Category: Therapy

What To Know Before Your First Appointment

I recently had a chance to talk to the folks over at BuzzFeed about what to expect during your first therapy session. I love the way they presented the info – so fun, accessible and entertaining.  Adjectives not typically associated with therapy – but they should be!

Check it out:

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One of my favorites quotes:

“Some people are just ready to spill everything and talk about the big stuff, and some people it takes much longer for them to feel comfortable sharing,” says Smith. “What’s important to me as a psychologist is to meet people where they are.”

Thanks, BuzzFeed!

Everything You Were Afraid To Ask About Therapy

There are a lot of misconceptions about therapy out there.

  • It’s only for “crazy people”
  • Psychologists can change their patients’ personalities
  • It lasts forever
  • It costs a fortune
  • Psychologists themselves are either perfect, or total “nut-jobs”

I recently had the opportunity to weigh in on a couple of these – and many more – myths about therapy.  The article turned out awesome, informative and fun to read.  Here are a couple of my quotes:

They’re not here to tell you if you should call off your marriage or quit your job. “The real job of therapy is to get to know yourself better and change the way you’re thinking, the way you’re behaving, or the way you’re understanding the world,” says Smith. “The process of therapy is not to give good give advice.”

and

“Sometimes I think people hesitate to embark on therapy because they feel like ‘If I go once I’m going to be sucked in for 10 years, three times a week,’ and it feels like this huge decision,” says Smith. But the length and frequency of therapy is very individual. It can be a one-time deal, a few months of sessions, or longer depending on what you’re going through and what you’re looking to accomplish.

To read the article in its entirety, check it out on Buzzfeed.

 

Why Therapy?

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“Therapy is a waste of time and money.”

“You don’t need therapy if you have good friends.”

“Therapists just want to change people into something they’re not.”

“I should be able to fix my problems myself.”

“I don’t believe in therapy.”

I have heard all these things in my 15+ years in the field of psychology.  And honestly I, too sometimes wonder what the heck therapy (and therapists!) are good for.  Does anything of real importance actually happen in the therapy office? Are people really helped by “talk therapy” or is it all a scam?  Would be all be better off just popping a pill and calling a psychic?

The answers to these questions are:

  • Powerful things can happen in therapy.
  • Yes, people are really helped by talking about their problems.
  • And, no, we’re not better off just popping pills.

Here are some of the reasons I believe therapy is so powerful:

  • There are few other situations in life in which you get to be the center of attention for a full hour.  Therapy is a time in which you get to call the shots, meaning: you get to choose what to talk about, how to talk about it, and when to move onto another topic.  I tell my clients that the therapy session is “their time” to do with whatever they like.  When else does that happen?
  • Talking to a therapist can seem like talking to a friend, at least at first.  But it differs in some important ways: your therapist doesn’t tell you about their own problems, fears, etc and your therapist doesn’t have a dog in the fight.  Meaning, it doesn’t matter to your therapist if you take job A or job B; choose boyfriend C or D; or quit calling your mother for 3 months.  Her feelings won’t be hurt no matter how you live your life.  Her main priority is that you improve your mental health.
  • The therapy office is a safe place to try out new ways of thinking, understanding and interacting with your world.  Because sharing your life with your therapist is just the first part of the therapy, the subsequent (and more interesting and transformative) parts include challenging your old ways of thinking and behaving in the hope of getting to a different place psychologically.  This takes time and effort – and yes, even a little discomfort at times – but is at the heart of the therapeutic process.
  • When push comes to shove I view myself as an educator.  I educate folks about all sorts of different things in the course of my typical day: child development, parenting, stress management, mental health – the list goes on and on.  Why read a million self help books when you can get a one-on-one tutoring session?

No doubt about it, therapy is a pretty weird and intimidating process.  But it’s powerful and worthwhile.  Want more information about psychotherapy and how it works? Check out more articles here.

 

Mental Illness and the Holidays

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As soon as Halloween rolls around, psychologists around the country know to expect their phones to start ringing.  The combination of shorter days (and less sunlight), the time change and the impending holidays proves to be a tough mix for a lot of us.  As a result mood can go down, anxiety can go up and mental health can fly right out the window.

There are about a million reasons why the holidays can be hard on our mental health.  But contrary to popular opinion, it’s not just those who have lost a loved one who might struggle during this season.  It’s also those who have strained family relationships, those who struggle financially, those who aren’t where they thought they’d be at this point in life, and those who don’t feel they measure up at any point in the year – let alone this one.

The holidays are also tough on mental health because so much is expected of us.  We’re expected (often by ourselves AND others) to have perfect homes, perfect clothes, and perfect appetizers set on a perfectly-decorated table.  We’re also expected to have smiles on our faces, thanks in our hearts and plenty of joy and Christmas cheer to spread to everyone (even when we don’t feel it ourselves).  Some of us don’t get invited to any holiday gatherings and feel dejected about that.  Others get invited to so many parties that the entire month of December is spent in the car scurrying from one festivity to another.  Some have no one to celebrate with, others have plenty of people around – but not the one they wish were there.

