Ask An Adult: Do I Need Therapy?
The Debrief: How do you know if you need therapy? Is therapy still an option if you're broke? What kinds of therapy are available? Can you get therapy on the NHS?
Illustration by Assa Ariyoshi
Many of us at one time or another have felt emotionally overwhelmed – like we’re being held underwater or looking at the world from behind thick frosted glass – and not sure why we feel sad or angry all the time. But does that necessarily mean therapy is called for?
Ignore the stigma and think about you
‘If we have a look at the definition of therapy, it is usually something along the lines of “treatment of a psychological disorder”’, says Scott. ‘That doesn't sound like a definition that most people would attach themselves to. It implies that there is something psychologically "wrong" with the person and that really isn't the case.’
This can often be a barrier to people getting help, so if you’re feeling low or unable to cope, try to get rid of the idea of a mental illness when weighing things up. ‘When people are struggling to cope with a situation or have fallen into unhelpful ways of thinking about themselves, life in general, their ability to cope etc, that is not a psychological disorder, in my book. That is an inability to deal with a situation with clarity and in an empowered and helpful manner,’ says Shirley. ‘Who doesn't want to be living in their natural clarity of mind and wellbeing?’
Dr Aghdami adds that celebrities can help you come forward for help too. ‘I believe more openness, more knowledge, and more understanding about mental health issues are essential. I have had patients come to me with a magazine in their hands, saying, “I read this article about this problem, the very same problem I have. Now I know it's not only me, and that things can change, so here I am to do something about it”. People in the public eye who have experienced their own psychological difficulties and have taken part in interviews and TV programmes are helping enormously to reduce the stigma too.’ So if you identify with someone else’s struggle, don’t be afraid to share your own.
You don't have to be at your lowest ebb to speak help
The majority of people start seeing a therapist when they’re at their worst, says Scott. ‘A large percentage of people who come to see me, are at a point of desperation,’ she says. ‘There is an impending situation which they need to deal with and don't believe they will be able to cope or they are already in a situation and not coping very well.’
It’s tempting to hold off sending that inquiry email or picking up the phone to ask about appointments if you think your problems are too small, but your worries could deserve attention. The small problems we experience can matter a lot. Scott says: ‘If someone understands where their experience is coming from and how to manage and understand their thinking, it impacts everything. Our thinking is the most powerful tool we have to create our experience, but sadly we aren't taught how to harness it correctly, we fall into whatever way we think and keep thinking in that way, even though it may not be very helpful. Sometimes we can limit ourselves unintentionally because we didn't know there were more helpful ways of thinking and challenging limiting beliefs we may have fallen into.’
However, therapy isn’t always the only answer.‘If a person feels they have a minor problem and they need support to overcome it in order to live life more fully, and to feel more comfortable in their own skin, then they may find a range of resources can help - friendships, family, self-help materials, social groups, sports clubs - and/or therapy,’ says Dr Aghdami.
If something massive is holding you back, then it may be time to consult a professional. ‘If a bigger problem is getting in the way of functioning well and enjoying life, then many of those options won't really help and therapy to address their psychological problems will be more suitable,’ Dr Aghdami advises.
How can you have therapy if you don't have any money?
The cost of therapy can be prohibitive, but many counsellors will give heavily reduced rates for people on low incomes, and mental health charity Mind offers free talking treatments. Mental health is available on the NHS, but access can be slow.
Scott, who normally only sees clients for six or so sessions, says that there are other approaches you can take. ‘If funds are limited, there are very powerful and helpful approaches that don't have to run over years or even months,’ she says. ‘I would also suggest that if finances are an issue, they should discuss this with the therapist. I am sure there are many therapists who would be flexible and do what they can to assist someone in terms of their rates, especially if the person is committed to change and undergoing the process.’
Remember you hold the power
‘In my view, therapy is all about change, and whichever approach of therapy is offered, it will only help change happen if it results in the patient doing things differently in their day-to-day life,’ says Dr Aghdami. ‘So therapy should, in my view, always support and encourage changes in behaviour, when the patient is ready to translate insights into changed actions, and this is a central aspect to the therapy I provide.’
Friendship can be therapeutic
Carrie Bradshaw once joked to her lady gang in Sex and the City that she didn’t need therapy, just new friends. Your mates can be vital during tough times, but they might not be able to give you everything you need. ‘Friendship is very important! A good chat with a trusted friend can sometimes help enormously to feel better, loved, valued and supported,’ says Dr Aghdami. ‘But unless a friend is particularly aware and empathetic, their advice may well be based on what they would do in your situation. Therapists are trained to help a person reach their own conclusions on what is best for them, uncluttered by what the therapist would do in a similar situation. Psychologists are also trained to spot when a person's psychological processes such as their thinking patterns are unhelpful to them. They can then help a person develop effective skills to retrain their thinking to be less gloomy and daunting, and more realistically optimistic instead.’
Scott argues that it all hinges on what you want from therapy. ‘If it’s just to unload what's going on in their heads, then friends are a great source of comfort in those situations. If someone wants to change how they are feeling about or processing a situation, then finding the right therapist may be a better option. An example would be treating one of the most intense phobias around: emetophobia [fear of vomiting]. Because very few people understand how to deal with someone who has this phobia they may actually help the person keep the phobia in place, by helping them to avoid situations, thereby intensifying the phobia and validating it.’
Seeing a trained therapist who is trained to deal with this phobia, will help. ‘I wouldn't be able to teach a friend of mine to play the piano, for example, but I could teach them how to, overcome a phobia or anxiety. It all depends on the skill set of the friend!’
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