The ‘C’ Word

Warning: This blog post contains many sweeping generalisations about a topic that I barely understand at all. Take everything that sounds remotely convincing with a pinch of salt the size of a tablespoon.

I want to start this post off with a confession: I really don’t know anything about counselling. My workplace offered counselling as a free benefit. I got 6 sessions paid for me under the scheme. You may not be aware, dear reader, but I’ve had a spot of difficulty recently in my life. In response to this difficulty, I decided to utilise this work benefit to see how it could benefit me. Work hasn’t been paying me for months anyway, so I need to find something useful about still having a contract with them. Financial well-being certainly isn’t one of the current benefits on offer…neither is general support in the face of a life-changing cancer diagnosis, but I digress.

Now, I’m not totally sure about this, but I’m pretty sure counselling and therapy are quite different things. How they differ, I’m also not sure. Luckily, like most of the users on Twitter who decide to engage in arguments over complex issues, I’m going to read a single article on the internet on the differences and will then consider myself an expert.

Apparently, the differences between psychotherapy and counselling depend largely on how the two disciplines are treated in the country in question. Here, in the United Kingdom, they overlap a lot, as you can see by the name of one of the two professional accrediting bodies in the field – the British Association for Counsellors and Psychotherapists (BACP). That makes me feel better and less like an uneducated idiot for now knowing, although my original claim that they are ‘quite different things’ seems to be incorrect. It’s ok to be a little wrong in the pursuit of bettering your knowledge.

Both psychotherapy and counselling are types of talking therapy to help you deal with issues in your life. The accredited professional is trained to listen to the things you say and assist you in exploring them further to reveal deeper truths about your behaviours, and the wider impact they may be having. This is achieved by discussing things, such as events that have troubled you and emotions that you have been feeling in relation to those events. Of course, this is a far more complex process than I’m making it sound here. I’m trying to boil it down to its core elements but am sure that becoming qualified to do this requires an individual to be trained in many complex theories, studies and techniques.

Any subject which requires you to understand human behaviour is complex in my opinion. We are all so different; sometimes in subtle ways, sometimes in glaringly obvious ways. Whenever we are required to deal with people it is a mini study of human behaviour. The better you are at analysing and responding to others’ behaviour, the easier your life will be. For example, imagine you are working as a cashier in a supermarket. A customer may be short-tempered with you as you take your time scanning their items – you’re there for another 5 hours, so aren’t in a rush. “Could you hurry up!” They may snap at you. You may be offended, but you may also then notice that they have two young children with them who are crying. Perhaps you then realise that it was them that you overheard on the phone whilst you were serving another customer in what sounded like a tense call. You may then decide that you will not react badly to their behaviour as you recognise that they are stressed and struggling. Your better emotional intelligence benefits you both in this situation; you don’t dwell so long on how they were rude to you, or make a comment back which escalates the situation, and they may recognise that they were taking out their frustrations on you, leading to an apology. The stakes are much lower than if you are a therapist/counsellor dealing with a client, though. Most jobs are not directly trying to identify, tackle and transform behaviours like a counsellor/therapist is tasked with. That makes their job difficult and what works for one person may not work for another, despite the core issues being very similar. I imagine it requires a huge amount of natural emotional intelligence and empathy, alongside a cool grasp of the learnt knowledge, to be successful.

According to the website I used, a common difference between the two fields is that psychotherapy will evaluate these things based on both present and past experience, whereas counselling focuses more on current experience. From my experience of counselling, I can attest to that fact as we spoke primarily of current experience. That isn’t to say I couldn’t speak about things that have happened in my past, but they would usually come up during a discussion about what is currently going on in my life. We did not spend large amounts of time trawling through my past, discussing long-standing trends in my behaviour and how they may still be impacting me today. I can see why this would be beneficial, and I would be interested to seek a psychotherapist at some point to try it, but I’m not in a financial position to do so currently.

Under the scheme, I was only entitled to 6 hours of counselling for free. My counsellor was lovely and offered to do more sessions after saying “we’ve probably cut a few sessions short, so we can meet another few times if you like.” I told her that we’d need to cut it off at some time so now is as good as any. She seemed to feel guilty that I’m in the middle of a stressful point of my cancer journey, waiting to hear from the surgeons as to whether they can remove my tumour, or if some other outcome has been decided. My counsellor had been through cancer treatment a few years ago, which meant she was extra sympathetic to my situation. I’m sure it is why she was recommended to me by the company running the scheme.

