(360) 952-3070 [email protected]
A Guide to Self-Advocacy in Therapy

A Guide to Self-Advocacy in Therapy

by | Counseling, General, Mental Health

If you have been in therapy before or are currently looking for a counselor, know you are not alone if it feels like an intimidating process. The therapy world comes with many acronyms (CBT, DBT, EMDR, ACT, etc.) and it can be daunting to identify what it is you look for in a therapist. Research over the past 50 years has shown that the quality of the relationship between therapist and client, known as the ‘therapeutic alliance’, is the strongest predictor of successful outcomes in treatment. Given the importance of the therapeutic alliance, it is important that you feel seen, heard, and respected by any clinician you work with.
 
 
When meeting with a therapist, whether entering treatment or after care is established, you reserve the right to ask questions. Here are some you might ask to help yourself identify if they are a good fit for you:
 
  1. Do you have experience providing therapy to people with similar issues as mine?
  2. What are the different therapy approaches you practice, and which do you think will work best in our work together?
  3. How do you collaborate with your clients throughout the therapy process?
  4. How do you collaborate with other treatment team members (medication providers, case managers, etc.) when appropriate?
  5. Which types of coping skills do you normally help your clients learn and practice?
  6. How do you measure progress?
  7. What can I do if I feel the treatment isn’t working for me?
  8. How will I know when to stop or pause therapy if I am doing well?
  9. What is your training (what certifications or degrees do you hold)?
  10. Based on what you know about me so far, do you believe we’re a good fit? Why or why not?

 

 

 

Asking your therapist questions about their work to ensure goodness of fit empowers you to make an informed choice about your mental health needs. Not only does this help you decide if a therapist is right for you, you are already taking a step toward autonomy and practicing empowerment. What matters most in your mental healthcare is ensuring you feel seen and heard.
 
 
Some self-reflection in identifying if your therapist is a good fit:
  1. Do I feel respected by my therapist?
  2. Do I resonate with my therapist’s approach to treatment?
  3. Does my therapist listen attentively to me?
  4. Do I feel validated by my therapist?
  5. Is my therapist transparent with me about their treatment approach, and do I understand it?
  6. Does my therapist check in with me about progress and my experiences in treatment?
  7. Is my therapist an ally to me?
  8. Is my therapist open to my feedback about what works and what doesn’t?
  9. Is my therapist a safe person for all pieces of my identity?
  10. How am I feeling about working with my therapist so far?

 

Remember, you are the expert in how you feel. Check in with yourself often about what is going well, and what is not as helpful, as you progress in therapy.

 

 

 

 

 

 

 

 

Climate Anxiety

Climate Anxiety

by | Sep 10, 2024 |

Hope, Action, and Climate Advocacy “I thought I couldn’t make a difference because I was too small.” -Greta Thunberg   We live in the age of information, which means it is increasingly difficult to limit one’s access to breaking news. More and more we are seeing...

Get Outside For Your Brain

Get Outside For Your Brain

by | May 10, 2024 | , ,

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Get Outside For Your Brain

Get Outside For Your Brain

by | Anxiety, Coping, General

When I am among the trees,

Especially the willows and the honey locust,

Equally the beech, the oaks and the pines,

They give off such hints of gladness

I would almost say they save me, and daily.

Excerpt, “When I Am Among The Trees” by Mary Oliver

We live in a world that allows us immediate, constant access to Internet spaces. This offers us accessibility, economic opportunity, entertainment, cultural exchange, education, and productivity. However, for as many benefits as there are, we’re also presented with challenges – Cognitive overwhelm, social isolation, distraction. Worldwide, we spend an average of six hours and 40 minutes per day on screens, and we average five or fewer hours in nature per week.

 

Research shares with us a wealth of information about how nature is beneficial for our emotional and cognitive health. When we disconnect and get ourselves into nature, we are happier, perform better on tasks, feel more energized, and experience real-time, literal connection to the world around us. The biophilia hypothesis (“biophilia” literally means love of life or love of living systems) suggests that humans have an innate tendency to seek connection with nature and other forms of life. This hypothesis states that spending time in nature triggers a physiological response that lowers stress levels. We have many studies that show humans perform better on cognitive tasks while listening to nature audio, pausing to view nature scenes, and green spaces adjacent to schools boost cognitive development in children. We know that adults perform better on work-related tasks when they, too, have access to green spaces.

 

Nature helps us feel joy, we become more creative, and moving our bodies further supports the metabolization of emotion. Neuroimaging studies have shown that being in nature activates regions of the brain associated with empathy and emotion regulation.

