To think counselling isn't always the answer to any problem

[Cheesenredonion]

Any problem relating to low self esteem or difficulties in childhood, that is.

I wish people would acknowledge that firstly counselling is out of reach of most people due to the cost. I know it is available on the NHS in some areas, but this tends to be for limited periods (it's 6 sessions here) and there's a long waiting list.

Plus, although depression and anxiety are medical issues some problems are not. Having a difficult childhood isn't, having slightly low self esteem isn't, and so on.

It's not always easy to get to if you have young children and/or don't drive.

Also, is it effective for everybody? I'm concerned as I feel counselling is, to be blunt, the new cure-all, but I don't think it's helpful for everybody but every problem on here at the moment - 'get counselling!'

I have had counselling which I didn't feel was enormously helpful, but this isn't saying it is never helpful - it's saying its a possibility amongst other possibilities.

Agree with you cheeseandred

Some people just don't click with counselling. Full stop. The whole talking thing just isn't for them.

It's advised as a panacea and it can be a lifesaver and life-rebuilder, but it can equally be a waste of time and money for others.

As others have said, I think people say 'have you had counselling' as a way of saying "im really uncomfortable with what you're saying, this is the best thing I can think of to shut you up fast".

Also, just to agree again with what other posters have said, some 'counsellors' would achieve more picking grapes or sorting peas than 'counselling'. At the other end, highly trained and experienced therapists are extraordinarily - even frighteningly - perceptive. It must be strange for them - they have such a level of awareness that it can't be easy to switch off, it must be quite draining.

But there's not only useless counsellors, there's counsellors who are actively damaging people who've gone into it for the power play. It's a mine(d)field.

no therapists are not there to give advice though very often asked to

though some do the boundaries get blurred and they do not tackle this in their own therapy or supervision

also while reflecting on what a client has said a client will often take this as a therapist giving advice. it is too difficult for them to listen themselves and have faith in what they are saying so easier to be in a position of well my therapist told me ..... of course this should be explored but often clients work it out for themselves. it took me some time to work this out

I would disagree that short term therapy is best at times it is at times it is not. CBT can work really well puts in place coping strategies for say anxiety. Does it deal with the deeper issues that causes the anxiety, well it is an ongoing debate. Short term therapy for someone who has suffered years of abusive and destructive behaviour is unlikely to be of much help. It can take months for clients to even talk about or recognise the abuse they have suffered before working on how they feel. sadly the NHS is very limited on what can be offered but there is low cost therapy offered through many agencies

It's not a quick fix solution, no. It's a bit like getting fit, you have to put the work in. The therapist can't do it for you. Too many clients expect almost instant results but in my experience (in both chairs) it takes time to really make a difference.

Many therapists offer a sliding scale of fees, by the way. It's a shame the NHS has such limited resources but there are many low cost options in the third sector.

I agree you have to put the work in, but some people cannot put the work in as they are far too ill. It is no one's fault when counselling fails under such circumstances.

How long should you expect counselling for a really deep seated problem to take? At what point does it become a nice money spinner for rent a friend? I feel the issues of transference can make it hard to end the counselling relationship.

That's the second time you have used that phrase ReallyTired and I'm calling you on it. It's dismissive, snide and unpleasant.

A difficult childhood and poor self esteem are so, so damaging long term (from personal experience and friends experience) that i dont know why you seem so keen to section them off from anxiety and depression, as they often go hand in hand with both and are often causing/the root of both.

No it probably isnt the answer to everything but , if you find a good counsellor you get coping strategies and an objective view from someone with no agenda. That is, family/friends are often unconsciously invested in you staying where you are because thats unchallenging to the status quo and their current known and therefore 'safe' dynamic with you. In the midst of the tsunami of emotions and negativity depression causes you lose your perspective and often your logic. Having someone with both but no agenda saves my sanity when i have been at rock bottom.

