Starting your psychotherapy journey

As you start your psychotherapy journey, here are some questions to ask yourself:

1. What’s happening to you and in your life such that it seems like you will benefit from mental health treatment?

2. What are you looking for? What are you hoping will happen in your mental health treatment?

3. What assumptions do you have about what happens in mental health treatment?

4. What have you tried so far? What has been helpful and what has not been helpful? Can you tell why?

Here are my thoughts about these questions…

1. If what’s happening in your mind – your thoughts and feelings and what you do in response – is causing you enough distress that you think something is wrong (that is, you’re googling about it, you’re asking people about it, you’re preoccupied by it), then you should talk to a mental health professional. You may think that this is a low bar, but you would use the same criteria for any other part of your body. If your tooth hurt enough for you to google it or ask a friend, you should see a dentist. Besides distress, the other criteria is functional impairment. If you don’t do things that you want to do because of what it will make you think or feel, you should seek help.

2. I hope you are hoping to learn how to relate to your internal experiences – your thoughts and feelings and what you do in response – more effectively. We aren’t aiming to get rid of your uncomfortable thoughts and feelings, though you will have certain thoughts and feelings less frequently when you aren’t resisting against them.

3. There are all kinds of myths that still exist about mental health treatment. At this point, going to psychotherapy is as normal as going to the dentist. Dental treatment and mental health treatment are also similar in that being at the dentist is a vulnerable experience that can be painful in the beginning, but then offers long-term relief.

If you’re seeing me, I’m assuming something happened, either due to your biological vulnerabilities or your life experience or both, that prompted you to avoid some part of your internal experience in a very specific way that has amplified the experience. We’ll discover that together and help you relate to it differently.

4. When you’re talking about what you’ve tried so far, try to think about the processes, not the logistics of it. “I went to therapy for X amount of time” is less helpful to you than “At this time, my growth focused on these skills or getting relief from that and what I did was helpful or unhelpful in this or that way.”

What do you need to do to get better? In your answers above, I assume you established:

1. Something is happening in your mind that is causing distress or impairment or both.

2. You’re hoping for relief by learning how to relate to your mind more effectively.

3. You assume that relating to your mind effectively is a learnable skill. Rather than feeling ashamed that you need to learn the skills, seeking help is a reason for you to feel proud about how you’re taking care of yourself.

4. When you think of what to do next, you need to be very specific.

At this point, do you know what you need to do to get better? Some people can tell what’s wrong. Some people can’t tell what’s wrong. Either way is fine. It’s important to reflect on it, because I’ll approach our work together differently if your answer is, “I know what to do, but I can’t figure out how to consistently do it” compared to if your answer is, “I have no idea what to do.”

Why are you willing to put in hard work to learn how to relate to my experience more effectively?

Everyone has a different answer. Here are some common themes to get you thinking. Be as specific as you can be in your own answer:

I have something important coming up and I want to be present for it.

I want to be able to do something that I can’t currently do because of what’s happening in my mind.

Life seems too hard when I’m responding to it like this. I need a new way of living.

I have felt calm, grounded, connected, and happy before. I want to get back there.

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The bio-psychosocial model of emotional disorders

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Why I maintain hope