Saturday, January 6, 2018


Many people are suspicious of the talking therapies.  Some mock the standard therapist's phrase 'And how does that make you feel?'  Counsellors are sometimes derided for offering their services to healthy people in difficult situations; some say that people should just be strong and get on with life, that we are all going soft.  

They have a point.  It can be quite annoying to sit with a counsellor or therapist who adopts an over-precious voice, a patronising tone, and an automatic manner.  Some therapists do seem to think that counselling can be done by numbers; that, as long as they enforce clear boundaries, do nothing unexpected, and say 'I'm afraid that's all we've got time for this week', their job is done.  That stereotype is alive and well, and often thoroughly respected.  It is sometimes born of the need to make an artificial profession out of  something humans have been doing for thousands of years: talking with, and being with, each other in a healthy way.

Even so, there are great benefits in having a profession dedicated to talking (counselling and psychotherapy are often, rightly or wrongly, nicknamed the talking therapies).  Some people have deep secrets that they need to disclose, and that requires trust.  An easy way to create basic trust is to create a profession with rules of confidentiality.  A therapist is likely to keep your secrets, where a friend may not be.  A therapist will generally not be part of your usual social groups, and so is less likely to disrupt your position and comfort in the community with what they know.

Many therapies limit initial intervention to six sessions, often through resource limitations.  It's debatable whether this is long enough to get to know a person in depth, and one limitation of talking therapies is that it is pot luck whether you get a therapist who is caring and understanding enough to get to know you within a shortish space of time.  Also, backgrounds differ, and if your character or environment has differed greatly from the therapist's, you may find yourself battling to be heard through their prejudices.  A good therapist should have some kind of supervision, which is designed to make them self-reflexive and keep them unprejudiced... but there are no guarantees.  Sometimes therapist and supervisor will together create a myth about you which you can't shake, because you're not privy to their conversations.  So while talking may help, it is worth investing in a therapeutic relationship over time, so that you can get to know each other.  After all, friendships work that way: good relationships often need time, ups and downs, and hard work, to be fruitful in the long term.

I believe that a therapeutic relationship is a human relationship like any other, and need not be put in a separate box.  However, it usually has a particular character, borne of the fact that the understanding is that counsellor A is there to help person B, not the other way round.  In other words, therapeutic relationships are deliberately one-sided, so that a person in need of help can receive it from a person prepared to offer it.

That said, different therapists have different approaches to.. well... approachability.  I have known some who believe that the therapist is there not to be a friend, but to perform a different kind of interaction: some think it's a bit like surgery, a clinical operation; some think that to be too friendly gets in the way of some types of relationship that it may be necessary for the client to work through... there are almost as many types of therapist as there are types of relationship.

However, I personally don't see why a counselling relationship shouldn't have many of the attributes of a friendship.  After all, the social skills and techniques that we use as collaborative  humans have evolved over a long time, and there is a lot of wisdom in them.  And friendships contain periodic problems and even enmity... so the whole range of human interaction could be available in a counselling relationship.  Obviously, a wise counsellor will flex their approach to the needs and limitations of the client.  But this, I think, is sometimes overplayed.  Many times, a client will find themselves flexing to apparent limitations in the counsellor... and unless the counsellor is prepared to invest in the relationship, with humility and openness, the client can spend their time effectively carrying the therapist through narrowly-focused sessions, because the counsellor is not showing themselves able to invest in a rich variety of interaction.

I'd use the analogy of a walk through a wood.  A narrow-band therapist will treat it like a guided tour, stick to the paths, and keep the relationship rather formal and inhibited.  A wide-band therapist will be able, if warranted, to allow the walk to become an exploration that includes bushes and undergrowth, and even climbing trees.

So, if you are going for counselling, take an interest in the counsellor's own unique approach to the relationship, and don't be afraid to ask them how they see counselling relationships.  They may be prepared to tell you a bit about their approach.  Though a warning here: I have met several therapists who are weirdly secretive with clients about their methods.  This, too, has its reasons: it may be that their method involves not telling the client their method!  but, in general, don't be afraid to quiz the therapist.  And if you feel uncomfortable, tell them, or change to another counsellor.

Whether a friend or a counsellor, why does talking help?  A few reasons:

1. You can disclose things that have been bottling up.  This provides release.  For many clients, this is the main benefit: being able to give your 'shit', as it were, to someone who can take it!
2. You get a different perspective.  Many mental illnesses are exacerbated by loneliness and solitude.  Solitude often magnifies suffering, because all you have is your own mind to work with.  Talking enable you to borrow aspects of someone else's perspective for a while, and release yourself from the oppression of yours.  Or, more importantly, to gently explore your own perspective, but with some reflective help, in supportive company.
3. You have a foil to work things through.  Counselling relationships are often dyadic - in other words, one-to-one.  This is restrictive, but has some benefits.  For instance, the counsellor can hold a thought for you while you step up to another thought; or hold a feeling with you while you get used to it; a bit like using a ladder to climb.  A counsellor can remind you of things you have said that seem inconsistent, or unusual, or interesting.  Two heads are sometimes better than one.
4. You are in company.  If you are lonely or alone in some way, being in company can in itself be a benefit, and bring health.
5. You have a routine of sorts.  Usually, counselling has a routine and a rhythm to it.  If you meet weekly, it can help make your week bearable, because you know you are visiting a trusted person one every seven days.  It can become a little landmark in your schedule, and give you comfort.
6. You can escape your own network for a while.  If you are oppressed or abused in your domestic or work environment, then you have a chance to escape that, and be with someone different.  Many clients find this a distinct advantage, enabling them to get respite.

So there you go, a few reasons to try counselling if you want to.  Talking is something we've all been doing for thousands if not millions of years.  A healthy talking relationship can be a way of creating health in difficult circumstances.

Just make sure, though, that you use judgement in choosing a therapist who is right for you.  Go with your gut feel.  Sometimes it's worth persisting, but if you really feel you don't trust your therapist, don't be afraid to change to a different one.  That's what you'd do with friendships; therapeutic relationships can be similar.

Talking therapies can be useful, especially if you need to disclose or work through something which it's harder to talk about with your usual social circle.  But make sure you feel the therapist is taking the trouble to get to know you, and that the relationship has enough 'bandwidth' for you to feel that it is rich, supportive and helpful.  Dig a bit to get to know your therapist's method.  Counselling is worth a try... but don't be afraid to change your counsellor if you feel that they have not earned your trust.