Overcoming Therapy Stigma: How to Break the Barriers to Mental Health

Prejudices are explained as a kind of saving plan of our brain. The human brain is limited, and there is not enough time to process each information separately. For this reason, prejudices and stereotypes categorize the world in order to make sense of the world quickly and come to short-cut conclusions, it is a result of trying to simplify information processing.

As in all matters, there are many prejudices and stereotypes in the society about mental health. These may be aimed at mental health professionals (psychiatrist, psychologist), the beneficiary, or the service itself.

Mental health services include psychotherapy, counseling services and, if necessary, psychopharmacology. Everyone can receive psychotherapy, as well as psychiatric support according to the needs of the person. Drugs used in psychiatric treatments are called psychotropic drugs. Unfortunately, there is a prejudice against psychotropic drugs in most society, just as there is a prejudice against psychiatric disorders. Because of these prejudices, the diagnosis of diseases can be made late, treatment is started late or not started at all. Untreated diseases cause the disease to become chronic and the quality of life of individuals to decrease significantly. Since we will focus more on psychotherapy today, we will briefly go over the prejudices against drugs used in psychiatry.

To take a brief look at them:

Addiction & Side effects & Similar effects: Most drugs such as antidepressant drugs, antipsychotic drugs and mood stabilizers are not addictive. In any case, every drug should be used and discontinued under the supervision of a doctor. While using drugs, there may be some undesirable effects, these are called side effects and may occur at certain rates for each drug. However, if it can be balanced and ignored, this will not be a problem. If the person is uncomfortable with this, they can share it with their doctor and the arrangement can be made again. This does not happen in the same way and severity for everyone. Some may have some effects, while others may not. Discourses such as hearsay, "someone else used it, it was bad or it was good" should not be respected, because every drug and treatment progresses according to the person, even if the drug used is the same. In addition, drug treatment is essential for some disorders, the spread of such rumors causes people to stay away from treatment. Questions about this should be asked to the expert and researched from the right sources.

One of the misconceptions about both drugs and psychotherapy is that "one can solve their own problems". Of course, one can solve some problems by himself or herself according to the context and conditions, but it is also important that we talk about "which problems and how" here. We may find some of our traumas at a level that does not bother us much over time, but sometimes they do not. Just as this risk is unnecessary, the deterioration of the quality of life during this time may also cause other problems. With early support, we get to a much faster and more useful result. As mentioned before, medication is essential in some psychological disorders, such as when a person cannot heal a broken foot on his or her own and goes to the hospital and receives treatment. In addition, this treatment does not make the person dysfunctional, on the contrary, it interferes with the symptoms that prevent the person's functions and contribute to better management and finding a solution. In this way, the person can be more active in his or her own life.

In the same way, in psychotherapy, the person is not self-sufficient, but is aware of their needs and takes action on this issue, and they apply for this reason.

In the psychotherapy process, individuals make sense of their thoughts, feelings and behaviors; It is a process in which they become more aware of themself and what is going on around them. Psychotherapy is an applied process in which studies are carried out between the client and the counselor to improve and protect the psychological health of the clients with scientifically proven methods and approaches. The older the history of humanity, the older the existence of psychological problems (1).

Psychotherapy is an important step that a person takes to manage difficult situations in a healthier way. It is a unique experience for each individual, it includes differences for clients and is a long-term process.

The person may have prejudices about psychotherapy based on their environment or their own personal experiences. If we talk briefly about these prejudices;

1- "People with problems go to the therapist": Every person has stressors and problems in their life. Sometimes these problems are less. In some cases, the problems may be more intense. In addition, there are also psychological problems experienced for different reasons. In fact, getting psychological support for these is an indication that the person is open to personal development. Apart from this, the person may also apply to psychotherapy for reasons such as gaining awareness about themself, getting premarital counseling or parental counseling. Because it is not possible for us to be an expert in every subject, and if we go to the doctor because our stomach hurts, we should get service from a specialist in the field of mental health. In addition, we all have our own blind spots – including psychotherapists – and this is the only way to discover them.

Another version of this belief:

“Referring to the psychotherapy process is a matter of weakness”

The psychotherapy process is a process in which individuals make sense of their inner world, psychological structure and the relationship with their environment (1). While definitions of being strong or weak can carry in themselves misconceptions, there is no causality about being strong or weak as one of the reasons for seeking psychotherapy. Psychotherapists also do not evaluate people with these characteristics.

