Should I Go To Therapy?

“To be ill adjusted to a deranged world is not a breakdown.” -Jeanette Winterson

How do you know if therapy is right for you? Here are some points to ponder if you’re considering seeking a provider:

  • Therapy is not like talking to a friend

Friends and family can be part of a large and wonderful fabric of support, but talking with a therapist is different. Ideally a counselor is objective and focused, and challenges you to think differently. We are not satisfied with the status quo, and it goes without saying that therapy is a one sided relationship unique to any other.

  • You may be assigned a diagnosis

Sometimes people are worried about going to therapy because they don’t want to be assigned a diagnosis; in reality, most insurance companies do require some sort of diagnostic code to approve payment. However, many individuals discover they are experiencing what I refer to as “life stuff.” Perhaps you aren’t a person that has had major depressive episodes in your lifetime, but you may have a major decision on the horizon, and talking out the pros and cons might help you refine what you’d like to do. Death of a loved one, life transitions, and adjustment to parenting are other examples where the support of a therapist might greatly enhance your healing. Please do not be intimidated by the idea of a diagnosis, as you may have one or you may not. Regardless, I encourage you to challenge mental health stigma when you see it and reflect on what a diagnosis might mean to you.

  • You need help to create the change you have been waiting to see

Most of us are busy people with many balls in the air, and finding the time and the mental space for therapy can take some real focus. You may be experiencing symptoms of an illness that create obstacles to your attention, motivation, or insight. If you know that you would like to see change in your life or within yourself, yet you haven’t been able to make this happen, talking with a therapist might give you some much needed clarity and perspective.

  • If at first you don’t succeed, try another therapist

Therapy is personal, and the alliance is paramount. If you do not feel comfortable with someone that you’ve met with once, a hundred times, or any number in between, meet with someone else. There is a personality out there for each of us, and sometimes it takes a little trial and error to find it. Do not assume that all therapy is not for you, it simply might need to be a different provider.

  • There is nothing wrong with you

I’ve written it before and I will continue to write it: there is nothing wrong with you. You are human, imperfect, tenacious, strong willed, individual, and spirited. You are continuing and moving toward the future. You may find a therapist beneficial in helping you “course correct” and provide a sounding board for all that you do not know exists or cannot verbalize to others. We are available to you, but there is nothing “wrong”; only what is, and what you would like to see change. Remember your strengths and use them to propel you towards your goals.

You can take on your mental health. Whether you choose therapy or use other positive ways of living, a healthier, balanced you lies ahead.

 

 

 

 

 

It’s So Nice Out-Why Do I Feel Bad?

Here in the Mid-Atlantic, we have four seasons, which means more barometric pressure and seasonal flux to impact our bodies and minds. Sometimes people are surprised to learn that spring and summer are busy times for mental health practitioners. This time of year is difficult for many, and it feels counter-intuitive. The nicer weather coupled with longer days seem to instrinsically mean we don’t struggle with our moods or anxiety.

In fact, the opposite is often true. At times, the opposing situation can highlight something you didn’t notice originally as striking in contrast. You’re reading this text on a different color as the background; a black paper isn’t as noticeable on a dark table. When colors oppose one another, they become more obvious to our eyes. The same is true for our brains and how we see our moods. Perspective shifts occur when the outside world looks so wonderful: budding flowers, fuller trees, more sun, and longer days can make our low moods or buzzing anxiety feel louder and at the forefront. Everyone around us is happier, which also highlights a contrast. There is more comradery in the winter when many others (even those without a diagnosis) feel lower and more lethargic, so there is strength in numbers. We all talk about how the early darkness and cold temperatures affect our moods, whether we have a diagnosis or not. It’s “normal” to be bad in the winter. When spring hits and everyone bounces upward, it can be hard for those who don’t despite their best efforts.

It’s also true that people with seasonal shifts to their moods will have more difficulty in the spring instead of during the winter, which seems to not fit our stereotypical idea of seasonal patterns. We’re supposed to feel more depressed in winter, right? But that’s not what always happens.

Unfortunately, much like the holiday season, spring and summer come with travel plans, vacations, and family outings. Individuals who don’t have much family, do not have financial means to travel, or who choose not to associate with unhealthy members face this discrepancy from others around them. Social media makes it harder to escape the trips and family photos, and this again can contrast not only with a person’s chemical imbalance, but lack of healthy, supportive friends and family.

