Do I Need Therapy?

Most people will ask themselves this question numerous times before picking up the phone to call me.  I personally feel that almost everyone could benefit from an experience in therapy, however, it is a large investment of time, money and energy and those are realities that need to be considered.  Here are a few observations I have made over the course of working with people that might be helpful in making this determination.  Things to consider:

You have tried to solve the problem on your own and have noticed that the issue (symptoms, behaviors, problems) keeps returning despite your efforts:

Usually people enter therapy only after they have tried to make improvements on their own.  I can’t think of a client who has not tried extremely hard prior to calling me.

Others close to you have suggested to you to seek help:,

Research has shown quite convincingly that others can, in many situations, be better judges of our behavior than we are.  This can be a difficult thing to accept:  it is human nature to want to believe that we are aware of all of our struggles, however, the reality is that even the most self aware people have their blind spots.  If your friends and family are concerned enough to share their observations such as depression, anxiety, worry, relationship problems, etc, take them seriously, they may be noticing something important.

You have questions and concerns that your friends and family can’t answer to your satisfaction:

Most people turn to friends and family first for help.  In many cases this is very helpful, but in others cases, people experience their friends’ and families’ advice and perspectives as  well intentioned but not overly helpful.  Sometimes friends and family are just “too close” to you to offer the unbiased perspective that you need.   I often joke with my own friends and family that I am much more helpful to my clients than I am with them.

You have a gut feeling something is “off” but aren’t sure what it is:

Listen to this!  Although others can be better than we are at noticing and predicting our behaviors, we are the experts on what we are feeling.  Gut feelings are huge indicators and in my opinion should be taken seriously.  Therapy is a place where you can explore where this feeling is coming from and then make a determination whether or not it warrants further attention.

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Brain Scans and Psychotherapy

This is your Brain on Psychotherapy

Even though many people might know next to nothing about neuroscience most people have at least an inkling that medications like Prozac, Zoloft, Abilify, etc cause some kind of biochemical change in the brain.  New brain scans, similar to the one above, offer us the ability to visually witness changes in brain activity by comparing brain scans of patients before medication and while on medication.

What you may not know, is that these same hi-tech imaging studies are also revealing evidence that suggests that the brain also undergoes similar neurological changes (i.e. improved functioning) as a result of psychotherapy.    In a recent study (y Helen Mayberg, M.D., and colleagues, who used similar scans in 17 unmedicated patients with major depression before and after they had 15 to 20 sessions of psychotherapy.  She also compared the scans with those of 13 patients who were already successfully treated with antidepressant medication alone.  What she found was that both groups saw a reduction in depression and both groups showed significant changes in brain activity on the brain scan.

These  findings are exciting, and also make intuitive sense to me.  We know that experience alters the brain.  When we learn to ride a bike, we form new neural connections in the brain which allow us to ride the bike.  These new connections also allows us to remember how to ride again in the future. Psychotherapy is an experience, except we aren’t learning how to ride a bike.  We are modifying thoughts, beliefs, and expectations.  We are identifying, practicing, and learning new ways of being in the world.  As we do this, we are changing our brains in a way that will allow us not only to feel better in the moment, but perhaps just as importantly, to “remember” how to feel better in the future.

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Articulate Listening

Here is a little article I wrote for the Boulder Valley Public School District’s THRIVE newsletter. Mainly aimed at helping parents talk with their kids, but the principles could be applied to any relationship.

Although we have been talking to each other for thousands of years, we often fail to truly connect with what it is we are actually saying to one another. As a psychologist, the one truth I can state with certainty is that when we fail to truly understand one another, our relationships suffer. In my experience, our “communication problems” usually have less to do with what we say to one another, and more to do with how we listen to one another. If we can learn to listen as articulately as we speak, I think that we will all see our relationships improve. So as we enter into this New Year, here are 5 suggestions that will help you to dramatically improve your listening skills and improve the relationships with those around you.

Be actively available: Most people mistakenly assume that their loved ones will come to them if they have something important to talk about. I call this being “passively available”. Being “actively available” means taking the initiative to reach out to those around you and invite a discussion. For example, a simple “It looks like something is bothering you, I want you to know that I am here to talk with you” is often enough to open up the lines of communication.

Be willing: Be willing to listen to whatever it is that the person is saying in this moment. This means that we have to be “willing” to experience some uncomfortable, even difficult, feelings in ourselves when we are listening to whatever is being said to us. All too often we jump into problem solving mode to try to make the uncomfortable feeling go away. When we do this we stop listening. If you can hang in with the uncomfortable feeling, you will be able to hear the whole story!

Be reflective: When you feel you understand an aspect of what someone is saying to you, repeat it back to them using your own words. For example, if someone talks about feeling confused about an important decision, you might simply say “so you are really trying hard right now to decide what is the best solution for you”. This simple strategy may feel a bit awkward, but it is an effective way of letting the person know you are listening to them. It also provides them with the opportunity to correct you if they feel you are missing the point!

Be respectful: Respect their perspective, you don’t have to agree with it, but you can try and place yourself in their shoes. Simply stating that you can imagine how they might be feeling about a particular issue goes a long way.

Be thankful and encouraging: Thank them for trusting you enough to open up to you. This really lets them know that you value this type of communication. Also convey to them your belief in their ability to get through the situation. Often times this is exactly what the person wants and needs to hear.

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