Counselling and psychotherapy

Psychotherapy and counselling are talking therapies, based on the assumption that talking and reflecting about our own thoughts, emotions and experiences are powerful tools to feel better and change. In particular, the role of emotions is fundamental in our daily life and too often they are not considered, mistreated, denied or swallowed. Emotions on the contrary are our own individual compass that indicates how well we are dealing with our life and our goals. Paying attention and taking care of them is a way of assuring a balanced and mindful psychological life.

Emotions’ psycho-education

In cognitive behavioural psychotherapy and in counselling, if the patient happens to be confused, overwhelmed or simply not used to pay attention to emotions, one of the first steps in therapy is acknowledging them. This process is called “emotions’ psycho-education” and it implies getting to know each of our emotions, their role, aim and physiological activation in order to discover how our mind is functioning. This usually works by monitoring everyday our affective reactions and discovering which thoughts and goals are related. Therefore recognising and labelling the emotions we perceive is the prerequisite for regulating them in a healthy way. 

What scientific research is telling us?

Despite being a technique that has been used since the birth of counselling (and even earlier), it is only in recent times that scientific research has found the biological proofs of the powerful effect of labelling emotions. A research carried out by Lieberman et al. in 2007 clearly showed that affect labelling impacts the functioning of specific areas of our brain that are responsible for emotions’ processing and regulation. Specifically, translating feelings into words decreases the activation of a little region of our brain, the amygdala, that is responsible for automatic emotions activation.

On the contrary, affect labelling seems to increase the activity of a specific region of our pre-frontal cortex (the right ventrolateral area) that is responsible for a high-level processing of emotional information. A decrease of the amygdala’s activity and an increase of that specific aerea of the pre-frontal cortex help alleviating emotional distress.

If you find yourself in a period of strong emotional distress, you may consider talking it through in psychotherapy or counselling; talking therapies are an useful tool to better understand what is going on and to find different strategies to better deal with it.

References:

Lieberman M.D, et al., “Putting feelings into words: affect labelling disrupts amygdala’s activity in response to affective stimuli”; Psychol Sci. 2007 May 18(5):421-8.

First session in psychotherapy

Deciding to start psychotherapy or counselling can bring forth questions and doubts. Above all, most questions permeate in the first session, which is always laden with great expectancy.

Questions like ‘What should I say?’, ‘Should I open up to my therapist straight away?’, ‘Will I feel comfortable speaking to my therapist?’, ‘How can I tell if my counsellor is the right one for me?’, ‘What should I expect from my first session of therapy?’ and so on may arise.

Let’s examine these questions.

Questions and doubts

What should I say? 

Usually the first session is a preliminary consultation that helps both therapist and client introduce each other and see if common ground is found for further collaboration. As the therapeutical process begins during the first interactions in the initial session, the therapist will gather information about the client and the specific reasons that brought them to ask for help. The first session is crucial to the patient too, as they will eventually decide whether the counsellor is a good fit for them.

The therapist will usually guide the client through a series open-ended questions to assess their situation.

Should I open up to my therapist straight away?

There is no straightforward answer to this question as we all tend to follow our own instinct. For example, some try out therapy with a clear idea of their issues while others may feel confused and overwhelmed at the idea of pinpointing their case. Others may have mixed feelings about it and may experience troubles connecting all the dots when outlining their complex inner picture.

Some aspects of our suffering can elicit intense shame or guilt and therefore, building and establishing trust with a therapist has to be an essential prerequisite for opening up.

Some people find it quite easy to open up and talk comfortably from the beginning whereas others may find it tricky as they require more time and trust.

Will I feel comfortable speaking to the therapist? 

Therapists and counsellors are trained to work and help people with psychological issues. They are able to create a comfortable and non-judgmental setting showing an active-listening attitude.

Obviously, each therapist differs from another in personality and type of training, so each counsellor will adopt a slightly different approach to the client. Also, we all have personal preferences when it comes to people.

Some clients prefer a straightforward and direct attitude, others may opt for a female therapist as opposed to a male therapist or vice-versa, or look for a therapist from a specific country or of a specific age.

How can I tell if the therapist is the right one for me? 

The impression you will get from the first consultation will determine whether you want to embark upon the therapeutic journey with that specific therapist.

Beyond the therapist’s qualifications and specialism, the match for you will make you feel comfortable enough to open up by giving you food for thought.

What should I expect? 

From a first session you may expect to start thinking about the reasons that brought you to counselling in the first place, as well as the causes and consequences related to what you regard to as an issue, along with your expectations and ultimately, motivation. Will may expect a welcoming, non-judgemental and confidential setting where you will feel comfortable about expressing your troubles.

But above all, the first consultation will give you interesting insight into the world of psychotherapy as a tool to provide you with a new perspective on and solutions to a particular issue.

Young adults and mental health

Several psychological disorders tend to manifest and strengthen between the end of adolescence and the beginning of adulthood.

In particular, mood disorders have an average age of onset of 25. Conversely, anxiety disorders have a more variable onset: some of them appear fairly early in life, as separation anxiety or specific phobias that tend to manifest during childhood, while others, such as social phobia, obsessive compulsive disorder and panic disorder tend to appear slightly afterwards, during adolescence and early adulthood.

Scientific research has shown that people suffering from a mental disorder usually tend to wait for a long time before seeking help. Sometimes months or even years may elapse without asking for help or a professional like a psychologist, a psychotherapist or a psychiatrist for assistance.

Why does this happen? 

Many reasons may contribute to the avoidance of counselling and the delay of seeking help. Hesitancy and uncertainty about asking for help are often attributable to feelings of guilt and shame. Seeking assistance is not easy for most people as the society we live in today expects us to always be at our best. The act of acknowledging a problem may be perceived as a sign of weakness and vulnerability, hence the fear of exposure and loss of social standing.

We may also think that what we are experiencing is but fleeting symptoms of a transient condition that might well disappear in time. Luckily enough, sometimes this is actually the case and the symptoms will simply and naturally dissolve, whereas some other times, signs and symptoms may lead to an actual mental disorder. In the latter case, it is very likely that the chronicity and severity of symptoms, as well as the consequences that they may cause in our daily life, may be affected and worsened by lack of treatment in individuals with strong help-seeking barriers.

If you experience psychological symptoms that make you feel as something were off, talking to a professional therapist is strongly recommended as a counsellor may help you understand the cause and the severity of the situation and, if necessary, point you in the right direction and towards the best psychological approach to tackle the issue.

If the onset of a mental health condition manifests during adolescence and early adulthood, hesitancy in seeking help may be particularly counterproductive for young adults as in this case it implies an even more delicate scenario.

Why is it important for young adults to seek help? 

The first years of adulthood are a window to our future dotted by several remarkable decisions and events such as diplomas and university degrees, our first job, stable relationships with friends and a partner. Some of us will also start a new family.

While we are young adults, we strive to envision the direction our life will take. Our very attitude towards life and the choices we make will inevitably influence it in the long term, much more than we can imagine.

At such an important and delicate moment, suffering from an untreated disorder may dramatically impact on our future. Mental health clearly can affect how we relate to other people and the social environment we build around us, as well as how we focus on and effectively engage ourselves in study or work-related goals and achievements.

This is why it is so important for young adults not to be afraid to acknowledge any psychological difficulties and not to lock the door to their inner world, but instead open up and ask for help to better understand what’s going on and finally allow a change.