What To Tell Your Therapist

Photo by Meraki Creative Co on Unsplash

Photo by Meraki Creative Co on Unsplash

“How do I tell him/her?”

If you have ever been to therapy before, there is a possibility that the question above popped into your head at some point. If you have never been to therapy before, but are considering it or have been thinking about it, this blog post will explain the importance of addressing difficult conversations with your therapist or future therapist.

Handling expectations and finances

Just like many other things, therapy is an investment of time and money. Many people erroneously think that that their lifelong struggles can be over in just two therapy sessions. This is just not realistic for several reasons. The first one is that your therapist doesn’t know you. Maybe you talked to him or her on the phone before your first session, but he or she will have to continue to assess many variables (especially in the first few sessions) in order to get to know you. 

The second reason is that you have probably been engaging in some sort of pattern or behavior for quite some time (think dynamic with your partner for instance). Maybe you both decide to seek couples therapy because you have felt disconnected for a while or have been fighting intensely for months. One or two sessions will probably not change the way you have been relating to each other these past months. Therapy is a process and for that reason, you need to feel comfortable with whatever fee you and your therapist agreed on. Some therapists will work with you based on a fee that you can afford, while other therapists have a set fee, so it will be up to you whether or not you want to work with that therapist. Nevertheless, it is very important that you speak up if the fee is inconvenient for you. Therapists will either work with you or talk about other options (e.g. referrals).

“My therapist did not understand what I was trying to say.”

Do NOT stay quiet about this. If you feel like your therapist did not get you, let him or her know. As therapists, we are trying to figure out what is going on in your life. The reality is that we can be spot on, but we could also get it wrong. It is extremely important that you let us know if that is the case, so that we have a clearer picture of what your experience is like. You can simply say something like: “I don’t think that is what I meant, what I meant is….” or “Actually no, it is more like this…” Please correct us! I cannot emphasize this enough. Don’t think that you will hurt our feelings or disrespect us by correcting us.

“My therapist said something that triggered me.”

No therapist is a divine, perfect, human being. This could happen, either early in therapy or maybe a few months later. If something that your therapist said triggered you and made you feel uncomfortable, sad, frustrated, annoyed, disappointed—whatever it is—tell him/her. If you really like and trust your therapist, explaining what happened inside of you as he/she said X, can be very powerful. I encourage you to try it before dropping therapy and leaving. It is normal that close relationships experience some sort of rupture, but repair can be possible and practicing it can turn out to be good experience. Ruptures are opportunities to strengthen a relationship. Also, examining what triggered you is part of the therapeutic process, and there is a lot that both the therapist and client can learn from that.

“I am ready to finish therapy, but I don’t know how to say it.”

Sometimes, your therapist might be the one bringing up the idea of termination; other times you might be the one thinking about it. If you had already made a decision or are contemplating it, tell your therapist. Your decision could be based on finances or on simply feeling like you are ready to move forward on your own. Whatever the reason is, it is always a good idea for both you and your therapist to be on the same page, and to have at least one “termination” session. Usually, this is where you both can talk about what you learned from the process, form each other, what shifted or changed, and things to keep in mind for the future.

Trust your gut, and if you ever want to say something but are too shy or afraid to say it, take a deep breath and try to express it. Therapists will not criticize you for opening up about your internal experience.

To schedule an appointment with Stephanie Paez, LMFT-Associate, contact stephanie@thepracticeatx.com or call (512) 910-4052.

The Practice ATX

512-861-4131

When Anxiety Becomes too Much.

Image by Ryan on  Flickr

Image by Ryan on Flickr

I don’t know anybody who hasn't faced anxiety.

Odds are you have suffered from anxiety, someone in your family has anxiety, and your friends struggle with it as well.  The truth is we all feel anxious during the day and at different times in our lives.  Sometimes it is manageable, sometimes we need help.

On any given day, most of us travel through a wide range of feelings associated with four primary feelings: anxiety, sadness, anger and happiness.  Anxiety tends to rear its head when you are going through major changes, such as moving or changing jobs, or when experiencing ongoing challenges, such as financial worries or family conflict.  Sometimes you are not aware why anxiety has arrived, but there it is.

