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Why do the very people who seem to be most in need of psychotherapy stay away from it?

Today, almost all people only enter psychotherapy when they are in a tight corner - when they feel they are in trouble and just can't take it anymore.

All possible alternatives are tried first, and even when it is obvious that it is time to turn to a mental health professional, they procrastinate as long as possible.

In theory, the best thing would be to turn to a therapist as soon as the psychological difficulty begins, so as to avoid unnecessary suffering and self-sabotage. Instead, people usually spend years without dealing with their psychological problems, wasting time, ruining relationships, and throwing money away on bad choices.

Why do people behave in such an unreasonable way?

In this article, I attempt to explain why people get stuck in this unproductive way for themselves.

Unawareness of one's problem

The first condition that turns a person away from the psychological treatment process takes place when a person, in a situation of psychological suffering, is unaware that he or she has a psychological problem.

Automatically, when the person is unaware of having a psychological difficulty, he tries to locate the origins of his suffering outside of himself. And very often it succeeds.

In this way, the person locates the origin of his suffering in external situations that he judges as unfair or unfortunate. Or in others, whom he judges as evil or neglectful.

In short, it is always the other person's fault. To give a few examples: the person who has problems establishing intimate relationships is said to always meet with bad partners or friends who do not understand him. The person who fears failure in the world of work will say that it is the fault of the corrupt and dishonest society, or that it is the fault of the crisis, etc.

As soon as there is a problem, the person tells themselves that the causes are always to be found outside himself. Of course, sometimes the responsibility for a difficulty is objectively to be found outside.

For example, we are walking down the street and a tile that has slipped off the roof falls on our head. This is obviously the responsibility of the homeowner who has neglected the maintenance of his property. However, when we compulsively tend to look outside ourselves for the causes of all suffering, this highlights the tendency to remain unaware that sometimes the source of the problem lies within ourselves.

At this level, we do not take responsibility for contributing to our own situation of suffering and always look for the responsibility outside - and the world becomes the enemy!

Unawareness of the importance of the problem

This is the situation of the person who realises that he or she is suffering, perhaps experiences anxiety or depression, but does not consider his or her problem to be particularly important.

At this level, the person thinks that his or her suffering is basically no big deal. That one can go on just as well. He grits his teeth.

What happens is that the person mismanages their lives, damaging themselves in a thousand and one ways. For example, because of anxiety, they may avoid favourable work opportunities and satisfying relationships. Or because of the feeling of depression, they are less active and proactive than they could be. The person lives with a handbrake on and does not realise the opportunities he or she is missing.

Unawareness of the possibility of solving the problem

This is the situation of those who experience psychological distress but feel that the psychological distress, by its very nature, cannot be addressed and resolved.

At this level, the person says to themselves things like: the world is like this, everyone suffers, life is hard and nothing can be done about it.

Often, the person speaks out against psychotherapy. They claim that they 'do not believe in it' despite not having had first-hand experience or having had too short experiences. For example, they might have left previous psychotherapies as soon as negative feelings arose.

At this stage, people may rely exclusively on biological medicine, undertaking psychopharmacological therapy without the help of psychotherapy.

It is a cynical and bitter view, where there is little trust in oneself and others, but the most bitter situation is the condition that follows.

Unawareness of personal ability to deal with the problem

This is the situation of the person who realises that he or she has a psychological difficulty, perhaps suffers and feels stuck. At the same time, they realise that the problem is important and that it is undermining their ability to be satisfied with life. They also know that the problem can be addressed by others, perhaps they know people who have solved their problems with psychotherapy, BUT they think that in their case it is not possible to address the problem.

The person tells themselves that his own problem is more serious than that of others. Or he believes he has less capacity than others, fewer resources, and less willpower. Basically, he/she is convinced that he/she is worth less than others.

At this level, the person tells himself things like: I am worth less than others so I do not have the capacity to solve my problem.

At this stage, people are completely unmotivated and often do nothing to get out of their situation.

Cultural preconceptions about psychotherapy

The four positions of unawareness I have described are maintained by certain preconceived (and false) beliefs about psychotherapy, with which the person keeps themselves stuck in their own situation of suffering.

