What actually happens in your first therapy session? The Asian Mental Health Podcast Episode 3

👋Hello and welcome back to the Asian Mental Health podcast!

In this episode, we’re joined by Dr Ahona Guha who is a clinical and forensic psychologist, trauma expert and author based in Melbourne, to outline exactly what happens in therapy and what you can expect from going to see a psychologist.

This episode answers two questions submitted to us from the Shapes and Sounds community that asked, 

1. “how do I know if a therapist is the right choice for me? I have been to a therapist before and whilst it was good, I'm not sure if there are other therapies that I could have tried, or if someone else would have been more effective. Is there something I should ask for?”
2. “There are lots of different mental health providers in Australia - such as mental health social workers, psychologists, counsellors, art therapists, etc. How would you recommend which type of provider is suitable for me?”

You’ll also learn:

💡The first 3 questions that psychologists commonly ask their new clients⁠

💡What all those modalities you hear about (eg. CBT, ACT, Schema), actually mean and look like when you go to therapy... are they even different?!⁠

💡What exactly is trauma, and how to identify presentations of trauma within you⁠

💡An actual explanation of the difference between psychiatrists, clinical psychologists, registered psychologists, counsellors⁠… from a psychologist themselves

You can read the transcript for this episode ⁠below.

As we’re brand new to podcasting, we’d love for you to help us in three ways:

• Download this episode so you can refer back to it when you need!
• Join us in our mission of destigmatising mental health conversations in Asian communities by sharing this episode with your friends and family
• Connect with us on instagram ⁠@justshapesandsounds⁠

This podcast is proudly supported by the Victorian Department of Health via the Diverse Communities Program however all the thoughts and ideas you hear are independently ours and our guests. 

This podcast talks about mental health and answers questions directly from our community. However, all information provided is shared as general information only and does not replace individualised mental health care. Please always consult with your trusted GP when making changes to your mental health care plan. 

Lastly, as we’re discussing mental health, some of the conversations might be difficult or painful to listen to. If so, we encourage you to press pause on the episode and if it feels right, return to it at another point in time.

Transcript:

Shapes and Sounds acknowledges the Traditional Owners of the lands on which we’re recording and connecting with you from, the Wurundjeri people of the Kulin Nation and we pay our respects to Elders past and present.

Please be aware that this episode involves conversations relating to domestic violence, sexual assault, self-harm, eating disorders and suicide, which may be triggering. Please take a moment to check-in with yourself to see if you feel ready for this content today and if not, please skip to the next episode or tune back in at another point in time.

If you’re experiencing a crisis, please contact emergency services on 000 or Lifeline on 13 11 14, for immediate assistance in Australia.

MX IN - AMH Theme

Asami: Welcome to the Asian Mental Health podcast, brought to you by Shapes and Sounds.

MX continues in background

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Marcus: Hey Asami.

Asami: Hey Marcus. 

Marcus: So in this season, we've talked about family and emotions, but I thought we'd shift to talk about therapy and specifically, like, seeking help. What that sort of looks like. I guess just from my own experience, before I’ve started studying psychology and going down this path, I always thought therapy was just like a therapist giving you solutions, like you would go into the room and they'd be like, yep, do this and you'll feel better. And then you just come out of the room and be like, yeah, all my problems, all my worries. They're all solved. 

Asami: Like a prescription. Yeah, yeah.

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Marcus: Basically. Yeah. I think it ties into the idea of wanting to be very solution focused. And I think that's very prevalent in a lot of Asian communities, like, yeah, what can I do to solve this? And I just move on with my life.

Asami: And I wanted to ask, actually, when you realized that therapy does not work in that manner, were you shocked or was it like a good thing?

Marcus: Definitely, I was shocked because then at the start I would be like the psychologist is just asking me questions to make me think about things I probably already thought about. But over time I see sort of how that's more powerful and when you train yourself to reframe your thinking, then it's like a skill you learn rather than just like someone handing you like a solution. Yeah, yeah, it's definitely a lot more powerful in that sense.

