RELAX! FINDING TIME TO DE-STRESS SHOULDN’T BE SO STRESSFUL.

Posted on by

Woman reading book in hammockLast week I wrote about ways to manage anxiety.  Most of the methods included the need to relax in some way. The article I wrote about didn’t, however, specify just how helpful relaxation all by itself can be in reducing and managing day to day stress.  I decided to post the attached article which talks about the need we all have for self-care and relaxation, but then goes a little further to tell you how you might actually find the time you need to relax.

As I started reading through the article my first thought was that it would just say the same old stuff about exercising and making sure you get plenty of rest.  Then I saw the statement in paragraph 4, “the most common excuse for not relaxing is “I don’t have the time””. How true that is for so many people! Even those who find the time to run to the gym and work out often find that jamming workout time into the day is, in itself, extremely stressful. Exercise may be relaxing for some, but for many who are juggling ways to fit it into their lives it is anything but relaxing.

I love this article because it gives you ideas on how to relax that almost anyone can find time for.  Though I realize not everyone can tolerate getting up earlier in the morning, I love it! I make sure to get up at least 15 minutes before everyone in my house so I can start the day slowly and quietly.  If getting up early is not for you, most people can find 5 minutes of quiet time, even if it’s driving to work with the radio and phone turned off.

Take a look at the article and see what works for you. Then make sure to find a few minutes every day to implement some of these tools. If you’re chronically stressed and/or running around all the time I think you’ll find it’ll make everything else start to feel a little easier to manage. http://psychcentral.com/lib/2013/relaxation-make-time-and-take-time-for-self-care/

EMPOWERING WAYS TO MANAGE ANXIETY WITHOUT MEDICATION

Posted on by

Drawing of a man trapped inside a bottleThis article on managing anxiety was recently forwarded to me, and I thought I’d pass it on to you.  Our world has become so complex, over stimulating, and overwhelming that people are increasingly experiencing really terrible anxiety symptoms. I realize medication is sometimes necessary to control feelings of overwhelming anxiety and panic.  These days, though, I think we turn to medications too quickly before we see about managing anxiety without it.

This is an excellent piece that gives you ideas on how to manage your anxiety without resorting to medication. It’s a long article, but it’s an easy read and you’ll notice it’s divided into cluster areas so that you can read through the techniques are relevant to you. In each section there’s a description of the problem cluster and the types of symptoms associated with it.  Then there are 3-4 simple techniques one can practice to alleviate the symptoms they are feeling.

Now there are a couple of tricks to all of this.  Most importantly, you have to practice the techniques.  And that’s where therapy can be helpful.  Most of the techniques are really simple, but motivating yourself and maintaining the discipline to keep going can require a little help.  A good therapist who understands anxiety management techniques is your best friend when you’re trying to manage anxiety without medication.  When you’re really feeling anxious, the sense of dread or panic can get so bad that you can’t remember to breathe, or stop your thoughts etc.

The other thing you will notice when reading the article is that most of the techniques are supported by or supportive of other anxiety management techniques that are discussed and learned in therapy. For example, method 4, in which one learns not to listen to the voice of worry, is dependent on knowledge of how to progressively relax the muscles and then call up the relaxed state when ignoring the voice of worry. A professional can teach you that better than you can teach yourself.

So I guess my final word on the article and these techniques is that they probably help you and definitely won’t harm you if you do them on your own, but if you have a chronic problem with anxiety you will be best served by finding a good therapist that works with anxiety and helps their clients to manage it by using these sorts of techniques.  Either way, you can very possibly avoid a dependency on anxiety reducing medications that don’t serve to really help you to resolve the underlying anxiety. http://www.alternet.org/print/10-best-ways-manage-your-anxiety

LONG TERM PSYCHOTHERAPY – SOMETIMES BEST, BUT NOT A SIMPLE ASSERTION

Posted on by

Find a Therapist in ChicagoI’m sure that I’ve indicated a bias in many of my posts that short-term psychotherapy is better and more effective than long-term therapy.  It’s true that in general it is my preference.  The preference is based, however, more on the tendency of therapists to keep clients in services for the long periods of time without focusing on problem resolution than it is on an across the board belief that short-term therapy is better.  So I thought for a change of pace I’d comment on an article that asserts that long-term psychotherapy is better than short-term.

Unfortunately, the title of the attached article, “Long-Term Psychotherapy Beats Short-Term” is more than a little misleading.  After its assertion that long-term therapy beats short term it goes on to clarify that long-term therapy has been shown in a study to be more effective at treating “complex mental disorders”. That, of course, is a huge distinction since a large percentage of therapy clients do not come in with complex mental disorders.  They come in with mild to moderate symptoms of depression or anxiety, relationship problems, and a range of other problems in living.  And for these clients long-term therapy does not “beat” short-term therapy.  Instead it either digresses from the presenting problem or keeps people in services after their concerns are resolved.

