To think advising someone to get therapy isn't the magical solution to everything?

[JamesMiddletonsMarshmallows]

I am a CSA survivor and I had therapy as an adult, which was a totally pointless waste of time. Nothing wrong with my therapist, she was lovely, it just wouldn't have worked with anybody, it just really didn't suit me or the kind or person I am. I have dealt with my trauma in other ways and it doesn't affect my day to day life.

I'm really quite sick of advice for every other problem being "you need to get therapy" as if it's some magical cure for everything wrong within a person. Not to mention, it's hard as fuck to access - it's a postcode lottery on wether it's even available on the NHS (and when it is there's usually a waiting list) and private therapy is around £45 per hour where I live. And with an ever worsening MH crisis in this country, many people simply cannot afford to wait months and months to access therapy before they completely break down, they need help now, and it isn't always in the form of someone asking "and how do you feel about that?"

I think "access therapy" is a bit of ill thought advice and so I am imploring everyone to think a little harder before thinking this is a great suggestion.

@Canitbemagic if so pleased you were able to have your feelings validated - that is very good therapy!

And your second paragraph is SO right. I won't report my abuser because I have a good life and cope well and whilst justice would be great, the thought of standing in a dock retelling my story for a defence barrister to try and rip me to shreds...that's if I even get that far...for it all to be highly likely he's not convicted then there's a witch hunt out for me...just, no. I'm not sacrificing a good life and my good MH for a minuscule chance of justice, which would probably amount to a short prison term. And my family would never, ever believe me, even with a conviction (he's a family member and adored). They'd see it as a flaw in the justice system or something.

Agreed.

I've had several sessions over the years and found them useless. Didn't feel any different walking out to when I walked in.

OP, can I ask what type of therapy you were offered? You don't have to answer obviously! I'm just curious.

I think there’s different types of therapy and also there needs to be a good connect between therapist and patient. It absolutely isn’t a magic wand, and takes a concerted effort.

I have GAD and had MD in the past. I’ve had CBT in early 2010’s which was a pile of shite. “Counselling” which made me so frustrated as hoped to get some help coming up with solutions. EMDR for PTS which helped alot. All that on NHS, and I was painfully conscious I only had “so long” to get stuff sorted that triggered more anxiety so fairly counter productive, though it did resolve the flashbacks and severe anxiety it was triggering.

Then I paid privately for therapy. I had IEMT therapy and it has been hugely successful. My sessions were £75 for 2.5 hours and I had 3 sessions over 3 months - we made cut backs and used the small bonus DH got from work to pay for it (were on a debt plan so don’t have disposable income).

The therapy has helped me process the memories and emotions that were underlying the GAD (which was first triggered as a toddler much to my amazement!), it literally felt like bad shit was being pulled out of my brain - astonishing in a way. I was also taken through various techniques to manage anxiety when it rises, and have made practising those and incorporating them into my daily life an absolute priority.

It’s very hard work to manage, sometimes using the techniques to keep anxiety down is as exhausting as the anxiety itself. However over time it is getting easier and I’m having less episodes where I need to actively manage my emotions/mood etc.

Absolutely not a magic wand though. I always recommend therapy as I would love everyone to have the success I have - but when you think it’s taken 11+ years to find something that works for me, click with a therapist and have it work for my particular condition - it’s not going to work for everyone. That doesn’t mean people shouldn’t try it though.

I’m sorry to hear of what you’ve been through

op I compare it to going to a dietician or a physiotherapist, they will give you the information and help for the issue but they are not curing the problem. The dietician can give you a diet plan but they can't make you follow it, the physio can give you the exercises to do at home but not everyone will do them. Plus with any treatment it has to be tailored specifically to the person.

When a poster comes on here theyre posting because they want to be heard. They want to talk and sometimes they dont have someone in real life that they want to discuss their issue with so by attending a counsellor it gives them the opportunity to say it out loud and let them look at the issue without being stuck in their own head.

Therapy is not a quick fix solution and its definitely not a one size fits all. I also suffered csa but actually never went to therapy for it because it was something I found I could actually deal with myself so therapy would've been useless. However the last issue I had I wasn't able to handle it and found therapy to be a great lifeline.

It's not a magic solution, the 'recipient' has to be in the right place and there has to be an effective chemistry and trust between the client and therapist.
After many years, and several therapists, I am more understanding of the (private) psychiatrist who asked me in my 20s (as I thought) if I had been responsible for the years of sexual assault and rape. She may not have phrased it brilliantly, I may not have been in the right place to understand what she was asking - but it did create several difficult years.

