Wednesday, November 20, 2013

Mental Health 103 - Counselling and roads to wellness

I cannot begin this piece without first thanking many people who have sent emails, Tweets and left comments of support for my previous piece.  It reaffirmed my belief that "this is something worth talking about", and I was moved how my tale had touched so many people in different ways.  For myself sharing it was an important water-shed, an affirmation that "these things happened to me - but I refuse to let them to continue to have power over me".

Oh, there's still a footprint remaining - but time and treatment have helped to reduce them.  For myself and many others, the road to wellness in this area was counselling, which is sometimes called therapy.  A lot of people have opinions about counselling – ironically, when challenged most people turn out never to have been in a session.  There is a lot of misinformation out there, not helped by clich├ęs we've all see in films, TV and the media.

The phrase that I hear the most is “I'm not going to have someone sit there whilst I tell them all about my life, just so they can judge me”.  As someone who not only been through counselling myself, but has friends who have also used the service, I would like to talk you through my experiences.

Let’s start with what it isn't …

  • Counsellors don’t sit there and judge you
  • Counsellors don’t treat you like a child and tell you how to live your life
  • Counsellors don’t go home and laugh about what you've told them with their friends
  • Going to counselling is not a sign of weakness
  • Going to counselling isn't even necessarily a sign you have a mental illness


Let’s try and clear some of that out of the way now – the media stereotype we're used to is one of some awful wet-behind-the-ears hippy who just tell us repeatedly “so how did that make you feel?”.  I have never met a counsellor like that.

Counselling is about exploring an aspect of your life that is uncomfortable and causes you distress.  Let's be blunt about this, to get benefit from the session, you need to feel you should be there because there is something in your life that's such a pain point that you want to address it.  The counsellor doesn't know anything about you but what you tell them – so in truth, you are firmly in the driving seat.

Most counsellors work by essentially guiding your through processes as you explore past events, your thought processes, how it affected you afterwards, and yes indeed – how it made you feel.

For myself – I can quite simply and clinically recite to others the bare bones versions of those events “I was sexually abused”, “I saw someone killed”, “we tried for a second child, but it didn't work out”.  But the fact is, it’s the whole “how did these things make me feel” that’s the clincher.  For each of those topics it’s complex and labyrinthine, and I got so used to avoiding thinking about them, I honestly never explored how they did make me feel.  Regarding the sexual abuse for instance we explored in counselling how it affected going through puberty and adolescence, my sexual discovery, my confidence, and my feeling in situations where I felt similarly dis-empowered.

An important part of the counselling relationship is it’s confidentiality.  Counselling is a professional career which takes it’s obligation to your welfare seriously.  In fact in my opinion, counselling cannot work unless you have a level of trust with the person you’re going to spend this time with.

There are limits though to even this confidentiality though that it's important to understand – counsellors will remind you at the start of your session that they are obliged to break this confidentiality only if they feel you are likely to harm yourself or others.  But even this makes some obvious sense, this is about your wellbeing after all.

For myself and the areas which have caused stress in my life, they are not subjects it’s easy to talk with others about.  Certainly not people I have a relationship with.  They are about discussing a certain level of insecurity and are certainly “heavy” subjects, which need to be dealt with sensitively, and perhaps not casually.

I have to be blunt – when I was at University in Liverpool, a friend in my drama group wanted to meet me early at a pub one night, before the rest of our group.  She then dropped a bombshell that her father had just been diagnosed with an inoperable brain tumour with months to live.  But she didn't know if she felt comfortable about that, or indeed even wanted to see him.  You see, he’d abused her for years, and she was terrified he was just manipulating her again like he’d done before.  I have to admit, I just felt completely out of my depth in this conversation.  Being the best friend I could do, literally all I could do was “try my best”.  But this wasn't an easy conversation at all, and it really worried me if I had given the best advice, or listened enough.  At the same time I admit I did really feel honoured that Pip felt comfortable enough to talk with me about this.  I just really didn't want to let her down.

This is why I think it’s a bit bullshit when people say “you don’t need counsellors, you just need friends who’ll listen”.  Counsellors are used to listening to such stories, and dealing with such conflicts on a daily basis – of course they’re going to be not only more comfortable, but be able to produce a better outcome for the person in need.

Typically a round of “primary care counselling” which deals/tackles a single aspect of life takes about 4-6 sessions.  I had to use counselling for typically 6 sessions for each of those life issues I've discussed.

As mentioned, trust in your counsellor is key.  I typically use my first session with a new counsellor to explain who I am, and a high level overview of what my problem is.  I use this session to really probe the counsellors behaviour.  At the end of it, I either say “see you next week”, or “I'm sorry, I'm really not feeling comfortable with you – is there any other counsellor I can use?”.  Twice before I've had really nice counsellors, but I've just not felt I could be open and truthful with them, and it that case, it’s better for both of you if you say so upfront.  Counselling will only work if you feel safe enough to be open.

Why not keep taking the pills?

A lot of people fear medication – there is sadly no “cure pill” out there, but medications of different types can really dull some of the effects of depression, moods swings or anxiety which can help people to function relatively normally.

For some people, the drugs work marvels, and they can stay on them the rest of their lives and live a full life.  For myself after our attempt of a second child and how moody the steroids treatment had made me, the medication allowed me to get my brain back on an even keel until I was ready to do without them again.  The counselling then helped me to just deal with all the frustrated emotions, and to not only come to terms with it, but remember I already had a child and rediscover my joy in life (that might sound dumb – but in all the frustration for a second child I swear we sometimes forgot).

But for many people like myself, some counselling can help to explore the emotional issues and really reduce their power, with a view to allowing us to cope without them.

I will leave the final words with a friend of mine, Martin Sloman who works as a counsellor in Kapiti Coast.  I asked him about his thoughts about when people talk about counsellors “sitting there in judgement of people”,

“Firstly all good Counsellors never judge. Secondly a good counsellor has empathy, usually at least in part because of their own awareness of life's difficulties. I see counselling more like personal development. You don't go to school or college because you are thick. You hope to come out better equipped to deal with your future.”

If you want to explore more about counselling, I really recommend having a look the the FAQs of both Martin's website, and that of the Massey University counselling service, which I think really help to answer some fundamental fears around counselling.

As mentioned in a previous posting, most companies do provide access to a counselling service, and in the UK, you can usually get a session for primary care counselling, although there can be a bit of a wait.

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