I will agree with the author that clients coming in with complex mental health problems often need to stay in treatment for much long periods of time.  Most notably, trauma survivors including survivors of sexual trauma, combat, and longer histories of domestic violence may need a lengthy course of therapy or repeated courses of therapy to significantly resolve the associated problems.  Now, as far as psychodynamic psychotherapy is concerned I think that those therapists that are truly skilled at providing it may have success with complex mental disorders but they can’t just focus on helping people understand themselves. They also need to go further and address immediate and serious problems in living such as emotional dysregulation, problems with relationships, and dissociative symptoms to name a few. The article is far too simplistic in its claims and doesn’t take into consideration the highly intricate issues that people with complex mental disorders face.

So, yes, long-term therapy is needed for most clients with highly complex issues. Is long-term psychodynamic psychotherapy the answer?  I highly doubt it.  In upcoming blogs I will address some of the other therapies that are effective with complex issues. http://www.webmd.com/mental-health/news/20080929/long-term-psychotherapy-beats-short-term

ANOTHER PERSPECTIVE ON THERAPY EFFECTIVENESS

Posted on by

Find a Therapist in ChicagoThe attached article is a good one for both therapists and therapy recipients to look at.  It addresses reasons why therapy might not be succeeding.  I like it because it looks at the interaction between the therapist and their client, rather than just looking at what it is about the client that keeps them from changing, or what’s wrong with the therapist

The article raises a number of questions that therapists ought to be asking themselves about the types of interventions they are using or if there are factors in the way they perceive the client that are getting in the way. Clarification and evaluation of goals is raised first and foremost.  I know I sound like a broken record, but if the client and therapist haven’t identified what goals the client is working on and aren’t checking on progress in meeting those goals it’s very unlikely that there will be progress.  The only one of these questions that I’m not comfortable with is question #5: “Are we being patient enough?”  I do agree with the author that it sometimes takes a long time before enough trust is built for the client to say what’s really going on.  I don’t agree, though, that the fact that the client has not fired the therapist means that everything is probably fine.  I’ve seen too many examples of clients staying in therapy without success because it feels safe or they become dependent on the regular sessions, and too many therapists that are comfortable with that dynamic.  If progress is not being made there really should be a dialogue between the client and therapist about what’s going on, and hopefully the therapist is strong enough to initiate that dialogue.

The article also addresses fears that the client comes in with that might prevent them from disclosing important information or that keeps them from succeeding in getting better.  These issues provide a nice inventory for any therapy recipient to review in order to determine if there are barriers their fear has created that impede their own success.  Sometimes just reading a list like this and recognizing oneself in it is enough to loosen up the fear and allow the client to take the next step forward.

It’s a pretty short article, so take a look and see if there’s anything you take away from it that can improve your success either as a therapist or as a client.      http://psychcentral.com/blog/archives/2011/03/16/10-reasons-why-someone-in-therapy-may-not-be-getting-better/

 

HOW TO KNOW WHEN IT’S TIME TO END THERAPY – PART 2

Posted on by

Man at the CrossroadsMy last entry addressed the question of how to decide to end therapy either when goals are being met or when there is a general lack of progress.  This second article on ending therapy looks at issues related to the process of therapy itself and the relationship between the therapist and client.

The first issue addressed is what to do when you are feeling uncomfortable, frustrated, or in emotional pain.  Does the discomfort mean therapy is working and the pain is part of getting better, or does it mean something is not right and you should quit?   This is an amazingly difficult issue for a lot of people, especially early on in therapy when they’re not sure if they’re in the right place. Therapy causes people to feel incredibly vulnerable, and when one is just starting out it’s common to feel like the therapist doesn’t understand them or doesn’t do good work. How do you know if that gut feeling is right, or if it’s just the intensified vulnerability telling you that counseling is scary?  There’s no easy answer to the question.  It’s the main reason that people are told to “shop around” for a therapist before making a commitment. If you shop around then you can go with the therapist that feels most comfortable. But while it’s important to feel comfortable with your therapist, being comfortable doesn’t mean that the therapist is going to help.  I always go back to goal setting, collaboration, and mutual evaluation of how things are going.  If you’ve got a therapist that you feel comfortable with and that does sets and evaluates goals collaboratively then you’re probably in a good place.  Then, when things get uncomfortable in the middle of therapy, as is discussed in the article, it’s easier to talk about what’s going on and whether the discomfort means that you’re getting into important work or that it’s time to take a break.

