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Can Psychotherapy Help Me?
Summary: This page explores what psychodynamic psychotherapy can realistically help with, including anxiety, depression, grief, trauma and infant loss, and answers the questions people most often ask before starting therapy.
Estimated reading time: about 16 minutes.
What you will learn: how psychotherapy approaches anxiety, depression, grief, trauma and infant loss, what happens in a first session, how online therapy compares to in-person work, and how to think about whether psychodynamic psychotherapy is right for you.
Contents
You don't need a diagnosis
-Anxiety
-Depression
-Grief
-Trauma
-Pregnancy loss and infant loss
-Relationships
-Identity, culture and belonging
What psychotherapy cannot do
Psychotherapy isn't the only answer
Is Psychotherapy Right for You?
Online or face-to-face psychotherapy
Finding the right therapist
Questions people often ask
What Happens in the First Session?
What I've learned
A final thought
If you're thinking about psychotherapy
Further Reading
You may also find helpful
By this point you may have some understanding of what psychotherapy is and how it works. The next question is probably the one that matters most.
Could it actually help me?
It's an understandable question. After all, beginning therapy asks a great deal of us. It requires time, emotional energy and often the courage to look at parts of our lives we may have spent years trying to manage on our own. The honest answer is that psychotherapy can be enormously helpful for many people. It is also important to say that it isn't the answer to everything. No responsible therapist should promise that.
Psychotherapy cannot prevent painful things from happening.
It cannot remove grief.
It cannot guarantee happiness.
It cannot make difficult decisions for you.
What it can do is help you understand yourself more deeply, so that life becomes less tightly organised around emotional patterns that have caused suffering for so long.
For many people, that changes far more than they expected.
You don't need a diagnosis
One of the biggest misconceptions about psychotherapy is that you need a mental health diagnosis before asking for help.
You don't.
Many people who contact me have never seen a psychiatrist. They've never been admitted to hospital.They've never received a formal diagnosis of depression or anxiety. What they do know is something has changed.
They don't feel like themselves.
Perhaps they're constantly worrying.
Perhaps they feel emotionally flat.
Perhaps they're becoming increasingly irritable with the people they love.
Perhaps they've reached a point where simply getting through the day feels much harder than it once did.
You don't need to justify those experiences. If life has become more difficult, that is reason enough to become curious about why.
Anxiety
Almost everyone experiences anxiety. It's part of being human. The problem isn't anxiety itself.
The problem is when anxiety begins organising your life.
Perhaps you avoid situations that once felt manageable.
Perhaps your mind never seems to switch off.
Perhaps you're constantly preparing for things that never happen.
Many people describe feeling permanently "on edge", as though their body has forgotten how to relax.
Psychotherapy doesn't ask you to simply stop worrying. Instead it becomes curious about why your mind has had to remain so alert.
Sometimes anxiety develops after trauma.
Sometimes it grows from years of criticism.
Sometimes it follows experiences where life became deeply unpredictable.
Understanding those experiences doesn't erase anxiety overnight. It often changes your relationship with it.
Instead of anxiety feeling like an enemy, it gradually becomes something that makes sense. That change alone can be profoundly relieving.
Depression
Depression is often described as sadness. Many people tell me it feels nothing like sadness.
It feels empty.
Heavy.
Colourless.
Like watching your own life from a distance.
Some continue functioning remarkably well.
They go to work.
They look after their children.
They smile when expected.
Yet privately they feel disconnected from themselves.
Psychotherapy isn't interested only in reducing depressive symptoms. It's interested in understanding the emotional world in which those symptoms developed.
Sometimes depression follows a bereavement.
Sometimes years of putting everyone else first.
Sometimes the quiet belief that nothing you do is ever quite enough.
Every person's depression has its own story. Understanding that story often becomes part of recovery. If depression is something you're currently living with, you may also find my article Psychodynamic Therapy for Depression helpful, where I explore these ideas in much greater depth.
Grief
There are few experiences more universal than grief. There are also few experiences people feel so alone in. After a while the world quietly expects us to return to normal.
Friends stop asking.
Work carries on.
Life continues.
Yet inside, everything may still feel changed.
One of the things psychotherapy offers is somewhere grief doesn't have to be hurried.
You don't need to be "getting over it."
You don't need to reassure anyone that you're doing better.
You can simply bring the person you've lost into the room through your memories, your thoughts and your feelings.
Sometimes people discover they aren't only grieving the person who died.
They're grieving the future they imagined.
The life they expected.
Or even the version of themselves that existed before the loss.
Those losses deserve space too.
If grief has become part of your life, you may find my page on Grief Therapy helpful.
Trauma
Trauma changes far more than memory. It often changes how safe the world feels. People sometimes expect trauma to involve dramatic flashbacks. Sometimes it does.
Sometimes it appears in quieter ways.
Finding it difficult to trust.
Always scanning for danger.
Feeling emotionally numb.
Being startled by ordinary sounds.
Avoiding places or conversations that remind you of what happened.
