Psychologist, psychotherapist or counselor? What is the difference?

Qualified support to get better in a time of crisis is useful. But there is some confusion in the terms. Here are the main definitions.

Whenever you go through a phase of profound change , such as menopause , the help of a professional can be useful to guide you towards a newfound well-being. Physical changes , which can be brought about by hormonal fluctuations , are often difficult to accept and this internal disruption can also have repercussions on the psyche .

It must be said that most of the ladies go through these complicated months alone , perhaps with some motivating good reading, with the support of family and friends and a periodic visit to a good gynecologist. But there are some cases in which certain emotional states can become particularly intense and the time comes to consult a specialist to assess whether psychological support is necessary .

Today, however, there is a lot of confusion in terms: new figures are born (the counselor, the coach, etc) and even between psychologist and psychotherapist the difference is often not clear. We help you here to understand what path it could take for you.

Psychological support in menopause: psychologist, psychotherapist or counselor?

You want to get qualified support but, although you know that the first step is to go to a specialist, you are not very clear about the distinction between the professionals who could help you.

He is a professional, with a degree in Psychology and a member of the professional association (a fundamental factor for practicing the profession). Psychology is a science that studies human behavior and mental, affective and relational processes. The psychologist is a professional trained to assess the patient’s psychological condition. The main tools of his work are interviews, questionnaires and psycho-aptitude tests.

He cannot prescribe drugs because – as mentioned – he is not a doctor, but guides the patient towards the recovery of a state of well-being through relationships, listening. Try to stimulate positive actions that help to react to the perceived discomfort of the person who is addressing him.


It can be a doctor or a psychologist who has completed a post- graduate specialization course in psychotherapy that lasts 4 years . The difference with the psychologist is that the psychotherapist offers the person a path of treatment to deal with the different forms of psychological suffering. Generally the therapist does not prescribe drugs (if he is a doctor he could do it) but relies on other techniques that can also include, for example, hypnosis, relaxation or mindfulness.

There are several specialization schools that form different therapeutic paths. The best known schools are:

  • Psychoanalysis: follows the traditional Freudian approach, works on dreams and fantasies, on memories and thoughts. It is generally a therapeutic method that requires a long relationship between therapist and patient.
  • Psychodynamics: theoretical and practical models of psychoanalysis are used but with less frequent sessions and shorter duration than the classic approach born from Freud’s theories.
  • Systemic-familial: the patient’s malaise is placed in a family-type “environmental” context. The family is also involved in this approach, stimulating a change that must involve the whole nucleus.
  • Cognitive-Behavioral : probably the best-known psychotherapeutic approach that invites the person to reflect on their own behaviors and beliefs that generate malaise and difficulties, trying to stimulate real change, which starts from themselves and from the awareness of their reactions. In this context, relaxation, hypnosis and mindfulness techniques can be used. Generally the therapeutic course is short.


Literally “consultant”, the counselor is a person who has often taken a course to become a counseling expert, but there are no compulsory courses to define himself in this way. The counselor is not necessarily a doctor or a psychologist and in Italy, at present, he is neither a recognized figure nor a profession regulated by a professional register.
He is a person who offers support and help to people who can be comforted by an interview.


Like the counselor, the coach (literally “coach”) is not a regulated profession nor is there currently a professional reference register or special training requirements to use this specification.

Generally the coach deals with developing the potential or developing the talent, so he intervenes in the business or professional field to guide the teams towards specific objectives.

How menopause can affect the psyche

When the organism prepares for menopause, the body and mind go through more strenuous phases to live, as we have said. In the specific case of the psyche, the question is twofold and we summarize it briefly as follows:

  • The drop in the production of hormones that over time will lead to the disappearance of the menstrual cycle also has effects on the psyche because estrogen, in particular, affects the mood . Changes in hormone levels also affect certain areas of the brain such as those that regulate body temperature and blood pressure (this explains  hot flashes even in the middle of winter) and the sleep / wake mechanism (this explains the disorders sleep in menopause). The reduced production of estrogen and progesterone, finally, is also responsible for a  reduction in the levels of serotonin , the so-called “happiness hormone”.
  • The main disorders of menopause (including Vulvo Vaginal Atrophy which can greatly affect the couple’s relationship) can be experienced with particular discomfort and, consequently, induce emotional states of sadness, anxiety and irritability, up to – in cases more severe – in depression or panic attacks .

The disorders related to menopause that a good therapist can help solve

In menopause, a certain emotional vulnerability is normal due to hormonal imbalances, so seeing a general decline in mood can be part of the ordinary. For some women, however, this phase can represent an event so full of anxiety and nervousness that it causes a state of stress that is sometimes complex to manage .

When, moreover, it is lived with a sense of “overwhelm” for the disorders that it can entail and with a sense of “defeat” with respect to the idea of ​​not being fertile anymore, real psychological disorders can arise. Menopause is not a disease (it is worth repeating) but a natural phase of life, yet for many women the emotional state that derives from this change can become pathological . When this happens, they can manifest:

  • Nervous exhaustion : an expression with a slightly old flavor that, however, still indicates irritability and mood swings, a fairly typical corollary of menopause (as well as of premenstrual syndrome). But when the nerves are so close to the skin that personal and family life is particularly difficult, then you are beyond the physiological alterations of your mood and you may need to get help.
  • Depression : sadness and melancholy may have been normal moods on certain days, in which maybe the hormones particularly row against the good mood or you are impatient for some menopause ailment and it is nothing to worry about. When, however, the desire to do , to go out, even to cook for your family disappears and the desire to leave everyone out of the house makes its way , then this can be an alarm bell that must lead you to a call for help.
  • Eating disorders : alterations in hormone levels can lead to a greater desire for sweets and so far it is physiological (exactly as in the premenstrual period) but when tired and nervous, insomnia and sadness, you end up consoling yourself with high-calorie snacks that little to the Once they cause significant weight gain, then it’s time to stop and ask for help.
  • Psychological disorders related to intimate and couple life: in menopause, the decrease in desire can be a fairly normal consequence, but destined to resolve itself soon. However, when this condition persists and manifests itself as a consequence of other discomforts – such as vaginal dryness that prevents intercourse, blood loss due to micro-injuries , or pain during or after intercourse (dyspareunia) – then it is the case to seek the help of a gynecologist.

These disorders can also be symptoms of vulvo-vaginal atrophy , a real pathological condition that if not diagnosed early and not treated adequately becomes chronic and worsens over time.


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