I don't know anyone who hasn't been to therapy. By therapy I mean individual or group counselling on anything from bereavement to addiction, depression, sexual abuse, marital problems and anxiety. By "anyone", I mean my circle of friends, relatives and colleagues back home in the US.
Sure, it's not surprising, given that we come from the land of Woody Allen, Oprah, Jerry Springer and a former president who revealed his "childhood issues" on national TV. We've got The Sopranos (where Mob boss-protagonist Tony Soprano confronts his demons in riveting sessions with his female psychiatrist in the popular television drama) and New Yorker cartoons. ("It's a new anti-depressant'" says the pharmacist to a customer, pointing at a jar of golf-ball-sized pills. "You just throw one at anyone who looks happy.") While the Irish seem eager enough to spill their guts on radio call-in shows, I know only three of them who have undergone counselling. (One of these "confessed" during a late-night drinks session, and never mentioned it again.)
The Irish may have a miraculous gift for gab, but I am reminded of a Trinity College lecturer in Irish Literature who told his class that the Irish are bad candidates for psychotherapy, because they rarely reveal anything truthful about their inner selves.
Is this just more cultural stereotyping? No, says Ed McHale, director of the Clanwillam Institute in Dublin, who describes Americans' comfort level with disclosure as "out on its own". Additionally, there are still vestiges of a "children should be seen and not heard" attitude here, says Gail Grossman Freyne, a New Zealand-born family therapist and founder of the Family Therapy and Counselling Centre in Ranelagh. She views the American tendency to encourage children to come out and talk as positive.
Certainly there are historical precedents for Irish "resistance" to psychotherapy. Years of grinding poverty, large families and a lack of medical or social services fostered a fierce self-reliance and asking for help was considered self-indulgent. Maintaining a sense of privacy in a small country was paramount, and, if people did decide to talk, they called on a family member or priest. The Church conditioned people to believe that the present life was one of suffering, a friend points out. There was - and is - a real stigma associated with mental illness. "You don't want to be labelled 'crazy' or 'ready for the nuthouse'."
To be fair, much resistance to therapy - in the US and Ireland - is gender-based. "Women are still more open to counselling than men," says Margaret Roche, chairwoman of AIM Family Services in Dublin, a voluntary organisation that offers counselling, legal information and mediation services to people experiencing marital, relationship and family difficulties. When men do engage, therapists say, they are often very eager to make life changes.
As for class-based attitudes, traditionally, lower-income, less-educated Americans harbour stronger stigmas against psychotherapy than their middle-class peers, but lower-income families in Ireland embrace counselling more readily than other groups, observes Mary Pillow, a counsellor in general practice in west Dublin.
The good news is access to therapy is improving here, although both Ireland and America have a long way to go in providing affordable mental health care for all.
A large choice - from Freudian analysis to solution-focused brief therapy (a model in which clients identify their goals, and work to achieve them swiftly, rather than dwelling on past histories) - is available in Dublin.
Both AIM and the Irish Association for Counselling and Therapy report steady increases in the number of calls for referrals over the last four years.
The present interest in bodywork therapies including Reiki, reflexology, aromatherapy and yoga, as well as GPs' greater willingness to refer patients with possibly stress-related ailments such as psoriasis to counsellors, is encouraging, says Gail Grossman Freyne. And the establishment by companies of Employee Assistance Programs (EAPs) which offer on- or off-site counselling to workers, demonstrates the economic value of keeping employees mentally fit.
As a kind of "litmus test", I asked my friend Oein, a scrappy Limerick man who detests anything "touchy-feely", about his views on psychotherapy. "If they've had a six-month training course, it's useless. But if the psychotherapist has been properly trained, it can be worthwhile."
Shall we discuss this at our next session?
Resources: Family Therapy and Counselling Centre, 46 Elmwood Avenue, Ranelagh, Dublin 6. 01-4971188.
AIM Family Services, 6 D'Olier St, Dublin 2. 01-6708363.
Brief Therapy Group, 1 Chelmsford Rd, Ranelagh, Dublin 6. 01-4913033.
Irish Association for Counselling and Therapy, 8 Cumberland St, D·n Laoghaire, Co Dublin. 01-2300061.