more distressing, more complicated and overall worse than it already is. Acting now will also help you avoid regrets you might have later on for not acting as soon as reasonably possible, before the problem got worse. Deal with your problem now; Problems rarely just go away on their own.One thing that keeps people from committing to a self-help plan is the fear that they don't know enough yet to choose the best plan. Rather than risk acting on a less-than-optimal plan, some people simply don't at at all. Try to avoid letting this happen to you. It is not necessary that you have the very best self-help plan possible in order for it to work. It only needs to be a "good-enough" plan in order to work. Your plan need not be fixed, unchanging and set-in-stone. As you act on your initial plan, you will learn new information about what you can and cannot accomplish. You may become aware of new ways for addressing your problem that you didn't know about at first. You will learn what approaches work and don't work for you personally. Your goals regarding what you want to accomplish may change as well as you go along. You can modify your plan so as to accommodate what you learn so that your plan grows and improves as you grow and improve.
Example: Despite all his careful planning and clear communication, Bob may find that Sam never does return that toolbox. Bob may ask himself whether he wants to continue his friendship with Sam at all, or whether he wants to maintain the friendship as it is but refuse any further requests Sam makes to borrow things. How Bob decides to handle his relationship with Sam will depend on how Sam reacts, and how Bob feels about Sam's reaction. It may occur to Bob that he has the same problem expressing his anger and standing up for himself with other people; that his assertiveness issue is not limited to his interaction with Sam. If this is the case, Bob could then write a new plan based on a new, more general goal of learning how to become more assertive when he is faced with irresponsible or insensitive behavior. He will have already asserted himself towards Sam, so he’ll likely feel that he can learn to assert himself towards others as well.
9. Stick With The Plan, Despite Relapses. The final important part of self-help involves learning to stick to your plan even when you relapse. Relapse occurs when you fail to do the things you said you would do in your plan. Relapses are common. They occur because the old habits and ways of doing things that have contributed towards you having issues and problems in the first place are quite strong and deeply ingrained into your mind and body. It is always easier to continue doing what you are used to doing than to make changes, even when those changes are good for you. Understand that relapses are likely to happen from time to time (and especially likely when you become stressed) and that they aren't the end of the world when they do happen. When you relapse, you need to simply admit it, and get back to working on your self help plan. Forgive yourself for your failure and get back to moving forward with your plan. When it comes to self-help efforts, the only relapse that ultimately really counts is the one that you don't recover from. Example: Let’s say that Bob lets Sam get away with not returning that toolbox this time and doesn't say anything about it to him. Let's also say that he continues to let Sam borrow things. After all the time Bob has spent developing a self-help plan for asserting himself to Sam, this failure to take action would constitute a relapse. It would be easy for Bob to relapse into passivity with regard to Sam. After all, he feels friendly toward Sam and probably doesn't want to rock the boat with his friend. Yet, Bob knows at some level that it continues to make him angry whenever Sam takes advantage of their friendship. He knows that if he continues to let Sam's bad behavior go unchecked that he will probably get angrier and be inconvenienced again in the future when Sam doesn’t return some other tool he has borrowed. Allowing this to happen wouldn’t be good for Bob and it wouldn’t be good for his friendship with Sam either. Recognizing this, Bob decides to say "No" to Sam the next time Sam asks to borrow something, and then actually does say "No" when Sam next asks to borrow something. Although Bob relapsed from his original plan, he later decides to get back on track with his plan. It probably feels uncomfortable for him to assert himself in this manner, but probably it is ultimately more comfortable for him to assert himself than to seethe with unexpressed anger again and again. By choosing to go back to acting on his self-help plan for asserting himself and setting limits on Sam, Bob creates a chance for preserving his friendship with Sam. If Bob never says anything to Sam and keeps letting Sam's bad behavior slide he will probably end up feeling permanently disrespected by Sam and may end their friendship (an outcome Bob would like to avoid if possible).
Steps to Self-Help Overview
Making a formal step-by-step self-help plan, as we're recommending above, might seem foreign and 'stiff' to you, but it is a good idea to work through the process step by step nevertheless. Doing so helps you to be clear on what your plan is exactly. It helps you to make sure that your plan makes sense.
Working through the creation of a self-help plan in step-by-step fashion is a formalization of the way you probably already approach problem solving. You probably already unconsciously go through many of these steps when making decisions that affect your mental health. For instance, you might already choose to avoid the stress of working with someone you find difficult by not volunteering to be involved on committees with that person. You may choose not to travel by air to visit family, but instead to drive, because you fear flying. You might choose to work in a job that doesn't involve much human interaction because you know you don’t have the psychological stamina to deal with a lot of human interaction. You are probably already taking steps to figure your problems out, running through alternatives on how you might handle though problems and then choosing to act on alternatives that make the most sense. By asking you to write your self-help plan down, we're just encouraging you to become more conscious of this self-help planning process so that your plans will be as solid and useful as they can be
We make self-help choices and decisions all the time, big and small, and on a daily basis. Writing things down and making the process more formal and conscious is a good idea because we have learned from experience that when people do so, they tend to take the process more seriously, and then are able to create better self-help results for themselves. Much of self-help is common sense, but common sense is often exactly what we lack when we're under stress or other emotional strain. Creating a formal plan helps you stick to your own common sense during times when you wouldn't otherwise remember to do it or would otherwise become distracted by conflicting feelings and emotions.
Benefits of Self-help
There are many good reasons for taking a self-help approach towards addressing your problems and issues.
§ Self-help is empowering. Developing a self-help plan keeps you in control of your own destiny. The skills and methods you learn while engaging in the self-help process are likely to be generally helpful to you across many different aspects of your life. It is also emotionally satisfying to address issues on your own; doing so helps you to feel like a responsible and capable adult
§ Self-help means a customized plan. Designing your own self-help plan means that you can customize your efforts so that they fit your particular strengths and weaknesses, and reflect your personal choices about how to best address your specific issues.
§ Self-help makes other people feel good about you. Your decision to engage in self-help provides some assurance to other people who may be upset with you because of your issues that you are working on your issues and taking steps to overcome them. In many cases, your self-help efforts will be noticed and appreciated by those people around you who care about you or count on you.
You become a role model. If you have children, your pursuit of self-help is an excellent way to teach your children to be self-sufficient and capable when they grow up.
Self-help makes you a better, wiser person. By increasing your self-awareness capabilities, self-help efforts can help you learn to recognize potential problems before they occur (or at least early on in their progression) so that you can head them off before they become substantial. As your objectivity (your ability to see things as they are, rather than how you would like them to be) increases, you’ll find yourself increasingly able to be your own best adviser, steering yourself away from bad decisions and towards good ones with a minimum of fuss.
Self-help can be a time saver. Pursuing self-help efforts saves you the time you might otherwise need to spend with a therapist or counselor who could help you with your problems.
Self-help is private. If you are a private person who gets uncomfortable with the thought of sharing secrets with others, self-help can save you the embarrassment of sharing your issues and problems with another person.
Self-help is available and inexpensive. Self-help is generally free of cost and free or inexpensive to learn about. If you live in a rural area or small town, self-help may be one of the only good options available to you for receiving help.
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Disadvantages of Self-help
There are also sometimes significant disadvantages to self-help approaches as well.
§ You may lack the perspective to properly understand the nature of your issues. Your ability to help yourself will only be as good as your ability to be objective and clear about what the nature of your issues is. It is notoriously difficult to sort out, on your own, what your issues are really about. You may lack enough objectivity and perspective to make a true and accurate assessment or judgment concerning your own issues at this point. There are many ways that people find to deny or distort the truth of what is going wrong in their lives, even when such denial strategies do not serve their long term interests. In fact, there is a whole psychological literature that has developed to catalog the various defense mechanisms that people use to avoid knowing uncomfortable truths. For example, some people engage in a type of denial called "externalization". In this case, they are aware that something is wrong, but mistakenly think that the problem is caused by other people around them, instead of being due to themselves. Other people project their own troubling feelings onto other people just like a movie projector casts an image onto a screen. They may be angry people who aren't in touch with that fact. Instead of realizing that they are themselves angry, they project their anger onto others, and come to believe that it is other people who are angry. Such people believe that other people are picking fights with them (when they really aren't), and then "defend themselves" by picking fights themselves. Still other people engage in "workaholism". They escape from their problems by burying themselves in work to the point where they never have time to think about what drove them to do that in the first place. There are many more defense mechanisms than we've listed here. You can read more about defense mechanisms here (LINK to Defense Mechanism section of this document far below). You could easily be in denial about your problems and using some sort of defense mechanisms to avoid knowing about them, or understanding their true nature. If this is the case, you are unlikely to be able to understand the true nature of your problems. Since you can't fix what you don't understand, you'll be helpless to solve your problems and may only create more of them should you try a self-help approach.
