This article first appeared on May 1, 2018 in the newsletter for the San Francisco Chapter of the California Association of Marriage and Family Therapists. Click here to read.
One of the concerns often faced by people thinking about psychotherapy is that psychotherapy is commonly associated with mental illness, rather than with mental health.
Daniel J. Siegel, a psychiatrist and author of numerous books about the brain and neuropsychology (the understanding of how the brain works and how to make use of that understanding to help people) poignantly begins his presentations to therapists by asking: “who here has had a class on mental health?” In a room with one hundred or more therapists, perhaps five or so hands will go up.
Therapy is Not Just for People With Mental Illness, but for Learning to Deal with Your Life
With members of the public associating therapy with mental illness and therapists themselves primarily receiving training in how to work with mental illness and not in how to foster mental health, it is no wonder that therapy is most often seen primarily as a treatment for severe mental and emotional problems. Many people who find their way to therapy often experience intense shame because of this association—and we have no way of knowing how many people never see a therapist at all because of this shame.
Of course, psychotherapy can be very helpful to people who suffer from a specific problem, such as depression, anxiety, PTSD, etc., but the use of therapy is not restricted to just people with particular problems. Many people turn to therapy as a way to understand themselves better—why they do what they do, what events happened in their past that have shaped them, and how they might reassemble these pieces to create a more satisfying life.
You Can’t Always Do It Alone
While it may seem like it would be easy enough to do this work on your own, and, to some degree, that is certainly one way to approach this, there is no substitute for what happens when two (or more) people meet in a room with the sole purpose being the understanding and personal growth of one of them. Many psychotherapists have a word for this: the “third,” meaning that something new and unique is created that is the result of the combining of the conscious and unconscious minds of two people. The “third” can only be created by the two specific people interacting.
Therapy as a Place to Talk and to Listen
Another purpose of therapy is simply to have someone to talk to who will listen, offer ideas for thinking in a different way, and, most importantly, does not ask anything from you in return, other than for you to be there at the agreed upon time and to pay a fee for that time.
The content of what is talked about may vary greatly from week to week, from dealing with pressing problems to understanding yourself and your relationships in a deeper way. Regardless of what is talked about, being able to share your inner thoughts and feelings with a trusted therapist can help you to let go of some of the things that weigh you down and hold you back without the added burden of having to take care of the other person.
Surprising Voices for Mental Health
Although I am admittedly not much of a podcast person, I was recently moved by a podcast that was featured in the Daily Telegraph by Bryony Gordon, a columnist for the newspaper. In her series, Gordon speaks with different guests about their own mental health and how they have dealt with problems. As she introduces us to the podcast, she reminds us that “the point is, mental health issues affect everyone; one in four of us…it is really, really, really normal to feel weird. In fact, it is weirder if you feel normal the whole time.”
In the first podcast of the series, Gordon interviews Prince Harry, who speaks quite candidly about his own experiences with therapy and how talking with a therapist has helped him. I recommend that you check it out. Here is the link: https://bryonysmadworld.telegraph.co.uk/e/mad-world-prince-harry/.
And in another great article, basketball star Kevin Love talks about how therapy helped him deal with depression and anxiety attacks: https://www.theplayerstribune.com/kevin-love-everyone-is-going-through-something/. As more and more public figures talk about how therapy has helped them, hopefully, more and more people will feel comfortable seeking the help they deserve.
Questions about psychotherapy or about my approach to psychotherapy? Please see my website at www.marlacass.com and contact me at my San Francisco psychotherapy office: 415-218-2442 (phone link works from smartphones only) or at email@example.com.
Therapy: Not Just For Problems
Why do people come to therapy? Therapy, on the surface, can seem like a very strange thing to do (What! Tell my problems to a therapist??) and it is surrounded with misconceptions. It involves a commitment to show up at a certain time at a certain place and pay money to talk to someone you don’t know about things you may have spent years of your life avoiding. It can feel uncomfortable and can stir up things you have tried very hard to ignore. To make matters worse, having made that commitment to spend all that money to talk about things you don’t want to talk about, you will probably put pressure on yourself to change something in your life. After all, if we are taking up time and spending money, we expect something to happen, right? This doesn’t exactly sound like something most of us would sign up for. So why do it?
