I Need a Therapist, But Who?

How do you find and choose a therapist? You do not have to go to any random person that somehow is assigned to you. You have the right to seek out a therapist that interacts well with you and has an approach which fits your needs.

Trusty referral sources who can give you a good lead include:
your general practice physician who may suggest that therapy could be beneficial to you, or
friends or family who may have worked with a therapist they liked and recommend that person to you.

You might also see advertising, blogs, social media, or web sites of a therapist which give you an opportunity to learn about the person.

If you have not been referred to someone in particular, a good place to start is with your insurance company. 

1.  Make sure you have a mental health counseling benefit and find out how much insurance will cover and what your co-pay will be. This might be most easily done by calling the customer service number on the insurance card. 

2.  Look through the counselors that are contracted to be in network with your insurance. You should be able to use the insurance web site’s search feature for a professional. Or, if you are on the phone with customer service, they might run the search and e-mail it to you. 

3.  Look at the convenience of each counselor’s business location to your home and work routes. This may seem superficial, but people are more likely to continue with counseling on a regular basis when payment is assisted by insurance and it is easy and convenient to get to the counselor in your busy life.

Choose a few therapists to call. By the way, the terms therapist and counselor are interchangeable, meaning the same thing, usually a licensed professional with a masters level degree. Other designations you will find include psychologist with a PhD or psychiatrist which is a medical doctor in psychology who specializes in prescribing medication.

Think of your search for the right therapist as an interview process. Essentially, therapy should be a team effort with you and the therapist working together. You want to find a therapist whose experience, approach, and presentation fit with you. 

There are many types of therapy methods. An effective type is cognitive-behavioral therapy (CBT) which focuses on the present issues and helps you improve by addressing thinking patterns and practicing actions to change habits. This therapy and a more recently developed version, Dialectical Behavioral Therapy (DBT), are proven treatments for many issues.

Other therapies may include art or music therapy, experiential or Gestalt therapy, trauma focused therapy, systems approach, interpersonal or therapies which access the unconscious. It is important that the type of therapy is an approach which appeals to you. Also, actually enjoying talking with the therapist is immensely helpful.

Call each of the therapists you have selected and ask a few questions such as if they work with issues like you are experiencing and what type of treatment approach they use. You might be speaking first to a receptionist. See if you can speak either by phone or in person with the therapist to see if this is someone with whom you want to work. Some will be willing to have a brief conversation free of charge to establish if you want to enter into therapy with each other.

Here are some questions you could ask:

What license do you hold with this state and what is your education? How long have you been practicing?

I have these difficult issues occurring in my life and I have these symptoms. Do you work with clients with issues like mine? What types of clients do you work with: children, adults, families, couples? What type of therapy do you use and is it helpful for my issues?

How soon could you get me in for an intake session? Do you have availability for a weekly session, more or less frequent?

What insurance do you take? Are you contracted with my insurance company? Do you bill the insurance? Do you ask that the co-pay be paid by me at each session, or do you bill me for my co-pay after insurance has paid? (If you don’t have insurance which covers that therapist, ask if they have a sliding scale fee and how fees are determined.) Are you willing to establish a payment plan?

After speaking to a few therapists and asking the above questions, determine the one with whom you would like to officially begin therapy. Call back and schedule an intake appointment. This will include a diagnostic interview. The first session is longer than the subsequent regular sessions.

Therapists will typically discuss such topics as confidentiality, nature of the therapeutic relationship, treatment goals, and how you may take a break from or end treatment.

Find a therapist that you will experience as supportive and trustworthy. They should be able to give you honest feedback, recommend skills for you to learn and practice, challenge your thinking, and guide you in growth towards your goals.

Breakdown of Reason

I have been becoming more and more distressed by positions presented in the news, on talk shows, supported by various public figures, and rights groups. I, of course, have my own opinions and would like others to agree with me. But what is truly bothering me is the profound lack of discourse based on careful gathering of information and examining the pros and cons of different courses of action. 

I see people everywhere taking up positions, often based on feelings and basic schema, and then shouting others down and rejecting those with different views while labeling them. From my education over the years, I have been encouraged to think to solve problems. I have learned effective and ineffective approaches to thinking. There is the scientific method, there are the rules of logic, and there is the gathering of supported facts, and the use and misuse of statistics. 

