Ep 6: Should I go to therapy? Removing barriers to accessing support.

Posted

October 31, 2022

Show Notes —

There are times when we already know that we should seek help because of the changes that we are noticing in the way we deal with things in our life. The problem is that many barriers stop us from taking action and make us think twice about getting help. However, thinking about the long-term benefits of seeking help now will help us change our mindsets and start to overcome these barriers.

In this episode, Nathan Illman talks about why you may want to access psychological therapy and when might be a good time to do it. He also discusses the barriers to seeking out help, how to overcome them, and some of the practicalities of attending therapy.

KEY TAKEAWAYS FROM THIS EPISODE

  • Even if we’re emotionally intelligent, self-aware, and have good support, sometimes we still need the support of someone outside our support network to help us work through life’s challenges.
  • An important exercise to know whether or not to seek help is to think about the time when you were functioning at your best and compare it to where you are now.
  • You are not alone in what you feel and there is no shame in getting support from someone else.
  • Someday when you get older, you’ll look back on your life now and think about what could’ve happened if you sought out help.
  • You don’t necessarily need to let certain people know that you are seeking help. Only share it with people who will surely understand and be supportive.
  • We tend to prioritize other people’s needs but we have to shift to this mindset of helping ourselves and thinking about how psychological therapy would help us long-term.
  • The time that therapy will cost you now will pay dividends in the future.
  • Explore and know where to access support.
  • It’s okay to ask and understand the qualifications of experts to see if they are the right fit for you and your particular situation.
  • Public services have limitations. It is important to think about making room and investing your money in your mental health.
  • The first therapist that you see may not be the right person for you and it’s alright. You don’t need to completely give up on accessing mental health services. You may give it another go or find the right person for you.
  • Spend a little time looking at your options for the kind of therapy that might best suit you.

To find out more about Nurse Wellbeing Mission, visit our website: https://www.nursewellbeingmission.com

To join our. community of 250+ nurses and midwives and receive weekly wellbeing resources, join our Facebook Group: https://www.facebook.com/groups/nursewellbeingmission

E-mail us: nathan@nursewellbeingmission.com

Transcription —

00:05

Welcome to the nurse wellbeing mission podcast hosted by me Nathan Illman. This is the place where nurse and midwife wellbeing is at the top of the agenda. Each episode aims to help nurses and midwives around the world flourish through informative, inspiring and practical content and conversations.

00:27

Welcome to the nurse wellbeing mission podcast with me Nathan Illman. I founded nurse wellbeing mission, I’m a clinical psychologist. And I’m really passionate about supporting the mental and physical health of nurses and midwives. So this is my first solo episode that I’m providing for you. And I went around in circles about what to focus on this episode, I’ve got so many different topics that I feel I can offer something to you guys as listeners, but I thought I’d focus on something today that is based on personal experience, and really, I suppose sits within my skill set and expertise as a clinical psychologist.

01:09

So I myself have actually gone back to psychological therapy recently. I made a few posts about this within our Facebook group and the nurse wellbeing mission community. And it’s something that I know many people wrestle with many nurses and midwives is whether or not they should go to see a psychologist or a counselor. And I wanted to make a podcast episode about this talking about why you might want to go and see someone when it might be a good time to go and see a psychologist or counselor, what the barriers are for people in taking that step to pick up the phone or go along how you can overcome some of those and provide a little bit of information about some of the practicalities of what is it like going to therapy. So as someone who has delivered psychological therapy myself, and someone who’s currently attending psychological therapy, I’m in a pretty good position to give you some hopefully helpful information about those things. And I suppose my aim with this episode of the podcast is not to try and convince every nurse and midwife that everyone needs to go to therapy because of course, that absolutely isn’t the case. But hopefully, to help reduce some of those barriers for the people that it actually might be really beneficial for you.

02:29

So I might just start by telling you a little bit about me and my kind of recent journey. And of course, I’m not going to share everything about my therapeutic experience and the all the details about therapy sessions. But I’m happy to share a bit about the reasons why I went back to psychological therapy, and the role that it’s serving in my life at the moment. And this, this is going to be different for different people. But I think it helps provide a bit of context and sharing these kinds of stories can be quite powerful.

