Kathleen M. Pike, PhD

My Local Hardware Store

I love my local hardware store. It is a real hardware store. The kind that has staff mulling about waiting for you to ask them something. Customers show up with chewed up extension cords they want to replace, paint samples they want to match, and creepy crawlers in Ziplock baggies they want to exterminate. It is hard to stump them. Almost always, they say, “Follow me,” and the adventure begins. We wind our way through aisles filled with solutions to other problems until reaching the place where just what is needed reveals itself.

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I have always thought it was a bit odd that I would much rather wander around in a hardware store than a women’s clothing or shoe store. But last week, when I was following Sam to the Nuts and Bolts section of the store to find two 3-inch Philips Head Screws to fasten my chair seat back to its frame (I have no idea how the original screws fell out and disappeared), I had an ah-ha moment. I was not in a hardware store, I was in a home therapy store filled with home therapists ready, willing, and able to help. I felt an immediate kinship. Here’s what I mean.

1. Timing. When I go to the Hardware Store, I have finally decided to get help for something at home. Rarely is it the moment the problem first emerged. The light bulb has been out for a week. I have been wanting to seal the bench outside all summer. But the broken chair did it. It was time to get help. Similarly, in mental health care, people rarely seek help the moment an issue arises. For those who do eventually seek care, they can trace the first sign of symptoms back to an average of eleven years. Also, most people in psychotherapy have more than one diagnosis. A Rhode Island Hospital Study of 2900 individuals in outpatient psychiatric care reported an average of 1.9 diagnoses. One of the first questions I ask when someone begins psychotherapy with me is, “why now?”. Usually there has been an accumulation of stress and a moment that exhausts a person’s coping and resilience. They are pushed to a breaking point – like when I nearly fell out of my chair last week because of the loose seat.

2. Early Intervention. There was a hole in one of the posts of the pergola in my garden. I noticed it months ago. Didn’t really give it much mind. That is, not until the other day when my daughter and her fiancé informed me that it was the portal to a nasty wasp colony (not to be confused with my sweet honeybees). I had a much bigger problem to solve because I didn’t pay attention months ago. I called on the hardware store therapists for help. They walked me through all the necessary steps to remediate the situation and also guided me on what I needed to do to seal the hole to prevent a future infestation. It’s the same in psychotherapy. Early intervention is associated with a significant positive impact on a person’s prognosis compared to when we wait a long time to get help. When we attend to the issues as they arise, they tend to be more approachable and less entrenched. And although therapists – whether for psychotherapy or home therapy – are not daunted by problems that are more enduring, in both domains, good therapists help clients set up measures to prevent a repetition or relapse.

3. Patience and Perseverance. It is easy to replace a 3-way soft-white light bulb that burns out (or at least it was easy until the supply chain issues of late). Most individuals with anxiety and depression will respond to well-established psychotherapy interventions. But for some problems at home and in therapy the first line solutions do not work, or the problems are complex and difficult to diagnose and treat. When I went to the hardware store for guidance on how to finish a table from a raw piece of wood last summer, multiple trips and several pivots were required before the job was done. It is the same in psychotherapy, we start with evidence-based practices, but if individuals are still symptomatic, we need to try alternative interventions and consider consultation with other experts. Home therapy and psychotherapy require patience and persistence.

4. Satisfaction. I am filled with anticipation as I arrive at the hardware store. I am filled with optimism as the bells on the door chime in my departure. I leave the store armed with new knowledge, the necessary tools, and a care plan for the problem of the day. I can’t wait to get home and put it all into action. The joy that comes with tending my home. The effort pays dividends. Psychotherapy is a similar process. Beginning with great anticipation, evolving with personal growth, understanding and skills, and ending with enhanced life satisfaction. Research consistently demonstrates that the relationship between mental health and life satisfaction is strong and enduring.

5. Acceptance. On occasion, the therapists at the hardware store get stumped. One will check with another. Some banter and a huddle may follow before they declare defeat. “But…,” they say, “we may have some suggestions for what you can do to make it easier to live with.” An overly enthusiastic attempt at butchering a very large cut of meat many holidays ago left a divot on my kitchen counter. No, they did not have any material that would fill it, but they did have a polishing agent that would take down the roughness. Coming to terms with the reality that some things cannot be fixed, but they can be carried is a central tenet of acceptance in psychotherapy. A small divot in the kitchen counter is light years easier to accept than the injuries and losses that we bring to psychotherapy to heal, but the same principle applies. By cultivating a practice of acceptance in psychotherapy, we have the possibility of finding a place where the divot is not so prominent and the pain not so sharp. A place of contentment.

In the hardware store, in psychotherapy, and in life, with patience, persistence, and acceptance – whether in caring for our homes or our mental health – life is a journey that winds us through many aisles till we find what we are looking for. En route to addressing the issues we are focused on, we also pick up skills, insights, learning, and other lifesaving wisdom along the way. Just last week, on my way to the garden section of my local hardware store, I passed a wall of crazy glue. Don’t we all need some crazy glue to keep it together sometimes?!

Picture of Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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