Tag: depression

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I’ve never been to therapy, what should I expect?

Anna W

Whenever someone who has never been to therapy walks through my door, I always congratulate them on taking the first hard step inside. Therapy can seem very intimidating when you’re not sure what to expect… what the therapist will say, how deep things will get, how it will feel talking about personal difficulties, etc.

  1. Expect your therapist to ask about both about difficulties and highlights of your life
    • A good therapist won’t just focus on the bad or hard stuff. Your therapist should also ask about your interests, your social life, goals you’ve already met, and the better parts of your personality.
  2. Expect some unexpected emotions
    • Sometimes, people will experience some sudden tearfulness when talking about their difficulties. Other times, they are surprisingly casual when sharing a traumatic experience. You don’t have to do anything with these reactions just yet, just simply notice what is happening emotionally for you in the moment.
  3. Expect your therapist to talk about the therapeutic relationship itself
    • A lot (and I mean a lot) of therapy is learning to recognize your patterns of behavior, stuff that has become so habitual that it just becomes a massive blind spot. One of the ways therapists get clients to recognize their behavior is reflecting on the therapeutic relationship. Think “I notice you use humor to deflect whenever I ask a challenging question” or “I notice you get irritated with me whenever I point out your tardiness to session” etc. Be ready to talk about whatever is happening in the moment
  4. Expect things to get a little bit worse before they get better
    • I always give the analogy of resetting a broken bone. The resetting causes temporary enormous pain that can be as bad or worse than the actual break, but it’s for a good cause. Therapy can be much the same… you might feel a little worse off when working through difficult topics or emotions. Don’t worry, this won’t last forever, and it’s for a good cause.

There are as many ways to practice therapy as their are clients, but these are some consistent traits you will find across therapy experiences. Therapy should always pull you towards growth and healing, and you should feel like you have a trusting relationship with your therapist. Take the plunge into therapy, even if you are scared. It’s for a good cause.

Self-care

Coping with Winter Blues

Anna W

Many people who struggle with mental illness, particularly depression, notice that they tend to feel a bit worse during the winter months. This is for several reasons, with the most well-known being the lack of sunlight during the early evening hours. Sunlight is correlated with Vitamin D, which is correlated with mood, so it stands to reason that the amount of sunlight we get correlates with mood. While the relationship between sunlight and mood is a bit more complicated that that, it is one of several reasons that winter months are challenging.

Other reasons include stressful holiday seasons, cold weather, lack of aesthetics (the stick season isn’t what’s pictured for New England tourism), and the length of our winter season.

So… how do we cope?

  1. Get a sun lamp
    • Sunlamps, while the research on their efficacy is variable, can be a great addition to your morning routine. They can be pretty cheap online, too. There is little risk to adding a sunlamp to your living room, so why not? It isn’t recommended to use them in the evening as they are a form of blue light and can disrupt circadian rhythms, aka sleep patterns.
  2. Do less
    • While my life is busy with work and parenting, I generally try to schedule less. My body clearly has a need to slow down during this season, so I try to honor this need. I’m more likely to go visit Magic Wings or go to the beach during our mild summer months. In the winter, I like to hunker down with a book or some easy crochet. Keep it low key.
  3. Keep a routine
    • With less places to go (no beach visits) and/ or crazy holiday schedules, our routines can end up in upheaval. Try to keep some semblance of rhythm, whether it’s a warm cup of coffee in the morning or reading a book before bed. Try to give yourself some touch points of consistency.
  4. Be kind to yourself
    • It is not helpful to beat yourself up for feeling a bit worse during the winter. Shame has been scientifically shown to be a terrible motivator. If you have been beating yourself up for feeling extra blegh, try not to beat yourself up for beating yourself up. Self-compassion can start right here, right now.
  5. Keep in mind this is all temporary
    • Winter doesn’t last forever. The sun will stay out past 6 and the trees will bloom again. Hang in there, the late winter months are the home stretch.

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What is the most effective form of therapy?

Anna W

Excellent question! And one that is actually pretty easy to answer. Most people are familiar with the third wave of therapeutic modalities… cognitive behavioral, dialectical behavioral, and acceptance with commitment (CBT, DBT, and ACT, respectively). These three are evidence-based and can be very structured modalities. But there’s a whole plethora of modalities… psychodynamic, somatic, solution-focused, Gestalt, and Adlerian, to name a few.

Fun fact! Did you know that DBT was developed by Dr. Marsha Linehan, who herself had borderline personality disorder?

Dr. Marsha Linehan

So, which modality is best? Actually, the answer is none of them. It turns out, one modality is not better than the other. The number one predictive factor for therapeutic growth and change is this… it’s the relationship. If you feel like you get along well with your therapist, you trust them and you feel like you can share anything, then there’s a pretty good chance you will have a good outcome with therapy.

A relational therapist is not rigid. I don’t say “CBT for everyone”, because it’s not appropriate for every client’s treatment plan. A relational therapist notices both the client’s strengths and areas of growth, which helps inform the therapist on what will be most helpful for the client.

So don’t be fooled by “CBT is best” or “ACT is the most helpful” (even though I really do like ACT’s principles). If you build trust with your therapist, then you are well on your way to positive change.