Talking therapies

The people we spoke to had tried many different types of talking therapies. These included regular appointments with counsellors, psychologists, or psychiatrists, as well as forms of psychotherapy such as Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy, and group therapy. People also talked about the benefits of meeting and talking to other people through support groups about their experiences of living with a diagnosis of schizophrenia, psychosis and/or bipolar disorder. You can read more about this here: Support in life decisions, and Mental Health Community Support Services and Peer Support.

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The benefits of talking therapies
When talking treatments didn’t work

Almost all the people we spoke to had experience of some form of talking therapy over their lifetime. Most people saw a psychologist to ‘understand the root cause’ of their diagnosis, to deal with unwanted behaviours at particular times in their lives, to learn coping skills to deal with distressing emotions, or to explore ways to live with unusual experiences such as hearing voices. Although psychiatrists and psychologists have different training, psychiatrists can be trained in psychotherapy and some mentioned how their psychiatrist did psychoanalytical therapy with them, for example ‘Freudian therapy’. Carlo’s psychiatrist ran group therapy sessions where those who attended spoke about ‘things like fear and courage’. Some people had seen psychotherapists before their diagnosis to help with feelings of stress, anxiety or depression.

People accessed talking therapies while they were in hospital, through mental health clinics, GP referrals, mental health community support services, or privately. Lisa mentioned that many people she knew were referred through their GP and received six free sessions with a psychologist, via the Medicare rebate. She thought this was inadequate for ‘people with long term mental illness’.

When Tanai was in hospital they organised group therapies, where diagnoses were explained and people could speak openly. She felt she gained personal insight from these sessions.

For most people therapy sessions were face-to-face, however, Niall and Carlo spoke about using helplines such as Lifeline or beyondblue. David described how he had accessed phone support when his support worker was away. He said that this helped him to identify that he needed assistance with the ‘basics’, like eating properly, exercising and sleeping. This led to face-to-face counselling sessions.

The benefits of talking therapies

People described many benefits of speaking to a professional therapist. For David, it was about ‘understanding… feelings… motivations’, while others found it helped them deal with feelings of stress and anxiety or mood swings. Michelle, who was diagnosed with schizophrenia, described how she had seen a psychologist regularly. Although she didn’t discuss schizophrenia with her psychologist much, she found the sessions helpful with ‘coping with life generally’. Gurvinder had a ‘really good’ psychologist who gave him techniques such as mindfulness to deal with the voices in his head. Carlo said the group therapy sessions run by his psychiatrist also covered mindfulness, meditation and ‘spiritual topics’. He found these ‘really, really helpful’ because it was ‘beyond just the medication kind of dialogue’.

Opening up to a talking therapist for the first time was often an important step forward for some people.

Simon said he was referred to a psychologist after a ‘Freudian’ psychiatrist refused to work with him. It was the first time anyone had ‘ever listened’ to him.

Talking therapy opened new doors for some people. After the group sessions with his psychiatrist, Carlo described how he went on to see a counsellor and arranged family counselling with his parents, which helped him ‘address a lot of fears which probably stemmed from childhood’.

For Evan, having counselling gave him a sense of motivation and enabled him to do things he otherwise wouldn’t have done.

Some people felt very strongly that they needed talking therapy at particular points in their lives. Michelle said that when she had some ‘space’ from her illness and had ‘healed a bit’, it was the ‘right time’ to ‘look deeper’ into what happened and why. A few people told us that it was difficult when talking therapies were not available when they felt they were needed. Jenny described how she wanted CBT to help her control a disturbing voice that she was hearing. When her psychiatrist said ‘she’d had schizophrenia for too long and it wouldn’t help’, she said she felt so ‘down in the dumps’ that she attempted suicide.

A few others, however, didn’t think there would be any real benefits from talking therapy, or only realised the benefits later on. Tanai had just started DBT when we spoke to her. She was not sure if it would help but said she would ‘give it a go’.

It was only after she left hospital that Lisa realised she had benefited from the group therapies she had there.

When talking treatments didn’t work

Quite a few people talked about negative experiences with talking therapies or how they could not see their benefits. Some who had experienced counselling and psychotherapy found it repetitive and too open-ended, or felt it didn’t get to the point. Brendan saw a psychologist for 18 months and by the end felt there was ‘only so much that you can talk about your relationship and your mum and your dad’. Although the therapist had said if he stopped he might miss out on finding out something important, he didn’t think there was ‘a breakthrough to find’.

Taylor experienced counselling with two psychologists but felt this was not helpful at all. One gave her breathing techniques and the other ‘tried’ positive thinking techniques but she needed practical support.

For some people it was difficult to open up to or trust a therapist. Brendan mentioned the difficulty of finding a ‘good’ therapist: ‘you don’t know who’s good and who’s not’. David was ‘terrified’ of ‘talking about [his] innermost feelings’. He said he would have to get to know someone and trust them ‘to let down [his] guard’. Although Vanessa’s psychologist was helping her with sleep and other problems, she said she was reluctant to disclose ‘things that have happened in my life that I know are responsible for why I feel so bad’ because she felt there was ‘no confidentiality’ in the regional city in which she lived.

Quite a few people spoke about not getting on with some of the psychologists they had seen. Carlo and Tanai both described having an instant dislike to particular therapists they had visited. Carlo said of one therapist: ‘he had a smirk on his face and made me feel uncomfortable’. The first psychotherapist Michelle saw ‘rubbed [her] up the wrong way’.

Before he was diagnosed with depression Brendan saw a psychologist for other issues. He said he didn’t speak much about ‘what was going on’ for him.
Lisa was 14 when she saw a psychologist for help with bulimia. She said the psychotherapist asked a ‘bizarre’ question and felt she wasn’t the ‘right person to speak to’ at the time.

A few people felt talking to a therapist could make things worse for them.

Allen said talking about mental health ‘time and time again’ could prevent you from moving forward. He felt it was important to talk about things other than mental health sometimes.

A couple of people gave examples of when talking therapies had themselves created problems. Brian experienced Eye Movement Desensitisation and Reprocessing (EMDR) – used for treating trauma – when he was seeing a therapist about his sexuality. During the session he recalled being abused by his uncle and possibly by his father; he later realised his father did not abuse him. He thinks at that time he ‘just took on too much information and broke down’ after that. A few years later he said he started getting ‘signs of schizophrenia’.

Jenny said that she saw a social worker because she was hearing voices. The therapy worked, but the social worker’s voice became a new dominant voice that ‘tormented’ her.