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What is this therapy malarky?
I’m going to teach you to become your own therapist and make therapy part of your life for ten minutes every day. But before I do that, I’d like to talk about the shame and stigma surrounding therapy.
I’m always intrigued when I meet a new client who says to me at the end of a session, ‘Wow, that wasn’t so bad.’ (It’s usually men.) I always ask what they mean, as the preconceptions surrounding therapy fascinate me and, as you might expect, I’ve heard a range of responses back. Brace yourself!
It doesn’t stop there. I sometimes avoid telling people in social settings what I do for a living. I find my occupation often either worries people (they think I’m mind-reading or ‘diagnosing’ them based on our small talk), or makes them feel the need to disclose their entire life story, or it freaks them out.
When I worked as a clinical lead for an NHS therapy service, I learnt that some words associated with mental health stopped people attending groups. For example, if we set up a group called ‘Coping with Depression’, it would be empty. If we set up a group called ‘Boost Your Mood’, it would be full. I work with clients who ask me to remove the word ‘therapist’ from the invoice. I have even been asked to remove my title from the office door. Some patients are concerned about what others might think if they knew they were seeing a therapist. A medical doctor specialising in the body rather than the mind would be unlikely to get the same request, unless it was in an area like sexual health. Therapists seem to be something of a ‘dirty secret’.
I remember going for my first therapy session in my early twenties (a few years ago now), sneaking up the road, terrified someone would see me. I had the look of someone engaging in an illicit affair. Luckily my first therapist was a nun, dispelling any such potential rumours. Her office was in a convent. I was relieved when I discovered this because it was a useful cover-up. I could be at a confession of sorts!
Being serious, though, I was ashamed that I needed help. I was ashamed that I couldn’t work it out alone. I was concerned what others would think of me. I was ashamed I was struggling mentally with ‘coming out’. This was complicated further with a cultural belief at the time, a belief which I’d internalised, that men don’t struggle. Boys don’t cry.
Which brings me to this. A lot of people consider it shameful to need therapy. I used to be one of those people! There is still a degree of stigma around mental ill health. Making the responsible choice to be in therapy is still considered a sign of weakness or a failing. Likewise, therapists and therapy are still quite mysterious to some people. Sadly, these negative preconceptions are mostly driven by fear. Public perception of therapy is a lot more positive now than it was one or two decades ago. More people are coming forward for help. But that stigma is still very much around.
If you’re feeling even a hint of this discomfort and anxiety I’m talking about, please let me help allay any nervousness you might have right now.
The truth is, despite the ongoing shame around it, every single person on the planet would benefit from some therapy. Even if you’re perfectly content with your life, gaining the self-knowledge to understand why you’re happy means you can re-discover what makes you tick when life is less than rosy. Everyone, no matter how wonderful their life might seem from the outside, will experience some seriously tough times, and it’s not easy navigating those ups and downs. Sometimes we need support. That’s why in this book, you will learn:
- What therapy does to your brain, and how it helps, in a nutshell
- The process of therapy in more detail
- What you’ll be doing in self-therapy
WHAT THERAPY DOES TO YOUR BRAIN, AND HOW IT HELPS, IN A NUTSHELL
I have worked for thirty years with people in distress. And what I’ve learnt in that time is that it’s the response to a negative experience, rather than the experience itself, that has the biggest psychological impact. Some people cope well and adjust to horrible experiences. Some people suffer deeply.
I don’t believe people choose to suffer. I believe some people are programmed to suffer more than others, or get stuck in unhelpful patterns of behaviour.
How much a person suffers because of their response to negative experiences could be linked to how they think, how they deal with emotions, what rules they have in place for their life or how they behave. Most of these patterns are learnt or inherited as children and then carried into adulthood. You will learn more about this later.
In essence, a lot of adults are going through life using childhood coping strategies. And that, in my experience, is the root of much human distress.
The good news is therapy can change that, as thousands of research papers can attest to. Therapy means standing outside of your life and having a look inside, but doing so objectively. You can make fascinating discoveries about yourself when you play the formative events of your life back and begin to understand why you struggle. Therapy will encourage you to tell your life story and connect your experiences to what you struggle with today. It will help you understand patterns of thought, automated emotional responses, why you behave as you do and how you can change what keeps you stuck.
Each day in my practice I see people trying to manage issues such as anxiety, depression, trauma, loss, relationship issues and conflict. Therapy helps them unravel the cause of their pain and offers guidance that can ease their suffering. It is a collaborative process rather than a prescriptive one.
