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We are told that 1 in 4 people will develop a mental health issue over their lifetime. That is a lot of us! Celebrities are coming out of the woodwork to share their own stories of struggles with anxiety and depression, and well-being is on the agenda in workplaces, schools, colleges as well as the media.

So if most of us will struggle with our mental health at some point or another, why do we find it so hard to talk about? Why can’t we be open with others about how we are low, down, going to our therapist, taking anti-depressants? Physical health is firmly on the agenda: we complain of headaches, stomach cramps, aches and pains; we openly tell people we have a doctor’s appointment, we are on anti-biotics etc

What’s the difference: Physical health, mental health? Is it that sharing our feelings of vulnerability is intolerable? Do we assume that others will judge us unfavourably for admitting openly what most of us might keep hidden? Do we still see vulnerability as a weakness, rather than just another inevitable trait of being human? In fact mental health and physical health are closely interlinked. When we are physically low, we often don’t feel positive and energised about life. When our mental health is challenged, our physical health is also affected for example through sleep problems, eating problems, drug and alcohol use.

I would like to think that counselling and psychotherapy not only provide a safe place for people to break the loneliness and silence of mental health concerns, but also that the profession can affect the wider culture. Once people feel they have had the chance to share their experiences of anxiety and depression in a therapeutic context, and realise they have not been judged, they may be able to speak about the mental health more openly, encouraging others to do the same. We may finally break the taboo.

What’s awareness got to do with anything? People turn up for therapy because they’re unhappy with an aspect of themselves, their lives, their relationships. They are looking for something to change. Often people show up in the hope that they can change the behaviour of someone else; if only the other person could be different THEN they’d be happy. A lesson quickly learned is that we can never change other people. We can change ourselves and by doing so things (and people) shift around us.
So what is this process of changing oneself?

Cognitive Behavioural Therapy (CBT) focuses on behaviour change through changing habitual (negative) thought patterns. As a client, you will be encouraged to identify the thoughts and belief systems that contribute to your feelings of unhappiness. The thought patterns themselves will be examined and challenged, and you will then find that this alters your behaviour, and you start to feel better about yourself. This is a way of directly confronting ‘the problem’ head on and trying to change it. Makes sense.

Psychoanalytic therapy has more emphasis on tackling deep-seated, unconscious patterns of the client’s inner world which are revealed largely through how they relate to the therapist. These patterns are believed to have developed during childhood, and may well have gone unchallenged into adulthood. Through taking time to explore and understand their inner ‘map’, the client can then begin to make changes.

Other forms of therapy will take a view that a key component of the work is developing awareness, for example awareness of what you are thinking or feeling, how you are behaving, what is going on in your body and how you are relating to others and the environment around you.

Ironically, this attention to awareness is not done in order to change anything, but to highlight what is already there. By the counsellor listening carefully and reflecting back, the client is thereby able to see and understand their life more clearly, including areas where they are not paying attention and have less awareness. This is the real meat of the work, and is surprisingly transformative. Somehow this process activates the client’s resources which will in turn allow growth and change to happen. The counsellor has helped the client to accept who they are and how they are, and this in turn opens up new possibilities.

I see a lot of people in my practice who are in the active phase of parenting young children. This is not an easy time. Tiredness is ever present, and the lack of time and space to process your own experience is a challenge. People say that coming to parenting later in life is in some ways harder; perhaps having less energy than in more youthful years, and the adjustment of having had your own independent life taken away and being replaced with the relentless care needed by young children is not easy.

The possibilities for feeling that you have got it wrong or should have done better are endless with the task of parenting. We are all too aware of how problems in childhood are linked to difficult teenager years, and potential anxiety and depression in adulthood. The thought that as a parent the ‘mistakes’ you make could be creating the seeds of such unhappiness is intolerable. Much harder to step back and congratulate yourself on what is going well, and counter the fear by accepting that you won’t get it all right but it will be good enough.

Coming to therapy at this time might feel a bit self-indulgent and perhaps not the best use of limited time and resources. However, the opportunity to step back for an hour a week and have focused attention on yourself, can provide space to think about how you are with parenting, how you are with yourself, and offer possibilities for reflection and change. It is very tempting to think that giving more and more to others is the way through difficult situations. Sometimes the person you need to give more to is yourself.

I found myself talking to a client the other day, trying to bring attention to the feeling content of an experience, rather than the transactional, common day content. This could be described as ‘emotional texture’. Therapy encourages this kind of self-reflection, and it can take some getting used to when you first come to therapy as a client. So often we forget to look within; the world presents us with a constant array of stimulants and with the digital age we can entertain ourselves 24 hours a day, without a thought to what is going on inside ourselves.

Here comes the BUT…we pay a price for that. Depression and anxiety are prevalent throughout the Western world (and beyond); mental health has now taken over physical health as the main reason why people go ‘off sick’ from work in the UK; loneliness is endemic in society and public welfare services are overwhelmed with demand. Demand for what? For attention. For help. For connection. For an opportunity to start to feel better and more in control of life.

Counselling and therapy are certainly not the panacea for all ills. (Another) BUT they do provide a space in which people can focus on themselves and get to sort out what is working in their life and what isn’t; what is important and what isn’t; where they might be giving themselves a hard time or where they are in some emotional pain.

Attention to emotional texture is an opportunity to not just be pushed around by life. It offers the possiblity to cease operating in ways that are little understood or have become embedded over time with no current life value. It can be painful, scary, feel shameful and exposing, but the rewards are great. We are social creatures. Something in the act of speaking from a place a bit unknown, a bit hidden, a bit invisible to another human being in a trusted and safe space is empowering and potent.