Asami: That makes a lot of sense. Like you realize that you know the answers.

Marcus: Exactly.

Asami: Or like you move the gears if that makes sense.

Marcus: Yeah. And just speaking from like, personal experiences and like, speaking to like friends and family. I think there's definitely like a sense of shame and I think also not wanting to burden other people plays a huge part in that as well, like the barrier and the stigma surrounding seeking help. So yeah. 

Asami: Really like what you said about not wanting to be a burden. Like I do remember once being in therapy and actually being like, is it okay to tell you that?

Marcus: Yeah

Asami: Like sorry are we good for time. 

Marcus: Is it like too much for you? 

Asami: Like this is the session I've paid for. 

Marcus: Yeah. Yeah.

Asami: But totally. I really hear what you're talking about with the stigma in Asian communities. I think that's why we're making this podcast too. If we look at the research and why this conversation is so important, first and foremost, we know that Asians are the least likely to engage in mental health services compared with all other racial groups. And that has a lot to do with stigma. And one stat that might surprise you, that definitely surprised us is how that stigma presents. And there's one paper that shows that out of people accessing a university mental health service, only 6.9% of those people were Asian international students and 45% of people were the local students. So it's 6.9 versus 45%, which is it's a huge difference. So I hope that we can debunk therapy, maybe make it a little easier for people to understand what it is and what happens exactly in the room.

Marcus: Yeah. So to sort of explore that a bit more today we've got Doctor Ahona Guha with us here. So Doctor Hana Guha is a clinical and forensic psychologist. Her most recent book, Life Skills for a Broken World, was published by Scribe Publications in 2024. She works with victims of abuse and trauma and clients with a range of other difficulties such as anxiety, depression, perfectionism, burnout and relationship problems. She also works with perpetrators of harmful behaviors to assess risk, and provides treatment to reduce the risk they pose to others. She writes widely for the media on matters related to mental health, health, social justice, and equity. Her work has appeared in The Age, The Guardian, The Saturday Paper, Read Magazine, SBS and ABC. Welcome, Doctor Guha.

Ahona: Thank you. Pleasure to be here.

Marcus: So just before we jump into the first question that's been submitted by the Shapes and Sounds community, so obviously you are an author and also a practicing clinician. I thought we would just go through like, what is therapy? Like, say, someone who's never been to therapy? They booked their first therapy session and they go into the room. What would they expect?

Ahona: That is such a great question because there are so many myths about what are is, especially if you watch TV and and expect that you have to go into a shrink's office and lie on the couch and just have a person listen to you without actually saying anything for 45 minutes. That's the way therapy used to happen, certainly back in the day, but it's very, very different now. 

MX IN - Challenges Ahead

Therapy, broadly speaking would be seeing a trained clinical mental health professional. So you might go and saying, hey, I have lower mood and I want to work on this. Or you might have broader goals like, I know something's wrong, I just feel like I'm not entirely happy. But really, it's you working with a trained mental health professional, ideally around a set of identifiable issues to try and come to a shared understanding of it. And if we can't fully resolve them, how do we at least learn to manage them in a way that's going to be better for you. 

People often come in with a really vague idea of, well, someone's told me to go to therapy or I'm not fully happy. And I'm but I'm not entirely sure what the issue is. And I think some of that is because we don't really have good frameworks around mental health literacy. So people don't know that this is how I'm feeling. They feel like they are unhappy, but they are unable to identify that actually, my mood is low or that when I'm out in public, I'm quite anxious. So it's about starting to drill down from, I think, a bigger sense of I just feel off sometimes to this is the actual presenting issue

Marcus: Right

Ahona: And then to some extent, this is why it's happened and then this is what we do about it. And I think all of those steps are really vital.

MX OUT

Asami: Do you have like your first three questions that you ask? 

Marcus:Yes. 

Asai: Most of your clients, when they come in, like, does it start with what brings you in today? Or do you have like a textbook? Not textbook–template question?

