MIND MOVES/Marie Murray: It is sometimes said the mentally healthy choose psychotherapy. Like the person who has frequent dental check-ups, whereby decay is offset by treatment, mental health also requires regular self-observation, evaluation, insight and willingness to address problems.
The start of a new year is an appropriate time to remember the past, reflect on the present, anticipate the future, make a wish list of goals for the next year and consider what mental health issues, if any, require your attention.
Of course, many of life's hassles are just hassles: normal vicissitudes of living with which one copes through a combination of common sense, self-determination, affirmation of family and a supportive work environment. Other problems are eventually unravelled by time: that great healer and provider of perspective on life.
Some emotional difficulties are personal, some marital, some family-generated or work- related. There are problems that are a combination of these, allied to the exhaustion of juggling the multiplicity of tasks, the imposed roles, the expectations of others and the multidimensionality of 21st century life.
Still other stresses are specifically occupational, arising because of the nature of one's work, workplace conditions, relationships with colleagues or when workload exceeds a person's capacity in a way that is overwhelming, undermining or conducive to occupational burnout.
And sometimes, despite attention to mental health, there are emotional cavities, areas that cannot self-heal, that are infected, painful, throbbing for attention and a source of significant distress to oneself or others. Past wounds, personal hurt, psychiatric disorder, psychological conditions, interpersonal conflict - these may require professional consultation. But how do you know if you need attention and what kind of intervention you need?
Whether intervention is required for workplace problems depends on whether it has reached the stage of daily dread, intimidation or fear of harassment, humiliation or exclusion, alteration in capacity to perform at work and stress-related physical symptoms that affect you and your family in a pervasive way.
The question as to whether or not "help" is required in personal contexts rests on the degree of difficulty either experienced by you, by family members which they attribute to you, or by a family member which affects you or others sufficiently often to make life difficult.
Intervention is required if it is a problem that has not resolved with time, with your best attention; if it has physical consequences causing fatigue, headaches, sleeplessness, problems of eating too much or too little, substance reliance, overuse or abuse, irritability, mood unpredictability or alterations in mood; if it has changed home life, made family members sad, anxious, angry, depressed, withdrawn or helpless and altered the quality of life.
If you do not know what to do and who can help and if each day becomes a greater struggle than the day before, a GP visit and referral to an appropriate professional is required.
What is an appropriate professional? There are an alarming array of potential therapies in our highly interventionist world. In the absence of legal registration of counsellors, therapists and allied practitioners in this country, it is important to ensure a therapist is registered with a recognised professional body to which he or she is accountable; one with ethical standards, confidentiality and professional development requirements, annual registration, and disciplinary and complaints procedures. The Psychological Society of Ireland and Family Therapy Association of Ireland, among others, provides lists of those registered with them.
Psychotherapy as a discipline is just over 100 years old. Approaches to psychotherapy are many. These include cognitive behaviour therapy (challenging distorted and unhelpful thinking); couples and family therapy including systemic psychotherapies (examine context, meaning and relationships); constructivist psychotherapy (invites clients to examine their experiences, ideas and anticipated ways of acting); humanistic and integrative psychotherapy (for creatively unfolding and maximising the functioning of a person's life); and psychoanalytic psychotherapy (based on the ideas of Jung including understanding personality, the unconscious, wholeness, images and symbols, dreams and active imagination).
A psychotherapist's discipline of origin, for example, if the psychotherapist is also a psychologist, nurse, psychiatrist or social worker adds further information to assist selection for a specific problem. Psychiatrists are not usually consulted for career changes, nor life coaches for psychiatric disorder; marital therapy is not for mediation, nor mediation for clinical depression; family therapy is not cognitive therapy and counsellors may have designated areas of competence.
Knowing what you require, who provides it, that it is an appropriate safe intervention is critical: thereafter engagement with therapy tends to be a matter of personal choice, connection with the therapist, the model of therapy and the counselling goals. And give therapy time. Problems a life-time in their making cannot be resolved in a single session.
Clinical psychologist and author Marie Murray is director of psychology at St Vincent's Hospital, Fairview, Dublin.
mmurray@irish-times.ie