Can Psychotherapy Help Me?

About This Page

This page offers an introduction to psychodynamic psychotherapy and the kinds of difficulties that may bring someone to therapy. It explains how the work differs from advice or short-term problem solving, what you might expect from the first sessions, and how psychotherapy can help you understand patterns that have become difficult to change alone.

You can read the page from beginning to end or use the contents below to move directly to the section that feels most relevant.

Estimated reading time: 14–16 minutes

Contents:

You Do Not Need a Diagnosis
What Is Psychodynamic Psychotherapy?
When Anxiety Begins to Organise Your Life
Depression and Emotional Flatness
Grief and Bereavement
Pregnancy and Infant Loss
Trauma and the Experience of Danger
When Relationships Keep Repeating
Identity, Culture and Belonging
What Happens in a Session?
Will You Tell Me What to Do?
Psychotherapy Is Not the Only Kind of Help
What Happens at the Beginning?
Can Psychodynamic Psychotherapy Work Online?
Finding the Right Therapist
From Surviving to Living
A Final Thought
If You Are Considering Psychotherapy
Further reading
You may also find helpful

Psychotherapy can help, but it cannot stop painful things from happening or undo what has already happened.

It cannot take grief away. It cannot guarantee that you will feel happy. It will not make difficult decisions on your behalf.

What it can offer is a place to understand yourself more fully, especially the feelings and patterns that may have been influencing your life without being easy to recognise.

That understanding can alter how you respond to yourself and to other people. It may help you notice an old pattern before you are completely caught up in it. It may also allow you to speak about feelings that have been kept out of sight for a long time.

For many people, the important change is not that life suddenly becomes easy. It is that they no longer feel quite so alone with it.

You Do Not Need a Diagnosis

You do not need to have been diagnosed with a mental health condition before considering psychotherapy.

Many people contact me because they know that something has become difficult, even though they cannot yet put it into words.

You may no longer feel quite like yourself. You might be worrying more, sleeping badly or finding that you have little patience left. Some people continue to function well on the outside while privately feeling detached or exhausted.

There may be a problem in a relationship that you cannot resolve, or you may have noticed that similar difficulties keep returning with different people.

At other times, there is no obvious crisis. Life simply begins to feel narrower, flatter or harder to carry.

You do not have to prove that your difficulties are serious enough for psychotherapy. If something is causing distress or preventing you from living as freely as you would like, it may be worth becoming curious about it.

What Is Psychodynamic Psychotherapy?

Psychodynamic psychotherapy begins with the idea that we do not always fully understand why we feel and behave as we do.

You might know that you become anxious whenever someone is disappointed with you, without knowing why their disappointment feels so dangerous.

You may repeatedly become involved with people who are unavailable, or find yourself taking responsibility for everyone around you.

Some people want closeness but become uncomfortable when another person begins to matter to them. Others are extremely hard on themselves and cannot easily imagine being treated with kindness.

These ways of relating do not appear from nowhere. They often developed as attempts to manage earlier experiences.

Remaining watchful may have helped you live in an unpredictable home. Keeping your feelings private may have protected you from ridicule. Becoming highly independent may have been the safest response when other people could not be relied upon.

The difficulty is that a way of coping can continue long after the situation that produced it has passed.

Psychodynamic psychotherapy does not treat this as a personal failure. We try to understand why a pattern developed, what purpose it once served and why it still feels necessary.

This is not about blaming everything on childhood. Nor does it involve searching for one hidden explanation that accounts for your whole life.

It is more often a gradual process of making connections. A feeling in the present may begin to make sense alongside an earlier relationship. Something you have always regarded as a flaw may come to be understood as a form of protection.

When an experience becomes more understandable, it can become less controlling.

When Anxiety Begins to Organise Your Life

Anxiety is part of ordinary life. It helps us recognise danger and prepare for uncertainty.

It becomes more troubling when it begins to shape what you can do.

You may avoid places or situations that once felt manageable. Your mind may repeatedly imagine the worst outcome. Even during quieter moments, your body may remain tense, as though it is still waiting for something to happen.

People are often told to calm down or stop overthinking. This rarely helps for long.

In psychodynamic psychotherapy, we are interested in why your mind has needed to remain so alert.

