Bringing in the New Year with Meaningful Change: Finding a Therapist Requires a Good Fit

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Overall, most Americans consider psychotherapy beneficial. In a Consumer Report where seven thousand individuals were asked about their personal therapeutic pursuits, more than half responded favorably to the therapeutic process. Even with that favorable response, how do we know what constitutes “good” therapy? Some research has indicated that the client has felt great benefits from therapy, but continues to struggle with chronic symptoms like depression and anxiety.

The essence of psychotherapy is the pursuit of treatment for mental health issues with the help of a trained professional. Most important is the relationship with an unbiased party to gain insight into unhealthy patterns of behavior. There are many times throughout life when the benefits of a safe relationship can help one sort out those troubling patterns. The difficulty for the consumer seeking these services is in knowing what to look for when seeking a “good fit” with a therapist. The following are a few guidelines to help assist in finding that good fit.

First, do not be afraid to ask for a phone interview. Therapists that are open to scrutiny are willing to answer any questions you may have even before the first appointment is made. Once the first session is scheduled, have a little knowledge in hand about what may be the problem. Several reputable websites offer information regarding psychiatric disorders and recommended treatment modalities. Here is an opportunity to show the potential therapist that you are psychologically savvy and come with some understanding of what may be ailing you. Most importantly, do not be afraid to provide feedback to the therapist. A good therapist will not only welcome input into your perception of the progress but will ask for it. Often, this will occur in the first session where the therapist may make a suggestion of a course of treatment with a specific “checking in” point during the process. Do not be afraid of rejecting the therapist, this is an opportunity to potentially strengthen the relationship between therapist and client. If there are overall concerns of the treatment effectiveness, ask for a consultation with another therapist. Once again, a good therapist will welcome this and hopefully suggest a few referral sources to get a second opinion.

Psychotherapy is not like finding a surgeon to complete heart surgery; this is an intimate and professional relationship between two people where the client will possibly reveal very personal details of their life. The client should feel like the therapist can clearly explain the nature of the issue, feel understood as an individual and feel that their therapist is both compassionate and nonjudgmental. May this information help you in finding your “good fit” when psychotherapy is needed.

 

REFERENCE:

Article by Dr. Richard A. Friedman, professor of psychiatry at Weill Cornell Medical College, Science Page of the New York Times, Nov. 2007.  

We Say Farewell with Gratitude to one of Our Beloved

Outside of the privilege of being a therapist, I decided that part of my giving back to the community was to mentor other therapists to do private practice well. Today we say farewell to one of our beloved and send her off to do good work in her own practice. Wish her well. Send her love and light

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December 2013

Dearest Angie,

It seems like a million miles ago we met on that fateful day in the Child and Family Guidance office.
You were blazing in from somewhere in the field talking about the next live music show you were
going to and which one you had just left from. You showed me pictures of your kids on a social media site and spoke fondly of the life you lived. I can’t say why I knew, but I knew we would cross paths many more times. That was almost nine years ago.

When I started private practice about seven years ago, it was a whirlwind of falling down mistakes. I realized early this was like getting another graduate degree and I made a vow that if I could really figure this out and learn how to do it well, I would pay it forward and not make someone else have to suffer through the process alone. Do you remember me calling you several times to bug you about taking that second exam so we could get started? I remember realizing quickly that doing this together would be one looooonnnnnggggg experiment and we would both learn how to be mentor, colleague and friend.

And goodness has it been a ride…..

I have learned so much about myself in this process. I realize I still have a lot to learn about being a mentor, but I hope I have guided and been honest about my shortcomings. I most appreciate your willingness to do this together so I can go on and do it again, continuing to improve my skills to prepare the next person to be in private practice on their own.

Most importantly, I have watched you become one of the best practitioners I will ever know. I recall your fear and trepidation in those first months, struggling to ask for your needs to be met in the big picture of the day to day of private practice, to today- listening to you carefully calculate how to best serve your community while remembering to take good care of yourself.

