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

How to Live with Loss.

Pixabay/CC0

Pixabay/CC0

I recently experienced a loss that was hard to shake. Because I felt it, I had to go through the typical steps that, because I’m a therapist, I know to go through. But it still hurt. I’m supposed to know how this goes. I’m supposed to have it all together, but that’s not the way life works. Regardless of what your loss is – person, place or thing – the way we experience loss can be powerful and it’s important you know how to handle it.

For this reason, I thought I'd share some of the important lessons I've learned in coping with the grief that loss creates.

Acknowledge what was lost and what it meant to lose it.

I lost a job. It sounds silly (even to me), maybe even ridiculous that I’m choosing to talk about a job loss rather than what some might have expected – the passing of a loved one or the ending of a relationship – but to me this job had a greater significance than just a place I went to punch a clock (if people even do that anymore). This job afforded me close and personal friendships, daily experience into a field of psychology I now love working in, financial stability for my wife and I’s future plans and a sense of pride – because dammit I was great at my job. So, naturally when I was informed that I was being let go I was a bit shocked (and sad, angry, anxious, scared, excited, discouraged, distressed, embarrassed, and about fifty other emotions).

I didn’t know what to do. I’m a therapist, yes, but I’m also human and in that moment my training and education went out the window and suddenly all I saw was my insecurities and fears – I was a failure, I was weak, and I was letting the ones I love down. Not a particularly fun ocean of thought to play in, especially if you stay in it for too long it can start to feel like you’re drowning.

Open yourself to others and allow yourself to feel/grieve

After the initial shock of loss there is a tendency to do one of two things: sit in the middle of the metaphorical ocean slowly drowning form an overwhelming number of emotions and thoughts left in its wake or bury those emotions deep down and tell yourself to get on with your life. I tried the former, attempting to disconnect from my emotions through the guise of logic, thinking my focus needed to be on finding a replacement for the things I lost. I made it my mission to occupy my time with meet-ups, interviews and/or anything that would keep me busy (aka distracted). I knew better but again, I’m human. It wasn’t until my wife made a comment – about how well I was handling the job loss – and then asked how I was really feeling that I realized what I was doing. Of course, after a meeting with a few friends… therapist friends… the following day doubly confirmed that I needed to do what I do for my clients; take a few days/weeks to work through all the emotions I had neglected and reach out to others when I needed support or started to feel overwhelmed.

Living with loss is simple, but very difficult.

Acknowledge it, feel it and talk about it. That’s it. I don’t intend for that to sound easy, because I know it’s not. To use the ocean metaphor again, loss comes in waves and just as I described before; at first it can feel like you’re drowning but, as you begin to open up and talk about your loss those waves will hit you less hard and less frequent. The last thing I want to leave you with is something that absolutely needs to be said.

There is no timeline to understanding, acknowledging and living with loss. There is no manual, book or person that says you need to be at that shoreline by a certain date or time. As I’ve already said, loss can be a powerful influence on your life and it’s important that you take the time you need and reach out to the people you trust to successfully work through it.

To schedule an appointment with Kendall Campbell, LMFT-Associate, call 512-920-3654.

The Practice ATX

512-861-4131

Six Boundaries that Can Change Your Life

Snapwire/CC0

Snapwire/CC0

Why are boundaries important?

Last month, my colleague, Caroline, shared with you the purpose and benefits of saying “no” and it’s absolute importance when setting healthy boundaries in her blog post, "When Saying No is Actually Saying Yes." She helped us recognize and acknowledge our feelings around setting effective boundaries and in the process sparked additional intrigue for me…how do we know what healthy boundaries are and how do we know how they’ve been crossed?

To help us build this emotional intelligence and self-awareness, it’s helpful to explore the moments that you are feeling that distress to discover what boundary violations are occurring. Understanding these six types of boundaries will help us establish healthier boundaries with others and cultivate a healthier sense of self overall.

What kinds of boundaries are there?

1. Physical

These boundaries include personal space and physical touch. Has anyone ever rummaged through your purse without asking or hugged you after just meeting them? Do either of these examples make you squirm? That reactivity is your body telling you a physical boundary, whether it’s your personal body space or your personal environment, has been violated. You’re likely to welcome a hug from a long-time friend over a stranger on the street, just as you are likely to be more comfortable allowing your daughter to grab your phone out of your purse than you might be with a passerby in the store. Healthy physical boundaries include an awareness of what’s appropriate in varying settings and relationships.

2. Emotional

These boundaries refer to our feelings, including our expressiveness of them. These can be violated when we are criticized or invalidated. Has anyone ever said to you “there’s no reason to be upset” or “you’re making a big deal out of nothing.” Even if they’re trying to console you, this can feel damaging and leave us feeling unheard and dismissed. You’re likely to be more vulnerable and confide in a friend who has been through multiple life transitions with you compared to a blind date that you’re meeting for the first time. Healthy emotional boundaries include personal limitations we set for sharing personal information, which includes when this information is shared and with whom.

