Values and perceptions have undergone a sea change over the last couple of decades. There was a time when anyone who consulted a psychotherapist invited the label of “loony”, and was stigmatized. Now, however, seeking mental-health counselling is far more socially acceptable, and in fact is considered a healthy thing to do.
Also, therapy used to be earlier viewed as being only for the very rich. But today, although private counselling can still be an expensive endeavour, there are many other affordable options, including therapy centres at various public hospitals, schools, colleges, churches, charitable organisations. In addition, there are mental health helplines and free online counselling services available in India.
The reasons why people may seek therapy are many and varied. Most people do so when a part of their lives is not working, and they feel unable to either work out a solution themselves or to get the help they need from relatives or friends. The common denominator among these people is their psychic pain. This pain may take a number of forms. They include:
Feeling out of control. This, again, can manifest in several ways. Uncontrollable anger and violence is a message that the mind is sending to say that it needs help finding an outlet for pent-up feelings. Feeling uncomfortably crazy – whatever that might mean to you – is a feeling you can take to a therapist.
Interpersonal problems. These include communication, intimacy, marriage and other relationship issues. When the problem directly involves another person (e.g., a spouse or a parent), it is recommended that (s) he come in for therapy with you.
Wanting help with traumatic life transitions. These include changes such as divorce, being fired, or major illness.
Feeling unfulfilled. Examples include career dissatisfaction, seeking a marriage partner and feeling you’re running out of time, wanting children and not having them, unexpressed creativity. It can also take the form of simply wanting to be better at whatever it is you do.
Psychological discomfort. The mind is a storehouse of feelings. We often need training to be comfortable with feelings such as anxiety, depression, chronic anger and fear. Unfinished business, which is the burden of unexpressed feelings, can create emotional problems.
Psychological, physical and sexual abuse is extremely serious unfinished business. When you have unfinished business, you carry it around, along with its load of toxic emotions, not realizing it is weighing so heavily on you.
Addictive behaviour. This is a special form of out-of-control behaviour. People get addicted not only to alcohol, smoking, drugs or gambling, but also to eating food, spending money, watching television or surfing the Internet.
Physical pain from a psychological cause. We are all familiar with psychosomatic illness – the fact that a whole range of symptoms including headaches, fatigue, dizziness, insomnia, shortness of breath, lower back pain, abdominal pain, constipation, weight loss and impotence have a psychological root or are exacerbated by psychological factors.
Social adjustment issues. Many of us experience problems at work, school, college and in social settings. Psychotherapy can help us cope with our roles in organizations and with competition, alienation and peer pressure.
External pointers to a need for help. Pay attention when family members or friends or co-workers tell you that you need help – you probably do. However, there’s a caveat to this: feedback of this kind can also have a sub-text which is expressing a much more complicated message such as, “I am having a hard time dealing with you. I need help with this problem, so you should go get help.”
Spiritual discomfort. Daily life in our modern world can be spiritually disconcerting. Violent crime, ethnic hatreds, political tensions, the nuclear threat, and a growing sense of powerlessness of the individual cloud the human spirit. Often, when we are being affected by these developments, we do not realize that this is happening to us. It’s an insidious process, but it does generate a reaction in us: we close up, we retreat into ourselves, we act like automatons, we lose touch with ourselves. These are coping mechanisms, but they impact us grievously at the psychic level.
Seeking personal growth. Today, a growing number of people are seeking therapy even when things are okay with them and they have no particular psychological problems. They know there is always room for personal growth. Psychotherapists can help them find and steer themselves in a world where it is easy to get lost.
Also, many clients who seek therapy for an initial problem (say, depression) find that they like the new and improved version of themselves so much that they stay on in therapy just so they can keep improving – self-growth is a never-ending process.
What to expect, what to seek
If you’ve never been to therapy before, you’re probably wondering what that first meeting with your therapist will be like. It’s virtually impossible to describe precisely what you can expect, as each client-therapist relationship is unique. However, it’s probably safe to say that your experience in therapy will hinge in great part on some critical considerations. Here are some of the most important:
» In seeking to find a good therapist, do remember that you have a right to disclosure by the therapist of his or her qualifications and certifications. A competent therapist always starts with a Master’s or a doctorate in mental health. This should be topped up by hands-on training in an intensive and extensive course in psychotherapy. It cannot simply be learned out of a textbook or in a 10-day online “counselling course”.
» At your first session, evaluate the vibes you’re getting from the therapist. Trust your instincts about whether this therapist feels like the right one for you. It is perfectly in order to ask the therapist what expertise (s)he has in dealing with your kind of problem, and also the general type of approach (s)he would follow in this kind of situation. You will find that a well-trained and experienced therapist will focus on working with you to overcome your problem, not on judging you for your thoughts, feelings or actions. If, for instance, you go to a therapist for a problem of depression, and you’re hearing, “This is emotional weakness... you’ve got to be pull up your socks and be strong”, you should drop that therapist like a hot potato and find another.
» Because therapy is an ongoing process, and some problems and situations can call for long-term therapy, it is important to determine whether the therapist’s fees are affordable for you on an extended basis. However, most therapists will offer a concessional rate if you ask. Do not hesitate to ask.
» The therapist should inform you about the confidentiality of the process. Information you provide during therapy is confidential subject to various exceptions under the law.
» The more open you are able to be with your therapist, that is, the more you put on the table, the more you will get out of your sessions. The process of therapy requires you to share very personal information with your therapist, information that you may find embarrassing or even shameful to reveal. But it is only by levelling with your therapist that you can get the full benefit of her or his more objective perspective and expertise.
» Different therapists have different theoretical orientations and different personal styles. But, interestingly, studies suggest that it is not the orientation, style, or even years of experience that a therapist has, but rather the attitude of the client that correlates most closely with successful therapy. Clients who are committed to achieving results and are pro-active in the process are far more likely to benefit from therapy than clients who take a “prove that this will benefit me” stance. While you may have legitimate reservations about the likely benefits of therapy, be sure and discuss those reservations with your therapist early on, and at any later point in your therapy if such feelings should re-surface.
And, of course, the bottom-line is that if you do not feel comfortable about the process, or you do not feel you are deriving much benefit from it, it’s your call to take in seeking out another therapist.
(The author is a former editor of 'Health & Nutrition' magazine, and now works as a counseling therapist)