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An ultimatum is not the answer

Lisa Gordon, Ph.D.
• February 07, 2022

My daughter introduced me to early-2000s television show One Tree Hill. In one episode, the character Deb tries to convince her husband to attend therapy by offering him a choice between therapy and divorce. Spoiler alert: the couple begins divorce proceedings. As a therapist, I know better ways exist to convince your partner to see a therapist.

Think about the similarities between starting therapy and buying a new product. The consumer wants to ensure two things: that they have a need for the product (in this case, therapy) and that at worst, the product will do no harm; at best, the product will benefit them. 

Although you may have a telephoto lens view of your partner’s angst and dysfunction, your partner may want more objective feedback on their personal mental health. A primary care physician, an employee assistance program (EAP), or a self-assessment can provide that objectivity. If your partner is resistant to reaching out to a mental health practitioner, encourage them to see a medical practitioner, who will have the training to conceptualize symptoms such as sleep disturbance, irritability, muscle aches, or fatigue as possible indications of mental illness. If the cost for a medical appointment is a hindrance, perhaps your partner would be willing to consult an EAP, which often offers free services such as assessment, consultation, referral, and treatment. And finally, if the effort of contacting a professional deters your partner from gaining a fuller understanding about the need for therapy, gently guide your partner to self-assessments. Simply search online for “self-assessments for depression” or “self-assessments for anxiety” to access empirically validated assessment tools, complete with scoring and interpretation. 

Many people learn about psychotherapy from entertainment platforms, such as talk shows, reality television shows, and television series, all of which prioritize creating drama over truly healing people’s wounds or chaos. As a result, your partner understandably may equate therapy’s helpfulness to a fire alarm for a headache. To decrease the risk of therapy, encourage your partner to approach a first session as a window-shopping expedition, where your partner can articulate what they are looking to buy, and the therapist can articulate what they have for sale. Your partner may find it easier to attend one shopping expedition or one session, rather than fully commit to therapy. You can also make therapy more approachable by asking trusted people, such as friends, family members, or physicians, for recommendations. Offer to research well-respected therapists for or with your partner, and only provide your partner with the names of therapists that trusted others can vouch for. You can also offer to accompany your partner to a first session. Your presence may provide your partner with reassurance that the therapist will accurately understand the problems and view your partner in the most positive light.

Someday I hope psychotherapy follows the dental model in our country. Every six months you have an appointment with a therapist, and after the appointment, you either schedule additional appointments to address concerns, or you schedule your next appointment for six months later. There would be less stigma and thus no need to convince your partner to see a therapist. Instead, seeing a therapist would be one very-practiced element of maintaining whole-body health. Until then, if you think your partner would benefit from therapy, try some of the above strategies, and avoid proffering an ultimatum. Otherwise, “therapy or divorce” may end up leading you to more therapy, rather than your partner. 

Lisa Gordon, Ph.D.

Director, Postdoctoral Fellowship
Coordinator, Psychiatry Residents Program
Staff Therapist

Dr. Lisa Gordon is a seasoned clinician who specializes in treating anxiety and mood disorders, couple distress and the bidirectional relationships among these entities. Working within a cognitive-behavioral therapy framework, she strives to understand how automatic thoughts and harsh self-talk underlie individual and couple pain and dysfunction.