You may lack the knowledge of how to fix your issues. Even if you are able to be objective and accurate about the nature of your issues, you are still faced with the challenge of figuring out how to solve them. Creating a useful self-help plan requires accurate knowledge: 1) Knowledge of what is causing your problems, and 2) knowledge about how those problems can be fixed. People aren't born knowing how to fix problems. It takes access to resources and the willingness to read and study those resources before you can determine the best methods for helping yourself. Not everyone is able or willing to do this work.
You may lack the motivation or will-power to stick to a self-help plan. There is a final issue as well. Even if you know what to do to solve your problem, you aren't always able to stick to your plan and follow through well enough to benefit from your plan. Creating and maintaining the motivation necessary to stick to a self-help plan can be a very difficult thing to accomplish. Not everyone is able to motivate and discipline themselves sufficiently well, even when they are dealing with painful problems they very much want to solve.
Should you get stuck at any point during the self-help process, the best think you can do is to consult with a professional therapist or counselor specialized in addressing the sort of problems you are trying to work through. Professional therapists and counselors are trained to be objective observers of those people who come to them with problems. They assess issues raised with them according to well-established scientific and clinically based concepts and theories, and are able to guide their clients towards approaches that have been tried and tested for effectiveness. Professionals can help their clients to recognize when they are straying from the right path, and also provide support and encouragement for getting back on the path towards effective change. Finally, therapists and counselors provide their clients with important corrective feedback that they might not otherwise be able to provide themselves. Such feedback helps clients to recognize and overcome barriers and diversions to their progress.
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When Self-help Is Inappropriate
Some mental health issues are simply too challenging and serious to safely address on your own. Some mental illnesses (otherwise known as psychiatric disorders), including bipolar disorder, schizophrenia and related disorders, and severe forms of depression, for example, require medication in addition to psychotherapy and/or participation in a psychiatric rehabilitation program if reasonable outcomes are to occur. For instance, people with severe eating disorders need access to psychotherapy and often to medical attention too before they will get better. They are by definition unable to be objective about their conditions and may cause themselves serious harm or even inadvertently kill themselves if they try to treat themselves. Serious mental health problems really require professional medical and psychotherapy treatment; they cannot be successfully addressed with self-help means alone. Self-help has a role to play with regard to serious mental illness, but that role is a secondary one at best.
Medical interventions such as medication prescriptions and hospitalization can only occur with the assistance of a medical professional. When your therapist or counselor is also a physician, prescribing nurse or physician’s assistant, he or she can prescribe you the appropriate medication and dosage that will best support or lead to your mental health stability or recovery. When you aren’t already seeing a medical professional for your therapy, your therapist or counselor will be able to refer you to a doctor or other medical professional who can properly attend to your medication needs.
Milder problems and disorders, such as some milder forms of depression, anxiety disorders and attention deficit problems, may benefit best from professional treatment, but possibly can be handled through self-help care.
Deciding whether a given problem can be helped through self-help means or instead should be addressed through professional intervention is a vital and important part of self-help planning. If you make a mistake in this planning process and fail to get necessary medical or professional care, you may end up harming yourself inadvertently To help you make the right decision, we describe pros and cons of self-help for mental health problems in the following discussion, with the aim of increasing your understanding of when self-help methods will be appropriate for you and when they should be avoided, or assigned a secondary role.
Medical interventions such as medication prescriptions and hospitalization can only occur with the assistance of a medical professional. When your therapist or counselor is also a physician, prescribing nurse or physician’s assistant, he or she can prescribe you the appropriate medication and dosage that will best support or lead to your mental health stability or recovery. When you aren’t already seeing a medical professional for your therapy, your therapist or counselor will be able to refer you to a doctor or other medical professional who can properly attend to your medication needs.
Milder problems and disorders, such as some milder forms of depression, anxiety disorders and attention deficit problems, may benefit best from professional treatment, but possibly can be handled through self-help care.
Deciding whether a given problem can be helped through self-help means or instead should be addressed through professional intervention is a vital and important part of self-help planning. If you make a mistake in this planning process and fail to get necessary medical or professional care, you may end up harming yourself inadvertently To help you make the right decision, we describe pros and cons of self-help for mental health problems in the following discussion, with the aim of increasing your understanding of when self-help methods will be appropriate for you and when they should be avoided, or assigned a secondary role.
Deciding Whether to Use Self-help or Professional Help
It’s critical to recognize that some problems and issues are more appropriately treated by professionals than through self-help means. You should seek professional help whenever you find yourself in one of the following situations:
§ Acute Danger. You should seek professional help immediately if you find yourself in an unsafe living situation or relationship (perhaps where you are being sexually, physically or verbally abused), or if you are experiencing thoughts or urges to harm yourself or to harm someone else. If you are being abused, remove yourself from the abusive situation (e.g., leave the house or apartment) and call the most appropriate crisis service (such as your local rape crisis number or domestic violence shelter number. Call 911 (or equivalent emergency telephone service) if you can't think of anyone better to call. If you are feeling suicidal (you want to kill yourself), or homicidal (you want to kill someone else) call 911, your local mental health crisis telephone number, or your local police or sheriff’s emergency number. The professionals who answer the phone should be able to help you stay safe and find appropriate crisis counseling or treatment for you. If your issue can wait (if it does not put you or another person in immediate danger), call your local crisis hotline, domestic abuse hotline, community mental (or behavioral) health center, therapist, counselor, psychiatrist or psychologist, and make an appointment to see a professional as soon as is possible who can help you to cope. If you need emergency medical attention, you can go to your local hospital emergency room.
§ Hallucinations. If you experience hallucinations (meaning that you hear voices, see things or smell odors that others don’t hear, see or smell), seek help from a professional therapist, psychologist or counselor. You should also seek out the help of a medical professional, such as a psychiatrist, to discuss the possibility of medication. Medication is the only proven means of lessening or stopping hallucinations.
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Delusions. If you have delusions (meaning that you have ideas, perceptions or thoughts that don’t make any sense to others you share them with), seek help from a professional therapist, psychologist or counselor, and see a psychiatrist to discuss the possibility of medication which can help lessen or stop your delusions. You won't be able to generate a good self-help plan if you are delusional, because your judgment will be suspect.
Respected Opinions. If a person you trust tells you to seek help for a mental health issue or problem, listen carefully and seriously consider that there may be some good reason why they have recommended that you take this course of action. Contact a therapist, counselor, psychiatrist or other mental health professional for an evaluation. If your evaluation reveals that you would benefit from therapy, counseling and/or medication services, these professionals will either offer you appropriate services, or will refer you to another professional who will be better able to help you.
Failed Self-Help Efforts. If your self-help attempts are not working, or you find it very difficult to stick with self-help efforts, seek the help of a professional. There is no reason you shouldn't ask for help, as millions of other people do, when you need it.
Alcohol or Substance Abuse. If you have an alcohol or other drug abuse problem, seek professional help. A licensed substance abuse counselor, or similar professional can help you manage both your substance abuse issue and the many problems that inevitably result from substance abuse issues (such as poor family relationships and inadequate social support). You may also require the assistance of residential treatment programs and detoxification facilities. Medically supervised detoxification is absolutely necessary for helping people to safely come off of certain drugs, including alcohol. Trying to come off Alcohol "cold turkey" by yourself can result in your death! Twelve step programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are one of the better and more available ways of helping yourself stay sober after you've been detoxified. AA and NA offer exactly the type and frequency of support and encouragement you’ll need to achieve and maintain sobriety, and to deal with the emotions and changes that you’ll likely need to address as you remain in recovery. Alcohol or drug abuse or addiction, along with mental health issues or disorder, occurs far more commonly than we used to think. Treatment and counseling provided by a trained substance abuse counselor, or by a mental health counselor with substance abuse training is highly recommended.
Lack Of Clarity. If you find that you just aren’t sure what your issue or problem really is or what to do about it, consult with a professional. A professional, whether a licensed therapist, counselor, nurse, psychologist, or psychiatrist, can help you to better understand what your problem is, and how to deal with it.
