Deborah Hill Cone: Therapy should be free, because it works

Therapy can do wonders for a wounded soul. Photo / 123RF

Four years ago I was in a very bad state. I don't really remember much about that time: a blur of sorrow, drinking, pills, drama and smelly rats living behind the fridge. I would do anything just to get a bit of relief from the unbearable pain. My journals from that time are corrugated like Grain Waves because they got so wet with tears. (Sample entry: Help me.) At the time I thought I would never feel better or normal. I couldn't see any point in going on. I had no hope.

I could not imagine I would be where I am now. Happy. Cheerful. Someone who actually meditates every day. (Sigh. I wouldn't mind being thin with misery hip bones again, but you can't have everything)

I'm still a bit ramshackle. The garden needs weeding. There are snow drifts of dog hair on the carpet. But the house is warm, rat-free, my kids are perky and I did two yoga classes yesterday. ("Mum, please don't ever use the word yoga-tastic around me again.")

I was going to do my usual "I'm the worst slummy mummy" schtick, but dammit, I am a good mother. Sure, I don't make the kids floss every day or eat enough leafy greens and we spend whole days in our jarmies, but you know what? I am proud of how I try to give them what they need not what I need. That is because I am more peaceful. I have a happy relationship, lovely friends, and I think I might have found my tribe.

But. But. But. I would have none of this if it wasn't for one thing. My recovery I largely owe to my therapist. If it were not for her, I don't know that I would even be here, let alone be a functioning member of society who files GST on time and has a current WOF on my car.

It is hard to explain what therapy is if you haven't done it. Or even if you have. But all I know is when I was in a deep dark hole my therapist didn't throw me a rope or chuck down a ladder and tell me how to climb out. Instead, she got right into the hole with me and stayed with me. We climbed out together. Because you can't do this stuff alone.

Talk therapy works. And not just CBT (cognitive behavioural therapy) which is popular because it is short, and thus cheaper than psychodynamic psychotherapy, which has had a bit of a PR problem.

It is often caricatured and equated with some of the more outlandish or inaccessible speculations of Sigmund Freud more than a century ago. But the talking cure has come a long way since then.

And it works. Scientific American reports effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as "empirically supported" and "evidence based". If this was an academic paper, I would cite a study by Jonathan Shedler here which shows that patients who receive psychodynamic therapy once or twice a week not only maintain therapeutic gains but continue to improve over time. As I have done.

So I am very grateful. But also, I am very angry.

When I was in despair I got the help I needed, but most people don't. I got it simply because I am middle class and privileged and could afford it. Everyone should get this help. Because believe me, I know that it works. So why are we just leaving people sitting in the hole, alone? If they had a broken leg and couldn't afford to pay, we wouldn't leave them suffering, alone. We would get in there and administer first aid.

But the talking cure, which can help ease excruciating pain which feels every bit as real as a broken leg, is only available for people like me who can afford it. Other people can just self-medicate their pain with pre-mixed bourbon or whatever drugs they can get their hands on.

In this country there is very limited counselling and psychotherapy available through the public health system, and where it is available it is usually only available for people meeting criteria for a serious mental illness.

Most people will receive their counselling from a private practitioner or a charitable agency and they have to pay for it. Because of that many people (wrongly) think that therapy is only for people with severe mental health issues or people at the brink of collapse. Or, they assume that therapy is a glamorous hobby of the rich. It's not.

These days, I am actually grateful for that crisis. If it had not happened I would not be where I am now. (People don't usually wake up on a Saturday morning and think, not much on today, I'll find a therapist. ) I just wish everyone else was so lucky.

• Psychotherapist Kyle McDonald is campaigning to have the government fund free talk therapy for everyone. You can sign Kyle McDonald's petition here:
https://our.actionstation.org.nz/petitions/free-counselling-for-all-kiwi-s-open-submission-to-the-mental-health-review

Where to get help:

• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• Samaritans 0800 726 666
• If it is an emergency and you feel like you or someone else is at risk, call 111.