I've never been to therapy. What should I expect?

Congratulations! Beginning therapy is a wonderful step towards greater self-awareness, improved mood, relationships, and clearer decision-making. Therapy is quite different from other experiences and relationships most of us have had, so it is only natural that you would feel a bit nervous and unsure.

When selecting a therapist, it is important to work with a person who feels like a good fit for you. You might know right away that a person is a good fit simply by how you feel when talking on the phone to set up your first appointment. If you hang up and feel relieved, calmed, supported, understood, or hopeful these are excellent signs.

Your first session with the therapist is a time for you and your therapist to get to know each other and to get an idea of how to work together, as well as if you are a good fit. Remember, you are interviewing them about who they are as a therapist as much as they are interviewing you as a client. If you are eager to treat your depression using concrete tools and cognitive techniques, you would not be served best by a therapist who is eager to explore your childhood experiences and to delve into your underlying feelings and coping patterns. This therapist might achieve excellent results in treating depression in certain clients, but it would not be a good fit for your personality and goals.

You will be asked about what brings you to therapy and what you hope to get from the process. There will also be some history-taking, which could include information about your childhood, relationships, jobs, and other important aspects of your life. You should also expect to talk about how the therapist thinks you could work together to decrease any symptoms you might be experiencing, as well as to develop some strategies towards addressing the concerns you have. During your first session, ask a few questions:

• What type of therapy do you do? (Therapists use a variety of techniques and approaches—talk, art therapy, bodywork, relaxation—and it’s important to know if a therapist’s approach feels comfortable to you).
  
• What is your picture of how this treatment process will go?
• Is there anything else that I should know about you, your approach, or your policies?
  

While you might experience some feelings of relief and support during a first session, chances are that it will take some time to work through the issues that have brought you to a therapist’s office. So, don’t expect for problems to be solved during a first session. The main goal is to be sure that the two of you will enjoy spending time tackling some difficult subjects together, and can get results. So, be honest, open, and direct with yourself and with the therapist. Best of luck to you!

"My partner and I need therapy, but s/he won’t go." How to get the help you need.

Do you remember learning that people don’t change unless they want to? Good news…Research actually shows that people don’t need to seek out change in order to be affected positively by change that takes place around them, or is offered to them. If change only helped those who were ready to seek it out, you and I would not be watching “Intervention” for the 100th episode!

In relationships one person is almost always more willing and interested in seeking out support—from friends, books, online sources, or therapists—than the other. This doesn’t mean that one partner is more invested in the health and well-being of the relationship, but that we each have different comfort levels with acknowledging our concerns, asking for help with them, and involving others in the process. Your partner may not be “ready to change" through therapy, but this doesn’t mean that s/he is not ready for old patterns to shift, your communication to improve, or to notice an improvement in your sex life.

Here are some ways to invite your partner to take the leap with you:

• Find a time when your partner is more likely to be open and receptive to what you want to say. Avoid bringing up therapy in the midst of an argument, the moment you walk in the door, or when s/he is distracted by other responsibilities.

• Speak from your experience and say what you would like to change about your own behavior, communication, or feelings. For example, "I think that going to couples therapy could really help me learn how to talk to you about some of the mixed feelings I have about being on maternity leave and my new job as a mother.”

• Identify the strengths in your relationship and in your partner, while acknowledging the areas of your relationship that continue to be tricky for you to address. Example: “I am so proud of all of the work we’ve done not to let little problems turn into big ones. One thing that we’ve had a hard time changing is how we resolve our differences about money and finances, and I think it would really help me to have someone who’s objective help us understand each other’s views better, and come to some agreements that feel comfortable for both of us.”

• Suggest a time frame. Sometimes people are put at ease by a set amount of time to work on a specific problem. “Let’s meet with someone for the next 3 months, so that we can work out these disagreements we keep getting into about finances.”

• Work together to find a therapist who feels like a good fit for your personalities and styles.

• Give your partner some breathing room to think about the idea and let it settle in. During your first conversation, suggest that you talk about this again in a week or so to see how it’s settled in with both of you. In a week follow up to see if you can get the ball rolling.

If your partner is “not ready for change” & all of your efforts to put him/her at ease were unsuccessful, all is not lost. A fundamental principle of therapy is that change in one person leads to change within that one person’s relationships and family. If you are ready to work on certain issues in your relationship, then get to work! Individual or group therapy can help you express your feelings, change unhealthy patterns, improve your communication, work on problem solving, and improve your mood. This attention to your own experience will change your way of relating to your partner. It may even help your partner to take that leap into his/her own therapy, or into therapy with you.

Coping with Loss

"Standing alone in her grief for as long as it takes to remember it is also a thing that binds us together." --Brian Andreas

I have been thinking about loss a lot lately. In my role as a school social worker I hear astoundingly sad stories about children and teenagers who have had friends, siblings, cousins, parents, teachers, and so many other important people in their lives die in tragic and sudden ways, and from long protracted illnesses. Regardless of the person lost or the way that they died, having someone close die is undeniably painful, saddening, unsettling, and produces countless reactions in people of all ages. Their stories and experiences are remarkably similar and wholly unique, as are the losses each of us endures as children, teens, and adults.

In life, we face many losses. The loss of a job, the move of a close friend, the end of a romantic relationship, the death of a mentor, the end of single life when entering a marriage. With each of these experiences, grief and loss can make us feel alone and disconnected--from ourselves, the people we love, the things we've always enjoyed.

Some ways to get through feelings of grief and loss and to feel less alone:

• Write in a journal. Letting thoughts and feelings out helps bring relief.
• Remember who in your life is a support to you--friends, family members, teachers, clergy, therapist, co-workers, neighbors. Accept the help that they offer and let them know what might help you--cooked meals, company, a friend to watch a movie, a walk around the block together, a partner to drive you to a counseling appointment.
  
• Do activities that bring you relaxation, laughter, or a feeling of connection--hike, ride your bike, watch a funny movie, enjoy music, take a hot bath, talk, create art, play a sport.
• If someone close to you has died, attend a grief support group. Here in Los Angeles, we have a wonderful community-based agency called Our House, dedicated to this issue.
  
• Seek further help from clergy, a therapist, or a grief support center if you feel that you are not able to talk with friends and loved ones as much as you need to, or if feelings of sadness, loss, anger, or irritability seem to be interfering with work, relationships, sleep, eating or other important parts of your life.