There are the familiar details for anyone who has ever had a therapy session: a chair, a glass of water, a box of tissues, perhaps an inoffensive print on the wall.

Other than that, the rooms are largely featureless and give no clues as to what your therapist might actually be like. This is a running theme, as therapists also never answer your questions: the session isn’t about them, they must present themselves as the so-called ‘blank slate’.

Billie Piper has been in therapy for three years. Of her current therapist (who can’t be named for professional reasons) she says: “I go to her every week, she’s so smart and insightful.”

Now she’s decided it’s time to turn the tables and have her therapist answer her questions for once, discovering more about therapy in the process. “I’m so interested. I’m going to get information I wouldn’t get otherwise because I’m too scared to ask,” she says. 

Over to Billie. 

Billie: One of my biggest revelations when I started therapy was how codependent I am. What is codependency?

Therapist: There isn’t really an absolute definition but I think of it as being a schism in the relationship with the self which leads to a schism in the relationship with others. 

B: So, why does it happen? What effect does it have on your life?

T: Nature and nurture I think. I truly believe that there are those of us who are born extra sensitive and so are naturally more impacted by things in our growing up – such as trickiness in our childhood or bullying, for example. Trying to understand and make sense of things that are difficult as a little person with limited ability to contextualise or reason or discern what is or isn’t our responsibility often leads to the development of deeply held but false beliefs. “It’s my fault mum is sad.” “I’m worthless.” “If you knew what I was really like you wouldn’t love me.” Those beliefs, if gone unchallenged, can stay with us and leach into our feelings about ourselves and others for our adult lives and lead to unhelpful behaviours – either because we are so set in that way of thinking or because we try to mediate the pain of feeling the resultant emotions.

B: When is a good time to leave a dysfunctional relationship?

T: Abusive? Immediately. Dysfunctional? Do the work both individually and then together and you’ll know. 

B: How are instincts different from feelings, if at all? And, by ignoring our feelings, are we undermining our instincts?

T: Well, feelings aren’t facts. Our feelings are often stimulated by a thought. And that can often be an unconscious thought. So, while I might think that something is a gut instinct, it’s often a result of an unconscious thought, or an unconscious belief system that I have. If I’m sad because somebody frowns at me it’s easy for me to think, “Well, that makes me sad,” and that’s a completely appropriate and authentic response to somebody frowning. But somebody standing next to me might just be curious about what that frown meant, rather than thinking that what that means is the frowning person is angry at me. We talk about feelings, we talk about instincts, but we don’t really talk that much, or acknowledge that we might have a belief system that’s erroneous in there as well.

B: I feel like people talk about instincts and hold onto them as gospel.

T: I think that the most useful position to take if you’re entering into any kind of self-examination or any kind of therapeutic experience is one of curiosity.

B: Yeah.

T: So you might say to yourself, ‘I wonder why I feel like that? That’s interesting, I’m crying now.’ [Laughs] 

B: How do you like to start proceedings? That sounds awful, put like that, but is there an inventory, things you go through before you really start unpicking or pulling apart people’s issues? Is there a checklist of things before you then start going in to deeper questions?

T: Mmmm.

B: Do you want to talk about that? [Laughs]

T: I think different people have different approaches. Different therapeutic styles have different approaches. There will be some therapeutic modalities that will have quite a formal procedure. I think the most important thing, for me, is to be curious about the other person, genuinely curious. Really often, it’s not the thing that immediately presents itself that is the thing that’s tripping them up. And the other thing, I think, that is really, really important, is what does that person want to change? Why are they sitting in front of you? Do they want to change? What has brought them to therapy? Because, I can have all sorts of ideas about how I think you should be living your life. Which is completely untherapeutic. That’s just unsolicited advice! [Laughs] 

B: When I started with you, you asked, “What’s your health like? What’s your self-care like?” I know that some therapists don’t seem to get into that, which always shocks me. I don’t think people always connect their feelings to poor self-care. And I’m saying that as someone who has never attributed feelings of mania or drama to, ‘Oh, I haven’t eaten, and it’s three in the afternoon’. Those things are really basic, but they are key to getting yourself into a more stable place.

T: I think it’s hugely important to have a thorough assessment. To ask the very basic question of ‘Am I looking after myself?’ Because we respond to that physically, but we respond to it emotionally too. Very basically, if I’m not giving myself the care I should give to a child, then the message I am sending to myself emotionally and psychologically is ‘I’m not worth it’. Are you medicating yourself with something that then has an exacerbating effect on your mental health? Because that is a hell of a spiral. If somebody’s on antidepressants, and they’re drinking, that’s going to have a negative effect. If they take an antidepressant that affects their libido, and then they take Viagra, so they don’t sleep, so they take a sleeping tablet… Nothing exists in a vacuum.

