1.  You have been struggling with a mental health or addiction issue… or you wonder if you have.**

You might ask, “Well, how the heck do I know if what’s bothering me is really a mental health or addiction issue?”  The answer:  You might not be able to know for sure on your own.  If you have been asking yourself if you have a mental heath or addiction problem, then go ahead and ask someone who knows (a therapist or counselor) and can answer your question. (Go here for my article explaining the difference between a counselor and a psychotherapist (aka: therapist)).  A licensed therapist or counselor will be able to diagnose psychological disorders and recommend treatment, if it’s necessary.  They are trained to know what questions to ask and to help you flush out the problem, if there is one.  Consulting with a professional certainly wouldn’t hurt you either way.   If you go and find out you don’t really need to go, then at least you’d have your answer.  More often than not people find therapy very useful whether they have a diagnosable mental health or addiction issue or not.  On the other hand, if you do have an issue that is diagnosed, research shows that therapy is one of the best ways to help you feel better.

When there is a problem, many people make the common mistake of waiting until something drastic happens to seek help.  This is not necessary and not helpful.  Mental health and addiction issues that go untreated usually do not go away forever.  They may ebb and flow, but in general, they will progress without treatment.  Meaning there’s a good chance your problems could get worse, not better.  Really, why wait anyway?  Especially if there is a way that you could start to get some help?

2.  The problems you wonder about have caused a disruption in the way you function in your life.  A “disruption in functioning” means that your work, school, relationships, health or other areas have been affected negatively (American Psychiatric Association, 2000).  If you recognize any of the signs below, then functioning in your life has been “disrupted,” and therapy would be a good place to go for help.

• You are unable to sleep  - or sleep all the time (and your doctor cannot identify the cause).
• You noticed a change in your appetite (and your doctor cannot identify the cause).
• You have stopped doing the things you like to do or don’t really want to do the things you used to like doing.
• You have been late for or missed work or school as a result of the problem.  For example, you missed work/school because you felt sick because you drank too much the night before, or maybe you overslept and missed work because you were up all night arguing the night before, or perhaps your car died and you couldn’t get to work because your problem preoccupies you so much that you neglected to take it for maintenance, etc.
• You have conflicts in your relationships with your boss, coworkers, teachers or friends.
• You are fighting a lot or feel distant from friends and family.
• You noticed a change in your sex life.
• People around you have been suggesting you try counseling.

3.  You have a loved one who has been struggling with a mental health or addiction issue.

Many times when a loved one is struggling, so is everyone who loves them; particularly family members and romantic partners.  If you have a loved one who is struggling with an addiction or serious mental health problem, therapy for you is the best way to help them.  Honestly.  Loved ones absolutely would benefit from therapy themselves or as a family, if even for a short time.  You need to understand how your behavior and beliefs affect the situation and just as importantly, how the situation affects you.

This is an absolute must if we’re talking about addiction.  You need to talk about the impact on your life and learn how to take care of yourself in the midst of the tornado that we call addiction.  Just as importantly, you need to explore with a professional the impact of any of your behaviors that may be unknowingly maintaining the addiction.  I’m not saying at all that you are responsible for someone else’s addiction.  Let me be very clear: You are in no way responsible for the substance use or relapse of another person.  However, I am saying that you have a responsibility to your loved one and yourself to do what you can to understand how you may help or possibly interfere with recovery.

4.  An important relationship has been deteriorating.  This includes relationships with bosses, coworkers, clients, friends and family.  Maybe communication is breaking down or has broken down completely.  If you notice problems in a relationship, a therapist can help you find possible ways to address the problem in a way that either saves the relationship or ends it as amicably as possible.  If this is a marriage where children are involved, then the urgency jumps to the top of the list.  Children are shaped by and learn from the relationships they see their parents having.  It is critical to their development for you to get as much help as you need to deal with your relationships in healthy ways – even when you don’t agree.

5.  A major life event has happened and you could use some support. Major life events are big changes in life – even good ones.  Major life events that include an addition or loss of a relationship are particularly stressful.  Some examples are marriage, birth of a child, new job, moving, graduating from college, losses like loved ones or pets passing away, friendships ending, divorces or breakups.

