Breaking Barriers to Healing: Understanding Why People Avoid Therapy

If you’re considering therapy, you’re not alone. In 2021, around 41.7 million adults in the United States received counseling for their mental health within the past year. According to the Centers for Disease Control and Prevention (CDC), this is an increase from 19.2% of the adult population seeking mental health treatment in 2019 to 21.6% in 2021. The decision to seek counseling can be empowering yet intimidating at the same time. While the benefits of therapy are many, overcoming the initial fear and anxiety of finding a therapist can be overwhelming. It can sometimes be so great that it prevents people from doing so.

Understanding the barriers to making the call to schedule with a therapist can be a powerful tool for overcoming that reluctance. It is natural and fairly common to feel apprehensive about seeking help from a counselor. The National Alliance on Mental Illness (NAMI) reports that 70 and 90 percent of individuals reporting a significant reduction of symptoms and improved quality of life when they engage in therapy. Yet, more than half of the people needing services do not seek help.

Why? Here are five common reasons that prevent many people from seeking therapy.

Fear of Judgment

Fear and shame are among the most common reasons people avoid seeking help. The negative stigma and discrimination linked to having a mental illness lead them to steer clear of being labeled as “mentally ill” or “crazy.” Additionally, worries about the potential impact on their career, education, or other life goals also contribute to their hesitation in seeking assistance. Similarly, there can be fear of the therapist’s judgment when you shed your armor and expose your most private thoughts. Will they think your concerns are silly? Will they say there is nothing that can help?

Fear of Being Vulnerable

Engaging in therapy requires delving deep into your emotions and experiences, an intimate journey that may initially seem frightening. You may have avoided confronting the stressors and symptoms you’ve been experiencing; facing them head-on can be intimidating. Sharing your innermost thoughts with a counselor can also result in considerable anxiety, as it demands a level of trust that may be uncharted territory. Fear of change and fear of the unknown can also be related to feelings of being vulnerable. Being in pain and struggling with anxiety and depression can become familiar. It is hard to see things being different. Changing may require letting go of things you may not be quite ready for.

Practical Concerns

Barriers to seeking counseling may not be related solely to fears or anxieties. Financial considerations can be a real concern when contemplating therapy. The cost of sessions may feel unaffordable, with a lack of coverage or high copays. Modern life can be overwhelming, leaving little room for additional commitments. The time required for therapy might be difficult, with a lack of time off work or causing conflicts with family commitments.

The American Counseling Association cited that in 2022, approximately 47% of the U.S. population resided in a mental health workforce shortage area, highlighting the significant scarcity of mental health practitioners in various regions. Certain states faced an acute shortage, necessitating up to 700 additional practitioners to address this deficiency and alleviate the designation of being a workforce shortage area. The counseling field can explain this shortage in part due to a lack of funding and low reimbursement rates, an increased need for counseling services stemming from the lasting impact of the pandemic, and social unrest in the United States with limited increase in the workforce, and poor access for individuals living in rural communities, areas with poor transportation, or areas with few mental health providers.

“I Can Handle This Myself” Mindset

At times, we take on the concept that we should be able to handle our problems independently and that seeking help is a sign of failure. Sometimes our mind tries to help us, but ends up hurting us when we use defense mechanisms. Minimization can be a significant barrier that prevents individuals from seeking counseling. This defense mechanism involves downplaying the significance of struggles and emotions, convincing themselves that their problems are not severe enough to warrant professional help. “I don’t need help.” “I just need to suck it up and deal with it.” This mindset can lead to an avoidance of seeking counseling, as they may believe that their issues are insignificant or that they should be able to handle them independently.

Negative Experiences

Negative past experiences with counseling or mental health professionals might breed hesitation and profoundly impact an individual’s willingness to seek therapy, leading to reluctance. A discouraging or unsatisfactory encounter with a therapist can create a sense of apprehension and skepticism toward the therapeutic process.

They might have felt invalidated, misunderstood, or dismissed, believing that no therapist can help them and that their problems are too significant for counseling.  These negative experiences may breed feelings of vulnerability and mistrust, making it difficult for them to open up to a new therapist.

The decision to find a therapist and start counseling is more common than one may assume. Yet, being in a vulnerable place of change and self-reflection is challenging. The barriers that impact the decision to enter therapy can be complicated and involve many areas of life. It is crucial to view seeking help not as a sign of weakness but as a brave step toward healing and self-improvement. With the proper support from compassionate professionals, you can overcome fears and start a journey toward personal growth and improved well-being.

By nurturing a culture that encourages seeking therapy without judgment, we can empower individuals to embrace the transformative power of counseling and work towards a healthier and happier future.