How is counselling supposed to work?

[July56]

After being treated for breast cancer last year I’ve struggled to get my life back on track. Once treatment finished the shock of it hit me like a ton of bricks and I’ve done everything to sort myself out.

I had some counselling which I’ve gone back to. When I finished the first time I was just saying the same things over and over and felt I was wasting everyone’s time. I had been offered a limited number of sessions (6) through a charity and by the 3rd was worrying because I didn’t feel any better. I’ve gone back as things have not got any better and it’s a relief to be able to tell someone how I’m feeling.
I’ve had 4 telephone sessions so far and at the moment nothing has changed. I’m not expecting to yet but I’m not sure how counselling actually works. Do I talk about things until one day I find it less upsetting? Will I actually feel better or just learn how to live with how I feel? Each thing we discuss always ends back at the same point so I feel I’m back in that cycle again. As I don’t completely understand the process I’m worried I’m not approaching it right.

Hi, I had breast cancer six years ago and really struggled once treatment had finished, to the point where I was depressed, anxious and suffering with panic attacks. It's very common to feel down once treatment has finished. I had the 6 counselling sessions too but felt in the end that they didn't really work for me. Nobody tells you about the mental strain of going through cancer, I found that worse than the physical side. We can recover from the physical effects but then the mind has to process everything that your body has been through which takes time. I didn't just wake up one morning feeling great, I found that it was a gradual process of getting back to "normality". Take one day at a time, don't expect too much from yourself and be kind to yourself. At one point I didn't think I would ever feel happy again, but I can honestly say that I am happy now.
I found a good book called The Cancer Survivor's handbook or guide which had some great advice.

Thank you for taking time to reply I’m very grateful. My treatment was relatively quick and would agree the mental side is much harder than the surgery.
The whole thing has thrown up so many other unresolved emotions from family who’ve passed away and it’s completely hammered my self esteem & confidence. I’ve completely lost who I am in all this and some of the things I’ve talked to the counsellor about have helped me see that.

Can I ask if you’ve accepted what happened to you and how long it took to do that? I think until I can do that nothing will change. Thank you for describing how you feel, I’m very much the same which to me feels extreme when this happened over a year ago. I don’t talk to anyone around me about it, only if I’m having a really bad day, as I think they’d be shocked and not really understand. I glad you’re in a better place and you’ve been able to move on xx

You need to address this with your counsellor, she or he needs to work with you to find some sort of clarity about what you’re using the time for.

The fact that it’s bringing up other feelings of loss, including your ideas of identity would suggest that actually you’re doing some good work together.

You talk about a circular conversation in sessions, do you feel stuck? Sometimes what happens in the therapy is a reflection of your wider experience.

You can’t get therapy wrong but you can have bad therapy with the wrong therapist. The key is to address these issues in the sessions, take this to your therapist, discuss the fact you posted this, you might be on the way to some insight.

Good luck, I hope you make good progress back to health. It’s an incredible upheaval.

there's different types of talking therapies. You could ask your counsellor what approach they are working with and ask them what the mechanism for change is in their approach? www.nhs.uk/conditions/stress-anxiety-depression/types-of-therapy/

I've been in counselling for 6 months and am only just starting to see improvements. Its hard work, I've had to talk about some really painful things and we've worked through a lot of shame and at the moment its hard to see the light at the end of the tunnel but it has helped so much, when I look back at where I was.

I personally don't think 6 sessions is anywhere near adequate for any type of mental health condition. Mild anxiety or OCD maybe but anything more severe, 6 sessions will do more harm than good. Half the benefit of counselling comes from your relationship with the therapist. You can't build a relationship in 6 hours. I'm only just starting to really trust him after 6 months, 6 hours, forget it.

I’m really grateful for your replies, they’re really helpful. I’ve never done anything like this before and finding it difficult at the moment. From the replies you’ve given me it’s made me realise it’s going to take time.

@Fanthorpe yes I think stick is where I am at the moment. I’ve tried so hard to move on from everything but I’m just not able to.
When I was offered 6 sessions on the first occasion I honestly thought there was something wrong with me for not feeling better by the end.

Mild to moderate issues can often be fixed in a short course of CBT. Any deeper problems cannot be addressed that quickly and trauma work especially relies heavily on the bond with the therapist. You need a hell of a lot of trust between you to start making progress and Rome wasn't built in a day. There's nothing wrong with you. There's plenty wrong with the system but not with you.

