People sometimes ask, “How do I know I need therapy?” “How do I find a therapist that will truly understand me?” There are certainly long and detailed answers to these questions, but here are some condensed thoughts that may be helpful in answering these questions.

Generally, when a person is feeling that life is not going in the direction they had hoped for or for some reason life has stalled, not moving at all, this is typically a time we seek advice and counsel from family and friends. Sometimes you may not even know that things just aren’t right, but others are making comments about your mood, productivity, health, emotions. Or maybe there’s a problem or an issue that repeatedly shows up in your life and you find it never gets resolved, such as unhealthy relationship patterns with parents, partners, children, bosses, or co-workers.

Maybe there’s been a big change in your life — especially an unexpected one, such as the death of a loved one, the loss of a job, a financial crisis, or natural disaster of some kind — and you find you can’t adjust to the change, and instead turn to unhealthy coping behaviors such as drinking, eating, withdrawing, angry outbursts, or other addictions, instead of a gradual acceptance of the situation and active problem solving.

These circumstances are usually a challenge to normal stages of life development that call for change and new patterns of behavior. If a person finds that information on the Internet, talks with family or friends hasn’t been helpful, then it might be time to speak to a professional. Often therapy can be extremely helpful in changing fixed and unhealthy thought patterns and beliefs about one’s self, about one’s past, about how things “should” be. Fresh perspective, increased self-awareness, and skills such as mindfulness practice, effective listening and communication, can be the focus of the therapy. Short-term therapy often addresses these situational/developmental challenges.

Longer-term therapy may be required when a person has experienced trauma in adulthood and more particularly, in early childhood. Untreated, the traumatic experience can consciously or unconsciously haunt a person’s life. Trauma is defined as an experience or experiences that are so disturbing that it overwhelms the normal coping capacity of the individual. Trauma can be caused by a single incident or a result of chronic states of fear and stress caused by societal situations of racism, sexism, poverty, violence and abuse. Trauma can lead to personality patterns and symptoms that require a thorough assessment and possibly longer-term therapy that can lead to major life changes and healing.

So, therapy can be helpful in dealing with normal life adjustments and historic or current trauma, but therapy can also be helpful in treating diagnosed mental illnesses that may additionally require medication and other support services. Japanese Americans as a group tend not to use psychotherapy services for fear of the stigma of being mentally ill, weak, or dependent. Also a common concern among Japanese Americans seeking therapy is that a therapist may not be culturally attuned, understand unique life circumstances and family dynamics.

Early on in my career, a retired therapist who had worked in a mental health clinic for many years, said, “By the time a Japanese person comes to the clinic, they have avoided coming in for treatment for so long that their symptoms are extremely severe and troublesome.” I don’t know how accurate that statement is today, but I do know that in our community, seeking therapy is a difficult first step. I used to joke that the worn-down track of scuff marks on the carpet in my office was from all the wives that had to drag their husbands to marriage counseling! Sometimes after seven times down, someone else has to help with the eighth time up.

Finally, to find a therapist that fits your needs will require active efforts to research and network with others. If you have insurance that covers therapy, don’t hesitate to interview the person and inquire about their familiarity with your particular circumstance. Often doctors and ministers in the Japanese American community can make appropriate referrals. And the handful of Japanese American therapists may be part of a network of other culturally sensitive therapists in your specific area. Remember, your mental health is equally as important as your physical health. One impacts the other.

And remember, everyone deserves to live as fully and vibrantly as they were meant to be so please take good care of yourself!

Satsuki Ina, Ph.D. is a licensed marriage and family therapist specializing in intergenerational trauma. She can be reached at satsukina44@gmail.com. She is also a filmmaker (“Children of the Camps” — www.children-of-the-camps.org and “From a Silk Cocoon: A Japanese American Renunciation Story” — www.fromasilkcocoon.com). Views expressed in the preceding column are not necessarily those of the Nichi Bei Weekly.