3. Intellectual

These boundaries are slightly less obvious, yet likely happen more often than we think. Intellectual boundaries refer to our thoughts and ideas and are often violated when someone dismisses or belittles them. Have you ever had an idea you were excited about that was quickly shut down by someone you shared it with, leaving you feeling like you wanted to hide in a hole for weeks afterwards? Or maybe you’ve shared some insight on a political topic (who hasn’t these days) and been berated about it from an opposing party? It happens all the time. Healthy intellectual boundaries will include respectfulness and a willingness to understand not only one’s own ideas and values but others as well, even if they are opposing of our own.

4. Sexual

These boundaries compile the physical, emotional and intellectual aspects of sexuality. What does this mean? Essentially any unwanted sexual touch, ogling from others, sexual comments, or pressure to engage in sexual acts can qualify as a destruction of a sexual boundary. Curious about what the #MeToo movement represents? This is it folks – violated sexual boundaries. Healthy sexual boundaries will include consent, mutual agreement, respect and understanding of limits and desires that have been discussed between intimate or sexual partners.

5. Material

These boundaries refer to personal possessions. Does someone you know always ask to borrow money but never pay you back? Or maybe you lent your friend an iPad and they returned it broken? When someone pressures you to give or lend them your possessions or steals, damages or destroys your possessions, the boundary has likely been violated. Healthy material boundaries include limitations on what you choose to share and with whom.

6. Time

These boundaries reference how we use our time. These boundaries are a bit trickier to notice but are very apparent all the same. They are often violated when someone demands too much of another’s time. Do you find yourself always setting aside your own plans because a friend constantly wants to hang out instead? Or maybe your partner gives you grief for trying to take time for yourself or hang out with friends? Healthy time boundaries can be implemented by setting aside time for the various facets of our lives including work, hobbies and relationships in consideration of your values and priorities.

How to establish boundaries

These boundaries can seem tedious when we reflect on just how many variables cultivate our initial reactivity. But there’s a notable difference to negotiate. The dynamic of the environment or relationship for each is important for us to note in order to help us set clearer healthier boundaries overall. But how do we do this?

You know your body better than anyone else and if you are experiencing distress, it’s likely that a boundary is being crossed. Your boundaries are unique to you and they’re going to likely look different than others around you based on your comfort level with varying relationships, environments and culture.

Listen to what your body is telling you, be curious about the situation that’s evoking the overwhelm and as Caroline reminds us, “check-in if you’re emotionally exhausted or over-committed…slow down and re-asses.” Tune into your feelings, practice assertively addressing your limits, and take care of yourself along the way. This awareness will go a long way with helping you implement healthy boundaries for a happier and healthier sense of self.

To schedule an appointment with Alyssa Cornett, MA, LMFT-Associate, call 737-226-3803.

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How Does Mental Illness Start?

Image by Kristin Schmit on Flickr

Image by Kristin Schmit on Flickr

Is mental illness just in our head?

Researchers have been trying to answer this question for hundreds of years. We never even considered that the brain could be unhealthy just like every other major organ in our body until, in the early 1800s, we stopped blaming people's strange behavior on ghouls and goblins.

Once we realized that mental illness was a common experience, psychiatry found a good explanation for where it came from: the brain. It wasn't working like we wanted it to. This was the popular belief about mental illness (and still is) until relationship experts and family therapists started to challenge the idea that mental illness came only from the mind.

What about our relationships?

Is mental illness because of how we were raised?

Sociologists and relationship researchers noticed patterns of behaviors in people's families and social environments that caused people's unwanted behaviors. Conditions like poverty or abuse make mental illness more likely. Lack of quality friendships creates loneliness and isolation, which are symptoms of depression.

So, many health experts started to include social and family environments as causes of mental illness. But that still leaves us with an unclear picture of the origins of mental illness.

Where does mental illness actually come from?

Like most things, experts believe the answer is somewhere in the middle. We could be at risk for certain mental illnesses because of our genetics. Alcoholism, for example, unquestionably runs in families. But researchers don't know if this is because of learned behaviors or because of a genetic risk for alcoholism. Either way, prevention is super important because, if you have a genetic risk to abuse alcohol, there's nothing you can do about it anymore than you can change your eye color.

Except of course, to be careful with alcohol.

So no matter where mental illness begins, we should be thinking about mental health and wellness. When doctors ask us to get screened early for health risks like breast cancer or heart disease, it's not because knowing that risk will change our DNA, it's because knowing ourselves will help us create a path to better self-care and prevention.

So if you really want to know where your risk for mental illness begins, you can get genetic testing done, or maybe do a family tree. But what it really comes down to is this:

Are you taking care of yourself?

Mental illness is just like any other health challenge. You can prevent some of the major symptoms by moving your body the way it was intended, by hanging out with your friends and family (even when you don't feel like it), and by staying in the produce section of your local grocery store.

But, you can't prevent all symptoms of mental illness. That's why things like counseling and group therapy exist. Besides, mental illness is just a term we use to describe having less than our optimal mental health. 

So there's no reason to be embarrassed, ashamed or silent about mental health. We've all felt unwell. Taking action to prevent illness or intervening when you need more help is the key to all health.

Why should your mental health be any different?

-Posted by Dr. Mathis Kennington, LMFT-S

The Practice ATX

512-861-4131