One practical way to determine whether or not you need professional help is to look at how you’re doing on a day-to-day basis. If you’re able to take care of all or most things that most people are able to do, such as brushing your teeth, shopping, making meals for yourself, doing laundry, driving, working, concentrating adequately on what you're doing at any given moment, and making and maintaining friendships, you’re more likely to be able to help yourself with certain issues than if you can’t currently do those things. If you’re having trouble concentrating or sleeping, are suicidal, drug or alcohol addicted or are experiencing hallucinations, self-help may be too difficult. If you're really depressed, self-help efforts may be too difficult to sustain. Since self-help requires that you spend a lot of energy on thinking and acting in particular and new ways, consider whether you’re really feeling up to making the effort to do it properly, or whether it would be better to have a professional "guide" to help you along.
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Diagnosis vs. Self-Diagnosis
One major benefit of seeking professional health care (mental or otherwise) is that a professional is often in a better position to accurately diagnose your problem, and point you towards the best treatments available for helping you get better than you are. You may have heard the term "diagnosis" before. A diagnosis is a label given to a particular illness or issue that you might have. Diagnoses are identified by their symptoms, which are the complaints that people make when talking to their doctors. Mental health diagnoses have been organized in a book called the Diagnostic and Statistical Manual of Mental Disorders (or DSM, for short). In the DSM, each diagnosis falls into one of several possible categories, including, but not limited to mood disorders (such as depression and bipolar disorder); schizophrenia and other psychotic disorders; anxiety disorders (including panic attacks, phobias, post traumatic stress disorders and obsessive-compulsive disorders); dissociative disorders (including multiple personality and amnesia); impulse control disorders (such as compulsive hair pulling, or fire-setting); personality disorders (such as borderline personality and narcissism); and substance related disorders (such as alcohol or methamphetamine addiction).
One of the first things that a mental health professional will do when you visit him or her is to diagnose you. He or she will listen to you describe your issues and complaints, and fit them into one or more of the known illness categories described in the DSM. Diagnosing your issues is important, because it helps professionals to know which interventions to suggest to you (from among thousands that are possible) that will have the best chance of helping you to get better. Professionals know which interventions to choose based on your diagnoses because they are familiar with the work that thousands of scientists and clinicians have previously done to match particular interventions with particular diagnoses.
For example, let's say that you visit a mental health professional and complain about the following symptoms: You're experiencing severe mood swings, are feeling overly energetic lately, can’t concentrate, are spending money recklessly, are increasingly irritable with other people, aren’t abusing drugs or alcohol and have gone through similar episodes before in your life. Your professional will listen to what you have to say, and will ask questions about your experience to clarify things or get you to talk about things that might be important but which you've not mentioned spontaneously. He or she will likely want to learn about your past history of similar problems and may request medical records from other doctors if any exist. He or she may want to order several medical tests be done to determine if there is a physical cause, such as drug abuse, brain damage, hyperthyroidism or similar problem, that can explain your symptoms If no physical cause can be determined, you would probably be diagnosed with a psychiatric disorder that most closely fits with your presentation (in this case, possibly bipolar disorder). Your professional will know that certain treatments are known to be helpful for bipolar disorder (particular medicines such as "mood stabilizers" and "antidepressants", in this case) and will help you obtain those treatments, along with proper instructions and monitoring for their use. Other treatments that are known to be less helpful for treating bipolar disorder will not be offered. Alternatively, If you go to a professional and say that your major symptom is anxiety, that professional might diagnose an anxiety disorder, and create a treatment plan for you that includes interventions that are known to be helpful for treating anxiety disorders, including cognitive therapy, relaxation techniques, exercise programs, and anti-anxiety medication.
Only a doctor or similar trained and experienced mental health professional is qualified to make a true diagnosis and therefore to make treatment recommendations. Diagnoses are complex and difficult to make correctly. It takes many years of concentrated study to learn how to accurately diagnose patients, and even then, different doctors will sometimes make different diagnoses for the same patient. For example, the family of psychotic disorders are characterized by a variety of symptoms, including delusions, hallucinations and regressed (or "primitive") odd behaviors. Psychoses occur across many different types of disorders, including substance abuse, severe depression; bipolar disorder as well as schizophrenia and related psychotic disorders. When diagnosing schizophrenia, for example, it is necessary to rule out (or exclude) the possibility that other disorders (like bipolar disorder) or drugs (like cocaine) might be causing the problem. To make matters even more complicated, the very definitions of the different diagnoses change across time, as the DSM gets revised and rewritten. For example, not so long ago, homosexuality was a diagnosable illness defined in the DSM. This diagnosis was removed from the DSM in the 1980s when it became clear that it had been included there more because of cultural prejudice than for scientific reasons. Today, evidence from the biological sciences suggests that most homosexuality is biologically determined and thus a normal variation of human sexuality and not a disorder at all. It is rare these days to find a professional mental health provider who believes homosexuality is a mental illness.
Risks of Self Diagnosis
People who do not have the benefit of professional diagnosis and care run two risks when they try to diagnose and treat themselves using self-help methods:
§ Risk of Misdiagnoses. The first risk is that they might miss something subtle but important about their problem or issues which would, in turn, cause them to misdiagnose themselves, possibly with disastrous results. For example, someone might think they have an anxiety condition of some sort, but closer professional examination might uncover an underlying serious medical problem such as an heart arrhythmia The affected person might treat themselves as though they have an uncomplicated anxiety problem (e.g., with relaxation exercises) and completely miss the fact that they have a serious medical condition that requires medical treatment. There is really no good way to reduce this type of risk except to go to a professional for a professional diagnosis.
Risk of Wrong Treatment. The second risk inherent in self-diagnosis and self-treatment is that people might end up treating themselves with methods that don't work at all, which are inefficient, which are plain old wrong for their problems, or which actually cause harm. This risk is heightened when treatments and methods that people consider using are inherently dangerous when misused. For example, someone might try to treat their weight problem with with pills that were prescribed for someone else, or illegally obtained on the street. They might alternatively decide that the best way to lose weight is to starve themselves by fasting (not a good idea at all!) or by engaging in strenuous physical workouts on a regular basis. Research shows that starving yourself is unlikely to result in any weight loss, and may cause other problems to develop, including binge eating patterns which can lead to eating disorders like Bullemia. A non-health-professional person might not know this important fact and starve themselves anyway. Similarly, strenuous exercise might be appropriate and even healthy for some people, but it might provoke a heart attack in someone else (in a worst case scenario), or simply lead to pain and "Charley horse" that would discourage them from pursuing further healthier methods for weight loss.
It is never a good idea to take someone else's pills, by the way, and never a good idea to treat a problem with street drugs! Weight loss pills can be habit forming, for one thing, and may lead to an addiction. They can also cause medical problems. Medication might be safe for another person, but actually dangerous for you! Do not use medication except under the supervision of a licensed physician or other appropriate health professional.
Updated: Jun 26th 2006
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Conclusion
The take-home message with regard to self-diagnosis and self-treatment is that if you pursue the self-help route without the aide and assistance of a professional helper, take care to do your homework first. Consider how severely your issues or problems impact your safety, the safety of others, your own functioning and your peace of mind. Consider also how complex your problems may be and whether or not you have a reasonable chance of appropriately assessing and addressing those problems successfully. If you have any doubts at all as to your ability to figure out and treat your problems on your own, seek the help of a professional.
A surprising number of people will not seek professional help even when it is the right thing to do because they do not like the idea that they require help to manage their issues. If you think seeking help is a weakness, and that only 'weaklings' ever consult professionals, you’ll need to decide whether your macho attitude (for that is what that attitude is, regardless of whether you are a man or a woman) is helping or hindering your progress in solving your problems and issues. If your attitude is getting in the way of your growth and health, then you have to decide whether or not it is time to change your attitude. If in your careful estimation self-help will work for you then pursue self-help with determination. First, however, take the necessary time to understand your issues, and explore all of your alternatives for self-help. Avoid risky, extreme, or un-proven methods and 'solutions' that might endanger you or others (if in doubt, consult with a professional). If, however, you’ve thought it through and have decided that self-help isn't likely to work for you at this time, then seek out professional assistance now. Don’t stand in your own way by avoiding professional assistance.
