Ask Dr. Dombeck: Psychotherapy and Mental Health Questions
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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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Disclaimer

• Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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