If you are advocating that therapy is a waste of time, why are you concerned that therapy is not available on demand with no waiting lists on the NHS, and complaining that people have to wait months and months?

I know that there is a shortage of resources, counselors and appointments, however my main concern with NHS therapy is that there is no opportunity for an initial meeting to assess whether there is a good chemistry between client and therapist, meaning that much of the work that is carried out will be less than effective.

It may not work for everyone but it changed my life. I had time limited therapy so you have a set number of sessions (16 or 24) to resolve the issue and at a total cost of less than £2k was totally worth it.

I'd always suggest it as a potential solution.

I compare it to going to a dietician or a physiotherapist, they will give you the information and help for the issue but they are not curing the problem. The dietician can give you a diet plan but they can't make you follow it, the physio can give you the exercises to do at home but not everyone will do them. Plus with any treatment it has to be tailored specifically to the person.

Spot on. Therapy works no differently to any other type of lifestyle intervention - it needs active participation on the part of the person involved. As well as the therapy type and therapist themselves being a good fit for the person.

I agree it's not always the solution. I've had therapy that helped and therapy that made me feel much worse. So many factors influence how it will go - mainly the type of therapy and the therapist, IMO.

Therapy set me back and created terrible self doubt, self reproach and anxiety for me, on more than one occasion

But I think the times I have engaged with it I have either not found the right therapist or I haven't been ready for what it is or what it needs from me.

Agreed. People on here so flippantly tell posters to "get counselling" like it's a) that easy and b) a magic bullet. It annoys me way more than LTB or other cliches!

The thing is that there is no magical cure. But counselling has to be worth a shot, it certainly helped my OH change his life so i would always recommend it. No one is going to know whether it's going to work for them unless they try.
I'm sure if on those threads you wanted to share what worked for you then that would be extremely useful too. The more options there are to try the better IMO but don't write something off as worthless for everyone just because it didn't wok for you.

Obviously it isn't a magic bullet, doesn't work for everyone, supply is limited and quality variable but I don't understand you saying it shouldn't be recommended. It might not work but what's your alternative suggestion? What would work better? I don't think medication should be the answer and that's the usual alternative suggestion.

Many people have a wrong understanding of what therapy is and would do. It isn't mainly a chance to offload and a therapist will not make sympathetic noises like a friend or offer solutions they will do a lot of listening and offer interpretations and a framework to understand unhelpful patterns of thinking and behaviour. It will be painful and difficult to change those. For some people it is better not to have therapy or not at this time if they are not in a place to be able to make a change.

The NHS does mainly offer CBT because it can be manualised and is easier to deliver and evaluate consistently for a less experienced therapist. Very expert, experienced therapists will obviously be in short supply and have long waiting lists especially as they can make more money in private practice.

I can remember when waits for any kind of psychology input at all routinely exceeded 2 years. I usually didn't bother to refer because with that kind of wait it was essentially pointless. Now we have IAPT type services and whilst they often are a bit basic it is a whole lot better than what we had before which was nothing. They do help a lot of people with anxiety and depression who would have just had no service before. I wish there was access to a wider range of therapies and more highly skilled and qualified psychologists (IAPT therapists usually are not psychologists) but the investment required would be huge. We would need so many more people trained as they would be highly paid. I don't see it happening.

I think therapy can be a wonderful thing, but as you say it’s not as easy as ‘getting it’. Even if you’re able to access it on the NHS, everything from the type of therapy you’re offered to whether or not you feel relaxed with/trust the therapist can affect how successful it is.

The NHS mainly seems to offer CBT too which is not a one size fits all therapy. I found it useful for treating a phobia of mine as it’s quite specific, you can draw quite clear patterns and identify your coping mechanisms etc. But my partner has more general anxiety and CBT didn’t help him at all, it was too broad with too many aspects rather than one overarching core issue. CBT seems to work better when you have one specific issue you want to work through.

And yes access is a huge issue. MH services have been cut to ribbons in the UK and it’s a post code lottery in your area and how long the waiting list is. And as you say, private therapy is not accessible to all even on a sliding price scale. And again, you need to find the right therapist etc - even if you have the cash, you might be time poor and not have the time to spend researching and trying out different types of therapy and finding the right therapist.

You are totally correct. I've had some , hated going, hated talking, didn't get anything out of it until I read a book that was recommended to me by the therapist. Penny then dropped that I was responsible for getting through the issues and a therapist just signposts you to different resources.

Agree, but if it helps even one person, then maybe it’s a good idea to suggest it. I’m sorry it hasn’t helped you, OP.

I wish there was access to a wider range of therapies and more highly skilled and qualified psychologists (IAPT therapists usually are not psychologists) but the investment required would be huge.

