Tuesday 17 September 2019

Ireland is a nation in therapy: Is it a sign of new maturity or are we on verge of nervous breakdown?

There is a new openness in Ireland about mental health as well as a growing army of counsellors, psychologists and therapists offering solace. Is this a sign of a new maturity, or are we a nation on the verge of a nervous breakdown?

Let's talk about it: Laura Louise Condell says it is hard to navigate the different types of treatments and therapies. Photo: Tony Gavin
Let's talk about it: Laura Louise Condell says it is hard to navigate the different types of treatments and therapies. Photo: Tony Gavin
Radio broadcaster Nicki Hayes. Photo: Frank Mc Grath
Kim Bielenberg

Kim Bielenberg

It has become one of our fastest-growing industries as thousands now seek help for their mental-health problems. Ireland has become a nation in therapy, and a vast army of counsellors, psychologists and psychotherapists has emerged to help us to talk through our issues.

Even 20 years ago, those suffering emotional difficulties tended to keep themselves buttoned-up and hidden away from public view.

In our rose-tinted view of the past, we like to think that there were community supports, and anguished individuals could turn to a benign priest, or a friend at the kitchen table, for comfort. However, in truth, much of this mental suffering was locked away - literally, in some cases.

Now, like a cork flying off a sparkling wine bottle, it is all coming flooding out.

While in the past mental health was completely stigmatised and disparaged, increasingly it is out in the open.

This new openness reached its apogee earlier this month on RTÉ's Cutting Edge show, when the host Brendan O'Connor and two of the guests talked of their own experiences of therapy.

They chatted about going to their therapist like it was routine car maintenance, a dental check-up, a January detox- or even a sort of pastime.

Comedian Al Porter even said of his own therapy on the programme: "It's enjoyable - it's like mental tennis, good exercise for the mind going back and forth with somebody."

So are we now seeing therapy as a lifestyle choice - is it just another feature of Dublin 4 metropolitan life, in the same way that talking to your shrink was the fashion in Woody Allen's Manhattan of the 1970s?

One only has to look at the figures for some of the main accreditation bodies to see the sheer scale of the profession. The Irish Association of Counselling and Psychotherapy (IACP) now boasts 3,700 members; the Irish Council of Psychotherapy has 1,250 practitioners; and the Psychological Society of Ireland has 2,500.

Radio broadcaster Nicki Hayes. Photo: Frank Mc Grath
Radio broadcaster Nicki Hayes. Photo: Frank Mc Grath

There is some overlap between these bodies, but there are also many more therapists and counsellors affiliated to other bodies, or operating independently.

Trinity graduate Laura Louise Condell has had treatment since she was a teenager from a variety of therapists.

"For someone with mental-health issues, it can be very hard to navigate all the different types of therapy," says Laura Louise.

"I would say that it has taken 15 years to discover what works for me. It's like a minefield."

One of the problems is that anyone can advertise themselves as a counsellor or psychotherapist simply by putting a sign on their door.

Laura Louise also highlights the fact that internet coupon sites advertise quick online courses where you can become a psychotherapist in a matter of hours. On the other hand, therapists attached to more reputable professional bodies take many years to become fully trained.

Some might see therapy as the latest middle-class fad, like doing Pilates or following Gwyneth Paltrow's latest quirky diet, but the psychotherapist and author Stella O'Malley believes the phenomenon runs much deeper than that, with people from all walks of life now coming forward to seek help.

"I work in Birr in Co Offaly and I don't believe that it is just a Dublin 4 thing. I am seeing all sorts of clients - from farmers to office workers, to working-class people.

"People are now a lot less sniffy than they used to be about their own mental health.

"When I first started, people thought it was like a Woody Allen film and that they would be lying there on a couch talking about their dreams."

The image of the inscrutable, bearded, professor-type gazing blankly is in fact very wide of the mark. The vast majority of therapists are women, there is usually no couch involved, and many of them do not delve deeply into a client's past. O'Malley believes that there has been so much emotional pain bottled up in this country, it was inevitable that the population would want to talk.

"Everybody knows somebody who has suffered mental illness," she says.

