The View from This Side of the Couch

Posts Tagged ‘Depression’

The View from This Side of the Couch

Posted on: November 26th, 2019 by Lindsey Rogers, LCPC

“How do you do this job? I’d get so sick of listening to other people’s problems all day.” As a psychotherapist, I have heard this comment numerous times in the 14 years I have been working. Providing counseling is a tough job, sure, but it is interesting and rewarding. We get to be your secret keepers. We get to hear the good stuff: “I am pregnant.” “I am going to propose.” “I just got a promotion.” And we also get to hear the hard stuff: “I am cheating on him.” “I hate her.” “I hate myself.” “Life would be better without me in it.” And as we are guiding, challenging, listening, and supporting our clients, we have the utmost respect for the struggles and challenges that our clients and everyone face. According to the National Alliance on Mental Health (NAMI), 43.3% of American adults received treatment for mental health issues in 2018. Thank goodness there is less and less stigma about therapy these days. Companies are supportive of their workers taking time for therapy. Partners can see couples counseling as an opportunity to work on communication and trust versus the last stop on the way to a divorce. Yet despite all the understanding and positive messaging about the benefits of therapy out there, it still can be a bit confusing. Here are some common questions and answers to help you understand the perspective we have sitting across from you.

“What is a psychotherapist versus a psychologist versus a psychiatrist?”
It can be really confusing with all these titles and letters after our names. At Tobin Counseling Group, we are all considered psychotherapists and none of us prescribe medication. Some of us have master’s degrees in psychology or social work. We may have a LCSW or LCPC or LMFT after our names, which means we are licensed in Illinois as (respectively) a clinical social worker, professional counselor, or a marriage and family therapist. Other psychotherapists here have a doctorate in psychology or a PsyD, which means they are psychologists. A PhD or a PsyD in psychology confers the title of psychologist, which equates to being able to do psychological testing as well as psychotherapy. A psychiatrist is a medical doctor who prescribes medication. A psychiatrist can also provide psychotherapy.

“What are you writing?”
Don’t worry, we aren’t writing down our grocery list or working on the Times’ Saturday crossword over here (plus let’s be real, we’d need more than your session to tackle that). When we sit across from you, especially in the first session, we are writing down notes and your answers to assessment questions. We want to make sure we have a good understanding of your symptoms, history, and goals so we write down things you say or themes or patterns we are hearing. After that initial session, some therapists take notes and some do not. These are our process notes and often include key words to help us remember things you have said or themes we want to come back to later in the session. Some therapists write down names of family members they want to remember or other important things you reference. If we are asking you to do homework assignments, we may also jot this down to make sure to check in with you later.

“Why do I always cry when I sit down on the couch?”
Well, let’s be honest, you don’t always cry. But yes, there is a fair amount of crying that we see happening on our couch. But guess what, the therapy couch is the absolute best place to do it. We are always fully stocked on Kleenex. And here’s the thing: Crying is not a bad thing. We are so programmed to avoid negative emotions—there are few places where it feels safe to cry, especially in front of another person. So crying happens because it is okay to allow yourself to cry and we are often talking about difficult issues, sometimes sad issues. It is also okay to laugh and feel good during therapy. We get to feel the whole range of emotions and that happens during therapy sessions. Which is a good, positive thing, tears included.

“Why does therapy work?”
Therapy is a different way of talking. We are listening in a way that is likely different than what typically happens for you in your everyday life. A lot of times people reference feeling heard in therapy or feeling much lighter after going. There are few interruptions in our room. We are not staring at our devices or distracted by other people when you are speaking. Our main job is to show up for you in a therapeutic way to listen to what you are saying and help you. We are nonjudgmental and are in your lives only in the therapy room. So we are safe. With some exceptions to confidentiality, what happens in the therapy room stays in the therapy room. (There is a reason that was such a good advertising slogan for Vegas!) It feels good to know you can express a thought or feeling and it doesn’t leave our office. Keep in mind, we can’t tell you what to do (this is another question we often get!). But we can challenge your thoughts or help change your behaviors. We try to validate and encourage your emotional expression. We also explore ways to cope better than perhaps the current choices you are making. We are also not “just listening.” We are trained professionals who are using skills and techniques, like cognitive behavioral therapy, to help you.