You may notice anxiety when it comes and be able to move through it.  However, for many, anxiety is not a passing state.  It can be frequent, unrelenting, and take a toll on your life.  It can rob you of your ability to spend time with your family, perform at work, and generally engage in your life.  And everyone says the same thing.  Anxiety—It’s exhausting!  Agreed.

People often ask if they need professional help for their anxiety. There is no official marker for anxiety, no blood test we can take that tells us if our anxiety has become too much.  Odds are if you are asking the question, anxiety has taken its toll, and you could benefit from seeking help.

What does anxiety feel like?

Anxiety, in its most simple form, is a sense of fear that puts your mind and your body on alert.  Biologically, anxiety is a heightened sense of awareness so that we can identify potential threats and take care of them. This fight or flight response can ideally be engaged and disengaged as needed to deal with threats.

So, what’s the problem?  When anxiety is part of your everyday life your body simply does not turn off your fight or flight response.  Living in a constant state of anxiety can cause dire physical and emotional effects.  Long story short, anxiety is systemic: it’s in your brain and your body.

Many people who have anxiety will at some point face depression.  Both anxiety and depression are thought to stem from the fight or flight response.  This may help explain why so often people feel symptoms of both.  It’s also why the same tools that help with anxiety also help with depression.

How do I know if I have anxiety?

The National Institute for Mental Health (NIMH) reports that over 40 million people in the United State over the age of 18 suffer from diagnosed anxiety.  Bear in mind this is data for those who have been diagnosed.  What does this mean?  Millions of people suffering from anxiety go undiagnosed, which means they are not getting the support they so need.  It’s time to address anxiety—to move past shame and into the light where help is waiting.

If you have any of the following symptoms fairly regularly, you may want to consider that anxiety is on the scene:

·      Excessive worry

·      Sleep problems

·      Muscle pain  

·      Indigestion

·      Self-consciousness

·      Self-doubt

Understanding anxiety and the toll it is taking is the first step to getting help.  Rest assured: anxiety is real and you are not alone.

What helps anxiety?

Good news. You have lots of options.  There are things you can do for yourself to help with anxiety.

1. You can overcome fear, but you have to develop skills to manage anxiety.  The best thing about developing these skill is that once you identify some things that help you, you can pull them out of your tool box whenever anxiety resurfaces. Skill building happens through tools and resources. Very few people know how to deal with anxiety naturally. It's something we all experience and most of us need help along the way. So reach out to resources that can educate you or help you talk through what it's like.

2. Be gentle with yourself.  The less gracious and kind you are with yourself, the worse your anxiety will be.  What would you say to a loved one suffering from anxiety? Kristin Neff's work on self-compassion can be a tool to help you learn how to be gentle with yourself.

3. Get busy.  Have you ever noticed that when you engage in activities that require your focus, anxiety decreases?  Be strategic. This could mean taking a run, playing a game of cards, going to the movies.  Whatever works for you.

4. Talk with a therapist.  Research shows that talking with a therapist can lead to remarkable benefits when facing anxiety.  Some report immediate relief knowing they have reached out for help and started to face their anxiety.  A therapist can help you understand your anxiety and help you troubleshoot it. The best results happen when you combine therapy with medical intervention, if necessary. So don't be afraid to reach out to a psychiatrist, a nurse practitioner or holistic medical specialist of your choice.

5. Learn. Then learn some more.  Austin is full of opportunities to help you manage your anxiety.   For example, NAMI provides information, education, and support groups that can help. 

6. Tell your people.  If you’ve been enduring anxiety quietly, consider telling those closest to you.  Odds are they will be supportive.  Maybe you don’t want them to troubleshoot for you?  Let them know that the best way to support you is by being with you and lending an ear.  Who knows, sharing your story of anxiety may free others to share theirs? You could be their light.

Practice self-care.  Practice managing your anxiety.  It's a journey that never ends and you're not alone in it.

To schedule an appointment with Robyn Strelitz, LMFT, call 512-434-0868.

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The Practice ATX

512-861-4131