 

Back to social media for a sec – It’s important to acknowledge that we often see posts in the Internet space about folks who mountain climb, backpack across countries, and live on sailboats. It’s easy to engage in comparison and think of ourselves as not doing enough when we aren’t able to participate in viral-video-worthy feats. But, the nervous system doesn’t discriminate between the leaf on the tree at the top of the mountain and the leaf on the tree outside of your home.

 

Nature is everywhere, and can be free or low-cost to access. Some ideas, just to name a few:

  1. Sitting next to an open window
  2. Reading a book outside
  3. Picnicking with a loved one or friend
  4. Water balloon fight!
  5. Birding
  6. Journaling outside
  7. Hopscotch
  8. Disc golfing
  9. Running and/or walking
  10. Stargazing
  11. Laying in the grass and watching the clouds
  12. Gardening
 
Consider setting a goal of increasing your time spent outside by ten minutes per week, and notice what shifts. Do you have more brain space? More space in your body for your breath? Slow down and see what happens.
Climate Anxiety

Climate Anxiety

by | Sep 10, 2024 |

Hope, Action, and Climate Advocacy “I thought I couldn’t make a difference because I was too small.” -Greta Thunberg   We live in the age of information, which means it is increasingly difficult to limit one’s access to breaking news. More and more we are seeing...

Get Outside For Your Brain

Get Outside For Your Brain

by | May 10, 2024 | , ,

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Journaling and Mental Health

Journaling and Mental Health

by | Coping, Counseling, General, Mental Health

If you have ever had a conversation with your therapist about coping skill development, you have probably received a recommendation to begin a journaling practice. Understandably, sometimes journaling is met with skepticism – What does writing about my emotions solve, and why is writing so widely recommended?

 

Processing Emotions

  • Putting emotion on paper engages the prefrontal cortex – the part of the brain which puts language to emotion, grounds us in the present moment, and assists in regulating emotion.

 

Memory Consolidation

  • Put simply, memory consolidation is a process by which information in short-term memory is transferred to long-term memory. Writing about your experiences – positive or negative – strengthens the parts of the brain associated with this consolidation. What this means is that, over time, we become better at accessing various parts of a memory (sound, taste, touch, smell, thought, etc.) and this allows us to better make sense of memories that may be difficult or traumatic in nature.

 

Stress Reduction

  • Journaling has been found to activate the parasympathetic nervous system (the “rest and digest” response/the antithesis of fight/flight/freeze). Cortisol levels drop, breath deepens, heart rate begins to slow. Suddenly, the writer is able to be more present with themselves as they process.

 

More than what researchers have shared with us about how journaling impacts the brain (as noted above), put simply – writing with and for ourselves fosters an internal relationship. We are in relation with ourselves more often than we are anyone else, yet rarely are we taught what it means to interact with self or how to do so in a compassionate way.

 

If you are interested in exploring journaling but are unsure where to start, here are some prompts to explore:

  1. I feel __________ about journaling because…

  2. My relationship with myself could be described as…

  3. I want my relationship with myself to be more…

 

Remember, journaling is as individual as you are. Let there be spelling mistakes, run-on sentences, scribbles, and even drawings. Humans are gritty and messy; let the way you cope be gritty and messy, too.

Get Outside For Your Brain

Get Outside For Your Brain

by | May 10, 2024 | , ,

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Things You Might Feel Shame For, That Are Actually Very Common!

Things You Might Feel Shame For, That Are Actually Very Common!

by | General, Self Acceptance, Self Worth, Self-Esteem

As therapists, we hear from people in all walks of life. Every client is different and comes to therapy with varied experiences, but one thing remains true; most people hold shame for things they don’t need to. When we feel shame, our brains will often make us think that we’re the only one who could think or feel this way, or that only terrible people would be. Aside from being a horrifically uncomfortable emotion, intense shame is detrimental to our overall mental health, relationships, and long-term self-esteem. 

 

While this is nowhere near a comprehensive list, below is a list of things I often hear in therapy, that are entirely normal. If you’ve ever had these thoughts, you are far from alone!

 

“When ____ died, I felt relieved”

 

What shame tells you this means: I must be a terrible person to feel a positive emotion after a death. Did I wish this upon them? 

 

What it actually means: You’re a human capable of compassion fatigue, empathy for an end to suffering, potential safety benefits to yourself or others, awareness of resource strain, etc. Grief is always complex and there are typically many conflicting emotions that can include relief. 

 

“I lied/cheated/stole in my past”

What shame tells you this means: “I am a liar, cheater, criminal.”

 

What it actually means: Many people hold shame for very minor mistakes or choices from their past. Barring violent or aggressive actions, most of the time there is a reason for these choices, that once understood, lets in compassion instead of shame. 