“Can we be friends?”
Our relationship might feel pretty intimate; as we said before, we get to hear all your deepest secrets and inner thoughts. But therapy—and specifically this therapeutic relationship—works because of boundaries. We are professionals and this is a service we are providing to you that you are paying for. It is different than a personal relationship. We aren’t nor can we be friends with you, but at the same time, we do like you and care about you. We see your strengths and likely have a far more balanced perspective of you and your circumstances than you do of yourself. We cannot be friends with you on social media or connect with you on LinkedIn. We don’t Google you or try to find out more about you and you should do the same with your therapist. Our relationship has to exist in a professional way for therapy to work and feel safe for you and us as your provider. If we see you in public, we will wait for you to acknowledge us first. This is not a harsh social move or a matter of us snubbing you. We simply want to protect your confidentiality; if you wave or say hello to us, we will respond, but it is up to you to make the first move. Chicago is a small world so it is possible we will run into each other, but just as we have agreed to keep your secrets, how we know each other stays between us.

“What do you really think of me?”
We are all clients. Any therapist should have been in therapy during their training or may currently be in therapy. Remember that part above about this being a hard job? We couldn’t help and support you if we did not have support ourselves. So we can relate to and understand you. What we really think of you is that you are a dynamic, interesting person who we are invested in learning about and understanding as deeply as we can. We may get frustrated with you sometimes and we have to be patient. You probably make us laugh sometimes in session as well as cry along with you. We have so much respect for you and your story and we are trying to help you in the ways we know how to help. We want to do right by you.

Whether you are new to therapy or not, it is okay to have questions. It is even more okay to ask your therapist your questions. We will uphold boundaries and yet do our best to give you answers. A good fit matters when it comes to relationships but especially in the therapy office. If you don’t feel like your therapist understands you or your expectations are not being met, talk about it. And know there are a lot of sources of support out there so you don’t need to feel stuck if the relationship with your therapist is not working for you. The biggest question to ask yourself when you go to therapy is if you feel heard and understood. If we are doing that, we can make progress. And with that, we will look forward to seeing you at your next session.

‘Tis the Season of Gratitude

Posted on: November 26th, 2019 by Lindsey Rogers, LCPC

Fall and winter can be a difficult time of year. There is a lot of pressure to feel joyful, and when the cheery décor surrounding our workplaces, homes, and city is a direct mismatch to how we are feeling, it can foster an even deeper sense of sadness. Thoughts like, “It’s the holidays and I still can’t be happy?!” can overwhelm us and trigger feelings of guilt and shame. Finding joy and happiness can feel like an insurmountable task. But a powerful step in the direction of positivity is gratitude. Psychologist Robert Emmons, PhD is an expert in gratitude and defines it as “a sense of wonder, thankfulness, and appreciation for life.” Dr. Emmons divides gratitude into two parts: (1) acknowledging the good in our lives; and (2) acknowledging that the source of that goodness is outside of ourselves. It may sound tough to think about giving when you feel empty, but tapping into feeling grateful or thankful allows us those pinpricks of light to change your otherwise gloomy perspective.

How An Attitude of Gratitude Works
Depression and negative emotions turn us inward. It is hard to consider others or anything outside of ourselves and how bad we feel. Our perspective is skewed to a catastrophizing state of what is terrible and how life is going to get worse. When we feel this way, it is common to think that the curated version on social media is actually true and everyone else is having a great time during the holidays. Feeling bad can make us think, “Look at that! Everyone in Chicago is at the Christkindlmarket enjoying all sorts of holiday fun with their significant others but me!” Yikes, that sounds super gloomy. But those are irrational and definitely unhelpful thoughts. Implementing gratitude can allow us to have a bigger perspective and shift away from negativity. If you are feeling thankful, you are glad something happened or even happy something is over. If you narrowly miss getting sideswiped on your commute, you likely take a beat and think, “Wow, that could have been bad.” Depressive thoughts would keep you stuck. Those thoughts might include, “I am so careless,” or, “Why are bad things always happening to me?” Taking on an attitude of gratitude, however, allows you to zoom out from your own experience to see the bigger picture, like changing the screen resolution on your thoughts. There is that sense of “Whew, I survived that!” That feeling is gratitude. We are able to affirm what is good in our lives or in the moment instead of getting stuck with negativity.

