2021/09/23

Thoughts on therapy

So I’ve had a few comments since my first post about therapy specifically. Some thanking me for being open, and some wondering where to start. I thought I’d continue that conversation and talk a bit out my journey with it. Obviously everyone is different but this could be helpful if you’ve been on the fence about it.

Why go in the first place?

This is the core question you need to answer. For me, I’d reached a tipping point. I’d known I probably needed some sort of therapy for years. I actually had counselling when I was very young, maybe 10 or 11 years of age. I had a very up and down childhood and I knew it had probably bled into my behaviours as an adult. Maybe I’ll get into that a bit more at a later date, but it meant I’d become a very avoidant person, often cancelling plans and isolating myself if I thought I’d be even the slightest bit out of my comfort zone. It affected past relationships and friendships. Avoiding those situations just made me feel worse. If I cancelled plans then I’d feel good for a short period of time, happy that I could retreat into my safe space, but that feeling quickly turned into guilt and meant there were times where I wouldn’t leave my bed for days. I’d ignore people and just hide myself away. It would consume me.

This tipping point came when I was supposed to meet my girlfriend for dinner. I was feeling quite low for an unrelated reason and all I wanted to do was stay home. So I did. I told her I wouldn’t be coming to see her and ended up staying home alone in bed. Obviously I just felt so shit after that, especially seeing as she went to the restaurant alone. I was frustrated at myself for letting someone down. I knew we would have had a lovely time, but I’d just ruined something for someone else. It might sound relatively small but it was the avoidant behaviour coupled with my poor communication of my needs that made this whole situation worse. It was a pattern I was repeating, and one I didn’t like but I couldn’t seem to do anything different when that feeling came up. This was essentially the straw that broke the camels back and it caused a rift between us. I wanted to find out why I behave like that and if I could do anything about it. Was it my childhood and learned behaviours? The way I’d been treated in past relationships? Or was it just me as a person?

You’ll know when you should start therapy. You’ll have your goal come to you. It also doesn’t matter how big or small that goal is. I was worried that it was silly for me to go to therapy over avoiding situations. Really, I was running from my problems. Going to therapy has uncovered a lot of other stuff I wasn’t really aware of.

So how do you start?

So the first main question you have to answer is are you in crisis or not. If you are, then therapy isn’t necessarily the answer and instead there are helplines and services that specialise in crisis. You should really head to A&E or contact Samaritans on 116 123.

The second question is if you want to pay or not. In the UK, you can get certain types of therapy on the NHS, but often the wait times are long. I ended up going private and I feel very privileged to be able to do so. Most sessions range from £50-120 an hour depending on the type of therapy, and the qualifications of the therapist (although not always true).

I didn’t know this at the time though, I had no idea where to actually start. I spent an evening googling places, filling out forms describing what I thought my issues were. It was emotional and I cried a fair bit. It’s strange when you’re a man, there’s a lot of masking emotions because “that’s what you’re supposed to do, brave face and all that”. It was the first time I’d written down my problems and let someone know, even if it was filling out a form on a random website. It was hard not to feel overwhelmed. I’m honestly surprised I persevered.

I initially tried this site called Better Help. I’d seen a few ads for the service in the past, and they had some good reviews. You get paired with a therapist and you’re supposed to have an hour session to get to know each other before you commit. I had a really shit experience though. I got matched with someone from the states (I’m in the UK) and there was no way to change it. I was worried there would be cultural norms that are different, or time zones would be an issue etc. I was nervous all day for this video call, and they never showed up. I’d got all psyched up only to fall at the first hurdle. I felt defeated really. They might work better for others but that experience left a sour taste in my mouth and I moved on.

