Things I’ve Learnt in Therapy: Episode 1

VERY IMPORTANT DISCLAIMER: This column is not intended to offer legitimate medical advice or psychological assistance. This column is meant to highlight the author’s opinions and personal experiences of navigating the complexities of our modern-day mental health systems, and to share what the author has found to be beneficial. For more information on professional mental health and psychological services in the UK, visit www.mind.org.uk. Likewise, the author has also compiled a list of accessible resources and reading material on her blog, via: daniakamalaryf.wordpress.com/mental-health-resources/ 

Dear readers, I hope this column finds you well – and I mean this genuinely. 

It is safe to assume that we all have, at one point, received emails and messages with similar opening lines at a time when we were Most Definitely Not Well. Nevertheless, I hope you will eventually find my long-winded ramblings to be somewhat beneficial.

For those of you who don’t know: I’m Dania, former Editor-in-Chief of The Oxford Student (no, I will not shut up about this) back in Trinity Term Twenty-Two. I have now retired into the shadows of an “irrelevant finalist”, and embraced the peaceful lifestyle of a middle-aged lady going through her spiritual awakening. I like to think of this as an upgrade – from EIC, to Insufferable Columnist™ who finally gets to have a healthy work-life balance and an average of nine hours of sleep each night… what more could I ask for?! I honestly don’t even remember the last time I cried – and it’s actually incredible, MashaAllah! 

I have often been told that I have a very cynical sense of humour, and a chronic tendency to overshare. Although this has been a lifelong habit, I came to terms with a significant revelation in my early 20s that this behaviour is mainly because I am Autistic and ADHD! As I am sure, many at Oxford and across the globe, have also gone through similar experiences of being diagnosed in adulthood. The grief, confusion, relief, and anger – of witnessing your entire reality being shattered before your very own eyes, and then having to now re-construct this entire reality from scratch – can be overwhelming.

With a whimsical, weirdly-wired brain, and a mind as chaotic as my day-to-day life, I spent more than two decades not knowing a very crucial piece of information about myself that I do now. I also now know a lot of important things about the world around me, and how I understand and interact with this world. Yet, most importantly, I have FINALLY been taught such essential, life-enhancing skills that I initially was not equipped with when I was younger. 

What I also understand is: not everyone has the privilege to be taught these skills, or the opportunity to have these important conversations with their friends, families, or with a professional. So this is exactly why I am writing this column. 

I think an important part about learning anything in general, is to ensure that your knowledge is accessible to everyone. Although I am still learning, and will always still have a lot more to learn, I have also realised how this knowledge has been incredibly helpful to a significant number of people in my life. I can only hope that by having a wider audience via this column, that it would also be beneficial to those beyond my own circle. 

Our generation places a widespread emphasis on, “don’t be afraid to reach out for help if you’re struggling!” and that, “it’s okay to not be okay.” But not enough is talked about what happens once you actually do reach out, and when it heartbreakingly, does not live up to your expectations. If anything, there are multiple instances in which “reaching out” and being upfront about one’s struggles has the potential to only make things worse. 

There are many feel-good stories about how, “I took a mindfulness course for 2 months, and it completely cured my anxiety!” or, “I paid a visit to the university counseling service and it changed my life!”, yet, not enough about the reality of how EFFECTIVE, ACCESSIBLE, AND LONG-TERM SUPPORT, can be genuinely difficult to obtain. Or that misdiagnoses and misunderstandings by medical and mental health professionals themselves also happen very frequently. That waiting lists to see a competent therapist can take forever, and generally, how this whole industry is critically misunderstood (even amongst those who work within it), and critically underfunded. 

Despite having significantly benefitted from therapy, I still think our modern-mental health systems are incredibly flawed and highly inaccessible. More frustratingly, a lot of our understanding surrounding ‘mental health’ and ‘therapy’, also places a significant emphasis on the individual responsibility to ‘cure ourselves’ and ‘become better’. When in fact, a lot of our collective suffering can be attributed to systemic failures, and structural inefficiencies. Especially as governments and corporations continue to chant out hollow encouragements of ‘self-care’ and attempt to ‘reduce the stigma surrounding mental health’, it is easy to fall into an unhelpful pattern of encouraging everyone to simply, ‘go to therapy,’ as short-term individual solutions, to long-term structural problems. 

