Episode 9 – Psychotherapy.

To start your self referral for psychotherapy in the Cambridge and Peterborough area please follow the link below.


Hello, and welcome to episode 9. As advertised today I am going to talk about psychotherapy.

Psychotherapy is all about learning to better understand ourselves; learning about who we are. This may seem odd – of course we know ourselves – we are ourselves!

I think it is this sentiment that puts a lot of people off psychology and psychotherapy from the outset. It causes us to instantly dismiss it out of hand. The tendency is to immediately declare it nonsense. We don’t like the implication that someone else knows more about us than we do. The implication that we might not really understand ourselves at all. This is a threat to our whole concept of self. It threatens to undermine who we actually are.

It is certainly the way I reacted to it, until I was in a situation that forced me to ask some difficult questions. My Dad always referred to the social sciences as “noddy” subjects – no wonder I was reluctant to engage with it.

The brain is reliant on its concept of self for its peace of mind. It is the brains comfort and security in the world. It is the structure by which the brain understands and interprets the world. If it is wrong, it means our understanding of the world may also be wrong, and we naturally fear what we don’t understand. It is an evolutionary survival reaction. What we don’t know about may kill us. Uncertainty is danger, and therefore we fear it. And because of this we will always fight to hold on to what we think we know, to avoid uncertainty and fear.

But remember, if we want to feel better than now, that means feeling different from now. And to feel different we must think differently. And to think differently we need to challenge what we think we already know.

In episode 8 I suggested that when deciding what to believe we should focus not on what is true or false, but rather on what is helpful or harmful to us. In order to do this, we must understand which of our beliefs are useful and which are not. But even this is getting ahead of ourselves. Often we are unable to separate out which thoughts and beliefs are opinions, and which are facts. If you think your opinions are facts, you are in trouble deep.

When it comes down to it, it’s surprising how little we understand about ourselves. This is the illusion of explanatory depth at work again. Most of us have strong convictions about the type of person we are, our likes and dislikes, personality traits, political standpoint, our beliefs about right and wrong, science and religion.

But these “rules” for living can be surprisingly superficial. If we really start digging into them, we find that we have no idea why we think the way we do, what the basis for our beliefs are, let alone if they are helpful or harmful to us.

We may have emotional reactions to the people we meet and situations we find ourselves in – we are offended by a joke, angered by a neighbour, love football, hate rugby, can’t abide cyclists. But if asked why we have these responses most of us who haven’t previously engaged in therapy have no idea, in fact the question doesn’t even seem to make sense. Why is it that I hate rugby?  “Well I just do, I happen to find it unpleasant, that’s just me, the way I am”. But this is wrong. Rugby is not an intrinsically hateful thing, after all there are plenty of people who love rugby. There must be a reason why one person likes something and someone else doesn’t.

Psychotherapy is all about understanding where our beliefs come from. Understanding why we have developed certain beliefs about ourselves and the world. Our likes and dislikes, beliefs and opinions, are not developed by chance, but at the same time most of us didn’t actively choose them either. This may sound surprising, but it is exactly this fact that makes us think that we cannot simply change our negative unhelpful thoughts on purpose.

Our worldviews develop as a result of our experiences, especially the things we experience as children. We learn it, predominantly from our parents, but also from our friends and family, teachers and mentors, wider society and the media, and from the things that happen to us. As a result of these experiences every one of us develops both helpful and unhelpful ways of understanding ourselves and others; and of interpreting our place in the world. For the most part we have very little control over this process. As children we don’t get to choose which city we are born in, what lessons our parents teach us, or which school we go to. We have very little control over what happens to us, or the life position that we adopt as a result.

We develop much of our world view at a surprisingly young age. By the age of 3 people may have formed fundamental beliefs about themselves that will persist for the rest of their lives. The older we get the less influence our experiences have on our personal realities. Once we have formed an opinion, we like to stick to it.

But if we can understand where our beliefs come from, we will also understand that they are subjective. Maybe if we had been born in a different place, at a different time, and had different life experiences we would have loved Rugby, been more confident, a better listener, or more relaxed. Perhaps if you had been born 30 years earlier you would have voted for Brexit and not Remain, and vice versa. If we can understand this, we can also understand that now we are not children anymore. Now that we are adults, we get to choose if we want to continue believing what we naturally learnt as children, not because it is true or not true, but because it either helps us or harms us to continue thinking it. 