Ok, Sometimes, Therapy IS For Problems…
Many people see therapy as a necessary evil; as a place to go to talk about a problem that needs solving. Usually, the person coming to therapy has tried a lot of things before picking up the phone or getting on the internet. For example, she or he has likely talked with friends, thought about the problem, tried some possible solutions or distractions, and maybe read some books that might be relevant to their situation. After exhausting everything they can think of to do and discovering that the problem is not resolved, therapy might start to sound like a good idea.
Often, these people come to therapy with a very specific issue and a very specific goal. Coupled with this might also be a very specific time frame in which they would like to accomplish the work and arrive at a solution. This approach can work very well in cases where the problem is well defined and the person has already made some progress with respect to resolving the problem.
Unfortunately, our minds and our problems don’t always work in a linear fashion and, much like a home remodel, it is a good idea to have some room for unexpected things that may surface. At first glance, a problem may look like a problem, but looking under the hood, so to speak, may reveal underlying causes that require deeper investigation. In such cases, the problem may actual be a symptom of another problem.
For example, a couple may come to therapy to look at the way they argue. Helping them find ways to argue less will be helpful to a point, but understanding that they each come from families where every conversation turned into an argument will create a level of understanding that can lead to lasting change that feels more authentic than memorizing a script on how to argue less.
But Sometimes, It is for Personal Growth…
For another group of people, however, therapy is not specifically about solving a particular problem, but about looking at the problem of being human in a complex world. There are very few places where our inner life can receive such careful and gentle attention.
For these people, therapy is a place where the noise of their day to day life is quieted, at least for a short time, and they and their therapist become absorbed in the intricacies of observing something that is not always visible. Like a scientist observing the world through a microscope, looking at your life through the lens of psychotherapy can open up worlds that are fascinating and enlivening and can lead to a richer and fuller human experience.
Have you thought about what it might be like to take an hour out of your week to look at yourself? What might get opened up for you? What thoughts and dreams do you
And, Often, Therapy is About Not Having to Do It Alone.
For a third group of people, therapy may not be as much about problem solving as about problem management. Sometimes, things just are what they are and the solution is not necessarily about trying to find a fix to an unfixable problem, but in learning to accept the problem as it is, or having a safe and confidential place to talk so that it doesn’t feel like you are holding onto the problem alone.
People who fall into this category are often similar to people who come to therapy to look at their inner life, but, for people in this third category, there is a specific topic or issue that remains at the center of the therapy work. Talking about it with another person can create the space to manage the problem and let go of some of the overwhelm that may accompany it.
While most people come to therapy with the goal of fixing something or feeling better about their lives, therapy is not always something that needs a goal. Like Zen, the process of being in therapy can, in and of itself, create rewards that we could not have anticipated.
On Choosing a Therapist, Part 3
This article first appeared in the online blog, Psyched in San Francisco, on May 29, 2014. To read this article, please click here.
On Choosing a Therapist, Part 2
This article first appeared in the online blog, Psyched in San Francisco, on May 12, 2014. To read this article, please click here.
On Choosing a Therapist, Part 1
This article first appeared in the online blog, Psyched in San Francisco, on May 1, 2014. To read this article, please click here.
Deciding to Go To Therapy
This article appeared in the Fall 2012 issue of Bridge Newsletter.
In most cases, the decision to talk with a therapist is the result of a painful problem that has not gone away. You may have tried many things to fix the problem. You may have even taken steps to try to do some things differently, but the problem persists. The problem can range from a crisis that keeps you awake at night to a nagging feeling that something is wrong that just won’t go away. You may be at the point where you are wondering whether anything can help.
Perhaps you are thinking about therapy as a way to help you with problems in your relationships. You may be looking for ways to repair a troubled relationship, for guidance on how to be successful in your current or future relationships, or for support in ending a relationship that is no longer viable. You might be considering getting help for yourself alone or together with your partner.
You might also be wondering about therapy as a path for exploration and personal development. You may have a strong desire to understand yourself at a deeper level. Perhaps you are curious about what motivates you, how you relate to others, or how your past history impacts your current life. Therapy can help people look at places where they may feel blocked or stuck, and to open up to new possibilities.
