Archives for Personal Therapy
Starting a relationship with a therapist is very personal and can be nerve-racking for many. It's hard to know who's going to be a good fit without taking the time to meet a few. There are many posts out there that offer tips on how to find a good therapist. However, each time someone releases a "how to" for choosing a good therapist, it always seems key points are overlooked. There are many schools of theoretical approaches in the therapy world, and it's important to remember that the therapist you choose is practicing from her/his theoretical perspective -- there isn't one universal form of therapy. Here are some suggestions that, in my experience both as a therapist and as a patient, will help narrow the search to locate a therapist who will hopefully be effective for you.
If only there was an easy answer to this. Migraines certainly have a medical presentation, considering the headaches, and all of the symptoms that can come with migraines. But for many sufferers, migraines may be as much a product of emotional history, as of bio-chemistry.
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.
Chronic migraines are life-changing. It is a lonely struggle that family and friends don't tend to understand without experiencing it for themselves (and migraines are a very individual experience, so even those who have had a migraine don't necessarily know the struggle of another). With chronic migraines, the fear of the next attack always looms. In fact, the fear itself can even become debilitating. People have often relied on medical and alternative practices to try to relieve themselves from chronic migraine attacks. These methods can all be helpful, and it's especially important that people have a neurologist following the progression of their migraines. However, what isn't focused on enough is the role mental health plays in chronic migraines, and how much certain types of therapy can help with relieving migraines.
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?
Fear of flying is a difficult phobia to treat with conventional therapy techniques. Therapists often attempt to treat this phobia with standard cognitive-behavioral techniques, but run into roadblocks because of realistic obstacles. For example, systematic desensitization runs into problems because nowadays a person can only get to security without a ticket. So a person can't just build up steps to the flight the way a person can do with, say, going to the high floor of a building in an elevator. Many therapists also attempt to treat this fear by focusing on relaxation techniques: mindfulness, meditation, etc. These are useful and can be helpful, but are generally not enough on their own when trying to overcome fear of flying. Some airlines try to help this phobia by offering courses to learn about flying, why it's safe, and all of the logical components of this issue. But this is rarely, if ever, enough to overcome this fear. While the professionals referenced above have good intentions, fear of flying is difficult to treat without a multi-faceted approach that specifically focuses on fear of flying itself. In other words, flying phobia requires its own focused approach.
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.