If you know someone who has a diagnosis, please take this opportunity to reach out to them. Do not assume that because there is more warmth and sunshine that they are feeling better. They may be having a more difficult time and they may have a harder time saying it, so try to be sensitive to this.

Try to be patient with yourself if you are one of many who are struggling now. Take care of yourself and focus on your wellness plan, even if you have to let other less important things go a bit. Take this time as an opportunity to educate others on the stereotypes of mental health stigma, especially at this time of year. Remember to keep on going-and what they say in Delaware: If you don’t like the weather, just wait a few minutes! Our brain chemistry may not change so quickly, but we can keep at our wellness and our skills.Take on your wellness, and take on your mental health.

Stylistic Differences

My husband could tell you how much I love to argue.

Arguing isn’t really the right word, as it has such a negative connotation. I like to bicker, debate, dissect, and discuss. I like to hear what the other person has to say and toss it around in my head until I see something else, or collaborate on a new idea. I enjoy the “what ifs” and the “what elses” and the “maybes.” Disagreeing to me means that our discussion is interesting and dynamic, and that you’ll think of things that I didn’t. And I like having to prove my point, if it’s needed, because it means I really need to know what I’m talking about. Needless to say, I thrive on these mental challenges, and it is a huge part of the reason why I love my work.

Plain and simple: I think that two heads (yours and mine) really are better than one.

That’s just part of my particular style that I bring into the office. If you’re in therapy or looking to start, it’s important to know your style and that of the person you’re choosing. Here are some good questions to mull over and potentially ask a new provider, especially if you also enjoy a good problem-solving debate.

1. In general, how much feedback do you offer during sessions? If I have a question or decision to make, how do you see your role in that process? 

Asking this question may elicit information that you find useful. Some people look for a lot of feedback and others don’t- so knowing what level of participation to expect can be very helpful for a new person. The style of feedback may vary, as some therapists are more directive than others, but it may help to find out how much discussion you can expect during an appointment.

2. How do you feel if I (as the patient) don’t try the things you suggest? 

Here’s the thing: you’re seeking therapy because you want to change or want help with something, and so hearing new ideas are part of the deal. It will be uncomfortable at times, but change does not occur without discomfort. However, if you’re feeling that the therapist is not understanding why you’re not trying things, it can signal that you’re either working with the wrong person, or you’re not prepared to make that change in that way. Either way, it’s useful information. If you feel the provider becomes defensive, irritated, or you are not feeling heard, it’s time to move on. Otherwise, vocalize to the therapist that you didn’t try X intervention because Y happened, and come up with alternatives. The process of solving a problem includes trying multiple options to determine the best course, and some trial and error is to be expected.

3. Be open with your side of the story, and feel free to debate if needed. 

You and your therapist are partners, and you certainly don’t want to be antagonistic. However, voicing a different opinion or experience, or telling the therapist, “no, that’s not it” is WELCOMED. Simply stated, we need to know if we’re off the mark, or you have another point of view. Believe it or not, voicing these differences actually goes a long way in helping me get to know you and understand your personality, which will then assist me in choosing future interventions. Certain methods are not as likely to work with certain tendencies, and if I know this, we can save a lot of time. Being as open as possible helps you not only solve your immediate issue, but helps us work best together as time goes on.

YOUR sessions are YOUR time to work on the goals that YOU outline. It’s not about the therapist, although I can hear the collective shudder of professionals everywhere as I write that. Argue, advocate, bicker, try things or don’t try things if you like. But it’s all up to you, and a good therapist will meet you where you are-even if we debate you along the way.

Take gentle care, and take on your mental health.

It’s All About Language

What language do you speak when it comes to feelings? Mental health? Diagnoses? Given the choice, how would you explain depression or anxiety or anger to a child you cared for? How would you want that child to see the world?
Being trained as a social worker, I learned what is called the “strengths perspective.” We focus on looking for what is good about a person and their environment, while the traditional medical model tends to look for what is wrong. I don’t fault the medical folks- it’s their job to find out the problem and determine the best course of treatment. But when it comes to a person’s mind and spirit, that’s not my preferred perspective. I like to look at all of it, not just pieces of one or the other, because knowing strengths can tell you much about how to fix the problem.
I believe it’s important to develop a language for feelings. It truly matters. Most of us don’t learn this in school or even from our families. If it were up to me, every school would have a class in feelings and how to regulate our emotions, as well as how to talk about them. Instead, what tends to happen is we grow up using whatever skills we’ve figured out (some that are helpful, and others that are maladaptive) and we go out in the world and sort of mess up a little and maybe get a diagnosis or two, and wonder what is wrong with us. We wonder what is wrong with us.
Allow me to share my perspective: There is nothing wrong with you. 
 
