Therapy: Everything you need to know
Making the decision to have therapy is a serious matter and very important. Some people take years to take this step and others rely on it regularly. The truth is that when you find a therapist that works for you it can be a lifesaving experience and one that is sacred.
In this blog Dr Chloe will answer all your questions and help you figure out whether therapy is for you.
1. What is therapy?
It is, in most cases, a once a week meeting with a qualified professional to help you overcome Mental Health problems, heal traumatic experiences, and help you cope resiliently with life's distressing and difficult challenges. With the right therapy, you can learn to stand strong in yourself with self care, good long term coping mechanisms and self-compassion.
2. Are therapy, psychotherapy and counselling the same thing?
Pretty much. Each practitioner will have their particular orientation (eg Humanistic, Person Centred, Gestalt, Existenial, Psychodynamic, CBT) and all that means is that they theoretically frame their understanding of your presenting issues within these paradigms. In the end however, therapy is about discussion, reflection, relationship and the process of learning to accept and love yourself, your significant others and imbue your life with authentic meaning and purpose.
3. How long does a session last?
Normally 50mins and everything discussed is confidential. If your therapists is in the NHS they will take notes but you are the owner of these notes and can see them anytime you like. All notes under the data protection act are yours to see.
4. Do I have to talk about the past?
No. Often events from the past come up but this is not compulsory. A lot of therapy is focused on the here and now and looks at what you can do, how you understand your presenting problems today and what choices and resources you have at your disposal currently to help you cope and move forward with life. Some therapists will focus on family dynamics (Eg Systemic Therapy) and others will insist on Attachments and Parenting (Psychodynamic) but really you choose what you focus in during your sessions.
Before starting each session it is important to think about what would be most useful for you?
5. If I do therapy will I be seen as weak?
No. Making that decision to invest in your Mental Health and opening up and trusting a stranger takes courage. It is not easy doing therapy. There is nowhere to hide as you encounter yourself fully and you are encouraged to reflect on how you contribute to your lived experience, how you perceive the choices you have, what your attitudes are, what your blind spots are. Healing and resilience come with agency, authentic engagement and openness. This is tough and courageous.
After all 1 in 4 adults are diagnosed with a Mental Health condition in the UK and psychological services within the NHS have 6 month long waiting lists for counselling. So more people than you realise are seeking professional help.
6. Will just talking actually work?
No .It won't. Talking without engaging, reflecting, feeling and authentically opening up with yourself and your therapist will not work. Psychological mindedness is needed. Therapy works when you talk, feel, process what you are living through, practice acceptance, reflect on your limits and choices, and navigate authenticity and purpose.
7. Is therapy going to make me feel happy?
No. You will make you feel happy. Therapy will assist you in learning to love you. Accept you. Know you. This is the road to fulfillment and happiness. But very often, the process and experience of therapy will make you feel worse, as you encounter your wounds and dare to connect with the inner you, validating your pain and giving it space. This hurts. But the only way to reduce emotional pain is to go through it.
Mental health problems like Depression, Anxiety, Stress, Addiction start because your internal turmoil needs to find an outlet, take residence in your body and manifests in Mental Illness.
8. How long do I need therapy for?
This is up to you. However long you think you would find it useful. Some therapists offer no more than 8 sessions and others will prefer to work with you long term over a number months.
9. Will I have to do homework?
Sometimes. Most often not. CBT therapy is more prescriptive like that.
10. Is all therapy the same?
No it is not. As noted above there are different theoretical frameworks and it is important to distinguish between the different professionals in Mental Health.
They fall into the following categories and each offer their particular expertise:
Psychiatrist - A trained medical doctor, specialized in Mental Health and often works in the NHS diagnosing and medicating serious psychiatric conditions. They are the person you speak to about your medication, being sectioned, they often run psychiatric teams and wards. They will be regulated by the Medical Association and work both in NHS and private settings. It is unlikely a psychiatrist will offer you one to one therapy, though some do choose to extend their training and offer this.