Ahona: That’s a great question. My first question is probably going to be, how do you feel about being here today? Because that can be quite anxiety provoking for clients. And I think it's important for me to acknowledge that for clients. And there are some who've been in therapy for years and they'll say, fine, others will go, this is my first time and I'm really anxious and I don't know what to expect, and it's just important for me to know that. So for those clients, I can scaffold them a bit more and really explain the processes. I think the other questions I would probably ask are, so what brings you here today? What are your goals? And that's not to say you have to have clear goals that you must want to work through, but a general sense of these are the spaces in life that aren't quite working, and then will probably move to some extent into talking about childhood, but also about how therapy is going to work, because it's so important for a client to understand what I'm doing and why. All of those structures have to be in place for therapy to be safe and for it to be effective.

Asami: Oh, they’re kind of those questions that, it's so common to hear go to therapy, go to therapy, but to actually know what's going to happen in the first 15 to 30 minutes. It's so important, right? Yeah.

Ahona: And if you go in scared, you know, that's a very, very jarring place to be. And I kind of remember my first therapy session when I was, what, 22. And just being so anxious before because I had no idea what was going to happen.

Marcus: Yeah, for sure. I definitely resonate with that as well. And I remember going into my first session and the psych asked me, so what's been going on with you? And I just sat there. I was like, I don't know how to answer this. Like, I to really give you a moment to think about that, because I'm trying to explain so many different things to you. And it's like a lot of those things aren't like actually happening at the moment as well. So then having to dig through a lot of stuff, like so yeah, I think this is such a good way to sort of like tell people like, these are the sort of things that they might be asked in therapy. And like there are good starting points to think about. 

Ahona: And it's so okay to ask for clarification as well, because if you are asked you know, what brings you in today and you aren’t sure, it’s okay to say that and say, I actually need a little bit of support around that.

Asami: I feel like that segues into the community submitted question. Right. It's a really great question. This was submitted to us anonymously from the Shapes and Sounds community. The question is, 

“How do I know if a therapist is the right choice for me? I've been to a therapist before and whilst it was good, I'm not sure if there are other therapies that I could have tried or if someone else would have been more effective. Is there something I should ask for?”

I feel like there's a few layers to the question. 

Ahona: There’s a few layers to the question 

Asami: Yeah, I guess maybe we can start with the first question. Like how would someone know if a therapist is the right therapist for them?

Ahona: Yeah, I do want to say at the outset that there's no perfect therapist. So it's not like there's going to be a perfect match or or a perfect fit for you. But there will be people who are probably better than or maybe worse than. And we all have different needs and different types of personalities that we get along with. There are people who want a little bit more of a blank slate therapist, which is where the psych doesn't really disclose much about themselves and tends to be a little bit more, maybe hold themselves back a little bit more and that is fine. And there are others who want therapists, who can laugh, people who actually share a little bit about themselves. So we all have our individual preferences. And that might be things like gender and, you know, possibly age as well. I think it's important to have a sense of the type of fit that's going to be right for you before you go in the room, but also to be open minded. You know, you probably don't want to say, well, I want a Southeast Asian female therapist between the ages of 40 and 42 who just wears black because that's going to be very, very niche. You want a general sense of this is the type of person that I do align with. 

And then the other things are just the really intangible interpersonal chemistry things, like do you feel safe with this person? You know, do you feel like if you asked a question that they'd be able to answer, do you feel like they actually care about you? And obviously in a respectful, professional way. Maybe do a little bit of reading about the types of therapies, be open, but really be looking for the gut that kind of tells you I can trust this person's going to have my back, which is so important, I think.

Asami: And that’s really a gut feeling. 

Ahona: That’s a gut feeling 

Asami: And then if not, there are options to switch around.

