The benefits of therapy start with having the chance to feel happier on average than 80% of people who feel like you do now but don’t get therapy. Then there’s the effect that feeling happier could have on your life. Physically, happier people tend to have stronger immune systems, be healthier, have less disability in old age, and live longer. Good therapy is time-limited, goal-directed, and the opposite of self-indulgent, because it asks you to face the truth about yourself and your world. As for the idea that therapy is navel-gazing, it is about your relationship with others and with the world as much as your relationship with yourself. It can also make you happier, and happier people are more empathic, altruistic and willing to share.
Nowadays, going to a therapist should be as normal as going to any other specialist professional: Problem with your body? Go to a health professional. Problem with your mind? Go to a therapist. Getting therapy makes sense: mental pain is as real as any other pain, so it’s as appropriate to get therapy for your low mood as treatment for your lower back. Getting therapy is important, since the consequences of emotional problems for health, relationships and work can be disastrous: a World Health Organisation survey found that Depression on its own was the world’s fourth most burdensome health problem in terms of its social cost. And like other problems, emotional problems are cheaper to solve the sooner you start.
The key success factor in therapy is finding a therapist you like and trust. As with any other guide, you’re looking for honesty, insight, experience, competence, and affinity: in other words, a person whom you’ll feel comfortable talking to. A therapist who seems cold, formal or unresponsive won’t form the bond you’ll need to support you if therapy gets tough. If you like the sound of a therapist, see them for two or three sessions. You’ll find out whether they can bring up touchy subjects, listen, empathise, offer guidance and channel bad feelings to good effect – things which studies say good therapists do. You’ll know therapy is off to a good start when you and the therapist get on, agree where you’re going, and make early changes to how you see your problems.
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Start therapy when you’ve tried self-help and help from friends. If these haven’t worked for you, then it’s better to start therapy sooner than later, to get over your problems before they get bigger or mess up more of your life. Contrary to dogma, therapy can help at any age but the earlier you start the more time you’ll have left to enjoy the benefits.
Therapy is a journey of the mind and the heart, so like any journey it has lows as well as highs. The therapist needs to pace the journey so that you explore the depths of your feelings and then come up from the depths to experience clear insights and new energy. You can expect to face hard truths and feel raw emotions, but know that you only have to go as deep as you choose.
In the first few sessions I’ll be listening to your story, putting together a picture of how you came to be, where you are now, and how you can get to where you want to go. To help me in that, I use questionnaires. I may also ask you to keep a journal, or to log events in your life. By the third session I’ll have what I need to complete that initial picture or “formulation”, and I’ll have started making suggestions of things you could read or do to make progress. I’ll tell you what I think we can achieve together, and how long it is likely to take. Our contract will be informal, though I’ll write down our goals and a provisional plan.
After the first few sessions, most therapy becomes the process of finding a problem, exploring it, staying with it through strong feelings, finding the best route over or around it, preparing to take that route, committing to the route, keeping going until you have got somewhere useful, and checking where you got to. Your contribution is vital at each stage, particularly between sessions, when you will need to do something yourself to secure the progress you have made. Sometimes you’ll have gained a new understanding of yourself or your world, at other times new skills or new attitudes. If at any time you don’t understand where you’re going and how you’re going to get there, or you don’t want to go, or you don’t like where we’ve been, please say.
Sometimes clients come for an agreed number of sessions, but usually they start therapy with an estimate from me of how many sessions it will take, an estimate which we review regularly. Apart from that, both you and I can end therapy at any time if we think it is best for us. When we agree to end therapy, it’s useful for us to review what we’ve done, and to plan how you will maintain your progress after we end. We may agree a follow up appointment some time ahead to refresh what you’ve learned.
The therapeutic relationship is a professional one between client and guide, so to keep that relationship simple, we won’t be having a friendship or business dealings outside therapy. Within therapy, my job is to help you get stronger, so whilst I’ll be caring, I’ll also be challenging. You can count on me to be non-judgemental about anything that is discussed. My job is also to be a person like any other you meet outside therapy, so I’ll tell you if you overstep my limits. I hope you will do the same if by mistake I overstep your limits.
Like many therapists I call myself integrative. That is, I use the “mental maps” of several forms of psychotherapy: cognitive behavioural, psychodynamic, developmental, transpersonal, and so on.
There are many cases, both in history and in the news, of people finding the power to transform themselves and their lives. We now also know that the power to change by learning and growing new brain cells extends throughout the lifespan. Therapy harnesses these powers, and in studies it has been shown to change people so that on average they end up feeling better than 80% of people like them who didn’t get therapy. Nevertheless therapy has its limits: it’s quicker and easier to change:
• what is new than what is old
• what is small than what is large
• what is learned than what is innate
• what is simple than what is complicated
• what is seen than what is unseen
• what is in you than what is in your world
The therapist is there to help you, in the words of the prayer, to change what you can change, to accept what you cannot change, and to learn the difference.
Around 5% of clients in research studies feel worse after a course of therapy. Some get more bad news while in therapy. Others get therapy which is too brief to solve their problems. A few get therapists who miss the problem, don’t make them work, or use overly distressing techniques. I reduce such risks by doing a thorough assessment, giving homework, and keeping distressing techniques to a minimum. You can also reduce the risk by telling a therapist if you start to feel worse, so they can change direction. That said, even the best therapy will be uncomfortable at times as you accept hard truths, express bad feelings or try new behaviours. The therapist is there to help you pace the discomfort so you grow stronger until you are able to win the good things in life.
It’s good to have therapy regularly, with sessions close enough together for you to keep therapy in mind, but far enough apart for you to complete any homework and digest what you’ve picked up. Typically, I see clients every week, although depending on their problems and availability, I might see clients twice a week or twice a month.
People can overcome some problems and feel better without therapy. But even for simple problems, 15 sessions of therapy can get you the same improvement as 2 years without therapy. And for more complex problems a therapist can be even more useful. Across problems, 50% of clients in studies get to “meaningful change” after 9 sessions and recovery after 13 to 18 sessions. Acute symptoms can take about 5 sessions to change but chronic symptoms can take 14 or more. Similarly, Panic Disorder can take as few as 6 sessions, but other diagnoses take more. So the 8 to 12 sessions often offered by the NHS may not be enough. On the other hand, after the initial gains, progress in therapy generally slows, so when you seem to be getting nowhere, it’s time to stop, or at least take a break until you feel ready to continue the journey. A good therapist should give you an estimate of how long it will take to reach your goals, and at what point you could usefully take a break.
My clients are of all genders, sexual orientations and cultural backgrounds. They come from all walks of life: I’ve treated professionals of different field and student, housewives and child. My clients tend to live in or close to west bengal.