Dear Therapist:

I recently read an article describing different people who should be seeing a therapist. I have a good friend whom I feel matches the description in the article. The more I think about it the more I honestly think he could benefit from seeing one. The problem is being a 21-year-old and being told by your close friend that you should be seeing a therapist isn't the most pleasant experience. How as a friend am I able to convey over this message in the nicest way possible and if there is no comfortable way should I ditch the whole thing entirely being that I might be hurting more than he has to gain?

Response:

Obviously, you know your friend and you know the limits of your relationship with him. Therefore, you likely have some sense of how he might react to your suggestion that he seek therapy. If it’s clear that he will not accept your suggestion regardless of how it’s presented, there would likely be little or no benefit from having such a conversation. In fact, it might harm your relationship, making it more difficult for him to confide in you if he at some point recognizes that he could use help.

If you recognize that this is the case, you may be feeling conflicted. You may feel that you should somehow help your friend, but acknowledge that you can’t. You might simply need to wait for an opening. He may mention something, or the subject can come up in an innocuous manner.

You may believe, however, that your relationship is such that your friend will take your concerns to heart. In this instance, he may benefit from a discussion. If this is so, to what degree are you concerned about what is actually best for him, and to what extent are you worried about the effect the conversation might on your relationship? Theoretically, if you knew that your friendship would suffer (for instance that it would become more awkward), but your friend would be more likely to seek help, what would you do? Would the decision be easy or difficult? Would it be different if you were suggesting that he see a career counselor if he was clearly unhappy with his job? Or if you would recommend physical therapy if he was having trouble walking?

Sometimes the reasons for our reluctance to do something are unclear. We may focus on the obvious, neglecting to recognize other factors. When we become aware that this is occurring, giving thought to other (usually emotional) reasons for our hesitancy can help us to arrive at the proper decision.

If you decide that you should discuss your concerns with your friend, your experience within your relationship will likely guide your words. There are some general suggestions that I could make, but you should decide for yourself whether they are appropriate to your particular situation.

Discussing your own experiences and issues can help break the ice, helping your friend to feel that you are not judging him, but simply trying to help. Similarly, the use of “I” and “me” statements take some of the focus off your friend. For example, “I feel that you’ve been unhappy lately” rather than “you’ve clearly been unhappy lately.” Additionally, focusing on specific concerns can be more palatable for your friend than discussing him more generally. He should get the sense that it’s not about the fact that he matches a particular description, but rather about a specific issue with which you believe he is dealing.  It’s not about who he is, but rather about your sense, as a friend, that he could use some help in particular areas.

The type of relationship that you have with your friend can help guide you in the right direction. Your own self-exploration can help identify underlying reasons for your fear of broaching the subject with your friend. If your concern is that the discussion may harm your relationship, try to remember that your goal is to help him. If you believe that the possible harm to your relationship will in turn harm your friend—and that this outweighs any likely benefit—your decision may be not to bring it up. It is possible, however, that this concern is unfounded, and that your relationship may be ultimately strengthened and deepened by your obvious concern.

-Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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