Double Take: Family therapy might be worthwhile, even if no problems are obvious

Dear Dr. Wes and Miranda: I’ve read your tweets about cutting, in which you recommended family therapy. Nobody in my family cuts, but my 20-year-old sister still thinks we all need to go to family therapy. I don’t know why. We don’t fight at all. Any suggestions?

Miranda: There are many, many reasons to go to family therapy besides cutting.

Do not believe the myth that only those with a serious mental illness go to therapy. A lot of families go in together after a death, divorce or other big life change. So there could be another reason your sister suggested this idea. Why not ask her?

The key to remember is that if one person in the family seriously thinks that the whole family needs a few therapy sessions, it may be a good idea to explore that option. The whole family needs to have a discussion as to why your sister thinks this and if it’s the right choice for your family. Just because you don’t see a serious problem out in the open (like cutting) doesn’t mean that there isn’t one buried in there somewhere.

Maybe your sister is dealing with something and this is her way of asking for support or help. It could just as easily be her seeing a problem within the family dynamic or a concern with another member of the family. But her issue, whatever it may be, deserves attention.

Sometimes it’s hard to be completely honest with your family, and therapy is a good way of working through any problems they might have in a safe setting. If your family decides this is worth a try, don’t let false stereotypes of therapy stop you from getting involved. You may find it helps out a lot, now or in the future.

Dr. Wes: There are those who think we’ve become a people of excess therapy. That our society now depends too much on the search for good feelings and not enough on good behavior; and that perhaps psychologists are to blame because we’ve been pushing therapy since the 1960s and ’70s.

Some attach naïve motives to this, that therapists live in a sort of Mr. Roger’s world where just talking about things makes them better. Others imagine a less charitable motive — profit.

I can’t speak for anyone else, but I see therapy work all the time, particularly if the focus is the whole person: feelings, behavior, thoughts and physical health. If I didn’t think that, I wouldn’t be successful with my clients, and I’d have gotten out of the biz long ago.

But I also understand your skepticism. In your case, you think there’s not enough conflict in your family to justify the effort. You might be right, and I don’t usually recommend people head to therapy without a defined problem around which to center their discussion. That will usually broaden as the therapist comes to understand the family, each individual and the issues, but it’s nice to have something to start with.

The catch in your letter is that, just as Miranda suggests, someone in your family does see a problem. Maybe your sister only wants to get to know the inner workings of her family members a bit better.

Or maybe she just thinks it would be cool to see a therapist. The perception of therapy over the last 20 or 30 years has gone from weird and highly stigmatized to highly desirable, and many teens and young adults seek it out themselves. In fact, the majority of kids I’ve seen in the last five years asked to come in. It’s the rare ones now who feel coerced by parents.

But let’s assume instead that Miranda is correct, that there is something your sister wants to explore she needs the help of her family do it. Lend her your support. Go in with the family and see what there is to see.

Obviously not everything works for everyone, but a whole lot of kids and families I’ve known over the years were glad they gave it a shot.