Trauma is not simply about remembering an event. It's about how that experience continues living within us.
Psychotherapy doesn't aim to erase trauma.
Instead it helps create enough safety for those experiences to become less overwhelming and more understandable.
For many people, that is the beginning of feeling that life belongs to them again.
If trauma is central to what you're experiencing, you may wish to read more about my approach to Trauma Therapy.
Pregnancy loss and infant loss
Some losses are particularly difficult to speak about.
Miscarriage.
Stillbirth.
Infant loss.
Parents often tell me they feel everyone else has moved on while they remain living with a child who is still part of their family, even if that child is no longer physically here. Psychotherapy offers somewhere that relationship doesn't need to disappear.
There is no expectation that grief follows a timetable.
No pressure to "find closure."
Only the opportunity to think together about a loss that continues to matter.
If this reflects your own experience, you can read more about my approach to Infant Loss Therapy.
Relationships
Sometimes people don't come because of anxiety or depression at all. They come because the same relationship seems to keep happening.
Different partner.
Different workplace.
Different friendship.
Remarkably similar ending.
Perhaps you always become the one who looks after everyone else.
Perhaps you struggle to trust people who genuinely care about you.
Perhaps conflict feels unbearable.
Or perhaps closeness itself feels frightening.
Psychotherapy becomes interested in these repetitions. Not because they're signs something is wrong with you.
But because patterns can only begin to change once they've first been understood.
Identity, culture and belonging
There are moments in life when the question isn't, "What's wrong with me?"
It's, "Where do I belong?"
Moving country.
Growing up between cultures.
Becoming a parent.
Retirement.
Illness.
Loss.
All of these experiences can quietly reshape our sense of identity. Having trained in Intercultural Psychodynamic Psychotherapy at the Tavistock, I've always been interested in how culture, family and identity influence emotional life.
For many people, psychotherapy becomes one of the few places where every part of themselves is welcome.
You don't need to choose between different identities.You simply begin understanding how they have shaped the person you've become.
You can read more about this on my page about Intercultural Psychodynamic Psychotherapy.
What psychotherapy cannot do
I think it's important to be honest about this.
Psychotherapy cannot promise a life without pain.
It cannot stop people leaving.
It cannot prevent bereavement.
It cannot undo childhood.
It cannot remove uncertainty.
Life will always contain those things. Psychotherapy offers something different. It helps us meet life with greater understanding of ourselves.
Sometimes that means making different choices.
Sometimes it means recognising old patterns before they take hold.
Sometimes it simply means discovering that we no longer have to carry everything on our own.
That may not sound dramatic. In practice, it can change the way people live.
Psychotherapy isn't the only answer
There are times when psychotherapy forms one part of a wider picture. Medication can be life-changing.
CBT helps many people. Psychiatric care is essential for some conditions. Practical support, family, friends and community all matter. Good psychotherapy doesn't compete with these things. It works alongside them.
Different stages of life ask for different kinds of help.
Part of my role is thinking carefully with you about whether psychodynamic psychotherapy is the right place to begin.
Sometimes it is.
Sometimes another form of support needs to come first.
That honesty matters to me.
Is Psychotherapy Right for You?
If you've read this far, you've probably realised that psychotherapy isn't something that can be reduced to a simple definition.
It isn't advice.
It isn't about someone telling you how to live your life.
It isn't about endlessly talking about your childhood.
Nor is it about trying to become someone completely different.
At its heart, psychotherapy is an opportunity to understand yourself with another person. That may not sound particularly dramatic. In practice, it can change the way people experience almost every part of their lives.
Not because the world suddenly becomes easier.
But because they no longer have to face it in quite the same way.
Online or face-to-face psychotherapy
One of the questions I am asked most often is whether psychotherapy works as well online as it does in person.
For many people, the answer is yes. The fuller answer is that people often think and speak more freely in different environments. Some people value travelling to a consulting room each week. The journey itself creates a boundary between everyday life and therapy. Walking into the same room, sitting in the same chair and leaving again afterwards becomes part of the rhythm of the work.
Others discover that they speak more openly from home.
There is no rush across the city.
No concern about being recognised.
No waiting room.
Simply a familiar space where they can begin to think about themselves without the additional demands of travel.
Since moving to Canada, I have continued working online with adults throughout the United Kingdom. I was initially curious about whether something important might be lost.
Instead, I found that the therapeutic relationship remained every bit as thoughtful and emotionally meaningful as the work I had previously done face to face.
The screen disappears surprisingly quickly.
The conversation remains.
If you'd like to read more about online work, I explore it in my article Why Choose Psychodynamic Therapy Online?
Wherever you are based, you can find out more about online psychotherapy across the UK.
Finding the right therapist
If there is one piece of advice I would offer anyone considering psychotherapy, it is this.
Don't only ask whether therapy feels right.
Ask whether the therapist feels right.
Qualifications matter.
Professional registration matters.
Experience matters.
But psychotherapy is also a relationship.
You should feel able to ask questions.
You should feel able to say when something doesn't make sense.
