Should Your Therapist Give You advice?

Sigmund Freud, Wikipedia

If you’ve never been to see someone about a mental health issue before this may seem a weird question.  However, there are two broad approaches to our kind of work.

In the old days, clients would pitch up, describe what was going on, and receive an expert opinion.  Possibly this came about because many of the first modern generation of mental health providers were psychiatrists, medical doctors specializing in mental health.   

 

So they’d act like traditional doctors, dispensing wise counsel to their patients.

But in the 1940s, the idea of a client centered approach became popular. It was championed by Carl Rogers, a psychologist (not a medical doctor!) who believed that we are each our own best expert. He advocated that mental health workers should listen to and work with the client to set goals and find solutions.

Today mental health providers who give advice are called Directive and those who are client centered approach are called Non-Directive.

Generally speaking, people in the West lean towards wanting Non-Directive practitioners because it generally falls in line better with our individualistic, egalitarian cultural approaches while people in South East Asia lean towards wanting Directive practitioners because it falls in line better with their group oriented, strong hierarchical cultural approaches.

I say generally and am making sweeping statements because this is just a casual blog post. If you want to debate this, we can talk about it.  For now the question is, if you are looking for help and a bit uncertain about what you want, what should you know?

Here are some thoughts:

A big pro of the Directive approach is that you don’t have to make any decisions. You pay someone to do it for you. If you get someone good, who thinks like you, that can work very well. 

 

The big drawback is that what works for me, may not work for you. If you are not totally in sync, the advice may not work - or make things worse.

A big pro of the Non-Directive is that you are involved in every stage of the process, and so you are much more likely to develop good approaches that suit your unique person and situation. 

 

The big drawback is that it takes a lot of work, and it can be tiring.

Me, I suggest it’s best to work with someone like me who does a bit of both. You see, there are times when something is clear to me because of my training and experience.

For example, I’m very happy to say things like, “There are three ways of doing this, A, B and C. From what I know of you, I’d go with approach B as it’s most likely to suit you best.”

I’m also not shy about giving opinions. For example, “I think you should consider looking into your relationship with your MIL, because it sounds toxic and I think it may cause you trouble if you don’t address it.”

But I also check with you that this is what you want. And if you disagree, that’s okay. Because I’m someone you work with; I’m not your nanny. In the end, you decide what's good for you.

When Hate Gets To You, Reach Out (Plus, Tom's Awesome Tuna Shirt!)

Does it seem to you that hate is becoming mainstream?

My brother called me this morning, worried about the terror attacks in Barcelona, Cambrills and Turku over the last few days, coming right on top of Charlottesville, Manchester and London. As he's in Saudi and I'm in Malaysia, we are also aware of the many hate crimes that don't hit main stream news media.

"I don't believe in profiling," he said, "but we have to do something about violent arseholes!"

In case you're confused which particular violent arseholes we were thinking about, the answer is all of them. 

You see, if you take me, my brother and our partners and their sibs and partners, just us very close family, you will see a kind of United Nations effect. 

 We range from Nippon Paint's brilliant white to the finest dark chocolate in terms of skin, and we cover most of the major faith groups. 

We're from Europe, North America and Africa and we live in all those places plus the Middle East and Far East Asia.

In other words: whenever someone blows up "the enemy" or mouths off about "the x problem" you're talking about one of us. It is very hard not to fall into hate. Especially when politicians and faith leaders make speeches about how you are Evil Incarnate.

I can't fix the world but I can help manage my feelings.

What helps me is engaging with people who are cheerfully accepting of differences. The kind who  just respect that we're all different and celebrate it.

When I'm having an anti-X moment, I pick up the phone, and go for a coffee with a friend who isn't like me, and we just hang and have a good time. It can be a Malaysian Christian Mala or a Cambodian Muslim May or a Thai Hindu Myriam - it doesn't matter. Just reminding myself that friendships cross divides cheers me up.
 

Good random experiences are a tonic too. Like when me and my friend Emanar were in Central Market a week or two ago, talking to two Malay girls running a clothing stall.

(For non-SEA readers, most Malay people are Muslim. These two definitely were because they wore tudungs, traditional local Muslim headscarves. Although some Muslims drink alcohol, Malaysian Muslims usually believe their religion forbids them to drink and the law prohibits them from buying alcohol. )

"I need a party shirt for my husband," I said to them.

They hauled out a lovely batik, perfect for a posh event.

"I love it," I said. "But I'm thinking more of a party at the pub."

"He can wear this there too," the sisters giggled. "And he'll look so handsome!"

"He's dressed nicely all week at work. Do you have something more relaxed?"

The sisters thought for a second, and then dived into their stock, producing the best beach party shirt I'd seen in years and asking, "Will tuna fish be suitable for the pub?"

"The tuna fish," I said seriously, "will be the talk of the regulars for weeks!"

"Tell them where you bought it!" the girls chorused instantly.  

Such a simple story, right? An everyday occurrence. But when I hear hate speech urging us into "Us & Them" remembering that little scene gives me hope.

Hate isn't universal. And when we reach out and remind ourselves of the ordinary people who are quite happy to accept differences, the world looks a little better.

PS the sisters have the stall on the first floor, on the balcony, directly facing the main door. Their batik shirts are awesome, and they had several more tuna shirts! You should go and take a look.

 

Your Therapist Recommends: "How to Remove a Brain" (And Why I Don't Use Leeches) Review of How to Remove a Brain by David Haviland

If you're already suspicious of doctors and medical institutions—a common trait among high-achieving professionals and those with a history of trauma (PTSD/cPTSD)—David Haviland’s How to Remove a Brain: and other bizarre medical practices might just send you running for the hills!

This is a wonderfully weird book that drags up every strange, wacky, and sometimes horrifying medical practice from history to the present day. It's written with a pen dipped in sarcasm, and I found myself laughing and groaning in equal measure.

But here’s the serious, therapist-focused reason I loved it:

The Roots of Emotional Disconnection

Reading about doctors who used to avoid speaking to patients directly—preferring to write letters to other doctors instead, simply because seeing "nasty body bits" was beneath them—gave me a lot of food for thought.

I believe this historical "stand-back-and-don't-engage" attitude is the exact thing that has long permeated the mental health profession, making it feel cold, detached, and untrustworthy to many of you.

For Clients with Anxiety: You need a therapist who is present and engaged, not someone operating on old-school, rigid professional distance. This book validates your intuition that distance does not equal competence.

For Trauma Survivors (cPTSD/Abuse): When you have a history of being dismissed or harmed by figures of authority, the last thing you need is a clinical relationship that feels like another power imbalance. Haviland’s book helps shine a light on why medical institutions can feel so deeply dehumanizing.

My Approach is Different

However, I want to be clear: the therapy I provide today has evolved light years beyond this "stand-back" philosophy.

My practice, which specializes in depression, anxiety, and trauma recovery, is built on the opposite philosophy:

We work together. My role is not to stand back and judge, but to be an active, present, and human partner in your healing.

It’s Not a Spectator Sport: Modern, trauma-informed care is about working with your whole self—your thoughts, your body, and your nervous system—not just analyzing you from across the room.

No Bizarre Practices: We use evidence-based, modern, and compassionate techniques to help you feel safe and in control. No brain removal or leeches necessary, guaranteed.

Ready for a therapeutic relationship that is human, direct, and effective? Email me ellen.whyte@gmail.com or WhatsApp: +44 7514 408143  The first 15 minute consultation is free.

P.S. Yes, I do worry this book might fuel some science scepticism, but the truth and the history of why institutions feel untrustworthy are important starting points for healing and change. Huge thanks to NetGalley and the publishers for this insightful read!