The second issue addressed is about ending therapy when the therapist is engaging in unethical behavior.  It may seem obvious that when the therapist is attempting a personal or sexual involvement it’s time to find a new therapist. It’s not always so black and white though. There’s a lot of debate about whether therapists should talk about their own personal issues in therapy.  A lot of people will tell you that personal disclosures should never happen, but I’m not so sure.  I think personal disclosures can normalize problems and solutions for the client, and should be used if they will be helpful.  Gift giving and meeting outside of session should be completely off the table, though, and any time that the therapist’s personal disclosures feel even a little questionable, or if you feel like they want you to counsel them, it’s time to say goodbye.

I recommend reading the article, as it gives other types of examples and suggestions about what to do when you’re unsure about the relationship or progress of therapy.  Bottom line if you’re unclear is go and talk to someone impartial.  Find another therapist, a friend, or a professional association and see what they think about it.  http://www.psychologytoday.com/blog/the-ethical-therapist/201106/two-more-good-reasons-end-psychotherapy

HOW TO KNOW WHEN IT’S TIME TO END THERAPY

Posted on by

Find a Therapist in ChicagoThe attached is the first of two articles on ending therapy.  Ending therapy is a topic I hear about all the time from friends, family, clients and other professionals and I’m pleased to have found articles on the subject.  This first article addresses ending therapy either because it’s been successful or because it’s not successful. The number one, most common concern I hear from people is that therapy is going on and on and they don’t know when it should stop.  The author here addresses the issue from the perspective meeting goals.  If goals are met it may be time to say goodbye.  If one has been in therapy for a while and progress is not being made in meeting goals it also might be time to say goodbye.  It always strikes me when I’m discussing this topic with people how many of them have never discussed goals with their therapist or do not review progress in meeting them. They may have had something specific on their mind when they started, but they didn’t set goals and the sessions have evolved into a running dialogue on anything and everything going on in the client’s life. There is no discussion of whether progress is being made, or when it might be time to end.

I am horrified by these stories every time I hear them. An astounding number of therapists have been trained that the best therapy is about the process and not about goals, and that setting goals interferes with the client’s ability to progress.  What, exactly, it is that these clients are progressing toward is beyond me.

Anyhow, my one big takeaway from this article is that clients should always make sure that they are clear on what their goals are, and are reviewing them with their therapists.  If a therapist doesn’t want to make goals with you or doesn’t want to discuss progress, and a lot of them don’t, then it’s probably time to find a new therapist.  If you have established, clear goals it will be easy to know when it’s time to quit.  Really, the therapist should raise the issue of ending therapy, but if they don’t the only real challenge will be in raising the subject without fear of offending the therapist.  A good therapist won’t be offended. http://www.psychologytoday.com/blog/the-ethical-therapist/201105/ending-therapy-two-good-reasons-fire-your-psychotherapist-and-how-

WHEN IS THE RIGHT TIME TO SEEK HELP FROM A COUNSELOR?

Posted on by

Find a Therapist in ChicagoThe article that is attached provides a nice framework for people trying to decide whether to seek help or not.  I don’t see much in the literature about when to take the leap and seek help, so it’s a nice addition. The decision to seek counseling or therapy is especially difficult because it’s a decision about whether to make oneself vulnerable to a stranger or not.  For this reason, as well as the high cost of therapy and the anxiety around not knowing what is going to happen when one gets there, a lot of people put it off and hope that their problems will resolve themselves.  And sometimes they do, but often they don’t.  Also, a lot of people have had bad experiences with therapy in the past and don’t think it’s going to be helpful for them to invest their time and money again.  So they wait until they feel like they’ve run out of options before making that leap of faith again.  I understand both of these factors very well.  It’s why I started Compatible Counseling Solutions in the first place.  I hate to see people make themselves vulnerable to someone that’s not going to help them, and I’ve seen it happen time and again.

If you are at the point where you’re wondering if now is the time, I urge you to read the attached article and see if any of the scenarios that are described fits you.  If you’re not sure of exactly what you need I hope you’ll consider contacting me. I can help you sort through whether, and what kind of counseling will be most helpful to you and I can help you find an effective therapist that meets your needs and maintains a focus on your goals without keeping you in services indefinitely. http://www.psychologytoday.com/blog/in-practice/201301/do-i-need-help

Integrating Coaching Techniques into Therapy Provides Enhanced Flexibility and Effectiveness

Posted on by

INTEGRATING COACHING TECHNIQUES INTO THERAPY PROVIDES ENHANCED FLEXIBILITY AND EFFECTIVENESS

Last week I commented on a New York Times article that bemoans the trend for therapists to brand themselves in order to increase business. The article specifically took issue with specialization, stating that specialization forces therapists into niches just for the purpose of marketing and it also took issue with coaching as an inferior service intended to give the client a “quick fix”, rather than lasting change.

