Imagine you are 50-years-old. You have a successful career, a loving family, and a beautiful home. You have a good circle of friends and interesting hobbies. On the outside, it looks as if you have it all.
But, inside, anxiety is gnawing away at you. It is not the transient anxiety we experience when we are starting a new job, sitting an examination, or awaiting medical test results, which is an understandable response to a stressful life event. This anxiety is all pervasive. Despite being a high performer, you are constantly dismissive of your success and fear that some day you will be "found out".
Or maybe you are nearing your 80th birthday and were living a happy enough life until one night you saw a man being interviewed on television. He was talking about being abused as a child by a teacher. He spoke about feeling afraid, powerless, and worthless. That compelling interview triggered a feeling of dread and disquiet deep within you. Suddenly, you felt like you were 10-years-old again, in a classroom with the blinds closed, feeling paralysed with fear as your teacher edged closer to you.
People experiencing issues like these are among the clients who attend Pro Consult Counselling and Psychotherapy, Galway's longest established counselling service which is based at 1 St Helen Street, Cooke's Corner. This not-for-profit organisation was set up 32 years ago by two clinical and counselling psychologists working with the Brothers of Charity Services, the late Peter Dorai Raj and Dr Kathleen Fitzgerald, Pro Consult's clinical manager. Both were very interested in counselling and believed there was a need for a community counselling service in Galway which would be easily accessible and affordable.
People with psychological problems were mostly referred to the psychiatric services at that time. Apart from some counsellors who worked in private practice, there was no general counselling service in Galway, says Dr Fitzgerald. So, she and the late Mr Dorai Raj set about filling that void.
"Peter approached Bishop Casey and he gave us a premises in Newtownsmith in 1992. Brother Alfred Hassett of the Brothers of Charity gave us great support, too. They both understood the need for a counselling service.
"Later, we found a new premises at Cooke's Corner. We get a small grant from the Government through Tusla [the child and family agency]. In the early 1990s, it was €100,000, but it was halved during the recession and never returned to the original amount. We are a registered charity and have come through very difficult times - the recession and Covid-19.
"We try to break even but some years we don't. Funding is always a problem for us. Our standard client fee is €70 and 44 per cent of our clients pay that. We always ask people on a low income what can they afford. We have 14 counsellors on our books, seven accredited and seven trainees (these have done their academic training and are with us to do their hours ). If we could get a bigger grant, we could employ more counsellors. There is a great spirit among the people working here. All the staff wanted to keep the place going [during the recession and Covid-19]. People took financial reductions to do so. We have great administration support, too, we have two terrific secretaries."
Pro Consult, which provided 6,000 counselling sessions in the years 2020 to 2023, has seen a substantial increase in client numbers since the pandemic. The most common issues people present with are stress and anxiety, according to Dr Fitzgerald.
She describes anxiety, which is frequently referred to as a modern day epidemic, as a "generic term that covers a multitude". The counsellor's role is to find what is triggering this emotion and help the client develop coping strategies.
Bullied at work
"When you dig down, you may find that the person was bullied at school by a teacher or pupil," she says. "They never told anybody. Now in adulthood, they are being bullied at work. The anxiety was there, now it is triggered.
"We get people too who were physically, emotionally, or sexually abused as children. They come in with a global issue of anxiety and depression or low mood. We ask if anything traumatic happened to them as a child. When you dig down, you find they came from a dysfunctional family or their mother or father may have had an alcohol problem or they may have been sexually abused or bullied as a child. It [the trauma] has been embedded.
"Maybe on the 10th session, they will tell us they were sexually abused as a child and say we are the first person they told. These people could be in their 60s or 70s and they are revealing this for the first time. They were afraid to tell their parents because they might say it was their [the child's] fault, that something in them had attracted the abuser. That's often what you unearth under the anxiety label. So much goes back to your childhood."
Media publicity about sexual abuse, for example, may bring these long suppressed and unwanted memories to the fore, she says. "A survivor will tell their story on television, for example, and a client will say to us that's exactly how they feel. They felt it was their fault. [Later in life] they may feel they are not good enough. This is the legacy of sexual abuse."
Dr Fitzgerald says the abuser may tell the child: "'You made me do this, you encouraged me, it was your fault'. An adult man is saying this to a nine or 10-year-old child! If you are 10 and your little brain is developing.... we know from neuropsychology how things are embedded in your brain as a child. It is very hard to get these out of your head."
Many people experience panic attacks which she describes as a build-up of anxiety. "People think they are having a heart attack when they are having a panic attack. We ask them if their GP checked their heart? If it was fine, we tell them it was a panic attack due to anxiety and stress. We give them strategies for dealing with the symptoms such as breathing exercises and cognitive restructuring [a technique which helps people identify and change negative and unhealthy thinking patterns]. At a later stage, we look at what is behind the attacks. When someone comes in, we don't start digging straight away."
Some people seek counselling because they have a low sense of self worth. Not valuing or believing in themselves is affecting their motivation, success, and mental health.
She says some people, often those who are highly successful, have imposter syndrome. They believe they are not as competent or intelligent as others might think they are and are undeserving of the success or the high regard in which they are held. They believe they are frauds, even though their success is abundantly evident, and they are afraid of being exposed for who they really are. They can feel weighed down by this anxiety. "They are often in very prestigious jobs and live with the constant fear of: 'If people really knew what I was like...'"
Housing crisis
Relationship problems are the second most common issue, after anxiety, for which clients seek counselling. These include everything from issues with partners, children, wider family members, and employers. Adult children who returned to the family home during Covid and continue to live there, or have been forced to move home recently due to the housing crisis, are other challenges that people are navigating.
Younger clients, particularly those in their 20s and 30s, are dealing with the fallout from the Covid-19 pandemic, says the psychologist. "A lot of people, not just this group, suffered during the pandemic. They missed out on social outings, they could have lost their jobs, or maybe their friendships changed. There was loneliness, too."
Some clients are coping with bereavement. "They may have lost someone in an accident or very difficult circumstances or the person may have died of cancer and had a very bad time. The person who survives can be traumatised. This was especially the case during Covid." Losing a much loved pet can be very distressing, too.
Self-harming is an issue for some of Pro Consult's clients in the 18 to 30 year age group. "They will tell us they are doing it. It is always a way of releasing unendurable pain."
She believes addiction masks trauma. "You will often see someone who was bullied or abused as a child turning to alcohol when they get to their teen years. It dulls the unbearable pain of what they are carrying."
Pro Consult's clients normally availed of five to 10 counselling sessions per person pre-pandemic but interestingly, since Covid-19, this has gone up to 14 sessions. "We find that people need longer counselling than they used to prior to 2020. Fifty per cent of our clients would be self-referrals and the remainder would be referrals from former clients and organisations such as COPE, Simon, and the MS Society."
Most of the people who contact the city counselling facility, which launched its new website recently and provides face-to-face, telephone, and online counselling, are aged 36 to 50. The next highest group are those in the 51 to 65 age group. Dr Fitzgerald has noticed an increase in the number of people aged 66 and older accessing its service since the pandemic. Some are in their 70s and 80s. The oldest would be in their 90s. Most are from Galway, Mayo, and Clare while others are from Wicklow and Louth.
For further information, contact Pro Consult at (091 ) 589581.
