• Mamta Ward

Cultural Barriers -

What’s stopping you from seeking counselling?

There are many ways in which we can create barriers for ourselves, talking ourselves out of the help and support that counselling can give us. In my experience, members of our communities often have to overcome even more of these, and sometimes suffer for longer than they need to before seeking that support. So this article is about examining those reasons and providing some reassurance about how counselling can work within them.

The stigma surrounding mental health is still very strong. Although this is starting to shift a little, our insular, insulating communities hold on to the idea that mental illness is a weakness of character and that all we need to be mentally healthy is the support of a loving community. But it is this community that, with the best of intentions, creates the shame that prevents us from getting the help we really need. My clients often don’t want their families to know they are in therapy. Both because they want to protect them from worry and because they want to protect them from feeling the shame that they think they will feel. And often this is not the shame the family feels towards the client, but the shame of what the family believes others will think if they know. Because of this, therapy sometimes takes place in secret. But therapy is all about you, and takes place on your terms. If you need it to be a secret, it can be a secret. If you have additional requirements like fluid sessions or special days, times and places, these can often be accommodated by your therapist as long as this is communicated within the boundaries of your relationship. This is not about changing the social construct and perception of therapy (though I hope that will change in time) – it’s about how to fulfil your needs within those perceptions.

We can also stop ourselves seeking help because of internal shame, and this is harder to overcome. Clients feel guilty about feeling they need therapy in the first place. In first-generational immigrant clients there can be a strong sense of “I should be able to cope. My parents went through so much more and coped so much better”. That might be the case, or that might be your perception of what happened but, either way, it doesn’t matter. No-one else’s pain makes yours any lighter. No-one holds the right or the monopoly on being hurt. Again, this is about you, and your way of being able to cope with what is happening for you.

And this idea of “you” also creates a barrier. The idea of “community”, especially when the community is in a minority, can make it feel like there is no room for the individual. We are sometimes expected to surrender ourselves and control our own needs for the better of the whole. Departing from this idea can sometimes feel like we’re rejecting our cultural roots. Religion can play into this as well. The idea of a divine will can make us feel as if we’re wrong to feel unhappy or that we deserve it or even that it is meant to be this way. In a world where our religious communities also become our social communities, moving away from these ideas can feel we are moving away from our racial, religious and cultural values.

Perhaps this is why clients seek therapists who share those values. Therapists who share an implicit understanding of their culture, who they feel are able to understand their viewpoint. But this can create a new problem – if the therapist is part of the same community, how can it be secret? How can it be safe? And this is why it is so important to stress confidentiality. The emotional safety of the client is at the heart of the process, and nothing is shared outside the terms of the contract. This is a value every credible therapist holds very dear, and is at the top of our ethical to-do list. I tell my clients that, upon the unlikely event I run into them at a community gathering, I will not acknowledge I know them and will not approach them unless they approach me. Again, this is not about changing society. This is about you, the client and what works for you.

Online sessions are another effective way of overcoming this barrier. The idea that a therapist can share the same cultural background, but be halfway across the country and so not be a physical presence in the community is comforting to some people, and I have noticed an increase in clients who do not live anywhere near me, perhaps for this reason.

So yes, there are very significant barriers. But they can be overcome. There is no reason not to seek the support you need. So what’s stopping you?

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