Mild to moderate issues can often be fixed in a short course of CBT. Any deeper problems cannot be addressed that quickly and trauma work especially relies heavily on the bond with the therapist. You need a hell of a lot of trust between you to start making progress and Rome wasn't built in a day. There's nothing wrong with you. There's plenty wrong with the system but not with you.

There's a big difference between counselling and therapy.

Counselling can be about listening, giving someone the opportunity to talk through as often as they want to. If they hear real errors of perception (my mum hates me, she won't lend me £50), they may gently challenge them.

Therapy can be really challenging and uncomfortable.

You may need to join a survivors group, or a support group. That may be more what you need to makes sense of what's happened to you and compare your normal with other people's.

@picklemewalnuts thank you for replying. I’m having counselling and understand about talking things over. Is it more about finding an understanding and a way of living with things rather than resolving issues?

Perhaps.

I think in counselling you reach the conclusions yourself, by talking things out. So when I was 20 I had counselling at uni, which was about helping me decide whether to drop out. I remember the counsellor pointing out that I didn't 'need' a graduate wage, that most people manage on less. Then when I had a very stressful situation when my foster placement was breaking down, a counsellor helped me untangle all the different stresses, that had gathered into a ball of unmanageable panic.
She helped me identify things I could do which would help me feel better- things like craft, music- and get some balance in a life which had been driven by stress for quite a while.
Another guy I saw just sighed and said 'yes, that must be very stressful'.

My therapy was quite quite different. Very challenging. Unpicked the way I think and perceive the world. I could be a good counsellor.
I'd not have the first idea about being a therapist- it was deep and complex and subtle.

I don't know if that helps you, sorry. But I'm happy to listen while you try and work things out.

I’m really sorry to hear that you were left feeling you were at fault for not feeling better after your sessions.

It sounds like your sessions are designed to help you transition into the next part of your life, helping you to form positive approaches. It seems to me that perhaps you’ve reflected in a more profound way about yourself, and perhaps the life you led before you were ill also needs some examination?

A good therapist will work with you towards the end of your set of sessions to look at what might be next for you, support you to explore further.

I think you might want to have a look at the BACP website and look at practitioners in your area, read their bios, see if anyone appeals to you and have a chat with a few of them.

Hi OP, in answer to your question, I, could accept the fact I had cancer, but what I found difficult was accepting that the cancer could come back. To begin with whenever I had that thought I would go into a total panic. But then as time went on and my mind had processed what I had been through I was able to have a more balanced view and that was that no one is guaranteed a tomorrow, and that the cancer might come back but then again it might not, so what was the point of worrying about something that might not happen. Now thinking about cancer doesn't dominate my thoughts like it used to, it is still there but tucked away in a very small corner of my mind, if that makes sense. I would say that it took a good two years if not a bit longer to reach that point.

I'm not sure if that helps but I'm happy to try and answer any other questions you have.

Thank you for your replies, they’re really helpful. When your head is in a muddle sometimes it’s hard to see what’s going to help you. I’ll speak to my counsellor this week and get a better understanding of where it’s heading and how I’ll benefit. I question everything I’m thinking and feeling at the moment. I’ve felt I should know the answers to all of this or questions I’ve been asked in the sessions which is ridiculous otherwise I wouldn’t need help!
@Fanthorpe thank you for explaining the difference between therapy & counselling, that was really helpful.
@Mamamia456 I worry about the cancer coming back or that it’s been missed but the bigger thing is the surgery I’ve had and that I actually had cancer. I’ve found the surgery devastating and I’ve got more to go but no idea when because of covid. I still have moments where I realise this has happened to me and it’s like I’m hearing it for the first time. Family and friends think once I’ve had the next op I’ll be ok as I’ll be back to ‘normal’ but I won’t be at all. I can’t seem to explain that to them as well as get my head round it all too. I’ve found this has taken a lot more from me, my self esteem is very low as well as my confidence. Being a strong person before and not being able to cope now has just made this worse. From the outside others look like they’re doing are ok and getting on with life quickly while I’m not is hard. Your reply is really helpful, thank you so much for your reply.

You might like to read ‘The Examined Life - How we Lose and Find Ourselves’ by Stephen Grosz, it an easy to read description of therapy sessions, I found it a really insightful.