B: I know a lot of people, friends, who say they suffer with anxiety, take antidepressants, or anti-anxiety pills, and then drink on them.

T: Fundamentally, alcohol is a depressant. So withdrawal can often be high anxiety.

B: What would you say are the biggest misconceptions about therapy? I had a personal misconception: I used to think that if you were a creative person, not having something to feel miserable about would stifle your creativity. Are there any that spring to mind for you?

T: The biggest one is that the therapist holds the key somehow. You know, “I’m going to therapy and you’re going to fix me.” I think sometimes there’s a bit of a misconception that it’s going to be something that’s done to them.

B: And I think it’s something that makes people slightly stuffy about going, the idea that the therapist is particularly powerful and possibly manipulative…

T: OK, I think there can be quite a lot of time spent trying to get to a place where the client understands that, actually, you’re not going to fix them. You’re not going to do something to them that is going to make them better. They are going to have to have some agency. Sometimes people come to therapy because they feel disempowered in the face of something. “I feel helpless, do it for me.” So, ironically, people don’t love it when we go, “Well you’re the one that’s going to do the work.” 

B: Who faces bigger challenges today, men or women?

T: Oh… [laughs] women! In all seriousness, I think individuals face challenges, not necessarily whole genders. Do women have a harder time than men? I think, historically, they have had. But I think there’s something around supporting individuals who have challenges, supporting everybody is the thing that’s going be the most significant change [for the future]. We’ve thought that in order for women to get on, we need to behave like men. And I just think that’s unhelpful for everybody. You know, in order for things to be equal, somebody must go down in order for somebody else to go up – I just don’t think that’s true. I think we need to raise everyone up.

B: It’s a very liberated time for women. And mostly, obviously, it’s brilliant and there’s a lot of wonderful things happening for women. But there’s also an awful lot of stress that comes with it. And people don’t want to talk about that because it sounds oppressive. And there’s also quite a lot of male-shaming and that feels quite uncomfortable too. These are just my observations…

T: I think if you’re trying to do it all, then it comes back to community, actually. If I’m getting support in my life from lots of different areas, then things will be a bit easier. If I’m trying to do every single job in my life, then I will struggle. Whether I’m male or female, if I feel like I’ve got to bring kids up, be the major bread-winner… If you try and do everything without support it can end in tears.

B: What…?

T: What is this support of which you speak?

B: [Laughs] Yes, what is that? I think it’s hard to trust people. And there’s a controlling nature to all of this as well, you know, ‘I cannot bear to have someone else do this for me. I need to make sure it’s perfect.’ Or maybe that’s just me? I see it in a lot of my female friends though. They don’t want to delegate. Because, ultimately, it’s not going to be done as well as they could do it, or in the way that they like it to be done. 

T: So what is engendering that necessity for control? Why do I need to control every aspect of my experience, of my life and my world? A lot of that’s because I feel internally out of control.

B: In your time of working as a therapist, are you seeing a lot of issues with control? Does control seem like more of an issue now than it has done before?

T: I think it’s tricky to answer, because I would have to speak globally. But I think, in my practice, most of the people that I see will have some kind of issue with control – they’re either out of control of being in control, or they are in control of being out of control.

B: Letting go is one of my biggest struggles. And, every time I’ve done it, it feels so good. But it takes so much of me to let it happen. It’s embarrassing that, for me, it’s such a leap of faith. But once you get into the habit of it, you feel free. I walked around for years saying, ‘I don’t feel free, I want to feel free’. And I would say I was the biggest part of the problem. I was doing the opposite of what I should have done.

You know, I can say that I want my kids to have wholesome meals at every moment, or I want to be ethically right all the time – all of those things should make me feel more together, but it has the reverse effect. And trusting that people can do stuff for themselves, my kids or my peers, that’s a really big step. Especially if you’ve been a bit of a nihilist for a long time… So to finish, do you think all people need therapy?

T: No, I don’t.

B: Who are the lucky ones? How have they slipped through?

T: I think most people benefit from community. And from having somebody to talk to, somebody they can use as a sounding board. But, fundamentally, I think therapy is a better facilitation. You are doing the reflection, you are doing the thinking, you are doing the work. You’re the one that’s sat in front of somebody and said, “I want to change something.” And that’s huge. So… people who don’t need therapy are people who don’t want to change anything.

B: Wow!

T: I think everybody benefits from connection. Let’s just put it that way.

If you would like to find a therapist, visit bacp.co.uk.

Images: Getty