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    7 months ago · · 0 comments · Sticky

    How to Find an Effective Therapist?

    What are the most common myths, and what qualities should you look for.

    Therapy helps millions of people around the world to cope and to improve the quality of their lives. But finding a good therapist can be tricky. Especially if a person is doing it for the first time.

    How can someone tell if the therapist they’ve approached will be effective and help them?

    Before describing the qualities of a good therapist, I want to mention few myths, which people still believe about psychologists, therapists, or counselors.

    1. Myth: “My therapist use only orthodox, scientifically approved techniques.” Many people think that if a particular psychological school or technique has been around for a long time, it is definitely effective. But psychotherapy is not an exact science like medicine or math, so when a therapist uses only “science techniques,” it doesn’t mean that they are effective.

    2. Myth: “My therapist is a published author. They’ve written many books on psychology or counseling”. Writing books and doing empirical research is essential, but just because someone is an abundant writer doesn’t mean that they can be an efficient therapist.

    3. Myth: “My therapist has a doctoral degree, so they should be good”. Of course, degrees and credentials are important, but many counselors and therapists don’t have them, yet they are highly effective. A flashy diploma on the wall is not the best way to select a good therapist.

    As I mentioned above, psychotherapy is not an exact science. It is an interpersonal process of building trust, developing client-counselor relationships, and providing a safe space to address very personal problems.

    So how to select an effective therapist?

    Simple!

    Look for some of the following qualities in your potential therapist: 

    • An effective therapist is a knowledgeable, caring, and empathetic person who understands that successful psychotherapy is first and foremost a kind and trusting relationship between client and therapist.
    • An effective therapist is sensitive to their client’s suffering. They listen to understand, show empathy and acceptance.
    • An effective therapist starts by focusing on the client’s personal and cultural needs to decide the best therapeutic approach.
    • An effective therapist is always client-centered. They continuously gather information and feedback from the client to determine if their approach meets the client’s needs. 
    • An effective therapist is culturally and socially aware of their client’s background. They know that there isn’t a “one fits all” solution and are always open to learning from their clients. They realize that the client’s own potential is the driving power behind a successful therapy.

    8 months ago · · 0 comments · Sticky

    How to overcome the “I am not good enough” syndrome?

    Self-limiting beliefs can hamper our lives in multiples ways. One of the most common I’ve encountered in my practice is the “I am not good enough.” Added to that, I have my own experience with it. For years, I was struggling, and I could not fully enjoy my achievements because I thought I wasn’t good enough. I was dismissing compliments, saying I “got lucky,” and doubt my choices. This situation put me in a constant hellish circle of work/ try harder, not good enough, anxiety, depression, and all over again. It took me years to get out of it, and here are a few tools that helped me, and they are helping my clients.

    1. Acknowledge your self-doubt.

    When you start feeling “I am not good enough,” don’t just ignore the feeling and bury it. Address it, “speak” kindly to yourself, and reject the unrealistic, negative thought.

    2. Acknowledge your strengths.

    Look at your accomplishments, write them down, and you will see that those weren’t just “lucky breaks.” You’ve worked hard to achieve them. Make a list of all of them and look at it every time you feel low.

    3. Find your passions and share them with others.

    We tend to downplay the levels of knowledge and experience we have acquired. Find a way to share your passions with others; when you do this, you will constantly remind of your accomplishments.

    4. Learn to accept compliments.

    People who struggle with “not good enough” limiting belief tend to shrug off a compliment. They tend to minimize their accomplishments. When someone acknowledges your good work, learn to say “thank you” and savor the feeling.  

    5. Give yourself permission to slack and fail.

    Struggling to be “good enough” can lead to burnout. Give yourself time just to play around, and don’t take yourself too seriously. Practice your hobbies; without an objective to achieve, enjoy the here and now moment.

    6. Seek professional help.

    If, despite your best efforts, you continue to suffer with “not good enough” syndrome, get professional help. A good therapist can help you overcome it because if left unchecked, feeling like this can lead to anxiety and depression.

    8 months ago · · 0 comments · Sticky

    Myths about anxiety

    Understanding anxiety can be tricky. There are many myths and misconceptions about how it presents itself and how people who suffer from anxiety behave.

    Myth #1

    You can always tell if someone is having an anxiety attack.

    This statement can’t be further from the truth. For people who have suffered and managed anxiety for years, expressive suppression has become the norm. They can look calm and composed on the outside, while their heart is racing, and they feel sick in their stomach. Even if an observer notices the visual symptoms of blushing and sweating, they may not be able to link it to the notion that the other person has an anxiety attack.  