02:59

So for me, I’m in a place in my life where I’m not struggling with intense symptoms, say of depression or anxiety. I haven’t experienced any kind of recent trauma mostly been relatively stress free in terms of my working life. Having set up nurse wellbeing mission this year, actually, I’m doing something very meaningful and purposeful, which is kind of contributed to an overall great sense of well being for me. However, some difficult life circumstances have happened for me in the past year. Notably my dad dying last year, and my wife and newborn son having to move suddenly, from Australia back to the UK, and managing lots of difficult circumstances around the death of my dad, some kind of family issues that showed up there, and then having to readjust back to life in the UK. Whilst all of this was happening, that was in conjunction with some other things from my past that felt like they were showing back up again for me.

04:01

So I, like many other people who work in health care, or what you might call a wounded healer. I had some really difficult experiences that happened to me when I was a child, particularly as a teenager. And it’s quite good to think sometimes to reserve the word trauma for things that were really, really traumatic for people. But let’s just say I was under height, very high stress. And those kind of wounds have resurface for me in recent times, really, I guess because of the stuff that had happened with my dad and the stress of that. Anyway, so I just realized, for me it was it was a good point in which actually, I really needed the space with someone who was trained to actually work through some of that stuff. And help me to understand myself a bit better and to sort of navigate this time in my life. It’s a big shift in my life. So as you might be able to tell from what I’m saying there. We don’t necessarily need to have a serious day diagnosis of mental illness or even a diagnosis, to seek therapy for it to be helpful for us.

05:06

So for me, I did lots of work on my own self care. I’m a clinical psychologist who really, I tried to practice what I preach, I meditate, I exercise a vegan diet, are really focus on things that are beneficial for me. And I have a fantastic relationship, my wife, and I talk to you about everything, we’re very open with our emotions. However, I still felt like I needed that space of therapy to talk to someone or work through what was going on up here in my head. Because it’s just not possible to do that ourselves on our own. Even if we’re really emotionally intelligent, we’re really self aware, it’s just helpful to have someone to reflect back to us some of the things that are going through our mind. 

05:51

So there’s a little bit of background about me, and me going back to therapy. So all talk about now is answering this question, which may be going through your mind, if you’re a nurse or midwife you could be a student, you could be an academic you could be working in a clinical setting is, am I sick enough? Do I need to go to therapy? That’s a question people will ask themselves. So what I’m gonna ask you to consider right now is think about you at a time in your life where you perhaps functioning your best. And we can call this your kind of a baseline if you like. So we don’t want to compare ourselves to other people. Of course, sometimes that can be helpful. But really, what we want to do here is to determine whether or not it might be helpful to seek help professional help for something is to think about yourself at a time where you are at your best and compare that to where you are now can be useful exercise. So it might be several years ago, when you were a student, you really felt like you were flourishing. It might just be six months ago, you felt you were fully at your best them. And imagine what life felt like then. What were you doing differently? How you going about your day to day business?

07:08

How did you feel when you woke up in the morning? Did you have a spring in your step? What kind of things did you use to think about or not think about? What was a good question to ask yourself is, what were you not getting hung up on? What were you not worrying about that time? What were your relationships like then? So thinking about your working life? What was your relationship like with your colleagues, your patients? What were your relationships, like with other significant people in your life, romantic partners, friends, your parents? And also what kind of other behaviors were you engaging in? So for example, to what extent were you engaging in self care? So self care could look like any behavior that is designed to enhance your psychological, physical or spiritual growth? Were you going to church? Were you exercising regularly? Were you eating, you know, three to four healthy meals a week?

08:09

Now have a think about how things are now for you. Think about where you’re at and think about a contrast. So what’s going on what’s different for you might not be all of those things. Think about? What are the main areas that feel like they have perhaps deteriorated for you. It may be that your sense of self, your relationship with yourself has deteriorated in some way. Perhaps you’re viewing yourself in a particularly negative light at the moment, or even self condemning, perhaps you’ve been struggling to forgive yourself for something. And now actually, you are very preoccupied by something that happened in the past. And it’s very difficult to let that go. And that’s creating a lot of anxiety, stress for you, perhaps you’re not sleeping now. Whereas the other time we just considered perhaps you’re sleeping seven hours, eight hours per night.