For some people, anxiety is linked to trauma. For others, it developed in a family where moods were unpredictable or where making a mistake had serious emotional consequences.

Anxiety can also appear when there is a conflict between what you want and what you believe you are allowed to want.

Understanding where anxiety comes from does not mean that it immediately disappears. It can, however, begin to feel less mysterious.

Rather than experiencing anxiety only as an enemy, you may start to recognise what it is responding to and what it has been trying to prevent.

You can also read more about my approach to online therapy for anxiety and depression.

Depression and Emotional Flatness

Depression does not always look like obvious sadness.

It may feel more like emptiness or a loss of interest in things that once mattered. Some people describe moving through life at a distance from themselves.

It is possible to continue working, caring for children and maintaining relationships while feeling privately disconnected.

Psychodynamic psychotherapy is interested in the emotional life beneath depression, rather than only trying to remove its symptoms.

Depression sometimes follows a bereavement or another significant loss. It may develop after years of looking after other people while paying little attention to your own needs.

Anger can also become part of depression, particularly when expressing it has never felt safe. The person may turn that anger against themselves and become increasingly self-critical.

There is no single explanation that applies to everyone. Each person’s depression has its own history.

Psychotherapy offers somewhere that history can be listened to. What appears to be weakness may turn out to be the exhaustion of having coped alone for too long.

I explore this further in my article about psychodynamic therapy for depression.

If these experiences feel particularly connected with masculinity, self-reliance or fatherhood, you may also find my article about depression in men and the difficulty of accessing therapy helpful.

Grief and Bereavement

Grief is part of being human, but that does not make it easy to live through.

It can be especially lonely because the world continues while your own world has changed.

People may stop asking how you are. Work resumes and everyday conversations return. You may feel that others expect you to be moving forward, even when the loss remains present in almost everything.

Psychotherapy gives grief somewhere to exist without being hurried.

You do not need to reassure me that you are coping. There is no requirement to demonstrate that you are moving on.

The person who has died may remain present through memories and feelings that shift from one day to another. Love can sit alongside anger. Relief may be followed by guilt. There may be things you wish had been said or understood.

Sometimes a person is grieving more than the death itself. They may also be grieving the future they expected to share, or the part of themselves that existed within that relationship.

The aim of therapy is not to remove the importance of the person who has died. It is to help you find a way of living with a loss that has become part of you.

You can read more about my approach to online grief and bereavement therapy.

Pregnancy and Infant Loss

Miscarriage, stillbirth and infant loss can be difficult to speak about because other people may not fully recognise what has been lost.

Parents may be grieving a child, a future and a relationship that was already emotionally real, even when others did not have the opportunity to know that child.

There can also be pressure to recover quickly or to focus on trying again.

Psychotherapy offers a place where the child can remain part of the conversation. There is no expectation that you should reach closure or leave the relationship behind.

The work may include grief, anger, guilt or the effect of the loss on your relationship with a partner. It may also involve fears about future pregnancies or the experience of watching other families continue with lives that now feel painful to witness.

People grieve differently, even within the same family. Therapy can help make space for your own experience without deciding how it ought to look.

Trauma and the Experience of Danger

Trauma can change the way the world feels.

Sometimes it is experienced through flashbacks or nightmares. At other times, it appears as constant watchfulness, difficulty trusting people or a sense of being cut off from your own feelings.

The event may be over, but part of the mind and body continues to respond as though danger is still present.

Trauma therapy should not force you to repeatedly describe something before you feel ready.

The first task is often to create enough safety for the experience to be thought about at all. This may take time, particularly when another person was the source of the trauma.

We may begin with how the trauma affects your present life rather than focusing immediately on the event itself.

You may notice that certain situations bring back a feeling of helplessness, even when you know rationally that the current circumstances are different.

As the work develops, the experience can become part of your history without continuing to dominate the whole of your present.

When Relationships Keep Repeating

Some people come to psychotherapy because the same relationship seems to keep returning in different forms.

The people may change, yet the emotional position feels familiar.

You may find yourself doing most of the caring while receiving little in return. Perhaps you become involved with people who remain distant, or you withdraw as soon as someone becomes important.

Conflict may feel unbearable. You might agree to things you do not want, then feel resentful afterwards.

