Understanding 10: This book does not prepare you to be a therapist. Help others, but don't take control and "treat" others.
While I want to urge and help you to take responsibility for your own life, I want to persuade you not to take charge of anyone else's life. It is important to distinguish between what might be called "helping" and "treating." A "helper" may listen and give empathy, suggestions, encouragement, feedback, care, and share his/her experiences, plus many other things, but both helper and helpee should always realize that the helpee must make the decisions, be responsible for applying the self-help methods, and "live with" the outcome.
A "treater," such as a surgeon, is highly trained and usually takes responsibility for diagnosing the problem and assumes full control in the operating room because the patient can't help him/herself in that situation. You have not had the years of training and supervision necessary to become a competent therapist to someone else. If you feel that a friend of yours is allowing or asking you to take charge and tell him/her what to do or to make him/her feel better, please refuse to do so. Tell your friend that he/she must make the decisions, take the action, and assume the responsibility (no matter how much your would like to be a hero and save him/her). If the friend is unable or refuses to handle his or her own problems and needs someone to take over, please insist that your friend to seek professional help (and stay only a friend, not a second competing therapist).
On the other hand, I want to make it clear that it is great to help friends and to receive help from them. The world would be a healthier and more beautiful place if all of us helped each other. But that "helping" never includes taking over their life. Mutual helping or support groups are wonderful opportunities to help and be helped (see chapter 5 and Gartner and Riessman, 1984).
Understanding 11: If your problem(s) could be caused by physical-chemical factors, see a physician first.
Certain physical conditions, such as low blood sugar or hyperthyroidism, can cause symptoms that seem to be psychological, such as fears, nervousness, irritability, depression, etc. Likewise, psychological factors can cause physical symptoms, like exhaustion, paralysis, pain, nausea, baldness, headaches, backaches, skin rashes, sleeplessness, impotence, high blood pressure, etc.
Probably, physical, chemical, and constitutional factors play a role in almost all personal-emotional problems. A psychologist or social worker cannot deal with the physical causes; you must consult a physician if your problems are possibly physical and not psychological or interpersonal (see step 1 in chapter 2).
Understanding 12: When your problems are severe and/or your self help efforts are ineffective, seek professional help immediately.
While knowledge of self-help may prevent or relieve many problems, there are certain situations in every life where outside help is necessary. Self-help is like first-aid; so, if you need surgery, don't use band-aids, see a surgeon right away! What are some of the psychological situations that call for professional help? When one is so depressed that there are thoughts of suicide, when one's thoughts are confused or unreasonable, when a person experiences urges to hurt someone, when feelings towards other people are very strong (so that one is not likely to be thinking straight), and when someone has tried and tried to help him/herself but nothing seems to work. Usually when your psychological problems are quite serious, you will need therapy, medication, a support group, and self-help. Get what you need.
Furthermore, if anyone earnestly suggests that you seek professional help, take their advice even if you don't understand why or don't agree with them. Never be embarrassed about seeking help; why should you expect yourself to know everything about psychology, any more than you would expect yourself to know calculus or how to repair a TV set? Indeed, what is really foolish is to need help but decide not to get it. Research has clearly shown psychotherapy to be helpful 2/3rds or 3/4ths of the time. Don't let your own lack of knowledge or fear of what might happen or concern about "what people will think" keep you from getting help whenever you need it.
See the section in chapter 2 about Finding a Therapist. Make your selection of a therapist carefully by getting recommendations from people who know and by checking his/her training and credentials. It pays to know a lot about psychotherapy, the training of therapists, the types of therapy and which are most effective with different problems, the cost of different approaches, etc. Several links cited there provide the information you may need.
Understanding 13: This book cannot meet all your needs.
The highly self-controlled person needs more than a bunch of self-change techniques. He/she must pick his/her own values and goals, set his/her priorities. He/she must have insight into him/herself and an accurate view of the world. He/she needs companionship, acceptance, and love.
None of us can solve all our problems by ourselves, no matter how well informed we are about self-help methods. This book, plus hundreds of others, can suggest many effective methods and even "care for you from a distance," but you may need specific feedback to identify your specific problems, confrontation about some foolish idea you have, warm approval and support when your confidence lags, or someone to take you to a hospital. This book can't give you individual attention or a hug or a shoulder to cry on, in times of stress. I wish I could, but those things must come from a caring person near by, such as a friend, a relative, or a teacher. Getting and giving care are both highly therapeutic. You will have to reach out to others and when you do--please be very explicit about what you need. Most people want to help others and benefit from helping.
Understandings for groups and classes: Be clear about the purposes of your group, know how you can contribute, maintain confidentiality, and help others feel safe. Be sure you understand the reasons for the requirements of your group
Many students tell me they learn more from small group discussions than from reading books and classroom presentations. I'm sure that is true for some. We all have our favorite ways to learn. Mutual helping groups are interesting but require work--dedication to a purpose, self-disclosure, an eagerness to listen, learn, think, accept and help others. Every person must be willing, after getting to know each other well, to openly share his/her problems and positive or negative feelings, to learn and use good communication skills, and so on. In a good helping group, the payoffs are great: you learn from others' lives, from their successes and failures. You gain useful skills. You profit from the helpful ideas and honest feedback of 8-12 other people. You also get the warm feelings and insights that come from helping others.
Be sure the rules of confidentiality adopted by the group are clear and accepted by everyone. Insist on it. Be sure that everyone in the group or class knows that they don't have to answer any question if they don't want to. Accept your share of the responsibility for making the group a meaningful experience; that usually means sharing your experiences and your deepest concerns at the moment. Be gentle and empathic with everyone in your group at all times, no matter what they disclose. See the discussion in chapter 5 of self-help and support groups for handling all kinds of stress and unwanted behaviors.
All these understandings are to prepare you for making maximum use of this book and to introduce you to the ideas of self-help, mutual-aid, and psycho-social education.