Why you probably need therapy before you think you do

The Wrong Question About Therapy

Muzamil opens the conversation by naming the core confusion that keeps people from seeking help. Many of us believe that mental health awareness is important. We talk about depression, anxiety, and the value of seeking support. But the question most Pakistanis actually ask is different: Do I need therapy. This is not a question about well-being. It is a gate-keeping question rooted in shame.

Ali agrees. “I think everyone needs therapy, but not to the same intensity,” he says. The barrier is not understanding that mental health matters. The barrier is the belief that you only go to therapy if something is already broken.

Preventive Care, Not Treatment

Ali uses a simple analogy to shift this thinking. “Do you need to brush your teeth,” he asks Muzamil. Of course. Why. Because neglect causes decay. But do your teeth suffer damage after one day of not brushing. No. After two days. You will have bad breath, but your teeth are fine. After a month. After a year. Now you have a real problem.

This is preventive care. The damage builds slowly, in the background, until one day the neglect catches up with you. Mental health works the same way. “If you are not actively taking care of your mental health day-to-day, the process of mental health decline is slower,” Ali explains. But accumulate enough unresolved issues, and suddenly you are in crisis.

Grief Is Not Depression

One of the most damaging confusions in our culture, Ali points out, is the blur between grief and clinical depression. People write to him saying that a friend or family member recently lost someone and now they are depressed. What should they do.

“That is not depression. That is the most natural thing that any human being would go through if someone that you loved passed away,” Ali responds. Grief is not a disorder. It is a sign that you loved someone and now you feel their absence.

What makes this worse is how our culture handles grief. Men especially are taught to be pillars of strength, to bottle the pain, to move on. Muzamil notes that in Pakistani society, people do not properly grieve. “Whenever I have someone sitting in front of me who is crying about the loss of a loved one, the way that I always see it is that these tears that you are crying are physical proof of how much you cared,” Ali says. To suppress that grief, to pretend it is not happening, is to rob yourself of a healthy, necessary process.

The Medical Model Does Not Apply

In Pakistan, the understanding of therapy is rooted in the medical model. You go to a doctor, describe your symptoms, and he gives you medicine. The implicit expectation is the same with therapy: you tell a therapist what is wrong, and they fix it.

This misses the entire point. Therapy is not advice. Therapists do not tell you what to do with your life. They do not say, “Go abroad” or “Stay here” or “End that relationship.” The work is different. “In therapy, we respect the individual’s autonomy. We respect the individual’s ability to make decisions. We respect the individual’s ability to take responsibility for those decisions,” Ali says.

What Therapy Actually Is

Therapy is self-discovery with a guide. Ali describes it as being in a car where the client is in the driving seat. The therapist is in the passenger seat. Where you go, the turns you take, the direction you choose. This is entirely up to you. The therapist explores with you. Why did you take that turn. What led you to this choice. Have you noticed that whenever you face this kind of situation, you always respond the same way.

This happens through different therapeutic approaches. Ali practices cognitive behavioral therapy, which traces back to Stoic philosophy. You cannot always control what happens to you, but you can control how you respond. Therapy helps you understand your patterns and, from that awareness, choose differently.

Vulnerability as Healing

Many people come to Ali and say they feel better after just three sessions. He tells them the truth. You are not better because I have done something to you. You are better because for the first time, you have a space where you can be entirely yourself. A space without judgment. A space where you can cry, be vulnerable, and know that you will not be pitied or told what to do.

“Just having that space, it is incredible to think,” Ali says. For many people, a therapeutic relationship is the first truly open, honest, non-judgmental connection they have ever had. That alone is healing.

Taking the Step

Muzamil’s final message to anyone watching is simple. Do not wait until you are broken. “Even if your life is absolutely fine, try therapy for two, three months,” he says. Do the work of self-discovery. See what you learn. See how it feels to be truly known and heard by another person. The barriers. Fear, stigma, the belief that you will lose control. These are real. But they are also surmountable. And on the other side of them is a more honest, more integrated version of yourself.