Perhaps counselling isnt for you or you didnt bond with your counsellor. I had one i just couldnt relate to and one who just instantly 'got' me - he has been a lifeline. We just clicked instantly ie. he can tell what i mean even if i cant always explain it very well...it is hard to tell someone stuff that seems silly but is the last straw or a 'button' that tips you over into misery. If its not for you maybe a journal or a good friend is the answer.

Rent a friend

I can assure you a relationship with a client is very different from relationships with friends. Friends are involved in your life will know about you as a person what will a client know very little much of it will often be based on assumptions as the therapy is about them

Therapy could go on for a few years ideally with long term therapy it's for the client to decide when they feel they want to end their therapy and some may return some not. At times clients do get attached and this can be worked through for some its very difficult, endings often are but clients making that decision for themselves is I feel the better way for their therapy to end

Freudianslipper Im curious as to what approach you practice?

Sorry for the thread hack OP.

I agree. Sometimes things are just very bad, need no further analysis, and will become an ongoing source of upset if you treat them like an ongoing topic of conversation.

Not always, though. Got to be careful of that.

I've done cbt and it was useless for me.

I've had counselling too several times for a different matter and again, I can't say it did much for me. As nice as the counsellors were, I've never felt 'matched' with one. i was assessed once by an American lady and her get to the point blunt honesty was a breath of fresh air but I've never encountered a therapist like that unfortunately, they're been too gentle and softly softly for my personality which I found irritating even if they seemed like lovely people. I can accept that for most circumstances, that 'softness'/gentleness' would be an asset for a therapist, but not for treating me.

I did feel better about not having to go anymore but some of that is to do with not handing over £40 a time for no real output.

For me anyway, Yanbu.

ReallyTired I feel we need to distinguish between what is an illness and what is adject unhappiness. Sometimes its medically normal to feel wretched. People need to find real life support and friendship rather than relying on rent a friend.
Yes, because irl people are just queueing up to support their depressed friends and listen and help them work through their distressing memories and so on... in an unbiased way...
And it might be medically normal to feel wretched. But that doesn't negate the need for support. Unfortunately people seem to require labels for legitimacy, which shows just how unsupportive society can be towards people "just having a hard time".

To the OP - Plus, although depression and anxiety are medical issues some problems are not. Having a difficult childhood isn't, having slightly low self esteem isn't, and so on.

I had a "difficult childhood". Nothing major, no SA. No big red flags to anyone. Not mentally ill. Naturally, as I began to feel worse and on edge due to circumstances, I confided in friends, as you do as a teen and things are changing. This didn't go down well, I definitely got the idea I should keep quiet and carry on... was I mentally ill yet? Eventually, a teacher in college intervenes and I am diagnosed with depression by the GP. Offically mental! Unfortunately I was not taken seriously by mental health professionals when I made a real attempt to get help a couple of years later (having made major life changes for the better but still feeling dreadful) and they decided I wasn't mentally ill after all, just affected by things and troubled.
I won't drag you through the next decade, but do you see what I'm getting at? I'm now in therapy and unpicking all this stuff, and it's so obvious that a little support, someone to talk things through with, would have gone a long way if it had happened earlier.

My counsellor helped me work through something in 5 sessions that had plagued me for over fourteen years. I have plenty of extremely supportive friends all willing to listen. To describe a counsellor/therapist as 'rent a friend' is extremely dismissive and utter bollox

Element - so counselling is working for you? And thats great. It works for some. No one is disputing that.

What I'm standing against is the posts on here - think 'I'm having some problems with my relationship and I know my relationship isn't great but my mum and dad divorced so -'

GET COUNSELLING.

'I'm so upset because my mum died last week.'

GET COUNSELLING.

'I'm terrified as I have some important exams to sit.'

GET COUNSELLING.

'I'm pregnant and don't want to be.'

GET COUNSELLING.

