What is Counselling Like?
CN: Sexual assault, talking therapies
Counselling, specifically counselling after sexual assault, is hard. Really, really fucking hard. It's not like the therapy sessions you've seen on American TV shows/films, not like the sort I always idealised from the therapist's office in Freaky Friday (the one with Lindsay Lohan - great film btw). I've only ever experienced counselling in the form of NHS-run talking therapies, and one brief stint (one session) of a shitty CBT session in a sweaty room at my universities' doctor's surgery. I have much to say about counselling in itself, and I have a lot to bitch about regarding general NHS mental health systems.
I'm not sure whether it's a 'first love' kind of thing, but I still hold that my first counsellor/those first counselling sessions were the most beneficial to me. My first counsellor was kind, and her approach was soft and slow, allowing me to open up and talk about things I had never talked about with anyone before. We only had eight sessions together, although there was an option to extend if it was necessary, and the service also offered therapy for people going through hard-hitting court cases. The route to finding her was easier than my more recent experiences as I then lived in my smaller hometown, and the practice I was visited was non-threatening and comforting. I remember the small, warm room, with a slightly sweet smell, and the universal mark of every counsellors office: the sad box of tissues on the small table in between you and your counsellor. Also, the weird art on the walls - I'm sure someone curates the atmosphere and chose the art specifically for a rape counselling session, but sometimes I have found myself spending time critiquing the wall art as opposed to unpacking my trauma...
Now, let's get the ugly out the way. Besides the actual talking in therapy, there are two main things I want to bring up administration wise that make the whole system a lot more eye-roll worthy than it should be.
First up: IAPTs tests. 'Improving Access to Psychological Therapies' tests (which is quite an ironic name based on the experience I'll recount below, along with many others' experiences) are routine questionnaires handed out to patients trying to receive therapy/counselling. They are also usually handed out at the beginning of every session, and in the last session you have to fill out an extra long one. With rape counselling, there are also extra forms to monitor how you are 'recovering'. Now, I understand the idea of them, to have a routine way of accurately diagnosing mental health problems, and to monitor risk of patients suicide with the aim of intervening effectively. But, the questions themselves are vague, triggering, and often pretty difficult to know how to answer - '(within the past 2 weeks) have you had little interest or pleasure in doing anything?' 'have you been overeating or not eating at all?' 'do you have trouble concentrating, e.g. watching TV' - from the amount of times I have filled out these tests, I think I could probably do it with my eyes closed. The problem is, when you are reaching out to professionals for help (for the first time or the fourth), it doesn't make you really feel listened to or important when the first thing you do each session is spend 10 minutes filling out the same sad little form everyone else does. If you haven't been to therapy before, be prepared to fill out a form such as this. As I said, they are there to help you and to try and give you the best treatment possible, but just know you are not alone if you want to run right out of that badly-decorated room as soon as you see them sliding that form towards you.
Second up: the atrocious NHS filing systems. Although I have gone to doctor's/referrals to initially try to get help more times than I can count, almost every time I am asked: 'So, what can we help you with?'. Seems nice enough, but when you realise they have nothing on file from the past five times you have talked in depth about your trauma to your doctor, or explained your crises to a random consultant on the phone, it seems not so nice. Although I seem to have a electronic 'file' at the doctor's, a file that each of my past therapists have written in feverishly whilst I talk, there seems to be no substantial record detailing my specific case. This ultimately means I have to recount my traumas endlessly to numerous different professionals, making the process of reaching out so much more difficult than it needs to be. Perhaps I have had a specifically bad experience with it, but again this is just a note that you may have to repeat yourself needlessly quite a few times.
When you do go to therapy, especially rape counselling, my most valued advice is to not plan what you are going to talk about or what you 'need' to say. My third and fourth rounds of therapy were run by The Havens in South London, who are an absolute God send (their information is on the Contacts page). The first sort of therapy I got from them was one to one talking therapy. My therapist was kind and emotive, and would actually respond in a normal manner when I talked about the devastating things that had happened to me. Some therapists I have had stick too much to the 'objectivity' rule, and whilst that may be good for some, The Havens counsellor fitted me perfectly in the way she would really interact and truly have a conversation with me, making me feel heard and respected. I would vent to her for an hour every Monday, for eight weeks, and she would let me talk about anything I wanted to, even if it was completely unconnected to my assault. She began to practice some CBT practices with me, but I unfortunately need to get over my annoying cynicism a bit more before I can feel the full benefit of CBT. I felt safe, I felt heard, and most importantly I felt supported by The Havens services.
The second sort of therapy I received from The Havens was group therapy. I had always yearned for group therapy, and actually receiving it helped me invaluably. There were 10 of us, who would sit in a circle, mediated by two trained counsellors (one of which was my own counsellor). Being in the company of others who knew exactly what you were feeling was incredibly comforting and cathartic. Advice was given and received, and the support that came from and was given to each member of the group was incredibly special. It may not be for everyone, but group therapy helped me in the way I could express myself and know I would be fully understood.
Talking therapy can be good, and it can sometimes be bad. You just need to find the right person. I read something the other day that said 'a therapist is like a pair of jeans, you shouldn't be afraid to try out a few different styles to see which one fits best' and I wholeheartedly believe in that. That being said, I am guilty of jumping at the first therapist who wants to help me (especially after waiting for over a year for NHS services). I have never had private counselling, but have heard many good things about it, if you or your family can help you afford it. It is important to know that if a therapist is not working for you, that is okay, and you have every right to request another or continue looking elsewhere for someone who will truly help you.