Ahona: If not, there are options. I'd say probably having a really good rationale for why you want to switch as well, because there are times when people who struggle to maybe commit to longer term therapy work, or people who are very perfectionistic and just want the perfect therapist are going to switch without actually understanding why. So you probably want to be thinking through very carefully as well, if this psychologist isn't the right one for me, why is that? Is this about them? Is this about me? Is it that I was expecting something different? And maybe I have to readjust to what the therapy actually is? Is it that they've actually highlighted something that I need to work on, that I don't want to work on, and I'm being avoidant. So many questions there.

Marcus: Yeah, that's so many things to think about. 

MX Sting 4

Marcus: So you've kind of touched on, like doing a little bit of research and like the different techniques that might be out there that like different mental health practitioners might use. And in the question, it did kind of infer that as well, like saying there are other therapies to try. So what are like the main sort of techniques that like mental health practitioners would use and like what do those sort of entail?

Ahona: I suppose I want to say that I'm just going to be talking about mainstream psychological therapies here. So if I'm excluding, say, music therapy or art therapy, that's not because I'm being biased. It's more because I'm talking about what I know.

MX IN - A sip of coffee

Ahona: I think at core, every single type of therapy is pretty much exactly the same, just rebadged and repackaged with, yes, different skills, possibly. But essentially every single type of therapy is going to try to understand a issue through the lens of the whole person. So thinking about two really common ones, CBT cognitive behavioral therapy and ACT, acceptance and commitment therapy, and they work in similar ways. So with CBT, for instance, you're really drawing out the relationship between a person's thoughts, beliefs, emotions and behaviors. And you're trying to change all of those. Things like maybe the world's awful and I'm never going to feel better. Starting to challenge that. So we can start to learn to manage emotion better. We can start to understand our thinking and think about whether our thinking is quite biased and skewed. And we can also start to change behavior. So if you're very depressed, just getting out of bed and going for a walk sometimes, and I know it sounds really simple, but that's actually really important.

Asami: It makes me think about like how CBT really allows you to focus in on the areas in your life where you do have control and where you can exercise control. It's like there are, as you say, like we're living in a broken world, but there are things within our control. Like we can.

Ahona: We can dress for the weather, we can recycle, we can buy less. We can, you know, choose to maybe go to a nice yoga class instead of lying in bed and scrolling. None of that's going to take away from the really difficult things happening around us. I don't want to be one of those mental health providers who says, close your eyes to the horror of the world. But we do sometimes have to focus on the things that we can control, just so we can tolerate the awful things happening that we can't control. 

And acceptance and commitment therapy is just slightly different. It really holds in mind that we all experience typical emotions. Every life is going to hold suffering and that we can either accept that and we can learn to cope with that, or we can try and push it away. And often as we try and push things away, just by shutting down emotion or maybe starting to drink, or maybe using drugs or just doing things to shut down the distress, we actually feel worse. So ACT has good techniques to actually start to separate from maybe some of the more difficult thoughts that we have, but also great emotional techniques for how you can allow emotion to just be there, because that's something that a lot of therapy clients struggle with. So there's a lot of focus on things like mindfulness and just learning to notice our thinking. But unlike with CBT, where we then reframe it, with ACT we are just separating and going, that's a thought. It doesn't have to be true. I can just watch it come and go. 

MX OUT 

You know, these are all different roads, but essentially you are going to be arriving at the same destination. Some roads might be longer or some might be a little bit more scenic, some might be short and sharp and brutal. So it really depends on what feels right for you or what training your therapist has. 

Marcus: So how would someone go about choosing what therapeutic technique suits best for them?

Ahona: I think it's usually collaborative, and usually when I've got a client who would, you know, benefit from either. I explain both of those options, just like I did to you now, and I'll say which one appeals? And typically people have a sense of one, you know, versus the other. If I have strong feelings about a approach, I'll explain the rationale for that. And that's always a shared conversation, because I do have to take into account things like finances as well and how often a person can come. And I'll then work with that, give them a bit of a realistic frame around look. This is how far we are going to be able to go with that and maybe focus our work just on this smaller part. And then we put the other bigger stuff aside for later.