The question of whether it is unconsciousness that creates preconceptions, or whether it is preconceptions that create unconsciousness, is as sterile a question as asking whether the chicken or the egg came first. In fact, the two always go together: the situation of unawareness is always accompanied by one or more preconceptions, which in turn reinforce that unawareness.

I proceed to illustrate - and unmask - the preconceptions about psychotherapy that I have personally identified. The list is neither complete nor definitive:

  • Psychotherapy is for the insane. This very powerful preconception drives away from psychotherapy all those who fear being judged negatively by those - friends, acquaintances, colleagues, relatives - who learn that one is in psychotherapy.

Antidote: psychotherapy is a path for intelligent and courageous people who choose to work hard to improve their lives, identify their goals and achieve them: it is something to be proud of being in therapy!

  • Psychotherapy is a rich person thing. This preconception alienates many people who think that going to a psychologist means adding to their discomfort by spending a lot of money.

Antidote: psychotherapy may not be as expensive as one imagines. One can always try to contact a professional and ask.

Antidote 2: the expense of psychotherapy today saves large sums of money tomorrow, either by preventing from making wrong choices (a divorce that can be avoided, years of study at an unsuitable university faculty, etc.) or by helping to make and pursue the right choices. Psychotherapy is an economic investment in oneself.

  • I want to make it on my own. This preconception appeals to people's sense of pride, but in fact, restricts them from using all the tools at their disposal.

Antidote: the therapist is there to help the person find their own creative solutions. He does not influence, he does not tell what to do. He accompanies the person on the journey within himself and helps him to do it himself. It is like going to the gym and being accompanied by a personal trainer, who will not help the person to lift their weights, but will help to create the best situation - through advice, information, and support - for the person to do it themselves and train at their best.

  • Fear of being brainwashed. This preconception influences people who are afraid of being manipulated. Perhaps they feel they have always been exploited by others and the last thing they would want is to be in front of a psychotherapist who manipulates and exploits them.

Antidote: a psychotherapist is a professional who has been trained through a long and hard course of study, is registered with a professional association and is obliged to comply with the association's code of ethics and current legislation. If one feels exploited and doubts the professionalism of the therapist, one can contact the relevant professional association and carry out the necessary checks.

  • Fear of opening up to a stranger. This preconception restrains people who imagine that they will suffer harm if they allow themselves to open up to a person they do not know.

Antidote: the therapist is there to help and is bound by professional secrecy. What is told in the psychotherapist's office does not leave there.

Antidote 2: it could be that the person has an intimacy problem: they are ashamed to reveal themselves to others. In this case, psychotherapy is the protected place, the gymnasium where one can begin, in one's own time, to learn to open up to others.

  • The psychotherapist only listens to people to make money. This preconception alienates people who think that opening up and confiding in another person should only be done in a situation of gratuitousness.

Antidote: the money represents the remuneration of a professional who uses their knowledge and experience to help the person get to know themselves better, grow and solve their psychological difficulties.

Secondary advantages of the condition

The four positions of unconsciousness that I have described are also maintained by virtue of the advantages that the person obtains in his or her role as a "sick" person, namely the special attention and care that is normally given by others to suffering people.

Preconceptions towards psychological care can then be reinforced by the fact that the person basically has no interest in getting well: the advantages he or she has in assuming the role of the suffering person are such that the person basically prefers to remain in his or her condition of psychological difficulty - and power over others!


Cultural preconceptions about psychotherapy are in turn fed by ignorance about how psychotherapy works, what it is for and when it is useful. This information is not widespread in our society. On the other hand, films, television and literature have often contributed to maintaining this state of ignorance or to spreading preconceptions and mystifications on the subject of psychology and psychotherapy. Nor are general practitioners, who generally represent people's first contact with their own health care, often uninformed about the nature and potential of psychotherapeutic intervention. Thus it often happens that the general practitioner does not know how to recognise a psychological difficulty, or, when he does recognise it, does not know how to handle it and who to turn to in order to deal with it.

This website has as its stated aim precisely that of correcting this state of affairs, disseminating useful information to combat the current state of ignorance where preconceptions on the subject of psychotherapy reign supreme.

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