Common Issues
Many concerns prompt people to seek counselling support. Below is a general outline of ten common issues. However, every individual is different. You may feel your situation is not represented here, or that it inter-relates with more than one of those listed.
1. Depression
Depression affects at least one in five people at some point in their lives. Though we all have 'off-days,' depression is far more than a temporary low-point. Its symptoms emerge in persistent feelings of sadness or despair; disturbed sleep and eating patterns; struggles in thinking, and lack of energy or motivation.
The underlying triggers for depression and tendencies towards it can be many and varied, recent or deep-seated. But whatever the cause, the upshot is that we turn life's burdens and our negative emotions in on ourselves, and the resulting heaviness leaves us feeling weighed down and de-pressed.
Counselling can help lift the lid on what lies underneath this debilitating state, by exploring its root causes and contributing factors. The aim is to identify and unblock what prevents any moving forward, alleviate low mood, and seek strategies to maintain a healthier state of wellbeing. Some people choose counselling as an alternative to medication; others opt for both together, in order to stabilise their mood whilst they address the deeper issues.
2. Stress
Some stress is good: It can stimulate us to produce our best. Too little, and we fall into 'rust-out.' But too much, and we hurtle towards 'burn-out.'
We may notice physical symptoms: Tiredness, aching muscles; headaches or even heart palpitations. Nervousness can show up through fidgeting, pacing or increased use of tobacco or alcohol. Our emotions may erupt in exaggerated, negative expressions of fear, worry, indecisiveness, short-temper and frustration; our racing mind may lose its ability to concentrate or remember.
The causes may be a build-up of outer demands until one more thing - large crisis or seemingly insignificant event - brings us to breaking point. Inner expectations of ourselves and others can also make us stress-prone, and we all have particular stressors personal to us.
Alongside attention to physical rest and recovery, counselling can provide a therapeutic space away from the turmoil. It can help us clarify our outer pressures, and inner driving forces, and enable us to identify our choices, so we no longer feel so trapped. With fresh insight and energy to make positive changes, we can regain our balance and ability to run our lives.
3. Anxiety
Appropriate concerns for security cross a line when anxiety starts to rule our lives. Its draining symptoms are felt in muscular tension, rapid breathing, digestive discomfort or nausea. We may struggle to relax, constantly fear the worst, feel on edge, avoid certain situations and become over-dependent on others. Ultimately, symptoms can collide in a panic attack, where overwhelming physical sensations are accompanied by a sense of losing control.
Our anxiety may spring from a deep-rooted outlook on the world learned through our upbringing; it may be related to more recent traumatic experiences that have wrought havoc with our former confidence. Our personality may make it hard for us accept our human limitations.
Counselling can be a safe place to express anxieties we feel may seem 'over-the-top' to others, and explore the different factors - within and without, past and present - fuelling this condition. Re-adjusting our outlook will mean letting go of what we cannot control, but taking hold of what we can. Greater grounding and confidence in our own resources to meet the unknown will help us become far less anxious, not least about anxiety itself.
4. Bereavement
These days fewer people die at home, and society tends to avoid the issue of death. Yet sooner or later, all of us lose someone we love. The different emotions this evokes at various times can take us by surprise. Grieving involves much more than straightforward sadness for a set period. Initial numbness may give way to complex feelings of anger, guilt, and depression as we journey towards acceptance of our loss.
Although there are common feelings, each person's pathway through bereavement is unique to them, dependent on their particular personality and their relationship with the one who has died. People can feel pressured to pull themselves together after a while, or even to suppress grieving entirely, for the sake of those around them. There are also the more hidden losses, such as a miscarriage.
Counselling can be a place to express the difficult emotions that need to be aired and shared. It can help to discover that some disturbing feelings are actually 'normal' for bereavement. The bereaved may be conscious of repeating themselves within their immediate circle, yet this is a necessary element in the healing process.
5. Loss
Loved ones aside, life brings many losses across our path - in health, work, relationships and other areas. Losing what is precious can cause us much distress and raise many questions, especially where we lose what we belatedly realise we have taken for granted.
The extent of our emotional investment is exposed, and the resulting upheaval can throw us into anxious insecurity, alongside strong feelings of bereavement. Coming to terms with loss is a necessary part of living, yet is often ignored in a world that prefers to promote gain.
An immediate loss can highlight the strength or weakness of our underlying foundations for personal security, hope and resourcefulness. Its impact may have both practical and emotional implications for our future living.
Counselling can facilitate our negotiation through life's losses by offering the opportunity to acknowledge the depth and meaning of a particular loss and to mourn what has gone. It can offer support in exploring new possibilities and ways forward. In the process, it may even unearth some hidden gains to be salvaged from the experience.