You should feel that the therapist is genuinely interested in understanding your experience rather than fitting you into a diagnosis.
Whether you choose to work with me or another therapist, I believe that relationship matters enormously.
Questions people often ask
Do I need to be in crisis before starting therapy?
No.
Many people begin psychotherapy because they don't want life to become a crisis.
Sometimes recognising that something no longer feels right is reason enough to begin thinking about it.
What Happens in the First Session?
For many people, the first appointment is the hardest part of psychotherapy.
Not because of what happens during the session, but because of everything that happens beforehand.
"What if I don't know what to say?"
"What if I become upset?"
"What if we sit in silence?"
These are some of the most common worries people bring with them. In my experience, the first session is usually much gentler than people imagine.
You don't need to tell your whole life story.
You don't need to have worked everything out beforehand.
You don't need to arrive knowing exactly why you've come.
The first conversation is simply an opportunity for us to begin thinking together about what has brought you here.
We'll talk about what's been happening in your life, what has led you to consider psychotherapy now, and what you're hoping might feel different. There is no pressure to speak about anything before you're ready, and there is no expectation that you'll leave with all the answers.
Because I practise psychodynamic psychotherapy, I usually begin with two ninety-minute assessment consultations rather than moving straight into ongoing therapy. These meetings give us both the opportunity to think carefully. They help us build an understanding of your difficulties, consider whether psychodynamic psychotherapy feels like the right approach, and decide together whether continuing would be helpful.
Perhaps most importantly, they give you the chance to discover what it feels like to work with me. Psychotherapy is built on a relationship. Like any important relationship, it's worth taking the time to see whether it feels like the right fit.
Will you tell me what to do?
Usually not.
This often surprises people.
Psychotherapy isn't about replacing your judgement with mine. It's about helping you understand yourself well enough to trust your own judgement more fully.
Will we only talk about my childhood?
Not necessarily. Some sessions focus entirely on what's happening today. Others naturally return to earlier experiences because they help explain patterns that continue into adult life. We follow what feels meaningful rather than working through a predetermined list of topics.
What if I don't know what to say?
Then we'll begin there. Some of the most important sessions in my work have started with someone saying, "I don't really know why I've come." Not knowing is often the beginning of discovering.
How long does psychotherapy take?
There isn't a standard answer. Some people find that a period of focused psychotherapy helps them through a particular stage of life. Others decide to continue for longer because the work begins to open up questions they hadn't previously realised they were carrying. The length of therapy is something we think about together. It isn't something imposed upon you.
What I've learned
After almost thirty years working in mental health, first as a psychiatric nurse within the NHS and later as a psychodynamic psychotherapist, one thing continues to strike me.
People are remarkably good at surviving.
They survive childhoods that were far more difficult than anyone ever knew.
They survive grief they believed would destroy them.
They survive relationships that slowly erode their confidence.
They survive anxiety, depression and loneliness while still going to work, raising children and caring for the people around them.
The difficulty is that surviving and living are not always the same thing. Sometimes the very ways we learned to survive become the things that later keep us feeling stuck. Psychotherapy is rarely about teaching people how to survive.
More often, it's about helping them discover that survival is no longer the only possibility.
A final thought
People sometimes imagine that psychotherapy changes who we are. I don't think that's quite right. More often, it helps us become less restricted by the ways we've had to protect ourselves.
The person who always apologised begins speaking more freely.
The person who believed they had to cope alone slowly discovers that asking for help isn't weakness.
The person who spent years feeling disconnected gradually begins to recognise themselves again.
Those changes are rarely dramatic. Most happen quietly. One conversation at a time. One insight at a time.
Until one day someone notices that life no longer feels organised around fear, obligation or simply getting through.
Instead, it begins to feel like their own.
If you're thinking about psychotherapy
If reading this article has left you wondering whether psychotherapy might be helpful, you don't need to decide today.
Sometimes it's enough simply to begin asking different questions.
If you would like to explore those questions together, I offer a free 20-minute introductory consultation. It's an opportunity for us to talk about what's brought you here, for you to ask whatever you'd like about psychotherapy or the way I work, and for both of us to think about whether psychodynamic psychotherapy feels like the right fit.
If we decide to continue, I usually begin with two ninety-minute assessment consultations. These meetings allow us to develop a thoughtful understanding of what has brought you to therapy before deciding together whether ongoing psychotherapy is likely to be helpful.
Whether you choose to contact me, another therapist, or simply leave this page with a clearer understanding of psychotherapy than when you arrived, I hope one idea stays with you.
You don't need to have everything worked out before asking for help.
Sometimes the first step isn't finding the answer.
Sometimes it's allowing yourself to become curious about the question.
If you would like to talk this through, you are welcome to get in touch through my Contact page to arrange a free introductory consultation.
Further Reading
What is Psychodynamic Psychotherapy? More than just being heard.
Thinking About Psychodynamic Therapy? Here's What You Need to Know Before You Start
Why Choose Psychodynamic Therapy Online in the UK?
Psychodynamic Therapy for Depression
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