Self-stigma and Counselling

Self-stigma and Counselling

Why people who need help with their mental health won’t go and get it?

The effects of the problem

Self-stigma is, if not the biggest, at least a major obstacle that  prevents people from seeking psychotherapy or counselling when they face mental health issues. Many feel that they should be stronger, tougher, harder when what they really need is the courage to admit that they need help, and reach out for it. Since mental illness is often stigmatised in society as well, this increases self-stigma, putting up a barrier to asking for help, leading to feelings of isolation and fear in addition to the original mental health issue.

So people plod on, with often worsening long-term mental health issues and possibly, suicidal thoughts. The World Health Organisation states that 264 million people around the world suffer from depression, with rates of anxiety and other mental health conditions on the rise as well.

Self-stigma is a self-built, high wall that stops people getting the mental health support they need and are ultimately seeking.

Self-stigma is the elephant in the room. To overcome it, we must first understand it: self-stigma arises from a culture and society’s sometimes unspoken biases and prejudices against mental issues. This we then internalise. This reinforces a negative view of mental health issues. If we find that we ourselves have a mental health issue, we apply this negative evaluation to ourselves, as if they were true.

Overcoming social stigma can be difficult. Sometimes it is due to the severity of the situation, an implosion, if you will, at other times it is recognising ones own thoughts and beliefs that are holding us back from seeking help, then challenging them with evidence and reasoning, and sometimes just being brave and taking a dive into the unknown. 

Where self-stigma exists, seeking help from mental health professionals can be challenging. Still, it is important to know that mental health professionals provide a safe, confidential, empathetic and non-judgemental environment for you to discuss your issues. 

Where does the self-stigma come from?

Society recruits us into believing that we must be happy all the time. If we do not have the skills to do this then we are to blame: we are somehow broken. Over time this leads to us internalising this as being to blame. This makes it more difficult to ask for help. Far better if we were to treat a mental health issue, the same as, a broken leg for example, where we have no self-stigma, and seek professional help, which enables and shortens the time needed for healing.

How Psychotherapy Works.

As a psychotherapist, I see many patients and clients with symptoms of depression, anxiety, and other mental health conditions who are benefiting from counselling, but who were reluctant to seek it. They were often overwhelmed, feeling hopeless, like no one could understand or help them. For years, they worried about what others would think and feared the judgement of others and professionals. Sometimes, they would see everyone but a mental health professional before coming to see me, treating the symptoms, looking for a temporary ‘fix’ to problems that were deep and dark and not shifting. There seems to be less stigma of going to an astrologer, Reiki, or other alternative healers than seeing a psychotherapist like me. The biggest reason for this is self-stigma.

One of the biggest benefits of counselling is that it provides individuals with an opportunity to speak about their thoughts, feelings and emotions freely, without being judged, criticised, ostracised or punished. Contrary to popular belief, counselling is not just for people with severe mental illnesses; it is for anyone who wants or needs to talk and find the best outcome for the challenges they are facing.

Psychotherapists know that there is no problem too big or small, boring or exciting, embarrassing, unexpected, harmful or harmless that it can be brought up in counselling. Counselling and psychotherapy have the ability to improve individual self-confidence, self-esteem, and self-efficacy, helping clients build positive and meaningful relationships with themselves and others.

By moving something, a thought, feeling, or experience out of the dark, shedding light on it, approaching it from different angles, its power over a person can be reduced, minimised, and ultimately, in most cases, removed. Alternatively by learning coping mechanisms and communication skills, counselling can also help individuals regulate their emotions, decreasing levels of anxiety and depression.

Counselling can also help individuals form a better understanding of themselves, their thoughts, feelings, and behaviours, enabling them to identify and create happy and healthy patterns, enabling them to move towards making positive changes that improve their lives and that of those around them.

Self-stigma is a significant obstacle that prevents individuals from seeking help for mental health issues. However, if you are curious enough to take a first tentative step towards it, most mental health professionals and all the psychotherapists at AMindset, are open and willing to talk about how it works, answering your questions and concerns. If you do take the leap, it can lead to significant benefits, including improved self-esteem, healthy relationships and an all-round better life.

Elise Phillipson


Elise Phillipson is a psychotherapist at AMindset (AM) in Central, HK and Central Health Medical Practice in Discovery Bay.​ You can find out more about Elise here.

Please complete the AMindset intake form if you want to start your therapy with Elise or another AM team member. Our therapists offer a FREE 20-minute introductory session for new clients.

Other Articles from Elise:

Christmas Alone 


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Christmas Alone

Christmas Alone

Don’t be stoic about being alone this Christmas, or any time when you are usually with family.

No matter what kind of person you are: a people person, or someone who likes to spend time alone, there is nothing as lonely as a traditional family day spent on your own.

It can be particularly difficult this time of year when growing up; it would be the most exciting thing to look forward to.

Be aware of your feelings:

Acknowledge disappointment if you were planning on spending Christmas with family or friends and nothing has come of it. It’s okay to feel sad.

Acknowledge that it may be possible to meet up with friends and family on another day, even if it may be a few months away, and feel the love and joy then: give yourself something to look forward to.

Accept how you are feeling. Move your pride and prejudice of being ‘strong’ and ‘stoic’. Being alone at Christmas can be awful, especially if your denial of your feelings comes back to bite you on the day itself. It can lead to resentment of self and others and a drop in well-being and self-esteem.