As stated in my last entry, I strongly disagree with the author on both of these points. Since writing that post I have come across this article (see link below) on integrating coaching techniques into psychotherapy. It provides an alternative perspective to the one in last week’s article. This author recognizes that clients don’t always have the time to process the meaning of everything that is going on in their lives in order to gain insight and create transformative personal change.  Oftentimes the issues that clients present with are urgent, requiring immediate action that they may not know how to enact.  By being skilled in using coaching techniques I therapist seeing a client with urgent concerns can move from their usual reflective mode to one in which they are highly directive in helping the client make a plan to resolve the urgent situation.

I like this article, because it’s not purely about the benefits of coaching but because it speaks to therapists like the one who wrote the article I commented on last week, and helps them to see that it’s not an either-or proposition.  An effective therapist can use coaching techniques when appropriate and then move into deeper territory with clients who want to make broader changes in their lives.

As for me, I make sure that the therapists I work with represent a broad array of therapeutic orientations.  None of the therapists I work with are expert at everything.  Some are specifically long-term psychodynamic therapists, some are primarily solution-focused and use coaching techniques in their work, and some represent other orientations or are adept at moving across a couple of orientation like the author of this article.

http://www.psychotherapynetworker.org/magazine/recentissues/2012-novemberdecember/item/1834-the-coaching-edge

The Pros and Cons of Marketing Psychotherapy Services

Posted on by

The Pros and Cons of Marketing Psychotherapy Services

A friend sent me this New York Times article on the trend of therapists to specialize, market their services, and “brand” themselves.  I don’t enjoy marketing and my friend thought I’d be able to easily relate to the author’s concerns. Yet, when I read the article I did not find myself empathizing much at all with the author.  This author is correct that therapists have learned marketing techniques to lure clients to their practice, and that their websites and directories can be very misleading. She goes on, however, to scoff at therapist specialization as existing only to help therapists earn more money and look good on paper, and at clients’ wish for solutions as being an unrealistic search for “quick fixes” at the expense of internal change.  While I agree that psychodynamic therapies are best practice for some client concerns and that some clients are seeking personal transformation, I believe the majority of clients need something more immediate, and that is not bad.  A lot of clients who are looking for therapy are in pain that they need some relief from now.  Some clients I see are in danger of losing their jobs, or their life partners, or have some other concern that can’t wait for them to have a transformative experience.  Knowing a therapist’s specialties helps clients to know where they can go for the best possible help, and since many solution-focused therapists are also competent at longer term models, they can help the client move into deeper territory once things are on a more stable track if that’s what the client wants.  And the reason life coaching, which the author also scoffs at, is as popular as it is, is because clients who work with competent coaches actually get their needs met through this brief, empowering and action oriented service.

So I guess marketing is a double-edged sword.  There are numerous references in the article to marketing strategies, which sound duplicitous and sensationalized, and those who promise results, especially within a specific time frame, are asking for trouble. But giving clients a general idea of a time frame (which can be revised) and a plan to help them move to a better place in their lives is a reasonable expectation that many people who are seeking help have. http://www.nytimes.com/2012/11/25/magazine/psychotherapys-image-problem-pushes-some-therapists-to-become-brands.html

Identifying and Overcoming the Post-holiday Blues

Posted on by

IDENTIFYING AND OVERCOMING THE POST-HOLIDAY BLUES

Each year at this time I breathe a huge sigh of relief.  The holidays are finally over and life can go back to normal.  A lot of us dread the holidays.  For me it’s a time of immense obligations and stress when all of my focus goes toward making sure that everyone has something to smile about on Christmas and the weeks surrounding Christmas. It brings out all the grudgingly over-responsible patterns in me, so I’m happy when it ends and there’s more space in my life.

There’s another side to the post-holiday period, though.  There’s that feeling of too much quiet when we all stop and look at our calendar and realize that we have to go back to the same old stuff.  For those who enjoy the fast pace of the holidays, or forget their troubles for a few weeks while they’re busy partaking in holiday cheer this time period can really be a downer.

I like the attached article about post-holiday blues because it doesn’t just give you a list of things you can do to cheer up like exercising, adopting pets, or doing volunteer work, but it talks about what to expect during the period, normalizes it, and provides some helpful and more realistic suggestions to help pull you out of your rut.   It also reminds you that sometimes the blues people feel is more than just a post-holiday syndrome.  For a lot of people there is a persistent feeling of sadness, hopelessness and helplessness that may be diagnosable as depression. It’s always a good idea to seek professional help if you’re feeling like you might not be able to manage your sadness on your own.

For garden-variety post-holiday blues I strongly recommend doing something new and different – really anything that changes your routines and feels new can stimulate your senses and give you a new lease on life.  Going for walks outside, starting a new exercise routine that seems fun, rather than burdensome, taking a class or starting a new hobby can make all the difference in the world.

Here’s hoping everyone had a happy and enjoyable holiday season, and is ready to start a bright new year filled with the hope and promise of even better times ahead.

http://greenwich.patch.com/blog_posts/coping-with-post-holiday-blues-b61053ec.