There is completely nothing wrong with you. There are many things wrong with the world, but not with you. There are definitely real diagnoses, and perhaps you’re someone that has one or more in your medical file. But that’s not something wrong. That is simply “what is.” 
It’s all about language.
Things “are” in the same way that you are a certain height. Typically, it’s not acceptable to ask someone, “Why are you so tall?” because we recognize these things just are. While someone’s height may be striking to us, we accept it as out of that person’s control. They just grew that way. It just is.

Your feelings are no different. Once we can accept that we feel certain things and our brain works in certain ways, we can move forward. Once we can agree that we just are, we understand there is nothing wrong. There may be things we don’t like about ourselves, or things we want to change or improve upon, but that’s a separate issue. Certainly if we have unsafe or harmful behaviors, we want to eradicate them so we can live a life in recovery. People sometimes have behaviors that are harmful because at the time, it seemed like the best option to handle their feelings. Coming to a new understanding about how we arrived in that place can help us release the judgment and forgive ourselves, and gives us a new language with which to think and speak of our emotions. It allows us to move forward, instead of critiquing where we’ve been. Understanding “what is” is not denying there are problems-it is simply removing the self-blame and accepting how you got there so you can do things differently in the future.
There is nothing wrong. We are all totally imperfect, flawed, tenacious, and strong people. A diagnosis is not a chip in the armor. Do not believe those who dismiss that mental health diagnoses are documented, neurological disorders. If you see things within yourself that you want to change, please find the resources to meet your goals, and if you are doing things that are unhealthy or harmful, you must keep yourself safe. But always understand you are never starting from a deficit. Plant your feet in your strengths-they will tell you how to find your solution and meet your goals.
And watch your language. 

Worrywart

“You wouldn’t worry so much about what others think of you if you realized how seldom they do.” -Eleanor Roosevelt

I always tell myself I have no time for worry. I truly don’t. Like you, I’m a busy person and feel the blur of the calendar days rushing by before I know it’s happening. Besides, what good does it do us to worry? What good does it do to know this, but still not be able to stop?

Many of us want validation and reassurance from the people we care about. We want to know if others think we’re okay, if they agree with us, or if we’re right about something. This doesn’t make us arrogant, or obnoxious, or anything other than human. It makes us care about ourselves and our situations, and the world around us. It makes us want to do better. It helps us grow and figure out solutions. Believe it or not, there is place for worry that can be honored, when we find out where our hearts go when our minds aren’t paying attention.

How do we know when we think too much about what others think, and worry becomes more pathological than productive? When it changes our decisions more often than not. When we are preoccupied with those people or situations. When it derails us from what we know deep down to be true and real. When we begin acting on the behalf of others for the sake of their opinion of us and forgo what we need to do for ourselves. When we get confirmation of what others think, and we realize we’ve been wrong the whole time, and wasted mental energy on things not productive or healthy. When we ignore our own well-being or rational voice of reason, or we literally cannot stop our process. When worry crosses these thresholds, we call it obsessive or ruminating in nature. It’s an important distinction from thoughts that do not impede daily functioning or quality of life. Regardless of a diagnosis, we can all benefit from thinking differently about our thoughts.

I like to think of it like running a race. There are many factors at play- the weather, eating the right breakfast, if you have an injury, if you slept well- but the point is to keep running. It’s great to take notice of what others’ think, and even absorb it a little, but you must keep running toward the finish. What’s worse, when we assume what others think, we may not even be right. We might be preoccupied for no reason. Even if we are right, at some point we need to decide if it matters at all. How much do we care, and how much do we want to care?

Give yourself an opportunity to acknowledge your concerns, and then decide what to keep and what to discard. I give myself an 80/20 rule for any given situation-I have a busy mind, and so about 80 percent of what might enter my mind can be acknowledged but not internalized. Put it in perspective for yourself before allowing it to derail you from a decision you have to make, and do not allow your mind to take up more time than is needed. If it’s truly in the rational, logical twenty percent, do something about it and move on. Otherwise, practice mindfulness and witness the thoughts, but don’t allow yourself to get caught up in a process that is no longer productive.