The first "noble truth" of Buddhism states a fact that is obvious to many people who will be reading this document: life involves suffering. At various times in life, most people will be faced with one or more mental health, wellness or life issues that will cause them pain in one form or another and which they will want to rid themselves of. People faced with such issues and illnesses have three basic options for getting help. They can seek help from medical or mental health professionals (or people who hold themselves out as teachers of one sort or another); they can choose to work on their problems themselves through a process of self-help; or they can combine professional/teacher and self-help approaches. There are many benefits to be had from professional helpers. In some cases and for some problems, the only real benefits that can be had are had through professional helpers. This is certainly the case with serious mental illnesses such as Bipolar Disorder or Schizophrenia. Nevertheless, professional helpers are expensive, seldom available as much as you might like, and limited in terms of what they can offer. For these and other reasons which we'll outline below, it is a very good idea for people dealing with painful issues and illnesses to learn methods for helping themselves
This document is directly concerned with helping people learn methods for helping themselves manage and even overcome various troubling mental health, wellness and life issues. Self-help for mental health and wellness issues consists of learning about the nature of distressing issues, learning how to measure or assess those issues and how they can be resolved, and then choosing and following a course of action that will help you to resolve those issues.
Taking Action is Key
Because you usually cannot solve troubling issues just by thinking about them, taking action is key to getting any sort of help. This is especially the case with regard to self-help. Just thinking about things that trouble you, but not taking action to change them is likely to be quite ineffective. Even though it is ineffective, the tendency to just think about things that trouble you and avoid taking action to address them is so common that multiple names have been developed to describe it, including "intellectualization", "rumination", and "procrastination", to name but a few. Avoiding taking action on problems is not an effective or useful strategy for self-help because nothing happens when you do this except that your thoughts go round and round. Worry and rumination without action lack a vital ingredient necessary for forward motion and positive change. A car cannot go forward without a transmission, no matter how powerful its engine may be. Like a car without a transmission, avoidance and worry in the absence of an action plan cannot get you where you want to go.
The topic of self-help covers a lot of ground. There are many different ways of helping yourself overcome problems, and not all of them will appear at first glance to be therapeutic. Doing your own taxes, fixing your own car or even serving yourself at a buffet lunch are all legitimate and useful self-help activities that can make your feel better about yourself. These are rather simple, narrow and specific activities, however, when compared with mental health and life-improvement oriented self-help efforts which are usually more complex in nature, requiring multiple actions and efforts to be coordinated before a benefit can be obtained.
A typical mental health self-help effort requires you to pay attention, make an emotional investment in change, perform one or more self-assessments, educate yourself about your problem(s), consider multiple alternative possible actions for addressing your problem(s), decide on a specific plan of action (selected from the alternatives available) which seems most likely to be helpful, and then finally commit and dedicate yourself to executing that self-help plan. All of this must be done before you will see any significant relief or results. These multiple components of a sound mental health self-help plan probably sound very complicated, but please rest easy; self-help isn't really that hard to do or to understand. There is a method to the madness and that method is largely based on common sense. This will hopefully become apparent as we consider the follow example showing how one man named Bob builds himself a self-help plan to help himself solve a difficult relationship issue.
Example of Taking Action (with analysis)
Bob and Sam are two friends who have known each other for years. One day, Bob realizes that he is angry with Sam and has been holding onto that anger for several days. It’s making him irritable and unhappy, so he decides to think the issue through further. He recalls that Sam borrowed his toolbox last week and said he would return it by Saturday, but he didn’t. On further reflection, Bob sees that his anger towards Sam has to do with that missing-in-action toolbox, and the disrespect that Sam's failure to return the toolbox on time seems to imply. Bob hasn’t said anything to Sam about the missing toolbox yet. He’s afraid he’ll blow up at Sam, since this isn’t the first time Sam has not returned something when he said he would. Bob realizes that he has been avoiding a talk with Sam about the problem for a long time. Finally, Bob thinks that, yes, he does have a valid complaint and that he will feel better if he speaks with Sam.
In this example, Bob's realization that his is upset with Sam because of Sam's failure to return the toolbox is an example of self-assessment and attention. The first component of mental health self-help involves your ability to realize that you, in fact, have problems. You cannot develop and put into action a self-help plan if you are not first aware that a problem exists and become willing to pay attention to that problem (to take responsibility for fixing that problem) in a sustained and serious way. You might think that this process of paying attention to problems is easy and automatic, but you'd be wrong about that. Many people have problems but are unaware of this fact. For one reason or another, they are in denial that they have problems. They are motivated to not know about their problems, or realize that problems exist, but blame those problems on other people rather than taking responsibility for them themselves. Only after you become aware that a problem exists, and take responsibility for that problem can you go to the next steps in the self-help process, which involve learning about the nature of your problem, and how that problem can be measured and fixed. Bob's emotional investment in his relationship with Sam helps him become aware that he is upset with Sam and motivates him to do something to make that upset go away. He has realized that taking action now - talking to Sam about the missing toolbox now - will save him further anger over the toolbox later on. He doesn’t want to feel angry in the future at Sam doing the same thing again. The fact that he has been avoiding confrontation with Sam may also be a clue to Bob that he cares for Sam; that he doesn't want to alienate Sam or deliver this message in a way that cause Sam to stop being a friend. He just wants Sam to show proper respect and return things on time. This realization that he values Sam's friendship helps Bob to know that how he approaches Sam about the issue is important. It will better serve his purpose to speak carefully and assertively to Sam than to aggressively scream and yell at him. Mainly, though, Bob has become invested in relieving himself of his current anger. He has gotten clear on what he wants, which is to have his things return to him on time when they are borrowed and to preserve his relationship with Sam. Bob has become emotionally invested in solving his issue. His task now is to figure out the best way to take action.
Bob thinks over the possible ways he can deal with his anger. He knows he has the option to just ignore his anger. If he does ignore his anger, it is likely that his anger will diminish over time (at least until the next time he thinks of Sam's disrespect). He also considers alternative actions he might take. He can talk with Sam assertively, telling Sam that he is angry about the missing toolbox and has been angry in the past about similar items that were not returned as promised. He can also get aggressive with Sam and let himself yell and scream. He can tell Sam that he won’t loan him anything ever again. He can stay mad and shut Sam out of his life. He can borrow something of Sam’s and not return that thing when he said he would. He can booby-trap his back door so that the next time Sam comes over to borrow something, a bucket of water falls on his head.
Bob thinks about the pros and cons inherent in each of the options he has generated for handling his dispute with Sam, evaluating each one for how well it will help him get to his ideal outcome - where he is able to remain friends with Sam but still get Sam to realize that he needs to return things on time. Bob decides that his best option is to be assertive with Sam, telling Sam that he needs to return the missing toolbox now, and that he can still borrow tools in the future, but only if he returns those tools on the agreed date. He further decides to tell Sam that Sam's failure to return the toolbox on time has left him feeling taken advantage of and disrespected, that he has been inconvenienced at times in the past by not returning the tools on time, and that he has been feeling angry about Sam's repetitive pattern of not returning things on time. Bob decides he will talk to Sam this evening, when he goes over to Sam's house to watch the ball game on TV. He decides he’ll keep his voice calm and will sit while he talks to Sam. He decides that he will reassure Sam that they are still friends if Sam seems upset by the conversation, but that he’ll stay firm about the borrowing regardless of how Sam reacts. He decides to tell Sam that if he can’t be sure he’ll return an item when he says, he shouldn’t borrow it from Bob. He’ll also tell Sam that if he doesn’t return any item on time in the future, he’ll be saying no about any further borrowing, even though he hopes never to have to turn down a request from Sam.
All of this decision-making constitutes a plan, one that Bob is dedicated to implementing. If Sam is a reasonable person too and a friend, he’ll probably apologize and swear to return any borrowed items on time in the future. If he isn’t reasonable about the issue, though, at least Bob will have done the best he could and be rid of his uncomfortable pent up anger at Sam's irresponsible behavior. Bob need not make Sam’s reaction to the conversation his own concern. He chooses, instead, to practice what therapists call, "good boundaries," by realizing he can only be responsible for his own feelings.
