Deciding to Start
If you're asking the question, you're probably ready to take yourself seriously
There's no objective threshold you have to meet. No level of suffering that qualifies you. If you're wondering whether therapy would help, it probably would.
People wait too long. They think they need to be in crisis, or have a diagnosable condition, or be unable to function. They compare themselves to people who have it "worse" and decide they don't deserve help.
But therapy isn't only for people who are falling apart. It's for anyone who wants to understand themselves better, change patterns that aren't working, or stop being stuck in the same places.
The question isn't whether you're broken enough. It's whether you're ready to take yourself seriously.
The same patterns keep recurring. Different job, same problems with authority. Different partner, same fights. Different year, same resolutions failing the same way. If your life keeps rhyming with itself, there's something to understand.
You're functioning but not thriving. You get through the days. You do what's required. But something's missing - joy, meaning, connection, aliveness. You're surviving, not living.
Your coping strategies are becoming problems. The drinking that used to take the edge off is now most nights. The work that gave you purpose is now compulsive. The avoidance that kept you safe is now shrinking your life.
Relationships keep going wrong. You push people away, or cling too tightly. You can't seem to choose partners who are good for you. Friendships fade and you're not sure why. You feel lonely even when you're not alone.
You're exhausted by being yourself. The performance of okayness takes everything you have. You don't know who you are underneath the mask. You're tired of pretending.
Something happened and you can't move past it. A loss, a trauma, a betrayal. Time is passing but you're stuck. The wound isn't healing on its own.
You keep asking this question. The fact that you're googling "do I need therapy" suggests part of you already knows the answer.
Therapy isn't always the answer. Sometimes other things need to happen first.
If you're in active crisis. Therapy is slow work. If you're in immediate danger - suicidal, in an abusive situation, unable to function at all - you might need crisis support, not weekly talking therapy. Stabilise first, then go deep.
If your basic needs aren't met. It's hard to do inner work when you're worried about housing, safety, or where your next meal is coming from. Practical problems need practical solutions. Therapy can't substitute for a stable life.
If you want someone to fix you. Therapy requires your active participation. If you're hoping to show up and have someone else do the work - give you answers, make decisions for you, tell you who to be - you'll be disappointed.
If you're not willing to be honest. Therapy only works if you bring the real stuff. If you're planning to present an edited version of yourself, to hide the things you're ashamed of, to perform wellness - save your money.
If the timing is impossible. Therapy takes time and money. If you genuinely can't commit to weekly sessions, if the financial strain would create more stress than the therapy relieves, it might not be the right moment. This can change.
Friends. Good friends help, but they have limits. They can't be objective about you. They have their own needs in the friendship. They might tell you what you want to hear. And there are things you can't burden them with - the same crisis for the hundredth time, the thoughts you're ashamed of, the full weight of your pain.
Self-help. Books and podcasts can offer useful ideas, but they can't respond to you specifically. They don't know your history, your blind spots, the particular way you get stuck. And reading about change isn't the same as actually changing.
Coaching. Coaching is forward-focused and goal-oriented. Good for specific challenges - career transitions, productivity, building habits. But it doesn't go into why you keep sabotaging yourself, what the patterns mean, where they came from. If the problem is deeper than strategy, coaching won't reach it.
Medication. Sometimes necessary, sometimes helpful, never sufficient alone for psychological problems. Medication can stabilise your mood or reduce symptoms, but it doesn't help you understand yourself or change patterns. It's not either/or - some people benefit from both.
AI chatbots. Available at 3am, infinitely patient, never judges. If you've turned to one, you're not broken - you're doing what makes sense when human help has been too expensive, too slow, or too disappointing. But the chatbot can't be changed by knowing you. It can't notice what you're avoiding or challenge the story you're telling yourself. And because it can't reject you, it can't truly accept you either. Acceptance from something that has no alternative isn't the same as acceptance from someone who could look away and doesn't.
Therapy. Offers what the others can't: a trained professional whose only job is to help you understand yourself. Someone who can see your blind spots, tolerate your full intensity, and stick with you through the difficult parts. A relationship specifically designed for growth.
Therapy can help you understand why you do what you do. Change patterns that have been running your life. Process things you've never fully dealt with. Develop more satisfying relationships. Feel more comfortable in your own skin. Make choices that actually reflect what you want.
Therapy can't change your circumstances directly. Make other people behave differently. Give you a pain-free life. Work faster than you're ready to go. Guarantee any particular outcome.
Therapy isn't a quick fix. A place to be told what to do. An alternative to making difficult changes in your life. Something you do to say you tried. A way to get someone else to change.
The work requires honesty, patience, and willingness to feel uncomfortable. It takes longer than you'd like and costs more than it should. But for the right person at the right time, it can change everything.
I'm a psychodynamic therapist practising in Croydon, South London. If you're considering therapy, I offer an initial 90-minute session where we can explore whether we're a good fit.
Read about what happens in a first session or how psychodynamic therapy works. When you're ready, get in touch.