See what I mean? Counselling may be suitable in some of those circumstances but it isn't in itself an 'answer.'

agreed.

reallytired
How long should you expect counselling for a really deep seated problem to take? - sometimes it can't cure it. Not everything can be. Counselling can help you learn to cope it though.

I feel the issues of transference can make it hard to end the counselling relationship.

A good therapist will be very aware of this and able to handle it.

Counselling isn't supposed to be an answer - it's supposed to help you gain the awareness and analytical skills to make the best possible decisions in the circumstances.

Many clients do not have a clue about the dangers of transference. Counsellors know about counter transference, but clients do not understand the transference trap. Transference happens on a subconcious level and the therapist reminds the client of someone else in their life like their mother, a boyfriend or another close person. Unwittingly the client wll develop feelings toward the counsellor which are not appriopiate. Unwittingly they may put the counsellor on a pedestal and no human being should be put on a pedestal.
Some types of counselling deliberate encourage a transference relationship. It can really hurt the client emotionally when the counselling relationship comes to an end.

You object to me using the phase "rent a friend" how about "rent a mother" or "rent a lover". What better language would you use to describe the problems of transference? Normally people who give us unconditional acceptance are people who are very close to us. Our primative sub concious does not understand the difference between a paid counsellor and someone who TRUELY loves us and TRUELY accepts us for who we are. All of us crave love and unconditional acceptance and its easy to become addicted to counselling.

It is naive to suggest that there is no downsides to counselling. Its understandable that a therapist would like it very personally the suggestion that they are unwittingly harming the client.

www.theguardian.com/society/2014/may/26/misjudged-counselling-psychological-therapy-harmful-study-reveals

To quote the link below

www.supportingsafetherapy.org/clients/endings/endings

"One guarantee about therapy is that it will come to an end; nothing lasts for ever and that includes therapy. However, ending therapy is not necessarily something that will be easy. It can be accompanied by feelings of loss, anxiety or sadness, all of which are perfectly normal emotions when ending a relationship. What’s more, the end of therapy can trigger powerful feelings that relate to other times you have experienced loss, rejection or abandonment."

Transference happens all the time in every relationship. The difference is that a trained therapist can help the client understand what is happening and why. It's not something dangerous to avoid, working in the transference is often what helps the most. Ever heard of people who repeat an unhelpful pattern in every relationship but don't realise what they're doing, just know something always goes wrong?

This is why some counselling courses are very inadequate and there are plenty of therapists who don't understand the unconscious dynamics, usually due to lack of depth in their own therapy. If a training only requires 30 sessions of personal therapy, how could that therapist work at any depth with anyone?

A therapist who has explored her own unconscious is not afraid of really caring about her patients, it is a real feeling, not some professional front.

"One guarantee about therapy is that it will come to an end; nothing lasts for ever and that includes therapy. However, ending therapy is not necessarily something that will be easy. It can be accompanied by feelings of loss, anxiety or sadness, all of which are perfectly normal emotions when ending a relationship. What’s more, the end of therapy can trigger powerful feelings that relate to other times you have experienced loss, rejection or abandonment."

yes. Exactly. That's when a lot of good work is done, handled correctly. It can be very constructive ... Handled properly.

I think there is more than one thing going on:

Like a lot of things, talk therapy has been rather degraded in an attempt to cut costs. So therapy, often expected to take some time to have a positive effect, is now 'counselling'. The amount of training, support and experience the counsellor will have can vary very widely. Since now in the NHS even people with quite severe difficulties will be offered short courses of CBT and often no more, I can see why there are a lot of people for whom counselling didn't work. And in an acute situation some people might need ADs or even hospitalisation before being well enough for therapy.

And yes, at the same time it is being held up more and more as a panacea and a kind of social avoidance. Troubled by something? Talk to people who are paid to listen, not your immediate circle.

