Therapy. Loads do it. Nobody talks about it. But with mental health issues on the rise (and referrals rapidly dropping off throughout the pandemic), it is worthwhile to note the efficiency of therapy in sustaining good mental wellbeing. To highlight why therapy remains inaccessible to so many, and to ask why more people do not have a therapist.

In 2017, I accessed my university’s student mental health services. I was referred to the counselling service, where I had two sessions with separate counsellors. Then I was sent to more specific eating disorder psychotherapy. But that did not work out either. I was also prescribed SSRIs (Selective serotonin reuptake inhibitors) to help with mood. Eventually, I found a private practitioner that I really liked and started my first round of cognitive behavioural therapy (CBT). In 2019, I had four sessions with a hypnotherapist. Hypnotherapy intrigued me as an alternative to the talking therapies I had experienced prior. In a deep meditative state, the therapist recites positive incantations to reinforce a positive mindset and rewire negative thought processes. But CBT and hypnotherapy are just two types of therapy: there are all types of therapy for all types of needs. Talking therapy, art therapy, group therapy, humanistic therapy, dialectal behavioural therapy, sound therapy. Tailoring therapy to an individual’s need is essential. The type of therapy must be suited to the difficulties they face, and the therapist must be someone that they can place trust in.

It is okay to take your time when finding a therapist. Talking about your mental health can feel intrusive, especially to a stranger. So, choosing someone that you have a good connection with is essential to effective therapy. But this can be tiring in itself. Rehashing the same spiel to every mental health professional is physically and emotionally exhausting. It often requires you to divulge personal details that may be upsetting or difficult to speak about. Give yourself time. But be persistent. When you find the right therapist, you will be glad that you did. Equally, do not be afraid to delve into the details as and when you feel comfortable. The most important thing to remember about therapy is that it is a judgement-free space. No good therapist is there to adjudicate or criticise your thoughts and feelings. They are there to listen and guide, never to make you feel stupid or wrong. Confidentiality is a given. Talking helps, and good listeners are underrated. That is what therapists are for. The things you cannot speak to your friends and family about, the tears you are afraid to shed, and the snot bubbles you choose not to blow in public.

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Investing in my own mental wellbeing is one of the best decisions I ever made.

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Yet there is a privilege attached to therapeutic choice. The first three therapists I was referred to were not for me. Luckily, I was able to afford private therapy. But only just. And it took me to the bottom of my student overdraft (plus a few IOUs) to get it. The first lot of CBT I had cost me £30 per session. But the hypnotherapy cost a whopping £70 per session, with the sessions lasting an hour and including a take-home recording of the hypnosis tape. It was a price only validated by the fact that I was working two jobs and living rent-free. (Thanks, Mum.) Investing in my own mental wellbeing is one of the best decisions I ever made. But not everyone is as fortunate. For many, costs of £10 to £30 per session are simply not viable. And so, therapy has become a luxury that many cannot afford. Those working for lower wages do not have the spare cash. Those working long hours do not have the time. On top of this, public mental health services are severely underfunded, meaning waiting times are notoriously lengthy and treatment less accessible. The result? A nationwide mental health crisis.

So yes, therapy is overwhelming, overpriced and oversubscribed. But it is also severely underrated. Taking time to ensure that your mental health is in check is just as important as your physical health. Holding space for yourself is neither selfish nor unproductive. Doing this on a daily basis is vital. Going to therapy is just one expression of this. The most important part of therapy is the toolbox of techniques and skills that you take with you. Mental maintenance for everyday life. But you can do this even if therapy is not a viable option for you right now. Here are three things that I learnt and use as often as I remember:

Forced positivity. Positive affirmations and manifestations work. Hear me out. Every evening (or whenever you have time) list three things you are grateful for that day, and three things you are looking forward to tomorrow. Look in the mirror and recite that you are everything you need, that you are loved, that you look good and your body is healthy. You might feel stupid at the time, but these positive reinforcements will start to manifest deep within your brain. The more you say them, the more you will believe them. If you often struggle with deep low moods that inhibit your ability to find positivity, that is valid. Ask someone close to help you write some down. On a good day create a list to come back to on the bad days.

Ask questions. When I feel anxious I am often overwhelmed by the endless what-ifs. What if this happens? What if I fail? What if they do not like me? Playing out these scenarios can seem intimidating, but in my therapy sessions, I learnt that the outcome is never actually as bad as you may think. Take an exam: what if you fail? The world does not stop turning, you do not fall down dead. If you fail you can resit, or find something new to study. Worried about going to a party: what if you do not know anyone? What if you are not having a good time? Chat to someone new. Or leave. Rationalising the anxiety of what-if outcomes makes them far less scary. Try it.

Breathe. Stop for a second to focus on your breathing. In for four seconds, out for six. Breathing out for longer activates your parasympathetic nervous system. (That’s the slow one – the opposite to the fight or flight, heart racing, anxiety or stress response.) Good for panic attacks, or general calming.

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You do not need a mental health diagnosis to need therapy.

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Therapy is not for ‘messed up’ people. It is for anyone and everyone that feels that they could benefit from occasional offloading. You do not need a mental health diagnosis to need therapy. You do not even have to need therapy to access it. If we all invested a little more time in our mental wellbeing, we could be a lot happier in our everyday lives. Myself included. And though therapy can be expensive, charities such as Mind and Samaritans offer free services to those in need of help. In spite of queue times, the NHS services can be highly effective and helpful when thorough support is provided. Private therapists also offer plenty of subsidies to students, job seekers and others who may lack access to mental health services.

So, if you have been thinking about seeking out mental health help, take this as your sign. Speak to your doctor about the options available locally to you. Ask your school, university or workplace what support is available. Retail therapy might be what you need right now. But psychotherapy could help you tomorrow.

Thumbnail illustration by Zsofi Mayer.