World Mental Health Month: Planning to seek help? Here’s how you can prepare to make the move

As discussions on mental health evolve with each passing day and find a space in both, virtual and offline world, ‘therapy' is a word that continues to dominate conversations when it comes to taking charge of our well-being. A series of social, political and personal events affecting people's lives have only encouraged the discourse, leading to increased awareness and acknowledgement of self-care and healing methods.

According to India's National Mental Health Survey 2015-16, nearly 15 per cent Indian adults need active intervention for one or more mental health issues and one in 20 Indians suffers from depression. An impact of the Covid-19 pandemic has aggravated people's well-being and in turn, rendered the mental health lexicon ever expanding in the internet age. From stress, anxiety, breaking down and burning out due to work-life imbalance, people are more open towards speaking about their experiences and taking steps towards self-care. While echoing their sentiments to close ones is the most immediate way to go about, there is also a growing inclination towards seeking professional help. The process to take that first step towards reaching out to a therapist, however, is riddled with doubts and concerns of safety, affordability and results of therapy.

Mid-day Online reached out to Shevantika Nanda, psychologist and co-founder of a mental health application ‘Mimblu', who offers clarity on fundamental questions that concern many individuals who are mulling over seeking professional help for self-care and mental health.

How does one know that it is time to seek professional help?
Nanda: I think every single person can benefit from therapy. One does not need to be in a specific situation, to start therapy. It's not just about sorting that problem, but also on focusing on strengthening your well-being. If one is really struggling, they have to just go and find out. In terms of specific ways, you can ask your friends who've done it before and read people's experiences online, and you can familiarize yourself with what the process looks like, to better prepare for it.

We are in this position in India, where definitely a lot of the stigma and judgment around seeking therapy is changing. One has to actively work towards changing that narrative as well. The idea of a therapy is perceived as something is wrong with you or there's a mental health disorder that you need to address. I think therapy is something that you also do to improve yourself. Or, you know, you may take a yoga class, painting or a singing class or anything else to improve any skill. In this case, also, you're improving the scale of your mental well-being, learning the right tools and techniques to manage your mood, your emotions and very often, also how to be more productive, how to be more creative, and those are all things therapy can help you with. So I think it's about changing that narrative.

How does one prepare for undergoing therapy in terms of what they are looking for? Are there any points they must list out?
Nanda: It depends on how familiar you are with the idea of therapy or not and how much you have sort of equipped yourself with information beforehand. So there are different types of therapists, you may have a therapist who tends to work on a short term period or someone who's more tuned to a long term method. There are also different types of therapy such as there's solution focused therapy, trauma-informed counseling, cognitive behavioral therapy, psychodynamic therapy, person-centered therapy, and all of these follow slightly different approaches.

I think it's also about understanding which one fits best with your needs. So I do encourage that, you know, people read up a little bit about the different schools of thought, just enough that you understand what you're looking for, from your experience.

The other bit of it is of course, talk to your therapist, before setting up an appointment, you know, find out whether they speak in languages that you're comfortable with, whether are queer-affirmative, which is very important and make sure that they also have the experience of dealing with the challenges that you may be facing. It's very important to make sure that your therapist specifically has experience with specific kinds of challenges such as anxiety or obsessive compulsive disorder for example. Not every therapist will have a specialty or, or expertise in every area. And then lastly, I would say be patient, because like with any other relationship, it takes at least two or three sessions to build that rapport with your therapist. I think being patient and having trust in the process is very important.

How do therapists assure one that confidentiality is maintained?
Nanda: As therapists we're all trained to be completely confidential. Some therapists also sign agreements with their client right at the beginning, which also cover the confidentiality clause. And it's a professional thing; it's followed worldwide that a therapist will absolutely not break your confidentiality.

Affordability is one of the major factors which renders mental health a privilege for many. How can it be tackled?
Nanda: So there are different ways to go about it. For example, if I have a client who has lost their job, I may tell them that, okay, it's all right, them to pay a lower rate. And when you get a job, again, we can go back to paying the originally agreed upon price. There are also a lot of therapists who offer a sliding scale, which basically means that they reduce the price for specific clients depending on their affordability. There are also a lot of apps out there, but one must make sure that these apps have qualified therapists.

There are a lot of therapists who work on sliding scales and those who work on a pro bono basis. It depends on you and your needs, but therapy should never be uncomfortable in any way. So if it is feeling like too much of a stretch or becoming a burden, it's important to have this conversation with your counselor or therapist early on.

And is it important to maintain consistency once you start, right?
Nanda: It depends on the therapists and their way of operating. But, regularity does help adding that predictability and a way for you to take out that time for yourself, you know in a week, because ultimately, therapy is a form of self-care, so that you're actively giving yourself that time and space.

You don't lose out on the progress necessarily if you miss a session. It is important to note that if you're only reaching out to your therapist when you have a problem that has a tendency to create dependence on therapy, whereas the end goal of therapy is actually empowerment, not to create dependency. The end goal of therapy is that we equip you with the tools and resources you need to best deal with challenges outside of the therapy and not that you stay dependent on therapy forever.

What is the process involved in termination of therapy?
Nanda: When you stop, there's a whole process that goes on around stopping therapy. Usually, you talk about it with your therapist, and actually plan the termination of therapy, three or four sessions in advance.

This includes looking at the goals of therapy when you started, points that you've achieved so far and talking about a process to slowly taper it down, which may look like you're going to switch from once in two weeks from every week, and then to once every three weeks or once a month. If you've done it with regularity for a while, it can be quite scary to suddenly stop. At the end of the day, it's such a personal and intense relationship and one must give it the attention even as you are getting it to a close.

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