    Myth # 2

    If someone is feeling anxious in a particular situation, they will feel anxious in a similar situation.

    A person’s behavior is not something that happens in a vacuum. There are lots of factors, which affect who somebody will react to a stressful situation. For example, being in a good mood and having a good night’s sleep improve one’s ability to face an anxiety-provoking situation or task.  

    Myth # 3

    If a person has an anxiety attack, you have to calm them down.

    It is upsetting seeing someone having an anxiety or panic attack. Especially if it is a friend or family member, however, the most common “Cool down, relax, all will be ok” response can backfire and make the situation worse:

    1. Because the anxious person may not actually hear them, the mind and body responses to anxiety can dim down our cognitive responses to reason.
    2. If they hear you, they may misinterpret your words as dismissing their suffering.
    3. Practically it is useless advice, as no one can simply relax on command, advice, or suggestion.  

    Myth # 4

    People who suffer from anxiety are fragile and weak.

    On the contrary – people with anxiety are some of the strongest people out there. They get-up day after day to face situations that scare and hurt them. Sometimes they consciously face tasks and situations, which trigger anxiety to learn to overcome them. They face their fears; they seek therapy and follow-through, so they can live the life they want.

    Myth # 5

    Suffering from anxiety is not a big deal.

    Let’s face it, everyone at one time or another had experience anxiety or irrational fear. And because everyone has felt it, they think they know what a person with an anxiety disorder is feeling. They don’t realize that the anxiety alters all enjoyable aspects of their life in a pretty bad way for such a person. They don’t realize the self-judgment, the feeling that you are afraid of fear itself. So, yes, anxiety IS a big deal! But is also treatable, and manageable with a proper therapy. If you or someone you know is suffering from anxiety, seek help and start living your life to the fullest.

    9 months ago · · 0 comments

    A counselor tips for dealing with the stress of uncertainty

    2020 will go in history books as the poster year of uncertainty. The whole world faced challenges, and we weren’t prepared for them. And while some people can deal with uncertainty better than others, in the end, no one can avoid the unexpected. Here are a few simple tips on how psychologists and therapists handle stress and anxiety caused by uncertainty.

    Avoid rethinking things you can’t control. Humans are cognitively wired to imagine and revisit the worst-case scenarios. But is the situation you are facing is not under your level of control, the only “benefit” you will get from reviewing it will be an additional stress.

    Control what you can. Keep your focus and energy on things you can control, even if it is a simple task like waking up on time or cooking a meal at home. Create a new routine. By bringing structure into daily tasks, your mind finds comfort by recognizing something stable and constant.

    Take your own advice. Look at yourself from a different perspective. If a friend was in your situation, how would you advise and comfort them? If they trust your wisdom, why can’t you use it on yourself? And this brings us to the next…

    Be kind to yourself. Remind yourself that the situation you are facing is something that you weren’t ready to address. It may take time to get resolved. By trial and error, we all learn by experience, and if you fail at first, don’t be too hard on yourself.

    Dedicate time for self-care. Higher levels of stress can cause physical health problems, like headaches, insomnia, and loss of appetite. Make a conscious effort to practice self-care by eating well, exercise, meditate, do yoga. Stress can cause loss of motivation, but keep in mind that sometimes motivation comes after the initial struggle.

    Limit your exposure to bad news. It can be a bit tricky, considering we are bombarded with information in every corner of our lives. However, dwelling on negative news doesn’t make us more informed, just more stressed out. Make the conscious decision to change the channel or close the browser tab.

    Reflect on past achievements. Self-motivation can be extremely helpful in difficult situations. And what’s better than recalling how you successfully handled challenging and stressful circumstances in the past? Give yourself credit that you survived and learned from your hardship.

    Learn new skills. Make an effort to learn something new. It can be anything – studying a new language, learning how to cook, or even getting a new degree. Acquiring new skills will improve your confidence and reduce stress levels.

    Ask for help and seek support from people you trust. Constant stress can cause waves of depression and self-isolation. Ensure you reach out to your social support systems like family and friends or look for the professional help from counselors and therapists. A professional can help you develop the best strategies for coping with stress.

    9 months ago · · 0 comments

    When Therapists Make Mistakes

    By Dr. K. Kolmes

    We don’t often talk about therapeutic blunders, although they happen all the time. There are so many ways for therapists to fail clients. There is probably the most common: a mismatch of styles, or a therapist who is not really helping her client. Then there are those moments when perhaps we fail our clients by not responding in the moment in the way the client might desire. Maybe we sometimes challenge when we should nurture. Or we nurture when we should challenge. Or we may do any number of subtle things, perhaps below the threshold of consciousness, not even fully acknowledged by our clients, but which create distance, disappointment, or detachment. Some examples of this are the stifling of yawns, spacing out for a moment, or failing to remember an important name or detail and the client feels we are not really fully present or engaged with them. This lack of connection may trigger feelings of disappointment, loss, or abandonment. For clients with relational traumas, events such as vacations, emergencies, or even adjustments in session times may also cause feelings of loss and abandonment.

