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By the time he was 24, Joshua Fletcher had experienced two unspeakably traumatic events.

First, in 2013 his younger brother Harry died, aged 15, from a rare liver cancer. ‘He was ill for 18 months and it was a very dark time. It was so difficult, not only to see my brother, who I loved very much, suffer, but also to see the ripple effects it has on your family. It eroded some lifelong beliefs about people I’d once seen as stoic.’

A year later, his father (divorced from his mother and living elsewhere) was diagnosed with incurable motor neurone disease. Fletcher quit his job as a primary-school teacher in Manchester to spend as much time as he could with his dad. 

After many months of suffering, his father died in 2016, aged 50. ‘It was pretty intense, seeing a once proud man die that way. It haunted me, it was heartbreaking, horrible,’ he says.

During Harry’s illness, Fletcher had had a nervous breakdown. ‘At one point I developed severe agoraphobia and couldn’t leave my room for three weeks. One day at work [in the primary school], I had to ring my mum to come and pick me up because – shamefully – I couldn’t walk. I just didn’t know how to deal with it.’

After his double bereavement, Fletcher began drinking too much. ‘I was making poor choices, hedonism-wise. I was angry and had extreme anxiety, I was just crying all the time as I tried to push everything away. But then there was an epiphany: “I’m better than this, and the people around me deserve better than this.” I took myself to therapy.’

Having experienced the benefits and wanting to help others in the same way, Fletcher, who still goes to therapy today, decided it was time to pursue a new career. (He had loved working with children but not the associated admin.) 

He studied counselling psychology at Keele University, and then cognitive behavioural therapy at Salford University. ‘I found something that people need and that I enjoy,’ he explains.

Seven years later, aged 34, Fletcher is a successful integrative therapist (someone who offers various types of therapy) and has helped ‘hundreds’ of clients in his  private practice.

Based in his native Manchester, where he is speaking to me from his consulting room, Fletcher’s demeanour is serious and gentle, with a soft, deep voice. You can immediately see why clients would open  up to him – and why he has also become a social-media star (@anxietyjosh), offering tips on dealing with anxiety to his 214,000 Instagram and 49,800 TikTok followers.

To crown that, Fletcher has written a new book, And How Does That Make You Feel? (published this month), which gives a sometimes funny, often sad and frequently hair-raising insight into a therapist’s life and relationships with clients.

Joshua Fletcher: ‘Everybody has a right to talk about their stuff’

Joshua Fletcher: ‘Everybody has a right to talk about their stuff’

‘I wanted people to understand more about therapy and how it works, but I had to find a way to get them interested,’ he says. ‘So I decided to let them take a peek behind the therapy-room door to see what happens there, but also to peer into my cranium to see what thoughts are firing off when I’m with a client.’

The result is a series of fascinating stories about clients Fletcher has helped over the years – and his reactions to them. 

They include Levi, an apparently scary bouncer, who believes he’s been possessed by a demon; Daphne, a world-famous actress still hung up on winning her mother’s love; and Noah, a man haunted by a serious crime he’s committed (more of which later).

Most startlingly, there is an attractive doctor, Zahra, for whom Fletcher starts to develop most unprofessional feelings.

It would be completely unethical to spill the beans on anything that goes on in a therapy room, so Fletcher worked hard to protect his clients’ privacy, changing details about all of them to make sure they were unrecognisable to readers.

So Daphne might not be a famous actress but instead, say, a world-renowned footballer? ‘No comment,’ says Fletcher firmly.

‘The sanctity of confidentiality is very important, so that was a big worry for me, but now I’m very comfortable. 

There was an absolutely rigorous process with my supervisor and publisher; there was legal consultation. No one in the book has any identifiable characteristics other than having a panic attack, which, as I am an anxiety specialist, happens with most of my clients – and I’ve seen more than a thousand.

I also told everyone on my client list that the book was coming out and they could read it and take stuff out if they liked. But everyone was fine about it.’

In fact, none of them even took him up on the offer of reading it.

But how did Fletcher feel about invading his own privacy? There are plenty of scenes in the book that paint him in less than perfect light. Does he really want the world to know how he’s secretly starstruck around Daphne? Or worse, about his attraction to Zahra? (It was reciprocated: she asked him out, he turned her down and they stopped working together.)

‘I included that story because I know it’s an obstacle lots of therapists face and we have to navigate those things. They will have clients they become attracted to and vice versa. It’s not surprising in such an emotionally demanding environment. But I wanted to show we’re trained to respondto that and deal with it professionally.’

Therapists are obliged to contact the authorities if they learn of a threat to the client or to someone else’s life. 

 I was angry, making poor choices and had extreme anxiety so I took myself to therapy

Fletcher writes about Noah, who ends up in hospital after a suicide attempt, and his guilt at having missed the warning signs. ‘Rationally, you’re not responsible for that person, but you’ve been allowed into their inner thoughts; you’d have to be a robot not to take that home with you.’

He is then horrified when Noah confesses to raping someone in his distant past. Fletcher has to decide whether to report him to the police, but is pre-empted by Noah, who confesses himself. (The crime’s victim did not want to press charges, so the case was dropped.) Fletcher doesn’t know what happened next, as it is outside the therapy agreement to keep in touch with clients.

‘Those situations are heartbreaking,’ he says. ‘I have disclosed serious crimes and I grieve when it happens; it’s one of the really nasty sides of the job. A lot of people who come to therapy have grown up in a hostile environment or an abusive relationship and suddenly they are face to face with someone who is offering unconditionality and that’s a beautiful thing. 

But if you haven’t grown up surrounded by kindness you’re more likely to commit a crime.’

Fletcher, who is in a relationship but doesn’t want to divulge details, is honest about his own failings and professional embarrassments. 

Take the time in 2017, a year after his father’s death, when he was taking class-A drugs at a friend’s party and was recognised by a former client from his training. 

Did he worry such confessions might lose him future business? ‘Kind of,’ he says. ‘But a lot of people are put off therapy because they’re afraid of an authority figure coming in and making judgments about them. 

I wanted to show people that I’m professional, but I’m human. I have my vices. At that time my grief was resurfacing and I was making hedonistic choices.’

Fletcher is also upfront about how he still has weekly therapy sessions. ‘I wanted to show other men that having therapy is brave. 

I’m a 6ft 2in northern man from a working-class town where we threw rugby balls at each other as a means of communication. But everybody has a right to talk about their stuff, not just people with a few extra quid in their pockets who want to moan about something.

‘For me, therapy is like going to the gym,’ he continues. ‘We’re lauded for being buff and looking great, but no one’s praised me for sitting in the therapy room and crying.

Yet that’s just as – if not more – healthy.

Your emotions are important. If you ignore them or repress them, you’re not going to feel very well.’

And How Does That Make You Feel? by Joshua Fletcher will be published on 14 March by Orion, £18.99. To pre-order a copy for £16.14 until 17 March, go to mailshop.co.uk/books or call 020 3176 2937. Free UK delivery on orders over £25. 



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This post first appeared on Daily mail