6.  You notice that you have been under a lot of stress or feeling burned out.  Feeling burned out is your mind and body telling you that you need to do something different.  You can’t keep up a crazy pace without refueling and recuperation.  You can learn effective techniques to rebuild your energy and stop yourself from burning out completely.  Remember this:  You can’t unburn a match.  You must acquire the skills that will protect you from burning out if you feel like you’re at the end of your rope.  You are responsible (to yourself and to those that count on you) for learning how to take care of yourself to either ensure this doesn’t happen or get help immediately when it does.

7.  You are generally unhappy, unsatisfied with life, restless and uneasy.   This is particularly pressing and jumps to the “urgent” category if you have been losing your temper lately, find yourself more irritable than usual and are reacting in ways you later regret.

8.  You want to improve your performance or creativity.  Therapy is very useful for teaching techniques which have been shown to improve performance in sports, performing arts, creativity, work and school.  It can help you reach your goals.

9.  You have been asking “why me?” or “why is this always happening to me?” lately.  Sometimes exploring patterns and relationships in your life can bring on life-changing realizations.  Understanding the choices we make and why we make them can sometimes lead to moving away from old patterns that don’t work and increasing happiness.

10.  You are ready to make a big change in your life.  Sometimes I hear “I’m sick and tired of being sick and tired.” When you realize that you have a part in maintaining this pattern in your life, you may become very motivated to change it.  This is when therapy is most helpful:  when you are motivated and committed to the work that is required to make a change in your life.  Warning: miracles happen here.

In conclusion, therapy can help with a number of different issues.  In fact, some say (and I agree) that everyone could benefit from experiencing therapy at least once in their lives.  You could surprise yourself and learn something you didn’t know or become empowered to change something you thought was hopeless. You learn about the most important subject to guide you toward happiness: you!  It’s “YOU: 101.”  I’ve been in therapy myself for many years… and plan to continue.  This is partly because I feel obligated to continue to work on myself so I can do my job and help other people, but…  mostly it is because I’m just happier when I’m working on being peaceful and accepting of myself.  I’m a work in progress.  We all are. (Go here for my article “How to Find a Good Therapist.”)

** If you are having thoughts about death, hurting yourself or someone else, this is a powerful sign that you should call for help right now.  Stop reading and pick up the phone.  Call your area’s suicide hotline or emergency room right away.

Reference:

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

1. Ask If They Have Ever Been in Therapy Themselves: Though they’re unlikely to tell you what for, most therapists will answer this question honestly.  It’s very important for a therapist to be aware of and working on their own issues and personal growth.  The good ones know this and do this.

2.  Training and Licensure:  Ask about their training and license.  Make sure they are licensed and in good standing.  Sites like Psychology Today and Good Therapy.org check licenses for each of the therapists they list daily.  Other sites may do this, too, but these are the 2 I use.  The letters behind someone’s name tells you what kind of license they have, but not whether they are in good standing or not.  Here is a good list of what the letters mean.  I won’t go into all of them here for sake of keeping this article brief.

I am a Licensed Mental Health Counselor (LMHC) in MA and a Nationally Certified Counselor  (NCC) through the National Board of Certified Counselors.  To obtain these licenses I needed to:

• have a masters degree in psychology or related field (mine was “Mental Health and Behavioral Medicine”);
• have 3000 hours of supervised, face to face counseling experience;
• have worked full time for 2 years after obtaining my masters degree;
• pass the “National Clinical Mental Health Counseling Examination;”
• provide references and proof of approved clinical supervision; and
• agree to prove that I attend 30 hours of continuing education approved by the board every 2 years.

3.  Experience: He or she should have experience providing therapy for the issues you are dealing with.  Just ask them.  Therapists follow a strict code of ethics regarding seeking supervision if they do not have the necessary experience.  You can find a list of issues I can help you with here.

