A Guide to Counselling and Therapy
Mental health issues can be complicated and messy. Usually, there isn’t an aspect of our lives that is left unaffected, and we might find it hard to compartmentalise. When struggling, we dig deep to access our resources or lean on our support systems. But sometimes, we might not have resources mobilised or feel underprepared to deal with what’s happening to us. At such times, we turn to external systems that can help. Counselling and therapy is one such system that we can access.
However, the process of accessing counselling and therapy isn’t straightforward, especially in a country like India which is still grappling with the idea of mental health. Stigma and neglect are rampant and further hinder us. There is also a systemic lack of education and awareness on mental health, psychology, emotions, counselling, and therapy. At such times, it might be overwhelming to figure out what counselling and therapy are and find proper support.
This guide hopefully can help. I have tried to provide as much information and details as possible without being overwhelming. The guide is also packed into sections so you can skip the noise and navigate to the topic that you want to explore. If there are any unanswered questions, write to firstname.lastname@example.org. I will do my best to answer but it might take a while. I will also keep updating this guide from time to time.
What is counselling?Counselling is a process where a person facing a personal or psychological issue invites another to form a particular kind of professional relationship that can be helpful. This relationship provides the person with conditions like undivided attention, unconditional acceptance, and confidentiality which might be hard to find in their everyday lives. These conditions can facilitate the client's change processes. As John states, 'Counselling is a cultural invention and a social institution'. It might not be helpful to assume that the client and counsellor are immune to the influences of culture and society. (John McLeod) We often use the terms counselling, therapy, and psychotherapy interchangeably. However, these terms do not always mean the same. Counselling is usually used in a context-based situation - school counselling, corporate counselling, marriage counselling, etc. Therapy and psychotherapy are often used for longer-term work in a specialised setting, or for working with a clinical population. The approaches and techniques, however, are pretty similar with individual variations based on the practitioner and setting. Depending on the context, diagnosis may or may not be a part of the process. The definition provided above is for one-to-one counselling but this is not the only available type. There are other settings where counselling can take place - group counselling, family counselling, etc.
What isn’t counselling?We often tend to attribute counselling and therapy to situations or relationships that may be supportive or healing. For example, I’ve heard many a school teacher or principal say they offer counselling to their students. While their intention may be to help the child through a situation, offering advice or solutions is not counselling. In fact, counsellors try hard to not bring advice or suggestions into the counselling process. Counselling also rarely happens between two people who already share a different kind of relationship. This is because there is a risk that the existing relationship might become confusing and challenging to navigate, with spillage on to shared social circles. Counselling thrives on the fact that there is a stranger who is removed from the client’s immediate circle. This can bring in a sense of safety and anonymity. Starting as strangers also helps clients and counsellors establish a helpful, professional relationship that is individualised and context-based. This is also why counsellors often refuse to work with their friends, family, colleagues, or acquaintances. There is a chance that their existing relationship might become complicated and for the counsellor to bring in their own biases. If a counsellor you know refuses to work with you, do not be offended. It is not because they think you are a difficult person to work with but trying to remain ethical and keeping your best interests at heart.
How is counselling different from talking to a friend/family member/trusted person?Talking to a close friend or trusted person can be really helpful. These are also crucial relationships we need to foster and maintain. However, counselling is a different kind of relationship. While your friend may offer support and comfort, they might not always be trained. A counsellor is a professional who is trained to provide you with a relationship that you can use for your own growth. It might seem like they are just talking to you but there is usually a lot happening beneath the surface that the counsellor is holding on to. One way to think about it and an example I often use with my clients is the idea of a messy room. The client knows they want a clean, organised room but are currently finding it difficult to achieve that. A friend might help clean the room and put things into boxes. However, a counsellor’s motivations are slightly different. They might help you understand why this mess happened, why it is important for you to not have this mess, what it would mean for you to have a clean room, explore what is keeping you from having a clean room, help you build a system of organisation, and execute this system. This way, they help you build the resources to keep the room clean in the future instead of just cleaning the room for you. This way, you can choose to reorganise the room whenever you feel like it, not be afraid of getting it messy again, and manipulate and access individual items in the room. Throughout all of this, they will also try to build emotional awareness by constantly (and sometimes annoyingly) asking you how you are feeling in different ways. The approach a counsellor takes to the process is ideally evidence-based. This means that it has been tested to work with a wide range of people. Their training also lets them personalise the process for every client based on what is working and what isn’t working.