6. Relationship Issues
From families and partners to work and social networks, relationships are an integral part of being human. Relationships need nurturing and always benefit from our attention, but sometimes we're aware of something more deeply amiss. Communication difficulties, competing needs or conflict; mismatches of expectation, outlook or approach, can all turn a potential source of mutual fulfilment into a draining frustration.
Our individual personalities and experience contribute to our relationships. We've all learned ways of relating from our formative years, particularly in response to those who have had the greatest say over our welfare. Sometimes we're not conscious of the characteristic elements of our relationship style and their impact on those at the receiving end - though we may get an inkling when we find ourselves stuck in repeated patterns of relationships, sometimes precisely of the sort we'd hoped to avoid.
Counselling can help us to reflect on our personal relationship style; to disentangle current relationships from the past and identify where we might be inappropriately burdening them with the weight of old unmet needs. It can support us in clarifying and then setting fresh boundaries and balances to promote healthier patterns of relating.
For some couples, individual counselling is only half the solution: They may prefer to pursue joint counselling, perhaps alongside some separate, personal work with another counsellor.
7. Mid-Life Concerns
Somewhere between thirty-something to fifty-plus, many people experience a significant period of inner upheaval. Past the energy of youth, yet not ready for retirement, they sense they are losing their way in the middle. Behind the well-charted outer symptoms of 'mid-life crisis,' the inner reality can be a disturbing range of feelings: Restlessness; panic at time running out; disappointment of unfulfilled hope; shock at one's changing body and tastes; exhaustion under a weight of responsibilities; vulnerability, and an urge to find a meaning in life, beyond achieving a standard of living.
Whether the mid-life stage is triggered by sudden loss or even unexpected gain, or emerges into awareness more gradually, it raises deep uncertainties. We're unsure why our current ways of living no longer seem to work so well. We may find ourselves considering spiritual issues, perhaps for the first time. We scrutinise past decisions; wonder who we have become, and search for how we really want to spend our remaining years.
Counselling can be a place to explore our own answers to such urgent questions. It can support the necessary task of reconciling ourselves with our past, reconnecting with our true selves in the present, and re-orientating our priorities to make the most of our time ahead.
8. Abuse
Abuse can happen when the desire for control replaces the according of value to a fellow human being. It involves the exploitation of a vulnerable other, and can take many forms, from verbal insult to physical and sexual violation. There is also passive abuse in the persistent neglect of another's need for love, nurture and protection.
Such treatment is both damaging and distressing. Its consequences may include difficulties in forming close personal relationships, where there is partnership and mutual respect; attempts to subdue the shame of painful memories through unhealthy addictive behaviours. Abuse can result in significant personal losses: Of confidence, innocence, self-respect, security and trust. Those who have suffered active abuse may also have been pressured into secrecy.
Counselling can support the recovery from such past trauma. It can offer a secure place with clear enough boundaries to make it safe to begin to trust again (though confidentiality is affected in a situation where someone is still at risk); it can be a place to mourn what has been lost, express what has happened and come to terms with its reality. Ultimately it can support the healing stage of re-connecting with life in a more whole way. The length of this process will depend on what has been suffered, how ongoing its nature, and how early it was experienced.
9. Anger
Anger is a powerful energy. Rightly harnessed, it can be a positive force for change. Wrongly directed, it can be destructive to our relationship and personal health.
As with any emotion, when we react to an everyday situation in an intense 'over-the-top' way, it is a sure sign of something deeper going on. But anger's symptoms are not just a fiery manner or explosive temper. If we feel unable to articulate it directly, our anger can come out in other ways such as sarcasm or sulks. Sometimes we turn it in on ourselves, and wonder why we feel so heavy.
Anger can be a reaction to situations where we feel powerless through being belittled, neglected, abandoned, excluded or otherwise unjustly treated. Current situations can open the old wounds of original hurts, even when they happened long ago.
Counselling can be somewhere to explore what is fuelling our irrational anger and identify the pattern of our particular triggers. Understanding our anger's true source can help us to reduce its grip and redirect its power more creatively.
10. Low Self-Esteem
How we regard ourselves plays a key role in how we live our lives and interact with our world. A poor appreciation of our abilities may inhibit us in risking new ventures and fulfilling our potential; too low a view of our worth may mean we allow others undue influence and control over our lives. The former may leave us feeling frustrated; the latter may leave us feeling crushed.
Low self-esteem derives from a set of underlying assumptions and feelings about ourselves absorbed from influential figures in our lives and re-inforced by seminal experiences. These may have become such givens that we may hardly be aware that they are there.
Counselling can help us discover the source of our self-limiting beliefs. Once conscious of them, we are free to re-evaluate their accuracy and usefulness to us now, and choose what to retain and what to let go. It can also encourage an exploration of other experiences that might tell a different story from the one we have always told ourselves. Developing a more balanced appraisal of ourselves can lead to healthier, happier living.