"When I look back upon the many months I pondered as to how I might get here without anyone knowing, and the devious routes I considered and actually took to accomplish this, only to realize that some of the symptoms from which I suffer are respectable enough to be acknowledged anywhere and valid enough to explain my coming here, it all seems so utterly ridiculous. I looked furtively out of the corner of my eye at the people I met here, expecting them to betray their shame or their queerness, only to discover that I often could not distinguish the patients from the physicians, or from other visitors. I suppose it is such a commonplace experience to you that you cannot realize how startling that is to a naive layman, like myself, even one who thinks he has read a little and laid aside some of the provincialism and prejudice which to some extent blind us all. I see how there is something emotional in it; if the patient feels only depressed or guilty or confused, then one looks upon his consulting the psychiatrist as a disgraceful recourse; but if some of the symptoms take form in one of the bodily organs, all the shame vanishes. There is no sense to it, but that's how it is. I have written a dozen letters to tell people where I am, the very people from whom in the past six months I have tried to conceal my need of this."[2] [2] Karl A. Menninger, _Man Against Himself_ (New York: Harcourt, Brace and Company, 1938), pp. 455-456. DON'T LET EXAGGERATED WORRIES HOLD YOU BACK When you stop for a moment to consider how widespread personal problems are--20 percent of Americans have serious emotional difficulties--isn't there something silly, ridiculous, and, frequently, self-defeating in being overly concerned about {266} keeping others from knowing that, for a time, you were depressed, anxious, unsatisfied, and frustrated to the point that you _decided_ to do something about these unhappy feelings? To be sure, discretion is sometimes prudent. An employer, your family, or some of your friends may be so provincial or bigoted as to think that counseling is close to a misdemeanor. Ignorant or uninformed people do tend to judge hastily and to condemn. But often, if you do have the endurance, many of them are also willing to change their minds when they have the opportunity to understand a little bit about what they fear. You cannot live for the approval of others. If you believe therapy may help you improve your life, don't allow yourself to be held back by exaggerated worries. It usually _is_ possible to keep confidential the fact that you have entered therapy when there are especially compelling reasons to exercise foresight and caution. _Explain_ your concerns to your therapist; he or she can then make every effort to help you. {267} 20 DOES THERAPY WORK?