Can Community and Openness De-Stigmatize Therapy?

This is Post 2/100 in my 100 posts in 100 days series.

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[image by tboard]


Yesterday I asked the question, Is There a Therapy Stigma? If you haven’t had a chance to answer that question…please take a moment to do so, as I’m interested in your opinion on this important subject.

One of the things that has been on my mind for the last couple of years is the question: Can the stigma be taken out of therapy if there was more openness and transparency in the process, rather than anonymity and secretness?

I have received various feedback on this subject…usually about 50/50. There are many who hold to the more traditional methods of anonymity and secretiveness in the therapy process (note: I’m not talking about client confidentiality here–obviously that is super important and must be upheld). While many, especially those raised in the internet age, are more prone to see the necessity of a more open therapeutic process. Wherever you fall on this question, I think the reality is that many things are changing in the field of therapy…and so it’s something we should be thinking about.

Two months ago I came across an interesting conference that I blogged about, Taking the Stigma Out of Mental Health with the Help of Social Media. I won’t spend this post talking about social media (because I will devote plenty of time to that soon), but I do want to mention some of the questions they were asking at the Mental Health Camp–a Conference about Mental Health and Social Media. The specific interest of the camp was “Erasing Stigma and Exploring Possibilities with Social Media.” And some of the questions they were asking were as follows:

* How can blogging help decrease the stigma of mental health?
* How does someone with a mental illness navigate the waters of anonymity in the transparent world of social media?
* How is the journaling that happens in blogging similar to or different from journaling for healing?
* How can social media participants with mental health issues help each other?

What’s interesting to me is that they were not only asking these questions, but they were getting at the idea that openness in mental health can de-stigmatize it. And more importantly, as we live more and more in an open society, especially with our reliance upon the internet…will therapy head more in that direction?

So I have been pondering various ideas in regards to my practice. And just a few questions come to mind that you might have some thoughts on.

What would it look like to have an office in a more public, highly visible and busy area? Say for example, in an office above retail shopping, or next to a coffee shop. Would you be attracted to that, or is that to open for you?

Do you think therapy should remain more anonymous and secretive?

If you were to see a therapist, would you keep it confidential, or is it something you would share with some people?

Do you think that therapy can be more beneficial if the client has a community of supportive people that are aware of the therapeutic process, and are able to lend support in and out of the office?

7 Comments

  1. by Ben on June 26, 2009  8:30 pm Reply

    When you first wrote about this a year ago, I wasn't a fan of it. But after experiencing times with people I have mentored, I would completely agree that atmosphere is almost everything. My main mentoring spot was Starbucks. What I found was in that open environment, you connected the time with comfort and relaxation as opposed to one of anxiety.

    The idea of being next to a coffee shop would be ideal. Someone could get a latte and it would almost act like comfort food to them, a nice, warm cozy reminder of sitting with someone and naturally chatting. Being in an open space also gives someone the semblance of control, they aren't confined into your territory but instead have the opportunity to look around and not feel confined to four walls and a dimly lit lamp. (My original post was better, btw. haha)

  2. by Ben on June 26, 2009  8:36 pm Reply

    Ok, one post down, one more to go, haha. To be honest, I would be scared to death if people publicly knew all of my deep problems. Therapy has a stigma of uncomfortability to begin with, it is almost like the "cough and turn" part when getting a physical. You aren't a fan of where the doctors hands are and you are just waiting for it to get over, however, you are happy that there aren't video cameras making it public.
    But, getting past my own fears of that, knowing that having a group therapy session could be beneficial to hear how others cope and find solutions to their problems could do a world of good.
    I think seeing a therapist would be something I share with my own friends and probably on my blog to be honest, but I would still feel uncomfortable sharing it face to face with someone outside of my own inner circle of friends.

  3. by Ben on June 26, 2009  8:36 pm Reply

    The only con I could see is a support group turning into a group of enablers in the long run. I believe that people need to find a sense of confidence and independence if they are truly going to find freedom in their problems. But as the saying goes, "birds of a feather, flock together" and people with similar issues could end up just venting to each other about the issues but not getting any solutions from them.

  4. by rhettsmith on June 26, 2009  9:23 pm Reply

    Ben, great comments....I will respond to each one them later today....thanks for posting them. Need to sort and think through them.

    rhett

  5. by rhettsmith on June 28, 2009  10:15 pm Reply

    Ben,

    Great comment....I guess there is a reason we all find ourselves opening up over coffee in a nice little shop. I think environment is huge when it comes to therapy, and I've thought about what it would look like to do therapy in a more social setting. Still private, but in a more social area...not hidden, off the beaten path.

  6. by rhettsmith on June 28, 2009  10:17 pm Reply

    Ben,

    Wow, nice analogy there....haaaaa. No one like being in that situation with the doctor.

    But, I'm not talking about exposing people's problems to others...I believe confidentiality is huge and important, and ethical. But I think there are some important dynamics in group therapy, as you mention, that can help people feel less of a stigma, and more open. Some stuff people will probably never share in a group setting, and that's fine....I don't share all either. But I think it can help us see that we aren't alone if we know others are struggling with stuff also.

  7. by rhettsmith on June 28, 2009  10:19 pm Reply

    Ben,

    Always a problem in group therapy....some people have asked me that in regards to going to AA. But I have found that AA has been super powerful and helpful to many of people who are struggling with alcoholism. So sometimes "flocking together" can be crucial to one's health...it's often up to the group facilitators to help set rules and moderate boundaries, etc, etc.

    You posted great stuff...lots to think about and ponder on my part. Appreciate it.

    rhett

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