 

 

“I _____ to cope”

 

What shame thinks this means: I can’t deal with the stress of my life. 

 

What it actually means: Substances, “nervous habits”, and impulse spending are just some of the behaviors people often feel significant shame for engaging in when they are feeling difficult emotions. If your behaviors are causing you harm or aren’t working to reduce your distress as you hoped, all that means is that they aren’t quite the right option for you. There is never shame in trying to feel better, there are only things that serve you and things that don’t. 

 

“I have intrusive thoughts about ________”

 

What shame tells you this means: “My brain is out of control, I’m disgusting/disturbed for thinking that way”

 

What it actually means: You have a normal brain, working exactly how a normal brain should. Intrusive thoughts are so common, that it’s more uncommon to be someone who hasn’t experienced an intrusive thought. To be frank, I’ve never met someone who hasn’t experienced intrusive thoughts, only people who felt strong emotion after them, and people who brushed them off and forgot about them. Having intrusive thoughts (even ones that feel totally out of character!) says nothing about who you are. If these thoughts are causing you intense distress it is certainly worth discussing with a mental health provider, but even then, there is no shame in experiencing them. 

 

 

 

Life Hacks For When Everything Feels Hard

Life Hacks For When Everything Feels Hard

by | Coping, Depression, General

Mental health challenges like depression, anxiety, and ADHD can make for difficult days. Ideally, with the right combination of therapy, coping skills, or medication, there won’t be so many hard days. But sometimes we hit a rough patch or experience a stressor or change in our functioning that leaves us feeling like even the smallest of tasks are impossible. If you’ve ever been there, you probably know the compounding effect and how hard it can feel to care for yourself and your space. There are many resources about how to manage these things from a longer-term perspective, but what do we do when we’re in the thick of it? Below you’ll find some specific examples, but the idea here is to tailor this general framework to what feels manageable in the moment. 

 

  • Release the expectation of what you “should” be doing
  • Do something even if you can’t do everything
  • Get creative with how it gets done
  • Ask for help 

 

Hygiene

For a lot of folks, showering can feel like a monumental task, so let’s go through some other options. Some people prefer to take a bath, or just turn on the shower and sit to conserve energy. For some, it’s the idea of getting out of the warm water that feels overwhelming, so picking out comfortable clothes or putting a heating pad on a towel to minimize discomfort does the trick. If all else fails, move to dry shampoo and baby wipes. Is it ideal? No. But you’ll feel better than you did before and that’s an accomplishment. 

 

Nutrition

Mental health challenges often directly impact appetite and nutrition; the type, frequency, and scheduling of eating and drinking can feel like a never-ending task. If this is you, think about foods that combine convenience and nutrition. Stock a bedside cart with non-perishable items that fuel your body so there’s no planning or preparing needed when you’re having a harder time. Throw out the rules of what’s expected if it sounds good to you and will give you energy. Lasagna for breakfast? Sure! Ham, cheese, and bread eaten separately but not put together into a sandwich? Why not! Keep a list of low-effort meal ideas on your fridge so that if seeing too many options feels overwhelming you can remove the burden of decision-making. Getting enough water can also be a challenge, so try adding flavor, sucking on ice cubes, stocking up on hydration aids/drinks, filling up one large water bottle for the day, or even bringing a water dispenser into your space.  If you find yourself struggling with nutrition long-term or feel like it is tied to other factors, please reach out to a therapist and/or dietician for help. 

 

Environment 

Many people find their home environment starts to reflect how they are feeling, and can sometimes begin to exacerbate the original difficulty. Again, we’re throwing out the rules that your space needs to look “perfect”, and instead focusing on the word “functional”. Your definition of functional will be individual, but in general, all it means is that you are physically safe and comfortable and can find the things you need with relative ease. Does it matter if your sheets match? Nope, but having sheets would likely feel better. Does it matter if you fold your clothes? No. But it would probably help to sort them into bins so you can find what you need. Does every surface need to be clutter-free? No. But make sure you can comfortably spend time in your home and have space to do other tasks will help them feel more manageable. 

 

Outsourcing

There is inherent privilege in being able to outsource certain care tasks (laundry, cleaning, meal prep, etc.) If you have the means to be able to do those by hiring someone, now may be the time to consider lowering your burden. That being said, for many people this is where asking for help from your supports must come into play. When you’re struggling, asking for assistance can feel embarrassing and shameful, but most people understand the struggle more than you might think. Ask for help in a way that feels manageable, but that would make an immediate improvement in your functioning. Ask your supports if they can grab a few grocery items on their next trip or run an errand for you, if they can take your dog for a walk or cover school pick-up. Some people find it easier to complete tasks for other people, so see if you and and a friend can swap tasks to benefit you both. 