08:09

So just see if you can imagine a little bit of a comparison there. And this can be a good point to start with asking ourselves, do I actually need some help from someone else here? Before we get to that stage, it actually can be useful to think about what have I tried recently to help myself? What have I tried recently, to improve my mental physical well being? And has it worked? You know, taking a good honest look at what we’ve tried? And thinking have I been able to do this on my own, or even with a bit of support from friends and family? And as I mentioned to you in my sort of background, my little story at the beginning about my recent reengagement with psychotherapy. I’ve been doing all these great things. And I that had been helping me through this difficult time in the past year, and I still recognize that actually, there was Something, something about my emotional world that I wasn’t able to manage to sort of optimize, I guess, if you like, on my own. And for me, that was a good enough trigger for me to seek therapy again.

10:15

So think about yourself, have you, perhaps you’ve been trying to change and unhelpful, or perhaps even destructive behavior in your life, maybe it’s alcohol consumption, maybe you’ve been trying for a few months to cut back your drinking, but everything you do doesn’t seem to work, for example, it could just be other health behaviors, for example, exercising, or it could be in your relationships, perhaps your relationships have become a little bit chaotic, perhaps you’re being much more reactive, and stressed and maybe unkind in certain relationships. And you’ve kind of tried, you said to yourself, I’m going to try and do better next time. And that’s not worked out for you. And that’s actually leading to quite a lot of distress for you. So when we ask ourselves this honest question of has what I tried actually been working, it can be quite difficult and confronting to hear that answer the response, if it’s No, obviously, all of us, as human beings, nurses, midwives, doctors, anyone, we have a drive to kind of protect our own sense of self, our ego identity. And it’s quite difficult to confront the fact that actually, we’ve not been doing so good, we’ve not been doing as well as we would have liked to in some area of our life, this can be a really good point to seek the help of a trained professional.

11:37

So I want to talk about some of the barriers that prevent people from accessing psychological therapy. There’s actually a lot of research on this. There’s a big research literature about why do people not access psychological therapy. So as a clinical psychologist, when I did my doctorate years ago, now, we trained when we’re given lots of education, about different types of therapy on what works and why they work and that sort of thing. But of course, there’s there’s no use and having all these wonderful psychological treatments, if people aren’t going to actually access those treatments. Similar to in medicine, it’s great that if pharmaceutical companies can come up with new drugs, or new different treatments, and maybe some new technological innovation in medical treatment, but of course, we need to get that roll that out to people to actually for it to have an effect in society and benefit people.

12:34

There’s some research that actually specifically looks at barriers to nurses and midwives, accessing psychological therapy and treatment. And I’ll talk a little bit about that now. And some of this, if you’re listening to this podcast, I expect will resonate with you, if you’ve been thinking about therapy, and you haven’t yet made that move. So let’s begin by talking about shame. So, shame is human emotion that we all experience, and you would have heard the word shame you would have, you would have had some sense of what shame is, shame is different from guilt. So shame is a sort of deep sense that, that we’ve done something bad there is something wrong with us as a human being. Guilt is feeling bad about a particular behavior or action that we have done, perhaps a moral transgression. Now, there can be a sense of shame around accessing help, because it can feel like there’s something wrong with me if I need to get help from someone else. So obviously, when our mental health starts deteriorating, perhaps you’re burnt out from work, there might be other things going on in your life, we can feel a sense of shame from other things going on. But then to actually have to sort of face the fact or face the possibility that you might need to get help from someone else, and that you haven’t been able to manage that yourself can create a deep sense of shame. 

14:01

Now, there are some particular things that exist within the professionals of Nursing and Midwifery and in medicine in general, that can contribute to that sense of shame and create that barrier or perpetuate that barrier. So one of these is the armor that is put up and the bravado that is created within medical cultures, medical systems, and nursing and midwifery. And I hear this from nursing and midwife colleagues that I speak to that during your training and after your training. And this isn’t always the case, but I do hear it commonly is that there was a sense that you need to be tough, and that you need to sort of push on and get through things to be resilient. So resilience is a word that has been used, perhaps overused, and unfortunately, consumers have the unintended consequence of making people feel shame if they’re not coping with difficult, genuinely difficult circumstances working conditions.