Speaking of statistics, everyone needs to know that correlation does not prove causation. The finding or observation that two things tend to appear together does not prove that one causes the other. There could be another factor exhibiting its influence on the first two. Often, we are not aware of or have trouble identifying the true influence. In addition, my education on the mind and human nature makes me well aware of the mistakes in thinking and the misperceptions on which we all develop our belief systems.

Though I am confident in my intellect, I am also humble enough to know that I don’t have all of the information. That is why we form research groups, create special committees on specific topics, and employ fact checkers. But even at that, we must take caution that the individuals or groups presenting their findings could be influenced by their own biases, their desire for a certain outcome.

I and other citizens of the enlightened civilization are becoming more and more disenchanted by the systems we believed in to perform the gathering of information and the developing of reasoned approaches. The American government, we were all taught, has a system of checks and balances which is very effective. The free press, unencumbered and protected by law, is there to expose the lies and ensure that the citizens have accurate information on which to form their own opinions. The citizens expect to have the right to true and accurate information, to not be kept in the dark, ignorant and subservient to those in power. The systems are not working correctly and the general public seems to be losing touch with the value of being educated and informed, of doing the hard work of thinking.

As I observe the breakdown of reason in our government, our press, and our citizens, I feel a sense of danger. I fear that others do not see it. Or those who are aware do not know what to do about it.

https://www.youtube.com/watch?v=87AEeLpodnE

Are You A Happiness Hater?

Being happy seems to be an obvious shared goal for most people. People with ongoing unhappiness or distress often enter treatment with the assumed goal of feeling better, of becoming happier. But an actual fear of happiness may undermine progress. Research is finding that people have beliefs which lead to anxiety when they try to be happy. For example, some people have a sense that enjoyment leads to an inevitable fall when something happens to disrupt it. They perceive the pain of that fall to be worse when they have allowed themselves higher levels of enjoyment. Others feel uneasy with times of pleasure because there is only value in productivity, having fun is wasting time; relaxing is being lazy. They may fear negative consequences if they take time away. In fact, though evidence shows that people who take breaks, attend to only one task at a time, or who take vacation time have higher levels of productivity, society in general and many employers do not recognize this. Instead, they disapprove of and have negative perceptions of the person who takes time to rejuvenate. Some people, especially depressed people, have dampened all emotions and need to practice feeling any emotion including happiness.

The prescription is choosing to take time for relaxation or enjoyment, even briefly, and allowing oneself to experience it without judgement. I struggle with experiencing anxiety related to taking time for pleasure, and I have had to make conscious steps to counter it. I am so terrible at prioritizing fun that I was paralyzed when it came to planning it. For several years, my coworkers would claim vacation times, especially in the summer, and I would be so slow in even contemplating it, that it would be difficult to find days I could take off around what my coworkers had already planned.

Because I am so terrible at planning what I even want to do, I have taken to choosing some days around a weekend and days around my birthday during the summer even without knowing how I will spend the time. At this point this summer, this has resulted in my being able to accept an invite to spend a day with a couple of friends including going for lunch together. I just scheduled an appointment for a massage the day before my birthday. The day of my birthday happens to be a discount day for an activity I want to do, and the next couple of days there is a live music event including several bands. 

I have spent so many summers resentful at spending the entire summer inside working and missing out on nice sunny days when I live next to a lake. I finally invested in a standup paddleboard which I can manage loading and transporting myself. Now, when a good sunny day is in the forecast (we have a lot of cool, rainy days) I at least take a half day off from work, a whole day if possible, to get the board and me out onto the lake. Taking the time isn’t the whole solution. While out a couple of weeks ago, I consciously made the choice to stop, lay back, notice the warm sun, the soft breeze, the water rocking me on the board. I chose to let myself feel pleasure, otherwise, I would have made it just another workout routine for exercise!