Don’t let anyone slow you down, and refuse to be distracted by outside people or forces. Run strong-shoulders back and eyes ahead. Keep your confidence up and your doubts away. Even if it’s your natural tendency to worry, push it aside. If it truly matters, it will come to light. If it doesn’t, you’ll soon be able to tell that, too. We have all the answers that we need at the moment that we need them. If you don’t have an answer right now, the question can wait.

I Expect, You Expect, We All Expect

“Expectations were like fine pottery. The harder you held them, the more likely they were to crack.” -Brandon Sanderson, The Way Of Kings

I dejectedly put my winter coat back on this morning.

After the last couple of weeks of warm(ish) weather, it was a hard thing to do. We’ve had a taste of spring and it’s a huge tease for those of us that look forward to the warmth and longer days. Have you noticed how after having a few 65-70 degree days, when the thermometer dips back down in the 40s, it feels absolutely frigid? Our bodies are no longer acclimated to the cold temperatures the way they are day after day in the winter months. Once it gets a bit warmer, we start to hope, and (dare I say it!) expect the warmer days.

We expect that it will warm up by March, by Easter, or by the equinox. We expect that when daylight savings time comes, it will be comfortable enough to ditch the winter coat. We do this to ourselves all the time, especially with our moods and relationships.

Many times I expect something and I don’t even realize it until I’m disappointed, and only after thinking it through do I process that I wanted a different outcome. We all have our baseline beliefs about the world and our relationships, and here are some examples:

  • We expect that the world around us will follow a sense of order and logic
  • We expect that people we love won’t deliberately hurt us
  • We sometimes expect that if we properly treat our mood disorder, it will not relapse or worsen
  • We sometimes expect that if we’ve “done everything right” than reward should follow
  • We sometimes expect that others around us are also interested in doing the right thing 

Obviously, these statements are not always true. At times, we relax into these philosophies about the world and only when they are challenged do we confront the discrepancy to understand our disappointment, anxiety, and pain. This emotional process can compound any that is already being triggered. For example, the death of a very young person tends to challenge our expectations and beliefs about the world. Children are supposed to outlive their parents. Young adults are supposed to have a whole life ahead of them. When events such as these call our expectations into question, it can compound the grief process. Sadness and devastation is certainly a typical response, but expectations that go unrecognized or unprocessed can get us stuck for longer periods of time.

Be aware and cautious of your expectations. Knowing that you are hoping instead of expecting can make a world of difference. If your response to a situation or mood seems disproportionate or irrational, try to get to the bottom of what you’re feeling. Just like the weather, our feelings are not always linear, logical, or rational. Just because our calendar says spring has begun doesn’t mean it won’t snow (at least in the Mid-Atlantic!) What we can do is be understanding with ourselves and our loved ones. We can know that there are times we hoped or expected more, to grieve the difference-the empty space between what is and what we think should be.

Spring will arrive here eventually, but I’m going to switch to hoping I don’t need my coat next week.

Balancing Act

“Zero plus 100 equals 100. But so does 50 plus 50, only with more balance.” -Jarod Kintz

Balance is such a tricky subject; even when we think we’ve got a handle on things, some extras invariably are thrown in to kink things up. Whether you’re talking about schedules, work/life, or work/fun, balance is integral to our well-being. Given our ever changing environment and our changing selves, we are constantly reassessing what we need and what needs to go.

Invariably there are times when things will be temporarily out of balance.  When we bring home a new baby, the house will not get cleaned, we will be behind on laundry, and we will eat frozen chicken nuggets for a few weeks until we can get a little bit more organized.  The same occurs when someone is sick, or we experience a death of a loved one, or another major life event happens.  Things are out of their homeostasis for a bit, and it feels off-kilter. 


The problem comes when we can’t get our footing back quickly or it is an ongoing issue.  Maybe our sick family member is chronically or terminally ill, or the baby we bring home has special needs that require a major lifestyle overhaul.  Maybe we live with a mood disorder that drains us more easily or we require more energy to care for ourselves.  Perhaps we are just plain busy- like most people- and that “one more thing” tips the scales in the unfavorable direction. Kids have to learn how to balance on one foot-they can’t just do it naturally. Similarly, we have to practice how to maintain the best balance we can psychologically.

