Welcome to our insightful blog, where we delve deep into the world of therapy. Here, we’ll guide you through what therapy truly entails, highlight the signs that indicate it’s time to seek help, and introduce you to the various types of psychological professionals.
You’ll learn how therapy can effectively address a myriad of problems and discover the opportune moment to begin your journey. Join us as we uncover the transformative power of therapy in promoting healing and enhancing overall well-being.
What is therapy?
Therapy, also called psychotherapy or counseling, is an activity by which you meet with a therapist to work on problems in your life. These problems can be wide-ranging from relationships, behaviors, life decisions, traumatic experiences, grief as well as bodily symptoms such as panic.
Therapy may also be used by people seeking self-improvement and growth unaccompanied by any specific problem because they just want to be the best version of themselves, whether seeking life’s purpose or understanding themselves better.
Ultimately, beginning therapy can be a big step toward being the healthiest version of yourself and living the best life possible. Therapy primarily focuses on talking to explore thoughts and feelings in a relationship with a therapist who is skilled, through training and experience, in helping people resolve these types of problems.
Therapy occurs within a relational space, where you, your problems, and any content that comes up is accepted with empathy. Therapy does not offer medication or diagnose mental health issues, although those may be sought alongside therapy through a psychiatrist or a psychologist.
The therapist may use various tools or techniques based on their training and skills to help you during the process. There are several types (called modalities) of therapies in which therapists have trained.
Popular therapies include:
- Cognitive Behavioral Therapy (CBT)
- Person-Centered
- Psychodynamic
- Integrative therapy
Although these modalities differ in theoretical approach or what they believe helps clients change, they all universally agree that the relationship between the client and therapist is the foundation for good therapy regardless of the modality they practice.
Therapy may be provided individually, between you and a therapist, or as a couple, group, or family, called individual, couples, group, and family therapy.
Is therapy the same worldwide?
In some countries, counseling can refer to support, coaching, listening, and advice-giving rather than therapy. You should talk to the provider if you are unsure whether you’re receiving therapy. A suggestion could be to ask whether they are using a particular modality as the basis for counseling. Samaritans UK is one example of a listening service rather than a counseling one.
What therapy is not
If you’re deciding whether therapy is going to be a good choice for you, you can also look at what therapy is not.
Therapy is not about judging you
Therapy is not about telling you you’re deficient in some way, forcing you to do or talk about things you don’t want to, or telling you that you need to do better in therapy.
Therapy is an open invitation for you to be yourself as you are, not as you may believe the therapist expects you to be. Therapy is about providing an accepting, empathic, and safe environment for you to work on what you want.
If you feel nervous about sharing something that you are embarrassed about, those feelings are accepted too, and it is pretty standard; you can go at your own pace when and if you’re ready.
Similarly, suppose you feel you’re not “performing well” in therapy. In that case, therapists generally welcome that and are accepting of it, even with significant silences or with your anxiety in the room. They want you to feel you can be yourself.
Therapy is not just turning up
Therapy will only work if you actively do the work. If you’re reluctant to be in therapy or you have expectations that turning up will be enough, then it’s unlikely therapy will be successful. You must actively participate to stretch those mind and thought muscles. While physical exercise requires dedication, so too does therapy. Therapy is emotional training for well-being.
Therapy is not a magic pill to life’s problems
Although a single session can be enough to help you, therapy is an opportunity to explore and gain better understanding and insights. You don’t usually get fixed by just talking to someone; it’s more reasonable to say the skilled therapist creates an environment by which healing can occur.
You will have to put in the work while the therapist provides the necessary conditions for you to heal. You’ll have to be prepared to put in the required time and effort to work towards creating inner emotional improvements.
Therapy is not advice-giving
Therapists don’t give advice about decisions in life. For example, don’t expect the therapist to advise you on whether you’re better off leaving a relationship or whether to confront your parents about an issue; what they will do, through their expertise, is help you work out answers to your own questions. Only you can make these decisions; you know yourself best, and therefore, you know what you need and what works.
Having said that, therapists may give possible interpretations of what and why some of the things you’re working on are occurring, such as the impact of your childhood on the way you think and feel now. They may also advise on other services that may be able to support you outside of the service they provide, such as addiction support groups, mental health crisis lines, or other supporting treatment options.
