Let’s talk about therapy: Seeking help before things spiral out of hand

By Shubhangi Shah

When you visit a doctor while you’re down with fever, you know what to expect. The doctor will examine you, ask a few questions, maybe prescribe some tests, give you some medicines, recommend what and what not to eat, and you are done. But what if you seek help for mental health? What do you think about how therapy works?

Popular culture has played a part in both stigmatising and de-stigmatising mental health. Speaking of the latter, director Gauri Shinde’s Dear Zindagi stands out for presenting aspects of mental health that are beyond mental asylums and serious disorders. It delves into the key stages of therapy, from the client-therapist (played by Alia Bhatt and Shah Rukh Khan, respectively) relationship-building to the former finally breaking free from her agony.

Although the film took a much-needed non-cliched take on such a sensitive issue that remains a taboo in several quarters of modern India, one cannot help but notice the romanticisation involved. For example, Bhatt’s character Kaira opens up to Khan’s Jahangir in almost the first session, the latter delivers lines that seem straight out of self-help books, they play kabaddi with waves, walk on beaches, ride bicycles, and, before you know, she gets cured just like that. But is that how it actually works? Is therapy that accessible? Does it always involve fun sessions like that on a beach or while riding a bike? Most importantly, do you start experiencing a difference in a matter of a few sessions?

Why do you need it?

Twenty-three-year-old Samridhi Tiwari started therapy in 2016 when she was in Class XII. Then, she was being treated for a chronic medical condition. The added academic pressure due to the upcoming board exams and entrance tests didn’t make her life any easier. They all boiled down to one and “led me to depression,” Tiwari said. She went to her therapist, who also happened to be her doctor, whenever she felt low or demotivated. “It became almost a routine for me to go and talk to her whenever I was dealing with something,” she says.

While it was mental health for Tiwari, it was to process grief that led 23-year-old Anjaly Raj to seek help.

Contrary to the popular belief that only those suffering from serious psychiatric disorders go for therapy, it can, in fact, help with a range of psychiatric and psychological issues. Psychotherapy, commonly known as talk therapy, can help address “symptoms of anxiety, obsession, and depression. It can help in building stress coping skills, improving communication and social skills, relationship concerns, emotional dysregulation, etc,” says Dr Jyoti Kapoor, a senior psychiatrist and founder of Manasthali —an organisation that works in the field of mental health.

What happens then?

The process begins with the psychiatrist or psychotherapist identifying the problem areas. Then, he/she explores the underlying causes behind the emotional and behavioural issues, examines the coping strategies one applies, and sets goals for treating or managing the condition, Dr Kapoor explains. “The process may take several months and even longer based on client’s receptivity, treatment approach, etc,” she says. “In some cases, one may need to undergo some psychological tests to identify underlying issues or get a clearer picture of the conflicts that may be subconsciously troubling the client,” the doctor adds.

When do you seek help?

“In a way, I always knew I needed professional help,” says Anjaly Raj. “But the tipping point came when I went into a relationship and started hampering it and my work because of health,” she adds.

For Samridhi Tiwari, it was “when things really spiralled down, and I thought I might not be able to survive tomorrow”. The condition she was suffering from made her lose a considerable amount of weight. “I weighed just 36 kg then and was actually on the verge of killing myself,” she says. Luckily, she found a therapist in her doctor, who was treating her for her condition.

Both Tiwari and Raj decided to seek professional help when things spiralled out of hand. However, according to Dr Kapoor, individuals who find themselves struggling with mood, emotional or behavioural issues can approach a mental health professional for a proper understanding of the issues they are facing.

Does it help?

“Earlier, I used to think I won’t be able to do anything with my life, that I won’t be relevant,” says Tiwari. However, once she started therapy, her health started improving, and she was able to eat again, study and concentrate. “But most importantly, this whole idea of killing myself changed drastically. Post-therapy, I didn’t feel like killing myself was an important thing,” she adds.

“Therapy helps,” says Dr Kapoor. “It helps you identify your inherent vulnerabilities, root causes of your mental or psychological problems and teaches you how to manage or modify them through practice, motivation, guidance, and insightful awareness,” she adds.

Red haired psychiatrist listening her patient after traumatic events while sitting on beige settee

However, not everyone feels the same. Tiwari feels it all depends on the therapist you are seeing. “I’ve heard so many stories of people visiting bad therapists, spending so much money, and then complaining that therapy is bad. It’s bad because you went to a bad therapist,” she adds.

Cost & duration

“Psychotherapy is a skill-based treatment, and hence its value cannot be quantified by market trends,” says Dr Kapoor. A session can go on for 45 to 60 minutes. Based on the therapist’s qualification, experience, skill, therapy approach, and location, you can be charged anywhere between Rs 1,000 and Rs 10,000 per session, the doctor adds.

“The duration depends on several factors like treatment goal, patient’s receptivity, and psychosocial factors,” adds Dr Kapoor.

Is mental health care accessible?

To date, Tiwari’s family doesn’t know she took therapy. She feels that accessing mental health care is a “very privileged thing” and only those who are financially independent can access it. Gladly for her, her doctor stepped into her therapist’s role and didn’t charge anything other than the normal consultation fee for the medical condition she was initially treating her for.

For Raj, the biggest hurdle between her and the care she needed was “stigma”. However, she feels that now therapy is a lot more accessible than it was some years ago. “Now, you can even access it from the comfort of your bed,” she says.

Offline vs online

“Online therapy makes therapy very accessible,” says Shipra Dawar, an entrepreneur and founder of iWill, an online therapy platform. Also, it has “proved to be effective, especially when done in a systematic and structured way,” she says. Speaking of its utility, she says, online therapy allows you to seek help from anywhere. “You can access it privately, and there is less restraint to start and continue,” she adds.

Young professional woman working in call centre on desktop pc with headphones. Real person with imperfections working in small office with headphones and microphone

Despite the pros, a lack of therapist-client relationships remains among its biggest cons. Also, the therapist at times cannot see the client’s body language, which can bring down the efficacy. However, Dawar thinks otherwise. “Many global studies have pointed out [sic] that there is no difference in connect between offline and online therapies.” But it ultimately boils down to the individual’s choice and situation. Also, online therapy isn’t a viable option for treating serious psychiatric disorders.

Pandemic and mental health

“The Covid-19 pandemic seems to have opened the floodgates to the understanding of what mental health is and its importance,” according to Bengaluru-based Parivarthan, an NGO working in the field of mental health since 1995. There has been a marked increase in the cases of anxiety, depression, grief, and survivors’ guilt. Corporate organisations have also started acknowledging the importance of mental health and why it should be facilitated, it states.

Access to mental health services, just like physical, is our basic right. And collectively, we have made strides toward destigmatising it. It’s about time that therapy is seen as normal as going for a health check for a physical ailment. Admittedly, we have a long road to travel.

Meanwhile, Tiwari attributes it to the timely intervention that she is alive today. “This is how therapy can be life-changing,” she says. For Raj, there were several takeaways. “Our journeys are different, and so are our privileges and traumas. So, why put unnecessary pressure by comparing oneself to others,” she adds.