Therapy—What Are You Signing Up For?

These days it's less of a taboo to go for therapy compared to the 1990s. Lately mental health has been in the spotlight getting all the right attention and cheering people on to get the help they need. But not everyone will reach out for the help. What is stopping them?

Let's look at some of the basic things I have heard in the past.

My problems aren't as bad as everyone else's

Perhaps in the grand scheme of things, there will always be someone who is worse off than you. There will also always be someone who is better off than you. Perhaps the thought that your problems are not bad enough for therapy if you have considered it, is the one thing that is keeping you stuck. Perhaps you have learned in the past that everyone else's needs are more important than yours and that they only way for you to survive at some point in your life was to accept this.

But accepting this doesn't make it true. Ever heard of fight, flight, or freeze? This type of thinking means that you freeze. You start acting as if it's true. Fighting back didn't help you in the past when you were a child and didn't have the power to fight the idea, so why should it now?

I have had people in my therapy room who have been victims of abuse and have suffered decades of bullying who have unconsciously been adding fuel to this fire by having these patterns of thinking.

A trained therapist will help you to recognise thought patterns like this that might be destroying you, and help you to find the power to break this pattern for yourself. A trained therapist is never the one who does the work, it's you. It's you who reach your goals.

How do I know I can trust my therapist?

Therapists take confidentiality very seriously. If you don't feel that you can trust your therapist, then they are not the right match for you. The therapy relationship is in most cases of utmost importance because you need a space where you know you can talk about your feelings knowing that what you share is confidential. Confidentiality is different across borders, but therapists in England will only break confidentiality should they feel you are threatening terrorism, in a position to seriously harm or kill another person, or if a child is in danger. They are not even required to report you if they know that you have broken the law in other ways. Your therapist should clearly state what might cause them to break confidentiality during your first session.

Most therapists (even those who have been in practice for many years) have regular supervision. This is to ensure client safety and that the therapist is working ethically. In some cases, the supervisor does not know the name of the client but only the initials. Clients should be made aware if their information will be shared in supervision.

Who decides on the goals?

It should always be the client, who decides what they want from the sessions and what their goals will be. The therapist should explain to the client how they work and how many sessions can be expected. In most cases it is really not possible to state how many sessions but the client should be given some indication on possible duration such as six months, a year, or possibly longer. It is always up to the client how quickly goals are achieved, although the therapist doesn't play a passive role.

Therapy isn't a sanctuary.

Although it could be a sanctuary in some way, it is not designed to let you sit back and continue life suffering. As therapists we are trained to challenge you when the time is right and when we feel you are able to be challenged. Trained therapists will never push you beyond what they believe you can tolerate, even though it might cause slight discomfort in the moment if a client is not used to being challenged.

The therapist isn't out to get you and when they challenge you, it will be in a non-judgemental way that will help the client discover things that other people may see in them but cannot find the words to tell them either because they don't have enough self-awareness themselves or because of fear of how a person might react.

Therapy is too expensive—I couldn't afford it

There are many places out there that offer affordable therapy. MIND and Time2Talk are just two of them. Most therapists work on a sliding scale that offer therapy at a rate that is affordable to the client. It is true that in private practice, clients might be turned away, but there should always be the option of being referred to a service that might offer the help the client needs.

The reason that some therapists might not be able to accept clients paying below a certain amount is that they themselves pay room hire fees and there is also a cost to them to get to room.

Places like MIND have offices all over the country and can often provide therapy for as little as £10 a session. There are also charities that could provide free therapy, although this is usually only for people who are homeless or struggle with zero income, people who are disabled, or people in rehabilitation. Most counselling colleges will be able to offer low cost therapy by student counsellors.

If you feel that you need therapy and you are unsure of anything, call a service and ask for help. If our bodies get sick, we go to a doctor. Why should it be such a stigma to accept that sometimes our minds can get sick? If you feel at all suicidal, call the Samaritans. Their UK number is 08457 90 90 90.