Therapy: Go If You Can, Go When You Can

(Originally published in The Quint on August 1)

If you're like me, you may have wondered if therapy was for you. Until I finally started seeing a therapist last year, I thought about it many, many times. One thing I've learned (and I've learned a lot; that's kind of the point) is that deciding whether to go for therapy is like deciding if you need to pee. If you're a normal human being who's made it this far in this complex, strange world, you probably need to. If you're asking yourself if you really need to, you probably do. You can hold it all in and deal with it later, but has any good ever come of that?

The way I see it, therapy is where you present your therapist the tangled mess of your thoughts and feelings. They can't untangle this mess for you, but they'll help you draw the answers out of yourself, holding your hand the entire time. Over the weeks, you'll keep untangling sections, and you'll have to work hard not to let them go back to the way they were. After all, the process is about sustaining as much as it is about repairing. At some points, the ends will come free, and you will try to keep them as sorted as possible in the time to come.

So my two cents about therapy: go if you can, and go when you can.

The big "if"

I say "go if you can" because therapy can feel inaccessible. While mental health is becoming part of mainstream conversation in India, it still isn't widely understood or accepted. Apart from a small minority of urban, socially-mobile, economically-privileged sections who are exposed to discourse around mental health, many people harbour misconceptions. Here are a few I see frequently:

"Therapy is a quick fix." This is far from the truth. Therapy takes time. An issue that seems straight-forward might stem from tangential, deep-rooted factors that need to be unpacked. In the case of anxiety, for example, you can't just figure out a coping mechanism and leave it at that. You have to uncover years of thought patterns to address them meaningfully. That can't happen overnight.

"You have to be seriously suffering to justify going for therapy." The spectrum of diagnosed mental illness is diverse. Some people face significant difficulties because of unconducive environments and trauma (past and present). Others equate therapy with personal development or spirituality courses. They may want an outside perspective to help them reflect, perform forensics on their thoughts and behaviours, and ultimately lead more fulfilling lives. Therapy is for everyone who is on this continuum and also for everyone who isn’t.

"Mental illness is a modern problem." Mental illness has always existed. A favourite line among Boomers is: "Things were easier in the past. We were happier and never even knew what depression and anxiety meant." This is a classic case of rosy retrospection — the fading of negative memories over time. But when you ask a grandparent about their younger years, it's clear they experienced pain, heartbreak, depression, and anxiety. Their cultural context may have discouraged them from expressing and addressing these feelings. Instead, they were forced to cope silently (and unhealthily), leaving them with long-lasting emotional scars. Mental illness isn't new. We're just finally finding ways to talk about it.

"Mental illness is caused by dysfunctional and/or nuclear families." Many people believe that if a person's family unit were strong enough, they wouldn't need therapy in the first place. I understand why this is a tempting belief. Family is powerful, and countless studies suggest that positive social networks help us live longer, better lives. In traditional joint family setups (the norm for most of South Asia), relatives lean on each other for support with finances, child-rearing, and elderly care, among other things. So it makes sense that in this setup, a person might believe that a family member's mental health was also their responsibility.

But again, this isn't true. Family can't be a stand-in for therapy. Our historical patterns of interaction with family – no matter how functional and loving – sometimes lay the blueprints for the maladaptive behaviours and thoughts that eventually bring us to therapy. Also, therapy has to come from outside. Just as no parent would insist on performing surgery on their child, they can't provide unbiased, objective counselling either. Therapy can only work with someone you're not close to because a therapeutic relationship doesn't have the element of "Enough about me, how are you?" that should exist in any other relationship. One-sided conversations and selfish venting would be considered emotional dumping in any other scenario. In therapy, it's the entire point.

Aside from the stigma, therapy can seem off-limits because it's often exorbitant. It makes sense that you often leave a session feeling lighter; after all, you've probably paid for it with your arm or leg. In all seriousness, there are more affordable alternatives to traditional therapy. These include web therapy, pro-bono counselling centres, online "listening sessions,” and employer-provided confidential counselling for employees and their families. There are options.

Therapy is a beautiful process. If you can make the finances work, don't let anything else hold you back – especially not stigma, misconceptions, and dissenting voices. That noise will always exist. You'll just have to tune it out.

The big "when"

The other question is when to go for therapy. Go as soon as you can.

Don't be like me and put it off for years, wondering if you really need it. I'm not sure why I did this but I’d imagine it was fear. I knew myself and the inside of my brain pretty well, but I was afraid of the unknown variable in this equation: the therapist. I was afraid my therapist might judge me or think I was overreacting. I was afraid things would feel worse before they felt better. I was also afraid that "feeling bad… sometimes" wasn't a symptom of anything bigger; it was just life and I’d have to make my peace with it.

Of course, I was overthinking it. Instead of giving therapy a real shot, I'd skipped too many steps ahead by imagining the most extreme outcomes. I'd looked so far into the future that I couldn't take the small leap of faith in front me.

Last year, I finally started seeing a therapist. Late or not, I was right to have taken the plunge. Over the past year, my brain has been given a slow makeover, and I’m starting to get better at understanding and accepting myself. My first day in therapy was the first step up a mountain I'll probably climb for a while. But at least I'd reached the base camp.

Today I laugh at myself. I was stupid to put off therapy for so long. Don't wait as long as I did to do something so important. You might not like it, but you won't lose much from trying it.

Remember, it's like peeing. Go if you can. Go when you can.

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