Here are a few thoughts: 

If you truly feel that there is too much, try to eliminate or get some help with the workload. 
Easier said than done when it comes to single parents or primary caretakers of loved ones. But asking for help is crucial, whether it be from respite care, a paid caretaker, or a friend or family member. Even if there is something you are capable of doing, simply doing less can make a big difference. Paying someone to help with a few dinners, housecleaning, or dog walking can go a long way. If you can’t afford it, perhaps you can barter services. Pick up a neighbor’s groceries if you’re already going, and ask that they houseclean in exchange while you’re gone. Sometimes it’s a matter of doing less of what you don’t like that can help. 


Remember the things that comfort you. 
I love to organize, and I’m good at it. If I’m feeling bothered, sometimes just cleaning out a closet or sorting for a yard sale really helps me to feel productive and more in control of a chaotic environment. Remember the old standbys: alone time (or social time if that recharges you), a shower or soak in the tub, music, exercise, and eating well all make us feel good physically and mentally. Know yourself and what feels comforting to you, so you can have a list of things available. 


Don’t put on the pressure. 
Ever notice how a long string of negative thinking can really snowball? “Why am I feeling this way? Why did this happen? I just can’t exercise today. I should really journal” and on and on. Once the “shoulds” start, I know I’m in trouble! Pay attention to what is going through your mind and try to refocus. If you can’t exercise how you normally do, perhaps you can still be active but change what you’re doing. Something is better than nothing, and nothing can sometimes make us feel worse. 

Keep your appointments.
When the calendar gets full, we are tempted to cancel or postpone our appointments. Try to see when you can fit them in, especially if you think it’s a good idea to see your behavioral health provider. Sometimes the urge to avoid therapy comes when things are out of balance, and it’s good to reflect on this. Is it time for a new therapist, or are you too overwhelmed or tired to confront an issue? 


Take advantage of the apps and other technology. 
Find some apps that help to track your mood, or forums that you can visit online for support and education. If Facebook is upsetting or a negative influence, trim down your friends list, limit your time on it, or cancel your account altogether. I’ve been very impressed with the app Virtual Hope Box.

Check it out and see if it’s for you, and ask others what they have found useful.

This too shall pass. 
The only guarantee is that life will change. Whatever is happening now will end at some point. Try to see the good and enjoy what you can before things shift again. Remember that when we think something is negative, we see in hindsight a reason or a way of growth. It’s not comfortable, but it helps us become who we really are.


Laugh and celebrate your flaws.   
If you messed up, pat yourself on the back. You’re wonderfully and beautifully human, and you’re still here to talk about it. Don’t spend energy on your mistakes- once you apologize and try to rectify the situation, look forward. 


Balance takes work, it takes practice, and it takes flexibility to change and reassess. Moreover, it takes courage that may require some digging, but it’s in there. When we’re tired, the last thing we feel like doing is thinking more and trying to make changes, but the payoff is huge. Ask for help and realize things will not change overnight, but they will change-all because of you and your strength to take on your mental health.

Purpose

I love reading Glennon Doyle Melton and her blog, Momastery. This quote of hers from a recent post inspired me, especially as we head into a new calendar year:

“People always ask: G, how do I find my purpose?

I look at them and ask: What breaks your heart? There you go. That’s your purpose.”

Glennon’s take is that life is beautiful and brutal all at once, which she terms, “Brutiful.” I absolutely connect to this description, as I’ve always felt that the most difficult things are the most worthwhile. The things that allow our soul to positively burst with joy also seem to be the hardest (raising children come to mind, anyone?) This quote also makes me think about how we come to who we are, which never seems to be a linear progression and is full of bumps, bruises, and obstacles. But if we can remain rooted in ourselves in spite of this messy, sometimes haphazard journey, our purpose comes to light for us.

Sometimes our purpose is presented to us, and at other times, we seek and even fight for it. Others may tell us we can’t achieve; if that’s the case, we can find meaning in the failures. Often, our purpose may seem like a default path that is only slightly better than others, but we can embrace it and create within it what we find beautiful and true. There are times that we feel no logical reason to believe in someone, following a calling, or trust a process, until it unfolds clumsily before our eyes. And at others, we must carve a new meaning for ourselves and for those around us, and ignore all the noise of doubt and nonsense. We must listen to the voice of who we are, whether it shouts or whispers, because it is always there. We get busy and it’s easy to ignore it. Our roles change in life and we forget to listen and reassess. Depression and anxiety create doubt, negative thinking, and worry. Despite all of this, we must listen to what we know to be true.

