Over the years, friends and acquaintances have informed me of various situations that could benefit from therapy (e.g. “our sex life is non-existent,” “I’m in a rut…again,” “I really don’t like my body.”) After inquiring whether these friends and acquaintances have sought therapy, I’ve heard this response on several occasions: “I have friends to talk to; I don’t need a therapist.” This statement has always troubled me. Here’s why:
A friend is not a licensed mental health professional (and even if they are, they cannot ethically and legally be YOUR therapist).
A licensed therapist is a mental health professional who has attended graduate school, has completed state-issued exams, and acquired over 3,000 hours of closely supervised clinical training (i.e. 3,000 hours of counseling practice). This background is only the foundation for years of experience with countless clients and continuing education requirements that follow the acquisition of a state license. The term, therapist, can refer to Marriage and Family Therapists (MFTs) and Social Workers (LCSW) whom have completed a Masters degree, psychiatrists (MDs) whom have completed medical school, or psychologists (PhDs, PsyDs) whom have completed their doctorates.
A therapist is a trained professional qualified to assess your symptoms and/or concerns, to identify goals that would assist in improving your situation, and to provide specific interventions to reduce your distress and meet your therapy goals. While your friends may be empathetic and supportive, they are not objective experts in mental health and wellness.
Friends are not obligated to follow ethical and legal guidelines to maintain your relationship and confidentiality.
Therapists adhere to specific ethical and legal guidelines that are intended to avoid “dual or multiple relationships” with their clients. A dual or multiple relationship consists of having two or more types of relationships with one individual (e.g. your accountant who also happens to be your high school friend and neighbor, your hairstylist whom you also meet for dinner on occasion). A therapist can only be your therapist; a therapist cannot be your friend, your mentor, your cousin, etc. Thus, a therapist cannot be your friend.
The reason that therapists avoid dual relationships with clients is to protect confidentiality and to ensure that clients are able to have the emotional safety to openly share struggles. While your friend can promise confidentiality, they are not legally and ethically bound to this. (Unfortunately, most of us have had experiences with friends whom have broken our confidence.)
Additionally, friends may not be able to offer emotional safety or availability in many scenarios. For example, soon after your friend’s mother passes away, they may not be accessible to you for emotional availability and support. Also, you may hesitate to share your struggle with premature ejaculation or childhood physical abuse with friends. Furthermore, we may find that frequently consulting our friends about long-standing concerns can become a burden or an overwhelming strain on our friendship.
Friends are free. Therapists are paid.
This dynamic contributes to therapy’s benefits. For example, if you meet with a therapist once per week, you are agreeing to spend time dedicated to improving your life, your well-being, and your mental health. When you pay for this service, you are FAR more motivated to address your concerns and be held accountable to attend to your therapy goals. This payment also ensures that you are receiving professional assistance, that you do not provide reciprocal emotional support, and that you are guaranteed time to attend to your emotional/psychological well-being.
Friendships are (ideally) mutually-beneficial, equitable relationships.
This means that in addition to receiving support from your friends, you provide emotional understanding and empathy to your friends, support them through their struggles, and attend to their emotional needs.
With a therapist, it is their job to ONLY support you and your emotional needs. Therapy is a one-sided relationship; it is about you, your needs, your struggles, and your life. This is one of the wonderful gifts of therapy; the relationship with a therapist is uniquely beautiful, it is sanctioned to be one-sided, focused on YOU (without an opportunity to reciprocate care, support, and empathy for another). Therapy frees you from attending to another person’s needs; this allows you an opportunity to honor yourself and what is best for you.
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In the statement, “I have friends to talk to; I don’t need a therapist,” there is an implicit assumption that only those without social support and friends seek therapy. This is not true. At all. People in therapy have friends. In fact, many people in therapy are well adjusted, social, incredible, dynamic, and capable with strong social supports and many close friends. By sharing, “I have friends to talk to; I don’t need a therapist,” one stigmatizes therapy and the courageous people who seek its benefits.
By stating or believing that a friend is a therapist, one is misled and left short-changed. While friends are cherished and needed, a licensed therapist offers an extraordinary relationship, providing professional/informed guidance, safe emotional boundaries, and freedom to focus exclusively on YOU.