Change your expectations of this Christmas, whether you choose to spend it with others or alone.

Expecting perfection leads to disappointment and having low expectations can lead to no action, creating a self-fulfilling prophecy.

Spending Christmas with Others

Be pro-active. Instead of hoping someone will reach out or invite you, reach out to them.

Hope only sometimes leads to a solution, but action always does

Chances are that the other people thought you were busy or were hoping you would call. Reach out and see.

Don’t turn down invitations because of your pride. Accept that people have invited you because they want you there.

If someone asked you to spend Christmas with them and their family, and you answered no because you thought that you would only intrude, they did not really mean it or it makes you feel uncomfortable, call them and ask if the invitation is still open.

But: accept invitations from people you actually like, so you can enjoy your day with them.

Avoid people you do not want to spend time with.

Spend time with those you can spend time with. If you can do something and get there in person, do so. If need be, get out of your comfort zone and suggest something. If you cannot meet up, schedule a call, Zoom, FaceTime, or even just chat over WhatsApp.

If you cannot be with family this year, organise your own:

Host or join an ‘Orphan Christmas’ at home, in the park, on the beach (weather permitting), make it a potluck so everyone can contribute, or go out for a meal.

Create your own temporary Christmas Family. There are not many days left, but ask your single friends, or those whose partner is away if they would like to spend Christmas with you. It does not have to be big, or expensive. These days, it’s about being with people you like and get on with instead of being alone.

Go to a church, temple, or another prayer place, even if you are not religious. These places have had millennia of perfecting these traditional days to work for everyone. Usually, there is a post-service event where you can talk to other people who are not quite ready to go home either.

Volunteer at Christmas There is nothing quite like the good feeling we get from volunteering, especially in comparison to sitting home alone and feeling lonely. When you volunteer, you are actively helping other people feel better which, in turn, lifts your mood and mental state. The conviviality experienced with other volunteers is positive and good for mind and spirit.

Spending Christmas Alone

If you really are better on your own, make sure your day is planned. Have a planned walk or a marathon of uplifting movies that will get you through.

Focus on what you can do:

Is there something you’ve wished you could do if only you had the time? Something you really wanted to do? Give yourself the gift of time and permission to do it at Christmas this year. Plan it out, look forward to it and do it.

Go for a long walk around the city or in the countryside, getting rid of the cobwebs in your mind, invigorating and connecting with the oldest part of your brain that likes to look at and listen to natural surroundings.

Be kind to yourself.

Reward yourself throughout the day by doing things you love: a long bath, spa treatment, a good book or a box set to lose yourself in, cooking, a long walk, or something that makes you feel happy and comforted.

Do something you like that brings you joy.

Decorate your house as if you are not alone at Christmas because you are worth the decorations. Turn your home into a warm, self-loving nest. It can be a little tree with lovely little lights in the corner or the biggest tree with lots of decorations and flashy lights, depending on your personality, style and budget.

Get yourself a nice Christmassy candle. As we have learnt from aromatherapy, scents have a powerful effect on us, taking us back to places we love or hate and helping us feel better and comforted.

If Christmas is something you would rather ignore completely, surround yourself with people who do not celebrate either, and do something different with them. Even lunch or a movie will do.

You don’t have to celebrate Christmas.

Get yourself somewhere else. On the day itself, go out, and change your environment.

If you can afford it, have a change of scene altogether.

Many cultures do not celebrate this holiday, so get to one of those countries where Christmas is not on the calendar (i.e. Thailand) and revel in it being just another day…  Get out of your comfort zone and ask your friend to come with you.

Stay away from social media, as it can lead to negative comparisons, leaving you lonely and depressed. Do a digital detox with things that make you happy.

Lonely with Your Friends and Family Present.

If you have to spend Christmas with family who will not meet your emotional needs, have a call, chat, or video with friends you do connect with, or the Samaritans. They are brilliant listeners and allow you to talk it off.

Choose another day to meet up with those who meet your needs, such as good friends or have a ‘reward yourself’ day to recharge your batteries.

Whether Alone or with Others:

Practice gratitude. Sometimes we get so bogged down with what we don’t have that we neglect or take things we do have for granted. Sit back, look around and appreciate what you have, even if it’s just a little thing. Gratitude increases the positive chemicals in our brains, making us feel better.

Plan ahead. At Christmas, look ahead and plan for next year. What goals will you set? What would you continue doing? What would you stop doing? What will you start doing? Write a plan, timeline and actions to create a positive outlook for your future with goals and ways of getting there.

Sleep! Have a few good nights’ sleep, as sleep deprivation can increase stress and depression.

Alcohol is a depressant. Drinking your sorrows away is a myth – try other drinks. Hot chocolate or aniseed milk are warming, good before bedtime, watching a movie, or reading a good book.

If you’re not coping or are not sure, reach out. Either friends, family, or the Samaritans. They are here to listen, are open all the time and are happy to take your call, even if you feel just a little blue or lonely.

See a counsellor or psychotherapist to talk about it. We are here for you, on your side, supporting and working together with you to figure things out and get you through this tough time.

Elise Phillipson is a psychotherapist who practises at AMindset in Central and at Central Health in Discovery Bay.​

Please contact us if you would like to speak with a counsellor about how we can support you.

by Elise Phillipson

Find out more about Elise here