Also, some of people seem increasingly disinclined to accept some kinds of feelings as part of life. For example, I don't think you automatically need therapy because someone close to you has died. Grief is hell but it is normal, and ultimately I don't believe it can be circumvented. You have to go through it, and over time you adjust, cope, recover. If for some people grief becomes prolonged or seriously debilitating, then probably some kind of therapy intervention will help. Otherwise, it probably won't affect how well or how fast you recover at all.

www.psychiatrictimes.com/articles/dsm5-and-medicalization-grief-two-perspectives

medicalization of grief.

Sigh. (I'm not talking about when severe grief tips over into illness here).

Transference and countertransference are very complex. Training should provide enough understanding of the complexities of them both. it is the redirection of a clients feelings onto the therapist. they can be both positive and negative, love, admiration and attraction to feelings of anger, mistrust and hatred it can be harmful when not managed correctly (this is why supervision is essential for therapists) but far more often it allows a client to explore that relationship or feelings they have.

it is not as simple as becoming someone's mother/father/ex-partner it can change throughout therapy it can change within one therapy session. at times can cause more confusion for a client, that can be part of the work but also when the therapist acts in an unprofessional way (which should be reported).

I do not think anyone on here is saying therapy/counselling is the answer to everything or for everyone. I believe it is often given as an answer to someone who is going through a difficult time because they themselves have had a good experience from therapy. it can also be I can not deal with what you have to say we are only human it is not a terrible trait to find it difficult to listen to loved ones problems seeing someone you love in pain and there is nothing you can do can make some feel incredibly anxious and fear they are making a situation worse, it may also bring up something for them that is unresolved we tend to feel we need to make someone better and if we cannot we are failing in some way. yes some people are selfish and have little interest in other peoples feelings but I think the vast majority at times struggle to just be there for someone who is in terrible pain and that sadly causes more pain for that person

as I said before at times the role can seem little more than just being there to listen, to allow someone to be heard without judgement, without opinions and a place where someone can explore their inner most fears and feelings and shut the door and leave them there. just that in itself is enough for some people it is very powerful and allows them to grow, acknowledge their feelings are valid. therapy can not work on the person or persons who are not there only the person in therapy though often relationships will change as the person changes, not always for the better but hopefully for the better for the client. we do not have this in our relationships with family, partners and friends we do have conditions to our relationships or they are placed on us (maybe not love) that is why the relationship is different

AliceScarlett I work as in integrative counsellor/psychotherapist

ReallyTired
You object to me using the phase "rent a friend" how about "rent a mother" or "rent a lover". What better language would you use to describe the problems of transference? Normally people who give us unconditional acceptance are people who are very close to us.

For those of us who had never experienced unconditional acceptance from friends/family, and who tried talking to friends, but were shunned for having problems, what do you suggest? I ended up in therapy precisely because up until that point I'd consistently got the message from others that I should shut up an muddle through and was somehow wrong for feeling so bad. The reason certain life experiences have affected me so much is because there was no outlet or escape at the time. Furthermore, because of this I was wide open to inappropriate and abusive relationships, being walked all over by people etc. I - and others - have needed someone impartial with a code of ethics, a safe place to talk through things. As far as I know, it's pretty common for people to feel they must be rubbish if they need to talk to someone they have to pay - and I have felt like this. It's cruel to pick on this, perhaps you should have sympathy and direct hurtful comments to the society at large that lets people struggle alone.

I used to think counselling/therapy was a load of balls. This was due to (a) amatuer psychologists types completely getting the wrong end of the stick and insisting they're right - especially when it involves victim-blaming under a veneer of fake empathy - and (b) that I'd been taught to bottle everything up and thought others bloody well should too! Turns out that way leads to problems down the line...

