Why see a counsellor?

Life can be difficult but often we cope pretty well with its challenges — things change, time moves on, we adapt in some way or the situation improves, so we begin to feel better. Yet at other times, the ways we usually deal with our concerns no longer seem to work.

Perhaps a difficult situation gets worse or out of the blue something very distressing happens. You might feel suddenly overwhelmed or gradually be getting more unhappy. You may be troubled by the past, disturbed by recent events or have a sense that something isn't right but not know why.

Other people might be concerned about you but don't seem to be able to help, and nothing you do really changes things. Or maybe you don't feel truly yourself in some way — even though life seems to be going okay, you still feel stressed, anxious, depressed or confused. What then?

This is when counselling can help, by giving you the opportunity to talk in depth about your concerns in a professional, confidential relationship, away from other parts of your life, with someone dedicated to listening closely and helping you explore things to find a way through.

What’s counselling for?

People see counsellors for all sorts of reasons. It might be about the past or the present, the loss of someone or something, or being stuck in ongoing circumstances, whether that's in work, family life or in how you feel about yourself.

Some of the concerns commonly discussed in counselling are: family and relationship difficulties; feelings of depression and anxiety; work-related stress; loss, grief and bereavement; abuse, bullying or other traumatic experiences; navigating life changes; questions about identity; self-harm; suicidal thoughts; and many more.

For some people counselling provides an extra layer of concentrated support to help deal with emotional distress. For others it might be an opportunity for personal development and growth, a space to reflect on personal history, current challenges and concerns about the future, or a way to find new perspectives on yourself, your relationships and the wider world.

Sometimes people see a counsellor following a mental health diagnosis. If you have been referred to IAPT (iTalk) in the NHS but are stuck on a waiting list, or you want something more in-depth than seems to be on offer, then counselling might be for you.

What’s it called?

The terms therapy, personal therapy, talking therapy and psychological therapy are phrases that refer to a range of practices within talking-based mental health support. Each term can be used for counselling.

Confusingly, therapists themselves disagree about whether there are differences between counselling and psychotherapy. In the style of therapy I trained in, these words mean the same thing in terms of what actually happens in a session; they simply refer to the preferences, titles and traditions of different trainings, organisations and work contexts. So I tend to use the terms interchangeably. Sometimes I describe myself as a psychotherapist but often I use counselling and counsellor (or therapy and therapist) when talking about my work.

There are some other similar terms you might come across in the area of mental health. Psychoanalysis is a specific type of psychotherapy based closely on the work of Sigmund Freud and his colleagues and followers. Psychologist is a general term that refers to a range of practices within the broad field of psychology, including academic research. Clinical psychologists and counselling psychologists are psychologists with specific qualifications and training, some of which is in counselling and psychotherapy. A psychiatrist is a qualified medical doctor who has specialised in the medical treatment of severe distress (or ‘mental illness’) and will often have little, if any, in-depth training in counselling and psychotherapy.