Asami: Okay. I like that. And one thing that I've really heard around resistance to going to therapy is the word around diagnosis. So if you could talk to diagnosis and that would be great.

Ahona: Hey, that's such a great question. What does a diagnosis actually mean?

Asami: I think people are like, oh, what if I get labelled as something.

Ahona: And there are some diagnoses that are really pejorative. When I'm thinking about diagnosis, I think one of the key things I really, really like to encourage clients to remember is they are not real things.

Asami: The diagnosis.

Ahona: Yeah, yeah. It's not like I can look into your brain and say, that's the brain of a person with, you know, depression. So while cancer is a very real thing that you could catch on an MRI, or CAT scan, most of our mental health diagnoses are symptoms that tend to cluster together. And we've gone, well, that forms a pattern. So let's call it that. It's a way we have to make sense of the world. Doesn't mean that it's a real thing. It doesn't mean that it's your entire identity. 

MX IN - Chains Change

I think it's a useful way. And that's why I'm not one of those psychologists who who doesn't diagnose, because there are times when it is incredibly helpful. Ideally when you'd go in to see someone if you don't want to be diagnosed, it's absolutely okay for you to share that with them and then for you to talk through why, you know, that might be and what the issues are, but I'd say I wouldn't let that put people off from going to therapy, because usually if you're in therapy, it's not to be labeled, not to be stigmatized. And if you've got, say, depression or anxiety, these are the kinds of treatment that are going to be super helpful for it.

Asami: Yeah. Thank you for explaining that. And I think it really takes the charge and the fear out of accessing therapy.

Ahona: Yeah. Thank you. That's that's that's always my, my intention to make sure that people don't see therapy as a thing that's being done to them. I don't sit people down and say, here's a list of ten things you must do for your mental health, though I do encourage them to sleep. Move your body, eat. 

MX OUT 

[BREAK]

Marcus: So, Ahona, you work with a lot of clients who have experienced trauma. I just want to touch on this topic a little bit, because sometimes people can think of trauma as like the really extreme stuff like war, but I guess on the internet as well, like people sort of just throw that word around, like everything is trauma to everyone now. So I guess like, yeah, what's the scope of trauma? Like, what do we mean when we say trauma?

Ahona: It's a really tricky question. It's one I spent a lot of time deconstructing for my last book, which explores complex trauma in some detail, but really we're essentially looking at events which are either shocking, horrifying, which cause a lot of distress, which typically overwhelm a person's coping mechanisms. It can’t be something which you'd be reasonably expected to encounter as part of a normal life. So while, say, a parent dying might be incredibly hard, if you're an adult, that's not going to be traumatic. It's going to be very, very distressing. But distress and trauma are different. 

So trauma’s something which is something that you wouldn't be expected to broadly encounter, and there's often a harm perpetrated by someone else. So looking at anywhere from emotional abuse, which might be name calling, criticism, you know, holding children to incredibly high standards, getting young children to exercise because they're being told they're fat. These are all examples of the things that I've heard. Obviously got physical abuse and violence, sexual abuse, coercive control is one that is now starting to be acknowledged as being really traumatic. Yeah. And then there are, of course, non-human perpetrated events or things like natural disasters. I suspect climate change is probably going to be one that we start to talk about more in the trauma field as well, because it does interface pretty significantly with how safe a person feels in the world. Car accidents. Yeah. So quite a wide range of things really, but I think I tend to only use the term trauma when I'm talking about something, which is actually traumatic. Otherwise I'll say difficult event or distressing, right?

Ahona: Though, I mean to be honest, my coffeemaker blew up a while ago and I was posting on my Instagram, and I went “That was really traumatic” Well, it wasn't, but it was annoying because it spread grounds everywhere. 

Asami: Yeah, but in the moment it was. 

Ahona: But in the moment it felt very traumatic because I didn't have my coffee. 

Marcus: Yeah. Yeah. 