Psychotherapy also teaches us self-love and compassion. In episode 7 we discussed how positive change must always come from love and not hate. If we can understand the root cause of our negative thought patterns and unhelpful personality traits, we can be compassionate to ourselves, rather than beating ourselves up. We can understand that we are not to blame for our tendency to sulk, or shout, or cry in the face of adversity. We learnt these patterns of behavior from our families, from our friends and as a result of the things that happened to us in our formative years. We had no control over these things, and so it is not our fault. We will see that anybody placed in the same circumstances would have been likely to develop the same traits, tendencies and thought patterns. Having unhelpful thinking patterns or “negative” personality traits does not mean we are fundamentally bad people, underserving of love and compassion. We are not to blame for them. They are also not true facts about us. They are not real or absolute. If we don’t like these traits, now that we are adults, we have the option to change them. We do not have to be slaves to our past.

Once we have a better understanding of the basis of our beliefs, and with it an understanding of their subjective nature, we become free to start considering if our thought patterns are contributing to our wellbeing or causing us harm. If we can understand ourselves, we can truly love ourselves. We can learn to parent ourselves with loving kindness, rather than constantly criticizing and shaming ourselves. This is the beginning of real positive change in our lives.

Psychotherapy will be of benefit to everyone. It is not just for those who are suffering from anxiety, depression or other mental health problems, although it can certainly be helpful in these situations. The bottom line is that all of us are mentally unwell to a greater or lesser degree. Everybody experiences low mood, and everyone gets anxiety. Everybody has hang ups and insecurities. Everyone has things they don’t like about themselves. Everyone experiences shame, and everyone has developed unhelpful coping strategies to deal with these negative thoughts and emotions. These things are a part of being human.

I have never met anyone who has a completely healthy world view and sense of self, especially without any exposure to psychotherapy. On the contrary one of the biggest eyeopeners of my medical career is how fundamentally screwed up we all are. You would be amazed by the number of my consults that end in tears, regardless of the presenting problem. People come about an ingrowing toe nail, and leave with puffy eyes. Maybe that’s just down to my bedside manner?

All of us have so much pent up emotion just below the surface, because most of us don’t fully understand ourselves, or truly love ourselves. We hide these insecurities from ourselves and from each other, because we are ashamed of them. And because we all hide it, we assume everyone else is doing just fine, that we are unique in our screwed-up-ness. We think You’re Ok, I’m not Ok, and this makes us feel even worse, even more hopeless, even greater shame. But take it from me – you are not alone, and it doesn’t need to be this way.

Therapy should be considered as life training; lessons in how to find peace and happiness amongst the turmoil of human existence. There are very few people who don’t stand to benefit from it. But we are often naturally resistant to the idea. We resent the implication that we are not already experts in our own lives.

This is a slightly strange attitude. If you take up a hobby, learn a language or learn to ski, you would seek out an instructor to teach you how to do it, or at the very least read a book on the subject. We readily accept that there are experts in the world that can teach us how to do things that we currently don’t know how to do. Why do we assume that there will not be similar experts in living? People who have dedicated their time and energy to studying and learning life skills that we may not yet possess. Why do we assume that we don’t need to train ourselves to live well? We expect that we should be inherently good at life, and feel shame if we are not. We see needing “therapy” as a sign of inadequacy or weakness of character. But no skills are innate. If you have never skied before you will not be good at skiing. It is not a sign of inadequacy or weakness to seek tuition from an expert that knows how. Even if you can already ski you may enroll in an intermediate class to improve your skills. Even world champions still have a coach. If we want to be good at something we must train, and if we want to train effectively, we need tuition.

So, if you want to be happier, if you want to live better, you should have psychotherapy.

O.K, so you are convinced. What next?

If you are listening in the UK, everyone is entitled to free therapy (you’ve got to love the NHS). If you are in Cambridgeshire you can self-refer for this via the psychological wellbeing service; I will put the link on my Facebook page and website. There are a whole range of different services offered; from computer-based counselling, group therapy, to one to one counselling and Cognitive Behavioral Therapy (CBT). If you go on their website you can read and watch a video about the services they offer, then hit the big blue button and complete online assessment form, you can explain the kinds of issues you are experiencing, and the team will follow up with a telephone call and decide which service they think best suits your needs. We are incredibly lucky to have it and I would highly recommend taking advantage of it.

