Some people, in fact a huge amount of people, will tell you that for them, counselling doesn’t work.
** This doesn’t mean by the way if you haven’t tried counselling that you shouldn’t, far from it, some counselling is certainly among the most effective means we have to combat depression **
Come on though, why do so many people say so definitively that counselling does not work for them then?
The answer is actually somewhat quite simple. First off, counselling is as we know, a very scant resource. This means at best in the UK, someone referred to mental health services might (and this is a big might), be lucky to get some sort of regular counselling for a while. So, for the sake of argument, let’s say best case you might end up getting one hour of counselling, a week, for a few months.
At this point I can hear many people saying “yeah right, you’ll be lucky to get that!”, and unfortunately they’d be completely correct. BUT, even if you could get that amount and regularity of counselling, will it really help you? Well, what are they going to have to achieve during this short amount of contact with you is certainly a lot!
Let’s list a few things that this counselling will have to aim to achieve if it’s going to work…
- First it is going to need trust and comfort to build up between you and the counsellor. Let’s face it, this can take a while. Some of us are very reluctant to open up.
- It’s going to need to be engaging, to hold your attention, and to peak your interest, to get you invested in it.
- It’s going to need to someone to establish how you experience life, how things change through time for you, what’s worked and not worked for you, to get a reasonably good picture of your situation.
- It’s going to have you buy into it even to have a chance.
- It will mean spending each of the hour long sessions going over what’s happened since the last hour session, as well as reviewing how any suggestions from the week before have gone, so that’s more time gone.
- It’s going to have to provide solutions that work, that you can feel the results of, otherwise you’ll dismiss it and become unengaged.
- It’s going to have to work whatever you feel like each week, the timing of sessions might not suit you, perhaps you’re not in the mood at the time, coinciding with a time when you’re not receptive, preoccupied, too stressed.
- …it has got a hell of a lot to achieve, and the odds are stacked against it…
So, counselling has got a lot to achieve in that one hour a week hasn’t it? …and in the end, what is its goal anyway? It won’t be what you might like in an ideal world which would be for it to rid you of depression.
When you ask people who have decided counselling didn’t work for them you’ll hear a lot of “well, it sort of helped, but not really” and “it didn’t really fix anything”. Why would they say this? Probably because they are simply being honest.
Depression is an intense experience right? It can be utterly consuming, eating every second of your waking hours, and when you compare this to the one hour that you get with a counsellor it is obvious that the counselling experience for many seems like a ‘sticky plaster’, which whilst it might be a nice sticky plaster (yes, it can be good just to talk) it so often turns out at best a sticky plaster that falls off a little while after you leave.
The odds against counselling working are so high, due to its scant resource, will always be a primary reason why it does not work for so many people, and this is way way way more of a reason than any of the actual content delivered during the counselling, some of which can be very useful, there’s no guarantee that even this won’t be missed due to the delivery of a particular counsellor.
There’s good news though, as there are other ways forward.
In the next post… we’ll look at the content delivered in the counselling, and some of the genuinely valuable principles of common counselling like CBT. (Cognitive Behavioural Therapy). We’ll begin to shed some light on what can potentially work very well indeed, which doesn’t dismiss some of the sound principles, but builds on them, picking things that work.