MX STING 8

Marcus: Yeah. So I guess you've kind of talked about like emotional trauma and physical trauma that was also like perpetrated by like external forces. Yeah. So I guess I want to touch on emotional trauma a little bit more because I think that's sort of like hidden things we can't really see, like invisible forces that might be perpetrating trauma.

Ahona: And it's often not noticed or named and I think normalized to some extent. I think thinking about maybe the South Asian community is one that I can speak for, being a South Asian person, a lot of norms around how girls and women should behave. Corporal punishment was incredibly common when I was growing up in a way that was quite traumatic. It wasn't just a smack, not that I would ever smack a child, but it was beatings and that, you know, I went to school with people who killed themselves because they didn't get the grades they wanted at the university, and that comes from childhood emotional trauma and being told that they weren't good enough and being punished for not achieving a certain standard.

Marcus: Yeah. So what's the point in that sort of experience where someone would go, yeah. Okay. Now I'm experiencing some sort of emotional trauma. Like, what are the things someone might identify within themselves to be able to label that and then go and seek help?

Ahona: If we're talking childhood trauma, honestly, most children only identify that later because as a child, your entire world revolves around your parents. And if you start to see your parents as being people who might abuse you, people who might be bad, or people who might be dangerous, you feel like your life's in danger. That's too, too troubling for a child to hold. 

MX IN - Observations

But so far, what I've seen is that most people will probably only start to name subtler abuse and not the more overt physical or sexual violence when they're adults and when they start to go, oh, I'm always really down on myself and really hard on myself. I don't have any friends because I feel like people aren't going to like me. You know, maybe I can't soothe myself except through binge eating and then throwing up. Maybe I hurt myself and cut myself because I don't know how to soothe emotion. And it's then that that might start to go. But I probably need help. And it's when you start to then seek help that people will ask questions about what's happened to you in the past. And that's often when it's named.

And it could be a confronting thing for the first time to say there was emotional abuse. And a lot of my clients who come to see me with more of a complex post-traumatic stress disorder presentation. Yeah.

Asami: I think PTSD is also a term that gets thrown around a lot. Could you tell us what is PTSD and also the difference between PTSD and complex PTSD?

Ahona: Yeah, So PTSD or, post-traumatic stress disorder is a disorder that comes about after we experience something which is typically violent or life threatening or through exposure to these events at work so people can get PTSD through witnessing events like occupational violence at work. It's where the trauma with a traumatic event gets stuck in terms of how you process it. Because we can all process certain levels of traumatic events, that’s if we've got the appropriate support to really start to make sense of it, and if we can debrief properly and if we can then come to a good understanding of, well, that wasn't my fault. Sometimes when a trauma happens, all of that normal processing is stopped. Often we have beliefs that contribute to that, to things like if I acknowledge that I'm sad, then that's weakness. So we might be assaulted at work, for instance, and just say, no, I'm fine. And then over time that can start to build. Or we also start to form beliefs about who we are now and about the way the world is now. And flashbacks are a pretty common symptom cluster. They're probably not the most problematic but it's more the emotional changes after. So things like feeling intense anger, fear, numbness, you know, dissociation or starting to change how you think about the world. So people are bad. People aren't safe. I can't trust myself. There's also hypervigilance or a sense of, you know, feeling really startled easily. I work with people who can’t sit with their back to a open room. It has to be against the wall. And, you know, for some people that is really adaptive, because if you're in the police, you kind of learn to be a little bit hyper vigilant.

And complex PTSD happens when there's not one single event. So PTSD happens after a identifiable stressful event or a identifiable traumatic event. So something like a one time assault at work or a car accident being in an earthquake. Complex PTSD, you probably won't have the one single event, but there’ll be a range of things that over time form a traumatic pattern.

MX OUT

Asami: Thanks for explaining that, because I think sometimes you don't even know that that is what you're experiencing until you hear someone else explaining it.