Psychologist - A Clinical or a Counselling Psychologist offers one to one sessions or groups to treat anyone diagnosed and coping with a Mental Health condition. Some specialize in certain areas (eg Trauma, Psychotic and Schizophrenic Disorders or Children's Mental Health) and all will have studied psychology throughout (from Undergrad, to Masters through to Doctoral level). Clinical and Counselling Psychologists do exactly the same job, and work in the same teams, same settings either in NHS psychological services or privately. They will be regulated by the British Psychological Society and often supervise other training Psychologists. Psychologists offer much more than a listening service. They look at underlying causes and provide long term or short term recovery pathways to enable psychological growth, resilience and mental health. They work withing specialist Psychological Paradigms from Psychodynamic, Humanistic, to CBT and most of them will have been trained in all and will offer a mix, depending on the problem. Psychologists are able to determine the biological factors, as well as Mental, Physical, Emotional, Social and Systemic factors that contribute to the development of a Mental Health Condition. They are not able to prescribe medication but do understand pharmacology, will have experience of working in clinical settings and will help patients/clients reduce their medication. Most often they see their patients/clients once a week.
Counsellor or Psychotherapist - Anybody, from any walk of life that has received some training in Counselling and/or Psychotherapy often to Masters level but this is not compulsory. There are many different levels of training and if you decide to see a Counsellor or a Psychotherapist, make sure they are accredited to Diploma level by the BACP (British Association of Counselling and Psychotherapy) or by the UKCP (United Kingdom Counselling Psychotherapy). These professionals are normally in private practice and a look on The Counselling Directory will allow you to do a post code search to see who is local to you. Fees range from £30 - £50 per session and normally clients are seen once a week.
Psychoanalyst - This is a professional who has trained in psychoanalysis (could be Freudian, Jungian, Kleinian) and in many cases will require the patient to attend sessions 3- 5 times a week and work within a specific framework for understanding human Psychology. This is a very particular type of therapy which due to its intensity is rather costly and tends to be long term.
11. Does it matter what approach I go for? Should I do CBT?
It doesn't really matter what approach your therapist takes. There is absolutely no evidence thone approach is better and more efficient that any other.
Research has shown that the most important variables in determining the success of therapy and counselling are these:
-There is a meaningful relationship of trust between client and therapist where real dialogue and exploration of options is encouraged.
-There is a human connection which allows for deep exploration of blind spots and challenges.
-The therapist provides an unconditional accepting space so the client can really meet and accept themselves.
-There is no fixing but rather discovering and revealing of lived experience.
-The therapist is fair, honest, a true good listener, not judgemental, open, curious and respectful; without an agenda, without having all the answers and telling you how to live your life.
-The therapist is clear about their working frame, their boundaries and respectful of professional arrangements.
12. How do I choose a therapist?
Not all therapists can work with everyone. It is so much about connecting and feeling like together you can create a safe space to really discuss you. So you need to shop around. Most often people call around to get a feel and then it is absolutely fine to have an initial meeting to see whether you feel it might work or not. Sometimes you need to give it a couple of sessions.
The most important thing is that if you don't feel held, helped, understood and accepted by your therapist then you are with the wrong therapist.
If you are seeing a practitioner in the NHS that is tougher as you have less choice and you will be bumped down the list.
13. Should I tell my GP?
Up to you. If you want NHS counselling, then you have to tell your GP who will arrange this for you. If you do this privately, then it is a private matter and there is no need to tell your GP.
14. Will I get sectioned if I reveal my Mental Health Struggles?
If you are a risk to yourself, or others then emergency services will be called and a plan of care will be put in place normally by your GP or your psychiatrist if you are under their care to help you and protect you.
If you are seeing a practitioner privately and expressing your pain, without a plan to harm yourself or others then it is very unlikely that you would. However this is a complex matter and one you need to discuss with your therapist.
15. What sort of issues do people go to counselling for?
All sorts from breakups, breakdowns, divorces, traumas, depression, panic attacks, addictions, eating difficulties, grief, loss, sudden changes in physical health, illness, parenting difficulties, stress, work difficulties, bulllying, anxiety, sexual issues, relationship issues, loneliness....anything is ok in the pursuit of your wellbeing.
If you have any other questions, you are welcome to email us or leave a comment on this blog.
Thank you for reading. Please sign up at www.dr-chloe.com if you haven't already so you never miss a post. Dr Chloe Paidoussis Mitchell (Psychologist and Mental Health at Work Consultant blogs about Mental Health issues, Wellbeing, Self Care, Resilience and Mental Health at Work on a weekly basis.
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