In this two-part series, I talk about how I went for therapy for a year, and what actually happens when you get mental health support.
We’ve made an urban legend out of mental help.
In India, especially, we seem to thrive in an environment of secrecy. This cannot be spoken about out loud. Neither can that. Don’t even think about that one!
We all walk around bartering analogies and metaphors when it comes to ‘taboo’ topics. But underneath layers of shame, conditioning, colonial hangovers (yes!), and “Log kya kahenge?” is the reality of mental health.
We can hide it, we can stigmatise it, we can look away when it appears in front of us… but we can’t avoid the fact that it exists.
Mental health is a thing. And like any health, it can suffer. Injuries of the mind, though unseeable, are grievous and destructive. Yet, unseeable is not the same as invisible. We can definitely see the consequences of ignoring mental health issues.
Trust me: I have been to therapy. (You can read about that here.) I know the benefits of ‘going to therapy’.
And having been, I also know what exactly is wrong with the way people talk about it and the lore that surrounds it. Here’s why I believe that the only way out of this dark place is through rewriting the mythology of mental health.
Note: While I have been in therapy, I am not generalising its effects or giving you advice that you should follow.There is no blueprint to mental health. What worked for me might not work for everyone; more so because these are processes tailored to me.
Additionally, my experiences are also impacted by the fact that I have had the privilege of being able to access a good therapist, and have the support of my family to do so. Both of these are not easy to obtain in India.
The Mythology Of Therapy
People have really strange ideas about mental health, and mental health issues.
Either it is thought that it isn’t real, or if its existence is accepted, they think that is akin to madness.
Some also believe that mental health issues are comparable to physical health, and can be ‘cured’. But anyone who has struggled with physical conditions such as diabetes or asthma knows that using words like ‘cure’ is also part of the stigma.
Mental health issues are set off by triggers, like the need to eat is set off by hunger. We can’t control our reflex responses to the things which set us off, but management is real, tangible, possible.
You see, managing mental health isn’t about erasing its issues, because you cannot. It’s about the small stuff, like not feeling nauseous when doing something as small as figuring out your commute when you’ve moved houses. Or watching a depressive episode creeping up on you, but reaching out for help before it settles over your head like a monsoon of nothingness.
‘Cure’ would imply that there is an end point in sight, but there is none, simply because mental health is a non-physical human experience. The lack of a material form makes mental health difficult to pin down, and (no lies) even harder to manage.
But nonetheless, even in the worst of mental health situations, management can be a reality. If it is not a reality, it is because we have not designed our health systems to accommodate it yet.
Instead, cultural obstacles and declining governmental funding keep pushing away the possibility of restructuring and rebuilding these health systems to accommodate, even invite, those who want mental health support.
The mythology of therapy is constructed on the foundation of missing information, and what little information that exists is tampered with to suit the story we want to believe about it.
Psychology Vs Psychotherapy Vs Psychiatry
One of the biggest barriers between understanding and accepting professional mental help is obviously the jargon.
I am sure there are dime-a-million websites giving you basic information on the difference between psychology, psychiatry and psychotherapy. But I have always found them to be focussed on what their qualifications are, rather than how they will help you.
So let me simplify it for you, and tell you what my mental health professional has said.
An umbrella term encompassing a number of different subject areas (social, industrial, educational, etc.). Every psychologist has a Masters or a PhD degree in their field.
Those seeking mental or emotional wellness usually reach out to counseling or clinical psychologists, who have specific training in a hospital setting. You approach them as clients, rather than patients.
They use psychometric tests (personality tests, IQ tests, etc) and honed observation skills to diagnose the issue you are suffering from. The work of a counselor/clinician is to evaluate the individual and provide a diagnosis.
A counselor/clinician is not necessarily trained to provide therapy, in which case their role is concluded by referring you to a psychiatrist (if you have a condition that requires medical intervention) or a psychotherapist (if you require non-medical intervention).
A system of various methodologies wherein personal interactions on a regular schedule are utilised as a medium to identify and unlearn faulty behavioural responses to triggers.
By reconstructing these faulty tendencies (which are, by the way, ‘faulty’ and not ‘your fault’), we can overcome day-to-day barriers which keep us from happiness.
Psychotherapy is centralised around the therapy setting, because it aids in making the unlearning and reconfiguring processes structured. The therapy setting becomes a trigger, a positive one, which helps generate new responses to old triggers.
There are about 330 methodologies in the field of psychotherapy, and while not every counselor/clinician might not be a therapist, it is most likely that a therapist has a Masters or a PhD degree.
A field of trained medical doctors who have completed their MBBS degree, following it up with an MD degree or a diploma in psychiatry.
A psychiatrist is someone you approach as a patient, because they diagnose emotional disturbances as a result of chemical imbalance (again, not to be stigmatised!).
This model is prescription-based, meaning it uses medication as a way to manage a mental health issue. There are a number of different models of therapy which might be used; in extreme cases, they might even use electro-convulsive therapy.
