When therapy doesn’t look like therapy

When therapy doesn’t look like therapy

This time 24 hours ago I was on a plane somewhere between Singapore and Melbourne, on the long journey coming back from two weeks away with my family in England.  As I’ve been saying for a few months, for anyone who lives overseas from their family, going ‘back home’ isn’t really a “holiday” because it’s usually associated with lots of visits to family members you only see infrequently and who you only ever have a limited amount of time with before you fly away again.  Today I’ve spent the day unpacking, sorting out the house, the practice, catching up on emails / admin jobs ready for the week back at university and in the practice with clients – anything to resist the waves of exhaustion and jetlag!

While I was away, I spent a lot of time reflecting on what ‘therapy’ means to me.  As I’ve explained before, as a registered, professional Clinical Counsellor and Psychotherapist, with personal (and company) values that are grounded in authenticity and integrity, it matters deeply to me that I practice in evidence-based forms of therapy.  That means a few things.  It means I am:

• Committed to my professional development (and within any 12-month period undertake many hours of training and development in my field)
• Committed to working with modalities (types) of therapy that have been scientifically evaluated (quantitatively and qualitatively) as effective for the sorts of mental health challenges that my clients are struggling with
• Committed to working with clinical supervisors to support my practice, my client’s needs and to essentially ensure that I’m not missing anything
• Committed to working within my professional scope of practice – which means if I am not the best person to support my client and their needs, I either work with someone else who can fill that gap, or I help them find someone better suited to providing that support

Hopefully you can tell that it matters deeply to me that I practice ethically and from a place of transparency about how I work.

There are a few things though that irk me in this space, and I get on my soapbox when I feel people are unhelpfully being misled.  This matters because I believe that good therapy can be transformational and can support the healing needed from the very worst of experiences, but that bad therapy can be very damaging and to my mind is unacceptable.

What even is therapy?

The term therapy has kind of crept into our language here in Australia, I think in part because of the influence of American approaches to psychological support / treatment.  It’s really a shortening of the term psychotherapy. I like this clarification of therapy from my professional body’s website (PACFA – Psychotherapy and Counselling Federation of Australia):

“Therapy is the process of meeting with a counsellor or psychotherapist for the purpose of resolving problematic behaviours, beliefs, feelings, and related physical symptoms. Therapy uses an interpersonal relationship to help develop the client’s self-understanding and to make changes in his or her life.

Although counselling and psychotherapy overlap considerably, there are also recognised differences. While the work of both Counsellors and Psychotherapists with clients may be of considerable depth and length, the focus of Counselling is more likely to be on specific problems, changes in life adjustments and fostering the client’s wellbeing. Psychotherapy is more concerned with the restructuring of the personality or self and the development of insight.”

 (If you’d like a fuller understanding of the key differences between counselling and psychotherapy, click HERE.)

So, Counsellors, Psychotherapists and Psychologists all provide therapy in different ways, depending on a whole range of things like the sorts of modalities that they’ve been trained in (EMDR, DBT, CBT, ACT, Schema Therapy, Narrative Therapy, Play Therapy are all modalities), the kinds of people that they work with and the issues that they are struggling with, and also their own interest field / focus.  It’s super important that not only do you feel connected to the human that is your therapist (do you vibe with them?) but also that they have experience with people who have the same kind of stuff going on as you AND that they use appropriate modalities to work with those issues.  For example, EMDR is a very effective (supported by empirical research) modality to work with event-based trauma. Some modalities e.g., Narrative Therapy aren’t as effective for trauma (but are for other issues).

‘Therapy’ can come in many forms

I believe that ‘therapy’ can come in many forms.  The research I’m conducting for my PhD is looking at how (trauma-informed) physical activity can help support mental health.  I believe that for some people therapy doesn’t work so well sitting on a couch in a room talking through their painful experiences, and that for some people walking in nature and talking is more therapeutic. For others, group spaces – that social connection piece – plays a really therapeutically important role.  I also think that therapy can look like listening to other’s experiences, learning from others and the associated impact of normalising experiences.  Other non-therapy practices / experiences that can be really therapeutic include things like:

• Books / podcast interviews – many of our leading clinicians / researchers have written books directly to regular people (rather than ‘textbooks’ for clinicians) and / or have been interviewed on podcasts
• Ecotherapy – being in nature, sometimes guided and as part of a formalised group, but it can be as simple as going for a walk in a forest or at the beach
• Peer support – working with people who have lived experience or a history of mental health conditions
• Yoga / meditation / breathwork / bodywork / massage – all forms of somatic ‘therapy’

While I was in England, I did some unconventional ‘therapy’ of my own when I went to my old boarding school with my best friend who started boarding the same year as me. It’s something we’ve talked about doing for a little while – to see the school, and the three separate boarding houses we lived at throughout our time there.  For us it felt like an important way of acknowledging our little part’s pain, their trauma and losses.  It was also a way to acknowledge how far we have come, and to finally create a sense of peace for ourselves.  I’m not sure that it would have been as meaningful if I hadn’t done so much actual therapy on my experiences of boarding school, nor if I had gone alone, or without my best friend.

What I really want you to take away from this week’s writing is that therapy needs to be evidence-based to be truly effective, however therapy can take many forms.  Not all of the elements that make therapy effective have been measured enough to be understood properly yet – for example how does physical activity (exercise) actually help our mental health, or how come social connection is so important for some people’s recovery but is somehow less central for others.  The important thing is to find the right therapy, therapist and combination of ‘therapies’ that works best for you.

If you would like to explore whether the kind of therapy we do at Thea Baker Wellbeing, please get in touch with us at: www.theabaker.com.au / hello@theabaker.com.au / 03 9077 8194.