Britain on the couch: How we are flocking to therapists to improve our lives

Once upon a time Britons were famous for being all buttoned up. Now, it seems, we're opening up as never before, rushing to counsellors to tell them of our lives and feelings. The nation's consulting rooms have never been so full of well-adjusted people, eager to give their happiness that extra edge.

Once upon a time Britons were famous for being all buttoned up. Now, it seems, we're opening up as never before, rushing to counsellors to tell them of our lives and feelings. The nation's consulting rooms have never been so full of well-adjusted people, eager to give their happiness that extra edge.

Tomorrow a major new report reveals that more than four in every five men and women would prefer to share their problems with professional counsellors than, as was traditional, to keep their feelings to themselves.

The nationwide study from the British Association for Counselling and Psychotherapy shows a marked shift in public attitudes towards therapy, once seen as suitable only for those with serious psychiatric or psychological problems.

The BACP study, Self Awareness or Self Indulgence?, says that a staggering 83 per cent of people are now prepared to seek professional help - the result of their increasingly stressed-out lives and of marital breakdowns.

Strict client confidentiality makes it difficult to estimate exactly how many people seek counselling. But numbers have spiralled, with thousands of people a year attending workshops on topics ranging from managing aggression to combating burn-out at work.

The BACP says its membership - made up of qualified practitioners - has tripled in the past decade to more than 20,000 as more and more therapists flock to meet the growing demand. The UK Council for Psychotherapy reports a similar rate of growth, while Relate, the relationship guidance service with 2,000 counsellors nationwide, reported an increase in the number of people using its service from 127,000 in 2002 to 140,000 in 2003.

Phillip Hodson, a spokesman for the association, said that people are turning to counselling because, increasingly, they are forced to "live like computers".

"To some extent it's inevitable," he said. "The big changes have been the Second World War, the 1960s and the Pill. We have fractured families. Divorces have risen from around 3,000 in 1930 to about 160,000 now. We have privatised a whole range of services in our lives and now, to some extent, we have privatised advice and support as well."

Cruse, which provides a free service to the bereaved, said inquiries increased by nearly 90 per cent between 2001-02 and 2002-03, when more than 158,000 people sought help from the charity's 5,000 volunteers.

Life coaching is the most popular of Britain's new therapies. Thousands of people are signing up to become qualified coaches, trained to help others to live a fuller life. "The coach's role is to clarify and fully understand the client's experience of the world through active, non-judgemental listening and precise questioning," said Kim Morgan of the Derbyshire-based Barefoot Coaching, whose courses are accredited by the National Council of Psychotherapists.

"Our coaches know when they have reached the limits of their expertise and, importantly, when to refer a client to a professional therapist for more complex emotional or psychological issues," she said, reporting that demand for coaching from the general public has at least quadrupled in the past two years.

Some in the field, though, decry the demise of old-fashioned British reserve and say we are nurturing a generation of needy men and women dependent on others to solve their problems. Also, they fear that an unregulated industry in therapies is placing vulnerable people at risk.

The most trusted forms of talk therapy - counselling, psychotherapy, psychology and psychoanalysis - rely on established schools of thought and scientific methods. The current shift, however, is towards less well known or supervised areas, new terminology and titles - the so-called lifestyle guru, for example - and courses and qualifications that are easily available.

Last month, for the first time, the National Counselling and Psychotherapy Accrediting Bodies agreed to set up a national register of approved practitioners - a significant step on the road to full regulation.

Christine Mead, head of counselling services for the Terrence Higgins Trust, the UK's leading HIV and Aids charity, said the quality of training given to counsellors was far from consistent. "Counsellors in training do placements with us and we see huge differences in the quality of training," she said. "Some people do an insubstantial course and come out with a qualification."

Professor Frank Furedi, a leading sociologist and author, warned the growing army of so-called stress managers, life coaches and gurus are "in the business of creating more customers by promoting a sense of insecurity in people".

"People now regard anything unusual or troublesome as something that a professional is better able at coping with than they are," said Professor Furedi, author of Therapy Culture: Cultivating Vulnerability in an Anxious Age and head of sociology at the University of Kent.

"We are allowing counsellors to shape our lives," he added. "When you get people who say counselling was good for them, what they mean was that they enjoyed being listened to."

Dr Raj Persaud, a psychiatrist and broadcaster, is alarmed at what he called Britain's "dependency culture". "People should be wary of it as the only pathway to good mental health," he said. "What is the cut-off point at which you should try to deal with your own issues?"

Nick Totton, a Leeds-based psychoanalyst, said therapy was becoming less stigmatised. "I think something that is steadily changing is that people don't see therapy as a stigma any more, and that is great," he said. "Increasingly people are realising that it does not imply something is wrong with them if they have counselling."

Stress

'Use it when you need it, but don't abuse it'

Laura Kerr, 35, took counselling to help her through an eating disorder and another period of serious stress.

Before going to university Laura decided to spend a gap year in Germany. But she soon found herself isolated, with just British Services Radio for company, and developed anorexia. "The positives of counselling are it's somebody who is not directly involved with the whole situation," she says. "It's a safe environment to express your feelings. You can say whatever outrageous thoughts you have without upsetting anybody."

But she has mixed feelings. A few years ago, unhappy in her job, Laura felt she needed "focus and direction" and went back to counselling.

"I had a rough patch and knew that I was having problems," she says. "It was stress, and where am I going in my life? I felt a bit vulnerable and needed support."

Again, it was successful, but during the last two sessions she realised she was saying nothing she couldn't say to a friend. "Counselling can be overused. I would say use it when you need it, but don't abuse it," she says.

Exam worries

'She taught me how to calm myself'

Alex Cooke from Ealing, west London, will be 18 next month. He went to a life coach after disastrous exam results.

Alex's plans for the future were thrown into disarray when he received his AS-level results earlier this year. They were much worse than expected. He had recently been diagnosed with dyslexia, which explained his difficulty with revision, and also problems with his confidence. Fortunately his mother, Hilary, knew of a life coach and booked an appointment.

"She taught me how to calm myself when I'm stressed," he says. "I felt able to talk about things to her. I've had quite a stressful year and I realised that AS-levels weren't the route I wanted to take, anyway. I'm doing a catering course, a BTEC, which means I can skip the first year of a degree, so I don't lose any time."

His mother adds: "The coach got rid of a whole lot of negative beliefs. Without her I wouldn't have known what to do with him next."

Bereavement

'Counselling helped me to keep my sanity'

Sandra Holroyd, 44, from Reading sought professional help following the death of her husband.

When her husband, Andy, was killed in a motorbike accident, Sandra was forced to keep much of how she felt to herself while she put on a brave face for her children.

"The grief was eating away at me but I had to carry on because of my children. I can't tell you how awful it was to have to tell them," she says. Fortunately she had read about the bereavement counselling service, Cruse. "Counselling helped me to keep my sanity," she recalls. "The counsellor assured me I wasn't mad, that my experience was normal." It also gave her space to grieve, and to discuss things she couldn't "in polite society", such as having to identify her husband's body.

Sandra has since remarried. "I do believe that without the help I received I wouldn't have been able to hold on. To cope, to find someone else, I would attribute it all to the help I received."

Interviews by Andrew Johnson