Recognising a pattern does not always make it easy to stop. These patterns are often tied to deep expectations about what relationships are like and what you need to do to remain safe within them.

Psychodynamic psychotherapy gives us an opportunity to notice those expectations as they appear.

They may also become visible in the therapy itself.

You might worry that you are disappointing me or feel pressure to present yourself in a particular way. There may be moments when you mistrust something I say or feel angry with me.

These experiences are not treated as interruptions to the therapy. They can help us understand how relationships feel from within your emotional world.

This is one of the ways psychotherapy differs from simply receiving advice about relationships. We can think together about what is happening while the relationship is unfolding.

Identity, Culture and Belonging

Not every emotional difficulty begins with the question, “What is wrong with me?”

Sometimes the more useful question is, “Where do I belong?”

Moving to another country can unsettle the sense of who you are. So can becoming a parent, leaving a profession or losing a relationship that helped define you.

Culture is present in how we understand family life and independence. It influences what can be spoken about, what must remain private and what is expected of us.

You may feel that different parts of you come forward in different places. At home, you may occupy one role. At work, or in another country, you may feel like someone else.

Some people feel caught between loyalty to their family and the wish to live differently. Others feel that they belong to more than one culture without feeling fully at home in either.

My training in intercultural psychodynamic psychotherapy has made me particularly interested in how migration and family history become part of emotional life.

Psychotherapy should not require you to reduce yourself to a single identity. It can provide a place where conflicting parts of your experience are allowed to exist together.

What Happens in a Session?

There is no set list of topics that you are expected to discuss.

A session might begin with something that happened earlier that day. At another time, you may find yourself returning to an old relationship or speaking about a dream that has stayed with you.

You do not need to arrive with an organised account of your life.

You can talk about whatever comes to mind, including thoughts that seem unfinished or difficult to explain.

My role is to listen carefully to what you say and to the emotional patterns that may be developing around it.

I may notice a connection between two experiences or wonder about something that has become difficult to speak about. At times, it may be more helpful to stay with a feeling rather than trying to explain it too quickly.

Psychotherapy is not a performance. You are not required to produce insight in every session.

Some important moments are quiet ones, when something can be felt in the presence of another person without needing to be immediately solved.

Understanding is part of the work, but change is not purely intellectual.

It can also come from having an experience of being listened to differently. You may express anger and discover that the relationship survives. You may allow yourself to need someone without feeling humiliated.

These experiences can gradually change what you expect from relationships beyond the therapy room.

Will You Tell Me What to Do?

People sometimes come to psychotherapy hoping for a clear answer about a difficult decision.

There may be times when practical guidance is useful, especially where safety or access to other services is concerned.

In general, however, I will not tell you how to live your life.

The purpose of psychotherapy is not to replace your judgement with mine. It is to help you understand what may be interfering with your ability to use your own judgement freely.

Advice can solve an immediate problem, but it does not necessarily alter the pattern that produced it.

Therapy tries to reach the part of the difficulty that advice often leaves untouched.

Psychotherapy Is Not the Only Kind of Help

Psychotherapy is not always the only support a person needs.

Medication can be important, and structured therapies such as CBT are helpful for many people. Psychiatric care may be necessary when symptoms are severe.

Practical circumstances matter as well. Housing, financial security and supportive relationships all affect mental health.

Good psychotherapy does not dismiss these realities or present itself as a solution to everything.

Part of my role is to think honestly with you about whether the work I offer is appropriate. There may be occasions when another form of help would be more useful, or when it should take place alongside psychotherapy.

What Happens at the Beginning?

Making first contact can feel difficult.

You may worry that you will not know what to say or that your problems will seem unimportant. Some people are concerned that they will become upset and not know how to recover.

You do not need to tell your whole life story during the first meeting.

We begin with what has led you to seek help now.

Most people start with a free 20-minute introductory consultation. This gives you an opportunity to tell me something about what has brought you to psychotherapy and to ask questions about how I work.

When it seems appropriate, I then offer two 90-minute assessment consultations.

These meetings give us time to think about your current situation and your personal history. We can also consider what you hope psychotherapy might offer.

Assessment is not a test. It is the beginning of trying to understand your difficulties together.

It also gives you a chance to notice what it feels like to speak with me.

