Accessing therapy, and the notion of going to therapy is no longer shunned at, which is progressive. However, many people remain unable to access therapy due to various reasons. Nonetheless, we do need to find ways of cultivating robust mental health and practising habits that support both our physical and mental well-being.

Why people may not be able to access therapy

Despite going to therapy being an act of courage in itself, many people who are keen to access therapy aren’t always able to. Here are some reasons why people may be unable to access therapy.

Cost

Therapy is not cheap, and many people have been excluded from benefiting from therapy due to cost. There aren’t many therapists or services offering low-cost fees. For some, the low-cost rate is still a huge financial sacrifice that they cannot meet. This leaves a certain group of people who could benefit from therapy excluded.

Stigma

As a society, there is a lot of stigma around mental health and therapy, leaving some feeling ashamed to seek therapy. This is a bigger issue in the minoritised communities, where therapy is taboo. We live in a world where people are meant to be “strong” and “pick themselves up” which means accessing therapy is viewed as a sign of weakness.

Based on my experience in the NHS, many young people access mental health support when they have severely deteriorated, and their families play a part in concealing their mental health challenges from society due to shame and stigma. This is an even bigger problem in minoritised communities. This means that their treatment outcomes are poor as they miss out on receiving treatment during the onset of their mental health challenges. Accessing therapy early and seeking help before the mental health challenges increase could indeed mitigate the deterioration.

Lack of awareness

Some people may not be aware of the benefits of therapy. They may not have an understanding of mental health and what therapy is. There are some communities and cultures that do not believe in therapy. They view therapy as a white middle-class invention, and an indulgent, with no value to them. This notion is reinforced by the fact that therapy is inherently a white middle-class concept and is practised by predominantly white therapists. Only in recent years, more and more people from minoritised backgrounds are beginning to have a grasp of what therapy is, and accessing it.

Poor representation

Many people are deterred from accessing therapy as they are unable to determine how to find a therapist that is a good fit for them. While this is an issue for anyone accessing therapy, it is even bigger a problem for people from minoritised backgrounds due to the lack of representation from people of their own backgrounds. The argument around therapist-client fit is never resolved as the relationship between therapist and client is key, regardless of their race, colour, class and culture.

However, it is true that many clients find it easy to talk to therapists who are from a similar cultural, racial, or class background as there are familiar references that do not need explaining. This is a real issue for people accessing therapy, which needs to be considered.

Fear of vulnerability and judgment

Therapy can make one feel exposed and vulnerable in many ways. The idea of having such an intimate relationship with someone with whom you get to tell all your secrets, and reveal shameful aspects of yourself can be daunting. The fact that therapy creates a power imbalance - as the therapist does not tell their clients their own issues, becomes even more unbearable for people accessing therapy.

Fear of judgement is a real issue, especially for people who may have had a lot of trauma, or people involved in behaviours that may be considered immoral. While therapy is not a space for judgment, this does indeed become a deterrent. Being vulnerable is not something that we all embrace, more so in the presence of an unfamiliar other. There needs to be a relationship and safety. Fear of vulnerability does indeed become a big limitation for many.

Denial

Denial is a defence against accepting the reality, however, it doesn’t make the problem go away. Some individuals may be in denial about their problems, no matter how big they are and think that they do not need therapy. This is indeed detrimental in the long term as what starts as a small issue can develop into a bigger problem if not addressed at the right time.

Time constraints

Despite therapy now being available online, which makes it easier to access, some people just don’t have the time to attend therapy. This is mainly for people in full-time employment with families. Some people do not find online therapy helpful to them as It may feel impersonal to them. While this is a subjective feeling, they miss the opportunity of doing therapy as they cannot engage online and don’t have the time for in-person sessions.

Previous negative experiences

I have encountered many people who have had negative experiences with therapists in the past, leading them to be aversive to therapy. While the experience may be related to a particular therapist, it clouds their judgment on therapy as  a whole.

Self-care tips

With these deterrents in mind it is important that we identify ways in which people can take care of themselves and cultivate their mental well-being without going to therapy.  If you are unable to access therapy, here are some useful self-care tips and why they are important.

