Q&A: Monica Hill on Couple's Counseling, Therapy & Mental Health

A Q&A about couple's counseling, therapy & mental health for current and former NFL players with Monica Hill, LPC.

How can mental health affect a player’s relationship with his family, spouse or significant other?

It can affect them in almost every way imaginable. From both an intimacy perspective and a communication perspective, if your mental health is not as it should be then you don’t want to talk, or you may or may not want to be intimate with your partner.

With their children, it can make them seem very distant and not relatable. Even if your spouse or children are not impacted, it can cause you to be depressed as an individual. It’s almost like your mental health should be looked at as your physical health.

Players may be used to dealing with physical ailments, so do you find that it's harder for them to think about the mental aspect of injuries?

That’s exactly right. They are taught to deal with it. They’re taught to not talk about physical illness, so when the mental illness starts to happen they apply that same methodology. They do not talk about it, and they hold it in and try to self-manage. Just like their physical health, they get to a point where they say, “I can’t manage this anymore, I have to get help.”

In the game, self-management is something that they are taught - It's something that is uncommon to most people but the norm for athletes. Men, in general, are taught by nature that they can do it, so there are a lot of barriers.

What are some of the most common challenges you have seen in your experience working with players in couple’s counseling?

It’s very surprising to me. When I did the marriage counseling at The Trust’s Couple’s Conference, I was absolutely surprised at reactions coming from men. One of the biggest challenges we have is that they do not understand how helpful therapy can be.

Once I went in there and they got to experience it, I think it opened their whole world up to, “Oh my gosh, this is not so bad” and things like “She’s a therapist, and she understands men as well as she does women.”

So, I was an advocate for the men, not someone against them in their challenges. When I did that session for The Trust, they were 45 minutes to an hour each, and the time I spent post session was absolutely phenomenal. I spent probably 4X as much time with them afterwards in small groups or one-on-one with them, and it was a lot of the men were saying, “Hey, I think I can use that.” So that was the most surprising to me. Once they are exposed to the possibilities of what this can do, they welcome it.

What are some red flags, warning signs or early indicators that players or families can watch for as they relate to mental health?

Mood change and changes in intimacy. When you are getting into some mental health issues and crises, there are two extremes: they either retract from intimacy or they become very aggressive in their sexuality. Men are not as good at asking for help, but a wife or significant other has a discerning spirit. Females have a discerning spirit for their children and their spouses, and they can typically sense that something is wrong.

Men are typically not going to say they need help. If you discern that they need help one of the keys for the wives is to figure out how to get help to him that he doesn’t even think he needs. Because he didn’t ask for it, but you can discern that he needs it. And it's important to keep his ego intact, and to make sure it’s something he understands. I think The Trust does a wonderful job with the men they have in positions telling the players that this is what they need.

For a player facing mental health challenges, what can a significant other do?

This is a human skill that I think we don’t know very well, but it's about listening. Sometimes you have to listen through the silence. If the wife starts a conversation and says, “Babe, what’s wrong?” You’ve got to listen through the silence, even if he doesn’t say anything for 45 seconds - Just listen.

Most people will evolve into conversation. We learn this with children, who don’t like silence. Spouses don’t like silence, so they start to talk to create conversation. And if they don’t say anything, wait until tomorrow. Say, “Babe, are you sure there’s nothing I can do?” or “Is there any way I can support you?” I ask them, “If you had three wishes, what would they be?” Some say they wish they could play again, or they wish they had the money. You don’t talk through that, because men just need you to listen. And women are notorious for talking through it. So I believe sometimes its important to just have a listening ear to hear them out. Don’t judge them or critique them, don’t interrupt, just listen.

What are the biggest benefits a player can receive from going to counseling?

I think one of the main benefits is to tell their story. Everyone thinks, “Oh you’re a football player and you’re ok, you made it, etc.” Therapists are very good discerners and listeners. We offer a place to listen and not to be judged.

You’re a three-part being, and I think there’s no place like a therapist that supports all three. You’re a spiritual, mental and a physical being. A doctor can give you the physical part of it, your faith can give you the spiritual part, but if you have the right kind of therapist, a good one knows all three parts of you and can offer that in a way that no other profession can. I had to learn the biology of males and females, and I’m not a medical doctor but I did have to learn that. But the mind is what I understand the most, and the spirit I've had to add to the repertoire to be able to totally understand a person fully. I think a therapist is really where you can go to get all three parts of you understood.

How important is it for players to consider counseling?

I am thoroughly convinced that the time is fast approaching where everyone should have a mental therapist on hand, just like they do a doctor. You don’t go to the doctor every day, just when you need it. I believe we need to understand that it’s not mental crazy, its mental health.

My goal is to help them understand that it’s about their health, not that they are crazy or weak. How do they get healthier in their thinking and emotions? Not that they are sick, but how do they get healthy or remain healthy? Those are the important questions that therapy helps to answer.

What are some common misconceptions about mental health & counseling?

That the team is going to think I’m crazy and kick me off the squad. If a player is dealing with a physical injury, they don’t want to deal with a mental one as well, so they fight back. They cannot deny their medical injuries, but they aren’t going to lose that “second part” of them, so they fight to hold on and try to deal with it. I may have to go to the doctor because my knee is killing me, but I’m not going to see someone about mental health too.

What are the first steps a player who is facing a mental health challenge can take?

The Cigna EAP is a good place to start. Also, talking to another player who has gone through it and can tell them about the experience - Player-to-player stories are a great resource. I loved being exposed to the players at the Couple’s Conference, and as much as you can, expose the players to that type of material and introduce them to panels in their cities. The more that you can expose the players to a real person instead of a concept, that’s huge.

Do you have any success stories with former players that come to mind?

I’ve treated several people locally and discussed scenarios over the phone. Probably one of the biggest success stories was at the Couple’s Conference, I had breakout sessions with several couples. A huge guy came into the session and his wife thought he was closed off, wasn’t talking, etc.

Because I listened and heard him, her mouth was literally open during the session. She didn’t know him and she didn’t know his emotional pain or struggles. She was pounding on him for life - just to do life, the kids, marriage, finances - but she didn’t open up to who he really was. So, me being there and giving up that space to open up to, he literally cried during the session, which I don’t know she had ever seen.

In that moment of him exposing who he really was, it absolutely changed their marriage. She became more compassionate, more giving, and he became more vulnerable. It changed them as people, and changed their relationship.

What advice do you have for former players and their families or significant others regarding mental health and counseling?

Don’t try to go at it alone. First try to go at it together as a couple, and if you can’t bridge the gap, absolutely get someone that you think can support you as an individual.

Mental health is so complicated, and I’ve seen people’s lives change from coming to just one session. Their perspective on life changes. You don’t really know how much your mental decision-making and thought processes guide your physical and spiritual wellbeing.

Dr. Monica Hill is a Licensed Professional Counselor (LPC) & the owner of Hill and Associates, Marriage and Family Counseling, LLC. Dr. Hill is also an author and certified professional speaker.

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