Archives for Friendships
One of the stereotypes of therapy is the assumption that depression (and anxiety) are the result of a "bad" childhood. The idea that the depressed person's parents weren't attuned enough, or they were abused, neglected, bullied, or something else. Even clinicians can easily fall into the trap of looking for what was "wrong" in a person's upbringing -- and often there are very relevant events and patterns that can manifest in a depression. But the assumption generally is that some thing(s) "must" have happened, right? Often, yes. But I'm not so sure this is always the case. I have seen quite a number of people in my practice who have had, what I and they would consider to be, a "good" upbringing. The parents were attuned, supportive, and sensitive to their needs, they had fun, enjoyed their siblings (for the most part) experienced many different things, had friends, were social, traveled, etc. Sure, there were times when things weren't great, but as a whole, their upbringing seemed good and happy.
I know, clinical word, right? -- "Sucks". But it does. Depression sucks. I've seen many people in my practice who struggle with depression, and there's nothing easy about it. One day you feel pretty okay, and another day you're suddenly having a hard time getting out of bed again. Or you may feel like you're just going through the daily motions, even if you're out of bed. It can last for days, weeks, months, or years. It is not a fun condition, nor is it something any person should take lightly. People who are depressed tend to share some things in common: They often tend to feel like an outsider, not good enough, not likable, like they are always doing something wrong, like they will fail or be rejected if they try.
Please click on either of the following links if you haven't read part 1 or part 2 of this social anxiety series. With social anxiety, people can get caught up in trying to be agreeable. For example: "That sounds good!", "How nice!", "How neat!", That's really cool!", "That's awesome!", etc. (There are reasons for this agreeability, such as fear of rejection, fear of being negative or critical, or of overtaking the conversation, but we'll save that discussion for another time). While obviously there's nothing wrong with being supportive or validating to another person, these comments generally don't do much to help to open a conversation without adding something with it. Genuine interest in the other person helps creates a more fluid conversation because it adds an element of real curiosity that can open the conversation.
This post is part 2 of a 3 part social anxiety series. Please click here if you'd like to read part 1 before continuing. Otherwise, read on. There is something that I call the "Social Anxiety Window". This is the amount of space and leeway where people feel comfortable when having a social conversation. For example, some people feel that they can engage in light small talk, and prefer to keep the conversation focused on the other person. This keeps the topics on the surface, and avoids bringing oneself (or even both) into the conversation. This is representative of a fairly tight window. For a socially anxious person, having a tight window for acceptable conversation tends to reinforce the anxiety because once the other person has said their part, it leads to conversation jumping. Searching for different topics in a conversation tends to be a more difficult mental exercise, as opposed to expanding a topic into broader conversation. As mentioned in the previous post, what often happens with social anxiety is there is more focus on thinking of the next question to ask to keep the other person talking, rather than trying to find a way in to engage with what is present.
Some people look forward to social situations and seem to thrive off of them. Many others have a more difficult time with social situations, leading people to cancel plans, skip out on social events, or attend, but find themselves uncomfortable and looking for ways out the whole time. In my practice as a psychotherapist and coach, one of the main issues I've seen with social anxiety is that people who are socially anxious tend to overthink what they are going to say in a social situation, and don't spend enough time actively listening. This causes them to miss the cues that can open a broader or deeper conversation (unconsciously, this probably happens out of a fear of connecting on a deeper level, as well as fear of vulnerability, even if there is also a conscious desire to connect -- this topic on its own could generate many books of discussion).
I have to admit, as a therapist with many years of training, and still aiming to improve my work every day, it always frustrates me when I hear people equate the delicate and challenging nature of psychotherapy with talking to a friend. Sure, therapy can at times involve a venting quality, and this is completely welcome as part of the process. However, this isn't the extent of what therapy is about. Therapy isn't simply an ear and a supportive voice, even if listening and support are part of the picture (and sometimes listening and support is what a person needs; and it's also important to hold in mind that not everybody has an ear or a supportive person in their lives).
Based on my previous post about the usefulness and necessity of anger at one's therapist in the treatment -- rather than abandoning the treatment in these moments -- it was brought to my attention that a follow-up could be helpful to explore when switching therapists may be a good decision. It can't be overstated how complicated of an issue this really is. What makes changing therapists so complicated is understanding the greater picture of what's triggering the urge to leave. Is it something the therapist is specifically doing? Is a pattern being re-enacted by the client -- with the therapist --that happens in their own lives outside therapy as well (a very common phenomenon that can actually enhance the treatment)? Is it a dynamic that's triggering past emotional states that could actually be useful to understand in the treatment? Is the client wanting to leave the therapist for actually not being a good therapist, or is it more about the difficulty of facing the negative emotions within an overall good treatment? And so on. Basically, how does a person determine when the therapist is problematic, versus when the difficult emotions of an otherwise positive treatment are triggering a desire to leave?
This topic can take an entire book to talk about, so this post alone will probably not do it justice. When people think of therapy, many people think that "good therapy" means that you feel good in therapy all the time, and that if you're not feeling good in therapy, then you're receiving "bad therapy." This is far from accurate, and this perception can prematurely end treatments for people that may have been very useful and effective if this phenomenon was better understood. On a fundamental level, therapy obviously does need a foundation of safety, support, trust, and caring between therapist and client. But therapy is complicated. Change is complicated. Life is complicated.
Maybe "misused" isn't a great word since it implies a form of external judgment. Therapy is generally whatever the person seeking therapy needs it to be. The purpose of therapy is different for each person; and what is therapeutic is also different for each person. Some may desire a person to be with them through the various daily life issues that present, and have someone to turn to who will fully hear, understand, and care for them no matter what comes up in life; someone else may want a deeper understanding of themselves in order to change repetitive and painful life patterns; others may want help with a more concrete approach to changing a specific behavior; some others may desire to have a person to whom they can show the most vulnerable parts of themselves, even if these parts aren't "pretty". Or it could be a combination of all of these, and more. The list goes on... However, it is worth giving further thought to a point I've seen come up from various perspectives in the therapy world.
Happiness is quite complicated, yet at the same time it really doesn't have to be. The problem with happiness is that there are certain fantasies that people hold onto that really distort a healthy sense of happiness. That being said, when it comes down to it, "happiness" is whatever it means for each person. However, movies, tv, media, and others have strongly influenced unrealistic expectations for what some people expect happiness to be.