The word “therapy” is often interpreted to mean that something is broken and needs to be repaired: for example, someone needs to go to physical therapy to help them walk after knee surgery. But therapy is not necessarily about fixing something that is broken. When we feel better about ourselves and have a greater understanding of who we are, we tend to be able to ride out the bumps and have increased energy to engage more fully in our own lives and in our relationships.
Often, people are reluctant to seek psychotherapy because they feel shame or embarrassment about talking to someone about their problems. Perhaps they come from a family or cultural background that frowns on sharing “things that belong in the family.” This can make it feel awkward or even impossible to consider psychotherapy. While it may feel like a contradiction to go to therapy to talk about this, looking at your hesitations with a competent therapist can be the best way to move forward. Taking some time to explore the negative messages you may have heard about therapy can give you the tools to decide your next step.
For many people, talking about themselves can feel awkward. They may fear that they will be rejected or judged in some of the same ways they have been rejected or judged in the past. A trained therapist is interested in providing help, not in judging you. She or he will work with you to find ways to help you to feel safe when uncomfortable topics or feelings come up. It can help to keep in mind that it is often the wish to avoid discomfort that keeps us stuck. Your therapist should be with you every step of the way to make sure that therapy unfolds at a pace that works for you.
Often, people are reluctant to consider therapy because of a previous experience that did not go well. Maybe you once saw someone for help, but you didn’t feel any better. Or perhaps you were sent to see a therapist against your will because of a family situation such as a divorce, and you thought it was a waste of time or you were left feeling that there was something wrong with you. Whatever the reason, giving therapy another try may lead to getting the help that you deserve.
Finding a Therapist
Even people who are ready to begin therapy can find the process of locating a therapist to be daunting. How do you even start? Some ideas may include asking a healthcare provider, such as your doctor, OB/GYN, or chiropractor. You might ask trusted friends and family members, although it may not be a good idea to see the same therapist as the people closest to you.
The Internet has opened up new possibilities for finding a therapist. Many therapists have websites that offer very useful information about their practices. In the past, getting a referral to a therapist usually meant receiving just a name, address, and phone number. Today, therapists are writing about topics such as their theoretical interests and their approach to therapy. Some therapists’ websites include blogs and lists of suggested books. All of this information can help you to begin to get a sense of the person and how he or she may be able to help.
Once you have decided on a potential therapist, the initial phone call will give you further information about her or him. Most therapists are willing to spend a few minutes on the phone in advance of the first meeting. This is a great time to ask questions regarding the therapist’s experience with the issues you want to talk about, and to find out the fee. It is also an opportunity to listen to the therapist and to start to get a sense of whether this person is someone you will feel comfortable talking to.
The First Appointment
Your first appointment is another opportunity to make your decision about therapy and the therapist. In most cases, you will quickly have a sense as to whether the person you are meeting with is a good fit. Does the therapist seem to understand you? Does he or she respond in ways that make you want to share more of your story? A therapist who makes you feel like you want to stop talking or makes you feel like you are being judged is probably not a good fit and you may want to explore other possibilities. Before deciding that a therapist is not a good fit, you may want to think about why you feel that way. As we discussed earlier, talking about ourselves with someone we have just met can feel awkward and uncomfortable. Try to be sure that the issue is genuine lack of connection with the therapist and not discomfort with the idea of therapy. You may even want to talk about your hesitations with the therapist to help you get some insight about how you are feeling about starting therapy. Sometimes, it may also help to have several sessions with a therapist before deciding whether she or he is a good fit for you. Often, the first session can go by quickly as you begin to talk to your therapist. If you are undecided about a therapist after the first meeting, you may want to take an extra session or two to make your decision.
A Good Fit
Just like with people we meet in other parts of our lives, there are therapists with whom we will resonate and therapists with whom we will not resonate. The best therapist in the world, or even the person who was the best therapist for your friend or for your boss, may not be the best therapist for you. Unfortunately, the nature of therapy is such that people are often trying to find help during a time when they are in pain and feeling overwhelmed. Finding a therapist with whom you feel comfortable and who you feel can be helpful to you is worth the effort. Give yourself permission to meet with several therapists, if necessary, to be sure you will be working with someone you trust. Often, people either stay with the first person they meet with, despite misgivings, or they decide that therapy is not for them after a session or two with someone who makes them feel uncomfortable. There are many excellent therapists who can offer you the help and support you are seeking. Please take the time to make the best decision you can.