The joy of modern therapy is that it uses strategies informed by the latest cutting-edge research in medicine, neuroscience, social sciences and pharmacology. That is to say, we are complex physical, emotional, thinking beings, and we need more than psychological insights to help us function at our best. Good therapy should always be holistic in its approach, by which I mean it should consider the whole person.
LET’S LOOK AT THE FACTS ABOUT THERAPY:
- It is a scientifically proven method of improving mental wellness
- It improves brain chemistry
- It can reprogram neuropathways to help a person function in more helpful ways
- It improves quality of life
- It improves mood and anxiety issues
- It improves work life, home life and general motivation
- It helps people break the cycle of destructive behavioural patterns
- It eases distress
THE PROCESS OF THERAPY: UNDERSTANDING THE MECHANICS IN MORE DETAIL
As I mentioned, I’m going to give you a therapy crash course. Think of it like a compressed version of the work I would ordinarily do with a client. This foundation work is essential. Then we’ll move on to the maintenance work: the ten minutes a day of self-therapy. I’ve deliberately chosen ten minutes, partly because quick acts of self-care can fit more easily into busy schedules, but also because you’ve a better chance of committing to the self-therapy long term if it’s a much more achievable ten minutes, as opposed to an hour.
I want to explain the basics of how therapy works by using the analogy of a cake with three layers.
The processes I explain here will come alive when you are doing the actual work. For now, though, I hope this analogy will offer some insight into why I suggest the exercises I do. Just know that if I am suggesting you try something, there will be a strong clinical reason for doing so – we’ll cover that in more detail shortly.
The top layer of the cake is your thoughts and feelings. Your thoughts and your feelings are separate but interconnected, and they’re constantly communicating with each other. For example, if the rather unwelcome thought, ‘My partner doesn’t care about me,’ crops up in your mind, it will automatically create a feeling of sadness or something similar.
Likewise, you may experience a sudden shift in your emotional state that leads to a catalogue of unhelpful thoughts. When you are sad, it may prove difficult to have optimistic thoughts about yourself or your life. Thoughts may sound more like, ‘I’m not good enough,’ ‘I’m a disappointment’ or ‘I’m rubbish.’
Thinking is a cognitive process. Sometimes it’s automated and unconscious. You could be working and suddenly your mind jumps to a memory of a holiday. Sometimes it’s conscious. For example, you might be wondering what to buy at the supermarket, or the best route to a wedding next weekend, or considering how to proceed with a delicate contractual negotiation. Thoughts come with a narrative, with one thought often leading to another.
An emotion, on the other hand, is an automated (that is to say, automatic) experience that you feel. Thoughts may or may not be attached. It may be in response to an event. It may happen unexpectedly. Our emotions are like the weather, they can fluctuate between two extremes in a very short space of time. Learning to acknowledge them and letting them guide you is key.
Neuroscientists estimate that we have between 60,000 to 80,000 thoughts a day! That explains the expression ‘a mind in overdrive’! We are thinking all the time. But thinking itself isn’t the problem.
The problem is that critical, catastrophic or inflexible ways of thinking, and negative emotional responses, often become automatic. We’ve learnt them from our early life experiences. For example, if someone comes from a family with very critical parents, they may automatically think the worst of themselves and struggle with negative thoughts when they are in situations that mirror aspects of their childhood. Consequently, regulating emotions may prove a problem.
By that same token, someone could have learnt as a child that some emotions aren’t acceptable, such as anger, fear or vulnerability. They may struggle as an adult dealing with these emotions, and consequently experience negative thought patterns whenever these emotions arise.
I’ve worked with many clients who weren’t given permission to show vulnerability as children. When they are in situations that evoke difficult-to-handle emotions as an adult, they automatically have very critical thoughts about themselves, such as, ‘I shouldn’t be feeling this way,’ ‘I am weak’ or ‘I am useless.’ In short, they have been programmed to respond in a particular way in certain scenarios due to their early life experiences.
Automated thinking and emotional responses tend to be habitual. Unless, of course, we stop to evaluate how they are negatively impacting our life and make a conscious effort to change our responses. Therapy brings hope here. New ways of thinking and healthier emotional responses can be opted for. Change is possible.
But good therapy won’t just focus on the top layer of the cake. Sure, that’s fine for a quick fix in the emotions and thoughts department. But if you want the secret to long-lasting change? You need to look at those middle and bottom...