Healthy diet

A healthy diet includes all the nutrients the body requires- protein, carbohydrates, healthy fats, water, iron, etc. The body and mind an intricately linked. Having a healthy diet translates into a robust immune system, healthy skin, optimal energy levels, a healthy digestive system, and regulated chemical balance. Cooking yourself a good healthy meal can also be a good form of self-care and a mastery activity which bolsters our sense of well-being.

Stress management

Stress is one of the key causes of poor mental health - chronic stress can lead to burnout. Stress increases the chances of developing anxiety, depression, insomnia, high blood pressure, migraines and fatigue. Chronic exposure to the stress hormone cortisol and adrenalin has been linked to other physical health conditions such as autoimmune disorders and hypertension. It is vital that you find ways to combat stress and give yourself time to rest. Planning your tasks in manageable chunks, and approaching the tasks in a graded manner will help you lower your stress levels.

Routine

Having a routine is hugely significant in giving your body and mind a rhythm that it can follow. Just like a baby that needs a feeding, sleep, and playtime routine, our bodies and minds respond well to routine and some kind of structure - repetition - to help regulate itself. Not having a routine leaves one in a state of dysregulation and also makes it difficult to self-regulate, something that our bodies are capable of doing for us naturally.

Sleep hygiene

Sleep is a key component of well-being. Sleep is a necessity, and it is good quality sleep that matters the most. Sleep allows our bodies and minds to naturally repair themselves, heal and reset. Sleep is also essential for emotional processing something that we do in our dreams. Sleep hygiene means engaging in habits that promote sleep as a natural process -this aligns with routine. Sleep hygiene may mean things like getting rid of gadgets, not speaking to friends on the phone late at night, getting into bed early, and not drinking coffee, alcohol or other stimulants after a certain time of the day.

Personal hygiene and self-care

The external world is typically a reflection of our internal world. You are more likely to feel good after a shower and wearing your best clothes than you do walking around unshowered, unkempt and in dirty clothes. The notion of your body being your temple is helpful here in highlighting the significance of taking care of your body, which will also feed back to your mind. Self-care is a mastery activity which can evoke the body’s natural opiates - endorphins, our feel-good hormones.

Treatment of underlying physical health issues

It is hugely significant to have checkups with your GP and dentist. Many people have or suspect they may have some health problems that they do not address in time. These may be impacting their mental health and treating the underlying condition translates into enhanced mental health.

Community and positive relationships

No man's land is an Island! We need others, we are social beings. Having positive relationships with others around us and fostering a community is key to positive mental health. Isolation and loneliness can make small problems look even bigger - the experience of being “psychically” held by others is profoundly powerful and its healing mechanisms are what made our ancestors thrive as groups of people.

Journaling and personal reflections

Journaling is a powerful way of processing. Putting one’s personal reflections, thoughts and feelings is hugely significant and therapeutic. Journaling is something that is done subjectively, and no one has to read, judge or mark what you have written. Being able to have an honest appraisal of oneself through journaling can indeed lead to an autonomous change in behaviours and attitudes that may be problematic in one’s life.

Affirmations

Affirmations are a powerful way of expressing self-love and self-validation. We are so quick to seek validation, compliments, and words of affirmation from others, yet this is something we should be giving ourselves. We cannot fully love others if we do not love ourselves. Self-love starts with affirming yourself, reminding yourself of all the qualities that you embody and what you want to see manifest out of that.

Affirmations are a love language  “words of affirmations” and they go along with other love languages like quality time. If you affirm yourself you are likely to treat yourself with kindness and compassion and become less critical. Write a list of affirmations and use them daily when you wake up.

Identifying your values

Values are key to our sense of self and well-being. They guide how we live our lives and what matters to us. When we live a value-led life, we are likely to feel purposeful, and a sense of wholesomeness, which translates to positive mental health. Many a time, our suffering stems from leading a valueless life which makes life empty, defeated and as if you are a passenger in your own life.

Write down your values and identify how your current life aligns with your values. Note what us is you can do/change to get yourself back to living a value-led life. This can be a painful process as it may mean letting go of certain relationships and habits we have engaged with which misalign, or are in conflict with our values.