15:04

The current climate of healthcare, of course, is not conducive to optimizing nurse and midwife wellbeing. There in the UK, particularly is the context that I obviously come from there are massive shortages in staff here, there are serious systemic issues with the way that nurses are trained or, and provided support for the emotional side of the roles that they’re doing. And nurses and midwives are just not protected from potentially harmful traumatic things in the way that they perhaps should be. So of course, really, there is no shame in struggling with some of these situations, because we are only human, you are only human. But of course, if you are working in a team or department in which there is a real sense of bravado, that, you know, you should be okay, working, having done a night shift the day before. And, you know, essentially, the messaging is that you’re weak, if you need to take a break, or you need to go outside for a walk or engage in some sort of self care, when of course, you’re going to feel that there’s something wrong with you that you are less than if you’re considering accessing psychological therapy, because that point at which we actually say, I need someone else to help me, it completely feels like we’re giving away that sense of control, doesn’t it? Thought we had control of ourself of our own well being our own psyche, and then it can feel like, Oh, my goodness, that would mean that I am no longer in control, and I have to give that up. So shame is a big barrier. And because of the particular cultural features within medicine, and Nursing and Midwifery, this can really add to that sense of shame. Part of what I want to do, and I hope to be doing with this podcast is to try and normalize the experience of seeking help to make it feel less threatening. And that’s why I shared my story, my experience of me going back to therapy. So it’s very well known that men tend to seek help less than women as well, there are higher rates of things like substance use in men, and it’s thought that men tend to self medicate, for example, rather than going to seek help from someone else. Again, because of traditional sort of masculine gender, gender roles. Many men have the sort of belief that men don’t need to get help men shouldn’t get out men should be able to deal with things on their own.

17:45

Obviously, I’m sharing with you that personally, I don’t hold those beliefs, I think that it’s okay to seek help. And for me, I think there is a certain level of humility, especially for someone like myself, who is a clinical psychologist who works with people clinically, a certain level of humility to actually say, you know, what, I haven’t got all the answers. I haven’t got all the answers for myself. And I haven’t got all the answers for other people. And it’s okay to go and find someone else who can help me get through this. So I speak to nurses and midwives as part of what I do with nurse while being mission. And I can tell you, there are lots of other people out there who are thinking and feeling the same thing as you, as a nurse or midwife, whether you’re a student, whether you’re working in a hospital, whether you’re working in the community, there are people who share the same feelings as you same similar feelings of burnout, and maybe even depression, and wondering whether or not they should access, support and help. You’re not alone in how you feel. And there really is no shame in going out and getting that support from someone else. And our minds might try to convince us that we are less than others, if we do that. But a good way to think about this is what’s the alternative? 

19:10

When you look back on your life when you’re older. So you’re 80, 90 and you’re at the end of your life, looking back on this time, at that stage, do you think then that it would have felt like the right decision to not seek help or seek treatment for your difficulties, really just in the name of preserving some sense of, kind of outer exterior sense of strength and resilience to other people around you. By that time? You wouldn’t even be working in the same place that you’re working now. You may no longer even stay within the profession of nursing and midwifery. Pretty sure most people if they think about their life from that perspective, looking back from the end of their life, they would have wanted their past self to do whatever they could to actually enhance their sense of well being, to create a better life for themselves, and particularly, to enhance their relationships in other areas of life other than just their their working life. Because at the end of the day, that’s what matters most to us as human beings, is a sense of connectedness with others.

20:20

Now, of course, one of the other aspects of shame and not wanting to appear that we’re weak is important to consider that, that is a reality within certain teams or organizations. And I’ve heard that before from people that if they were to let their senior team members, for example, know that they were seeking treatment for something that would genuinely impact the view that that person had on them. So this is a reality that we perhaps cannot escape. And I don’t want to sort of invalidate that or deny that, that the existence of that. So you may be someone who’s thinking, Well, I think it might be good for me to actually seek some treatment. But actually, I don’t want my manager to know or I don’t want my colleagues to know, because the sort of implicit messaging or maybe even explicit messaging, you’ve heard from them as people who go to therapy are weak in some way. In that kind of situation, then, of course, I would really recommend just being kind of discerning about who you tell you’re going to therapy or treatment,

