Kyle MacDonald is an experienced psychotherapist and regular co-host on the NewstalkZB mental health awareness show The Nutters Club.

Kyle MacDonald: How to help those who don't want help

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There can be lots of reasons why individuals don't want help, but let's focus on denial. Image / NZ Herald
There can be lots of reasons why individuals don't want help, but let's focus on denial. Image / NZ Herald

I had a couple of great responses to last weeks column, from people who were curious about how to help someone who did not want help, or were reluctant to engage with a GP or therapist.

So what can you do when someone doesn't want - or believes they don't need - help?

There can be lots of reasons why individuals don't want help, but let's focus on denial.

Freud talked fairly extensively about denial, as what he called a "defense mechanism", which basically means a way of organising our experience that minimizes pain (if it isn't happening, it doesn't hurt).

We can likely all think of times when in hindsight we were "in denial" about the reality of a situation, and normally because we didn't want the truth to be true.

Whether it be our health, our weight, a relationship breakdown, alcohol and drug use or just the fact we are unhappy about where we find ourselves in life: denial is something we can all recognise because it's such a fundamentally human experience.

So how can you help someone you care about who may be in a state of denial about their own emotional health, or even more of a challenge, addictive behaviour?

Firstly, put aside any ideas you may have about challenging, confronting them or holding a Hollywood style "intervention". They very rarely work. And when you think objectively about why, it's obvious: it creates resistance and reduces the chance of a person being open to thinking about their own behaviour.

You can lead a horse to water, but if you force it to drink you risk drowning it.

In general, we need to approach gently and help the person reach their own conclusions.

"Motivational interviewing" is a particular counselling approach used with people in denial about their addictions. It suggests starting with information to get the person thinking about their own behaviour. But don't rush to "action", because if the person isn't ready to make changes, this will also turn them off.

So assuming you're safe, and there's no threat of violence, and they're safe and not acutely suicidal, here are some practical suggestions about where to start:

Raise concerns gently, when both you and the other person are calm

Avoid "jargon" and labelling, don't tell the person they're depressed, ill, an alcoholic or otherwise diagnose them

Instead stick to talking about specific concerns, and your observations, "I'm worried about you, it seems to me you're really unhappy..."

Stick to clearly observable behaviours, and stay away from what you think might be going on in their head (no one likes being told what they're thinking or feeling)

Research, or ask professionals to recommend good, engaging information. (the list and links at the bottom of this article are a good starting point)

Be kind, and as discussed last week when in doubt validate, validate, validate

And be patient. It's unlikely one conversation will shift someone's view, but feel free to keep gently raising it, and kindly offering your point of view, and setting clear limits and boundaries about what is okay, and not okay for you.

DO YOU HAVE A QUESTION FOR KYLE? SEND US AN EMAIL

• Questions will remain anonymous

Where to get help:

Lifeline: 0800 543 354 (available 24/7)
Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
Youth services: (06) 3555 906
Youthline: 0800 376 633
Kidsline: 0800 543 754 (available 24/7)
Whatsup: 0800 942 8787 (1pm to 11pm)
The Word
Depression helpline: 0800 111 757 (available 24/7)
Rainbow Youth: (09) 376 4155
CASPER Suicide Prevention
If it is an emergency and you feel like you or someone else is at risk, call 111.

- nzherald.co.nz

Follow Kyle on Facebook and check out his website here.

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Kyle MacDonald is an experienced psychotherapist and regular co-host on the NewstalkZB mental health awareness show The Nutters Club.

Kyle MacDonald is in private practice at the Robert Street Clinic in Auckland. For more: psychotherapy.org.nz or his Social Anxiety resource site: overcomingsocialanxiety.com.

Read more by Kyle MacDonald

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