Steps in the Self-help Process
Bob's problem solving process example above shows how a good mental health self-help plan can be arrived at. Bob becomes aware that there is a problem (by paying attention to his feelings), commits himself to solving that problem (by taking responsibility for the problem and making an emotional investment towards solving it), and considers his action options in the light of both his own and his friend's personalities (by performing a self-assessment, and by considering the various alternatives). He chooses the best of the options he generates (selecting the most appropriate actions for meeting his goals) and then finally makes a commitment to himself that he will carry that plan out. He carries through on his intention by actually speaking with his friend later that night. You can use Bob's general pattern for creating a useful self-help plan to create your own self-help plan
We can further clarify how to create a good self-help plan by describing each step in the planning process in some detail. We encourage you to use these steps in planning your own self-help efforts; these steps will help you to make sure that your self-help efforts have the best chance of producing good results for you.
Decide whether to seek professional help or to pursue self-help. Before you launch into a self-help process, you need to know that self-help is an appropriate means of addressing your issues. Self-help is not appropriate as a means of treatment when you are dealing with serious illness, or when you have reason to believe your judgment may be compromised. It is a more appropriate path to pursue when you are dealing with less serious, non-life-threatening conditions.
Steps 1-4: Problem Analysis
1. Understand Your Problem. You must understand the issue, problem or symptom you are experiencing before you can realistically try to figure out what to do about it. As a first step towards self-help, take steps to understand the nature of your problem or issue. Watch for any tendency you might have to externalize your problem (e.g., to see the cause of your problem in someone else's actions rather than your own). Own up to any responsibility you may have for creating or maintaining the problem. Understanding your problem requires that you take some time to identify the nature of your problem; what might be causing that problem and why and how it has become an issue for you. Because mental health and life issues are usually troubling and anxiety provoking, there is a tendency to get emotional while thinking about them. It is easy to get distracted or fooled by self-defensive feelings when you get emotional, and also easy to act on mistaken perceptions. In your "panic" to avoid dealing with your problem you may minimize it inappropriately (concluding that it is less of a problem than it really is), or exaggerate it (making a "mountain out of a molehill"). You may not want to admit your own role in creating or maintaining the problem, and instead, inappropriately blame others for your own failings. Think carefully about the nature of your problem rather than just going with your first impression or urge. If possible, talk with trusted others about your problem to gain their (hopefully unbiased) perspective. Do your best to relax, to be honest, and to not be defensive about your situation. Letting go of your emotion (anxiety, depression, panic, etc. when thinking about and reading up on your issue (as much as this is possible to accomplish) will help you to learn whether you are really motivated to change or not and whether you would be better off seeking professional assistance vs. trying a self-help approach.Example: Bob recognized his anger and the reason for it (e.g., Sam’s borrowing the toolbox and not returning it when he said he would). He also admitted to himself that he was still mad about past times Sam and borrowed things from him, and he hadn’t said anything about it to Sam those times.
2. Break The Problem Down Into Small Parts. Even when you understand what your problem is, it may be too big and too well established for you to figure out how to fix all at once. Instead of trying to tackle the entire problem all at once, break it down into manageable parts. Then, make a plan for how you will fix or address each part separately. Example: Since Bob knows he really is in control of his anger enough to talk with Sam, and that he still values his friendship with Sam, he decides to talk with him about the borrowing rather than yelling at him or starting a fight. Bob is calling on his strengths in this situation; his ability to talk with Sam and to do so reasonably and calmly even when angry, while also recognizing and honoring his feelings of friendship for Sam. Although this example is not really a very complex problem, Sam has still taken the time to break the problem down into multiple separate parts. He needs to figure out a way to 1) stop feeling upset, 2) get his tools back, and 3) preserve his relationship with Sam if possible. Separating out his varying goals and desires for how the situation should come out has helped him to decide how to best handle the situation. This same knowledge will continue to illuminate what his next steps should be, if more are needed.
3. Define Problem Goals. For each of your small manageable problem parts, figure out what your goals are; where you want to end up at the end of the self-help process for each part of your problem. If you don't know what you are working towards, you will never know when you've arrived there. Example: Bob has identified three goals; 1) to stop the distress his feeling of anger at Sam is causing; 2) to get his toolbox back from Sam on time; and 3) to maintain his friendship with Sam.
4. Decide How To Measure Progress Towards Goals. Find ways to measure progress you make towards accomplishing each of your problem goals, so that you will always know: 1) what your problem starting point looked like, 2) how far you've come towards meeting your goals at any given moment, and 3) how you'll know when you've met your goals and are done. Example: Bob's first opportunity to measure his progress towards meeting his goals comes when he talks with Sam. Whether or not Sam gets upset with Bob is out of Bob's control, so Bob cannot legitimately measure his success by how Sam reacts. Instead, he determines that he will have met his goal if he is able to say what he wants to say in a clear, calm and firm manner while doing his best to not alienate his friend. Whether or not Sam returns the missing toolbox is another opportunity for Bob to measure the success of his communication with Sam. Bob can monitor how well Sam does at returning tools he borrows on time in the future. If any of these events don’t go well, then Bob will know he needs to not lend Sam anything he needs to have back in a timely manner.
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Steps 5-7: Planning a Solution
5. Educate Yourself About Problem Solutions. Learn about the different methods available for helping yourself manage your problems and issues. You may not know what to do about your issue at first, but it is overwhelmingly likely that other smart people have thought and written about how to best solve the problem you are experiencing. Read what these authors have to say about solving your problem. Alternatively, consult with other people whose opinions you respect, asking them how they have solved problems similar to the one you are faced with. Example: Bob isn't necessarily aware of this, but his decision with regard to how he will approach Sam about his toolbox can be understood in terms of assertiveness theory, which is a way to think about problems people have in communicating with one another. Basically, people's communications can be classified into one of three categories: Aggressive communications (where one person abuses another person), Passive communications (where one person allows another person to abuse them by not defending themselves), and Assertive communications (where one person defends themselves against another's abuse, but does not attempt to abuse the other person in turn). In our example, Bob chooses to act assertively in his communication with Sam (by stating clearly that he is upset and wants his tools back, while also communicating that he values the friendship), rather than aggressively (where he might 6. Choose The Best Solution For You. After learning as much as you can about different ways your problem can be solved, make choices about which of these ways will work best for you personally, based on your understanding of your own strengths and weaknesses. Example: Bob clearly chose to use his strengths (in keeping his temper under control, in being willing and able to speak his mind clearly) to resolve his problem. He may not have been particularly aware that these abilities of his are strengths. Nevertheless, he chose a plan that made good use of what he knew he could accomplish, given the situation he found himself in.
7. Write Your Plan Down. Having figured out: 1) what problems you wish to change; 2) how to break those problems down into small, manageable parts; 3) what your goals and objectives are with regard to your problems; 4) how you will measure progress towards addressing your problems; 5) what your problem-solving options are (various ways your problems might be approached); and 6) which methods and options will work best for your specific situation and personality, then sit down and actually create a plan. Write your plan down on paper or in a computer file, choosing which methods, techniques and approaches you will use as you carry out your plan, and what deadlines you will keep to. Write down a separate plan for each manageable problem and goal you have identified.
Example: If Bob were to write down his plan, it would look something like this:
Goal 1 -- To stop the anger I feel toward Sam.
§ Method - Talk with Sam about returning the things he borrows to me on time.
§ Measurement - Relief at having said what I plan to say.
§ Deadline - This evening.
Goal 2 -- To get the items back from Sam when I expect them.
§ Method - Tell Sam exactly what I want and explain that I won’t lend to Sam again if Sam doesn’t return something to me when he says he will.
§ Measurement - 1) Sam returns something he borrows next on time or doesn’t. (If he doesn’t, I stop lending to Sam.) 2) Sam returns future items he borrows on time or doesn’t. (If he doesn’t, I stop lending to Sam.)
§ Deadlines - Next time Sam borrows and the times after that.
Goal 3 -- To maintain my friendship with Sam.
§ Method - When I talk with Sam this evening, I will stay calm and reasonable and use "I" statements" to explain how I feel, in spite of my anger.
§ Measurement - I will know I have succeeded if I carry out this method as described here, but the rest will be up to Sam.
§ Deadline - I will know the friendship has been maintained by our interactions and activities together over the next several weeks
yell at Sam and call him a "freeloader") or passively (where he might swallow his anger and let Sam get away with being late yet again).