4. Things to Avoid:

If your counselor is doing these things, consider trying another one – or at least discuss your concerns with him or her.  If you don’t get a response that is appropriate with an immediate change in their behavior, definitely keep looking.  Does your new counselor…

• Talk over you? It’s going to be hard for a person who talks when you’re talking to hear what your saying.  It’ll be even harder for them to help you.
• Make sexual advances?  If this ever happens, even you feel attracted to your counselor, it is absolutely unethical, unacceptable and should be reported to the appropriate professional licensing board.  Counselors and therapists know that this is never acceptable.  You may wonder why, if both parties consent, that this is inappropriate.  Trust me, it is.  It is an abuse of the natural power differential that happens in therapy and should never occur under any circumstance.
• Touch you when you don’t want to be touched (not just sexually, any touching)? Some people are huggers, some aren’t.  If you aren’t and your counselor gives you a hug, it might not feel ok.  You should talk to him or her about this.  If it continues, find another counselor.  If you are a hugger and the counselor isn’t, then you may wonder why this person is acting in a way you perceive as cold.  FYI: I’m not a hugger, and in fact find it difficult to find even rare instances when this is ever appropriate.  I much prefer to respect your personal space.
• Seem like they’re putting on an act or playing a part?  Your therapist being authentic not only makes it easier to relate to him or her, but is necessary to be a good therapist.  If you find yourself feeling as if the person is a phony, find someone else.
• Cover up mistakes?  Everyone makes mistakes.  It’s what you do afterwards that counts.
• Consistently late for appointments?  This really just shows a lack of respect for your time if your counselor is always late.  Being late a couple of times is one thing, but if you find yourself always starting sessions late, it may be time to move on.

5. Things to Look For:

If you can answer “yes” to these, it’s a great place to start.  Do you feel as if the person:

• Listened to you and gave you their full attention?
• Has an accurate understanding of what your goals are?
• Seems like they care about you and your goals?
• Acts with compassion and unconditional positive regard for you?
• Pays attention?
• Welcomes questions about their credentials, techniques and experience?
• Checks in with you about the progress of therapy and whether you think you are on track?
• Is sure to tell you the truth, even if it’s something you don’t want to hear?
• Supports you or even pushes you (in a good way) towards your healthy goals?

• It’s for people who are “nuts” or “out of their minds.”
• If you’re strong enough you’ll figure it out yourself.  ”Weak” people go to counseling.
• They’re going to judge me.
• Counselors are just nosey.
• It’s going to involve someone telling me how to live my life.

In reality, counseling and psychotherapy helps through the experience of interacting with a trained professional to either deal with problems, increase performance, or both.

• It provides support during times of increased stress, such as illness of a loved one, changing jobs, grief and loss.
• It offers a way to gain perspective and insight about your emotions, relationships and all kinds of behaviors.
• It helps identify patterns of thinking and feeling which affect relationships, work, school, behavior and performance.
• It helps identify the many forms of anxiety, depression and anger and helps alleviate them.
• It provides ways to build healthy relationships.
• It helps develop communication skills for dealing with conflict.
• It provides means for self-improvement and maximizing potential.
• It identifies ways to change things that are not working in your life.
• It builds motivation to change for those who want to change, but can’t seem to actually do it.
• It is a means for addressing pain, working through loss and adding meaning to life.
• It provides a map to trusting yourself, identifying what you want and creating the life you want.

Often I hear the following questions:

“So what am I supposed to talk about?”

You can talk about anything; whatever you’d like.  Many times people will have a specific problem they are trying to resolve, so they talk about that. Sometimes people want to learn about relationships, communication, or want to improve performance.  Sometimes people don’t have a specific problem but know they are generally looking for a change.  Other times people are struggling with loss, depression, anxiety or the effects of traumatic experiences.  I’m trained to know what questions to ask, so you don’t need to worry about this.  I always approach my clients with respect and no judgement.  Whatever you want to talk about is going to be ok and you never have to discuss something you don’t want to. If you’re not sure exactly what your goals are or what you’re looking for, we can discuss it in our first meeting.

“How long is this going to take, anyway?”

The short answer to the question is that it really depends.  The goals and plan of therapy will be made together, and in the end, unless they are infringing on the rights of others, they are completely up to you.  Therefore, the length of time depends a lot on what is needed to achieve your goals. Psychotherapy is most effective when people start on their own and have a strong desire to change.

“What if I hate it?” 

If you hate it, you can stop coming. Unless you’re mandated into counseling, no one will force you to continue if you do not think it is helpful for you.  It is within your rights to terminate treatment.  I’ll talk to you about your rights and obligations when we first meet.

“Alright, I’ll try it.  Now what?”

Give me a call at 61-SHINE-009 (617-446-3009) to have a free, brief phone consultation.