21:30

You don’t necessarily need to let certain people know, I’m obviously being very open about the fact that I’ve been to therapy, I’m literally recording this on a podcast. For me, because of the kind of context that I’m in, it feels like there’s really no kind of I’m not expecting any judgment from people about me sharing that. And to be honest, I don’t really care whether people do judge me for it. But I completely appreciate that for some people. That’s a basis of real concern, in which case, what I don’t tend to recommend to people is only share it with people you’re confident, will actually understand and be supportive of you going to psychological therapy. People that you get a sense that they have positive attitudes or beliefs towards accessing support. That could be friends, it could be a parent, it might just be one single colleague at work. And, of course, you want to share that with someone that you trust, you don’t want to share it with someone you think might tell people that you don’t want to know, for example, of course, we don’t have to tell anyone we’re going to therapy if we don’t want to. It’s a kind of personal and individual endeavor, that you’re going to go and access that support. And it will help you make more hopefully radical changes in your life, to really improve your well being and other people around you will probably notice that there are some changes happening for you and be very happy for you. But of course, you’re not obliged to tell anyone you’re going.

21:30

So let’s talk about some of the other barriers that have shown up in a recent research paper that was published in 2021. A few of the other barriers that were mentioned by nurses in particular, for not accessing therapy, where time was one of them being busy at work, for example, just really not feeling like they could actually leave to then go and get support in their own personal life. Actually, just being busy with desk day to day managing a family, for example, is clearly a barrier with time. And of course, this is a real issue at work when if you’re already overworked, there’s not enough staff, if you were thinking for perhaps of accessing an employee assistance program, for example, actually feeling guilty about leaving your workplace to then go and access some sort of counseling may be a kind of barrier for you, or in your personal life. It may be that you’ve got responsibilities with your children, or maybe you’re caring for an elderly parent, for example, and you feel guilty about giving up some of the time to do that which may be limited if you’re working full time to then spend an hour or whatever for yourself.

24:17

So for me, this was a big consideration as well as the time factor. I’ve got an 18-month old son, I split my working time with my wife, I parent, my son the other time I try and I’m trying to run a business I’m trying to cram in time to build momentum with that and do the things I want to. I’m trying to have a social life. I’ve got my mum that I like to try and see my brother, of course so what our minds do is they tend to start prioritizing things. And for many of us who work in healthcare, we tend to prioritize other people’s needs. It’s so such a common thing. And I’m sure many nurses and midwives out there listening to this will feel this way. But we have to shift this mindset, we have to look at the kind of longer term benefit of accessing something like psychological therapy.

25:10

So the hour or say two hours with travel preparation or whatever it might take per week of you accessing therapy. In the moment, it will feel like you will focus on all the things that you’re not able to do in that time. And you’re probably feeling stressed or anxious if you’re listening to this and thinking about the therapy. But the fact is accessing the therapy is what’s going to help you to not feel so stressed and anxious in the long term, and is actually going to make you be the more of the kind of person you want to be in the relationships, you think you’re neglecting by going to therapy in the short term. And that’s what I tried to focus on. So I tried to focus on each week when I’ve been going to therapy, my mind keeps telling me all the things I want to do in my business, and I’m missing out on. But actually, it’s about reminding myself that this is really helping me become the person that I want to be. It’s helping me deal with the emotional things that I want to, but it’s going to help me and it is helping me be the kind of partner I want to be, the kind of dad I want to be the kind of son I want to be and the kind of psychologist that I want to be. So that’s something that I offer you to consider is think more about the long term benefit of of what it will help you with that. What seems like that time cost to you now will pay dividends in the future.

26:36

Another practical barrier that’s shown up, or the shader from this research paper that I mentioned previously, was as you just know, where to access support. So in a qualitative study, there are a number of nurses who said, I don’t even know where in my organization I could seek support from. And this is, can be a bit of a failure, I guess, of well being support within large organizations in particular, and sometimes small ones, is that there’s a lot of stuff on offer many of pretty much all NHS Trusts now will have wellbeing services, specifically for staff plenty of online resources. However, despite this kind of wealth and depth of resources, actually, like anything, if it’s not marketed to people, or advertised to people, people aren’t going to know about it. And because you’re a busy nurse or midwife, you’re not going to spend your spare five minutes, probably looking through all of the resources or trying to find those resources.