I would, however, still like to share all the meaningful lessons I have learnt, especially after more than a decade of navigating this very complex system that has somehow managed to pass me around from one professional to another, since the age of ten. I have been taught everything from breathing techniques which I then found to be completely useless, to “writing in a diary will help you process your thoughts and feelings!” as if I was not yet doing that already, and being constantly reminded how, “you need to fix your sleeping schedule, stick to a balanced diet, and socialise with people if you actually want to feel better!”

And yet, how was I supposed to ‘fix my sleeping schedule’ on days when I genuinely could not bring myself to get out of bed, or ‘stick to a balanced diet’, when I did not have the capacity to even stomach my food? How was I to ‘socialise’, when I had unknowingly isolated myself from my loved ones by consistently ignoring them, simply because I did not have the energy to respond to their calls and texts, and that I have ruined some of my relationships because of my behaviour? 

These were questions which often remained unanswered – at least partly; because none of the answers I received ever felt like they were providing me with an understanding of The Bigger Picture™.  The string of professionals I have seen over the years, each offered me different solutions to very specific problems, which were helpful given the circumstances. But prior to my Autism and ADHD diagnoses, I often still felt just as lost and helpless as I consistently struggled to understand my existence in this strange and confusing world.

I learnt a lot of important concepts like, “I should be kinder to myself”, and how, “accepting myself does not mean accepting my bad behaviours.” Although I agree with both statements and still think they are true, I spent many years groping in the dark and struggling to define what my ‘bad behaviour’ actually entailed. Was I being ‘kind to myself’ even when I did not deserve it? Was I being ‘kind to myself’ by choosing to sleep-in instead of meeting my deadlines? Was I being too self-critical when I over-apologised after making a simple mistake, or was I merely holding myself accountable? 

These were always questions that both myself and previous therapists have found difficult to answer, especially because I was told that, “it all depends on context,” and that I would, eventually, have to figure it out on my own. What I have only recently learnt, is that being Autistic often makes it much easier to misunderstand such important ‘context’, especially when it comes to applying these principles on a day-to-day basis. It also makes it much easier to fall into a habit of rigid, definitive, black-and-white thinking. This is a common trait shared not only by those on the Autism spectrum, but also by many who struggle with other types of neuro-developmental and mental health conditions, such as Borderline Personality Disorder (BPD). 

In 2021, I was introduced to Dialectical Behavioural Therapy (DBT) after my Autism diagnosis, and for once, everything finally started to make so much sense. While DBT was initially developed by Marsha Linehan for those who struggled with BPD, these skills have been proven to be incredibly beneficial even for those who do not struggle with mental health conditions, and also for those who, like me, are Autistic/ADHD. In my case, at least, I have found DBT to be the most thorough, effective, and all-encompassing type of therapy I have had the opportunity to sit through. Of course, I am fully aware that I can only speak from personal experience, and that everyone’s experiences will ultimately differ! 

Though, in general, what compels me the most to keep sharing what I’ve learnt is that I think DBT teaches such important life skills that I wish we ALL had learnt in school. The core tenets of DBT encourage being more mindful and validating, practicing ‘radical acceptance’, and learning how to be non-judgemental. DBT also places an important emphasis on effective communication, while improving one’s ability to problem solve, self-soothe, and to handle conflict and crises more appropriately. 

Through DBT, I have also finally learnt how to no longer think in extremes. It made me understand that self-awareness (especially of my own flaws and shortcomings) is not antithetical self-compassion; In fact, it is integral to self-compassion, especially in learning how to genuinely respect myself and the people around me. 

DBT introduced me to the idea of thinking in ‘dialectics’, which many of us at this university have probably already heard of in an academic context (*cough* Marx *cough* dialectical materialism *cough*.) Yet, if anything, I found it ironic how I initially did not realise how something as simple as, “two opposing and contradictory facts can both be true at the same time”, and, “accepting that my reality is just as valid as the reality of those who disagree with me”,  was a concept I needed to consciously practice also in my day-to-day life. In this context, it did not mean that I was not allowed to feel hurt over certain things, or that I should allow people to keep hurting me simply because I understood where they were coming from. It only meant that I could still empathise, without letting that empathy enable other people’s (or even my own) harmful behaviours.

If anything, being at Oxford has only made me realise how we often get caught up with so much theory and academic concepts, that it becomes easy to slip into an unhealthy pattern of ‘academic thinking’ where we eventually forget to humanise ourselves. 

These are only some of the many ideas which I look forward to exploring further in this column. At the very least, I sincerely hope that my reflections on the skills that I have learnt through DBT (combined with the knowledge from my ongoing History degree) would be beneficial to others, as it has been to me. 

Image/artwork credit: Dania Kamal Aryf