Perhaps you’re a person who doesn’t believe everyone has a purpose. I believe if you’re reading this, you do. I believe that if you are here, your purpose is, too. Of course, you are free to disagree, but then I challenge you to think about Glennon’s question. Further, I ask you think of not only what breaks your heart, but what heals you? What comes to your mind when you imagine healing your heart? What comes to your mind when you think of caring for yourself?

As we close another year and look to the renewal of another, what will you do in 2016? I urge you, if nothing else, to think about your truth. Refuse to be a bystander in your own life, and do not fall into thinking that all things simply happen to you. Make things happen. Think. Create. Love. Allow yourself to stretch to every corner and love who you see. You’re a living, breathing, beautiful mess of a person, and there is a place and purpose for you. For all of us.

Take on your mental health, and advocate for someone else. Have a very spirited 2016. 

Funky Fall or Awesome Autumn?

“Love is a fruit in season at all times, and within reach of every hand.” -Mother Teresa

The change of seasons is a difficult time for many of us. In particular, fall is a natural time for endings as we wrap up the calendar year and let go of the warmth and the greenery of summer. Shorter days and colder weather pull us, sometimes kicking and screaming, into the holiday season which may or may not be a celebrated time. We feel so sensitive to the seasons because even in our contemporary age, we are part of nature. And nature is ever-changing, and we must change with it.

Remember, change is not a four letter word. Here are my tips for giving yourself the time and space to have an awesome autumn instead of a funky fall:

1. Adjust your expectations. 

If you’ve read my blog to any degree, you may have picked up on the fact that this is a big one for me. We have expectations for ourselves and our loved ones, whether it be for the future or for things in the past. Specifically, when we have unreasonable expectations, we set ourselves up to fall short. Keep your expectations fair and consider how you’re feeling.

2. Wake up at the same time every day. 

More important than going to bed at the same time, waking at the same time sets your body’s clock. It’s difficult during daylight savings time, as you may be naturally waking much earlier now. Use a fifteen minute rule for sleep-if you’re not sleeping within fifteen minutes, do something else. If you are waking earlier, try to go to bed earlier until you can reset your body.

3. Make time for mini self-assessments through the day. 

People often describe feelings as a snowball rolling down a mountain, and before long, it’s huge and you can’t remember how it started. Try to set an alarm periodically through the day and ask yourself how you’re doing. If you know you’re getting tired, anxious, short-tempered, etc., you may need to do something. Doing something can mean asking for support, using a positive coping skill, or simply informing your loved ones that you’re not feeling so great. This can not only avoid conflict in personal relationships but also keep you from being a snowball of emotions. You can use a five point scale, a color system, or whatever makes sense to you to identify your state of well-being.

4. Identify what works-and what doesn’t. 

When I’m tired, talking about my feelings irritates me, which I find sort of funny given my line of work. I love exercise but can’t always find time to do it. Having two practical lists of what works and what doesn’t is a great way to learn about yourself and be ready to act. It takes practice to figure out what works for you, but if you practice, it will become automatic.

5. Do nothing, for limited periods of time. 

Soon after the “fall back” of daylight savings, I feel like I’m walking through sand and expending a lot of energy but not going anywhere fast. Sometimes we need to stop and do nothing and allow our bodies and minds to rest before we can get back to our responsibilities. This is not only okay, but necessary. And…

6. Don’t allow yourself to feel guilty. 

Why do I feel this way? What’s wrong with me? Why can’t I get up early and get this stuff done? Why am I so tired? Why am I not over this by now? Why can’t I be more ______? Why do these things happen to me? If these sort of sentences sound familiar, you’re not alone. The problem is, when we speak to ourselves this way, we not only hard-wire our minds to think these things, but we compound emotions on top of emotions.

Practice speaking to yourself with love, understanding, and kindness. Allow yourself the room to either stretch your wings, or curl up into a ball. You always know what you need, and can act from a place of confidence and know that like all things of nature, you will ebb and flow. Simply love, and know that there is nothing wrong. In fact, everything is exactly what and who it is supposed to be. Including you.

Choose to have an Awesome Autumn, and take on your mental health.

Questions For A Potential Therapist

If you’re thinking about starting therapy, consider interviewing a few therapists and asking some thoughtful questions. While this list is in no way exhaustive, I find these to be the most productive things to ask a potential therapist. Based on your personality, clinical needs, and treatment goals, getting some answers up front may save you some much needed time. Here are my top eight of what to ask at the initial appointment, or over the phone if time allows.