Ahona: Yeah look it’s a difficult thing to diagnose.  So I do also want to highlight that lots of people kind of have a history of trauma, or maybe even complex trauma, without having complex PTSD. 

Marcus: Right. Right.

Marcus: I guess, like just from what we've discussed throughout the conversation, I think a theme that I can sort of see is that a lot of this is sort of framed around like different ways of thinking, and a lot of the therapy is tackling that and the way you might process different things. But like what would be something specific for like someone who might have gone through trauma or complex trauma 

Ahona: Yeah, So first line trauma treatments are trauma focused CBT, and then there's also EMDR. That's basically eye movement desensitization and reprocessing. It's quite an acronym and that's why we shorten it to EMDR. But essentially you're following stimulation and that might be eye movements where you're following someone's fingers. It might be tapping. And then you're also thinking about a distressing memory or just a difficult thought or a bodily feeling. Essentially it's a great way of really settling distress and then helping us arrive at more helpful cognition. 

Schema therapy is also being tested currently for PTSD, which is a longer term therapy that basically says that we all have a range of needs, and that when those needs aren't met in childhood, we all form schemas or a range of ways in which we learn to learn to relate to the world. And I often use EMDR and schema in combination, especially for complex trauma. And if someone does have trauma, I'd probably encourage them to look for one of those therapies.

Asami: But that leads directly, literally, directly into our next question. This was submitted by someone called Daniel from the Shapes and Sounds community. The question is, there are lots of different mental health providers in Australia, such as mental health social workers, psychologists, counselors, art therapists, etc. How would you recommend which type of provider is suitable for me?

Ahona: Okay, I would probably suggest if you've got some really serious, significant issues which are impacting on quality of life, I'd probably be steering people more toward a psychologist. I think therapies like art therapy, music therapy, equine therapy are great, but they're not going to essentially help you heal in quite the same way that maybe structured psychological treatment would. There are some mental health social workers who are, who are also very, very well trained. And I think it comes down to training and experience, not to the specific label. If you're stressed and you just want to talk, then it's perfectly appropriate to go and see a counselor. Or maybe you know someone who just offers supportive therapy. But if you've got, say, PTSD or complex PTSD or schizophrenia or bipolar disorder, you'd probably be looking for a clinical psychologist, maybe a psychiatrist, to really help you with kind of the medication. I tend to always look for training, and I think training is really important.

Marcus: Right. Okay. Yeah. So you sort of touched on like, psychologist, psychiatrist and clinical psychologist. Yeah. So what's sort of just the distinction between those three especially like psychologists and clinical psychologist.

Ahona: Well, so really psychiatrists are basically medical professionals who do a lot of advanced training so they can work with mental health issues. There aren't very many in Australia. I think something like 4000, for the entire population. So they're not typically going to be providing therapy. And they typically work more with things that aren't super common but that are more complex. So often personality disorders, again, psychotic conditions, bipolar conditions, that would be what you'd probably want a psychiatrist onboard to be starting to guide your care from a medication perspective.

The difference between a psychologist and a clinical psych will differ based on who you ask. But essentially the idea behind clinical psychology is that we have, you know, specific additional training and things like assessment, diagnosis, but it's really just different training pathways, such to become a clinical psychologist, you have to do at least a master's or a doctorate degree in clinical psychology. Whereas to be a generally registered psychologist, you can go on other internship pathways without having that specialist master's doctoral component.

Marcus: Okay.

Asami: And I think it's also important to highlight like if you are a person and you go and seek therapy and then you're seeing a registered psychologist, but the work that might be required may be that of a psychiatrist or maybe a clinical psychologist. The mental health practitioner that you work with also has the capacity to say, this is outside the scope of my practice, and I'll refer you to someone.

Ahona: And not the capacity, but a very strong ethical obligation to and as a, you know, registered clinical psychologist, that's actually in my code of practice. So if I have a client come to me and I identify that, say they have psychosis and I don't work with that, I actually have to, you know refer out. I have to highlight that which is just good practice.