Therapy is not providing a friend who will listen to
Therapy is based on a relationship called the therapist and client relationship; it is its own type of relationship alongside others we have in life, such as friends, fathers, or mothers. While friends can offer support, therapy is based on solid theory and the experience of the therapist to help you overcome psychological difficulties.
It is not a friendship because to be friends, it would need to be reciprocal, but it provides a space where you don’t have to worry about a friend’s opinion and are free to set the agenda. It is its own relationship and can even be deep and caring, but it exists within boundaries to help you get the most out of therapy.
Therapy is not an emergency line
If you’re in a crisis or emergency involving mental health, therapy is not generally for emergency access to help. As part of the therapy contract, your therapist will make clear the service they provide and its boundaries. The therapist may have out-of-hours support and emergency services. If you are concerned about getting help outside therapy, you should raise this with your therapist.
Therapy is not, at core, about diagnosis
Some people may have or want a mental health diagnosis. Examples include autism, bipolar disorder, borderline personality disorder, and post-traumatic stress disorder. In therapy, the diagnosis can help the therapist understand and even inform how they provide therapy. Still, therapy sees that very much as a starting point and seeks to look behind the label to the whole person.
Therapy is more about understanding the whole of you – the inner you, your story, feelings, what has shaped you, and how that relates to any problems you share. In therapy, the therapist will recognize you as more than any diagnosis or symptom; they will see you as a whole, unique, and complex being.
This does not mean therapists are against treating mental health issues with medication or don’t believe in diagnoses; it just means they are trained to help with these issues by working within the context of your whole being. They are informed but not blinded by any diagnosis you may have.
Comparing All Psychological Professionals
In this blog, I use the term therapist as an umbrella term for anyone who practices counseling or psychotherapy. Therapists are trained to work with you over the short or long term to help bring about psychological change and enhance well-being.
They do so primarily by talking with you, though other tools, such as art or mindfulness, may be used. Therapists don’t typically diagnose you and work with common mood issues such as depression and bipolar disorder.
What Are The Different Types Of “Therapists” And What is the Difference Between Them?
Here are other types of professionals and the main differences compared to therapists.
- Coach. A coach looks to identify and make changes a person needs and wants and what is holding them back from achieving them. Coaching looks at the issue in the “here and now” and what changes are required both internally and externally to obtain the confidence needed to achieve these goals. It’s not typically associated with creating deep awareness of the past and how it impacts the present.
- Clinical Psychologist. Psychology is the scientific study of the mind in the way people behave, interact, or think, both consciously and unconsciously. Psychologists may be skilled in diagnosis, for example, a personality disorder.
- Psychiatrist. A psychiatrist is someone who has had medical training and has decided to specialize in psychiatry. The term psychiatry refers to the study of mental disorders. This includes their diagnosis, medication, management, and prevention. Psychiatrists often work on a broad range of cases alongside an area of expertise and research.
- Mediation. Mediators often work in workplaces, human resources, and independently. They work to resolve differences between people—for example, difficulties with an ex-partner or a work colleague.
What problems can therapy be used for?
Therapy can be helpful for many psychological problems. Therapy is used for complex and severely distressing issues, such as suffering from a psychosis where you hallucinate or hear voices, to life stresses, such as feeling low due to work stress. In most cases, problems will be comorbid, where a number of problems coexist.
Here is a brief description of the major categories of problems for which people come to therapy. This list is not exhaustive but indicative.
Life Stresses
Although a degree of stress is a healthy part of life, stress can build up incrementally and cause various issues and symptoms, such as difficulty sleeping or feeling tired and run down.
Specific stresses in life may include bereavement, relationship breakup, life-changing illness, work difficulties, financial difficulties, family troubles, or children not leaving home. Stress does not have to be related to negative experiences; positive events can be stressful, too, such as moving house or getting married.
Anxiety
People with anxiety respond to particular objects or situations with fear and dread, as well as with physical signs of anxiety or panic, such as a rapid heartbeat and sweating. Fears could range from health anxiety, phobias, e.g., fear of spiders, and social anxiety, to a general feeling of anxiety that may be continuously experienced.
A particular anxiety called OCD (Obsessive Compulsive Disorder) is where people have constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions that try to cancel out those obsessions. An example is a person with an unreasonable fear of germs who constantly wash their hands.