What is your experience working with X population/disorder/situation? 

This is my favorite question. It’s absolutely fair to ask how much the person has been exposed to similar situations that you’re in or with a certain diagnosis. The answer will tell you two things: a) what their experience actually is, and b) their interpretation of your situation. I find the answer to option B most interesting, since what you really want to know is if they’re hearing you and their initial analysis gels with your own assessment and understanding.

What is your theoretical orientation? 

Many people exposed to mental health in some way are becoming more familiar with these terms: CBT, DBT, mindfulness, exposure and response prevention, and PTSD, just to name a few. I’m happy that these are becoming more mainstream, and we therapists definitely have our favorites. It is well worth your time to ask what a therapist is knowledgeable about; some have certifications or specialties that are very valuable. Many general practitioners use a variety of techniques borrowed from many theories, and I find this helps to individualize care based on needs and personality. The most important thing is to hear whether or not your therapist is willing and able to use other perspectives that may be the best fit for you, even if it’s not their most commonly used approach. 

How directive are you during sessions? 

If feedback is important to you, this question matters. Are sessions discussion based, or is the therapist mostly reflective and quiet? Different types of therapy require different levels of involvement, and so how talkative your therapist is will impact you greatly. You can phrase this as “give and take” or whether someone is interested in “problem-solving”, but find out how much participation from this person you can reasonably expect.


How structured are you with a certain amount of weeks in treatment, or are you flexible with coming as needed? 

I know therapists who ask new clients to commit to a certain number of sessions before reevaluating their goals and progress, and I know others who are open to a person coming and going as life requires them to get more support. I find value in both approaches, but you may want to know before beginning with someone how they prefer to operate. Keep in mind, however, that you are going to need to work in and out of the office to practice your new skills, and attending therapy more often (especially in the beginning) is usually the best way to build a relationship with your therapist, and progress towards your goals.

Are you ever willing to meet with my spouse/child/parent/friend? 

This comes up frequently in treatment, since may clients have friends or family that wish to attend sessions from time to time in order to better understand and assist their loved one. Finding out if your therapist is willing to do this ahead of time can be very helpful. Understand that this is very different from family therapy or marital therapy, where there would be treatment goals for two or more individuals together. Having a loved one attend a session does not change your own treatment goals, but focuses that session on how that person can help you, what you might need to tell them, or involve recommendations from the therapist on how to manage a mood disorder within a relationship, to name a few examples.

Are you willing to coordinate with my doctor/school/employee assistance program?

If this is something you think would be helpful, ask. Different therapists are willing to have different levels of involvement with other professionals, and it’s much better to know at the beginning of treatment. Discuss the pros and cons of your therapist talking with other providers for a more collaborative care approach.

How do you handle crisis calls or contacts after hours? 

What are the hours the person is available by phone? Can you email or text? Who do you contact to schedule an appointment, and what are the policies for crisis calls? Practitioners have many ways of managing these issues, and knowing ahead of time what parameters they have is critical for you. For example, I specify to clients that I will not “friend’ them on Facebook, which is my own personal level of comfort, but others may do otherwise. All of these issues fall under the scope of office policies that you have a right to learn about.

What topics do you find yourself studying the most for your continuing education hours? 

How many hours a clinician needs every license period varies by state and education, but most often the choice of how to obtain those hours are up to the individual. I think it’s helpful to know what a therapist spends his or her time learning about, and if it correlates to why you’re attending treatment. The therapist may not hold a certificate in cognitive behavioral therapy, but if she’s spent 36 of the last 45 credit hours studying it, and that’s what you’re looking for, it may be a good fit. 

Other questions- things such as where the clinician attended school, with whom they may have trained, or where they have worked may not be as paramount to your success in therapy. In no way am I knocking my numerous colleagues that attended prestigious institutions or have impressive resumes, but I’m not convinced these are a prerequisite to being a skilled clinician. I believe what matters most is the relationship you can build with this person, how open you can be when you talk with him or her, and how much you feel you can partner together to accomplish your goals.

Ask yourself this very important question: Imagine your absolute worst and lowest time- can you picture reaching out to this therapist in that moment? If the answer is no, ask yourself why. Is it time to continue interviewing other providers?

Take on your mental health. A good therapist can handle any question you throw their way, so get talking, and ask away. It’s our job to give you the information you need to reach your goals.