Steps 8 and 9: Taking Action
8. Act On Your Plan. Put your plan into action, and commit to sticking with it, though it might be uncomfortable or inconvenient to do so. Dealing with your problem now will help your problem from getting larger, more distressing, more complicated and overall worse than it already is. Acting now will also help you avoid regrets you might have later on for not acting as soon as reasonably possible, before the problem got worse. Deal with your problem now; Problems rarely just go away on their own.One thing that keeps people from committing to a self-help plan is the fear that they don't know enough yet to choose the best plan. Rather than risk acting on a less-than-optimal plan, some people simply don't at at all. Try to avoid letting this happen to you. It is not necessary that you have the very best self-help plan possible in order for it to work. It only needs to be a "good-enough" plan in order to work. Your plan need not be fixed, unchanging and set-in-stone. As you act on your initial plan, you will learn new information about what you can and cannot accomplish. You may become aware of new ways for addressing your problem that you didn't know about at first. You will learn what approaches work and don't work for you personally. Your goals regarding what you want to accomplish may change as well as you go along. You can modify your plan so as to accommodate what you learn so that your plan grows and improves as you grow and improve.
Example: Despite all his careful planning and clear communication, Bob may find that Sam never does return that toolbox. Bob may ask himself whether he wants to continue his friendship with Sam at all, or whether he wants to maintain the friendship as it is but refuse any further requests Sam makes to borrow things. How Bob decides to handle his relationship with Sam will depend on how Sam reacts, and how Bob feels about Sam's reaction. It may occur to Bob that he has the same problem expressing his anger and standing up for himself with other people; that his assertiveness issue is not limited to his interaction with Sam. If this is the case, Bob could then write a new plan based on a new, more general goal of learning how to become more assertive when he is faced with irresponsible or insensitive behavior. He will have already asserted himself towards Sam, so he’ll likely feel that he can learn to assert himself towards others as well.
9. Stick With The Plan, Despite Relapses. The final important part of self-help involves learning to stick to your plan even when you relapse. Relapse occurs when you fail to do the things you said you would do in your plan. Relapses are common. They occur because the old habits and ways of doing things that have contributed towards you having issues and problems in the first place are quite strong and deeply ingrained into your mind and body. It is always easier to continue doing what you are used to doing than to make changes, even when those changes are good for you. Understand that relapses are likely to happen from time to time (and especially likely when you become stressed) and that they aren't the end of the world when they do happen. When you relapse, you need to simply admit it, and get back to working on your self help plan. Forgive yourself for your failure and get back to moving forward with your plan. When it comes to self-help efforts, the only relapse that ultimately really counts is the one that you don't recover from. Example: Let’s say that Bob lets Sam get away with not returning that toolbox this time and doesn't say anything about it to him. Let's also say that he continues to let Sam borrow things. After all the time Bob has spent developing a self-help plan for asserting himself to Sam, this failure to take action would constitute a relapse. It would be easy for Bob to relapse into passivity with regard to Sam. After all, he feels friendly toward Sam and probably doesn't want to rock the boat with his friend. Yet, Bob knows at some level that it continues to make him angry whenever Sam takes advantage of their friendship. He knows that if he continues to let Sam's bad behavior go unchecked that he will probably get angrier and be inconvenienced again in the future when Sam doesn’t return some other tool he has borrowed. Allowing this to happen wouldn’t be good for Bob and it wouldn’t be good for his friendship with Sam either. Recognizing this, Bob decides to say "No" to Sam the next time Sam asks to borrow something, and then actually does say "No" when Sam next asks to borrow something. Although Bob relapsed from his original plan, he later decides to get back on track with his plan. It probably feels uncomfortable for him to assert himself in this manner, but probably it is ultimately more comfortable for him to assert himself than to seethe with unexpressed anger again and again. By choosing to go back to acting on his self-help plan for asserting himself and setting limits on Sam, Bob creates a chance for preserving his friendship with Sam. If Bob never says anything to Sam and keeps letting Sam's bad behavior slide he will probably end up feeling permanently disrespected by Sam and may end their friendship (an outcome Bob would like to avoid if possible).
Steps to Self-Help Overview
Making a formal step-by-step self-help plan, as we're recommending above, might seem foreign and 'stiff' to you, but it is a good idea to work through the process step by step nevertheless. Doing so helps you to be clear on what your plan is exactly. It helps you to make sure that your plan makes sense.
Working through the creation of a self-help plan in step-by-step fashion is a formalization of the way you probably already approach problem solving. You probably already unconsciously go through many of these steps when making decisions that affect your mental health. For instance, you might already choose to avoid the stress of working with someone you find difficult by not volunteering to be involved on committees with that person. You may choose not to travel by air to visit family, but instead to drive, because you fear flying. You might choose to work in a job that doesn't involve much human interaction because you know you don’t have the psychological stamina to deal with a lot of human interaction. You are probably already taking steps to figure your problems out, running through alternatives on how you might handle though problems and then choosing to act on alternatives that make the most sense. By asking you to write your self-help plan down, we're just encouraging you to become more conscious of this self-help planning process so that your plans will be as solid and useful as they can be
We make self-help choices and decisions all the time, big and small, and on a daily basis. Writing things down and making the process more formal and conscious is a good idea because we have learned from experience that when people do so, they tend to take the process more seriously, and then are able to create better self-help results for themselves. Much of self-help is common sense, but common sense is often exactly what we lack when we're under stress or other emotional strain. Creating a formal plan helps you stick to your own common sense during times when you wouldn't otherwise remember to do it or would otherwise become distracted by conflicting feelings and emotions.
Benefits of Self-help
There are many good reasons for taking a self-help approach towards addressing your problems and issues.
§ Self-help is empowering. Developing a self-help plan keeps you in control of your own destiny. The skills and methods you learn while engaging in the self-help process are likely to be generally helpful to you across many different aspects of your life. It is also emotionally satisfying to address issues on your own; doing so helps you to feel like a responsible and capable adult
§ Self-help means a customized plan. Designing your own self-help plan means that you can customize your efforts so that they fit your particular strengths and weaknesses, and reflect your personal choices about how to best address your specific issues.
§ Self-help makes other people feel good about you. Your decision to engage in self-help provides some assurance to other people who may be upset with you because of your issues that you are working on your issues and taking steps to overcome them. In many cases, your self-help efforts will be noticed and appreciated by those people around you who care about you or count on you.
You become a role model. If you have children, your pursuit of self-help is an excellent way to teach your children to be self-sufficient and capable when they grow up.
Self-help makes you a better, wiser person. By increasing your self-awareness capabilities, self-help efforts can help you learn to recognize potential problems before they occur (or at least early on in their progression) so that you can head them off before they become substantial. As your objectivity (your ability to see things as they are, rather than how you would like them to be) increases, you’ll find yourself increasingly able to be your own best adviser, steering yourself away from bad decisions and towards good ones with a minimum of fuss.
Self-help can be a time saver. Pursuing self-help efforts saves you the time you might otherwise need to spend with a therapist or counselor who could help you with your problems.
Self-help is private. If you are a private person who gets uncomfortable with the thought of sharing secrets with others, self-help can save you the embarrassment of sharing your issues and problems with another person.
Self-help is available and inexpensive. Self-help is generally free of cost and free or inexpensive to learn about. If you live in a rural area or small town, self-help may be one of the only good options available to you for receiving help.
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Disadvantages of Self-help
There are also sometimes significant disadvantages to self-help approaches as well.
§ You may lack the perspective to properly understand the nature of your issues. Your ability to help yourself will only be as good as your ability to be objective and clear about what the nature of your issues is. It is notoriously difficult to sort out, on your own, what your issues are really about. You may lack enough objectivity and perspective to make a true and accurate assessment or judgment concerning your own issues at this point. There are many ways that people find to deny or distort the truth of what is going wrong in their lives, even when such denial strategies do not serve their long term interests. In fact, there is a whole psychological literature that has developed to catalog the various defense mechanisms that people use to avoid knowing uncomfortable truths. For example, some people engage in a type of denial called "externalization". In this case, they are aware that something is wrong, but mistakenly think that the problem is caused by other people around them, instead of being due to themselves. Other people project their own troubling feelings onto other people just like a movie projector casts an image onto a screen. They may be angry people who aren't in touch with that fact. Instead of realizing that they are themselves angry, they project their anger onto others, and come to believe that it is other people who are angry. Such people believe that other people are picking fights with them (when they really aren't), and then "defend themselves" by picking fights themselves. Still other people engage in "workaholism". They escape from their problems by burying themselves in work to the point where they never have time to think about what drove them to do that in the first place. There are many more defense mechanisms than we've listed here. You can read more about defense mechanisms here (LINK to Defense Mechanism section of this document far below). You could easily be in denial about your problems and using some sort of defense mechanisms to avoid knowing about them, or understanding their true nature. If this is the case, you are unlikely to be able to understand the true nature of your problems. Since you can't fix what you don't understand, you'll be helpless to solve your problems and may only create more of them should you try a self-help approach.
