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The Inner Work of Therapy

I have been working as a mental health professional for over 7 years now. I have worked with people who struggle with mental health difficulties ranging from problems that require inpatient care or psychiatric treatment, to those whose problems can be treated by attending one or two psychologically informative workshops or reading a few self-help books. In my experience, when people seek help from therapeutic services for common mental health problems, they usually meet recovery within one or two episodes of being seen and never seek formal help again. Unfortunately, some people spend years flying in between therapeutic services, seeking help for difficulties that they can never seem to find lasting recovery from (Thoits, 2022). This is not to say that help-seeking isn’t of any use. On the contrary, the evidence suggests that self-help interventions, such as books and apps, are effective in reducing mild to moderate symptoms of depression in adult populations (Serrano-Ripoll, Zamanillo-Campos, Fiol-DeRoque, Castro and Ricci-Cabello, 2022). One study found that peer support groups that were professionally led or else facilitated by recovered individuals with a prior history of depression, were just as effective at managing symptoms of depression as other standard forms of care (Shorey and Chua, 2022). Ultimately, recovery from mental health difficulties is far more likely for those who are treated, than for those who remain untreated (Thoits, 2022).

People turn to mental health services for support, because they expect to see changes to their lives, they never could have made through their own efforts, and for a lot of people this is the case. However, part of the reason why some people don’t see any changes from what I have observed is that they are not fit, willing or ready to make any changes. Therapeutic interventions, whether they are purely self-help or facilitated by formal services, can only enable change; they can’t bring it about. I myself have had Cognitive Behavioural Therapy (CBT) four times, and Counselling 3 times in the past, and only one of those times did I actually complete treatment. Later, I learnt that my lack of a good outcome in therapy had more to do with my unwillingness to engage properly with therapy, rather than there being a problem with it. Everywhere I went, I kept being told that I needed to do “the work” to feel better. I resented that because I didn’t want to do any work. That was the reason I came to therapy in the first place – I was struggling to get out of bed in the morning, let alone do anything else. For the longest time, I thought there had to be another way, so I went in and out of therapy trying to find it. Looking back at my own treatment history, I realised that it wouldn’t have mattered where I went, or what kind of help I was offered, if wasn’t prepared to do the necessary work, the changes I was promised wouldn’t come. Managing a client’s expectations is a big part of my job as a therapist. There is only so much that I can do to help with what my clients are willing and ready to do in the time that we have. People can recover from mental health difficulties or else learn to manage them, but the approach is not always quick, and it isn’t always easy. There is no secret answer or hidden technique, nor do we have a magic wand that we can wave to make people’s pain go away in in instant. Recovery looks a lot different compared to what people expect it to look like. The idea that they are the only ones capable of making changes to their life is not pleasant. Nobody wants to save themselves; everybody wants to be saved. But the reality is that we are the magic wand. Therapy is designed to facilitate change in the most manageable way possible. Ultimately, we are the ones who need to bring it about. The changes that I have made to my life have helped me to develop the confidence I need to address my problems head on. I feel better now, but the result that I wanted came after doing the work, not before. If you’re reading this article, I’m hoping that you are more willing and better prepared to make a change to your life at this time than I was back then. If you aren’t that’s okay too. This blog post can still serve a precursor to that moment. By making changes to your life, you too can build confidence, and start to feel better. Formal therapy will provide you with the tools you need to succeed, however, it’s all down to you to apply the techniques you learn in therapy to your life. You are the magic wand.


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