Do I Need Therapy? – And Other Frequently Asked Questions
Do I need therapy?
We can all benefit from an outside perspective from time to time, especially when going through change or crisis. Ironically, you can get stressed out even by a desirable and “on time” event, like getting married, having a child, or being promoted. Remember, the body doesn’t know the difference between “good” or “bad” stressors. During times of change or loss, you have an opportunity to reassess your identity and way of life. A lot of good can and will emerge if you use the opportunity to get support. In particular, if it’s in a professional, confidential setting, which is what therapy should be about.
Then, of course, any psychological or behavioural symptoms that impact your ability to function effectively in the world can and should be treated by some form of therapy. This includes anxiety, whether general or specific to certain situations, such as when you’re with people. You can also include panic attacks and insomnia here, as well as obsessive-compulsive disorders (OCD). Then there’s severe stress, which can also result in depression and burnout. All of these count as reasons to engage in therapy.
Which kind of therapy is right for me?
You can think of the main types of psychotherapy in three categories: psychodynamic, person-centred and cognitive-behavioural.
Psychodynamic therapies focus on “why” and the therapist will listen, interpret and help you process your past, in order to understand the present. This is a gradual process and there is a lot more of the therapist listening than engaging, also presenting a neutral space, than with the other types.
Person-centred therapy tends to be a warm, supportive style of working, where you are encouraged to release emotion in a safe space. You may receive advice but mostly you will be supported and encouraged while going through the crisis. This type of work can also be prolonged, until you are over the crisis and feel able to cope on your own.
Cognitive Behaviour Therapy (CBT)
The third type I mentioned, is cognitive behaviour therapy (CBT). This is a very different approach. It’s briefer, focused on the “now”, instead of on the past (although it recognises that your past has a role in bringing you here). It involves teamwork between you and the therapist to mutually identify the problems and co-create potential solutions. You’ll also learn some practical steps you can to take to get there. Then you’ll identify any potential obstacles to your progress, such as limiting and dysfunctional beliefs or habits. You’ll learn skills that will enable you to work actively on them.
When choosing a style of therapy, think about what you want out of the process. Do you feel strongly that you want to take time to explore the “why” of your current situation or state of mind? Or do you feel you can’t think clearly enough right now to focus on a solution? Do you just want to be “heard” and contained for a while? Or do you feel ready to work actively on changing the situation?
You can see how each style, summarised above, fits a different need. Alternatively, you may want to do dream analysis or work on meaning and purpose. In that case, Jungian analysis or existential therapy/ logotherapy may be a better fit for you.
How long will it take?
Typically the psychodynamic and supportive therapies can take place over months and years. Cognitve behaviour therapy (CBT) is a more short-term approach. It takes a more pragmatic approach to the “why” and the emotional component. The emphasis is on coping, both now and going forward.
Cognitive behaviour therapy (CBT) is typically a 4- 12 session process, especially when the issue is an anxiety disorder or stress-related. You would start with weekly sessions and move to fortnightly, then monthly, as soon as you’re ready. The emphasis is on teaching and training you to use the tools the therapist gives you. That way, you don’t have to come in for a session every time things go wrong. You complete the process once you reach the goals you agreed up front. You can set new goals, or move on—follow up is on a need-to basis.
Why Cognitive Behaviour Therapy (CBT)?
CBT is based in collaborative empiricism. Collaborative means we work together to make sense of where you are, where you want to be, and the plan to get you there fairly rapidly. Empiricism means that CBT has been widely researched and tested for many decades. Studies have shown that it’s as effective as medication in altering states of anxiety and depression. It’s also a protective factor in relapse prevention.
The collaborative approach means that when you attend a CBT consult, it’s a light, relatively informal process. You’ll learn actual techniques (e.g. for emotion regulation, identifying and changing dysfunctional habits and beliefs). You, the client, will have as much control over the process as the therapist does. You’ll be free to ask questions and make suggestions and your therapist will do the same; teamwork is essential.