What is a psychological problem?

Basically, when we get tangled up in perceptions (feelings, thinking) and behaviours (coping strategies, reactions, choices) in ways that significantly limit and corrode our lives. Problems can be individual, interpersonal, or even inter-cultural (problems that are a kind of negative dance between people or groups). In contrast, a psychiatric problem is one rooted not so much in how you feel or act, but in the bio-chemical operations of the body and brain.

What is the difference between a psychologist, and a psychiatrist?

Clinical, or Counselling Psychologists analyse psychological problems and treat them through talking therapies, education, and by helping people and organisations to understand & manage psychological factors. Psychiatrists are medical Doctors who diagnose mental health problems (often leaning towards bio-medical factors) and treat them with prescription medications, hospital stays etc.

..and between a psychologist, psychotherapist, a psychoanalyst, and a counsellor?

They are all talking therapists, and there is a great amount of crossover in their approaches. Some general differences are: counselling tends towards emotional support by providing a safe space to talk and be heard (sometimes this is all that is needed); psychologists and psychotherapists also do this, and will likely take a more active role – for example in explaining psychological dynamics, using techniques to bring about positive changes. Psychologists could be called the ‘scientists’ of the mind – they are University trained in the various fields of psychology, each rooted in research and academia – they usually work in universities, clinics and hospitals. Psychotherapists usually have specialised in a particular school of therapy – for example Freudian or Jungian Analysis; Interpersonal Therapy, Gestalt etc (there are over 200!).

How do I know if someone is suitably qualified?

Each profession has a different regulatory body (British Psychological Society; United Kingdom Council for Psychotherapy; and the British Association of Counselling and Psychotherapy). Psychologists should be Chartered with the BPS; Psychotherapists should be registered with the UKCP; Counsellors have two tiers – BACP accredited; and BACP registered.

In addition, they may be registered with The Health and Care Professions Council, a statutory regulator which checks qualifications and police records – usually a prerequisite for working in schools, the NHS and private medicine, social services etc.

How do psychological therapies work?

Well, this is a complicated matter! However, these are the essential factors:

– A safe space to talk, be heard, and think things through. This is quite a rare and special thing. Not being judged – a sustained interest in you and your experiences – trust placed in your innate abilities to find your way forward – a confidential confessional.

– General psycho-education: learning about how the brain works, particularly when it is not working so well: when we are overloaded, depressed, fearful and so on. Understanding and recognising a problem are the first steps to overcoming it, and greatly relieves helplessness and shame.

– Personal, dynamic change: exploring and discovering how your angst came to be – its genesis in the experiences & circumstances of your past, distant and recent. Finding, expressing, and working through strong emotions that were lost & buried – or learning to contain ones that are all too present.

– Devising, testing, and revising better ways of coping – with feelings, people, situations. Working successful strategies into new habits.

– Widening, renewing and renovating your conceptions & perceptions of yourself, others, and the World. Beliefs and rules that grew from past experiences and may have fitted those times, can be limiting and confusing in the present. Particularly so during key stages in life – child-to-adolescent-to-adult; marriage; parenthood; mid-life; late-life. Talking therapy can help this renewal.

How many sessions do I need?

This depends on: what you want to achieve; how long the problems have been going on for; how much of your life they affect. Also some problems lend themselves to self-management fairly quickly (eg phobias), whilst others take a lot of working through (long-term issues to do with self-image, embedded relating styles etc). A feature of CBT is that you can have a few sessions to learn new ways of looking at things and managing life – then put those into practice yourself, and return for more sessions as and when the need arises. Contrast with psychoanalysis – typically 2-3 sessions a week for several years, by the end of which the problems will, hopefully, be resolved as far as reasonably possible.

How often do I need to come?

Once a week for a 50 minute session is the norm, particularly in the early stages. After a while, the sessions can be less frequent – the time in between acting as a ‘lab’ to test out and put into place new coping strategies; the sessions reinforcing and deepening the progress.

What if I feel the sessions are not making a difference?

We should surely talk about that at the time. At times, patience, or more realistic goals are the thing – other times, we may have missed something, or the therapy may not be suitable.