More searching. I came across this site called My Therapist Online. It seemed promising. Disclaimer, this isn’t a paid review or anything, I just think the service is great! I didn’t know exactly what kind of therapy I needed. It’s hard not to feel overwhelmed by all the options out there. That wasn’t really an issue though because you tell them why you think you need therapy and what you want to get out of it. Their team will then look over your information and put together a small list of therapists they think will be best for you, and they recommend someone specifically. They also include each therapist’s prices and links to their bio and history so you can make an informed decision. You then choose the therapist that sounds like they’ll be able to help you the most, and is within your budget. You have an initial call with them for 15 minutes. It’s free and you don’t have to commit to them if you don’t think they’re a good fit. I was lucky in that the first therapist I spoke to was great. We spoke about what kind of thing I want to achieve by the end of therapy, what kind of person I’d like to be etc.

After that chat, I had to confirm I was happy to go ahead with therapy through My Therapist Online. One of their selling points is they act as an intermediary between you and your therapist when it comes to the payments so you never have to have awkward conversations about money with your therapist. You pay for your first two sessions up front, I think mainly as a sign you’re committed to the process. After that, you get invoiced each month for the amount of sessions you’ve had. Depending on the type of therapy, you might have fewer sessions over time. Then you arrange the date and time if your first session.

About my sessions

The type of therapy I have is called Strategic Brief Therapy. It’s similar to CBT in some ways. Basically it aims to solve the problem of trying the same solution over and over and not getting the desired results (like me running to isolation). They call these problems “attempted solutions” which I quite like. I’ve had to identify what these attempted solutions are like running away and isolating, among other things, and put certain strategies in place to try other solutions instead. Identifying these attempted solutions has been one of the hardest parts. Understanding why I behave a certain way has been extremely emotional but totally worth it. I’ve had to get very deep into myself to really get it.

I started sessions once a week, just for an hour. At the end of each session I was set some homework for the week. It started out small like answering two questions every morning:

Over the course of several weeks, these questions evolved and got more specific to issues I was facing. I was being taught tactics for dealing with situations I’d normally run from, and being forced into uncomfortable situations incrementally. My therapist had a good analogy, it was like building up my immune system to conflict and better behaviours. By exposing myself to situations I’d normally run from in smaller doses, I was slowly building up a tolerance. If I stopped practicing, this tolerance would go back down, but if I kept it up then soon enough I’d have a good level of immunity. These situations that were such a big cause of anxiety for me, would no longer be that bad.

I started this process in June of this year. It’s now September and my sessions have reduced to being monthly. Last week was the first time I’d seen my therapist in a little over a month. It’s a sign that things are improving for me. I just need to spend time now really getting into practicing the things I’ve learned, and need less time exploring my “attempted solutions”. I have a pretty clear idea what those are now! One piece of homework that’s helped a lot is journaling my frustrations and anxieties. This one practice alone has helped me identify so many things and I’d recommend it for anyone, regardless of if you need therapy. Just getting your feelings out onto paper, even if no one reads it, is so liberating. I’ve noticed triggers and patterns that I know how to deal with now.

A summary

If this post has made you think about going, that’s great! As my therapist would say…

Some people may think that seeking for help is a sign of weakness; however, being able to admit that you alone can’t deal with a situation and seeking professional help, shows great strength.

The things you need to figure out are…

Then it’s just a case of finding a therapist. I can’t recommend My Therapist Online enough, but there are other similar services. If you have an initial chat with a therapist and you think it’s not going to work, that’s ok. Try someone else, or maybe you decide that you’re not ready yet. That’s also ok. You’ll know when you need it.

Here’s a couple of links to useful therapy services in the UK:

Therapy has really changed my outlook for the better. I still have a lot of work to do but the improvement since June has been really good. I’m also hoping that by talking about this more, it removes some of the stigma surrounding therapy. Especially for men where it’s often seen as weakness.

If you want to know more, please feel free to reach out to me. My DMs are open on Twitter, or you can email me on mail at samking.co. If you already go to therapy, I’d love to hear about your journey too if you’re willing to share.

Anyway, thanks for reading, Sam.