27:41

Now, I sort of believe that we do have a personal responsibility at ourselves, to seek out some of these things. But of course, you know, if you are so busy, it can be difficult to make the time to do that. So what I’d really recommend is if you work in an organization, a large organization is actually just going on your staff intranet, or asking your manager, where can I find resources related to well being, there will be a variety of things, I’m sure there can be self help type resources, but all organizations will have some form of what’s called employee assistance programs. It’s basically a service where they can provide things like counseling to people. So just go out and do that go and explore. So if you can just allocate yourself even 10 minutes to do a little bit of googling. And I’m sure you’d be surprised at what you actually find you may have been working in an organization for a long time, and never really knew that this stuff was on offer. And you might be pleasantly surprised to find something that speaks directly to you. It might just be a little webinar that you can access. But also it might be actually individual psychological therapy is offered for free within your organization. I know locally here where I am in Brighton having done a little bit of research at local organizations wellbeing resources. There are several different free stuff, wellbeing sort of therapy counseling services that exist that provide a number of sessions for staff. It’s a great resource.

29:13

Okay, so another scenario then is that perhaps you are aware of local psychotherapy services, you’re aware of your public health funded services, you’ll maybe have some awareness of what’s going on in your organization, but you’re just not really sure whether what’s on offer is going to match particularly well the difficulties that you’re experiencing. So there can be a number of different reasons that someone might seek therapy have kind of touch a little bit on those. It could be issues with excessive worry and thinking things over, not forgiving yourself for a past mistake. So what happened in the course of your work? It could be that you witness something particularly traumatic, much playing on your mind and creating lots of anxiety and stress and potentially issues with using substances to manage the difficulties you’re going through. It could be that you’re experiencing work related bullying, for example, you know, that can be common in the nursing and midwifery professions. It’s a very unfortunate sort of phenomenon that happens, and that can create much distress with people. So there’s a number of different reasons people might want to seek out therapy. But then you might be thinking, Well, how do I know I’m gonna get the right service for me, and this is where a bit more of that discernment. And actually, perhaps experimentation is going to be important.

30:43

So what kind of complicates things, it does not make it easy if people want you to access psychological therapy is that there are a number of different people who actually are qualified to sort of work psychologically if you like, with people, there are counselors, different types of counselors, there are clinical psychologists like myself, there are people who work in private practice, who just called psychotherapists, for example, then their psychiatrist, some psychiatrist might offer therapy as well, as well as prescribing medications for mental health. So it does make it quite complicated. One of the things to bear in mind is that you are someone who is looking to find treatment for your difficulties. And you’re absolutely allowed to ask questions of the person who may be providing you that treatment. So it’s all right to ask what kind of experience a particular psychologist or a service has, in working with or treating the particular difficulties that you have.

31:55

A really good example of this, for example, is working with trauma or PTSD. So trauma is actually a specialist area. So just because someone has trained as a counselor, or just because they’re a psychologist does not mean that that person has had specialist training in applying evidence based approaches to working with someone who has undergone or is a survivor of some kind of traumatic experience, for example. So it is really important to sort of understand the qualifications that someone has and the kind of experience they have with the difficulties that that you’re going through. Totally alright to ask those kinds of questions work out, actually, is this going to be a good fit in terms of their expertise and their competence. So I’d really recommend you doing that, if you’re looking for someone.

32:46

There’s something I want to touch on here is another potential barrier being cost. Now, here in the UK, we have a public health system, Public Health Service, and there are in many of the countries of the people who be listening to this, which will provide you some level of care will provide you some access to care. And I think we overall, we do a pretty good job of that in the UK, you can offer a certain number of sessions generally, relatively easily for common psychological difficulties. Having said that, there are limitations to this, you know, it’s publicly funded, which means that you’re not going to get everything for that you’re not going to get any sort of an expansive approach necessarily. There are limitations to this. So it does mean that you’re not going to be offered the full range of different types of therapies for example. You might have a bit of trouble with picking and choosing particular therapists just because of availability. And in terms of how long you receive treatment for. You may be a bit limited in how many sessions they offer you. So this is where it’s important to have a think about investment of your home money in your mental health. So I know that many nurses and midwives are underpaid and really feeling financial pressure. And again, I don’t want to sort of take that away from people I truly understand that. Something I would like to offer you though is the potential benefits of investing financially in our own mental health, if you can afford to do it. If you can, maybe make room to afford to do it by cutting back on something else in your life. You can open up the possibilities for you in terms of what you access for psychological therapy.

