There has been a significant rise in people seeking psychotherapy and mental health support in Hackney and East London. We can see that in 2023 mental health services received a record 5 million referrals, a 33% increase from 2019. Also in 2023 it was report that 2000 people called crisis lines in Hackney specifically.
We might understand this rise as part of the continued shock and fallout from the COVID-19 pandemic, something we still haven't come to terms with in the public consciousness. Perhaps we could add to this the impact of a growing social decay and economic decline, resulting in housing issues as well as a lower standard of living. I know from my own NHS work that there is a huge exacerbation in mental suffering as well as an increasing demand for services. This also coincides with cuts in treatment offers and a general hostility towards meaningful, intensive psychodynamic psychotherapy over the pervasive fantasy of the quick fix offered by CBT and other manualised approaches. Scarcity has become a central operating problem at all levels but what is interesting is that institutions can lean into this wish by justifying short-term offers as best practice as a way to justify the scarcity. How consciously this is done is a huge question. More on all this another time perhaps.
However, some of the reasons for this growing need might not be all bad. It might indicate people's increasing awareness of their difficulties and a greater ability to ask for help and psychological support. There might also be a greater visibility and sense of access to services for those in need.
In addition to the more acute need of the crisis services, there is a growing culture of people in the East End of London searching out psychotherapy. Despite this, there continues to be persistent myths about those who seek psychotherapy, let's have a look at some of them...
Psychotherapy Myth 1: Psychotherapy is only for the most severely unwell.
It is untrue that only people in extreme states of mind need or require psychotherapy. Of course, those who are in severe distress or have suffered extensive trauma do require psychotherapy, but it is also a helpful and powerful intervention for all sorts of people, at all stages in their life.
Life transitions, as well as personal growth and depth of understanding, are all common factors for people seeking treatment. Coming to know yourself better, coming to know your desire and broaden your range of feelings and resilience are all reasons and results of psychotherapy. Depth psychotherapy like psychoanalytic and psychodynamic approaches that deal with unconscious process are the best suited for this.
Psychotherapy Myth 2: Psychotherapy is for the weak or the self indulgent...
This couldn't be further from the truth. To seek and then take up responsibility for your internal world, your mental suffering, your life and your relationships requires courage, self-awareness and resilience. It not only demonstrates a commitment to your own well-being and personal development but also to the world around you. Good psychotherapy can create a ripple effect from the personal to the social, affecting your relationships with others. It’s not an easy task though. Taking up, committing to, and working through in psychotherapy is challenging. It is not is for the self-indulgent.
What we might come to understand is that the past is still alive in the present, how it still haunts the here and now of our lives.
Psychotherapy Myth 3: Psychotherapy is only about discussing the past.
It is often thought that psychotherapy, particularly psychodynamic psychotherapy, is all about talking about the past. This is a big misconception often carried on by films and general gossip. Very often, good psychotherapy is about the present moment, present feelings, current problems and relationships.
However, what we might come to understand is that the past is still alive in the present, that it still haunts the here and now of our lives. This means that patterns are played out in real time within our relationships, both outside in the world as well as in the therapy room. Good psychotherapy is often in the here and now of experience, deepening feelings, getting closer to understanding them, and unconscious relational dynamics.
Good psychotherapy should feel alive, keen, and visceral.
There is no clear line between 'well' and 'unwell'—only the shared human experience of having emotions, a mind and the struggles of being alive.
Psychotherapy Myths: Stigma Fuelled by Fear
Many of these myths are perpetuated due to fear. They are a way of trying to separate and enforce a division between the mentally 'well' and the mentally 'unwell'. To create a barrier and locate something 'unwell' or needy or vulnerable in the 'mad' other 'out there'. This can be because many people are scared of the contents and processes of their own minds. A fear of madness, a fear of breakdown, a fear of the overwhelming power of their feelings, a fear of the strength of their hate or desire.
One of the many revolutionary acts of Freud was to challenge an idea of normality; deconstructing the myth of the normal and coming to know and understand the range of human experience and suffering is the project of psychoanalytic & psychodynamic psychotherapy. We might understand that it is normal to suffer psychologically and normal to feel as though it is abnormal to do so. Psychodynamic psychotherapy is for people struggling with ideas of what it is to be normal, that, in a way, it is normal to feel abnormal. For these and other feelings, psychodynamic psychotherapy can be helpful. It is not only for one sort of person but can be used by all sorts of people, facing all sorts of difficulties at whatever stage they might be in their life.
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