By Edel Coffey
Saturday May 9 2009

Jane Haynes has broken a golden rule of therapists by revealing the secrets of the couch in a controversial new book. So what do people talk about when they come face to face with their analyst?

In the film Annie Hall, there is a memorable scene where the couple Alvy and Annie, played by Woody Allen and Diane Keaton, talk to their psychotherapists about their sexual problems (Alvy wants more sex, while Annie can't seem to find the motivation).

When Alvy's therapist asks him, "How often do you sleep together?", Alvy says, dejected, "Hardly ever. Maybe three times a week". When Annie's therapist asks her the same question, she replies, exasperated, "Constantly! I'd say three times a week".

It's a wonderful insight into relationships, and while it might have seemed like a peculiarly New York experience upon its release, it is now a scenario that many Irish couples are familiar with.

It's not that long since Freud was banned in Ireland, but the number of therapists working here is growing, which suggests that demand is growing, too.

In a bustling clinic in Dublin's city centre, a small, anonymous-looking office with two armchairs and a lamp looks innocuous enough. But it is here that psychosexual therapist Mary O'Conor untangles the sexual problems of Irish couples and singletons alike.

When O'Conor tells people what she does for a living, she usually gets one of two responses. "They're either very interested or stop talking altogether," she laughs.

O'Conor has a waiting list of Irish patients seeking sexual healing, and her clients range in age from their 20s right up to their 60s (this is due to more Irish people now having second relationships and marriages in later life).

"A lot will talk about lack of sex," says O'Conor, "and that can lead to a lot of arguments -- that's where the compromises in relationships have to come. The one who wants more has to make do with a bit less and you meet somewhere in the middle."

The two main problems are erectile dysfunction in men and vaginismus (which makes intercourse impossible) in women. "The girls when they're in their late 20s or early 30s are mortified that they're virgins. They think, what will they do if they get into a relationship with a fellow -- how will they tell him? It gets to be a big, big thing."

For men, erectile dysfunction often stems from negative sexual experiences. "It will affect a man quite quickly if he has a few bad experiences. He'll already think, 'Oh God, I've got a problem'. And yet, at the same time, it's working fine in masturbation. So we're trying to get through to them in their heads: same penis, same guy -- it's just the situation that is different."

Psychotherapy is now everywhere, from television programmes such as the drama In Treatment, starring Irish actor Gabriel Byrne, to first-hand accounts in books and newspapers.

So, just why are so many Irish people seeking therapy in post-Celtic Tiger Ireland? Apart from depression, the most common reason is relationship problems (see panel over page). The number one problem is "communication", says John Farrelly, director of counselling services with the Catholic marriage care service Accord. According to the files of 2,000 patients who attended Accord between January and March this year, "47pc of people come to us because of conflict in their communication -- basically fighting".

Surprisingly, infidelity makes up just 14pc of cases, but more modern problems are on the rise. Financial issues causing strife in relationships are up 3pc on last year, while the internet has added to couples' problems, in the form of pornography and gambling. "Five years ago that wouldn't have even been on the landscape," said Farrelly. Mary O'Conor too has noticed an increase in problems caused by internet pornography addiction, both with couples and with young single men.

After relationships, the biggest problems for Irish people are now stress and anxiety-related. "The central concern is the recession," says Dr Alan Carr, who runs a practice at the Clanwilliam Institute and is Professor of Clinical Psychology at UCD. "Families are under huge strain and parents' jobs are threatened, so they're working longer hours and they're less available at home. We're seeing problems with depression and conflict in families from outside pressure. That's happening. That's real."

These stresses can "push the ante up", says Eoin Stephens, president of the PCI College. "A lot of people can be functioning well enough that they're just on the edge of a problem; they're anxious or a little bit depressed or they've a bit of a problem with alcohol. Unfortunately, circumstances such as this can push people over the line, where the depression or drinking kicks in in a big way. I think you're going to see a bit of that."

All are agreed that the sooner someone seeks help in such cases, the better. But it takes a big leap of faith for the average Irish person to start seeing a counsellor. "Most people spend about nine months before they even think about going to counselling," says John Farrelly from Accord. "They usually take a battering for a couple of months before they do. They basically try everything else first. A lot of people think that you go to counselling because of some huge traumatic thing that happened, but that's only a certain percentage."

And besides, trauma is a relative term. "Some people would say that when they're lying awake at night wondering if they're going to lose their house, that's a major trauma," says Shane Kelly, professional services manager with the Irish Association for Counselling and Psychotherapy (IACP). "People possibly don't realise that psychotherapy and counselling are options for them. The crux of this is that you're talking to somebody who's not related to you, is not your friend and is non-judgemental of you; that gives you the freedom to talk without being judged but in a safe and supportive way, and that in itself can help people. It just gives them a bit of clarity on their own personal situation."

Another problem is the damaging perception, especially in work situations, that getting therapy means you are not coping. "If you have a problem and you don't deal with it, it will affect your work, your family life and your relationships," says Derval Ryan, chairperson of the Irish Council for Psychotherapy. "The strong thing to do is to go and get help for it."

When we think of psycho-therapy, we tend to think of 'the couch', but in modern treatment that's just one option. "If you want to lie down on the floor you can," says Shane Kelly of the IACP. "The client is the most important person and whatever makes them feel comfortable and safe is done, but the idea of someone lying on a couch and a guy with a beard smoking a pipe and writing down everything you say, that's not what happens. In most cases, it's people sitting down face to face and having a conversation about the issues."

Sessions can last anywhere from 12 weeks to two years, and it is important to find a counsellor or therapist who is qualified to a standard you are happy with, as psychotherapy in Ireland is completely unregulated.

The point, says psychotherapist Jane Haynes, is "to help a person live a more fulfilled life". Haynes has just published her book, Who Is It That Can Tell Me Who I Am?, a controversial memoir, which includes case studies from former patients who consented to partake in the book. The book was a cathartic response to the sudden death of her own therapist, who she was seeing to deal with the trauma of her abandonment as a child by her mother and her father's horrific death from syphilis. She saw her psychotherapist five days a week for 13 years and her sessions were only terminated by her therapist's unexpected death.

While most of us would consider 13 years excessive -- even Haynes says she or her therapist should have ended it years before -- therapy is coming to be accepted as a staple of modern society, a quiet place to dismantle the effects of the crazy world we live in.

Indeed, that hour once a week or once a month can be a quiet refuge for many people, and Haynes describes her own reluctance to end her sessions with her late therapist as partly informed by this. "I never wanted it to end because it's an extra-ordinary place away from the domestic world."

While she doesn't recommend it as a 'national solution', she does say that "psychotherapy can be immensely successful and change people's lives, as it has mine, and even having gone through my son-in-law's murder, I still have the resilience and faith in human nature.

That is due to the therapy".

Jane Haynes' book Who Is It That Can Tell Me Who I Am? is out now, published by Constable

- Edel Coffey

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