PERCEPTION OF PSYCHOTHERAPY – When the resolutions don’t stick


So you decided to give up smoking or refined sugars, take up the gym or healthy eating. But we haven’t seen January through and our New Year’s resolutions are a distant memory of wishful improvements to our seemingly unchanging selves.

The New Year is a momentous international marker of the passage of time. Collectively, we take stock of the events and accomplishments of the previous twelve months. More privately, we look back at our lives and assess where we are at, what we are grateful for and what we want to do differently in the future.

Setting ourselves a date can help us focus our minds to bring about a specific change. Sometimes we do manage to quit coffee or start a new morning regime. But just wanting something to change isn’t always enough. Deep change that affects significant parts of our personality can seem impossible to achieve when we realise that we are essentially stuck with ourselves and no amount of determination can make us less critical, calmer, more active, or beat that chronic sense of isolation.

My work is in part about developing self-awareness to enable clients to bring about change. People can learn to behave differently, understand themselves and others in new and more useful ways.  Learn to manage their emotions and mental processes more effectively. Also working with the unconscious, people who engage in psychotherapy, will experience changes in themselves that appear to have come about without any effort. They did have to commit to the therapy and attend regularly, but it is the process of the therapeutic relationship that brings about the most surprising and usually most needed development in the inner or real self.

It is said that in the USA everyone has a shrink. In northern Europe, if you haven’t had therapy by the age of 30, people wonder what is wrong with you.  Although still not quite as popular, in the UK, it is becoming more commonplace for individuals, couples and families to resort to therapists when circumstances become challenging or people get fed up with the way they are and just want to explore being different and getting something new and more satisfying from their life experiences.

My therapist is originally from the UK but based in Andalucía. Whilst talking about the challenges of working in Gibraltar, she explained that in Spain, people struggle with the concept of paying for a relationship. My impression is that in southern Europe the general public doesn’t seem to have grasped the concept of skilled professionals who offer reparative relationships.

Hardly anybody gets all their developmental needs met in their early relationships. Whatever lies unmet manifests in later life in different wishes or behaviours that often don’t lead to the desired result, maintaining our lack of satisfaction or state of frustration. The unconscious is programmed in relationship with others, through repetition in our early years. It then usually requires the help of a trained expert to re-wire the neural pathways in our brains via the process of the therapeutic relationship.

Most of the time what takes place in a psychotherapy session is that the client is listened to by someone who really knows how. It is surprising how few people really listen to others, despite the great need that we have to feel heard and understood. Empathy is another very important element of what a therapist should provide, which seems undervalued in our society today. Clearly, there is a lack of understanding regarding the power of empathy as well as how much we need it. Lack of empathy causes much ill-health.  Something is usually experienced as traumatic when there is no empathising environment to assist the sufferer in assimilating their experience. The resulting symptoms and long-term effects pose a huge cost to our society, not just in terms of health care but also in other support services that often are required.

In Gibraltar, there is still much stigma attached to issues of mental health.  However, I am aware that increasing numbers of people access talking therapies and many have told me about how they have seen, or go to counsellors. I know that I am privileged to hear these stories because people understand that I won’t judge them and feel that it is something they can talk to me about. But I am just as aware of how they would like me to hold this information in confidence.

Because I know it’s a good thing, I try to encourage people to shirk the shame currently often attached to this method of self-development in Gibraltar. Making psychotherapy more accessible and visible in the community is also helping to address the stigma. Over the last year, I have been working with a local charity to offer group therapy in the community. Some group participants are happy to then talk to others about their involvement and refer others to the service.

Another barrier to therapy is the cost. We are used to spending money on beauty treatments, mobile phones and hobbies.  Many of us pay monthly instalments to repay loans for cars, furniture or holiday expenses. Money is the most universal excuse for not doing something that one isn’t prepared to, when there is a monetary cost involved. Change can be hard and scary but if there are things that you have been struggling with for some time and aren’t able to change by yourself, investing in yourself could be the best use of your hard-earned cash.

An ex-colleague of mine likes to say that what people save on therapy they spend on legal fees. £75 for 90 minutes of couple therapy sounds expensive. But we don’t think twice about paying that for a dinner at a restaurant. The way I think of it is that the alternative of investing in therapy to improve your marriage could be each party paying £200 per hour to their lawyers.  In one particular local case, the cost of a divorce would have bought the individual 20 years of therapy and, most importantly, saved them a lot of grief.

One particular challenge to us, Gibraltarians, as a community is the issue of responsibility. Families are often closer than in other parts of the world. Experts in human behaviour are warning parents of doing too much for their children. A result of increased resources is that many of our practical needs are taken care of by others and the negative impact that can have on children is that it often affects their capacity to take responsibility and develop a healthy sense of autonomy. In Gibraltar, we are well resourced, which combined with our current systems often leads to people expecting ever increasing desires for comfort to be provided for them. However, when it comes to dealing with the creation of our health and happiness, we need to work at it mostly by ourselves.