Overall, I did find the counselling helpful. The website I was using to research the differences between psychotherapy and counselling stated that counselling is usually done in periods of 12 – 24 hours, broken into hour-long sessions. I can certainly see why a longer period than six hours is recommended. In the first few sessions, you are establishing a relationship with your counsellor. They’re figuring out what makes you tick and you’re figuring out how emotionally broken they think you are. It’s hard to be truly open and honest with a stranger. We have a ‘figuring out’ phase with most people we meet, especially when that person wants to delve into the most traumatising and volatile parts of our life. Trusting this random professional enough to open up is an important part of the process.

Knowing myself quite well after 29 years of being stuck in my own head, I firmly believe that I am good at establishing rapport with people fairly quickly. Especially so when that person is a softly spoken Scottish woman in her mid-sixties… I could listen to her speak all day, but our paths did not cross for that purpose. She was destined to sit through my monotonous grumblings about how sad I am that I’ve got cancer. If that’s what she was expecting, I may have disappointed her a bit.

The thing is, I have a close-knit group of friends, a lot of which I truly feel I can talk to about anything, no matter how dark and disturbing it may be. My family are extremely supportive and many of them speak to me regularly about how I am. My fiancée is a beacon of positivity who always makes me laugh. Luke, my best friend and best man at my wedding, is also one of the funniest people I know; he’s always a message away, and we speak regularly on the phone. I’ve even got the cutest puppy in the world keeping me company. My support network is really strong and I’m incredibly lucky. I’ve always known it but it has been proven true beyond any doubt since I was diagnosed. Having that strong network makes a huge difference in how I cope with the things that are happening to me. I’m not saying that I didn’t need the counselling, but it took me a while to feel any benefit from it if I’m honest.

On top of my solid support network, I feel that I’m quite an open person. I’ve read accounts of others who were diagnosed with cancer and their immediate reaction was to hide it from everyone. Some of them state that they didn’t tell anyone for years, including their own family in some cases. For better or for worse, I will speak to anyone about my cancer. That doesn’t mean I believe this to be the better option of the two. Everyone is different and will process it however they see fit. For me, being open about it helps me process it. That in itself is therapeutic for me, just as continuing on with life as if nothing has changed may be therapeutic for others.

In the context of counselling specifically, my support network and openness allow me to regularly dig into my issues outside of these sessions. During the sessions I was never deeply upset, crying or having a huge realisation about my life based on the conversations we were having. In fact, I spent a lot of the session digging into the tough aspects of things going on but found a lot of humour in them. That may be a defence mechanism, but I truly didn’t feel sad a lot of the time during these periods. Only in a few sessions did I feel myself getting more animated and emotional. I remember getting annoyed when we spoke about my employer and how they have dealt with my diagnosis, and another time I felt very sad when discussing how my diagnosis has affected those around me. Both of these things came in sessions 5 and 6, so I think there’s an argument to be made that I was only just making headway when the benefit ran out. They were also just after key events had happened involving those things. Those sessions were the ones that made me think the most. My counsellor did offer a very valuable perspective, especially on the work issue. I think that was where I realised that she had helped me in a truly unique way that others around me probably wouldn’t have.

As I attended more sessions with my counsellor, I could feel myself relax more and I was speaking more openly and honestly about my behaviours. Speaking to someone who you do not encounter in any other contexts in your life, and who encourages you to dig into whatever is bothering you that week, brings many benefits, even if it takes some time to feel comfortable enough to be that open with them. You realise that they are not there to judge you, whereas your friends and family may judge you; even where you think you aren’t bothered that they may judge you, it can impact how you relay a series of events or cause you to soften the intimate details of the story to make yourself sound better. It is especially true with people you know well, as you also understand what they are likely to judge you more for. You may pander to their personality more than you even admit to yourself. It may be a key part of your therapy to identify that you do that, and try to understand why; inside that answer may be a hidden truth about you and how you cope with the world. Having a completely independent person to talk to was the most beneficial part of counselling for me, but unfortunately, this only became obvious to me in the final two or three sessions.

I know a few friends who are open about the fact that they attend therapy, or who have discussed needing therapy in the past for various issues. None of them have discussed specifics about their motivations for seeking it with me and I haven’t asked for reasons why. It is irrelevant to me really. When they have told me that they are either currently in therapy or have had it in the past, I’ve always just asked if it has helped them. All of them have been complimentary about it, once they have found the right therapist for them. This seems to be the key to success. I’ve heard a few stories about struggling to find one that felt ‘right’.

If you are looking for therapy or counselling on your own terms, not through a company scheme where they provide you with the options based on some criteria that you have provided, I imagine selecting the right person is extremely important. Fortunately for me, it was taken out of my hands. It’s probably also easier to find a therapist if your primary reason for seeking help is because you are dealing with cancer. Not that it means the professional you are matched with will definitely be right for you, but there’s a clear and definable ground to seek help on. If, for example, you are seeking help because you are struggling to maintain relationships, this may be down to a multitude of reasons. That means you may approach a person because it sounds like they have the right experience and skills to help you, but over time you don’t feel your relationships improving. There is another facet of finding the right therapist, though, which is based far more on personality and behaviour.