 

These are small changes, and while it may not seem like much at first, showing up for yourself in these incremental ways helps to both provide the energy your brain and body need to move through, but also to signal to your brain that you’re worthy of care. It doesn’t matter how you show up for yourself, only that you do. 

 

 

 

Get Outside For Your Brain

Get Outside For Your Brain

by | May 10, 2024 | , ,

When I am among the trees, Especially the willows and the honey locust, Equally the beech, the oaks and the pines, They give off such hints of gladness I would almost say they save me, and daily. Excerpt, "When I Am Among The Trees" by Mary Oliver We live in a world...

Pride Month: How to Support Someone Coming Out

Pride Month: How to Support Someone Coming Out

by | General, Relationships, Teens

June is Pride Month, so let’s take this opportunity to go over some ways you can support the LGBTQ+ folks in your life if they choose to share their experience with you. Your response should vary based on your relationship dynamic, but in general, these are some rules to follow: 

 

Listen and don’t assume: Every person’s experience is different, so be careful not to assume anything about their experience, needs, or preferences based on what you’ve seen other people do or examples in media. If you don’t know what questions to ask, a simple “tell me more about this” or “what has that been like for you” is a good way to signal you are open to more information and that you want to know their experience. 

 

Ask questions, but don’t expect to be educated: Ask questions about their experience, but if you are not familiar with the LGBTQ+ issues or terminology, be prepared to do some research instead of asking satisfying your curiosity at the expense of your loved one. Have questions related to the specifics of laws, family planning, brain chemistry, etc.? There are so many resources online that you can use instead of placing that burden on a singular person.

 

Don’t center the conversation on yourself: Many people respond with a well-meaning, “you could have told me” or “why didn’t you tell me sooner?”, usually intending to confirm to the person that they would have been open and supportive. Unfortunately, this changes the focus of the conversation to the person needing to apologize or manage your relationship instead of sharing their experience. They are telling you now, and that’s all that matters. 

 

Manage your fears and expectations on your own: Many people, especially parents, immediately start to think about the future when someone comes out to them, and this often focuses on safety and future expectations. Well-meaning people will often say that they are “just worried about how the world will treat you”, or that they “hate that this will make your life harder. LGBTQ+ folks are acutely aware of the discrimination they will face and do not need to be reminded of that. Respond to them the way you wish the world would. 

 

Resist the urge to make a “big deal”: While some folks love the idea of a celebration when they come out, most are just looking to know that your feelings toward them are no different than they were before you knew this part of their identity and that you will support them. While some outward demonstrations of support can be appropriate (things like putting up a pride flag, making requested changes to displayed pictures or items personalized with names, or sending care packages), make sure you also engage in the same things, conversations, and activities you used to do before they came out, remember they are still the same person! 

 

Acknowledge your gratitude: Trusting someone with this information is a huge deal, so be sure to communicate your gratitude that they told you, even if was later than you would have wanted or expected. 

 

Respect their privacy: This information is not yours to share unless you have explicit permission from your loved one. It is theirs to tell on their own, how they want to. So if you’re chatting with extended family members or friends, don’t bring it up (even in a positive light!) unless that person has given their consent. There may be reasons they are not wanting to share this information with certain people, and it undermines their trust in you. 

 

Commit to using correct terminology: If you haven’t had much exposure to LGBTQ+ folks or the community, it might feel like you are overwhelmed with new terminology and “rules”. No one will expect you to get it right all the time at first, but they will expect you to be actively learning and trying. Commit to asking what identifiers your loved one uses, and be willing to correct yourself when you make a mistake. If you do mess up, simply correct yourself and move on. Long, belabored apologies are unnecessary and again put the focus on you and your loved one having to manage your emotions. Here is a resource of common terms to get familiar with: https://www.hrc.org/resources/glossary-of-terms 

 

 

 

 

 

Counseling: Hope for Those that Are Suffering

Counseling: Hope for Those that Are Suffering

by | Oct 8, 2018 |

Suffering. It’s the reason most people come to counseling. It comes in varying intensity, duration, and complication.   What’s your brand of suffering? Is it… Anxiety that’s no longer manageable? Sadness that’s stuck around too long? Grief that’s shaken you to...

7 Ways a Counselor Helps Facilitate Change

7 Ways a Counselor Helps Facilitate Change

by | Sep 26, 2018 |

It is a mistake to assume that someone is ready to make a change, just because they tell you they’re thinking about it. Change is more complicated than Nike’s “Just do it!” slogan. Counselors know that lasting change builds over time. Many counselors use a strategy...