Depression is one of the most common mental health conditions, affecting 8-12% of people in the UK each year, and is the most searched for issue on RSCPP. Symptoms include long-lasting feelings of unhappiness and despair, and loss of interest in normal activities. In especially severe cases, depression can also lead to self-harm and suicidal thoughts.
28-year-old Helen* has lived with depression for many years, as a result of traumatic experiences during her childhood. She has been in and out of therapy, with a number of different therapists, since the age of 13 but finally found a long-term solution to her feelings of depression when she met Accredited Counsellor Ian Tromp through RSCPP.
"I guess you could say I was kind of desperate at that point," she says. "I first met Ian in July 2013, and our sessions continued until January 2015. It was mainly to do with depression, and I wanted to address things that happened in my childhood. I started seeing Ian a month before my wedding, because the pressure was just mounting on, so I wanted to explore that pressure as well."
I wanted to address things that happened in my childhood, and explore the pressure I felt around my wedding.
Having had bad experiences with other therapists in the past, Helen says, "I decided to have one final go, because I'd been in therapy before but it wasn't very successful. My friend recommended the [RSCPP] database, because she found her therapist through it, so I found Ian and arranged for a session, and thought I'll just see how it goes."
Accredited Counsellor Ian Tromp is accredited by the British Association for Counselling and Psychotherapy (BACP).
"In our sessions I worked for a long time with Helen on simply building connection and being dependable and trustworthy," he explains. "We actually had our first few sessions by Skype, which was a way of building trust. Helen was wary because she'd had difficult and painful experiences with previous therapists, so we took time connecting online until she felt ready to meet face-to-face."
Ian worked with Helen using integrative counselling and elements of mindfulness, complemented by a mindfulness course that she took independently. She says she felt almost immediately that he was different from therapists she'd had in the past. "He was very, very calm, and a good listener," Helen says. "I did not feel judged at all, which I did in previous therapy sessions with other therapists."
Ian was very, very calm, and a good listener. I did not feel judged at all.
Looking back on her initial goals, Helen says, "I wanted to be able to deal with issues from my childhood and the way they'd affected me, in such a way that I could get the depression under control, rather than let it control me."
Ian says: "Helen arrived at our sessions in crisis about her impending wedding and her feelings about having to confront her family around the wedding. She needed support to get through these experiences. She was also drinking at the time and wanting to work with that - which she did very quickly."
During their earlier sessions, one of the biggest challenges was naturally building a therapeutic relationship of mutual trust and understanding. Despite Helen's previous bad experiences of therapy, she says: "I don't think [the change in me] took that long at all, considering how many different therapists I'd had before, and how long I've been in therapy."
She adds: "It was definitely a gradual change, but if you consider that, in the space of less than two years, I managed to get my issues under control with Ian, it's quite remarkable."
For Ian, the change came when he allowed Helen to discuss feelings that she had previously 'disallowed'. "My allowing those feelings made a big difference, and I think allowed her to be with other feelings that she had disallowed for a long time," he says.
With Ian I was able to talk about things that I'd never talked to anyone about before.
"I would say we went through stages of deepening into our relationship. She felt comfortable enough to open up to a degree after our Skype sessions, and then this deepened over the next couple of months, and then again," he adds.
Likewise, Helen says, "straight away I felt very good about [our sessions] and I felt listened to. I focused on talking about things that I'd never talked to anyone about, and that's where it comes in how great Ian is really, because I was not able to talk about these things with anyone before."
She adds: "I just trusted him so much that I could talk about it with him. That trust did not come straight away but, because of the therapist he is, he made it all possible for me to create that trust and foster it."
Both Helen and Ian immediately highlight one particular incident, which they see as a breakthrough moment in Helen's therapy. "In April 2014 I had a breakdown and I self-harmed," she explains.
"It was a very specific event that triggered the breakdown," she says. "One of the things I hated was my job, so I was trying to change it. I prepared very well for an interview and I just didn't get the job, and the way it was communicated to me was just too much at that time, in the state of mind I was in."
Helen adds: "I had to go to hospital and they gave me some tranquilisers. Afterwards I phoned Ian and let him know what had happened, and he suggested that we have more sessions, and have them more frequently."
Therapy became even more intense for me. I realised I had to put in more work.
Crucially, Ian says, "I feel what was really significant here was that I didn't try to stop her [self-harming] but really tried to be with her in her anguish – asking her not to stop, but to do as little damage as possible. I think this made a huge difference for her."
He adds, "I think at this point she really allowed herself to be 'held' for the first time – we had built up to that over the preceding period, but it was as if she had an experience of really letting go, and feeling herself 'caught' by me."
Indeed, for Helen this incident marked a real change in her experience of therapy. "Therapy became even more intense for me, and I was even more determined to get better," she says. "That was when I realised I had to put in more work; if I didn't do it myself, with the help of Ian, it wasn't going to happen," Helen adds.
"I felt it was important that Helen should initiate the ending of our sessions, and that she should not in any way experience me as pushing her away," Ian says. "I knew a time would come when she trusted herself enough to 'go it alone', and wanted to wait with her as long as it took for that feeling to be there."
Indeed, in October 2014, Helen told Ian that she would like to try coping on her own, and they wrapped up their sessions in January. "That final session was really just to say 'ok, I'm embarking on a journey now, on my own'," Helen says.
"We left it really open; Ian said that I can always come back, or have a one-off session to see where I'm at, and I said I will take him up on his offer, but first I need some time to pass because I need to gather self-confidence in coping by myself," she explains.
I learnt that I can do it, that I can be helped, and also that I can be vulnerable.
"So far it's been going very well. I think my self-awareness has increased – I was always very self-aware of my feelings, but I was not always aware of what to do and how to cope with them, and now I feel it's all possible, and it's very ingrained in me," she adds. "I learnt that I can do it, that I can be helped, and also that I can be vulnerable.
Finally, she's keen to stress, working with Ian made her realise that: "That [therapeutic] work cannot happen without a good relationship with your therapist. I could recommend Ian to everyone, but then he might not be suited to someone else like he was suited to me. You have to have a therapist who's a good fit."
She gained some peace in herself. She became brighter, shinier, and more confident.
Ian too has seen a real change in Helen, and feels positive about her future beyond therapy. "I think she gained some peace in herself, a little more simplicity of feeling," he says. "And I think I saw her energy brighten as well – she became brighter, shinier, and more confident – she seemed to inhabit herself more fully," he says.
"I felt very good about something she said in an email recently, that she knew she could trust that she really has changed because the goodness she feels is impermanent – it comes and goes, and sometimes she feels unhappy and even touches on depression, but she's also come to trust that happiness is possible again," he adds. "That felt very real to me, very ordinary and human, and so wonderful."
*The client's name has been changed and her consent was provided prior to both interview and publication