Moving Forward: 18. Do I Need Therapy?

Moving Forward: 18. Do I Need Therapy?

This article is adapted by Dr Jane Clark from an article originally written by Jane and Dr Peter Harvey. See our introduction for a background on this series of articles.

Everything getting on top of you

There may be times when you feel that everything is getting on top of you and that you would benefit from some outside help. How do you know what you need and how do you get to it? This is a difficult decision to make and this brief section will only serve as the barest of outlines of what can be a bit of a minefield.

Basic principles of seeking professional help

Perhaps it is important at the outset to set down some basic principles. First, asking for help is not a sign of weakness. Some people still think that going to see someone like a counsellor or a psychologist or a psychiatrist smacks of personal failure and lack of moral fibre.

This in no more true than thinking you a failure if you ask a mechanic to repair your car or a doctor to examine you. Sometimes we all need to seek help from someone with specialist knowledge. Particularly in the case of emotional distress, it can be very helpful to share your thoughts and feelings with someone neutral, outside of your family and friends, to whom you feel you could say anything without fear of upsetting them or of being criticised.

Second, if someone suggests that you might find it helpful to talk things through with a professional, this does not necessarily mean that they think you are ‘cracking up’ or ‘mad’. It may feel like this to you sometimes, but remember that when you are faced with overwhelming stresses and you feel that you are in turmoil, these may be appropriate feelings that reflect the situation that you are in.

It also does not mean that they think that what you are experiencing is ‘all in your head’ and somehow imaginary or unreal. They are picking up very real, very powerful feelings that might be useful to discuss in a safe, secure setting.

Third, you will not be committing yourself to weeks and months of lying on a couch talking about your dreams – the cartoon stereotype of a psychotherapist or psychiatrist.

There is not enough space to go into all the reasons why this is not accurate for the vast majority of professionals who use a variety of different approaches and techniques to help you. And in many cases, it may involve a couple of sessions talking about those things that matter to you.

What do you want out of therapy?

You need to be able to have a very rough idea of what you might want ‘therapy’ to achieve. It might be a relatively straightforward matter of helping you to sort out the confusion and distress, to help sort out your priorities or it might be that you want a more in-depth understanding of yourself and what has happened in your life more generally.

We know that a variety of psychological interventions can make a meaningful difference to the well-being and quality of life of people with cancer.

What can therapy help with?

So, once you have made the decision, what can (and more important what can’t) interventions like these do? The primary aim for most professionals working in this area will be to help alleviate the distress that brought you to them in the first place.

They may also want to help with specific problems if needs be – extreme fear of needles, for example, or prolonged low mood that might stop you participating fully in your medical treatment. They may do this in a variety of ways, but all should involve listening to you in a non-judgmental and empathic way.

They should allow you to tell your story from your point of view. They may ask some gently probing questions if they need, but they should enable you to feel safe enough to talk about things that matter to you.

Being able to put your story together for a sympathetic listener may be all that you need – this may the first opportunity that you have had to do this, as your life has been so chaotic until this point. In fact, doing something like this after the upheaval of treatment can be a good way of starting to put things into place.

Sometimes your therapist will be able to tell you that what you are experiencing are expected reactions to extraordinary events and may be able to reassure you by validating your feelings. They may let you know that many people who have gone through diagnosis and treatment experience similar feelings so that you can feel that you are not the only one.

It may be that during this talk you or your therapist identify some issues that either of you feel might benefit from some further exploration. It will be your choice as to whether you want to pursue these at this time, later or even at all.

How to find someone

If you feel that this might help you, how do you find someone? Some cancer centres have good access to a variety of professionals such as counsellors, clinical psychologists or psychiatrists. Such people may be available to you even when your active treatment has finished.

The advantage of accessing someone who is part of the overall team managing your treatment is that they will be familiar with the specific issues surrounding cancer and can keep in close touch with other members of your care team.

There are also centres such as Maggie’s where you can access psychology or counselling sessions.  Some cancer support centres either have people who work with them or may have lists of people who they know to be helpful and experienced. Sometimes other patients can tell you if they have found someone who they have found helpful.

Dr Jane Clark, Consultant Clinical Psychologist

The information and content provided in this page is intended for information and educational purposes only and is not intended to substitute for professional medical advice.

June 2021

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