There is however, a waiting list. And as great as the NHS is there are limits to the services that are offered. If you are outside the UK, or you have already done you 6 sessions of CBT and found it was not enough, all is not lost.

Obviously, there are plenty of private psychiatrists, psychologists, and councilors out there, and if you can afford it, what better way is there of spending your money than on happiness? As to which type of therapy, Freud or Jung, CBT or CAT I’m not sure it matters too much. The basic concepts are pretty much all the same. I think the most important thing is that you find someone you trust and believe in, in an environment that works for you. It does need to be psychotherapy though, and not just talking about your feelings. Talking about how bad we feel, how awful life has become, does not in itself make us feel better. The aim is not to just talk about your feelings, but to learn to understand them, so that you can change them. It must be an active process.

Not everyone will be able to afford private therapy. But that’s OK. Although I have had both Cognitive behavioural therapy (CBT) and Cognitive analytical therapy (CAT) most of my own personal journey has been done independently, using online resources, podcasts and reading. Ultimately the only person capable of making a major impact on your health and wellbeing is you. Only you can control your own thoughts, and so you are the one that must do the hard work. Having someone to guide you on the journey face to face is helpful, but not essential. There are countless books available on self-help, self-improvement and psychotherapy. There are several that I frequently recommend to my patients.

I think a good place to start is with the 4 agreements by Don Miguel Ruiz. It is a beautiful description of why what we think we know isn’t necessarily real, and how these false beliefs can be harmful to us. My Mum bought me this book about 10 years ago, it is widely referred to in our house as “Mums book”. She had been harping on for years about how it had changed her life, whilst my sisters and I rolled our eyes and thought “there she goes again”. It sat on my book shelf gathering dust and despite her enthusiasm I never opened it. Its an amazing book, and its message (the message that’s the same secret to life as all the rest) truly is life changing. Its hard to understand why we are all so resistant to learning this “secret” even when those closest to us are shouting about it from the rooftops. I will leave the links to this and some other recommended reading on my Website.

So, your homework for today is to go have some psychotherapy. Whether it is making a referral online, or starting with some of the recommend reading, I want you to start on your own personal journey of discovery, to learn to understand why you are the way you are, to be compassion and love yourself for the way you are, and to understand that the way you are today does not have to determine the way you are tomorrow, if you don’t want it to.

I said at the beginning of this series that the road to health and wellbeing is not all plain sailing; that it involves a lot of hard work. Psychotherapy is not easy. Learning about ourselves, facing our faults, fears and insecurities, even admitting that we have faults, fears and insecurities in the first place, is hard. It is emotionally difficult, it is time consuming and requires commitment and dedication. It is also beautiful. It is one of the most important things you can ever do for yourself.

We often mock and sneer at these concepts of finding yourself, spiritual growth, and self-love. I have been thinking a lot about why this is. I think people are threatened by it. If you have failed to embark on your own journey, if you are too afraid to face your demons (and we all have them, without fail) then hearing other people say that they have done just that threatens your own sense of self-worth, and so we sneer and we mock. We tell ourselves that those people are talking nonsense (I think in the US you guys call it WooWoo) and this protects us from our own responsibility for self-improvement. I really hope that you don’t fall into this trap, because it denies us of so much peace, wellbeing and happiness.

And with this in mind I want you to take the first step right now, this instant. “The hardest step of any journey is the first….No time like the present…ect.ect.” I want you to go and fill in your online referral form (honestly even just the process of filling in the form is therapeutic, it forces you to think carefully about how you are feeling, and what might not be working for you. We bury this stuff, because we don’t want to face it, but it is there under the surface making us sad). Or order a copy of the 4 agreements and start reading. Action is itself therapeutic. Act and you will feel instantly a little better, because you are taking responsibility and control.

So, go now and get on with it. You have been needlessly suffering for years, because nobody told you that you didn’t have to. This is incredibly exciting, game changing stuff. Today is the first day of the rest of your life. I can’t wait to hear about how you get on.