You may lack the knowledge of how to fix your issues. Even if you are able to be objective and accurate about the nature of your issues, you are still faced with the challenge of figuring out how to solve them. Creating a useful self-help plan requires accurate knowledge: 1) Knowledge of what is causing your problems, and 2) knowledge about how those problems can be fixed. People aren't born knowing how to fix problems. It takes access to resources and the willingness to read and study those resources before you can determine the best methods for helping yourself. Not everyone is able or willing to do this work.
You may lack the motivation or will-power to stick to a self-help plan. There is a final issue as well. Even if you know what to do to solve your problem, you aren't always able to stick to your plan and follow through well enough to benefit from your plan. Creating and maintaining the motivation necessary to stick to a self-help plan can be a very difficult thing to accomplish. Not everyone is able to motivate and discipline themselves sufficiently well, even when they are dealing with painful problems they very much want to solve.
Should you get stuck at any point during the self-help process, the best think you can do is to consult with a professional therapist or counselor specialized in addressing the sort of problems you are trying to work through. Professional therapists and counselors are trained to be objective observers of those people who come to them with problems. They assess issues raised with them according to well-established scientific and clinically based concepts and theories, and are able to guide their clients towards approaches that have been tried and tested for effectiveness. Professionals can help their clients to recognize when they are straying from the right path, and also provide support and encouragement for getting back on the path towards effective change. Finally, therapists and counselors provide their clients with important corrective feedback that they might not otherwise be able to provide themselves. Such feedback helps clients to recognize and overcome barriers and diversions to their progress.
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When Self-help Is Inappropriate
Some mental health issues are simply too challenging and serious to safely address on your own. Some mental illnesses (otherwise known as psychiatric disorders), including bipolar disorder, schizophrenia and related disorders, and severe forms of depression, for example, require medication in addition to psychotherapy and/or participation in a psychiatric rehabilitation program if reasonable outcomes are to occur. For instance, people with severe eating disorders need access to psychotherapy and often to medical attention too before they will get better. They are by definition unable to be objective about their conditions and may cause themselves serious harm or even inadvertently kill themselves if they try to treat themselves. Serious mental health problems really require professional medical and psychotherapy treatment; they cannot be successfully addressed with self-help means alone. Self-help has a role to play with regard to serious mental illness, but that role is a secondary one at best.
Medical interventions such as medication prescriptions and hospitalization can only occur with the assistance of a medical professional. When your therapist or counselor is also a physician, prescribing nurse or physician’s assistant, he or she can prescribe you the appropriate medication and dosage that will best support or lead to your mental health stability or recovery. When you aren’t already seeing a medical professional for your therapy, your therapist or counselor will be able to refer you to a doctor or other medical professional who can properly attend to your medication needs.
Milder problems and disorders, such as some milder forms of depression, anxiety disorders and attention deficit problems, may benefit best from professional treatment, but possibly can be handled through self-help care.
Deciding whether a given problem can be helped through self-help means or instead should be addressed through professional intervention is a vital and important part of self-help planning. If you make a mistake in this planning process and fail to get necessary medical or professional care, you may end up harming yourself inadvertently To help you make the right decision, we describe pros and cons of self-help for mental health problems in the following discussion, with the aim of increasing your understanding of when self-help methods will be appropriate for you and when they should be avoided, or assigned a secondary role.
Medical interventions such as medication prescriptions and hospitalization can only occur with the assistance of a medical professional. When your therapist or counselor is also a physician, prescribing nurse or physician’s assistant, he or she can prescribe you the appropriate medication and dosage that will best support or lead to your mental health stability or recovery. When you aren’t already seeing a medical professional for your therapy, your therapist or counselor will be able to refer you to a doctor or other medical professional who can properly attend to your medication needs.
Milder problems and disorders, such as some milder forms of depression, anxiety disorders and attention deficit problems, may benefit best from professional treatment, but possibly can be handled through self-help care.
Deciding whether a given problem can be helped through self-help means or instead should be addressed through professional intervention is a vital and important part of self-help planning. If you make a mistake in this planning process and fail to get necessary medical or professional care, you may end up harming yourself inadvertently To help you make the right decision, we describe pros and cons of self-help for mental health problems in the following discussion, with the aim of increasing your understanding of when self-help methods will be appropriate for you and when they should be avoided, or assigned a secondary role.
Deciding Whether to Use Self-help or Professional Help
It’s critical to recognize that some problems and issues are more appropriately treated by professionals than through self-help means. You should seek professional help whenever you find yourself in one of the following situations:
§ Acute Danger. You should seek professional help immediately if you find yourself in an unsafe living situation or relationship (perhaps where you are being sexually, physically or verbally abused), or if you are experiencing thoughts or urges to harm yourself or to harm someone else. If you are being abused, remove yourself from the abusive situation (e.g., leave the house or apartment) and call the most appropriate crisis service (such as your local rape crisis number or domestic violence shelter number. Call 911 (or equivalent emergency telephone service) if you can't think of anyone better to call. If you are feeling suicidal (you want to kill yourself), or homicidal (you want to kill someone else) call 911, your local mental health crisis telephone number, or your local police or sheriff’s emergency number. The professionals who answer the phone should be able to help you stay safe and find appropriate crisis counseling or treatment for you. If your issue can wait (if it does not put you or another person in immediate danger), call your local crisis hotline, domestic abuse hotline, community mental (or behavioral) health center, therapist, counselor, psychiatrist or psychologist, and make an appointment to see a professional as soon as is possible who can help you to cope. If you need emergency medical attention, you can go to your local hospital emergency room.
§ Hallucinations. If you experience hallucinations (meaning that you hear voices, see things or smell odors that others don’t hear, see or smell), seek help from a professional therapist, psychologist or counselor. You should also seek out the help of a medical professional, such as a psychiatrist, to discuss the possibility of medication. Medication is the only proven means of lessening or stopping hallucinations.
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Delusions. If you have delusions (meaning that you have ideas, perceptions or thoughts that don’t make any sense to others you share them with), seek help from a professional therapist, psychologist or counselor, and see a psychiatrist to discuss the possibility of medication which can help lessen or stop your delusions. You won't be able to generate a good self-help plan if you are delusional, because your judgment will be suspect.
Respected Opinions. If a person you trust tells you to seek help for a mental health issue or problem, listen carefully and seriously consider that there may be some good reason why they have recommended that you take this course of action. Contact a therapist, counselor, psychiatrist or other mental health professional for an evaluation. If your evaluation reveals that you would benefit from therapy, counseling and/or medication services, these professionals will either offer you appropriate services, or will refer you to another professional who will be better able to help you.
Failed Self-Help Efforts. If your self-help attempts are not working, or you find it very difficult to stick with self-help efforts, seek the help of a professional. There is no reason you shouldn't ask for help, as millions of other people do, when you need it.
Alcohol or Substance Abuse. If you have an alcohol or other drug abuse problem, seek professional help. A licensed substance abuse counselor, or similar professional can help you manage both your substance abuse issue and the many problems that inevitably result from substance abuse issues (such as poor family relationships and inadequate social support). You may also require the assistance of residential treatment programs and detoxification facilities. Medically supervised detoxification is absolutely necessary for helping people to safely come off of certain drugs, including alcohol. Trying to come off Alcohol "cold turkey" by yourself can result in your death! Twelve step programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are one of the better and more available ways of helping yourself stay sober after you've been detoxified. AA and NA offer exactly the type and frequency of support and encouragement you’ll need to achieve and maintain sobriety, and to deal with the emotions and changes that you’ll likely need to address as you remain in recovery. Alcohol or drug abuse or addiction, along with mental health issues or disorder, occurs far more commonly than we used to think. Treatment and counseling provided by a trained substance abuse counselor, or by a mental health counselor with substance abuse training is highly recommended.
