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On the whole, we Brits don’t like the idea of ”therapy” – it still feels very American and a little self-righteous. And yet, an increasing number of us need emotional guidance as we face the challenges of work, redundancy, relationship breakdown, bereavement, or just the unpredictable ups and downs of life and beyond.
“Most people just crash into adulthood,” says Owen O’Kane, psychotherapist and author How to Be Your Own Therapist. “Unless we were lucky in our parents, psychological well-being was not part of our childhood: we were not taught the key skills of managing difficult thoughts and emotional regulation,” he says. In addition, after the pandemic, he has seen the highest level of emotional distress in his 30 years of practice. “The level of struggle is surprising,” he says.
O’Kane, 54, who was born in Belfast, worked in palliative care before becoming a psychotherapist, an NHS clinical lead, and is now a private practitioner. “There’s a misconception about therapy,” he says. “I’m not a fan of being headstrong and quiet. You cannot hand over the responsibility to your therapist, and you cannot expect him/her to simply ‘fix’ you. Reaffirmation can be counterintuitive.
“But a therapist can be helpful when someone can’t see the wood for the trees,” he says, “to stand by them and help them understand themselves and why they keep doing what they do. certain patterns of behavior again.”
Everyone could benefit from therapy, he believes. “We’d all love a personal fitness trainer if we could afford one – this is no different. But NHS waiting lists are longer than ever, and many people cannot afford a private therapist.” In the absence of a therapist, he believes, doing nothing is not an option. “The idea of self-therapy is to put you on the road: a crash course to get to know yourself and understand yourself.”
O’Kane’s approach blends the disciplines of cognitive behavioral therapy (CBT), trauma therapy and mindfulness. His book is insightful, stimulating and practical, with written exercises and simple tasks for the reader. “It doesn’t help anyone who is in trouble just to talk about their problems,” says O’Kane, who advises BBC drama writers on the credibility of their scripts. “The ‘knowing’ must be matched with the ‘doing’, with the aim of changing our behavior and dealing more easily with our problems in the future.”
Here, in O’Kane’s words, are seven key skills that can help you become your own therapist.
1. Know your own ‘story’
The story of your life will contain many treasures that will help you understand who you are, and how you can have a fuller future. Start by literally plotting out a timeline of the main events of your life – just the highlights, like a movie trailer. Go through the highs and lows: what are your thoughts and feelings about them? Most people go through life and never stop trying.
For example, do you see that there were times when it was difficult to trust people, and that this may affect you now? Most of the stuff that creates big emotions in your life right now is less about the moment, and more about issues you haven’t dealt with in the past. By starting to understand these, you can turn them into something useful. When you have the courage to tell your own story without making changes or revisions to it, you are saying that you are no longer ashamed of it, and that is life changing.
2. Your response to an event is the most important thing, not the event itself
We have high expectations that our lives should go according to plan, but this is never guaranteed. We will all encounter periods of difficulty or pain. And in times of distress – losing a job, ending a marriage – people tend to attribute their upset to the event that just happened. And of course there will be an initial surge of negative emotion. But when this is over, instead of thinking: “This is not fair!”. Ask yourself: “Is there another way to look at this?”. You have two choices: see this as a moment to lie down and admit defeat, or a moment of opportunity.
For example, a person who has been made redundant may only see failure, and blame themselves. They may be thinking: “This is a disaster” and “How am I going to pay the bills?”. Step away from the disaster and think about similar times in the past that you have dealt with. Your negative emotions are strong at the moment, but emotions are never permanent: they pass. Each possibility will provide new opportunities for growth and resilience. “I can’t manage” becomes “I’ve survived tougher moments”.
3. Keep a sense of perspective
For 10 years, I worked in palliative care: the intense field of death, and death. This had a lot to do with my understanding of what makes a better life: working with people who had to face their mortality was grounding, it gave me perspective and forced me to look at things differently.
I learned many lessons during the period, but mainly, I came to understand that how we use our time is crucial. The relationship is by far the most important thing: you don’t see someone’s career achievements on their tombstone.
4. Psychological flexibility is key
Most people have rigid ideas about the “fairness” of their lives “I have to please people”; “I must not disappoint”. But research shows over and over again that if you work from scratch on how you think life should be, you’ll end up inflexible. This way, if something goes wrong, it proves that you are rubbish.
Learn how to negotiate your own rules. Instead of the above, try: “I don’t have to be perfect”; “Sometimes I get it wrong”, or “I can’t always be at my best”. This takes practice, but if you realize that you are rigid in your thought process, stop yourself and ask if there is another way of looking at it.
I compare this to the suspension on a car: if it’s stiff, you’ll feel every bump in the road, but if you’re flexible, the ride will be smoother and more comfortable.
5. Don’t categorize emotions as ‘good’ or ‘bad’, but ‘interesting’.
Feelings are symptoms, they are there for a reason. And people cling to positive emotions – they want to be happy, successful, in love – and suppress negative emotions such as fear or anxiety. This is completely understandable. But we need to be curious about these “negative” feelings, and what they are teaching us. No emotion is wasted.
For example, that worry about a big work project could be telling you to procrastinate. That grief after a breakup is hard, but it is healing. Telling yourself – or someone else – to “look on the bright side” is counterproductive because it invalidates your feelings and slows down your recovery.
6. Always examine the evidence
Your inner critic is there to stop you from getting hurt, and your anxiety is driven by “what if”. You may think that you will not be able to cope with being single, or losing your job, but what is the evidence that this thinking is true?
I tell my clients to imagine themselves in a court of law. Would their testimony about how they feel stand up in court? Is this evidence biased, or personal? Deal with your inner critic by being a lawyer in your own life.
I also encourage people to write things down – keeping a diary, for example, can be very useful. If you’re having trouble, challenge your negative thoughts by writing down 10 key points of evidence against you. You might surprise yourself that you can’t think of anything.
7. Unapologetically show who you are
Of course there are uniforms and rules in life: we have to present ourselves in a certain way and act appropriately in a work situation, for example. But we spend a lot of time in our lives trying to show up as something different from how we are: this is not the way to a happy life. I grew up gay in Northern Ireland during the Troubles, and lived my early life with Catholic shame and guilt. I had to move away to make the impact, and I only came out in my early 20s.
Ultimately, it is a human freedom to be comfortable with ourselves and to be true to our inner values. This sometimes means speaking up, albeit unpopular, and pushing through boundaries. If you see someone being bullied, and no one else is standing up for them, be the one who does. You may cause discomfort and upset people, but this does not mean it was the wrong decision.
Other people’s opinions don’t matter in the long run. If everyone likes what you’re doing, you’re doing something wrong. If we spend our lives waiting for approval, we will be unhappy. Trust yourself and your judgment. And always ask yourself this: what actions will I take?
How to Be Your Own Therapist by Owen O’Kane (HarperCollins, £9.99)
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