It's easy to assume that particular groups of people seek psychotherapy for particular types of problems. Candidates might include the high-flying professional experiencing extreme stress at work; the woman in the throws of a mid-life crisis; the white teenage girl struggling with anorexia. It's often pointed out that therapists themselves tend to be from more affluent backgrounds (often having to fund their own training), and that those from a similar demographic are most likely and able to access their services. Psychotherapy ought not to be the preserve of the few - it is the right of anyone who feels they need it, whatever their background.
Access therefore needs to be made much easier. This is a country where 1 in 4 people experience a mental health problem during their lifetime, 6 out of 10 young people do not receive support for conditions such as anxiety and depression, and over 6000 people per year take their own lives. Clearly, something must be done.
Access to training must also be simplified. When timely access to psychological support (and not just medication) is desperately needed by so many, a dramatic increase in the number of skilled therapists is required.
Aside from these structural concerns, we also need a better social understanding of psychotherapy and its continuing relevance. This involves demystifying ideas we might have about what happens in the consultation room - notions of the exclusive knowledge that may be imparted or the magical ways in which a psychotherapist can make all your problems melt away. There is no mystery to psychotherapy. That is, no mystery beyond the remarkable ability of authentic and compassionate human relationships to bring about therapeutic change.
Prime amongst the myths that persist about psychotherapy are the following;
1) Your psychotherapist will make you feel better
People seek psychotherapy for a number of reasons, generally to come to terms with and work through difficulties in their lives. In this sense, they hope that, through the assistance of the therapist, their difficulties will lessen and they will feel better. However, one of the most annoying preconceptions encountered by people in therapy is how others can often expect them to feel better immediately. "Was it good? Did it help?" are common questions I've been asked after seeing my therapist. People struggle to understand why you might seem more vulnerable - "But you are in therapy!" they say, as though you will have your mental and emotional needs taken care of in an hour each week.
Exploring parts of yourself that you find unacceptable or experiences which are painful isn't exactly a joyride. It can however lead to greater self-awareness as the basis for mindful change. For me, psychotherapy prompted a radical shift in the way I saw myself, helping me to accept and incorporate difficult experiences and understand the way I relate to the world more generally. But this wasn't an easy process that came with a guarantee of measurable results or a clear endpoint where everything would be tied together. Life just isn't that simple.
2) Your psychotherapist will tell you what to do
If you go to psychotherapy seeking definitive explanations or instructions on how to live your life, you will likely be disappointed. Some types of therapy are more directive than others, and approaches such as Cognitive Behavioural Therapy can be extremely prescriptive in the way they tackle problematic thoughts and behaviours. But psychotherapy is not an advice service, or worse, a consultation with a guru privy to esoteric knowledge from an external source. Any mystique is quickly and disappointingly shattered when you realise your psychotherapist is just another human being, albeit with attuned awareness of themselves and others, and a knowledge of particular theories. There's nothing magical about psychotherapy beyond the astonishing capacity of human relationships to be healing, transformational vehicles for change. Through a mutual connection of equals - rather than the deference of the 'broken' party to the superior 'helper' - it may just be that psychotherapy sheds light on resources that are in fact already within the client.
3) Psychotherapy is for people with mental health problems
We must be careful not to subscribe to a narrow idea of psychotherapy as something for mental illness. Psychotherapy is for people experiencing problems with living, as we all do. Perpetuating the idea that therapy is for a certain 'type' of person only potentially disenfranchises others from realising the potential of it being useful for them too. Instead, normalising psychotherapy as something that is practiced in all kinds of ways with all kinds of people sends a message that there is nothing special or 'other' about therapy, just as there is nothing special about experiencing difficulties with our mental health and wellbeing. We all do, whether or not this takes the form of a diagnosable condition.
4) The success of psychotherapy depends on the type of approach used
There are many and varied types of psychotherapy available, but the key ingredient in whether or not therapy will be helpful isn't the type of approach used - it's the quality of the relationship between the client and the therapist. Certain approaches may resonate more with some people than others, but the approach is of little consequence if it doesn't take place within the context of a safe, containing relationship. More than the knowledge and theoretical paradigm of the therapist, it is the qualities they embody such as responsiveness and authenticity that facilitate an alliance with the client without which no psychotherapy can take place. In this sense, the therapist is as important as the therapy.
5) Psychotherapy is unscientific
There's a relentless push in the NHS towards manualised interventions which achieve clinically-measurable results within a short space of time. Talking about longer-term therapeutic relationships often falls on deaf ears, as though there is something inherently unscientific about the mechanism by which supportive relationships themselves bring about change.
We only need to look at attachment research to see that this is simply not true - that our neuroscience is moulded by our early relationships and that, throughout life, our relationships have the capacity to heal just as much as they do to destroy. Just as the stunted growth of the brain in an abused child has potential to recover with later nurturing, perhaps one day research show how our psychoemotional health responds positively to psychotherapeutic relationships on a neurobiological level. In his research into remediating the experiences of trauma through connection with the body and safe relationships with others, Bessel Van Der Kolk points towards interpersonal solutions to complex psychological difficulties, reminding us of how "being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives". This isn't just the case for the 'mentally ill' or traumatised, but is a universal human need, and one that psychotherapy can go some way to meeting.
In this sense, there's nothing special about psychotherapy, nor is it specially reserved for anyone in particular. It is relevant to us all.