The relationship matters, and it is reasonable to take time to decide whether it feels right.

You can find more information about how psychotherapy begins and the different sessions I offer.

Can Psychodynamic Psychotherapy Work Online?

Psychodynamic psychotherapy can work well online for many people.

Some people value travelling to a consulting room and having a physical space that is separate from the rest of their life.

Others find that they speak more freely from a familiar room. Online work can also make regular attendance easier when work, parenting or health make travel difficult.

Since moving to Canada, I have continued working online with adults across the United Kingdom.

My experience is that a meaningful therapeutic relationship can develop online when there is privacy and a regular time for the work.

A reliable connection is useful, but technical perfection is not required.

As the relationship develops, the screen usually becomes less noticeable. What remains important is the conversation and the experience of being thought about.

I have written more about why people choose psychodynamic therapy online. You can also find information about online psychotherapy across the UK.

Finding the Right Therapist

Training and professional registration matter when choosing a therapist.

The relationship also matters.

You should feel able to ask questions and to say when something does not make sense. It should be possible to disagree without feeling that you have failed at therapy.

A therapist should be interested in your particular experience rather than quickly fitting you into a standard explanation.

This does not mean that every session will feel comfortable. Therapy can bring you close to feelings that have been avoided for good reasons.

The discomfort should take place within a relationship that feels respectful and safe enough for you to speak honestly.

Whether you work with me or someone else, finding a therapist with whom you can gradually become more open is important.

You can read more about my professional background, training and experience.

From Surviving to Living

After almost thirty years in mental health, first as a psychiatric nurse in the NHS and later as a psychodynamic psychotherapist, I remain struck by how much people manage to survive.

Many people have endured childhoods that were far more difficult than anyone around them understood.

Others have lived through grief while continuing to work and care for a family.

Some have spent years in relationships that slowly altered how they felt about themselves.

The capacity to survive is valuable, but survival can come at a cost.

A person who learned not to need anyone may become painfully isolated.

Someone who became skilled at keeping everybody else calm may find it hard to recognise their own feelings.

The child who survived by remaining unnoticed may grow into an adult who struggles to take up any space.

Psychotherapy is not usually about teaching people how to survive. Most people who seek help have already become very good at that.

The work is more often about discovering that survival no longer has to organise the whole of life.

A Final Thought

People sometimes imagine that psychotherapy will turn them into a different person.

That is rarely how I understand it.

Psychotherapy more often helps people become less restricted by the ways they learned to protect themselves.

Change may involve speaking more freely or being able to ask for help without immediately feeling weak.

It may be as simple as recognising what you feel before automatically attending to everyone else.

These changes are often quiet. They happen through conversation and through the gradual experience of being understood.

At its centre, psychodynamic psychotherapy is an opportunity to get to know yourself in the company of another person.

You are not being analysed from a distance or told who you are.

We think together about parts of your experience that have been difficult to understand alone.

The world does not suddenly become free of uncertainty or loss.

What may change is the extent to which your life is organised around fear and old expectations.

Over time, it can begin to feel more like a life you have chosen and less like one you are simply enduring.

If You Are Considering Psychotherapy

You do not need to know in advance whether psychotherapy is right for you.

The first step may simply be allowing yourself to wonder why something has become difficult to carry alone.

I offer a free 20-minute introductory consultation for adults considering online psychodynamic psychotherapy.

It is an opportunity to tell me a little about what has brought you here and to ask any questions you have about the way I work.

You do not need to have everything understood before making contact.

Often, understanding begins in the conversation itself.

You May Also Find Helpful

Trauma Therapy

Grief Therapy

Infant Loss Therapy

Intercultural Psychodynamic Psychotherapy

Men’s Mental Health Therapy

Contact / Book a Consultation

you do not need a diagnosis

What is psychodynamic psychotherapy

When anxiety begins to organise your life

Depression and emotional flatness

Grief and bereavement

pregnancy and loss

Trauma and the experience of danger

When relationships keep repeating

Identity culture and belonging

What happens in a session

Will you tell me what to do

Psychotherapy is not the only kind of help

What happens at the begining

Can psychotherapy work online

Finding the right therapist

From survival to living

Final Thoughts

If you are considering psychotherapy