Identity issues and mental health: A core element of therapy

We all have identity issues, and they can have a significant effect on our mental health. When entering a therapeutic relationship with a counsellor, it is worth considering that identity issues explored early on can help create a framework for the whole process of exploring yourself.

What do you think of first when considering identity issues? Is it gender, sexuality, race, religion, neurotype, or something more subtle? Are you mainly identified with your work-life role? Do you focus on what you do or who you are as a person when talking about yourself? Are you strongly identified with a parental role to the exclusion of everything else in your life?

Reflecting on 50 years of Pride, I can see that being forced to deny your identity has caused major mental health issues for queer people, their family and friends, and the society around them. The Netflix show 'Heartstoppers' illustrated beautifully how an exploration of identity is integral to growing up. It always has been. The difference is that 50 years ago when I was at school, I would have been branded as a criminal or insane if I had been open about myself and any exploration of gender or sexual identity.

Societal structures try to limit and constrain our identity by dictating what is acceptable and what is not. What I love about my work with teenagers is what I learn about myself and the restrictive culture of my childhood by being present with their struggles and awesome openness to diversity in all areas of life.

Acceptance is key

But it's not all about sex and gender. It's about acceptance of every part of ourselves. Another joy of working with teens is seeing the way autistic young people are advocating for themselves, not as people who are 'broken' but as individuals who are different. They don't need fixing; they need to be accepted for their neurodiversity. They need to be given the space and the freedom to accept themselves exactly as they are.

In some ways, that is the key to all good therapy. As children, we get messages about how and who we should be. To a greater or lesser extent, we internalise these messages and begin to believe that is who we are. We survive by building a façade that keeps us safe in the world.

In my personal therapy, I have worked on the masks I wear in different situations and how I can remove the mask and feel safe to let people see me as I am. I will never again wear a suit and tie. I am not comfortable wearing such apparel, and it symbolises the compromises I have had to make in my personal identity to fit in, get and hold employment, and blend into the bland binary world we have unwittingly created.

What are your masks? Think of a situation you regularly encounter where you experience discomfort, hold yourself together, put on an act, and are exhausted at the end of it. What does the real you want to do? Run away? Rebel? Accept that this is a worthwhile sacrifice of self for the rewards gained? Are you desperate to connect from behind the mask?

Whatever your reason for masking, you are not alone. Equally, you are not alone if you want to stop the pretence, explore and express your true self in all its glory. But that can be quite daunting.

"If you're differently-abled, if you're a person of colour, if you express your identity in a way that's different from the norm, for whatever reason, there's an implicit bias where people, frankly, sometimes take you less seriously."

-Alexandria Ocasio-Cortez

How can counselling help?

When you begin exploring and expressing your true identity you can experience resistance from those around you. Friends, partners and colleagues have all gotten used to you. Here you are after a few therapy sessions, and you are beginning to speak and act differently. Persistence and confidence are required. Some around you may not like the new persona that is coming across. True friends, of course, will welcome and encourage your experiments in being your true self.

The benefit of therapy lasting more than six to 10 sessions is that you can practice all the conflicts and relationship issues that may arise in the safe confines of a therapy hour. This is when real fundamental change can take place.

With the support of a therapist, you can explore ways of being that feel comfortable for you. You can experience yourself in a relationship that encourages the free expression of thoughts and feelings, safe in the knowledge that you will not be judged or criticised. When ready, you can begin taking this out into the world.

It may seem strange at first. Maybe you are coming to therapy to find ways of coping with anxiety or depression, and you have some expectation of learning exercises or strategies that directly deal with those issues. If that is all you need, then it would be good to be clear about that with your counsellor. Most professionals, however, will be qualified and keen to work on a deeper level.

You may find that you are resistant to peeling away the layers of protection you have built around your identity over so many years. The shell you have created has helped you survive well enough. If simply surviving is enough for you, then therapy may not be for you. If, however, you want to experience what it is like to thrive, fully experiencing all aspects of yourself and your life without guilt or shame, then find a counsellor willing to work at the level of identity and buckle in for the ride.

Exploring your identity can be a roller coaster. You may be terrified at times and exhilarated in turn. Just remember to keep your eyes open and hold on tight.