Taking brief moments for pleasure is still a struggle for me. I feel guilty when I take a walk break in the middle of my work day every once in a while. When I arrived home from work yesterday, it was warm and nice out. I couldn’t find the motivation to go outside even though I had been inside all day. I consciously talked myself into just stepping out into the backyard for a moment. Pretty soon, the cat wandered up to me and was clearly happy I was outside. I sat in a chair and enjoyed the warm day as I sat in some shade and petted the cat at my feet. After a couple of minutes, I needed to go inside for something, but I had now had a taste of the outdoors, and I was compelled to go back out. Success!

This past Saturday, I spent time with a friend, went to a barbeque, took the scenic route there, and spontaneously decided to go shopping for a tree. In the middle of it all, I realized I had no plans at all for the day. I didn’t have a list of things to do that I felt I was neglecting. I was truly relaxed and going along with what was right in front of me. Now that was unusual for me! And nothing bad came of it; no terrible consequence for “wasting” a day. It was a very nice day.

http://www.scientificamerican.com/article/fear-of-happiness-underlies-some-mental-illnesses/

Join A Group You Care About

A sense of loneliness tends to precede the development of depression.

And depression often includes the symptom of loneliness along with isolation.

Since my early days as a counselor, my mentors instructed me to encourage depressed clients to get out and around people. At the very least, a friendly interaction with someone might occur and lift their mood.

It turns out that being part of a group helps to ward off depression, but it must be a group to which the person identifies and feels connected.

Multiple studies have shown that higher levels of group identification were related to lower levels of depressive symptoms.

Group membership can be a treatment intervention for depression.

In a 2013 study of over 4000 adults over the age of 50, those who were depressed and joined one group reduced their risk of depression relapse from 41 percent to 31 percent. Joining two groups reduced the risk to 21 percent. And with three groups, the risk dropped to 15 percent.

For group membership to be effective at decreasing depression, people have to closely identify with the group and feel connected to it, not just physically be around a group of people.

Groups help by offering support and a sense of purpose.

Some groups, however, do not protect. Groups that revolve around a destructive focus such as self-harm, substance abuse or a sense of victimization are groups to break away from.

Currently in my life, I am part of a group of people who work together as a team with the purpose of helping people get through emotional crises. I also am a part of online groups of handmade artists which actively support and encourage each other.

Go ahead and find your favorite group(s) and know you are contributing to your own and others’ well-being.

http://www.scientificamerican.com/article/depressed-try-the-social-cure/

Becoming Enlightened By Hanging a Light

I hung up a shop light today. I had purchased it months ago. It was often on my mind that it needed to be put up. But my luck with simple little household projects has not been very good. Usually, it is the attaching to a wall that just doesn’t work out. So I wanted the shop light installed, but I dreaded the possibility of a botched job. I doubted my ability to do that basic work.

It could be a quick project of possibly half an hour, but not in my case. First, I had to move piles of stuff that had landed in front of and on the table that I wanted the light to be above. Then I pulled the table out from the wall so a ladder could be set up. While I had things pulled out, it was time to sweep up the dirt. Then, it turned out I did not have all of the hardware I needed. As I drove to two different stores to find ceiling hooks, I countered my negativity about wasting time with thoughts of this being part of the fun. I will frequently make a run to the craft store without thoughts of wasting time. Why not enjoy a trip to the hardware store?

I climbed up the ladder with the new drill I had obtained at Christmas and still had not tried out five months later. I felt awkward balancing on a ladder. I felt awkward using a drill. I felt uncertain I was anchoring the screw enough that it would hold. I had to get reading glasses to see well enough to attach a pull chain to the light. I wondered if pulling that chain over time would be enough to cause the hanging screws to come loose. It all went into place and, for the time being, seemed secure enough.

This little project took three hours to complete. I got some space organized in the garage. I enjoyed the fresh spring air with the garage door open while I worked. I browsed through hardware stores and had new ideas. I practiced my handyman skills once more and seemed to do a little better than the last time I tried. I felt satisfied with my work space which will allow me to try out some electric wood working tools and learn a new craft. It always amazes me how a simple little project provides so much personal growth. It seems odd that to most observers there would be little understanding of the negative self-assessments which were overcome in order to complete it. And once again, it is a marker of my independence and self-sufficiency I keep proving while being single and managing on my own. I am tentative and anxious, but little by little, I gain some confidence. Definitely time well spent!

