Many clients would not dream of saying ‘I can’t cope’ until their emotional resources are completely spent. They struggle on, trying to manage without calling for help. For some it is a matter of pride, others have been punished for showing what is perceived as ‘weakness’, some have asked for help in the past to no avail and have simply given up. Admitting they can’t cope can have unpleasant consequences – will it mean a hospital admission? Medication? Losing face? Or even losing employment. There are lots of reasons why people hold out as long as they can without revealing their difficulty.

In other situations saying or thinking “I can’t cope” can become a pervasive problem. One of my clients said; “My sense of self-worth and confidence is so low, that even the smallest thing is a challenge. I can’t find change for the parking meter, and I stand in the street just thinking, ‘I can’t cope’. I don’t even have to say it to anyone, it’s like I’m saying it to myself throughout the day.” To this person, “I can’t cope” has become an acknowledgement to themselves of their own sense of inadequacy.

When a client says “I can’t cope” the listener knows immediately that
something is wrong, and that it’s no minor thing.  So it is a very effective way of communicating distress very quickly. The problem for mental health professionals is the sheer amount of exposure they have had to this particular phrase. It is probably heard on a daily basis in community mental health teams, and beyond a cry of pain doesn’t immediately indicate what help is needed.

So unfortunately instead of galvanising the listener into offering help, the phrase ‘I can’t cope’ can result in both parties feeling hopeless. A counsellor told me, “When my client says, ‘I can’t cope’ I feel like I have failed.”

Mental health professionals can ask for some pointers from the client on what ‘I can’t cope’ indicates, as for each person it will be different. I keep a list of some possibilities that we can look at together, and whilst not an exhaustive list it is a good start;

• I have pain or discomfort in my body that doesn’t go away and I need relief from it
• I am in an intolerable situation to do with; a relationship, employment, finance, accommodation, physical or mental health (say which one)
• I have an image in my mind that I can’t get rid of that is causing me distress
• I am unsure how to proceed to solve a practical problem, I need help to generate solutions
• Something is coming up and although I know what to do I need help to face it
• An event has occurred that I can’t get out of my mind
• I feel overwhelmed by an emotion – either sadness, shame, anger, guilt, disgust or fear (say which one)
• When I look into the future I can’t see anything that looks appealing
• I am really exhausted, I need help to generate some energy
• I have constant negative or self-critical thoughts and need to be able to think of some other things
• I want to be relieved from a sense of responsibility, it feels like it is all on my shoulders
• I don’t want to have to think about my problems any more, I need a break from them

Even if the client says, “all of these apply to me”, getting them to pick their top one can get the therapy moving again. Sometimes I get the client to generate their own list of possible meanings, and to turn to it whenever the phrase pops into their mind. If they choose a statement from this list to say to their family, friends or mental health professional they are more likely to get the help they need.