Agreed - if the funds were available this would be massively helpful. I have worked
as a therapist for a specialist service which is a step up from IAPT offering more tailored and specialist therapies. Many people when they finally got seen would say "IAPT did nothing cot me... CBT is useless", etc. What they usually meant when it was explored further was, "it wasn't right for me, at that time, with the difficulties I have". People who find CBT unhelpful generally (not always but generally in my experience), found the more specialist 'step up' therapies more helpful. But you're right - lack of funding it what prevents these being more widely available on the NHS.

*for, not cot.

I think that counselling and therapy have their place, but for me it made things worse (complex ptsd/ multiple traumas).

Ironically even though I work in MH I have always avoided getting therapy for my own past trauma although it has sometimes been suggested.

I feel as though I have dealt with it in my own way over many years and I think I am a pretty well functioning human being (although sometimes I do wonder whether what goes on in my head is normal. I assume we all do...). Sometimes I do have some issues where it gets triggered (as others have said motherhood was one) but usually I have taken some pills for a while and got through it and I think that at this late stage it will probably not be worthwhile to go digging over painful things.

So in my view it's an option. A very helpful option for some and not for others. The main things are that it has to be clear exactly what the expectations are on both sides as I think that's where the trouble is. CBT is very here and now largely and it needs a lot of active participation filling in diaries and doing exercises outside of sessions. If that's not what you expect or want you'd be disappointed.

Lots of people on the thread have said they wanted the therapist/ counsellor to help them with solutions to problems but offering your own solutions as a therapist is regarded as a no no in most branches of therapy. It's more about helping the client to understand why certain issues arise and making their own solutions. As such if you have that expectation you'd likely be disappointed.

The NHS does mainly offer CBT because it can be manualised and is easier to deliver and evaluate consistently for a less experienced therapist.

Yes. And the widespread funding of IAPT primary care services - focusing primarily on CBT - came from the push for NHS therapies to be more evidence based in teams of outcomes, as this was a commissioning expectation. In other words, services were told that they must demonstrate concrete positive outcomes in order to continue to be commissioned (the 'Payment by Results' agenda). Since CBT is manualised and easier to measure in terms of outcome, it was focussed upon heavily within this agenda. This has led to the research base being skewed in favour of CBT being the most "effective" therapy (hence it appears in NICE guidelines for a range of conditions). It's not that other, more specialised therapies are inferior to CBT, they're just harder to measure in terms of concrete outcome. As the research base expands for these therapies, hopefully there'll be a greater drive for increased funding of these within the NHS.

I've had a few lots and it's always been helpful. One time the therapist was truly dreadful but even then, the things she suggested were quite helpful on a longer view. But apart from that one (which was an NHS referral, so no opportunity to see if it was a good match), the others I found and paid for. One was magnificent! Best two hours of my life. I felt so lightened by having someone do nothing but listen.

There are very very few people in this life who will listen attentively without judging, interrupting or giving advice.

But I don't think people realise you have to work to get something out of it and it can be upsetting and unpleasant while you're doing that. And it costs a lot of time and money.

Lots of people on the thread have said they wanted the therapist/ counsellor to help them with solutions to problems but offering your own solutions as a therapist is regarded as a no no in most branches of therapy. It's more about helping the client to understand why certain issues arise and making their own solutions. As such if you have that expectation you'd likely be disappointed.

Absolutely. No good therapist will say "here's what you need to do". It's about coming to a joint way forwards, collaboratively.

I think it depends on what is wrong, how an individual is presently coping and the type of therapy available.
I had a period of depression in my 20s and a very enmeshed and unhealthy relationship.
I went to therapy ostensibly for the depression and ended up talking incessantly about the relationship.
The therapist followed a non interventionist model, so I completed the sessions in a similar place to when I started.
I needed a more direct approach, basically a stranger to tell me to cop on.
Now I have ongoing unfixable difficult circumstances in my life, I am an open person and do talk to my family and friends but there is a limit to how much unburdening it is fair to do.
I know counselling would probably be helpful, and take the strain from my primary relationships, but at the moment I'm coping by distraction and pretending as much as possible that life is normal.
I'm not sure I'm able for the can of worms talk therapy would probably open. Especially in a locked down life where external distraction is limited.
It is very complex, but I think you and Sarah are right in that there needs to be more knowledge of what "therapy" actually is before people start it and that there is potential for it to actively harm as well as just not work.

I've suggested it when my marriage was on the rocks. It was provided my work and I accessed my first session within weeks. A lot of employers provide it free of charge.

We worked through stuff and were stronger than we have ever been.

I stand by the advice.