My heart bursts with sadness and joy! I have grown accustom to seeing you beautiful face every week and having time to just check in and be present with you. I will miss this terribly. But, knowing that you will drive less, spend more time with your family and create a lasting connection in your own practice brings me immeasurable joy.
Aurora Counseling for Healing and Change is the fruit of many, many long drives and nights away from home.

You may not know it, but you inspire me. Not many would put their trust in someone else to help
co-create their career. My heart is full of gratitude and during times of struggle, I will return to remembering your gifts.

I look forward to watching your practice evolve and learning and sharing with each other as the years move forward.

Thank you for traveling the journey with me.

The Real Stones in the Road

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In the fall of 1995, I was a sophomore in college and I felt like I had a lump in my throat. ALL THE TIME. I swore there was something wrong, returning to the old fuddy-duddy doctors at the college health center over and over again. Tension was building with my college benefactors (my great aunt and uncle), my best friend had left after attempting suicide and I was heading down an ugly path of one night stands. I was turning into a woman I clearly did not recognize.

I guess one of the crotchety doctors got tired of my throat complaints after making me eat another tongue depressor for what seemed liked minutes on end. AAAhhhhh…..eeeeehhhhh…..Really Dude (in my best California accent) don’t you see that cancer growing in the back of my throat? I am dying here!! He stops, sighs BIG, looks straight at me and says, “I think we need to send you upstairs.” WHAT! Upstairs!! That is where the crazy people go. I am not crazy, I just got this thing- growing in my throat! The third floor of the Student Health Center was the Counseling Center and I did NOT want to go. I rolled my eyes at him, snatched the referral slip and slid off the scaly lizard green exam table pushing past him.

Days, maybe weeks passed and I stayed mad at that crotchety ass hole trying to tell me I needed a therapist, not a tonsillectomy or an MRI– Something!! Finally, after another tawdry night of God knows what with whom will remain nameless and possibly faceless, I made the call.

This particular counseling system required a consultation to find the best fit. I met with a woman who had the wildest long black hair. I occasionally tilted my head like my neurotic cat does wondering if she actually designed it to look that way. But really, I was about to lay some shit down that she could not handle- or at least that is what I told myself. I spewed onto her my complicated and difficult family history, the sexual abuse and how, although I had many difficulties in my relationship with my own mother, I did NOT want to see a boy therapist.

She actually had the audacity to ask me, “WHY?” I remember thinking, ‘Whatdaya Mean, Why?’ The idea of being behind closed doors with a MAN I knew nothing about and then having to share my darkest secrets with made me more nauseated than I was already feeling. In the end it didn’t matter who it was, I was certain no one could really handle me or what I had been through. I was going to bitch slap this therapist around with every tactic I had and wear her out until she cried mercy.

I don’t think I have ever been so armored up in my whole life. I remember the consultation room felt so tiny and all there was was me, a wild, black hairy nest of hair and her white, white paper with the scribbles of my life. Sitting with a difficult decision is like having a sweaty, hairy stomach slide, –slide, –slide down your face…over AND over again. I left wet and sticky and all I could do was take a nap. Me and the wet hairy stomach rubbing its smelly self on me.

Watch this for an Excellent Visual:
http://www.youtube.com/watch?v=enJJeOqHbqE&feature=youtu.be

 

Her name was….Well, I really don’t remember….But let’s call her Kathy or Karen or one of those normal names. I remember her as being all kind of orange and red with short frosted hair. She smiled a lot and watched her digital clock. I used to caress the edge of the arm of the textured couch. Other times I dragged my nails through it just to hear something else make noise besides myself.

Our first session was like standing in knee deep mud. I gave her my best devilish stare and like a howler monkey- made screeching noise to the tune of chaos that was my life. I had planned to torture her with every word until she put her hands over her ears and begged for me to make it stop.

But instead, she breathed in and out, in and out…… and just looked at me with deep set puppy eyes. What THE FUCK was the matter with her? She was not freaking out like I had been ALL MY LIFE!! She listened. She heard me. She seemed to act like she understood. She did not judge or shame me.