    Recently, I was having one of those weeks. The details aren’t important, but I’ll acknowledge that I had taken on a few too many things. Top it off with having a few people needing to meet at different times. Add to that one way I manage client confidentiality: putting client names into my hard calendar (which I do not carry about with me) and then transcribing the sessions later to my iPhone calendar simply as “client,” to preserve confidentiality in the event that my phone is lost or stolen.

    The result?

    I mistakenly transposed a client session time from my hard calendar to an hour later in my phone. And, yes, I missed the client appointment. A client arrived at my office, waited in the waiting room, perhaps knocked on my door, wondering about my whereabouts, and I wasn’t there. The mistake was realized within the hour and I phoned her and we spoke.

    But still. I was confused and felt bad that it had happened.

    After eleven years of becoming accustomed to some clients not showing up, some clients canceling last minute…this was new. Never before had I been the one to miss the session.

    Therapy is about being present. Being witness to your client’s emotional life, and literally, being awake and engaged for fifty minutes at a time, taking in all that your client shares and responding based upon your knowledge of the history of this person. What then, do you do when you fail to be present in the most obvious of ways? By actually not showing up?

    This event brought me back to 1992:

    A year into therapy with my therapist, I show up at her office, which also happens to be her home. As I pull my car into her long gravel driveway, deep into the woods of Pittsboro, NC, I notice that her car isn’t there. Hmm.

    Maybe her car is being serviced?

    The front door of her home is unlocked, as usual and I open the door and let myself into her office and sit down on her couch to wait. Her orange tabby cat pokes his nose into the office and then rubs his body against the doorframe as he sways back into the recesses of the house.

    I wait for about ten minutes, but I think I knew she wasn’t there from the instant I’d arrived. Still, it slowly dawns on me that she’s not just running late…but she probably isn’t coming to our session at all. This is….different.

    I stand and walk into the hallway and hover there, weighing the threshold between her therapy office and the rest of her home..the edge where her work life ends and her real life begins. I look for the first time into her living room…forbidden territory which I’ve never had a real glimpse of before. I scan the room, taking in all I can from my vantage point in the doorway, looking at signs of her lived life: a blanket on the sofa, books and magazines on the table, pictures on the walls, a coffee cup on a side table. I call out her name. Nothing. Nobody home. I note the desire to walk further into her home and poke around. This seems such a unique opportunity to learn more about her, but the thought of being discovered wandering around her home is a strong deterrent. I slowly leave her house, get back into my car, and drive home.

    When I get home, I call and leave a message: “It’s Keely. I think you forgot our appointment today.” She calls back later that day to apologize and I joke on the phone,”Well, I was going to discuss my abandonment issues with you today, but you didn’t show up.” I appreciate how it feels completely okay for me to make this joke because she has been there for me, week after week, for over a year. It is clearly a joke, and her missed appointment this day is a clear aberration. I know she will laugh at my joke. And she does. And that feels good. I know she knows it’s not a big deal to me, and that she is forgiven.

    I can’t even remember if we spent any more time of it other than a brief acknowledgment at the beginning of the next session.

    Back to 2009:

    But here I am, 17 years later, a therapist myself, who is earlier into treatment with some clients who do not yet know or trust that I will be there for them. When we make mistakes as therapists, how do we convey both our regret, and the reassurance that this is not typical. And, more importantly, despite the fact that (hopefully) mistakes of this nature are atypical how do we position ourselves to be fully available for the range of our client’s feelings, whether they be rage, despair, sadness, or blame over the fact that we have let them down? Some clients may shrug off a mistake as no big deal, but for others it can be a very big deal. We cannot let our own desires for forgiveness and understanding get in the way of our first job to our clients which is to be present for their feelings.

    Many of our clients have long histories that involve being let down by others. When a therapist fails the client in any way, this often ripples on the theme of being let down by others. It can be important to show up and be present for the processing of how this affects our client. Patients can also use their own responses to therapist errors to explore past failures by others in their own lives. When a therapist hides or denies her mistake, she not only risks avoiding an opportunity to move the therapy forward, but also creates a second breach by showing she cannot be trusted to model appropriate responsibility or, even, the ability to enact human error.

