Let's talk about it...
Let's Talk About It...
Some clients have strong preferences, but other factors matter more than gender in creating a good therapeutic alliance.
"So what do you think?" , "Megan" asked toward the end of her first appointment with me. I gave her a brief summary of my assessment and told her she met the criteria for a diagnosis of major depressive disorder. I said she would probably get a lot out of treatment and mention some things we could work on together. She still seem to be holding her breath, as if waiting for the punchline. “I guess…” she began, then stopped. “Well I guess what I really want to know is…. Do you think I'm crazy?", she asked. Deep down Megan feared that she was broken in a fundamental way. Many people who start therapy (and many who are afraid) share this apprehension- that when a trained professional looks deep into their psyche they'll discover an essential deficit. For Megan it was the fear of being “less than” or an imposter, and that even psychotherapy couldn't fix her. What Coming to Therapy Means Most people start therapy when they're struggling, often through the hardest time of their life. For this reason, it can feel like a defeat, especially in a society that continues to “other” those with mental health challenges. But the truth is that deciding to start therapy is a sign of your whole-ness. No matter how hard a time you're having, or how hopeless you may feel, a part of you is determined to find the support you need. Seeking therapy signals your acceptance that all is not well, and acceptance is the foundation for change. Most therapists will recognize the vulnerability behind a question like Megans', they'll probably let you know that the struggles you're having are common. Therapists generally understand that having mental health challenges means you're human, not crazy. Indeed, countless therapists, myself included have had their own battle with the psychiatric condition. I reassured Megan that I didn't think in terms of “crazy”, and that in fact, my impression of her was the opposite of what she feared. “Coming to therapy is a sign of what is right with you, not what's wrong”, I told her. “We all need help from others, especially when we're hurting”. A part of Megan recognized that she needed help and was willing to overcome societal stigma and her hesitation to get it. That willingness was a sign that she was already on her way to finding relief. What You Discover in Therapy Here's what you're likely to find out when you start therapy. First, you'll find validation for thoughts and feelings that you may have struggle to understand. Your therapist will help contextualize your experience; Of course you sometimes assume people are talking about you behind your back if your mom constantly criticized you. Of course you have a hard time feeling secure in your relationship so in the past partner betrayed you. You'll probably discover that your fears and struggles makes sense, on account of what you've lived through. Maybe you've survived major trauma and have a hard time feeling safe. Perhaps you've experienced a sudden death, and you're often anxious about the health of your loved ones. Instead of beating yourself up for reacting in ways you don't understand, you can develop a compassion for yourself and what you've been through. You may also find out that you have more strength than you knew, the same strength that has sustained you this far and that drew you to therapy. While it may seem paradoxical, you'll come to see how fundamentally sane you are. Many of the people I work with start to see the truth that what they call crazy is the radically sane part of themselves that refuses to go along with the insanity around them. For example, you might have been labeled the problem child in your family because you were the only one who refused to sweep long-standing issues under the rug, and you couldn't help but shine a light on the things that everyone else chose to ignore. It's a sign of health to know when things in your life aren't working, just as it's a good sign when your body warns you by reacting to pain. And finally, you may begin to accept that the patterns giving you trouble with relating to others, thought processes, and emotional responses--developed when you desperately needed a way to survive. Maybe you learned to never get your hopes up, for instance, because they were so often dashed when you were a kid; now that you're grown up, it's still hard to trust that things will work out. Although these ways of coping might not work so well anymore, they got you through a perilous past. The same wise part of you that formed these defenses may begin to let you know that it's time to try something new. Even if you feel broken, starting therapy shows that the seeds of new life are already within you. The healing process begins well before you set foot in a therapist’s office. When Megan realized that her value as a human being was not on the line, she gradually became less guarded in our sessions. Her honesty with herself and with me helped her to make remarkable progress in therapy. Megan was willing to take a close look at herself and at the habitual behaviors that had hurt her relationships with key people in her life. With hard work, she was able to develop greater self compassion even for the part of herself that was struggling. By the time we parted ways she reported very few symptoms of depression and was optimistic that she could eventually find the love that she craved. Seth J.Gillihan, Ph.D. is a licensed psychologist and the author of several books, including Mindful Cognitive Behavioral Therapy