Over the next year, so many things unfolded. But one thing that has stayed with me was that she suggested that I seek out and find my two half brothers whom I had only met one once when I was eleven. Before leaving from my work with her, I had not followed through with this; I am sure for many different reasons. If I knew where she was today (hopefully enjoying peaceful retirement not being emotionally pummeled by college students) I would want to tell her that when I was ready, I finally did and although it is not the kind of relationship I wish for, it does exist. I suppose in a way, I hope that she is proud of me. These thoughts are really about wanting her to know that I am grateful that for the very first time in my life someone knew how to hold space for with the hot mess I had become.

You wanna know what is really HI-LAR-IOUS? That lump in my throat? That choking cancer I swore was killing me? They turned out to be tonsil stones- a real problem that is often just as stinky and ugly as the one I fought upstairs in the Counseling Center. But, both the doctor and I were right. I did have a cancer. Shame was metastasizing in my mind and he could not help. I needed a higher power- or at least the one on the third floor. 

 

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LIVE.OUT.LOUD 

 

 

Why Yoga- by A. Jiles

Why Yoga- by A. Jiles

Dear M,

I gave you a short and sweet response to your inquisitive question this afternoon, but I think you deserve a thoughtful and complete response. I can’t count on one hand the blessings yoga has brought into my life, but I do know I love the person I am when practicing with an open heart and a quiet mind.

*Yoga brings me to the present. I’d like to lie and say that my mind is an empty abyss when I step onto my mat, but I’d be throwing you a line. My mind is a crazed jungle of thoughts, and images, and lists, and that negative self talk tape that I’m trying so hard to overcome, emotions, and memories. Yoga helps challenge me in ways that lead me to the present. It helps me let go of everything waiting on me in the real world, and for the briefest of hours, I connect to myself. I connect to the breathe. I connect to the spirt.

*Yoga puts me inside my body. For years, I walked around disconnected from my physical self. I blame my 20s and the urge to undertake any and all unhealthy habits, but I started to see my body as separate, as this demon I had to battle. My darkest moment arrived on a stationary bike. I broke down and sought a practice that would help me accept my body, not completely overhaul it to fit a standard of unattainable perfection. Literally, yoga makes me touch and notice my body. A practice I am finding is hard for a lot of people. I have to feel and see what my <insert body part> is doing. My attention becomes single focused. Inhale. Exhale.

*In the center of it all, I find stillness. Things slow down for me when I’m practicing yoga. Instead of multi-tasking a billion things, I get to just be still. I give myself permission to find the quiet. Of course, a yoga class is not completely silent, but when all is said and done, I relish in the stillness of my mind, my body, and my breath.

*Yoga leads me to gratitude. Gratitude for all things. Good or bad. Insignificant or monumentally important. When I started looking at the world with gratitude, I stopped yelling. I stopped trying to prove my worthiness. I began to be thankful for the moment. Do I still have crappy days? Of course I do, but my general outlook on life feeds on gratitude and kindness.

*Yoga has brought me closer to God/universe/spirit. I’ve searched. I’ve rejected. I’ve argued the existence. I’ve defined myself against God for years. If I knew anything about myself, I knew that I didn’t believe in the theology and ideology that permeates the South. I never believed that I would find God on my yoga mat (as a matter of fact, I was skeptical as hell), but as my practice matures and deepens, I have begun to believe that yoga is almost solely responsible for me connecting to my version of God. God is all around us and has no name, but she/he/it lives in the space between you and me. The connection between souls. The connection to nature. The connection between my feet and my mat.

*I found courage on my mat. I’ve never been afraid to be me, but yoga gave me the courage to be me proudly and without hesitation. Yoga made it alright for me to be different. Being outside the norm is not always easy, but it is so much more rewarding than living under someone else’s expectations. Kicking myself up into a handstand might seem like a feat of strength, but for me, it is about having the courage to turn my life upside down and relish in the beauty of my courageous spirit.

