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When to Consider Psychotherapy...

1. When a life event is having a strong, prolonged negative emotional impact that doesn’t improve over time…. All of us experience loss and change that can trigger difficult feelings. The ending of a major relationship, a financial setback, a serious accident or illness will usually activate normal responses of fear, sadness, anger or loneliness. While these feelings may be strong and distressing, they usually diminish over time. If you find that your negative feelings are persisting or increasing or that they are having an increasingly negative impact on the quality of your life, it may be useful to sort out the experience with a therapist. A therapist can help you see memories or meanings associated with the event and help you move through complex feeling responses.


2. When you notice yourself repeating negative patterns with work, family, friends or personal pursuits…. Do you chronically get into power struggles with your bosses or repeatedly end up with romantic partners who betray or undermine you? Do you have patterns of under achievement in areas of interest or find yourself unable to break out of old family roles and expectations? If, despite repeated attempts to think about and change distressing patterns you find yourself still repeating them, it may be time to discuss them with a therapist.


3. When your work and/or personal life is negatively impacted by your moods or feeling states…. Do you “blow up” or lose your temper to the extent that it threatens important projects or relationships? Are you often so “low” that you’re unable to motivate yourself to act in your own behalf? Does pervasive anxiety keep you from engaging in activities that would be pleasurable or profitable? Problems with mood have many components: they may be a learned response to unmanageable childhood situations, a reaction to recent trauma or a physiological tendency influenced by brain/body chemistry. A trained therapist can help you discern the sources of negative mood and explore various approaches to managing your feeling states and feeling better.


4. When you suffer from poor self esteem…. For many people, the hardest part of life is consistently feeling bad about themselves. They walk around feeling inadequate, defeated and ashamed or “like a fraud,” just on the verge of being discovered. They are their own worst enemies, harshly judging themselves, comparing themselves to others or berating themselves for past losses or failures. Psychotherapy has been demonstrated to help people free themselves from chronic self-criticism and attack. Through the trusting relationship with a therapist, many people learn to challenge and change their negative assumptions about themselves and develop a more positive and realistic sense of self.


5.When habits or substances negatively impact your life…. Is your drinking interfering with your ability to do your job? Are your credit card bills mounting because you can’t stop yourself from buying unnecessary “necessities?” Is your partner complaining that they never see you due to overwork? Does it feel you spend all or much of the day thinking about food, eating, weight, gambling or sex? When habits or substances make you feel out of control, it can be time to seek professional help. Psychotherapy can compliment specific recovery programs or can be useful as the primary means of exploring and changing the ways we use behaviors and substances to soothe, regulate or maintain a sense of self.


6. When you are moving through an important life transition…. Have you recently become married or divorced? Have you moved to a new city or completed a major career change? Are you a new parent or a new “empty nester?” Have you recently undergone a major surgery, medical procedure or just found out you have a major illness? Significant life changes challenge our old identities and calls into question assumed roles, rules, responsibilities and relationships. Psychotherapy can be one way to take stock of our lives and to clarify what we want during these new phases of our development.


7. When life has ceased feeling meaningful, joyous or purposeful…. Does your life feel dry, flat or routine? Do you find more often than not that you’re simply going through the motions, doing the daily tasks that must be done with little pleasure, satisfaction or delight? Have you lost touch with the hopes and dreams that used to motivate and inspire you? These states of spiritual and psychological aridity can signal the need to take a deeper look at ourselves and reevaluate our commitments and priorities. The responsiveness of a therapist can help us acknowledge the deep urgings and longings of our truer selves. Therapy can be a place where we chart a new course for our lives.


8. When an important relationship is in trouble…. Close, intimate relationships are the places where we learn the most about ourselves. They have the ability to bring out the very best and worst in us and our partners. If your relationship with your spouse, partner, child or family is a repeated source of pain, consider consulting a therapist. Often an objective third party trained in relationship dynamics can point out problematic patterns in communication, habits of criticism, attack, defensiveness or withdrawal and help a couple reconnect with what they value in each other.


9. When others express concern for you… Have family, friends or co-workers mentioned that they’re worried or concerned about you? Have you received feedback that you don’t seem yourself lately or that your behavior is alarming to those who care about you? It sometimes takes great courage for the people who love us to let us know that something seems wrong. This can serve as a wake-up call. If others have commented or asked about your well-being, therapy may provide a safe place to take a fuller look at yourself and the challenges you’re currently facing.


“When to Consider Therapy” was written by San Francisco psychotherapist Karen Rogers, MFT.

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