Dear Therapist:

I have a younger sister (age 24) who I care about very much. She had a rough childhood as far as being picked on in school and since she is a nonconformist got in a lot of trouble. Her relationship with my parents has also been very up and down with a lot of negativity and hurt feelings. She has a small part-time job that she gets no satisfaction from. To me she is clearly depressed and she admits as much. She is very smart and no matter what I suggest to her about going for help she has a million reasons why it won't work. I can't find anything to say or suggest that she can't refute. There is almost nothing that sticks. It’s like she wants to stay like this even though she admits that she is suffering tremendously. How can I help her?

Response:

It can be very painful when someone we love is clearly hurting. This pain can be magnified when we feel powerless to help. Often, someone else’s issue seems very clear, and the appropriate route the person should take seems obvious. Our own issues, however, are usually less cut and dried. When we deal with our own problems, our emotions, triggers, insecurities, and other factors often play a large role. This is not just with regard to how we deal with our issues, but also in terms of how we view them. It can be very difficult to separate our emotions from the logic inherent in a situation.

Your sister’s emotions may be affecting her ability to view her situation in a purely rational manner. Underlying sources for emotions may include relationship and trust issues, as well as low self-esteem. It can be difficult to take a passive role in your sister’s life, but she may not be ready to accept professional (or any) help. Though she is able to come up with reasonable-sounding explanations for why therapy will not help, these may simply be her conscious expression of unconscious fears and insecurities. For example, going for help may reinforce in her the sense that there is something wrong with her. If she felt that way as a child and adolescent, triggers to these feelings can be very hurtful—and tend to be avoided.  

It seems like you have a good relationship with your sister. It also seems that she is able to understand intellectually that people—perhaps even including herself—can gain from therapy. If your logical discussions do not bear fruit, this may be due to her emotional insecurities rather than an actual belief that therapy cannot help her. If this is the case, speaking about what on some level she already knows may always be rejected on emotional grounds (masquerading as logic). If you can better understand her hesitancy, and gently speak to her insecurities, she may be more receptive.

Your encouragement and support can go a long way toward helping your sister come to terms with her feelings. It can be helpful to discuss your own similar experiences and insecurities to show her that she is not alone in the way that she feels. This can also help her to see things through a more objective lens.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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