*My mat is my mirror. Once I had been practicing a year or two, I began to notice the emotions that came with different poses. When you first start practicing, you are so concerned with the physicality of the pose that you concentrate intensely on following directions and moving your body in a completely foreign manner. After you start to figure out the puzzle, you notice a new layer of depth. Instead of concentrating on getting your foot in the right spot, you start to sort through the array of emotions that arise as you waver between going to yoga, as you step onto the mat, as you close your eyes, turn inward, and notice your mind and breath, as you listen to the sound of the teacher’s voice and move your body into the prompted shapes, as you lay on the mat in savasana trying to be aware, but unattached, as you bring your hands into the last prayer pose of the class, and as you walk off the mat and back into real life. You start to notice those same emotions in your day-to-day interactions, and as in yoga, you can always come back to the breath.

*I listen now. Hard to believe, but I’ve always liked to talk and have always had a lot to say. Yoga (and some talk therapy) slowed me down. I learned to listen. To my body. To my breath. To my mind. To people. To life.

*I do yoga for that blissed out look that you left class with yesterday. Finding that bliss brings me back to yoga. Being able to give that bliss to others keeps me teaching yoga. Complete relaxation. Complete surrender to the flow and grace of life.

Short and sweetly, yoga makes me a better and nicer person.

I am honored and privileged to be able to share this gift with you and your sidekick. Thank you for allowing me to be your teacher. There is so much more I have to share with you, and I honestly can’t wait.

Namaste,

A. Jiles

Be Aware of the Post Holiday Blues

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What leads a person to have the post holiday emotional let down? More importantly, what qualifies as symptoms of an actual depressed state? It is normal, each year, to experience an emotional high anticipating the many aspects of the holidays and regardless of which holidays we celebrate, there is always a sense of excitement and anxiety that will abruptly disappear in January. Some experts report as many as twenty five percent of us will suffer with a holiday let down lasting for a few days to a week with symptoms similar to depression. So often our expectations are not realistic or we have high hopes for repaired relationships that do not materialize and are left with feelings of disappointment and grief. Many experience a high from all of the bustling around in the commercialization of the season the let down is inevitable.

However, only some of these feelings will lead to an episode of Major Depression.

The National Institute of Mental Health reported that approximately 6.7 percent of American people over the age of 18 are affected by depression. These symptoms can include a consistent lack of motivation, unintended changes in weight, sleeping too much or too little, irritability, a sense of helplessness or hopelessness and feelings of suicide (even a vague sense of not wanting to exist qualifies). Most importantly, these symptoms must significantly affect the person’s ability to function on a day-to-day basis. It is very common for a person to report they are “getting by” with the minimum life requirements, yet all other aspects of their life have been neglected by the depression. If many of these symptoms have persisted for two or more weeks, it may be time to seek professional help through therapy and when necessary, medication.

But once the holidays have passed and the emotional let down begins, there are many preventative measures that can be taken to stave off an episode of major depression. One can begin by simply following through with those new years resolutions that are often quickly forgotten. Most importantly, EXERCISE. If ever there was a cure-all, exercise is it! It improves our mood, boosts those happy neurotransmitters that make us feel like “everything will be o.k.”, increases healthy sleep patterns and decreases irritability. These improvements do not account for the additional positive physical effects on the body.

Other important preventative measures include taking time out for ourselves. There appears to be a common misconception that if we make time to do something just for ourselves we are being selfish. Yet, I will consistently argue that it is a farce if we are depleted and continuing to attempt to give to others. Remember, we can not take care of others without first taking care of ourselves.

Finally, a tactic used with cognitive-behavioral therapy, focus on the positive aspects of your life and use that energy to move forward. In what ways could you use this positive energy to begin a new chapter in your life, start a new project or renew worthwhile relationships? Let us be grateful for even the small moments of grace offered in our lives and remain proactive in our self-care to prevent depression. 