Lack Of Clarity. If you find that you just aren’t sure what your issue or problem really is or what to do about it, consult with a professional. A professional, whether a licensed therapist, counselor, nurse, psychologist, or psychiatrist, can help you to better understand what your problem is, and how to deal with it.
One practical way to determine whether or not you need professional help is to look at how you’re doing on a day-to-day basis. If you’re able to take care of all or most things that most people are able to do, such as brushing your teeth, shopping, making meals for yourself, doing laundry, driving, working, concentrating adequately on what you're doing at any given moment, and making and maintaining friendships, you’re more likely to be able to help yourself with certain issues than if you can’t currently do those things. If you’re having trouble concentrating or sleeping, are suicidal, drug or alcohol addicted or are experiencing hallucinations, self-help may be too difficult. If you're really depressed, self-help efforts may be too difficult to sustain. Since self-help requires that you spend a lot of energy on thinking and acting in particular and new ways, consider whether you’re really feeling up to making the effort to do it properly, or whether it would be better to have a professional "guide" to help you along.
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Diagnosis vs. Self-Diagnosis
One major benefit of seeking professional health care (mental or otherwise) is that a professional is often in a better position to accurately diagnose your problem, and point you towards the best treatments available for helping you get better than you are. You may have heard the term "diagnosis" before. A diagnosis is a label given to a particular illness or issue that you might have. Diagnoses are identified by their symptoms, which are the complaints that people make when talking to their doctors. Mental health diagnoses have been organized in a book called the Diagnostic and Statistical Manual of Mental Disorders (or DSM, for short). In the DSM, each diagnosis falls into one of several possible categories, including, but not limited to mood disorders (such as depression and bipolar disorder); schizophrenia and other psychotic disorders; anxiety disorders (including panic attacks, phobias, post traumatic stress disorders and obsessive-compulsive disorders); dissociative disorders (including multiple personality and amnesia); impulse control disorders (such as compulsive hair pulling, or fire-setting); personality disorders (such as borderline personality and narcissism); and substance related disorders (such as alcohol or methamphetamine addiction).
One of the first things that a mental health professional will do when you visit him or her is to diagnose you. He or she will listen to you describe your issues and complaints, and fit them into one or more of the known illness categories described in the DSM. Diagnosing your issues is important, because it helps professionals to know which interventions to suggest to you (from among thousands that are possible) that will have the best chance of helping you to get better. Professionals know which interventions to choose based on your diagnoses because they are familiar with the work that thousands of scientists and clinicians have previously done to match particular interventions with particular diagnoses.
For example, let's say that you visit a mental health professional and complain about the following symptoms: You're experiencing severe mood swings, are feeling overly energetic lately, can’t concentrate, are spending money recklessly, are increasingly irritable with other people, aren’t abusing drugs or alcohol and have gone through similar episodes before in your life. Your professional will listen to what you have to say, and will ask questions about your experience to clarify things or get you to talk about things that might be important but which you've not mentioned spontaneously. He or she will likely want to learn about your past history of similar problems and may request medical records from other doctors if any exist. He or she may want to order several medical tests be done to determine if there is a physical cause, such as drug abuse, brain damage, hyperthyroidism or similar problem, that can explain your symptoms If no physical cause can be determined, you would probably be diagnosed with a psychiatric disorder that most closely fits with your presentation (in this case, possibly bipolar disorder). Your professional will know that certain treatments are known to be helpful for bipolar disorder (particular medicines such as "mood stabilizers" and "antidepressants", in this case) and will help you obtain those treatments, along with proper instructions and monitoring for their use. Other treatments that are known to be less helpful for treating bipolar disorder will not be offered. Alternatively, If you go to a professional and say that your major symptom is anxiety, that professional might diagnose an anxiety disorder, and create a treatment plan for you that includes interventions that are known to be helpful for treating anxiety disorders, including cognitive therapy, relaxation techniques, exercise programs, and anti-anxiety medication.
Only a doctor or similar trained and experienced mental health professional is qualified to make a true diagnosis and therefore to make treatment recommendations. Diagnoses are complex and difficult to make correctly. It takes many years of concentrated study to learn how to accurately diagnose patients, and even then, different doctors will sometimes make different diagnoses for the same patient. For example, the family of psychotic disorders are characterized by a variety of symptoms, including delusions, hallucinations and regressed (or "primitive") odd behaviors. Psychoses occur across many different types of disorders, including substance abuse, severe depression; bipolar disorder as well as schizophrenia and related psychotic disorders. When diagnosing schizophrenia, for example, it is necessary to rule out (or exclude) the possibility that other disorders (like bipolar disorder) or drugs (like cocaine) might be causing the problem. To make matters even more complicated, the very definitions of the different diagnoses change across time, as the DSM gets revised and rewritten. For example, not so long ago, homosexuality was a diagnosable illness defined in the DSM. This diagnosis was removed from the DSM in the 1980s when it became clear that it had been included there more because of cultural prejudice than for scientific reasons. Today, evidence from the biological sciences suggests that most homosexuality is biologically determined and thus a normal variation of human sexuality and not a disorder at all. It is rare these days to find a professional mental health provider who believes homosexuality is a mental illness.
Risks of Self Diagnosis
People who do not have the benefit of professional diagnosis and care run two risks when they try to diagnose and treat themselves using self-help methods:
§ Risk of Misdiagnoses. The first risk is that they might miss something subtle but important about their problem or issues which would, in turn, cause them to misdiagnose themselves, possibly with disastrous results. For example, someone might think they have an anxiety condition of some sort, but closer professional examination might uncover an underlying serious medical problem such as an heart arrhythmia The affected person might treat themselves as though they have an uncomplicated anxiety problem (e.g., with relaxation exercises) and completely miss the fact that they have a serious medical condition that requires medical treatment. There is really no good way to reduce this type of risk except to go to a professional for a professional diagnosis.
Risk of Wrong Treatment. The second risk inherent in self-diagnosis and self-treatment is that people might end up treating themselves with methods that don't work at all, which are inefficient, which are plain old wrong for their problems, or which actually cause harm. This risk is heightened when treatments and methods that people consider using are inherently dangerous when misused. For example, someone might try to treat their weight problem with with pills that were prescribed for someone else, or illegally obtained on the street. They might alternatively decide that the best way to lose weight is to starve themselves by fasting (not a good idea at all!) or by engaging in strenuous physical workouts on a regular basis. Research shows that starving yourself is unlikely to result in any weight loss, and may cause other problems to develop, including binge eating patterns which can lead to eating disorders like Bullemia. A non-health-professional person might not know this important fact and starve themselves anyway. Similarly, strenuous exercise might be appropriate and even healthy for some people, but it might provoke a heart attack in someone else (in a worst case scenario), or simply lead to pain and "Charley horse" that would discourage them from pursuing further healthier methods for weight loss.
It is never a good idea to take someone else's pills, by the way, and never a good idea to treat a problem with street drugs! Weight loss pills can be habit forming, for one thing, and may lead to an addiction. They can also cause medical problems. Medication might be safe for another person, but actually dangerous for you! Do not use medication except under the supervision of a licensed physician or other appropriate health professional.
Updated: Jun 26th 2006
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Conclusion
The take-home message with regard to self-diagnosis and self-treatment is that if you pursue the self-help route without the aide and assistance of a professional helper, take care to do your homework first. Consider how severely your issues or problems impact your safety, the safety of others, your own functioning and your peace of mind. Consider also how complex your problems may be and whether or not you have a reasonable chance of appropriately assessing and addressing those problems successfully. If you have any doubts at all as to your ability to figure out and treat your problems on your own, seek the help of a professional.
A surprising number of people will not seek professional help even when it is the right thing to do because they do not like the idea that they require help to manage their issues. If you think seeking help is a weakness, and that only 'weaklings' ever consult professionals, you’ll need to decide whether your macho attitude (for that is what that attitude is, regardless of whether you are a man or a woman) is helping or hindering your progress in solving your problems and issues. If your attitude is getting in the way of your growth and health, then you have to decide whether or not it is time to change your attitude. If in your careful estimation self-help will work for you then pursue self-help with determination. First, however, take the necessary time to understand your issues, and explore all of your alternatives for self-help. Avoid risky, extreme, or un-proven methods and 'solutions' that might endanger you or others (if in doubt, consult with a professional). If, however, you’ve thought it through and have decided that self-help isn't likely to work for you at this time, then seek out professional assistance now. Don’t stand in your own way by avoiding professional assistance.
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