34:47

I myself am paying privately at the moment for both therapy and coaching. I’m in a privileged position to be able to do that. It’s still uncomfortable for me to be paying, you know hundreds of pounds, basically for these things, but I recognize the value of investing in myself. And when I put money down to do these sessions, it makes me go and it makes me do the things that I talk about in the sessions, if there’s some sort of action plan as well. And because when we invest in our own mental health, we do get a bit more access, bit more variety, bit more selection, if you like. So maybe that if you have the money to do this, then you can broaden your kind of net, if you like, of who you’re looking at working with, potentially.

35:32

Now, I mentioned kind of experimentation. And I guess what I mean by this is that, you know, what, the first psychologist that you see may not be the right person for you. And it’s alright for that to be the case, right, we all have our own personality. And sometimes it’s just not the right fit with somebody that we work with. So whilst I do my best to make my clients, when I was doing therapy previously, to make my clients feel comfortable, to make them feel heard and understood, and to deliver the kind of technical skills of doing therapy, you know, what, at times, they’re just people who, for one reason or another, they just don’t feel like my approach is the thing for them. And that’s okay, of course, you know, as, as sitting on the other side, as a psychologist, that can be quite difficult, because we want to be able to help people, but we have to acknowledge that actually, sometimes somebody else is is better placed towards a better match to providing that care and support for somebody. So because there are a different range of different mental health providers, different qualifications that can put someone in that position, to be competent to do the work, it’s important to have an open mind and be flexible, and not put too much pressure on things when you first start.

36:53

I’ve heard from people in the past that they’ve had an experience with a therapist or counselor that, you know, didn’t really sort of meet their expectations. And that really kind of put them off. And that’s a shame that can obviously also create a barrier if they didn’t feel like they actually are actually helped them. And they may then sort of generalize that and think, well, this just isn’t helpful, seeing a psychologist isn’t helpful. My advice rollout would be please give it another go. Give it another go. And maybe this time, asked more questions in the beginning, if you didn’t ask beforehand about kinds of people that they’ve worked with, or the kind of approach that they’ve used, just do your kind of preparatory kind of, I was gonna say interrogation, not interrogating them. But it’s just a bit of investigative work to make your decision to make more of an informed decision, perhaps about whether or not that is the person that you want to see.

37:44

With anyone who wants to work with me, I do coaching now, I’ve got a lot of social media materials, I’ve got this podcast, I think people can get quite a good sense of who I am and what it might be like to sit in a room with me, talking to me. So I would always kind of refer people to check me out basically, to listen to me to the kinds of things I say the way I say it, and the things that seem to be important to me, and you’ve probably get a good idea of if I’d be the right kind of personality fit for you, for example.

38:16

Okay, and I’ll just do a last little section here around what type of therapy should I seek out. What type of therapy do I need? This is quite a big topic, because there are so many different types of psychological therapy. Now, if you’re not in a position to pay privately to access psychological therapy, then this actually becomes quite a lot easier because in a sense, you’re kind of quite restricted by what you’re offered, especially in this country. But in most of Western countries, the main psychological approach that’s offered is something called Cognitive Behavioral Therapy, or CBT. There are a few other ones that are offered a little bit more sort of commonly, I suppose, in the past 10 years or so. So for example, dialectical behavior therapy, Acceptance and Commitment Therapy, interpersonal psychotherapy, or brief psychodynamic psychotherapy, in the psychological literature, there is evidence to support a real big range of different psychological treatments for different difficulties. So I’m not going to go into all of these but I think something that’s that would be important for you to consider is, to what degree do you like structure within your therapy sessions? And to what degree do you want to learn or go to therapy with the intention of being quite focused on specific things to identify and change in your life and learn new skills?