    This brings me to my other point: the awareness that for some of my clients, a big piece of the work is about perfectionism and self-forgiveness. How do we allow ourselves, as therapists, to be both present for our clients, and, at the same time, models of real human beings who are imperfect? Is my self-flagellation a lesson I want to share with my client? Or would it better benefit her for me to be self-forgiving? Where does one find the balance, and how much of this can we convey to our client? How do we create appropriate space to talk about mistakes without spending too much time on them? Do we make it clear that the client can return to it, if we move on and she later finds it’s still nagging at her? Difficult questions and likely the right response depends upon each particular client.

    Another factor for consideration: my office policy explains that I charge my full fee if a client does not adhere to my 24-hour cancellation policy. I do not feel it bodes well for the therapeutic relationships if we convey the belief that we value our own time more highly than those of our clients. This can be an interesting conversation to have with a client. What would she think is fair in the event of a therapist missing the session? A free session? A half-fee session? An extra fifteen minutes at the end of one session? A free pass for a same-day cancellation in the future without the penalty of full-fee? What is appropriate for a therapist to offer and what veers again into the zone of being too repentant? This exchange can be a rich opportunity for exploration with clients who wish to engage in it. Again, this can also bring up deeper issues related to fairness and resolution connected to other issues in our client’s lives.

    In the end, an important lesson for me as a therapist was that sometimes unintended things happen. We may strive for consistency and perfection, but we are all imperfect. We hope that over time that our consistency and responsibility will become apparent to our clients. But one goal of therapy is to reach a safe attachment in which one can weather disappointments and unintentional blunders without either party (especially the client) having to experience the threat of losing the relationship. Mistakes do happen and sometimes it’s just as important for us as therapists to remember this as it is for our clients. And, as in all relationships ― not just the therapeutic ones ― it’s often not about whether mistakes occur, but how they are acknowledged and repaired that really counts.

    9 months ago · · 0 comments

    On the Difference Between Therapy and Giving Advice

    By Dr. K. Kolmes

    “But what should I do?”

    It doesn’t happen often, but once in awhile, I will meet with a client who asks me some variation of the above. The thing that is most challenging (to me) about clients who directly ask what they should do is that they are usually those who are experiencing the most pain and confusion. It makes sense that people who are struggling, hurting, or experiencing despair would want someone to tell them what to do to make it stop. And, often, I would like to help them make it stop too, so there is a strong pull to give an answer.

    But giving advice is not psychotherapy. Therapy is a place to explore your feelings and learn about yourself. It’s a place of self-discovery. It’s a place to find out how you have become tangled up and a place to learn how to untangle yourself. It’s a place to gain a better understanding of your inner world and your relationships. This process is what people come into therapy to learn. It’s what mental health professionals go to school to learn how to provide. Sometimes it takes time and reflection to see the patterns and it isn’t a quick fix, as much as both therapist and client sometimes wish it were. Sometimes just acknowledging and sitting with that pain, confusion, and wish for an immediate answer is the best thing we can do.

    This does not mean that I withhold information from clients when I think it might be helpful. If I notice a theme or have some concern that a client may not be acting in their best interest, I speak up. It also doesn’t mean that I am non-directive. There are times when I get very directive with clients. I integrate cognitive-behavioral interventions in my work and I tend to use them when people need symptomatic relief or when people are trying to break habits. At the most extreme that can happen when someone is in danger and I need to get them into the hospital or go over a safety plan with them. In these cases, we may make a list of people to call and things to do when they are feeling actively suicidal.

    Less extreme versions of my being directive may include encouraging a client to make an appointment with a psychiatrist. Or I may develop a plan for a client to do breathing or relaxation exercises when she or he is anxious or call a friend to go to the gym when depressed. With my couples, I often prescribe “homework,” which includes communication exercises or plans to notice positive aspects of one another or the relationship. In my dissertation support group, I will sometimes make suggestions to counteract procrastination.

    But these are specific treatment approaches to specific problems and not the same thing as telling a client what to do with major life decisions. If you want a therapist to tell you what to do, as opposed to helping you figure out what is right for you, it could be worth thinking twice about what you’re seeking. Some people want others to tell them what to do because it means not having to take responsibility if things don’t work out. Friends and counselors can give you advice. But if what you are looking for is just someone to give advice or tell you the things that have worked for them, it may not be psychotherapy that you’re looking for. Conversely, if you are going to therapy and you find that your therapist fills the time with advice, suggestions, or anecdotes about their life, it could indicate that they have some discomfort with allowing the therapeutic process to unfold. Be aware that you can find someone else who creates the space for your process of becoming conscious and finding the answers that are right for you.