2- Gender Roles/ Toxic masculinity: Gender refers to all roles, expectations and beliefs attributed to the sex assigned at birth (to biological sex). The socio-cultural construction of women and men created by different societies. Pervasive masculinity roles are associated with power in most societies where gender roles are sharply defined. Seeking health services is associated with weakness and femininity. Such false and invalid beliefs cause men not to apply to health services, including physical illnesses, or to apply late, and they become more difficult for treatment after the damage grows. The continuation of these avoidances leads to reinforcement of roles and stigmatization for other people who need or benefit from this service.

3- “Relaxing is a priority during the psychotherapy process”: Psychotherapy includes different emotions at every stage of the process. As well as the comfort provided by sharing, feelings such as sadness and anger that are not desired by the person can also be revealed during the therapy process. It is expected that people will feel confused, uncomfortable or different emotions at the end of some sessions.

4- “I can talk to my friends what I tell the psychotherapist”: Here, it can be noticed that there is a framework that reduces psychotherapy to friend conversation. Of course, a person can share some or all of their experiences with their friends. However, although psychotherapy is conversation-oriented, it cannot be defined as conversation. It doesn't just include narration. They work together on what the psychologist and client bring to therapy. Psychotherapy has a certain form, process and goal.

Conversation is prevented by the therapeutic framework established between the psychotherapist and the client. It is a goal-oriented, progressive process in which scientific methods and techniques are used within a certain plan.

In addition, people may have unrealistic expectations about the psychotherapy process, and as a result, prejudices about psychotherapy may develop. Examples of false expectations about psychotherapy include:

1. “I must see the change or the result immediately”: When people come because of the problems they experience and the results they do not want, it is very understandable that they want to get rid of them as soon as possible and feel the result as soon as possible. However, these problems do not occur in a day, and the goal of becoming a completely different person in one day is not very realistic. Psychotherapy is a process in which permanent changes are aimed to be built, it progresses step by step in line with the goals. It is expected that there will be steady progress, not dramatic fluctuations between sessions. Most of the time, the psychotherapist presents the progress and changes towards the end with the first session at the appropriate time, and presents it to the people and can be discussed.

2. “The psychotherapist applies plans to the client”: In evidence-based therapies such as CBT, the therapist is not in an active role and the client is in a passive role, that is, “applied to themself”. It is a collaborative process. If we compare the therapy process to a car on the road, the client is in the driver's seat, while the therapist is the one who accompanies them on this road. The rate of benefit is dependent on the client's own effort and involvement as well as the skill of the therapist.

In order to create realistic expectations about the psychotherapy itself, this information about the process should be shared with the people by the therapist in the first session and the people should be informed. What the client can do is to transparently share and clarify every question and concern in their mind with the therapist during the whole process for their own benefit.

It should also be added that; Psychotherapy should be a field of practice that draws its resources from scientific methods, and the psychotherapist is the one who provides service with the ability to apply what they have learned. There are also many different variables, such as personal factors, client-therapist balance, and the client's characteristics are not the only thing that determines the process. Of course, there may be qualitative differences, but here we are talking about a-common biases that have been noted so as not to generalize specific experiences to psychotherapy itself.

How can we overcome these prejudices?

We can think about what can be done on an individual and social basis. From a social and institutional perspective, it is necessary to accept that access to mental health services is at least as important as physical health and to develop policies accordingly. and of course making these services equally accessible to all should be one of the most important tasks. There are too many stereotypes and very unrealistic content about mental health services in the media. These should be corrected and the right messages should be delivered to the people.

Individually, the first step might be to review the reliability of our own knowledge of it. Sometimes we may have prejudices about this in our minds in various ways, even if it is not obvious. When we talk about mental health service, we can look at what comes to mind first, what is in our mind, what are our automatic thoughts or images about it. We can filter the thoughts that come to our mind automatically and examine how much of them is based on information and how much is based on other factors. So we can test our thoughts.

The best way to break prejudices in every field is to touch the thing or group we are prejudiced against. We can try to benefit from these services when we need them, by not avoiding these services and not forgetting that one of the healthiest ways to do for our health is to apply to mental health services.

We can talk about these prejudices and false beliefs with other, and we can encourage them to receive these services. Especially men do not benefit from these services for the reasons we have explained, and in many cases the problems have grown and become more harmful to both themselves and their environment. We can learn about both toxic masculinity roles and false beliefs about mental health, and we can be effective in the dissemination of this information in our daily lives.

1.???????zakka?, T. (2018). Psikoterapi Tarihi ve Bütüncül Terapi. Türkiye Bütüncül Psikoterapiler Derne?i, 1(1), 1-24.

G.B.