No matter how you cut it, the holidays are tough on mental health.  For that reason, it’s important to be aware of the resources around us to help us get through until January 1st.  Here are a couple useful links:

Surviving the Holidays – With Flair

Tips for Reducing Holiday Stress – Produce for Kids

Tips for Parents on Managing Holiday Stress – APA

If times get really tough and you’re finding it hard to cope alone, consider reaching out to a psychologist.  Here’s how to find one close to you:

APA Psychologist Locator

Psychology Today

If you need to talk to someone right away, try:

National Suicide Prevention Lifeline

Suicide Hotlines by state

 

Depressed? Just Get Over it!

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In honor of Mental Illness Awareness Week, (#MIAW) I decided to write a post about depression and why, when someone is depressed, they don’t just “get over it.”  After all, why can’t people who suffer from depression just “think positive,” “be grateful” or exercise more and – just like that – feel better?

Because depression is an illness.

And just like we would NEVER say to someone with diabetes, “Just don’t think about sugar!”

or to someone with high blood pressure, “Just visualize that number down!”

or someone with a Multiple Sclerosis, “It’s all in your head!”

…we must not trivialize depression as something that can be wished or willed away.  Instead, effective treatment for depression is often multi-pronged, involving psychotherapy, healthy lifestyle management and possibly medication.  Luckily, we have lots of great options for the treatment of depression, and many of them are covered by health insurance – making gaining access to care a real possibility for most people.

For what to do after being diagnosed with depression, see my article.

To read a true story about post partum depression, read here.

For more information about effective treatments for depression, see APA’s article.

For more information about using your health insurance for mental health treatment, see APA’s article.

 

 

 

 

How to Help a Depressed Friend

So many of us have been there: watching a family member or friend spiral into a pit of depression, addiction or anxiety.  It’s tough to watch, and even tougher to know how to help.  It can be tempting to either:

  • ignore them
  • tell them what to do and get mad when they don’t do it
  • talk to our other friends and family members about them

It’s clear to see that none of these options are useful, but not so clear to see what is.

Here’s where the American Psychological Association‘s newest YouTube video comes in.  The third in a series of the same weirdly-pill-shaped-characters, I think this spot is my favorite yet.  It tells the story of Clara, a spunky cat-loving-race-walker, who is concerned about her friend Tom.  He has had some trouble at work and has recently taken up drinking and sleepless nights.  Clara wants to help Tom, but isn’t sure how.  She tries a couple of tactics (see above, with the addition of involving his mother) and after some failures, slamming of doors, and screeching cats, she succeeds in helping him find professional assistance (with a Dr. Smith nonetheless!).

It can be hard to make psychology funny (for psychologists anyway). So I especially love the light-hearted and funny tone of this really informative clip.  Check it out:

5 Tips for Succeeding in Psychotherapy

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Psychotherapy is kind of a weird thing. You meet with someone you’ve never met, tell them all about yourself and learn nothing about them in return. Then you go back time and time again doing the same thing (and paying for it!) with the hope that you will feel better, change a little and become a happier person.

I think that’s therapy in a nutshell.

Of course there are lots of ways of doing therapy, lots of different kinds of therapists and certainly lots of different kinds of patients with different histories, problems and complaints.  But even with all these differences, I have found that there are a few common things that people can do to make psychotherapy successful:

Come because you want to.  People come to therapy for lots of different reasons, but I have observed that therapy works best if it is not forced onto someone, or a result of a coercion or threat (“I’m going to divorce you if you don’t see a shrink!”).  Now, this isn’t always true: sometimes folks are sentenced to therapy or treatment in the legal system, or for other reasons, and that treatment can be effective.  I’m just saying that typically therapy works best when people come of their own free will.  It’s hard to participate in the often difficult therapy process if you are not on board with it in the first place.

Give it a chance.  People seek mental health services because they are hurting. It makes sense that they want relief right away. Unfortunately, therapy doesn’t always work this way. Sometimes, in fact, dredging up old hurts can make your mood worse for a time. It can take 2, 3, 4 sessions until you feel relief. It’s hard to be patient, particularly when you’re struggling, but the payoff is worth it, as psychotherapy aims to create change that will last well after the treatment has ended.

Do something.  The therapy hour can be quite healing, but it takes more than that to find achieve success.  To make the best use of your treatment, work needs to be done outside of sessions, too.  Whether it’s keeping a journal, doing behavioral exercises prescribed by your therapist or simply doing some good, hard thinking about the content of your session – it’s not enough to just show up once a week.