The Telling: The First Moment the Universe Heard the Story of my Sexual Abuse

It is honestly difficult to remember the first time I spoke the words, “He hurt me” with out the memory being encapsulated in a snow globe. I watch it play itself out; nothing exists except for my house on Mosswood Drive, me, my mother and a Strawberry Shortcake suitcase. It is not uncommon for a trauma victim to have memories that can only be remembered as if you are a third party, a ghost, entering into the memory watching your physical self play it out while you loom overhead. Your emotional Self hangs out above, floating and separate from you. For what ever reason, this particular memory is even more distant, yet at the same time, in a snow globe’s tomb, immortalized in my mind.
I was eleven or twelve years old. We had moved from a condo in my home town to a rental house, now renting with my mother’s boyfriend and children. This was the second one following the separation of her second husband and as usual, I was having a difficult time adjusting. Change was like a stabbing knife in my chest. I knew I was supposed to ‘get along’, but it was this boyfriend that I finally readily rejected, tired of being told indirectly to roll with the flow. That day, I had reached a breaking point, weary of the angry tongue lashing that was not uncommon, especially if there was no one around to stop it. I packed my bag and I was leaving. Listen, I packed my STRAWBERRY SHORTCAKE suitcase. What in the hell was I thinking?!! Clearly a person honestly capable of leaving would have a black leather suitcase. Every time I flip the snow globe and play out the memory in my mind, I stop dead when the childish suitcase is being packed. But I honestly was carrying heavy, grown up weight with no where to put it, except into my flimsy childish life.
My mother laughed at me while I sobbed, stuffing various clothes into my little girl life. It just made me hurt even more. Could she not see this pain? She was clueless…. even more clueless about the bombshell I was about to drop on her. My day bed faced the window out onto the front porch and was covered with a bright white bed spread, stuffed animals and flowery pillows. I originally bunked with my older soon-to-be step sister, but I was used to having my own space. I had white antique furniture, it followed me into every house I can remember, even in the houses of abuse. I had plenty of clothes. I always had plenty of stuff. But my soul was slowly dying.These words about soul loss may sound like drama, something Scarlet herself would mumble, but when we keep secrets, it rots our soul and each traumatic memory is wrapped like bacon in a thick layer of shame.
My hair was short and puffy. I remember wearing gray cut off Levi jeans with a white shirt that had hot pink and black geometric patterns on it. It was the 80’s in California. I am sure I had high top Reebok with multiple pairs of socks too. And I really was leaving. Anything. Anything to get away from this life. Anything to escape the indescribable pain of the past mixed with the emotional pounding that I was once again receiving from my mother. She seemed relieved when I was broken. This time I was desperate to use Strawberry Shortcake as my shield.
I went towards the front door, first turn to the right out of my room. She grabbed up my arm, became frantic that I was really leaving. Somehow I managed to get out on the porch, but never any further. I absolutely cannot remember how I made it from the porch with leaving in hand to the kitchen table, telling her, telling ANYONE for the first time.
I have no memory of my mothers face that day. She is a blur. I can remember the color of my shorts, but not her face. I cannot remember any consoling words except a vague idea that I was going to get help. I was at least heard momentarily and had some visions of seeing a therapist. But I cannot remember how the day ended. My snow globe goes blanket white and I want to remember if I even felt relieved. Did she hug me? Did she say she was sorry? I wasn’t even sure if she believed me.
Jump several days. I am watching myself talk to my first step father on the phone. His son was my perpetrator, my step brother. It was one of those old style, heavy, manilla colored phones with white plastic push dials. If you pushed just right, all the buttons would dial together and lord knows it was so heavy you could easily knock yourself out just trying to answer it. I am in my mother’s room alone, me and the phone to the right of the bed. My step father starts to ask me if what I said to my mother was true. He tells me as adamantly as he possibly can that “IF” this is true he will disown his son. I am grateful, but I also realize that this is the only person my mother has told and not to protect or help me, but instead help herself. He alludes to how my mother threatened to use the abuse against him in the divorce proceedings. I am betrayed all over again. I disappear into thin air in that moment, my ghost self sees the phone hang in mid air while I die from this sick pain that hollows out my chest. It will be years; Really, YEARS before it is ever brought up again. Now only my mother, my step father and I know the pain and we all bury it further away. I seal it up, like the snow globe and carry on with life, pretty, puffy and pink like Strawberry Shortcake.