39:49

So cognitive behavioral therapy, which is sort of one of the first line treatments for things like anxiety or depression or post traumatic stress disorder very In a structured type of therapy, that is time limited, typically between sort of eight and 12 sessions, something like that, sometimes less, sometimes more. Each session is, has a very sort of set structure if it’s being done properly. That is, of course, and of course, you know, it’s a sort of open space, and there is discussion, and you will talk to your therapist in a way that is not completely rigid. However, it definitely feels much more structured and kind of contained and you’re sort of following a kind of process. Then other types of therapy, such as psychodynamic psychotherapy, or what I’m currently going through at the moment, which is called existential therapy.

40:43

So if you’re looking to gain some new skills to help manage difficult emotions, say anger or anxiety, something about cognitive behavioral therapy, Acceptance and Commitment Therapy, or dialectical behavior therapy, they will be really good options for you. However, if you’re someone who feels like you’d prefer a bit more of an unstructured approach, so you go in, and you’re looking to talk, and explain and describe things are going on in your inner world. And, of course, have someone sat opposite you who is going to be compassionate and non judgmental, understanding, but isn’t going to be highly structured and kind of bit more rigid, then you might want to look more on the counseling side of things. And also, looking at existential therapy, potentially, you might be looking at psychodynamic psychotherapy, because these approaches tend to be ones that allow a bit more space, I would say, and that’s what I’ve been experiencing in my therapy recently is I go in and my therapist isn’t, there’s no sort of agenda if you like, I bring to the session, things that have been showing up for me, and she will sort of guide me along in this session. And there’s no rigid formula for what we’re doing. And of course, both of these different approaches can work and can be beneficial. And again, that’s why I mentioned the whole experimentation thing, you may try one thing and think, ah, like CBT, cognitive behavioral therapy, that is not for me, but don’t be put off completely by therapy or counseling, because there is someone else out there with a different approach that would probably be much better suited to you.

42:20

Okay, so I’m gonna put a sort of close to things here, I suppose the last thing I want to say, with respect to seeking treatment and seeking help is if things really are difficult for you at the moment, and life is really felt quite tough, especially if you’ve been having thoughts of killing yourself or of harming yourself or even harming other people, for example, that is really a sort of key sign it would be useful to seek treatment and seek support from someone else. If what you’ve been trying yourself hasn’t really been working. I really encourage you to pick up the phone and call someone. You could even start by just be calling a helpline, for example. Helpline for nurses or helpline for suicidality if you’re feeling suicidal, but then making that next step and actually doing a bit of research. And just giving it a go with with getting in touch with a service that provides therapy or counseling. Having worked in this space myself, I’ve seen people’s lives I’ve helped people transform their lives. And you can also be that person, you could be that nurse or midwife who accesses this gets through those barriers of potential shame or what people might think of you or what you might think of yourself, you overcome the barriers of time and the practicalities of accessing it. And in six months, your life could be drastically different to what it is right now. Of course, I’m biased as a psychologist, but I really hope you can tell I’m sort of speaking about this from the heart, being someone who has accessed and is accessing therapy myself at the moment and being someone who has been the person on the other side delivering therapy to people.

44:12

So if you would like to find out more from me you got any questions about this, please get in touch. You can contact me on Facebook, you can join our Facebook group nurse and midwife wellbeing mission. You can send me an email Nathan at nursewellbeingmission.com. I’ve been talking about therapy in today’s session, but as I’ve mentioned a couple of times I provide one to one coaching for nurse and midwife leaders. I have a coaching program which is all about helping you flourish to find ways of managing stress and lead with confidence and compassion. This is a slightly different to therapy. It’s where perhaps if we think about a scale of your mental health, perhaps you’re not really struggling in lots of different areas in your life, it’s in your working role, you are having some difficulty with processing emotions or managing stress. And you’d like to find ways to improve that. And perhaps be a bit kinder to yourself and overcome some of the internal barriers you have with being the kind of leader that you want to be. And that is something I can help you with. So feel free to get in touch with me about that. You can check out our services and resources on our website, nursewellbeingmission.com Thank you so much for listening. Whoever you are, wherever you are out there. I care about you. I care about the nursing midwifery workforce, and I really hope that this episode has been helpful for you. Thanks, bye

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