Mood Issues
With mood-related issues, you may have persistent feelings of sadness or fluctuations from extreme happiness to extreme sadness. Your moods may combine with other emotions, such as anger, emptiness, numbness, or tearfulness. The most common mood issues are depression and bipolar disorder.
Trauma
You have been through a traumatic event like a car accident, victim of crime, war, rape, serious life-changing medical procedure, or even a near-death experience. Even though the event is stressful, you don’t feel you processed it yet; you have flashbacks as if you are reliving the event, feel your nerves are fraught, or you just don’t feel yourself anymore.
Related Reading: The Different Types of Trauma & Their Effects
Relationships
Relationship issues include difficulty forming relationships, affairs, betrayal, abuse, sexual intimacy issues, communication and trust issues, separation and divorce, family issues, and parenting conflicts. Relationship issues can be worked on in therapy either individually, in couples or within families.
Psychosexual Issues
Sexual issues have a psychological basis to them, such as loss of libido, fear of sex, painful sex, premature ejaculation, erectile dysfunction, and performance anxiety.
Psychotic disorders
Psychotic disorders involve distorted awareness and thinking. Two of the most common symptoms of psychotic disorders are hallucinations— the experience of images or sounds that are not real, such as hearing voices—and delusions, which are false fixed beliefs that the ill person accepts as true despite evidence to the contrary. Schizophrenia is an example of a psychotic disorder. It is standard for these issues to be treated with medication and therapy.
Addictions and Habits
Addictions can develop from many activities, including drinking alcohol, taking drugs, eating, stealing, gambling, gaming, social media, working, having sex, and using the Internet. Often, addictions begin as a result of how these activities make people feel emotionally and physically. These feelings can be pleasurable – triggering a powerful urge to repeat the activity to recreate this ‘high.’
This can become a repetitive cycle that becomes very hard to break, affecting how you feel about yourself, your responsibilities, and your relationships. Equally, there are other habits with negative impacts, which can include self-harm, hair picking, excessive scratching, or biting nails.
Eating Disorders
Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. External signs include being seriously underweight, bingeing, and purging or bingeing by itself. Anorexia nervosa, bulimia nervosa, and binge eating disorder are the most common eating disorders that can involve underlying feelings of and cycles of stress, worry, and shame.
Self-Worth, Identity, and Attachment
Usually, it is not separated out as an issue but manifests as part of other problems when you present in therapy. For example, you may have low self-worth, which is an opinion you have about yourself and your acceptability and goodness.
You may be struggling with identity issues associated with your sexuality, spirituality, or cultural heritage and feel something is missing. Sometimes, with attachment issues, we can also struggle with fearful feelings of abandonment and rejection as a pattern in life, which can then impair our current relationships, such as the need to control the other person in case of rejection or loss.
In a psychological sense, attachment issues result from specific patterns of ingrained behaviors in relation to our caregivers. For example, a child who is not allowed to explore and feel a sense of safety may become insecure. Attachment theory believes some relationship issues carry into adult relationships, such as excessive distrust of a partner.
Personal Development & Growth
You can be on a journey exploring life, its meaning, your relationship with the world, and your beliefs. It’s not uncommon for people to explore their purpose, spirituality, life project(s), aging, life stages as well as death anxiety. People often want to be the best person they can be, whether in relationships or the community or being more self-aware of their own conflicts and issues.
Personality disorders
Sometimes, people can be diagnosed with a Personality Disorder, where people have extreme and inflexible personality traits that are distressing to the person or cause problems in work, school, or social relationships.
This can interfere with a person’s ability to cope in life. Examples include antisocial personality disorder, borderline personality disorder, obsessive-compulsive personality disorder, and paranoid personality disorder.
Psychosomatic Illnesses
You’ve heard it said that the mind and body are connected, influencing your well-being. Although medical issues can’t be cured by therapy, the relationship you have with your illness and how it makes you feel, such as your stress about the problem, can be worked on in therapy.
People come to therapy to manage medical issues such as cancer, pain, IBS, and fertility. Many medical problems can have a stress-associated element; thus, therapy can help you manage this.
How do I know when I should start therapy?
The truth is that most people entering therapy do so when there is a significant or critical issue where they cannot “just wait .” Wouldn’t it be nice if you had spotted a potential issue earlier, saved yourself a lot of time, money, and pain, and improved your quality of daily life?
