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How Can I Help My Friend?


I have a friend who has had long term mental health problems. Low self esteem, depression, anxiety, social phobia and so on. Over the years I’ve tried to help, to give good advice or support; to encourage my friend either to stay on the medication or go back to the doctor and ask for something more satisfactory and so on. These days he’s pretty stable although the self esteem problem is still around. He’s started therapy, to try and treat the problem instead of just the symptoms, although one of the big problems is that in our rural area there is a large demand for mental health professionals and limited supply. You are lucky if you can get one appointment a month. To me, it seems like my friend doesn’t seem that willing to do much work on himself – and recently I’ve realized that I am probably just compounding the problem. As someone he respects, I seem to have become an authority figure, and instead of using the tools available to him, he still seems to think he is a helpless victim and looks outside for answers (sometimes to me). It doesn’t help that I have a somewhat bossy personality, also that I get a kick out of trying to help him so perhaps I’ve been spoon feeding him too much help and this has made him less inclined to try things out for himself. What I want to know about is the best way that I can help and support my friend without making the situation more unhealthy than it already is. I know if he wants to change things, he has to be ready to do this himself and learn the techniques to do this himself but it’s very hard for me to hold back and not give him “helpful” nudges. Often I waver between wanting to tell him what I think he should do (I believe this is wrong! but so tempting!) and just challenging him to think differently but without pushing him down a particular path. I’ve been a ‘therapist substitute’ for a long time, with nothing more than psychology101 and the Internet as a guide… and I would absolutely hate to be holding my friend back from making some kind of progress. What kind of advice can you give for people in our position?

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  • Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
  • Dr. Dombeck intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
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  • Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.

You’re in an interesting place right now regarding your relationship with your friend. For years you’ve had a parental (in the sense of benevolent leader) attitude towards him, but lately your thinking has grown towards the realization that your helpful impulses might be serving your own needs as much or more as your friends need for helpful interventions. You’re on the right track, because you are genuinely concerned for your friend’s welfare and want to do the right things. It’s a hard call to know when to support and when to let well enough be, particularly when it comes to depressed people (apathetic behavior being a symptom of depression). It’s definitely fine to express your knowledge that life can get better if he engages various psychological and/or medical interventions. It’s quite okay to offer practical supportive pushes towards getting help (For example, providing the telephone number of a qualified therapist, or gathering and offering helpful resources like books and websites). It gets more ‘gray’ when it comes to you making an appointment for him, or pressuring him to change, particularly if he perceives you as more judgmental than compassionate. One thing you can do which will be helpful is to work on yourself so that you can better understand your own motivations pushing you to act ‘pushy’. For instance, is there an empathic feeling of helplessness that your friend’s helplessness provokes in you that you have difficulty tolerating? If so, are you trying to manage your own feelings by managing his? If this is the case, lay off a little and work on ways that you can better manage your own emotions. It is totally commendable that you want to help your friend, but you must recognize that you cannot ultimately control his behavior.

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