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What to avoid: counsellors without training or degrees; professionals who invalidate certain sections of society; professionals who run industrial mental health units which undermine the sanctity of a therapy setting; professionals who undermine your dignity and autonomy; professionals who avoid retraining and boast about using methods which have not been updated in decades; those who use spiritual jargon to hide a lack of real training and understanding of the subject; etc.
Not everyone needs medical intervention when it comes to mental health issues which occur on a day-to-day basis. Certain chronic mental health issues certainly warrant pharmaceutical support.
But in order to determine whether or not they do, it is necessary to get the diagnosis first.
In fact, it is likely that in some cases, an individual might require both therapeutical as well as medical help; in which case, a psychiatrist and a psychotherapist will have to work together to provide the necessary support.
The first step in your mental health betterment tour has to be understanding it, and I would highly recommend finding a trained professional to do.
By this, I mean that in India, it is not a legal requirement to have a degree or any training to offer counselling services.
Due to this, many ‘counsellors’ in India have taken short courses of barely a year (even less!), and offer their services without any training whatsoever. This is dangerous, because it can lead to more damage than help.
What To Consider Before Going For Therapy
Therapy is a journey that begins well before the first session, or even the first call to book one.
It begins when you recognise that something is problematic, and that it isn’t normal to have to struggle to live on a day-to-day basis, or to be happy. Next, you have to recognise that you need help.
Getting help is not always easy: you need support, at least a little bit of money, acceptance, and the right professional to help you. You also need to stay committed, and not give in to the urge to give up. And the urge will come.
It took a decade for me to go from ‘something is wrong’ to ‘I am in therapy’.
I had let ten years go by the time I started therapy properly; all of them terrible in some way or another. I had been bullied twice in two completely different places, and it destroyed my self-esteem. I hated myself, and it filled me up so much, I ended up hating everyone else too.
A lot of what made me go through the rigmarole of finding the right therapist was the fact that I needed to feel autonomous. Much of what I had been struggling with was a lack of control over my life, and the way in which I responded to my triggers.
Being granted autonomy was a part of the therapy setting that was created for me. It lead seamlessly to the identification of my micro-concerns and the reconstruction of my responses.
In my second session, I received a diagnosis. This is something that not many people realise is liberating. It is freeing to know what ails you, and it really gave me a sense of what I was dealing with.
I worked with my therapist for a year. And what I realised was that while I did have a guided narration through the journey, a lot of the reason I am able to manage my mental health today is because of the work I put in too.
What Did I Learn From The Kind Of Therapy I Went For?
Therapy Is About Healing
My trauma certainly needed soothing. In fact, the reason I call it ‘therapy’ is because the word soothes me. As someone who already has to contend with the burdens of my issues, it helps to have a calming word to fill my mind with.
Therapy is intended to relieve or heal, by definition. To heal means to alleviate, unencumber, recover, mend.
And I was able to heal with therapy. There was no cure, but the management was so helpful, that it didn’t feel like the end of the world at all times.
And now, that the world itself is signalling the end, I feel much more equipped to deal with the mental and emotional fallout.
It’s exactly this that I want to convey when I say we need to rewrite the mythology of therapy. We have designed our societies to seek cures, instead of healing. Watch us currently, as we put all of our hopes of overcoming this pandemic on the near or distant future where a cure exists.
But as I have said, mental health has no cures. And it is certainly one of the most devastating (and silenced) pandemics of our time. The only way to overcome it would be to make healing a central part of our policies around it.
Both curing and healing are important, but healing is about making something feel whole again and curing about eliminating the disease.
Therapy Is About Reaching Out
One of the biggest lessons I learnt is about suffering, those around you will either know or they won’t.
If you know you are suffering, then reach out. If you know someone is suffering, reach out. If you think you might be, reach out. If you think someone might be, reach out.
The thing about reaching out is that it is the start of a dialogue. Whether the dialogue is initiated in relation to yourself or to someone else, everyone benefits from having the conversation.
We can’t rewrite the mythology of mental health when we cannot even fathom rethinking it, in particular within our communities.
Conversations can trigger tectonic shifts in ideas. In my family alone, at least three other people have gone for therapy in the last two years because I did and I spoke about it. These are things we don’t expect as consequences; that if you raise your alarm, then someone else might hear their own.
Last year, a friend told me that he doesn’t go to counselling for any issues, per se. He just feels the need to clear out his mindspace and reconfigure stuff, and counseling helps with that. “It’s like a multivitamin!”, as he proclaimed.
And to me, that is the crux of it all: we need to casualise the value and benefits of mental help in the same way that we have casualised how we belittle and stigmatise it.
It is high time we normalise seeking mental help, do routine check-ups, and check in on those around us. You can do it amidst family, amidst friends, amidst colleagues. In rewriting the mythology, let’s rewrite the application of it as well.
We don’t realise this, but we live out our lives through how we are inside our minds. We need to be kinder to this organ and its capabilities.
And at the end of the day, when it comes to the mythology of therapy, here is the only fragment of truth about it: it is your story to make, but seeking help will never make you less of a hero in your own story.
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