Seven Habits to Increase Resiliency (The Ability to Cope)

Resiliency is being able to go through a tough or even devastating experience and recover from it. The recovery is both mental/emotional and physical. Making it through a challenging experience creates a positive expectation of being able to handle other situations which may arise. Regularly attending to personal mental and physical health helps to build resiliency.

Mentally:

Moderate thoughts so that they are realistic and not exaggerating the problem.

Noticing what can be learned or gained from an experience, even a painful one, increases the ability to manage it.

Gaining strength from the experience increases a sense of purpose and wisdom.

Stay in the moment without making it worse by bringing in past negative experiences or adding on future worries. Accept the way it is without judgement and labeling. Face it. Make a plan for getting through it.

Being positive isn’t simply thinking happy thoughts. It is more about faith that one is capable of making it and realistically managing the current situation.

Physically:

Aerobic exercise has been shown to increase dopamine and serotonin in the brain which helps to elevate mood. Exercise also helps to counteract the stress hormone cortisol. The saying, “sweat it out” is good advice.

The aspect of competing against oneself during exercise and in physical activities helps to build resilience. Gradually asking more of yourself than what you did before is a healthy challenge which leads to improved confidence and awareness of ability. Going a little further, adding on time, increasing the difficulty all improve physical health and one’s appreciation of personal progress and strength - both physical and mental.

Making a point of regularly practicing healthy mental and physical habits will help you to be prepared for those significant difficult times that life presents.

http://www.scientificamerican.com/article/enhance-your-resillience-stress/

Value the Quiet

Silence. Many people cannot stand even a moment of quiet. They turn the TV on before the quiet can be noticed by their minds. Some have nonstop involvement with the computer or the game console. Some will say that they hate the quiet. But it is so good and healthy for the brain to have times when outside noise isn’t bombarding it.

The brain needs time to process the stimuli it has absorbed for hours in a day. Often this processing occurs at night while sleeping. It also takes place during daytime moments of quiet involving loose wanderings of thought. I grew up in a manner which allowed such moments to occur naturally. I lived in a rural setting. During the summer, I could find myself sitting at the edge of the man-made stream running through our property for irrigation of the farming land all around. There, I might pick up a stick to scratch and dig at small rocks in the dirt. I would watch ants busily making their way. My cat would wander up, brush against me, and receive my petting. A breeze would go through our Aspen trees causing the leaves to make a sort of light, waterfall type of sound. My parents did not worry that I was spending too much time on some electronic device. We didn’t have anything but a TV which we watched in the evening. Sometimes I would lie on the couch or on the floor in the living room just soaking up the sun coming through the window.

Quiet is often a comfort for me. So it puzzles me when I encounter people who are bothered by it; they seem even to be afraid of it. For health of mind and body, it would be a benefit for people to learn to enjoy times of quiet. The body needs regular relaxation to counter the effects of daily stress. The brain needs time to rejuvenate, sort information, store it into memory, and to physically repair. Problem solving and creative ideas come out of a brain that is allowed to process without focus or pressure. When we make ourselves think, we use known information in standard ways we have learned or been taught. When we let the brain percolate and make connections on its own, unique ideas can spring up.

https://www.psychologytoday.com/articles/201305/the-enemies-invention

These days, mindfulness has become a process encouraged for a number of benefits. It certainly is a way to fully attend to the moment, taking in sensations we might miss due to constant busyness and non-stop evaluative thinking. Mindfulness lets us experience a moment such as the sound of a bumblebee on a flower nearby. We can choose to set aside time for practicing mindfulness. But the randomness of a wandering mind is also healthy. We can choose to allow for unstructured time in which we allow our mind to do what it will. This is the kind of time in which people complain of boredom. Instead of fearing and avoiding boredom, learn to enjoy one’s own mind playing with a daydream or remembering an amusing moment or curiously wondering about something in the world. Put down the phone, step away from the game, and just be. Try it for just five minutes. Or enjoy a walk for physical health with the added benefit of free thinking. These days, we have to make the decision to give ourselves unstructured time. In order to do that, we need to see the value in it.

http://www.lifehack.org/377243/science-says-silence-much-more-important-our-brains-than-thought