Stress: Part 2B: Cultivating Self-Compassion

I love the work we are doing in our practice together…take a peak at a different perspective of our nerdy passion with living a life cultivating the practice of being Awake-Alive to this one life of ours.
Such Gratitude to you Shaun…..

Shaun P. Kell's avatarshaunkellmft

Giving yourself permission to be human

My mentor Alicia Gregory, and I share a sort of nerdy obsession with good research on what I’ve taken to calling “the good life.” Lately I’m really loving what I’m learning about Self-Compassion. I commend Christopher Germer’s website and free guided meditation downloads. Since I started this post, I’ve gotten halfway through Kristen Neff’s book Self Compassion, which I have enjoyed too. If you’re looking for a “self-help” kind of book that introduces the concept, some of the background, and the research, this is a good place to start. Self-Compassion can begin with a startling realization: most of us talk to ourselves in ways we would never talk to another human being (or even the dog).

“Suck it up!” “You are stupid to feel this way!” “Stop feeling sorry for yourself and just have another drink!” “Who do you think you are to think you…

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Social Media- Not ALWAYS your Friend….Use with Caution

Upon initial thought, you may think a therapist talking about problems associated with FaceBook in the treatment room strange. Think Again! It is not an unusual part of the treatment to process the various issues that come up as a result of this form of social media. Given that I have the privilege of seeing many adolescents, it may be expected that these issues only surface as a result of treating this population. Again, think again. Many adults utilize FaceBook, however, sadly, often with little finesse or application of reasonable limits that a person may meaningfully set in their day to day direct interactions. In an effort to encourage adults to utilize social media in an appropriate way, I will share a few pieces of insight and suggestions for managing your use of social media in an effort to reduce problems that can often arise. First and foremost, FaceBook can be a meaningful relational tool, a way to connect with the people that are significant in your life. Research tell us that we cannot connect with more that 125 people through FaceBook at any given time. If you have 550 friends on FaceBook, it may be time to evaluate who you honestly want to share aspects of your life with. And don’t stop there, consider carefully who you choose to be friends with in the future and return to evaluating your friends list from time to time. If you connected with some long lost high school buddy and you realize that you really will never see or speak to this person outside of this social outlet, do you honestly want them to share in pictures from the first day of school that you recently posted of your children?
Here is something else that research is starting to tell us; how you “act” on FaceBook is often how you act in your real life. If you constantly troll the site, seeking out other people’s misery or regularly post about the terrible awful in your life, people most often experience you the same in direct relationship. If you find yourself posting passive aggressive comments really directed at other people or broadcast every single egregious behavior your child participates in, your day to day friendships likely resemble these same problems. Finally, if you find yourself saying, ‘I am sick of the drama on Facebook’, it would not be surprising if your own life fed on this same need for emotional chaos. This also means that if your child is bullying on FaceBook, social media is simply another outlet for that behavior, not that it would/does not happen elsewhere.
It is true that technology has sped past our capacity to genuinely evaluate the emotional implications of social media, but it is not an excuse to not take the time to set some reasonable boundaries around your use of it. Do you want to be known as the girl that ‘broadcasts every detail of their life’ or the one who ‘stirs up trouble’ by posting pictures of a family party that excluded other family intentionally? Or worse, the person that cannot stop ‘harping on their political views’ to the point that it feels emotionally invasive?
If you find yourself not able to delete FaceBook friends, that is yet another indication that you may fear possibly hurting someone else’s feelings, compromising your own values in your use of social media, but more likely a direct indication that fear of hurting other people’s feelings is fully present in your real life. My encouragement; Be Brave, Have Courage. Deciding the parameters under which you want to utilize social media that is honestly meaningful for you is not an indication that you feel you are better than someone else. Instead, it is an opportunity to set limits in your life. People who have clear limits and boundaries in their relationships with others are the happiest people. Social media is a relational tool, use it well and you will experience meaningful benefits.