I didn't make the timeline clear in my last post - the "difficult childhood" (again, mild) was until preteen years. This set me up to not cope very well with more difficult/distressing circumstances in my teens, and finally to be in front of a GP aged 17 diagnosed with depression (although had been struggling and had suicidal thoughts since 12) and a complete breakdown at 19. I wasn't randomly 'depressed', it was very much being upset and frightened by stuff that was happening, that I couldn't deal with (only in my late teens did I begin to feeling rotten without obvious triggers.) People thought it was just normal teenage stuff/hormones, that I was making a fuss, or overreacting. Even when I told them what was happening and how it made me feel. If I'd said "I'm having counselling" at the time (say aged 14), and told you why - would you be one of those people?

If I'd actually had the chance of counselling when the extent of things really affecting me was "my parents are arguing" I'd be much better off now. It would have uncovered really low self-worth too, and I think often you can see when people have a problem they present with - say a relationship issue - there are other underlying issues that feed into it/come to light. So counselling may be a good idea. It just depends on the person. Mumsnet will obviously give a really skewed view because it is the people who are struggling with something and can't talk openly to someone in real life who are most likely to post!

I fully expect that this post will be reported. To get out of depression people need help. Sometimes it requires a bit of medication or emotional support to help someone pull themselves together.

Some forms of counselling are useful. In particular skills based counselling where the client learns techniques that help them in every day life. There are techniques for coping with flash backs, panic attacks and negative thoughts. In my area the Herts Mind network are fanastic. They offer a range of affordable courses which give people strageries. Other areas of the UK have their own mind networks which offer similar courses. Ofcourse you need to be sufficently well to manage these courses which is where medication can help.

Personally I think that there is limited benefit on dwelling on the past too much. It is more constructive to focus on the present and a less extent the future than something you cannot change. I find that focussing on the past makes me feel more rotten. "The woe is me I shall sit on my fanny" approach has never helped me and it has never helped friends who have had that type of councelling. I feel that too much person centred councelling can make someone very ego centric and does not encourage the person to take any responsiblity whatsoever for their problems. Its easier to blame other people than get off your fanny and improve your life.

To become a happier person I have needed to get out of the distructive rut that I was in. My mental health is good at the moment and I feel I owe a lot to a course I did with the Herts Mind Network a couple of years ago.

ReallyTired I'd argue against transference being something to avoid, yes some types of therapy to encourage it and when the relationship comes to an end it can be very difficult. But they lessons learnt and the issues that have been worked through along the way, in the transference can be priceless and worth it.
Some people don't need to go back to them past, they can work on their presenting symptoms and move forward, learning better ways to cope. Which is great, in that case course, cbt, short term work, etc can be really helpful. Other people need to revisit the past in order to move on from it. I triage about 8 people a week and have done for over 3 years, we have this conversation nearly every time and is say the cbt/counselling split is about 60/40. That's primary care, if you did that in secondary care it may well be different.

ReallyTired some clients all they need is to sit on their fanny as you call it and have their story listened too and for they themselves to pick it over. person centred therapy may not have worked for you or your friends but for some clients that approach is what is needed especially when they have not for whatever reason been able to tell their story felt they have never been listened to or been able to be truthful. The process of therapy people will often going through stages of being what some might see as being self absorbed the trying to understand what has happened and is happening to themselves, what they feel, how they experience others, how their feelings are changing it can be overwhelming these changes it does not mean they do not take responsibility for themselves far from it, to allow yourself to become the person you truly feel you are and not what others think you should be is taking responsibility for yourself

I see many clients who have had CBT often more than once so has it worked well to help them at that point in time maybe but deep seated issues are still often unresolved and this can take time to work through that does not mean the CBT didn't work as it has been helpful but now a different approach is needed

Some clients would absolutely reject therapists teaching them any form of coping strategies am example this could be a male client who has real issues of women in authority (therapist is not in an authoritative role but he may perceive her to be). Some clients accept their depression others try to cure their depression others manage it much of the time they have lived with it the last thing they need is someone helping them with this they just want to work through it others need this approach it's individual as everyone is, everyone's experience in life, their mh, anxiety, depressions is their own experience