MIND MOVES Tony BatesOne of the toughest calls you may ever make is when you need to seek psychological help for yourself or a loved one.
It may take a long time for you to admit that you're in over your head, that whatever conflicts you may be facing are simply not going away, and that you need some guidance.
This may be a highly significant moment for you, one that indeed can require a lot of courage. But it's only the beginning. Now comes the hard part, making that call, and finding someone you can trust.
Naturally you want the best. Your inner life is a delicate matter and you don't want to make things any worse than they already are. You've heard stories that have scared the hell out of you.
A friend who disappeared into the psychiatric system and was so numbed with meds that they became lost to themselves and everyone who knew them. Others who contracted some fringe therapist who insisted on them revisiting their past lives, where they unravelled emotionally and lost the capacity to walk, talk and say Oedipus.
So where do you begin? Google "competent therapist I can trust?" The Yellow Pages?
Word of mouth would seem the best way, but this involves telling someone you're in trouble and you may not want to disclose this information to a colleague or friend. Chances are they would be sympathetic and supportive, but you don't know that. What if they lose respect for you? Where would that leave you?
As a likely member of a growing number of discerning service users, you may want to research the various schools of psychotherapy. The chances are you will hit on an approach that best resonates with your particular experience.
You may be drawn to analytic approaches that require a serious investment of time, but which promise to resolve the unconscious early life roots of your distress.
Or you may be drawn to the briefer "cognitive" approaches that promise to straighten out your thinking, help you resolve practical problems and pursue your personal goals.
Or perhaps it will be one of the host of "humanistic" therapies that attracts you. These emphasise the importance of connecting with your feelings. They offer a range of strategies for working with traumas which you have physically embodied and encouraging you to let out the pain you've held inside for too long.
The range of therapies available can be daunting. It doesn't help that practitioners of different brands are perpetually at war with one another, as they jockey for credibility and Government funding.
The basic gist of their squabbling is that we in X profession, school, approach are better equipped than those charlatans in Y profession to minister to your psychological health.
Turf wars between therapists always appear to be about "who's right" rather than "what works". They are incredibly confusing for potential consumers, and undermine the credibility of psychotherapy among the public at large.
Thankfully, there is established research literature to guide you in choosing someone who may work for you.
It turns out that the critical healing factors in psychotherapy are common to every brand.
Researchers have identified the predictors of success in psychotherapy and quantified their relative importance. Surprisingly, what counts most of all is you the consumer.
Your readiness to engage in therapy, your openness to taking risks and confiding in another human being is the single greatest predictor of success, accounting for 40 per cent of the outcome.
A further 30 per cent of success depends on the degree of trust and understanding between you and your therapist.
Only 15 per cent of success is attributed to specific techniques that define different brands of therapy.
The remaining predictor of outcome (15 per cent) concerns those extra-therapeutic factors - finding a new job, the support of a loved one - which exert a significant impact that's so often overlooked.
So where does this leave you as you embark on a search for greater wellbeing? The key is to look for a trustworthy person, someone with whom you feel some good chemistry. A wise therapist is someone who listens and asks good questions. A unskilful therapist is someone who dominates the discussion with their preferred theories and solutions.
Techniques and rituals of one sort or another are part of every therapeutic approach, whether it be lying on a couch, writing a journal, scripting an imaginary conversation with a person for whom you carry unfinished business, etc.
Whatever strategies they suggest should enable you to feel more grounded in yourself and move forward in your life.
How long should it take to know you're in the right place? Hard to judge after one or two meetings. Give it some time, but if the chemistry isn't there for you after your third session, it may be important to discuss this with them and consider someone else.
tbates@irish-times.ie
Tony Bates is a clinical psychologist and chief executive of the National Centre for Youth Mental Health.