As I stated earlier, we as humans are always trying to work each other out. From the second we meet someone we start looking for evidence of what this person’s motivations are in the world. Figuring that out tells us a lot about an individual. We do this by analysing mannerisms, body language, the things they say, how they react to situations and how their behaviour changes. Sometimes we meet people and instantly feel a connection with them, but the opposite situation happens too. Within seconds of meeting someone, we may feel suspicious of them or find ourselves responding to them in a defensive manner. If we don’t get on with the professional we’re paying to help identify and tackle our deepest, darkest behaviours, how do we expect to improve? It removes many of the motivations that we have to tell the truth, open up and trust what that person says. You should not be fearing attending the sessions because you don’t like the person you’re paying to see; it’ll lead to you resenting them, among other negative feelings.

I would assume that the contrary situation is possible too, although I’ve never heard about it happening to anyone I know. If we rely on them too much, or respect them to a level that we feel that we care what they think of us just like another friend, we may start to lie to not give as bad an impression of ourselves. In the same way that we can’t admit all of our negative traits to friends and family, we’d cover up the realities to paint ourselves in a better light. ‘White lies’ is a term used for little, seemingly inconsequential lies that we tell in our day to day lives. We didn’t seek therapy to tell white lies though, and they may be damaging to our objective of bettering ourselves. Ending up in this situation may actually speak to some of the issues that you have, as it shows that you aren’t abiding by the tacit agreement of the situation.

Of course, the reverse situation may occur too, where you feel that the relationship becomes inappropriate due to the professional’s behaviour. It is worrying to think of a professional abusing their power in a situation with someone who is vulnerable. A good case of it is spoken about by James Acaster, a comedian from the UK, in his standup show ‘Cold Lasagne Hate Myself 1999’. This masterful routine manages to be very funny yet incredibly sad, honest and vulnerable. Over the two parts, he establishes a lot of issues that he was been dealing with in his life. They include a dispute with his manager, dealing with various breakups, and his ex leaving him for Rowan Atkinson, a comedian who is well known across the world and plays Mr Bean… Yes, you read that last one correctly. It’s worth watching just to learn about that as it really is unbelievable. Towards the end, he discusses how he sought the help of a therapist. The relationship turns inappropriate, with the therapist even using some of the issues they identified in his behaviour against him, but I won’t give any more spoilers away about the details. Luckily, James identified that this behaviour was inappropriate and decided that he needed to break the relationship with her, something that was very difficult for him.

That is probably why so many people do struggle to open themselves up to others – it leaves you vulnerable. By opening up, you are providing others with a means of taking advantage of you, perhaps even manipulating you in some way. Whether that be because you have shared private information with them that you don’t want others to find out, or because you opened up about parts of your personality that they may use to their advantage, by preying on those aspects of it for their own gain. You really have to trust someone to be confident in sharing the most intimate details of your life. Sometimes the barriers to sharing openly are because of your background; you may have been brought up by parents that saw sharing emotions as weak, or who were just not very emotional people. It may be difficult for you to even identify that you have a certain problem and only realise it when you see trends in what others say to you about your behaviour. We’re also often busy and expect some form of hardship in our lives – these ‘flaws’ may be seen as minor compared to other issues going on in the world, so you accept them and don’t attempt to improve them, despite them bothering you and making you very unhappy.

Perhaps that is why a friend of mine who studies psychotherapy once told me that everyone would benefit from some therapy. I tend to agree after my short stint with it (I’m using ‘psychotherapy’ synonymously with counselling now – get over it). Hopefully, it won’t be my last experience of it. I’m sure seeking a therapist is a difficult process, but I can see it being very gratifying when you find one that really works for you. Although my councillor was great for me, I’d want to try someone else if I decided to use my own money on it. I’d be keen to find a therapist who would be interested in delving into more than just the cancer, which mine would have, but we only had 6 sessions and that was normally the primary thing on my mind. My good friend Benedict said that he is really proud of how I am dealing with my cancer diagnosis last week, pointing out that a few years ago he doesn’t think I would have dealt with it this well. I tend to agree with him. I’d love to discuss it further with a therapist, going through things that happened to me that caused me to change. There are plenty of theories I have about it all – it would be interesting to get into it with someone who is trained to listen and see what they threw back at me. I feel like I am quite an introspective person, but there are a lot of things that annoy me about myself. It would be great to say that sentence to a therapist. I’m sure that their eyes would light up and they’d start licking their lips as they say “Well, where shall we begin.”