How to Get Started on Thankfulness
This time of year, there are likely plenty of school-aged children tracing their hand and then turning their handprints into turkeys. Joining the ranks with the hand turkey might also be the practice of going around the table at Thanksgiving dinner and saying what you are thankful for. If you have been part of this table scene, how many times have you said pumpkin pie? Or the Bears? Maybe those aren’t profound moments of gratitude for humanity but they’re a great start. A way to expand past the amazing stuffing or the scoreboard on Thanksgiving is to first find some time that you can collect your thoughts. Start by taking out a journal or a blank document on your computer screen. Try to start a list of things for which you are grateful. This can be a feeling or an actual event. It can be a person, place, or thing. You can experience gratitude for something very tiny or something huge. Maybe you structure your thoughts around what you are grateful for at a certain time of day or time of year. Maybe you consider who you are grateful for and think a little more deeply about why. You can write bullet points or a list. You can write a letter to express your thankfulness to someone and you don’t even have to send it. Journaling is a great practice but there is no one-size-fits-all, right-or-wrong way when it comes to gratitude. And these are your own thoughts so be honest. No one gets to tell you that you aren’t actually experiencing gratitude.

How to Expand on Gratefulness
Gratitude is about seeing the good in life, but ironically focusing on your challenges or hard times can also be a good place to start. Remember when we were talking about feeling depressed? Making a leap to feeling thankful during the holidays may be too much. But if you are struggling or have been challenged in the past, examining how you got through it or what you learned from it can be a great way to tap into gratitude. You don’t have to fully jump into joy and reverence. But acknowledging in even a small way how now is slightly better than then or how you have grown and learned since that previous bad time is a great way to change your perspective.

Volunteer work and contributing in a philanthropic way can help foster a sense of gratitude. You can acknowledge how others need your help and you can see how others in need feel grateful. You can see how thankful someone feels when they are in need and you give them something they need. Helping others can trigger you to think about how others have aided you or currently support you. In this way, you are giving back and getting all at once. What a great deal!

How to Manage Roadblocks with Giving Thanks
Sometimes, gratitude is hard to come by, such as when you find that you are getting stuck on journaling or find yourself feeling bored. If you are starting to check out and you find yourself wanting to say something like “blah, blah, blah,” then put down your gratitude journal. Because here’s the thing: Gratitude does not work if you are going through the motions. You may need to change it up. If writing down grateful thoughts does not trigger positive feelings, perhaps you need to say those thoughts aloud to yourself or mediate on those thoughts. Another way to freshen up your practice is to change your expectations—maybe daily gratitude practice feels thankless but taking time to journal once a month works much better for you. Gratitude can be a personal practice but you can also share your feelings with others. You can communicate to friends, family, strangers that you appreciate them. They’d probably appreciate your gratitude, too. And do not worry, you won’t run out of gratitude. This is an emotion that can replenish itself so there is plenty to go around.

An important trap to avoid with gratitude is judgment. If you are journaling and those nasty “shoulds” start appearing, do your best to reset yourself and challenge those unhelpful thoughts. When thoughts like, “Well, I should really be grateful for this nice house but I actually hate it” or anything that makes you feel stuck creep in, put away this exercise and try again another time. Or try to counter that thought with something like, “But I do really feel grateful for my neighbors.” Your feelings are valid and you get to appreciate and value and express gratitude for what matters to you. There are ways to expand or grow. You can work on being more mindful and changing what you notice around you. But gratitude is about you feeling what you feel and you are the expert when it comes to that. No pressure to be grateful for anything. First try to examine what you are grateful for and if you want that to expand, keep asking yourself how you feel until you locate the pieces that trigger gratitude in you.

Gratitude, like cooking a perfect turkey, takes practice and the right conditions. Use this time of year to start thinking about and noticing things you are grateful for and see this as an opportunity to change your perspective and your brain. You will be supporting yourself and the world around you, which is goodness you can get on board with regardless the time of year.

How to Increase Confidence During A Big Life Change

Posted on: April 10th, 2019 by Kelsey Ruffing, LCPC

Humans are creatures of habit. We like to go to the same coffee shop and order the same drink from the same barista every day before work. We have our routines and we stick to them. This can be a healthy way of functioning, but this habitual nature can also lead to great difficulty when adjusting to change. It can also keep people from initiating change in their lives, whether that is finding a new job, moving to a new city, or starting a new degree program. Change can leave people feeling uncertain and anxious because it is different from what we know, and it can feel risky to alter that comfortable routine.

So, what holds us back from making big life change? Most would answer “fear”. You wouldn’t be wrong. Fear certainly holds us back from many opportunities for growth in life. However, there is something even deeper than fear that inhibits us from leaning in to change, and that is confidence. One’s own belief in themselves and their capabilities is the underlying cause of resistance to change. The more self-confidence you have, the more capable you feel you are of being successful. The less self-confidence you have, the more likely you are to believe you will fail and the more resistant to change you will become.

