On talking to therapists

One patient to another, we need to talk about how we engage with the people we go to for help. I say one patient (me) to another (others in therapy), but I also include here people who are considering therapy for the first time; those who have tried but did not like it but really should go back; those who need it but just won’t go.

And I really can’t stress enough – and I stress plenty as it is – those who care for someone they see going down the godawful waterslide of mental unwellness. The uncertainty can be worse for onlookers. You, the one suffering, you may have some idea about what feels off. The people who love you do not live inside your head. How much can they know? How much do you let them know? We all need help.

You need to talk to someone about what’s wrong. You do. I can’t think of anyone who does not. I don’t know why it’s not essential, like taking a test before being issued a driving permit. Sure, it’s not going to cover everything – you may pass the test but never again be able to parallel park – but there is some level of confidence that you are fit for purpose.

“You need to talk to someone,” they say. I say it all the time to all sorts of people. A long time ago someone said it to me.

Ok, what do we need to talk about? We need to talk about our pain, that’s got to be the biggest one. No matter how you experience or define it, if you’re in pain, I want you to ask, look, and find help. Don’t just think about doing it.

We also need to talk about grief, maladjustment, fear, obsessions, losing touch with reality, stress, crises of identity and many others ills and ails. For the moment, it’s fine if you’ve been defining those things loosely as opposed to the fine distinctions a trained clinician can make. It’s not usually ok, but if you feel any of those terms are relevant to you, then you know something is wrong and therein lies the start of your journey.

But then, the great stone on which we all stumble: “But how do I say…?” Sometimes we don’t even know what we want to say. It’s a bit like when people go to the doctor and say they have something known in these parts as “bad-feeling.” I used to think this was a thing that our elderly folk said, but now I know it’s more pervasive. Bad-feeling is a real thing.

The most important thing I’ve come to understand about this affliction is that many doctors in Trinidad actually know what the person is talking about. I’ve even heard some very good doctors ask patients who were having trouble describing their symptoms if they had bad-feeling.

But I think we can try to be a little clearer when we go to a therapist. I’ve always found the easiest route to clarity is honesty. In 2015, Matt Blanchard and Barry Farber at Columbia University published: Lying in Psychotherapy: Why and what clients don’t tell their therapist about therapy and their relationship.

Ninety-three per cent of patients (from a survey of over 500) admitted to lying to their therapists. They lie about the things they are actually there to discuss. They lie about how they feel about the therapy and the therapist.

None of that is terribly surprising.

No, the thing that really shook me was the certainty of the study’s premise. Not an “if” but a “what” of deception. It is expected.

But you can find the true words. Go ahead, ask them why you should trust them (the psychologists, psychiatrists, counsellors) with your fragile being. Ask them how they can help. Tell them you’re afraid. This is not only for first sessions; you can do this whenever you want.

Tell them life is too hard and you can’t do it any more and that you want to die. Their job is to listen and support, not to tell you to snap out of it. Tell them who you love and who you stopped loving. Describe the voices in your head or the way the way some images play themselves over and over. Say you’re angry if you are.

I feel: powerless-broken-betrayed-guilty-exhausted-frantic-suspicious-fat-fraudulent-fed up. Say it, whatever it is. Now tell them you want to get better. It’s a start.

Remember to talk to your doctor or therapist if you want to know more about what you read here. In many cases, there’s no single solution or diagnosis to a mental health concern. Many people suffer from more than one condition.