posted 29th May 2025
Successful therapy is not a one size fits all kind of thing. It’s often a meandering process that is founded in a unique relationship between two people. Society tries to make the therapeutic journey fit into a system that mostly serves to make us (clients, therapists and commissioners) feel that we have done the necessary ‘work’ to facilitate change and lasting improvement in wellbeing.
Here in the UK, our NHS does its best, as do the vast majority of clinicians who work in the system. But for people who have mental health issues, it struggles with funding and the invisible revolving door of patching people up a bit, sending them off to put into practice what they have been taught and then them coming back because the patching up didn’t quite work. Some people think that the standardised stepped treatment model of the NICE guidelines means that you get help in the form of talking therapy when you are unwell enough to get pushed to the top of the queue. We need to learn that treatment is so much easier and more effective done sooner, rather than later.
Often NHS therapy is time limited, you have fifty-minute sessions for a set number of weeks. The therapy will likely focus on how your thoughts impact your behaviours and how monitoring and changing your thoughts can change your situation. There is truth in this concept, our thoughts do indeed impact our behaviours, likewise our behaviours impact our thoughts, but this misses the fact that most people will have experienced trauma of some kind during their lives. Many people had a hard time in one way or another in their early life; the quality of care they received from parents, carers, teachers may not have been good enough, or there may have been factors such as ill health of the child or parent, a family breakup, poverty and other similar disruptions to stability. Many of us were raised in circumstances and an environment that harmed us in some way.
Some people will have had an extremely hard time and the thinking /behaviour model barely addresses this: it misses too the relationship of our body and physical sensations to our mental wellbeing. Our body literally keeps the score (a reference to the work of Peter Levine). If in therapy and in life, we fail to care for and listen to the messages our body sends us, we miss a major piece of data that’s likely essential for our recovery.
Systematised therapy so often misses the significance of the subtleties of neurodiversity and the impact of this on our wellbeing, if your brain is differently wired and that hasn’t been accounted for and cared for, you are likely going to struggle emotionally. Next there’s the epigenetic factor some of us are genetically predisposed to anxiety for example.
If we fail to include the impact of our individual life circumstances – the environment in which we were raised and now inhabit, we also fail to piece together the jigsaw of why we experience psychological difficulties.
Systematised therapy can miss the alchemy of the healing power of the committed, relationally intimate dynamic between client and therapist. It is so often here that true healing occurs.
We need to talk about, normalise and heal our experience rather than stuffing down the flow of emotions. Some people are shocked to learn that this flow of changing emotions is normal. It is understandable that as highly sensitive and attuned beings we move through our challenging lives in an ever-evolving emotional journey. Often this path is perilous or hard to navigate; at times it can be a hard climb, sometimes the path is easy, smooth, and safe. But our emotional life path never stays in one place, life is a single, unfolding challenge with multiple lessons along the way. Our momentary, daily, weekly and lifelong experiences bind together in our personal story from birth to death. I believe that good therapy should be open to encompass any and all of these facets of being human.