Sunday, 8 April 2018

On Psychological Health & Talking Therapy

Disclaimer: I'm writing the words I would have wanted to read some years ago. I know this will be obvious to some people, but it wasn't to me. Also I apologise if I slip into being too absolute. If you ever feel like I'm telling you what you ought to think or do, please forgive me, it's not what I intend, I just got over excited.

Two years ago I started going to talking therapy (I went for one year). I went privately because I was offered highly targeted, formulaic options on the NHS (eg addiction therapy, cognitive behavioural therapy etc), and I figured that the problem I was trying to overcome was more complex and integral than this set of behaviours or that one. I may have a substance abuse problem, and some people may only have a substance abuse problem, but for a lot of us the problematic behaviours are symptoms of the bigger picture.

My whole life there was something inside myself that I couldn't afford to look at, because I thought I knew there was nothing I could do about it. I had often dreamed about going into therapy, but I never did until two years ago, for two reasons:

1. I wasn't sure there was enough 'wrong' with me to legitimately ask for help
2. Asking for help was fundamentally incompatible with the identity I had drawn up for myself

Poetically enough the two things that prevented me from asking for help were intractable from the problem I needed help with. Like all problems, it was self-supporting as well as self-defeating. It's catch-22. If there's something wrong I ought to solve it myself; and if there's nothing wrong then I don't need help.

I think that my reasons are not uncommon, particularly in people raised as men, in traditionally masculine environments.

This is going to be an ongoing series, but the first thing I want to talk about is making that decision to ask for help, because that's the biggest, hardest step, and I want to support anyone thinking about taking it.

1. I wasn't sure there was enough wrong with me to legitimately ask for help

When I talk about my experiences with therapy, what I hear back most often from other people is, "I've always thought about going, but I don't think my problems are real enough." This is probably more common in people like me lucky enough not to have faced those obviously awful experiences like struggling to feed a family or losing someone unexpectedly. You feel you need help, but because you can't point to One Big Thing, and because you see others in seemingly worse situations, it seems... disingenuous, or even selfish to ask for it.

If that is you then I am going to imagine that you are previous version me and try to talk you out of that way of thinking, in two ways. First I'm going to make a philosophical argument that probably won't work, then I'll tell you what actually worked for me.

The philosophical argument is that we're confusing our real emotional need for support and understanding with a set of contrived physical events considered publicly (ie socially and culturally) to be objectively bad (eg death, physical abuse, divorce etc). In other words, we are trying to reduce how we feel to the events that make us feel that way, and then trying to assess how we feel (and what we need and deserve) based on the events. Where the events are not in the contrived list, the attached emotions are rendered illegitimate (in our heads), and thus the belief that asking for help is selfish and unjustified.

The problem with this way of seeing things is that there's no direct relationship between events and feelings. It is dangerously simplistic to imagine, for instance, that divorce always causes more emotional pain than, say, going to a restaurant for dinner, or being rejected by a friend. Surely it often does, but it depends entirely on the person and the circumstances. It behoves us to remain prescient that our psychological pain is real and legitimate regardless of what caused it.

This can be rather difficult, because it runs against a lot of people's moral instinct, especially those playing the traditional patriarchal, hierarchical morality game. Got hit by a bus? Shit, you must be feeling awful, take a week off work. Too depressed to go to work for no reason you can think of? Get off your lazy ass.

This kind of belittlement usually begins when we're very young, and continues our whole lives. It is both the cause and the outcome of the prevailing moral perspective of our time - the idea that there is a way things ought to be, and that it's our duty to make things more like that. It's an idea that sucks all the colour out of the world, because our feelings and actions are what make the world beautiful, not the problem with it.

When people react in this way - and I suspect we have all done it - it is both an attack and a defence, as well as a cry for help. Let's translate the example I gave, "Get off your lazy ass." It's an attack in the sense that it is trying to frame the target's actions as somehow wrong. The implication is that they ought to get off their ass because their reason is illegitimate. Make the world more like it's supposed to be by being more like other people.

But more importantly it is a counter-attack. It is an attack by the speaker on a part of themselves that they are denying, and thus a defence of the image of themselves which excludes that part. It is what I think of as the Ferris Bueller's Sister phenomenon. Ferris gets away with breaking every rule, his sister doesn't, and she hates him for it. She doesn't get to ditch class, so why ought he? To put it back in the example, 'I don't get to legitimise and express my feelings as a reason to skip work, so why should you?'

There are men (and everyone else, but I think more men) who suffer in relative silence (and sometimes in loud anger) for something like the reasons I've laid out above. I have no interest in quantitatively comparing which arbitrarily defined groups in society suffer most because I don't think there's an answer and certainly not a useful one (we all suffer, it's not a competition), but I know that there is a real and distinct psychological health threat for people who come to believe that their 'advantages' deligitimise their real psychological suffering. Hell, I know people with very few of those 'advantages' who see things the same way. And in the West we are the most 'advantaged' of all (I'm not sure suicide rates tell the same story).

So, let me say clearly: there is nothing that ought or ought not cause you to feel anything at all. All feelings are valid. Or, as David Hume put it 250 years ago, 'It is not contrary to reason to prefer the destruction of the whole world to the scratching of my finger'.

I don't know if reading this some years ago would have helped me. Probably not. It's only words, after all, and we're all expert at finding ways to wrap dangerous words in cages of other words. So, here's how I actually got over it: I approached therapy as an intellectual exercise. I justified going not because I had legitimate problems, but because I'm an intellectually curious person and here was an opportunity to spend money on exploring new ideas. I made it a leisure pursuit, not a cry for help (in fact it was both). You wouldn't feel guilty paying an expert to teach you French. Why would you feel guilty paying an expert to teach you some psychology?

It is rather telling to me of the state of our moral culture that I was unable to justify therapy based on suffering I was experiencing, but quite able based on pleasure that I might receive. 

Next time: More on the reasons I (we) find not to seek help, and why reasons may have nothing to do with the impulse to do so.

If you're considering exploring therapy you can find the NHS page here: . Going private will cost roughly £50 per hour (best money I ever spent bar none) and you can find an accredited counsellor here:

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