• Daniel Acosta M.A., AMFT

Self-Help or Therapy, What to Choose and When

Self-help or therapy? Which to choose, when, and why? A common question I hear from potential clients sounds like, “I don’t know if I should go to therapy or if I should just watch YouTube videos and try to figure it out myself?” This is an excellent question; how would anyone know which to choose; and how to determine when would be the right time to pick one over the other?



When I look at differentiating between self-help or therapy, an example comes to mind. That example being, when to use my hands (an internal resource) versus when to seek (an external resource) in this case below a physician. When I eat a slice of pizza with my hands this action is reflective of using an (internal resource as my hands are organic to self). Conversely, when I see a physician for back pain, I am going to (an external resource) for medical support. There are times when handling an issue by self is appropriate and there are times when reaching out for professional support would be commensurate with issue(s) someone is facing.



What are the benefits in therapy that I can’t achieve in self-help? According to (Perry, 2013), “A book cannot possibly hear you, it will never be a conversation. And if a self-help book doesn’t work, won’t that leave you feeling more of a failure than when you started? And if such books did work, wouldn’t we all be following their advice and living in a peaceful world? And how can a self-help book give you feedback?”


This sentiment is further supported by (Brown, 2017), “Therapists have the benefit of being able to respond to people. You can change; the self-help text or workbook doesn’t. And if the self-help therapy doesn’t work the way it’s supposed to, well, maybe you just didn’t try hard enough.”


Perry and Brown both make thought provoking points here and from their perspective this goes to responsiveness. A therapist can reply to a real-time issue in session with a client that comes up for the client and adjust to that thus meeting the client where they’re at in that specific moment in time. Whereas a self-help resource is more rigid in its structure as it is designed with a specific goal and/or more narrowed focus in its design and construction.




The next logical step goes to identification. What could be an indicator that it’s time to seek help? In a recent article there are signs that it’s time to seek professional help (Talkspace, 2019), “Some of the symptoms you might be experiencing might include: Constant crying and unresolved grief that has affected you for months, Lack of enjoyment while doing the things you used to enjoy, Constant feelings of worthlessness, Anxiety with panic attacks, OCD that affects you physically or emotionally.”


According to (Goldhill, 2017), “For those who can’t get a therapy appointment right away, self-help CBT exercises can still have a powerful effect.” Imagine an individual is sitting at home on the couch, it’s late at night, their all alone, and find themselves ruminating in their thoughts, worries, fears, or concerns thereby spiraling into depression, anxiety, or thoughts of self-harm. In this scenario, its past normal operating business hours, I would not agree with Goldhill in this depiction.

(Brown, 2017), “Self-help can be brilliant for those who are at least part of the way there, but we should be wary of any suggestion that it could replace therapy.”



I would agree with Goldhill’s perspective in a very specific context as articulated by Brown in the citation listed above. If an individual generally speaking is mentally stable, has an established, consistent, ongoing working relationship with a mental health clinician, knows when to access additional support as needed, and has progressively grown in that body of work to migrate to a place where they have the mental awareness and the know-how to be skilled in knowing when and how to use self-help exercises effectively this individual would benefit greatly from self-help CBT exercises. In essence self-help CBT exercises are one of many tools in the metaphorical toolbox one can access at an individual’s disposal in a time of need.


When the enormity of problems or troubles one faces are bigger than they can deal with and/or process successfully, there are other noteworthy resources available for free 24 hours a day to consider including: the National Suicide Prevention Lifeline, Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline, as well as the National Domestic Violence Hotline. Other options which aren’t 24 hours a day include the National Alliance on Mental Illness (NAMI). For my fellow military Veterans that need support 24/7 there’s the Veterans Crisis Line again for free that’s available to reach out to.

In closing, I’d like to point out in Goldhill’s viewpoint it stipulates CBT exercises, “can be helpful for those who can’t get a therapy appointment right away” thereby inferring a therapy appointment would be the preferred if not the default course of action with the caveat from my perspective being the severity of the episode that an individual turns to the appropriate resource. If you feel that you are experiencing a medical or mental health emergency call 911 or head to your nearest hospital or urgent care facility.


Daniel Acosta M.A., AMFT is a Registered Associate Marriage and Family Therapist in Mission Viejo, California. He works in private practice with men, women, and adolescents and provides individual, couples, pre-marital, family and marital therapy for clients in Orange County. If you would like to schedule a session he can be reached at 949-943-7820 or via email: daniel.acosta@therapysolutionstoday.com

References


Brown, M. (2017, August 23). Be your own therapist? Fine – if you’re up to the job. The Guardian. https://www.theguardian.com/commentisfree/2017/aug/23/therapist-self-help-therapy

Goldhill, O. (2017, August 20). Patients can be pretty good therapists to themselves. Quartz. https://qz.com/1057345/researchers-say-you-might-as-well-be-your-own-therapist/

Perry, P. (2013, March 28). Which Is Better, Self-Help or Therapy? Psychology Today. https://www.psychologytoday.com/us/blog/how-stay-sane/201303/which-is-better-self-help-or-therapy

‌ Talkspace. (2019, November 4). 4 Therapists on What You Won’t Get From Self-Help Books (C. Catchings, J. Filidor, R. O’Neill, & E. Hinkle, Eds.). Talkspace. https://www.talkspace.com/blog/self-help-books-versus-therapy/