• There are a number of reasons why you might have therapy and there are a few things to consider before starting 

  • Psychotherapist Andrew Samuels offers us his insights on the matter

  • If you'd like to find a therapist, you can do so on our website here

When therapists are asked to list their areas of expertise for inclusion in Find a Therapist service, they sometimes find they have checked over 20 boxes listing every imaginable problem from sex to suicide, anxiety to anorexia. But none of that really helps the client decide the first question: should I seek therapy?

So – how do you know if it's for you? The first thing to consider is whether you have spotted an emotional pattern of long duration. You don't need to wait for a therapist to tell that something is repeating itself. Are you thinking 'here I go again'? If so, then this is a sign that therapy might be useful.

If you are in what feels like a one-off crisis, then therapy might still be the right thing to consider – but most beginning clients reluctantly conclude that, after repeatedly experiencing patterns of distress, they can't manage their issues on their own.

The next question to ask yourself is 'how intense are my feelings about my situation?' A child psychotherapist colleague of mine plays 'the feelings game' with her young clients. They are given cards with faces on them, displaying feelings: happy, sad, disgusted, scared, angry, ashamed, surprised, bored, thoughtful, lonely.

Clarifying your emotional state of mind will help you decide whether or not to take the plunge.

In my experience, people looking for a therapist want to deal with problems in one or more of the following four areas: relationships (including sexuality), behaviour (including addictions and eating disorders), work and study, and the meaning of their life.

Relationship and sexual problems are the traditional ground for psychotherapy and counselling. These range from bad relations with parents and siblings, to peer relationships at school, college and work, to adult intimate relationships. It is really worth asking yourself if there are any common features in these three kinds of relationship. Remember that therapy itself is also a relationship and expect to experience in the therapy relationship the kinds of problems you experience outside it. If you have sexual problems, then it's important to remember that therapists are used to hearing about them. Nothing to be ashamed of.

If you have difficulties in how you behave in relation to food, drink, drugs, pornography, gambling and shopping, then a therapist might be able to help you understand what is going on behind the unwanted behaviour. Sometimes, the therapy may explore childhood issues that have driven you in a particular direction. At other times, the hidden meaning of such behaviours can be discovered which helps to manage them better.

Work and study issues figure more prominently in therapy than you would suppose. After all, these things occupy a great deal of our time and energy. Again, what happens in therapy if work and study issues come up will vary according to what the therapy duo decide. Sometimes, support and discussion of what to do will be the main thing. At other times, the approach will be less direct.

I said that people seeking therapy often have questions about the meaning of their lives. People in the kind of society we have created often lack a sense of purpose in their life, a lack of a goal with which they can really identify. This is understandable. Therapy can explore how this loss of meaning has happened, and what can be done to feel more fully alive in the world. It's important to get a balance between understanding what is going on in you as an individual and what has entered you from outside.

Here are a few reasons why you should perhaps not consider therapy right away. If you have physical symptoms, whether new or longstanding, you need to get them checked out medically. I am thinking of headaches, breathlessness, anything to do with the digestive system – and so on. It is irresponsible to think that such symptoms are all 'psychosomatic' or brought on by 'stress'.

Similarly, if you are experiencing a social or economic crisis, you should be aware that therapy is not necessarily the best help to get – for example, if you have become unemployed or lost your benefit, or have acute housing problems.

Finally, the decision to have therapy should be your own, personal decision, your act of choice. Having therapy because someone else has got it into their heads that this is what you need and is therefore pressurising you to find a therapist, is not a good idea. I am not saying don't listen to well-meaning advice – but try to find your own reasons for having therapy.

Further reading

What is therapy?

Experience of therapy

Types of therapy

Does psychotherapy really help?