Why do people come to therapy?

People often come to me with two common expectations. Some people relay the story of their life so far, and want it deciphered. Others come with a list of symptoms they want to have removed and are resistant to exposing their personal story.

The first client is inevitably looking for answers to their behavioural patterns (that is, the meaning of their lives) which through psychoeducation can be explained to an extent. The second client can be given homework and in-session exercises to assist reducing symptoms. Both clients are compartmentalising their issues in the same way stigma is apparent in the greater society.

The first client works on the basis that mental health issues are attached to meaning and story-telling. Thereby they approach mental health issues like a English book report in that it is imagined that once they reveal the author’s pervasive themes of why the main character has made the decisions they have that they will be able to move on with their lives. This perpetuates the stereotype that mental health issues are an inherent problem-solving incompetency solved by applied logic. Unfortunately, like many stereotypes this is a distorted truth, hence the success of Cognitive Behaviour Therapy.

The second client either understands that their applied logic will not necessarily solve their mental health issues or that they are entirely avoiding addressing the circumstances that brought them to this point in the first place. Once again, both approaches compartmentalise their issues in a way that reflects common stereotypes in the wider community.

Remember that stereotypes are an efficient way of addressing life. They are used every day, by everyone because if you were constantly engaging fully with every choice in life you would either have to live in a yurt, or become utterly hypervigilant which brings another host of mental health issues on their own.

I believe the most effective way of addressing the stigma toward mental health and toward engaging fully with services such as my own is by having the wider society understand the context of mental health issues. That we have to be at ease with the fact that we’re going to walk away from this talk tonight better informed, but with an infinite array of further questions. We need to see that a diagnosis is not a complete picture of a person, or is ever going to be a way of flawlessly predicting their behaviour like in The Minority Report but an efficient way of bringing a client the correct therapy or medication. Your brain forms according to your genetic inheritance and in response to your development, in some diagnoses one seems more influential on how a mental health problem manifests than the other.

All of these statements regard the issue of context. Stigma arises when we get lazy and in this case find it impossible to compartmentalise neatly how mental health issues affect different individuals. It is possible you will need to simultaneously blame your parents, society, and yourself at the same time. Meaning you are better off listening to metal than being into punk.

Medical treatment can greatly improve your life and symptoms, as can therapy but it is not a silver bullet that will mean you will fit in with society, get a great job or indeed have your symptoms magically disappear.