For example, people may enter therapy for hearing voices, compulsive thoughts, panic anxiety, or depression. However, when things are slightly off, or it feels you trudge on regardless, these could be some signs where therapy could help you preemptively.
Here are some ways to spot whether preemptive access to therapy could be beneficial:
Generally not yourself
What’s your norm? You may find yourself feeling angrier, and your moods change more than you expect, or it may be that you feel more sadness. Or you may feel more lonely and shut down. You’re feeling more “off” than normal, and what you feel may be uncontrollable or unexpected. This may combine with feeling fatigued and difficulty sleeping or concentrating.
Engaging steadily in more unhealthy behaviors or substances
You are moving more habitually towards using outside substances or behaviors as a way of coping and feeling better. This maybe in the form of alcohol, drugs, food, sex, self-harming. You may feel you’re moving more into a cycle where it feels challenging to relinquish the need.
Self-care doesn’t work
You’re feeling rundown, and tired, and your natural rhythm of life and flow is out of synchronization. So you go for a self-care route to help; after all, you’ve done it before. You take breaks, rest, go on holiday, and get support from family and friends. However, you still feel fatigued, run-down, have difficulty concentrating and sleeping, and something does not feel right.
Stressful events
There are so many generic life events that sometimes come up, from grief, loss of job, financial worries, divorce, or even moving houses. If you feel a weight of baggage associated with life events such as guilt, shame, and fatigue coupled with no space or time to care for yourself, therapy could be a good option.
You lose interest
Have you stopped doing the activities you ordinarily enjoy? This may be social life, work, or a hobby you once enjoyed. If so, ask why. Many people find that emotional experiences, low mood, and challenging events keep them from participating in life activities.
Traumatic event
You have been through a traumatic event like a car accident, victim of crime, complex grief, war, rape, serious life-changing medical procedure, or even a near-death experience. Even though the event is stressful, you don’t feel you’ve processed it yet, or you may feel your nerves are fraught, and you just don’t feel yourself anymore.
Impartial Outside support
Sometimes, we can feel confused, don’t know what direction to take, and need to make an important decision. You may have people around to support you. However, it’s hard to think straight if you have no one to talk to or have people giving you mixed messages and after all they may have an agenda.
For example, you are trying to decide to move abroad, but your family wants you to stay, and you can’t think straight and feel guilty. Therapy can provide a safe space to explore your feelings, understand where they come from, resolve conflicts or confusion, and make decisions.
Understand yourself better
For some people, therapy is an opportunity to grow by becoming more aware of themselves. There may be things about your history, spirituality, or identity that you want to explore, or you want to understand why you made a decision or even what stops you from achieving your life goals.
Understanding why we think, act, and feel the way we do can be extremely empowering. That understanding can lead to insight, which, once out in the open, can channel how you want to direct your life now and in the future.
Related Reading: How To Develop A Better Relationship With Yourself
Faltering relationships
If you’re feeling increasingly disconnected from your partner and seem to have lost trust or are developing anger, jealousy, possessiveness, and resentment. You may also find it hard to resolve conflicts or plan for the future.
Rather than wait for things to get worse, relationship counseling could be used to restore and understand what is happening behind that feeling of distance between you. Remember, this can equally apply to family, siblings, parent to child, or even friend. You can invest time into the relationship to get your needs met and relationships back on track.
Related Reading: Why Relationships Fail
Why does therapy work?
So, you’re in the therapy room. You sit, you talk, and you’re listened to attentively with empathy and acceptance. Depending on the type of therapy, the therapist may offer their thoughts and feelings as well as employ a number of different techniques.
You would be forgiven for asking, “How can this possibly work?” and “Surely if it were that easy, anyone could do it.” Part of the confusion could be because you perceive the therapist to do actually very little; there may be less structure or no fixed roadmap to get you there.
In his book Why Therapy Works, psychologist Louis Cozolino provides a detailed explanation of how and why therapy works from a neuroscientific perspective. I have summarized these as five fundamental ways the therapy process works:
- by understanding yourself better
- by establishing a better relationship with yourself
- by experiencing and connecting with your thoughts and feelings
- by social bonding
- by moderating fear
Note that all are not mandatory for the therapeutic process to be beneficial, but they do reveal what goes on within to effect change. Underpinning that change is our innate mental capability to find imaginative ways to express thoughts and feelings and the innate ability of our brains to develop new mental paths.
