5 signs that therapy can be the next step for you

by Ohoud Saad
Mental health has gone from a taboo topic to one that’s widely spoken about these days; albeit still taboo in some regions and for some families.

Social media gets flooded sometimes with information about mental wellbeing, how to prioritize self-care and different kinds of therapy for you to try. The information can be overwhelming. And it can also be empty and unhelpful. I spoke with Carine Karnouk, a trained counseling psychologist who provides psychotherapy to individuals and groups struggling with psychosocial issues. She received her Master’s Degree in Counseling Psychology from the American University in Cairo and is finalizing her PhD at the Charité Universitätsmedizin in Berlin. We spoke about signs that you need therapy, as well as other things that you might just find beneficial.


Your mental health is affecting your quality of life

If you feel that your mental health is affecting your social functioning, familial functioning, professional functioning, or school-related functioning, like performing less effectively, having concentration difficulties, unable to complete tasks like before, that could be a sign that you need therapy.

Behavioral changes

If you notice behavioral changes such as sleep and appetite changes, speaking too fast, speaking too slowly, moving too fast, moving slowly, these are all signs that something needs attention. Observing yourself and noticing changes in your behaviors that are related to regular mundane things is always a good start. 

Issues with emotional regulation

For example, if you think about an issue and try to cope with it, you feel that regardless of the amount of time or effort you try to resolve the issue, despite making this huge and unanimous effort, it's still there and it gets more intense and more frequent. Instead of worrying for five minutes a day, you start worrying for half an hour a day, or a full hour, two hours or three until it takes up most of your day. The frequency or intensity of unwanted or negative emotions become great and you're having difficulty coping with them. When you're unable to regulate these emotions on your own, you need to seek the help of a professional.

Personal issues are causing you embarrassment, leading you to avoid people

For example, if you have issues with your sexuality or with your body image, or if you feel like a failure at work, it becomes so overwhelming that it leads you to avoid people socially. It might even lead you to start lying and saying things about yourself that are not true; perhaps about your work or how you spend your time because the truth for you is hard to share.

Self-destructive behaviors

Addiction, over-spending, or sabotaging your relationships are some examples of self-destructive behaviors. Sometimes, you can realize this on your own; you realize that your bills are greater, or that you're unable to sustain a certain type of life, or that you're losing people in your life. Some other times, and that's one of the big signs, several people are telling you, "take a look at your life, a lot of things are happening and we're worried about you, we're concerned." And that actually makes you struggle to maintain your relationship with these people, you might start to resent them, fight with them, or avoid them even more. You start to isolate them or even they start to isolate you because you're sabotaging them by pushing them away because you're dealing with something much bigger.

According to Carine, these are the main signs that someone would need to go to therapy. It can be one of those signs that leads you to seek help, it can be two or three. But having said this Carine adds, “therapy is not something that requires criteria that you have to meet for you to go to. If you are somebody who wants to explore and learn more about yourself and learn more about your patterns and improve your quality of life, you can of course always go to therapy.”

Carine also advises to pay attention to what to look for in a therapist. Credentials are very important, and knowing the difference between a psychiatrist, a doctor who can prescribe medication to treat mental health issues, and a psychotherapist, who focuses on supporting individual’s work on desired emotional and behavioral changes, and who has at least a master’s degree, for example in clinical or counseling psychology. You should also know that there are several types of specialties so for example if I suffer from an eating disorder it's better that I go to a therapist who specializes in eating disorders and not one that's specialized in trauma. You should also know about confidentiality and your rights as a client. There are also different approaches used by different therapists. “Therapists are like gloves; not every therapist fits. And I think this is something that you have to be aware of,” Carine adds “and it would be preferable if people did their homework before. However, any experience will most likely lead you a step closer to where you want to go. “

According to research, 20% of clients end therapy prematurity. Having one in every five clients drop out of therapy before completing it is a big number and Carine has some reasons as to why. She explains, “In the MENA region, there are some barriers and taboos that come in the way. There are many people who come to therapy in secret because of the stigma around mental health and they might drop out of therapy prematurity if someone finds out. Another reason is affordability, even though they really need therapy it can become quite costly. Another reason is that they might have unrealistic assumptions or expectations from therapy, they expect that negative feelings or emotions are going to disappear like magic, whereas therapy needs time, effort, and commitment. Another reason is that sometimes it can become a bit too intense for people and they feel too exposed, they don't necessarily trust the confidentiality agreement.” 

There’s so much more to say about therapy and this is just the tip of the iceberg. So for now, be introspective from time to time. Don’t ignore unwanted thoughts or feelings. Look for signs that you need to seek help and don’t be afraid to venture and try to opt for a better quality of life. Carine concludes, “The important thing to know is that therapy is not magic, there are ingredients, components of therapy, that work regardless of the approach, like sitting with someone who doesn't judge you, who listens to you, who accepts you, who reinforces you, who challenges you softly when they feel like you need to be challenged, who gives you empathy, who gives you unconditional positive regard, who teaches you skills, and gives you other perspectives. These are all aspects to be included in every single type therapy.”

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