Go often.  I don’t have a one-size-fits-all approach to session frequency, but I can tell you that the more often you attend sessions, the faster you will achieve your goals (most of the time, anyway).  There’s a lot to learn about a person, so when sessions are too infrequent (say once a month) it can be hard to learn all there is to learn, catch up on what’s happened since the last visit and then get to the meat of the appointment. Once a week is the typical frequency with which therapy sessions are held, and I think it’s for good reason – particularly when you are just starting treatment.  Once you have hit a groove and progress is being made, less frequent sessions may be an option.

Keep an open mind.  We go to therapy to change something about ourselves or our lives.  That means we will probably have to do some changing.  Granted, change is scary and difficult, but unless we are willing to do some things differently, therapy just won’t work.  Now, that can mean thinking about things in new ways, changing our actual behaviors or interacting with others in alternate ways – but the fact is: in order for psychotherapy to be successful there has to be some room for modification.

Is it time to seek therapy? Check out these tips for deciding.

 

Video Game Detox

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There has been a lot in the news about video game and internet addiction.  From the controversy surrounding internet/technology addiction NOT being included in the latest edition of the DSM (for the record, I think it should have been), to the first inpatient treatment program for internet addiction opening in Pennsylvania, to this most recent video showing a boot-camp-style detox program for “internet addicts” in China.

The video is worth watching, it literally brought tears to my eyes watching these young men suffer.

But the real question is, is it necessary? Do we really need detox programs for internet addiction?

China seems to think so…and that makes me wonder if the US isn’t far behind.

What do you think?

Psychotherapy Myths: Busted

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Psychotherapy and counseling are more a part of our lives than ever.  They’re talked about in TV shows, movies, the local paper and social media. Statements like:

I need to go to therapy!
She’s so crazy, she needs a shrink!
He needs to tell his psychologist about that!

are said all the time.

The thing is, there are lots of myths about therapy, psychologists, and counseling out there.  I am going to take it upon myself to be the the mythbuster today.  Here goes:

If you have at least one good friend you can’t benefit from therapy.  Friends are awesome, and those who have one or two good ones are lucky.  However, friends and mental health professionals are not equal. Why? Because sometimes there are things we aren’t comfortable sharing with our friends and we can’t guarantee that our friends will keep our secrets like a psychologist will.  Furthermore, sometimes we have problems (alcohol addiction, marital woes, difficulty with parenting) that our friends aren’t prepared to help with.

Read more about why your best friend can’t be your therapist.

All of your time in therapy will be spent talking about your mother.  Our moms have a lot to do with who we are (or aren’t) but it doesn’t mean that all your time in therapy will be spent talking about her.  Sometimes therapy sessions involve delving into the past, but not always. Some folks come into my office with very specific, present-oriented goals and that can work out just fine – no mom-talk necessary!

Read more about innovations in psychotherapy over the years.

You’ll have to lie on a couch – and that’s just weird.  OK, I admit that I do have a couch in my office (though I prefer to call it a “sofa”) but folks rarely lie down.  Gone are those Freud-inspired days when patients rambled on while lying on a tufted velvet couch with the psychotherapist taking notes behind them. Sitting on comfortable chairs while looking at each other face to face is the norm these days – often with Starbucks or Diet Coke in hand.  Sounds nice, doesn’t it?

Read more about what to expect in your first session with a psychologist.

If you see a psychologist you will be branded “crazy” and that label will follow you around forever.  This is a valid concern. We’re all worried about our privacy – perhaps now more than ever.  The good thing is, psychotherapy services and diagnoses are confidential (with a few exceptions).  It’s important to really understand confidentiality and how it relates to your treatment, how you pay for treatment, and to whom your records are released when you enter therapy.  Just ask your psychologist for an explanation on your first visit (even better: before you make an appointment).  As for the “crazy” diagnosis? There’s no such thing!

Read more about first steps to take after being diagnosed with a mental illness.

Seeing a psychologist means you’re weak and can’t handle your own problems.  “Handling our own problems” entails lots of different things, but from time to time it means asking for help.  Sometimes it means asking your neighbor to watch your kids while you have a date night, or feed your bird while you’re on vacation.  Other times it means asking for help with managing an addiction or anxious thoughts.  It takes a lot of strength to reach out – perhaps even more than continuing to go it alone.

Read more about whether your drinking is problematic.

If you see a psychologist they can read – then change – your thoughts at will.  Oh, if only I had that kind of power (picture me smirking Dr. Evil-style).  OK, in all seriousness, I can’t read your thoughts and I certainly can’t change them to fit my own version of “right” and “wrong”.  What I can do is be an attentive listener and help you become more aware of your own thoughts, behaviors and moods.  And the hope is that I can assist you in changing yourself in ways that feel genuine and beneficial to you.  No dark powers involved.

Read more about what your psychologist really thinks about you.

Are there myths that I forgot?

Things you’ve wondered about in terms of mental health treatment?

Let me know!