Asami: Yeah, that's a great point.

Ahona: Because we can’t all work with it everything.

Asami: Yeah

Marcus: That's so fair.

Asami: I'm going to add my little bit as a registered music therapist 

Ahona: Yes, Do it.

Asami: Because I'm scared all the music therapists will get upset at me that I didn't say anything. But I think in terms of music therapy, music can be so existential in nature. And you're like, the world is broken. Just to reference your book, we live in like a really painful time, and sometimes it's really art and music. They're the avenues in which we can explore existential distress That's probably where I see my work fitting in, in many ways.

Speaker 3: I see it as a different door into the house of the psyche. And we are incredibly complex, multi-dimensional beings with a pretty significant subconscious component to how we operate. So I think having a range of ways into that and into the body as well, because music, art, that's so important. I don't think that when we think about mental health, we can separate the body from the mind, as we've historically done. You know, we're not just kind of brains blubbing around in a flesh mask.

Asami: Totally. And it makes me think, you know, sometimes going to see a psychologist can be so scary, but doing things like music therapy and art therapy, they are ways in which that speak to your interests. And then I've seen a lot of people kind of step from music therapy into psychological services. So it kind of works both ways.

Ahona: It goes both ways. And I've sent clients off to go and find art therapy or music therapy. And I've done my own art therapy, which was incredibly powerful. And that was when I was going through a very difficult time in my early 20s and did have my own clinical psych, but this was a beautiful addition to helping me explore who I was and what I was struggling with, and just gave me an additional frame to really try and understand that.

Asami: Yeah. Beautiful.

Marcus: Yeah.

Asami: So music therapists out there, I did you good. Don't you worry.

Asami: But, you've given us such a beautiful reference point for so many practices that psychologists offer. Is there anything else that you wanted to add to answer the questions? The questions were really about like, how do I know if a therapist is right? What kind of practitioner should I see? Anything else you want to add?

Ahona: Guess I just want to normalize and say that these questions are big, because there's so much choice and it's so hard to find a way into the mental health system at times. I think trusting your gut is probably important. I think trusting your trusting your therapist is also really important, but these are the things you really start to explore. So encouraging people to just try to to get help.

I feel like it's important to note that there are very few wrong choices here, and that sometimes just taking the first step and going to going to see your GP and asking for a mental health care plan, finding a, you know, professional, even if you then go, I'm not sure that that they were the right one is probably better than maybe staying sunk in paralysis.

Asami: I like that. Yeah. Don't get stuck in analysis paralysis.

Ahona: Absolutely.

Asami: Give it a go.

Marcus: Exactly.

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Asami: Well. I feel like we can wrap it up there. Ahona, it's a beautiful conversation. And thanks, Marcus, for leading us through. And Ahona, the way in which you can explain the practice, and offer points of advice and support has been so helpful. So thank you so much for your time. And thank you for these incredible books that you've written as well.

Ahona: Thanks for having me. It was a pleasure to be here.

Asami: Where can people find you online?

Ahona: I'm on Instagram. I have a Substack. That's pretty much it. I try to manage my social media use very carefully. Yeah, but Instagram is probably the best place.

Asami: All right, well, you can definitely find Ahona at ahonaguha.com. And, thank you to the people who submitted their questions as well, to the first person who was anonymous. And then Daniel, we've really learned a lot through you asking these questions. And to everyone listening, thanks so much. And please be sure to follow us on your favorite streaming platform. And if you'd like to join us and continue destigmatizing and normalizing mental health conversations in Asian communities, then we really encourage you to share this episode, especially this episode, because it explains, this is like therapy 101 podcast episode.

Marcus: I feel like I've learned so much in this even more than at uni.

Ahona: Okay. I'm terrified. Yeah. 

Asami: That’s great and terrifying. Yeah. Love it. So please share this episode with your friends and you can tag us on socials at Just Shapes and Sounds. So thanks everyone.

Ahona: Thank you.