World Mental Health Day 2022: Clinical psychologists explain what therapy is and how it works

According to the World Health Organization (WHO), 25 percent of the global population will suffer from neurological or mental disorders in their lifetime, and this number continues to grow worldwide. The pandemic and the consequent lockdowns contributed to increased levels of stress and anxiety across age groups. The demographic most affected is children and adolescents, who account for 20 percent of those suffering from mental health conditions as per WHO. The only way ahead to combat the stigma is to spread awareness not only about mental health conditions, but also about solutions such as therapy.

Mental health conditions such as depression and anxiety alter the way individuals lead their lives, impacting work or school performance, as well as interpersonal relationships with friends and family. The largest roadblock that continues to prevent people from seeking assistance is the stigma which surrounds mental health conditions. As per the WHO, nearly two-thirds of people affected by a known mental disorder do not seek help from a health professional.

Each year, the WHO observes May as World Mental Health Awareness Month to initiate conversations among the masses. During this period, we posed common questions around therapy to clinical psychologists Priyanka Varma and Sarika Karnad. Varma, founder of The Thought Co. has over ten years of experience in counselling and psychotherapy, while Karnad, in addition to being a practicing therapist, is also initiating poignant conversations on social media. Below, they answer questions to further our understanding of the process of therapy, and clarify misconceptions.

What is therapy? How is it different from counselling?

Varma: Counselling and therapy are used interchangeably in common language and this is often confusing for the lay person. Theoretically counselling is a space where an individual focuses on a specific concern with very clear goals and direction. It usually involves a few sessions and follows a very direct approach. However, therapy is more intensive, wherein an individual and therapist meet regularly over an extended period of time. While a clear goal is the objective at the beginning of these sessions the process involves deep introspection that facilitates self-awareness. This encourages identification of patterns and the accountability of the individual towards whether they would like to change these patterns and how.

How can we assess if we should see a therapist?

Karnad: If situations in your life cause significant emotional distress, or make you feel like you are struggling with dealing with it alone, it might be a good idea to seek help. If your patterns of sleep, appetite, and exercise have been affected by any event or thing significantly or if it is hard for you to cope with your emotions, it might be a good idea to seek help. But it is also important to note that a lot of people like to come for therapy without a specific reason in mind. The therapeutic space can also be used as a space to talk and feel, that is valid and important too.

How does one choose a therapist?

Varma: It is important to find the right therapist match for you. Most therapists will be open to a small introduction call before starting with a one hour session. Before a first call together, list down all the qualities you want in your therapist. This could be about the kind of concerns you want to work around, their age, education qualifications, or your preference for online or in-person sessions. Make sure you use that time to talk to them and ask all your questions (in the introduction call) before you begin your therapeutic journey. Choosing a therapist is not a science, it is about feeling of comfort, trust and safety. All these feelings may not come gushing in the first conversation or first session, but you will see glimmers of it in your first call. Lastly and most importantly, patience and willingness to understand with openness is the key to choosing a therapist.

How does therapy actually work?

Karnad: Honestly speaking, there is no single (right) answer for how therapy works. It is a unique process that is tailor-made to your individual needs and goals. Here's the thing. The ‘one-size-fits-all' rule does not apply here. Instead, on this journey, you'll uncover thoughts, emotions, and behaviours that are fundamental to the most important person in your life: you. Some of this might be helpful and some might also be unhelpful, but you're at full liberty to shed those if you'd want to.

Your psychologist's goal is not to tell you right from wrong, or make decisions for you, or even be your fortune teller (unfortunately, we aren't a traveling circus). As a psychologist, our goal is to help you uncover yourself and find ways to achieve your goals, so that you can create a shift in your behaviour, emotions, and thoughts, which in turn, creates a positive shift in your life.

How can therapy help?

Varma: Research states that expressing concerns in a safe space has a significant therapeutic effect. Therapy is beneficial for anyone who wants to establish better emotional wellness in their daily life - and this is not limited only to coping with a mental illness but also growing awareness and sense of self. This also does not have to mean that we seek therapy only when we are struggling mentally, a therapeutic space can also just be used for self-improvement, wellbeing, or coping with certain stressors.

While having some goals in mind, therapy can help you explore and understand yourself better. A therapist will enable you to reflect and add more perspective in your lived experiences to understand different relationships, thought patterns or problems better. A lot of people might come to therapy looking for a solution, but this space will give you the freedom to understand yourself better and find the solution independently over a period of time. Whether it's building habits, breaking some, or figuring our stressors out - therapy is a space to explore in whichever direction you like.

In your experience, what can people do to make therapy sessions more effective?

Karnad: Openness and authenticity from the individual and the therapist is the secret to making the most of your hour in therapy. The one hour in therapy is a snippet of the many feelings, and thoughts that plague our mind during the week. Allowing ourselves to authentically express them, in the safety of the space will only enable your therapist to understand your experience and assist you in understanding it better.

It has to be from both ends, as often people may struggle to find the most reflective word for their experience, but if the therapist is actively listening and being authentic they will be able to mirror the individual's feeling and thus aid in zoning in on their experience, create a more empathetic space and thus facilitate awareness.

What is the most common misconception around therapy?

Karnad: A very common myth around therapy is that therapists will be able to fix us. It is important to remember that therapy is not a magical space where all our problems will vanish. It is a journey where we have to explore ourselves and the therapist merely plays the role of the co-passenger. Every therapy session may not feel happy and productive where we get a solution for each of our concerns.

Sometimes it may be like opening up an overflowing, haphazard cupboard and not knowing how to organise our belongings in a manner that makes sense. But that's okay, it's a work in progress. The idea behind therapy is to get the individual in touch with their self-sufficiency so they feel more independent and capable of themselves.

If a therapist approaches the therapy session with the idea of fixing or helping a person then it may cause more harm than good. It may lead the person to be more dependent on the therapist and lose self-confidence, which is not beneficial in the long run. It is important to remember that therapists are humans too, and they are trying to figure themselves out and may go to therapy for the same. They have the training for holding space but no one can fix us except for us.

If you are someone or know someone who has been suffering from mental health issues, know that many conditions can be treated with evidence-based, timely, and low-cost interventions. The link between physical health and mental health illnesses such as depression has been well established. Don't be afraid to seek professional help just like you would for an injury or disease.