Do I actually
need therapy?

One of the most common things people say in early sessions is some version of: "I wasn't sure I needed this. I thought other people had it worse." And that's probably true — other people do have it worse. But that doesn't mean you're fine.

You don't need a crisis to start therapy

This is probably the most persistent misconception about therapy, and it keeps a lot of people from seeking help before things get really difficult. Therapy is not a last resort. It's not something you turn to when everything has fallen apart. Some of the most productive therapeutic work happens with people who aren't in acute crisis — people who are functioning, going to work, maintaining relationships, and still feeling like something is off. A flatness. A restlessness. A pattern they can't quite break.

If you're waiting to feel bad enough to justify therapy, that bar will keep moving. And in the meantime, the thing you're dealing with usually doesn't get smaller on its own.

Signs that therapy might help you

These aren't diagnostic criteria. They're just patterns that often bring people to therapy — and that therapy tends to be useful for.

You keep having the same argument. Not necessarily with the same person — but the same dynamic keeps showing up across relationships. A feeling of not being heard, or of always being the one who gives in, or of things escalating before you've understood what's happening. If you recognise a pattern but can't change it, therapy is a good place to explore it.

Your anxiety is running your life. Anxiety is normal — it's the body's alert system. But when that system is constantly activated, when you're avoiding things, replaying conversations, or catastrophising about things that haven't happened yet, it becomes exhausting. Therapy can help you understand the roots of that response and loosen its grip.

You're going through a significant life change. A breakup, a bereavement, a diagnosis, a career shift, a move, becoming a parent, coming out, retiring. Change — even positive change — can bring grief, disorientation, and a feeling of not knowing who you are in this new version of your life. Therapy provides a space to process that.

Something from your past won't leave you alone. Whether or not it meets the clinical threshold for trauma, if something is intruding on your present — through flashbacks, avoidance, or a constant low-level sense of threat — it's worth talking to someone.

You're struggling with food, your body, or substances. Disordered eating, problematic drinking, overusing cannabis or other substances — these often aren't really about the food or the drink. They're managing something. Therapy helps get underneath them.

You feel like you're performing a version of yourself. The gap between who you present to the world and who you actually are. Sometimes this is about identity — sexuality, gender, culture, values. Sometimes it's more general: a feeling that if people could see all of you, they wouldn't like what they saw. Therapy can be a place where you don't have to perform.

You've been diagnosed with ADHD — or you suspect you might be. An ADHD diagnosis in adulthood can bring relief and also grief — grief for the years spent thinking you were just lazy, or difficult, or not trying hard enough. Therapy can help you understand how ADHD has shaped your life and how to work with it.

Something is consistently affecting your work, relationships, or sleep. When what you're carrying starts having real-world consequences — you're withdrawing from people, your performance is suffering, you're exhausted — it's a signal you're not going to manage it alone indefinitely.

You just know. Sometimes there's no checklist. You just know you need to talk to someone. That instinct is worth listening to.

Myths that stop people from seeking help

"Therapy is only for people who are really unwell." It isn't. A lot of people in therapy are high-functioning by most external measures. Therapy helps you understand yourself — and that's valuable regardless of how well you appear to be managing.

"I should be able to handle this myself." This one comes up often, particularly in Malta, where stoicism and self-reliance are cultural values. But going to therapy is no more a sign of weakness than going to a physiotherapist for a knee injury. You are not supposed to be able to work through the deeper things alone — that's not how human beings are built.

"Talking about it will make it worse." In the short term, bringing difficult things into the room can feel uncomfortable. But the evidence is consistent: talking about difficult experiences, in the right context and with the right support, reduces their power over time. Suppression is what tends to make things worse.

"I don't have anything to talk about." You don't need to come in with an agenda. Good therapy is not a series of topics to get through — it's an unfolding. You will not run out of things to say.

"It won't work for me." This often comes from a previous experience of therapy that didn't fit — the approach was wrong, or the therapist wasn't right, or it wasn't the right time. Therapy not working before doesn't mean therapy won't work. It took me three attempts to find the right therapist for myself.

What makes therapy work

Decades of research point to one finding above most others: what makes therapy effective is not the approach, the techniques, or the tools. It's the quality of the relationship between client and therapist. The sense that you are seen, taken seriously, and safe enough to be honest.

This means it's worth taking time to find the right person. It also means your participation matters. Therapy is not something that happens to you — you are doing something in the room, even when it feels like you're just talking.

If you're in Malta and you're thinking about it

You don't need to have it figured out before you book. You don't need to know what to say, be in crisis, or be certain it will help. You just need to make the call.

I'm Michael Said, a PPBM 494 warranted psychotherapist in Mellieħa, Malta. I work with adults dealing with anxiety, depression, identity, ADHD, disordered eating, addictions, and difficult childhoods — online across Europe and in person at Demajo Medical in Mellieħa.