No one therapy, of course, works for everyone and there is no one-size-fits-all’ solution to mental distress. Furthermore, some people with psychiatric conditions adamantly do not wish to engage with psychiatric services. Others may be unable to interact with psychiatric services in any meaningful or sustained way. This group includes those persistently high on drugs, incapacitated by alcohol or in a state of unrelenting paranoia and suspicion of the motives of others, including those who profess to wish to help. Some individuals, too, may be in a state of denial about their mental condition even when, objectively speaking, it seems clear that their lives are being ruined by it.

If one particular form of therapy does not suit an individual, it is important that s/he is able to explore other treatment options. Sadly, though, many people give up too soon because the initial therapies and treatments they’ve tried have proved unhelpful. Such people may have low motivation and pessimistic outlook anyway (e.g. if they are suffering from depression) and, with the addition of the disappointment caused by failed attempts to benefit themselves through therapy to contend with, are tipped into a state of utter despair, hopelessness and helplessness.

Those who have some kind of secret relating to their emotional distress may also avoid therapy because they are terrified of the deep sense of shame the revelation of their secret may entail. For example, they may be carrying out some form of abuse connected to their own abuse in childhood (this is not, of course, to say that all those who have suffered abuse will go on to abuse others).

Another group of people who may avoid interaction with therapists, counsellors, psychiatrist etc. are those who realize that their psychological problems are connected to their traumatic childhoods but are afraid that ‘raking over the past’ will entail unbearable emotional pain. However, talking about one’s own experiences in a safe place and with a therapist who one trusts with whom a bond of empathy exists, can prove highly beneficial. This is because, often, if we have had a traumatic childhood, defence strategies and coping mechanisms we (mainly unconsciously) developed to protect ourselves, while serving a vital purpose at the time, are no longer useful once we are free of the traumatizing environment of our childhood. Yet they may have become so deeply entrenched that they continue to dominate how we feel, think and behave. For example, we may find we are hypervigilant and constantly on ‘red-alert’, expecting catastrophe at any moment even though now, as adults, we are relatively very safe. Or we may, due to betrayal by our parents/primary carers, feel deeply distrustful of everyone, making healthy relationships with others extremely problematic.

“The unexamined life is not worth living.” Socrates, The Trial of Socrates from Plato’s Apology.

Talking all this through with a therapist, helping us to understand how our current dysfunctional behaviour and ways of thinking and feeling are closely tied to our traumatic childhood experiences can, by giving us a greater understanding of ourselves and our motivations, help to free us from the unconscious forces of the past that continue to conspire against us. Furthermore, understanding ourselves can also help us to forgive ourselves for things we might have done to hurt others and help us to develop greater self-compassion. Also, through talking things through with a therapist and gaining this deeper understanding we can come to realize that our behaviour has not been abnormal – instead, it has been a normal reaction to abnormal circumstances.

However, because talk therapy can be so emotionally painful, it is highly important that we work with an appropriately trained therapist who we can trust, and who understands, validates and empathizes with us. (For other articles about the benefits of self-understanding, see Start Your Own Mental Health Blog or Study Suggests Writing About Our Traumatic Experiences Can Be Beneficial To Health.


Some Suggestions If Nothing Has Worked So Far

  • Has success not yet come because of a mismatch between yourself and your therapist? Research shows that the biggest predictor of whether or not therapy is successful is the extent to which the client and therapist are a ‘good fit.’ Indeed, this good fit appears to be more important than the type of therapy applied.
  • Has the length of the treatment been sufficient to allow it to work? Are we unrealistically expecting a ‘quick fix’?
  • Have all treatments and therapies been considered?
  • Is the therapist fully qualified and sufficiently experienced?
  • Discuss with the therapist why the therapy might not be working and how this situation might be resolved. A good therapist should be happy to have such a conversation and may explore avenues such as changing the frequency of the therapy sessions, changing which day/time of day they take place, taking a break from therapy, changing therapist or changing the type of therapy.
  • Are we resistant to treatment because talking about issues such as childhood trauma is emotionally painful, even though experiencing such psychological discomfort (In a safe place with a compassionate therapist) may be necessary for the long-term success of the treatment? It may be helpful to discuss this with the therapist.
  • Has therapy been disrupted due to transference (the redirection of feelings about another person, such as a parent, onto the therapist) or counter-transference (the redirection of the therapist’s feelings towards the client)?
Some examples Of Action That Can Be Taken When No Appropriate Therapy Can Be Undertaken
  • lifestyle changes such as removing ourselves from our stressful environment, if possible., improving diet, taking sufficient exercise, mindfulness meditation, talking to supportive and compassionate others such as friends, self-hypnosis, yoga, trauma-release exercises and other ‘bottom-up’ strategies.

David Hosier BSc Hons; MSc; PGDE(FAHE).