It really is ok to fail. Sometimes we have to take the leap and prove to ourselves that we really are capable of adjusting to change. Individuals that thrive when change occurs are confident because they have faced change before head-on and have failed. Ironically, failure and the overcoming of failure lead to greater self-confidence. When we test ourselves physically, mentally, spiritually, etc., we realize we can push beyond the boundaries we set for ourselves. When we test ourselves we learn that we are so much more capable than we thought we were. When we fail, we are forced to adjust, to learn more about ourselves, and to try again.

Perhaps someone is not ready to jump right in to change, and that is okay. There are other ways to boost self-confidence before taking the action. It is important to note, the more these interventions are practiced, the greater the impact they will have on self-confidence.

Self-talk is everything. What you say to yourself daily influences how you feel about yourself and how you treat yourself. Negative self-talk certainly outweighs positive self-talk in individuals lacking self-confidence. Replacing negative self-talk with positive self-talk can be a process and take time. The first step is to recognize your negative self-talk and become aware of it. The next step is to replace the negative with a positive in the moment.

Reflect back on accomplishments. We truly do not give ourselves enough credit for what we have accomplished in our lifetime. Take some time to write a list of successes and try to remember what those accomplishments meant to you at that time. Reflecting back on times you overcame adversity, won an award, or completed a difficult task at work allows you to recognize your capabilities and can boost self-confidence greatly.

Do something different. Remember that monotonous daily routine you have? Try to mix it up a little by implementing one small thing into your day or week. This could be trying a new place to eat, saying hi to a stranger, switching up that shade of lipstick, or reading at night instead of watching T.V. Implementing one small thing can ease you into change, add more variety, and increase positive feelings. Once you see small change is not so bad, big change may not seem so scary.

Affirmations are a must. Affirmations are positive statements we recite to ourselves daily. Affirmations have been shown to increase happiness, but they are also a great way to increase self-confidence. An affirmation for self-confidence would look something like “I am capable of handling anything that comes my way” or “I have what it takes to be successful in life”. Although you may not believe it right away when saying it, through daily repetition your brain will come to accept these statements and believe them to be true.

It is normal to feel hesitant when facing a big life change and having fear of the unknown is very common, but becoming resistant to change can be maladaptive to our health. Building upon self-confidence in order to feel capable of navigating change is key to ultimately becoming successful after the change has occurred. Building self-confidence is also the key to getting out of your comfort zone and exploring the variety of options that life has to offer. You might just surprise yourself and find that the change you were scared to make, is actually the change you needed!

The Boss, The Rock, and Don Draper walk into a therapist’s office…

Posted on: October 5th, 2016 by Justin Tobin

Written by: Justin Tobin

You know how that one goes, right?  Or maybe you don’t.  Because men, ‘real men’ like Bruce Springsteen, Dwayne Johnson, and Jon Hamm wouldn’t need therapy.  They don’t get depressed or anxious.  Or if they did, they certainly wouldn’t talk about it openly.  Or let it be known they have worked with a psychotherapist. But it turns out, that’s not true.  All three of these respected male celebrities have experienced and talked openly about their struggles with their mental health; Bruce Springsteen recently got candid about his lifelong struggle with depression in his new autobiography.  And it is time more men took their cue without fearing it would strip them of their masculinity.

frustrated young business man

Depression is prevalent in our society, and you’ve probably come across the staggering statistics one way or another: 15 million American adults experience depression in a given year; which breaks down to about 5 million men and 10 million women.  I personally think the rates are grossly underreported, especially for men, primarily due to the lingering stigma of depression. Too many men hide their depression from their wives, girlfriends, husbands, and boyfriends for fear of burdening them with their problems.  They hide their depression from their friends and family for fear of being seen as weak and not able to handle their problems or rise to life’s challenges.  Hiding not only echoes the belief that being depressed is not normal or healthy for a man, it also causes unnecessary isolation and crushing loneliness.

It would be unfair to fault the depressed man for not outwardly acknowledging or talking about their depression.  Simply put, they may not be ready to address their depression.  But there are many men who have decided to speak out, be honest, and shed shame.  And because some of these are high profile men like Springsteen, Johnson, and Hamm, it has made it easier to talk about in general because these men have been helping to flip the stigma upside down through their honesty.  We can even look to revered heroes such as Abraham Lincoln and Theodore Roosevelt and successful artists like Mark Twain and F. Scott Fitzgerald – they have all dealt with depression and found a way to reveal their struggles as part of their collective histories we can all learn from with fuller perspectives and appreciation for what it means to be a man working through mental health issues.

More men today need to follow this lead on talking about their depression.  Depression does not need to define who you are.  Like a Springsteen song, you can also be in charge of your own story.

 

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