Unique among all the positive emotions, hope require some degree of dissonance, difficulty, negativity, or uncertainty to be ignited. If there isn't some thing awry, we don't call upon hope. In studying this field, a pattern emerges. People high in hope have sustainably better physical and mental well-being. They also tend to live longer and happier lives. High-hope people see, and respond to, the world differently, and they use their thoughts to focus on what they can control. Our level of hope can have a big impact on our lives. High-hope people have passion and zest that fuels their energy. This passion is viable and dynamic because there is a degree of persistence and follow through that accompanies it. They are optimistic about their future and believe in possibilities. They see challenges as opportunities to grow and learn, rather than as obstacles. This is key to the success of many High-hope people. They not only bounce back from setbacks they seem to bounce forward and keep going despite the challenges. They believe possibilities can open up when they put in the work. Here's a tip sheet to get you into the habit of hope. Set and Achieve Goals Goal setting is only as important as the action you take toward achieving your goals, and people high in hope do both. They know that without a clear goal, it's easy to get distracted and lose focus. They don't let life happen to them; they proactively make decisions and take action to move forward in their lives. Whether it's a big dream or a small goal, the hopeful typically have something they're working toward. They usually visualize their goals and create conditions that set them up for success. One way that gets done is through micro goals, which are brief and reasonable to accomplish. Getting three emails out in the next 15 minutes or preparing lunch in the next 20 minutes are simple examples. Setting goals and taking action can create an upward spiral of engagement and accomplishment. Stick With Positive People Being around positive people is one way to keep an optimistic mindset. This doesn't mean being intolerant of another person's difficulties, negativity, or struggles, but it does mean that hopeful people tend to spend more time associating with those who share a bright and proactive attitude. People high in hope don't block themselves from naysayers or folks who have a more pessimistic viewpoint. They maintain a healthy balance but don't get overwhelmed by the negativity around them. They know that seeing different perspectives allows them to cultivate life realistically. Well they take in multiple, sometimes difficult, perspectives, they remain compassionate. Focus on the Present People high in hope tend to focus on what's in front of them. They don't dwell on the past or worry about the future, though they do set goals for themselves. They stay focused on what's happening right now. This allows them to stay positive and take action. Additionally, hopeful people are always learning. They're constantly trying to improve themselves and their skill set; this encourages contentment and openness to growth. Hopeful people are grateful for what they have; gratitude keeps them appreciative and grounded in the moment. They recognize that even though they may not have everything they want, they're still lucky to have so much good in life. Be Self-reflective and Confident While believing in oneself is important, highly hopeful people are able to forgive themselves as well. This is a unique combination because this type of confidence allows a person to be imperfect. In addition, they are willing to take reasonable risks to support their growth. Hopeful people know that failure is inevitable and that it's important to learn from those experiences, moving forward with positive momentum. This capacity for self reflection is valuable. Learning from mistakes means viewing failure as an opportunity rather than as a measure of self-worth. Keep a Positive Outlook You've heard this one before, and that's because it's true: when it comes to High-hope people, no matter what life throws at them, they endeavor to see the silver lining. They don't let the circumstance define their emotional response. In addition to having a positive outlook, high-hope people are also creative problem solver's. When faced with a challenge, they don't give up easily. Instead, they formulate solutions that help them overcoming the obstacles in their way. In chicken and egg fashion, positivity helps creativity, and being creative feeds positivity. They invest their energy in the future and hunt for the good. Dan J. Tomasulo, PhD , is the academic Director at the Spirituality Mind-Body Institute at Columbia University and teaches at the University of Pennsylvania.
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