What’s the main problem people present with in therapy?

blackmorevaleApril 24, 20210 Comment0

As a mental health professional and psychotherapist, I’m often asked the above question.

Stress, depression including bi-polar, behavioural disorders, eating disorders, obsessive compulsive disorders, addictions/dependencies, relationship problems, stress, grief and loss are but a few – but the overwhelming one by far is FEAR. Statistically, anxiety and panic are at the top of the list; both of which are forms of fear.

Fear is usually found lurking around when our mental health isn’t good – and it’s an insidious, nasty, annoying and incapacitating thought and feeling. It’s at the root of many mental health disorders – it may or may not be the cause; but it’s nearly always present. Whether it’s fear of being unhappy, alone, unloved, unappreciated, unheard, physically unwell, disliked, unsuccessful, unattractive, isolated, judged and many other insecurities we have – fear can tend to make us think, feel and behave in unhealthy ways.

However, fear is also a basic instinct and emotion; without which humanity probably wouldn’t have survived and thrived. In fact, most living things can become fearful. Fear alerts us to the presence of danger or the threat of harm, whether that danger is physical or psychological. As most know, we tend to react to it with ‘fight, flight or freeze.’

Fight is fairly self-explanatory, flight is run like hell and freeze is the ‘rabbit in the headlights’ or the ‘caught red handed’ syndrome! None of which are comfortable. We’re often advised to ‘face your fear’ – something I don’t advise unless you have professional support. Forcing someone to do something against their will is not only traumatic; it’s against our basic human rights (if we’re fortunate enough to have them).

In therapy we use various therapeutic approaches to combat fear; including exposure therapy and cognitive behavioural therapy to name a couple of common techniques. Another very common fear is the fear of therapy itself! As individuals we’re not great in owning our character defects and shortcomings. Exposing our insecurities, flaws, mistaken beliefs and generally our shadow or dark side is not easy. We tend not to want to go there, or admit we’re fallible; because most have quite fragile self-esteems and our confidence can easily be toppled.

Any suggestion of false-pride or overblown ego is usually met with either denial or defensiveness – as are many mental health problems. So a good therapist needs to have empathy, sympathy, compassion and understanding, plus good skills; so as not to make their clients feel worse. Anxiety is horrible if you’ve not learnt how to control it. The thought of losing control itself can literally be terrifying. Even change is usually not viewed as fun; rather it’s thought of as stressful. HOWEVER, the good news is that anxiety and fear can be successfully treated and living without much of either is incredibly liberating and can totally transform one’s existence – I’ve experienced it in my own life and seen it happen many times to others.

Psychotherapist David Stanton lives near Sherborne.