FAQ

Wellbeing refers to a state of being healthy, happy, and comfortable, both physically and mentally. It encompasses a sense of contentment and satisfaction with your life, and a positive outlook on your personal and professional experiences. It is influenced by a range of factors, including physical health, social relationships, work-life balance, and personal values and beliefs. Maintaining and improving your ‘state of wellness’ is important for overall health and happiness.

Absolutely, yes. There is now over fifty years of research focused on answering this question and the results are definitive. Psychological therapy is capable of producing long term positive outcomes for psychological difficulties and often drastic improvements in quality of life for clients. There are however important factors involved with the success of any therapy.

Evidence-based psychological therapies delivered by skilled, experienced practitioners are an obvious but crucial element of the process, but even in this case does therapy work for everyone? Of course not, and this can be for a variety of reasons, such as;

(a) a weak therapeutic alliance (the bond between the therapist and client may not develop enough to facilitate real progress in therapy),

(b) a mismatch in the therapies the therapist can offer and how the client processes their emotional experiences (in other words the therapist not having the right tools for the job),

(c) client readiness (the timing may just not be right for the person attending therapy),

(d) client motivation (client may only be attending because of pressure from loved ones, or feelings of guilt for being unwell) to name but a few.

BUT even if they appear, these hurdles are surmountable and for the majority of people therapy can deliver significant improvements in both reducing unwanted psychological experiences (e.g. feelings of depression, anxiety and shame, amongst others) whilst simultaneously increasing quality of life and feelings of empowerment. This conclusion is backed up by hundreds, if not thousands of research studies in the evidence base.

Due to it’s importance it is worth reiterating the two conditions under which therapy is generally most effective:

One: When a person finds a skilled counselor who they trust, and with whom they feel comfortable.

Two: When the person seeking therapy is highly motivated to make changes in his or her life.

This is not very different from many other areas of life where one is seeking to make changes. Learning to play a musical instrument, for example, is most likely to lead to success when the student has a good rapport with a skilled music teacher, and is motivated to practice between lessons. Personal training is most effective when one has a good relationship with a knowledgeable trainer, and is diligent in following the exercise program between meetings with the trainer. So too with therapy, a good relationship with the therapist and hard work both during and in between sessions lead to the best outcomes.

Generally, no. It is very rare for therapy to continue even beyond six months. There are exceptions to this, for example psychodynamic psychotherapy can in some instances go on for several years, however most modern therapies tend to be “time-limited” in that they have a set number of sessions in which they expect to see progress for any given psychological presentation.

Of course, each individual is different, as are their needs and level of distress they may be experiencing, so the session requirement may fluctuate somewhat in accordance with this, but on average courses of therapy aim to deliver results in the most efficient and timely manner possible. To give an example, the UK’s National Institute for Clinical Excellence (NICE) recently published new standards and guidance regarding the treatment of depression and recommends approximately 16 sessions of evidence based psychotherapy.

Here at Sanctum, the focus of our practice is on helping individuals accomplish their goals in as short a time as possible. In most cases this is accomplished in months, not years. The exact amount of time, however, varies with each individual (although it is worth adding that in my 15 years of experience there have been less than 5 instances when someone was seen for a year or longer). Two things that are often the biggest determiners of how long therapy lasts include: the severity of the problem being focused upon, and; the number of goals a person decides to tackle. I’ve worked with individuals who have reached their goals within a few weeks. Likewise, I’ve worked with others who decided to continue in therapy for beyond a year (even after reaching their initial goal) because they found the work of therapy so rewarding on an ongoing basis. But again, our objective is to help you succeed as soon as possible while ensuring that the changes we make together will be long-lasting.

This is something that is rarely spoken aloud but often thought, and an unfortunate stigma that still exists in the minds of many. As such, I feel it is important to address both how common and dangerous this perception truly is, because vast numbers of people refrain from seeking the help they need for fear of being seen as ‘weak’ or ‘crazy’ by those around them, ultimately leading to declines in their mental health, quality of life and future ability to seek help.

Breaking this stereotype and mythos around therapy is paramount to the work of any psychologist and therapist, and raising social awareness that “going to therapy ≠ weakness/craziness”.

The idea that attending therapy equates to weakness or craziness  falls apart once one realises that embarking on a therapeutic journey requires tremendous courage and strength on the part of the client. To reach out and accept help is no easy thing to do, and to do it in an instance where you are vulnerable, and likely not at your best, is even more of a testament to the power of will and fortitude it takes to commit to the work required when attending therapy. 

Deciding to attend therapy is best seen as a sign that someone is eager to make positive changes in life, recognizes what has been holding him or her back, and is taking action to move forward. We see examples of this same approach in many other areas of life. For example, imagine someone who is struggling with their weight and needs to get in shape to improve their health – if they hire a personal trainer would this be considered a sign of weakness?

There are many more similar examples that could be given to underscore that going to a therapist is not a sign of weakness. Instead, it is a sign that someone has identified a problem and is determined to find a solution. Determined enough, that they are willing to seek help from others in order to succeed.

This may need to be addressed in two components. Firstly, the laying down on the sofa element.

This is a stereotype that has been perpetuated over the years in media and film. While there actually are some types of therapy in which people can elect to lay down (some psychodynamic or psychoanalytic practitioners encourage this) it certainly is not a requirement, and is something that has never happened in my 15 years of practice!

Secondly, the talking about your childhood element. Talking about your childhood can be an important part of therapy if and when it is directly relevant to how you experience your life in the present. What I mean by this is, all our childhoods dictate how we develop and in turn, how we perceive and navigate the world as we grow up, right up to the present day. This is normal development that happens to all of us, so delving into it in depth during therapy is often not necessary. However, sometimes important events can occur during childhood which leave a lasting impact on how we process and behave as an adult, which can be problematic for us. For example, if someone has a significant loss, or experiences trauma at a young age, these horrible experiences (and the feelings and thoughts associated with them) may continue to directly impact how they cope and navigate life as an adult. In such instances, discussing these childhood events and processing them in therapy can be crucial when figuring out more helpful ways forward in the present.

In summary, therapy can necessitate talking about your childhood where appropriate, but by no means does it exclusively revolve around talking about childhood.

This is another stereotype perpetuated in media. However, it does feature (small) elements of truth.

Many psychologists and therapists do rely on written notes (some rely on audio recordings), and may well use a clipboard. These are often used to make shorthand notes as a record of what was discussed during a session, as well as to make notes of things they may wish to come back to as a client is speaking, so they do not need to interrupt the client in that very moment.

Many therapists also rely on traditional pen and paper when drawing out formulations – little visual illustrations that represent a working understanding of a problem – to share with clients.

All this being said, a good therapist will use their clipboard in a non-intrusive, unobstructive way which should not impact on your feeling of engagement and alliance with the therapist.

Regarding therapists only nodding and saying ‘hmm interesting’ however, it is true that most therapists do their best to avoid being overly talkative and allow for silence for their client to fill. The reason for this approach is that the therapist recognises that the client is the expert in their own experiences, and so it is the therapist’s job to create the space and environment for the client to share these, and to provide gentle encouragement to the client to continue speaking, as well as to indicate that they are listening intently. 

If you ever work with a therapist who remains quiet for unreasonably long periods of time, I suggest you raise this with him, or her. If the therapist responds with a well thought out answer, well and good. If, however, the therapist responds with silence, or by asking you “Does my silence make you uncomfortable?”, I would look for a new therapist. Life is too short.