St Patrick's Hospital in Dublin monitors attitudes to mental illness in Ireland by surveying adults across the country online.

According to the 2015 figures, 53pc of adults have worked with someone who has been treated for a mental-health issue (up 4pc since 2013) and 62pc have a close friend who was treated with a mental-health difficulty (up 10pc); while 43pc (up 6pc) report that a member of their family was previously treated.

So are we facing deeper psychological problems in 2016, or was the black dog of depression and other troubles always lurking menacingly in the background?

Psychologist Dr Claire Hayes, clinical director of the depression organisation Aware, says changes in the way we live have altered the landscape in terms of mental health.

"There have been so many changes over the last decade. People are becoming more isolated.

"There is not the same social support system that there was years ago, and there has been a breakdown in institutions such as formal religion. The pace of life wasn't as fast as it is now.

"Social media has affected us in all sorts of ways, with issues such as bullying and privacy being invaded."

Dr Hayes believes there are sometimes unrealistic expectations about what counselling and therapy can achieve.

"If somebody has been bereaved, for example, people might immediately think they need counselling, when what they really need is a good friend to talk to.

"Therapy should not be seen as a replacement for the supports of society, the community and the church," she warns.

We may all yearn for a companion who will share the burden of our suffering, but the nature of friendship itself has changed, according to psychotherapist O'Malley, and that may be at the heart of the problem.

"Loneliness is frequently an issue for clients of all ages who come to me," she says. "They always have friends but they don't go to their friends for help when they are in difficulty. They keep their friends for the good times.

"They don't ask them to help for fear that they won't be there for them, but that leaves them in a colder place."

The average social-media user may have dozens of Facebook friends, but how many of them would they actually turn to in a crisis?

The world of social media, where friends post pictures of their nights out and market themselves as if they were a fashion brand, is almost designed to create pangs of anxiety in other ways.

"Technology is a massive part of the problem for young people," says Dr Harry Barry, a therapist and author of the book Flagging Anxiety and Panic. "People are living in two worlds - the virtual world and real life.

"It's creating this artificial world out there where everybody has to be perfect, and you can't make mistakes.

"It's not real life and, as a result, it's the source of a huge amount of anxiety."

Dr Barry believes young people need to be taught life skills in order to cope with adversity.

The internet may be a source of anxiety, says Dr Barry, but it can also be put to good use.

One of his YouTube videos offering advice on how to deal with panic attacks has been viewed 270,000 times.

While it is tempting to look back to a less frenetic age where we could rely on the support of a close community, Cork-based psychologist Veronica Cullinan is sceptical.

"Maybe people weren't under the same amount of pressure as they are now - but a lot of people suffered in silence in the past," she says.

Cullinan uses the popular technique Cognitive Behavioural Therapy, which relies on challenging negative thought patterns in order to improve how someone feels. This method tends to focus on short-term solutions rather than looking deeply into the past.

Cullinan has not seen clients in her area who take to therapy as a lifestyle choice, but she believes it may be happening in more middle-class areas.

"It's something that you need to be able to afford. It's a good idea. Ideally, we could all have a check-up on our mental health in the same way as we have a dental check-up."

The Cork psychotherapist says well-known figures such as Bressie, the former sportsman and musician, and GAA stars have inspired many people to seek help.

So is it healthy for everyone, even those without depression, to go to therapy, or is it merely a decadent hobby of the moneyed classes?

Laura Louise Condell, who has suffered severe depression herself and acts as an ambassador for the mental-health charity See Change, says looking after your own well-being should be welcomed, even if you are not diagnosed with depression.

"There's so much pressure on people that learning tools that make you feel better about yourself can only be positive."

Nikki Hayes (below), the Spin 103 disc jockey who has spoken openly about her depression, also welcomes the new openness about mental health issues, but would not like it be seen as merely fashionable.

Radio broadcaster Nicki Hayes. Photo: Frank Mc Grath

"I was in work one time and one of the guys said mental health had become a fashion accessory - the in thing,"says Hayes.

"That upset me, because I would not like to see it trivialised. In a lot of cases, it is extremely serious."

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