Why go to therapy?

Although times are changing, there is still a lot of stigma around going to therapy, or struggling with our mental health.  This can make it more difficult for people to take that first step, even when they are struggling. 

There are many reasons why people may seek therapy.  It might be that they are experiencing quite intense feelings of sadness or helplessness (which could be symptoms of anxiety or depression), and whatever they have tried to do to make it better, it isn’t shifting.  It could be that those around them (families and / or friends) have tried to help and, although well intentioned, it isn’t helping.  It might be that coping strategies that they have are counterproductive or unhelpful, for example, consumption of alcohol or recreational drugs, or other behaviours such as over exercising or over working. 

Sometimes the motivations for seeking therapy might be external.  It could be there has been a significant life change (even ones that on the face of it don’t seem bad) such as a new job, redundancy, retirement, a change in relationship status, moving home, or a change in their or a loved one’s health.  It could be that they have lost someone close to them and they are grieving.  New situations, or uncertain situations can be deeply unsettling. 

Often, people may seek support because of relational issues.  It could be that they are struggling to get on with family members, friends, or co-workers.  Humans are a social species, and we can be deeply affected when we do not have satisfactory connection with others.

It could also be because they have experienced something traumatic, which has had a profound impact upon them, physically and / or emotionally. 

Sometimes they might acknowledge that they don’t feel 100% and experience negative emotions and they don’t know why, and they seek therapy to try and explore and understand this further.

It might be that they reach out from a place of curiosity, that they want to understand themselves better – what makes them tick (and equally what doesn’t).

They may even feel that a lot of the above applies to them, and they are feeling lost, and just not feeling like themselves.  They may feel emotions that make them feel uncomfortable, perhaps anger, rage, hate, guilt or any number of emotions that are difficult for them to sit with. 

When people make the decision to go to therapy, it is often because they feel the need for a change.  A change in how they are feeling, or a change in the way they behave, or how they think about a situation.  Therapy is a way for them to explore all of this. 

Before going into therapy for the first time, it can all seem a bit mysterious.  We may know somebody who has been to therapy and recommended it to us, or our frame of reference might be something that we have seen, perhaps in the movies or tv, or perhaps in something we have read.  We might embark on the journey hoping that our therapist (note, the term therapist or counsellor is often used interchangeably) may “fix” our issues or offer advice.  This isn’t how counselling works, rather the therapist will give them the opportunity to explore the situation, and gain more of an understanding of how this is affecting them, which in turn gives them insight into how to move forward.

One of the prevailing myths about therapy, is that by going to therapy, and working towards healing, we try to erase our past experiences, particularly the negative ones, or assign blame to others for situation they find themselves in.  I for one have heard the rhetoric “people go to therapy and blame their parents for everything”.  Through engaging in therapy, people are able to openly explore previous situations, guided by a therapist who is external to the client and their situation.  Reflecting in this way allows them to identify the impact of their actions on themselves and others, and also the impact that other people’s actions have had on them.  It also gives clients the opportunity to explore what it is that they are carrying from past experiences, to acknowledge them and to then explore how these play out in the present, either positively or negatively.  This doesn’t erase the past, but rather the client’s relationship to it.

Through this reflection, clients are able to identify whether a behaviour, an emotion or a way of thinking serves them in the here and now, or if this may be holding them back, emotionally, psychologically or physically.  If they recognise that a past experience, or way of thinking no longer serves them, that it isn’t necessary to keep themselves “safe”, or even just doesn’t quite “fit” when they try it on, they can acknowledge this, and make the distinction from the past and now and identify how they want to move forward and live their lives. 

It allows clients to identify a lot about their way of being, such as their negative patterns of behaviour or thinking, their struggles relating to others, their difficulties in loving others or even accepting themselves, or indeed whatever their struggles might be. 

Through this recognition, clients can make the decision to change to how they live their lives where they can (obviously, there are many things in life that are outside our control), rather than allowing these patterns to continue to rule how they live.  This can be really empowering, recognising that they are not powerless actors in their lives, but that they are the drivers.  Life isn’t simply something that happens to us.  How empowering would it be to put that thinking aside?

The therapeutic process can be really difficult.  It is sometimes painful and often we will want to stop, to put the uncomfortable feelings or insights back in a box, in a bigger box, in an even bigger box and lock it in a cupboard.  Because healing is hard.  It takes work.  It can feel like everything we know about ourselves is being slowly dismantled which can feel unwieldy and very disorientating.  But then, when we persevere, we build ourselves back up and we are stronger.  Because we know and understand ourselves better.  We know what is truly ours, and what is the influence from others.  We learn to identify what is and what isn’t acceptable to us, and we can put in place boundaries.  We start to live as our authentic and true selves. 

Often the changes that we decide to make or the shift in our way of thinking is only slight.  It isn’t necessary to have a full reset or rebuild.  We are still us.  And we are not broken, and needing help isn’t a character flaw or a sign that our mind doesn’t work hard enough.  This is often what we are told, often by well-meaning friends or family, but this way of thinking simply isn’t true. 

Therapy gives clients a safe and confidential space to talk about their situation and how this presents in their day-to-day life.  The therapist (sometimes described as a counsellor) will ask very early on (usually in the introduction call if you have one, or in the first session if not) what your goals for therapy are, so it’s a really good idea to have a bit of a think about this before you start.  These might be very specific, or they might be quite broad and vague.  This is all ok.  The therapist should tailor the sessions to you and as much as possible, allow you to lead and set the direction. 

Therapists are very aware of the balance of power within the room, and it is our intention to ensure that the balance as power is as equal as possible.  With my clients, I do not want therapy to be done to them, but to work collaboratively and for them to be active and leading participants in the process.  (A small cavate, the way therapists work will vary depending upon their training, and the models that they use.  There are a few, and it may be helpful to be aware of these when choosing a therapist.  Further details on these can be found on the BACP website here).  As a therapist, I draw on a number of models, specifically Cognitive Therapy, Existential Therapy, Integrative Counselling, Person Centered Therapy, Psychodynamic Therapy and I am also Cognitive Behavioural Therapy informed.  Please don’t be shy in asking if you are unsure how a particular therapist works, and ask them to explain if you are not clear.  It is important that the modality feels right for you, and also that you can build a good therapeutic relationship with them. 

A therapist should never force a client to talk about something that they don’t want to, but they may shine a light on something if they feel like it might be important (for example, they might say something like “you have mentioned x and I feel like this might be important to talk about.  How would you feel about that?” or “I notice that when we approach y, you change the subject. Why do you think that might be?”).  It is entirely up to the client how they respond, and how the therapy progresses. 

To wrap up, therapy really is an opportunity to explore, identify and change patterns that don’t work for us.  As a great philosopher of our time, Dolly Parton states “If you don’t like the road that you’re walking, start paving another one” (unsure when it originated, but can confirm that she tweeted it on the 20th June 2014!).