Michael Abrahams | The value of talk therapy

It is not uncommon for patients to present to my office seeking help for gynaecological symptoms, only for more important or life-threatening issues to be discovered.

For example, earlier this year, a woman visited me because she had noticed a vaginal discharge, but left my office not only with a prescription for medication for an infection, but also with a referral letter to a surgeon for a lump in one of her breasts, which eventually turned out to be cancer. Up to the time of her visit, she had been unaware of the danger that lurked in her right mammary gland.

Similarly, there are many times I have found that a patient’s psychological issues require more urgent attention than concerns related to her genitalia. When this happens, I suggest follow-up by a mental-health professional. Many take my advice and comply, but some are resistant, or even dismissive. Some are sceptical regarding the value of getting therapy, and I tell them that it has the potential to make a big difference in their lives.

Mental illness is much more common than most of us realise. According to the World Health Organization (WHO), one in four people in the world will be affected by mental or neurological disorders at some point in their lives. Some mental illnesses require pharmacological intervention, and in some cases hospitalisation. But many can be helped with talk therapy, also known as psychotherapy, with or without medication.

In my opinion, all of us could do with some therapy from a trained therapist. Often pride, stigma and mistrust serve as barriers to management of our mental issues, but they ought not to. Your mental health should be a priority, and talk therapy has been proven to be beneficial in managing mental disorders.

The benefits are many. For example, therapy may assist you in discovering deficits you have that you may not even be aware of, and in so doing help you to address and deal with them. For example, if you are in a toxic relationship, it may be easy for you to identify flaws in your partner.

You may observe that the person is arrogant, narcissistic and aggressive. You know this. But it may also be important to understand traits about yourself that would allow you to be vulnerable to be drawn to someone like that in the first place, and to stay with them. You may even have personality traits and behaviours that could ignite conflicts with people who are mentally and emotionally stable and be unaware of your flaws.

In addition to helping you understand yourself, therapy can also help you to understand the people in your space, enabling you to interact more harmoniously with them. On the other hand, therapy can lead you to understand that the presence of some people in your space may be causing you harm and equip you with the tools required to help you distance yourself from them and remain out of their reach.

NEW PERSPECTIVE

Therapy also helps to give you perspective. Sure, you may know what issues you have, but therapy can assist you in breaking things down and organising and arranging them in such a way that you are able to manage them effectively.

A good therapist can also help you to break cycles, not only of your own behaviour, such as repeatedly choosing the wrong partners, but also cycles that have the potential to affect future generations. Many of our psychological issues are caused by childhood trauma. In many instances, we may have even forgotten or repressed the trauma and be unaware of how it affects us today. But, by identifying the situations and events that have scarred us, we can exercise vigilance and ensure that we do not repeat the mistakes of our parents, guardians and other caregivers, and traumatise the young and vulnerable under our care, and perpetuate the cycle of dysfunction in the process.

Many do not realise that our mental health can directly affect our physical health. It can, and therapy has the potential to make us physically healthier, too. Stress and other negative emotions not only lower our threshold to pain and discomfort, making us more sensitive to negative stimuli, but the hormonal fluctuations that occur with psychological stress, especially if prolonged, can cause physical disease.

All these benefits occur as a result of therapy rewiring your brain. Brain imaging methods have demonstrated that psychotherapy can alter activity in the medial prefrontal cortex, the anterior cingulate cortex, the hippocampus, and the amygdala, areas of the brain involved in self-referential thoughts (“me”– centred worry thoughts), executive control, emotion, and fear.

The stigma surrounding mental illness and its treatment needs to be addressed and attacked with vigour. Failure to address our issues and not talking about them makes many of us walking time bombs waiting to be triggered and detonated. If you need help, do not be afraid to seek it. Please do it not only for your sake but also for the sake of your loved ones and society.

Michael Abrahams is an obstetrician and gynaecologist, social commentator and human rights advocate. Email feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or tweet @mikeyabrahams.