Life transitions and adjustment
Support through bereavement, separation, migration, a job ending or a family changing shape — at the Psychological Help Centre, Karachi, in clinic in PECHS and DHA, or online.
If you or someone else is in immediate danger, this page is not the right place. Here is what to do →
What people describe
Something changed, and you have not landed.
People describe it in almost the same words whatever the change was. I should be over this by now. Everyone else has moved on. A death six months ago that the household has stopped mentioning and you have not stopped thinking about. A marriage that ended, and a version of your life you had planned around that ended with it. A job gone — or a job that ended well, on your own terms, and left a hole anyway.
Others describe a change nobody would call a loss at all. A first baby, and the quiet after the visitors leave. A move to Karachi from somewhere smaller, or a child gone abroad who takes the shape of the week with them. People are often embarrassed to bring these, because the change was a good one.
Recognising yourself in a paragraph on a website is not the same as knowing what is going on. Most people come through all of this without ever seeing a psychologist, and that is the ordinary outcome, not a failure. This page describes; it does not assess you, and there is nothing here for you to score against.
When it is worth speaking to someone
Nothing on this page is a disorder, and a hard year is not a diagnosis. Adjusting to a large change takes as long as it takes, and there is no schedule you are behind on.
What is worth paying attention to is whether it has stopped moving, and what it is costing. A grief as sharp in month ten as it was in week one. Sleep that has not returned. Work or study that has slipped and stayed slipped. Withdrawing from the people who would help. Or a change that has not happened yet — an emigration, a divorce, a parent's illness — that you cannot think about without your chest tightening.
You also do not need to be in trouble to come. Some people use a handful of sessions to think clearly about a decision while it is still a decision.
Only a qualified clinician can tell you what is going on — a website cannot. You do not need a diagnosis, a crisis or a good enough reason to make an appointment.
How PHC approaches it
PHC is an assessment-first practice, and here that means something modest: before anything is worked on, someone sits with you and works out what is actually going on rather than assuming it is the obvious thing.
- An initial sessionWe ask what changed, when, and what your days have been like since. Much of a first session is listening. You are not asked to arrive organised, or with an explanation.
- Working out what this isSeveral different things look identical from outside. Grief, depression, an anxiety that has attached itself to a change, and the ordinary difficulty of a hard year all present as I am not coping, and they are not worked with in the same way. Where the picture needs more than a conversation, emotional assessment and symptom screening establishes which further tests, if any, are warranted. Often the honest answer is none.
- A psychologist matched to what that foundPsychologists at PHC are not assigned on availability. Assignment is on speciality, presenting needs and clinical fit.
- The work itselfMost of it happens in one-to-one therapy — 50-minute sessions, at our PECHS clinic or online. Where the change was frightening or harmful rather than simply hard, trauma therapy may be indicated instead. Where a low mood has settled in and stayed, depression is worked with as itself.Nobody here will tell you what to do with your marriage, your job or your visa.
Who you would see
The two psychologists below name this area in their own supplied credentials.
Nabiha RasheedClinical Psychologist
MPhil Clinical Psychology. 3,500+ clinical hours. Seven years as an early-years practitioner. In their own words, "offering unbiased, inclusive psychological guidance for people navigating trauma and major life shifts."Read their profile →
Aisha AhmadClinical Psychologist · 5+ years
Master's in Clinical Psychology. Self-esteem and self-worth, emotional regulation, attachment patterns and interpersonal relationship difficulties. Integrative, CBT, DBT and trauma-focused approaches.Read her profile →Who you see is decided at the initial session.
Questions people ask first
Is this therapy, or is it just someone to talk to?
It is therapy, and the difference is real. A friend listens and takes your side, which has its own value and is not this. A psychologist listens and then does something with what they hear — notices the pattern you are too close to see, and works on something specific rather than reviewing the week. You will not be given advice about your life. You will be helped to think about it more clearly.
Nothing bad has happened. It was a good change. Why do I feel like this?
Because a change does not have to be a bad one to be a loss. A promotion can cost you the part of the job you liked. A baby is an enormous joy and also the end of a life you were used to. People routinely arrive apologising for feeling low about something they wanted, and there is nothing ungrateful about it.
How long is grief supposed to last?
There is no number, and anyone who gives you one is guessing. Grief does not run to a schedule — an ordinary week can be interrupted by a very bad day a year later, and that is grief working, not grief failing. What a clinician looks at is not how long it has been but whether anything has shifted: gentler days among the hard ones, sleep coming back, being able to be with people.
I am leaving the country in a few weeks. Is there any point starting now?
Yes, and it is a common reason to come. A few sessions before a move can be used for the move itself — what you are carrying with you, and what you will be walking into alone. Online sessions can then carry on across time zones without you starting again with someone new.
Confidentiality, session length, fees and choosing your psychologist are answered in full in questions people ask before booking.
Speaking to someone starts here
PHC is appointment-only. Message or call and a real person answers — Monday to Saturday, 10am to 8pm PKT.
Not sure whether this is us? Contact us anyway. We will tell you directly whether we can help, and refer you elsewhere if we cannot.
Six details, and we can match you
- Name of the person who will attend
- Their age
- What is going on, in your own words
- Whether you would prefer a male or female psychologist
- Online, or in clinic in Karachi
- Whether the person attending is a minor or elderly
If someone else is paying, we will also ask for guardian or payer details. A slot is held once the booking payment is received — half the fee, at least 24 hours ahead.