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What Type of Person Never Admits to Needing Therapy?

It is a truism in psychotherapy that those who actually should be attending therapy are the ones who rarely find their way into treatment.

In “Pack Leader Psychology” I categorized personalities into three types: Dominators, Submissives and Avoiders. Dominators are the types most likely to need therapy yet also least likely to seek treatment. However, the behavior of Dominators is also the most likely to send others into therapy.

Scratch the surface of anyone in therapy for common problems such as depression or anxiety or ADHD and you’ll usually find a Submissive or Avoider whose life has been made difficult by a Dominator.

This shows up in predictable ways such as:

  • a child with an intrusive, opinionated “helicopter parent” who develops behavioral problems or school attention problems due to the parent’s anxiety and over-control
  • a spouse who has been controlled, threatened or even abused by a partner and who is experiencing nervousness, anxiety and insomnia
  • a family member frustrated with a sibling who is attention-seeking, dramatic, and can never be wrong about anything
  • a spouse who believes she has to submit to her husband who argues about everything and cannot back down in a fight

Submissives and Avoiders come to therapy to find ways to cope with the Dominators in their lives. While I can certainly help these patients, especially by helping them be more assertive, my effectiveness is limited because the person who really needs therapy is not in the room.

I actually would love to require that everyone come to therapy WITH the person who is the source of their problems. That would really help the process along! All psychology is about human relationships, after all.

But getting Dominators to show up in therapy or stay in therapy for the long haul is the trick. Because of their strong reluctance to admit any faults, Dominators have great difficulty admitting that they might need therapy or might need to address any personal deficits.

Dominators can’t admit fault because they experience high levels of shame and, as a result, have great difficulty being accountable for their behavior. Challenge them on a mistake and they will lash out at others rather than take the blame.

Of course, if the Dominator were in therapy we could dig deeper and look at their insecure attachments to parents in their childhood to explain this self-protective behavior, but…

This leaves Submissives and Avoiders to seek help to address their own emotional problems that often developed as a result of the Dominator’s behavior. If the Dominator is “always right and never wrong” this sows chaos in the lives of those around them.

While Dominators are reluctant to accept blame, Submissives tend to be very self-blaming. These people-pleasers have learned to default to thoughts of self-criticism. Even if they have been treated terribly by a Dominator, perhaps abused physically or emotionally, Submissives may dismiss feelings of resentment or anger because they “shouldn’t feel that way.” The disconnect between the obvious reality of the Dominator’s inappropriate behavior and dismissal of the Submissive’s true emotions leads to confusion and a loss of authenticity or sense of self. Anyone would be anxious or depressed in that situation!

If you know someone who lacks accountability, does not like to be proven wrong, can’t apologize and hates criticism, you probably know a Dominator.

When I gently point out some behavior patterns in their lives, patients often come to the obvious conclusion themselves, saying: “Sounds like my wife/dad/sister is the one who should be in therapy.” Yep!

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