by Jonathan Hers | Apr 10, 2024 | Counselling, Therapy, Tips
How can I best prepare for my therapy session?
Good question.
It’s best to avoid this situation: you put in the time to book another therapy session, you pay the money (gulp), you put it in your schedule, on the day-of you get your notification reminding you of your appointment, you travel to the office, you wait in the waiting room, you are welcomed into a room, you get to the chair, sit down, get asked the question, “what would you like to work on today?” A silence follows. And then you answer: “I don’t know.”
This happens a lot and I’d like to suggest gently that this is not an ideal situation.
I do want to start with saying that even if this is you, don’t be too hard on yourself. I’ve started many therapy sessions sitting in silence not knowing how to begin… and yes I’ve uttered these words. At other times I’ve just wanted to update my therapist on fun life events or ask simple questions that I’ve been pondering.
Even more, simply by booking a session you are already getting the gears moving in the change process. There are six stages in the change process (pre-contemplation, contemplation, preparation, action, maintenance, and termination). By booking a therapy session it means that you are past the first stage, which is pre-contemplation. The change process has already begun simply by contemplating your situation, deciding that you could use some help navigating your way forward, and then reaching out for help. The fact of having booked an appointment is substantial!
And yet, this question still remains relevant: how can I maximize my time in therapy? How can I make this investment even more fruitful? How might I go about preparing for therapy?
You want to get the best bang for your buck! Counselling – a valuable, set-part space and time for growth – can be enhanced by preparation.
So, how might one prep?
I’ve got three things for you: first, ten questions to ponder. Second, three tips. Third, one general attitude to develop.
Ten Questions to Prepare for Therapy:
I read a quote that said, “the best answers begin with good questions.”
I’ve compiled a list of questions that you can ponder before your sessions that will enhance your time together. I’ve gathered them from personal experience and from other clinical counsellors who have given me their insights on how one might best prepare for therapy.
- Whats not working? What do I want different? How will I know if it’s different?
- What do I have a hard time admitting to myself?
- What gets in the way of me getting to where I want to go? Bonus points if it’s a repeat offender.
- What do I want to change about my life? Make sure it’s practical, measureable, and reasonable.
- How would I have to adjust my time each week to achieve this change?
- How might I sabotage my plans to make this change?
- What is my role in maintaining the problem I am wanting to address? What do I gain from its existence?
- What could we focus on today that would help me leave feeling like it was useful?
- What stuck with me from the last session?
- What is bothering me the most right now? Is there something I can do to fix it? How willing am I to fix it?
Those are some questions to ponder before sessions that will help you get started in the right direction.
Three Tips to Prepare for Therapy:
Here are some other practical tips that you could take in to help as well:
- Have an ongoing tab on your phone or in your journal of topics, subjects, challenges that you are wanting to explore in therapy. Whenever new thoughts or insights or feelings rise up that are relevant, write those down in your notes.
- Take ten minutes before each session to mentally prepare. This moment of thinking, mindfulness, and silence will help you settle into how you are doing and what is going to be most important to focus on.
- Finally, a helpful reminder is that every session is NOT going to be groundbreaking. This is normal. Just like regular life, lots of the time we are not on the mountaintop, we are just in the thick of it. Processing our mixed emotions, asking good questions, risking vulnerability in the presence of a compassionate other. Let yourself embrace the process of growth and transformation which does not happen overnight. I’ve heard some studies that suggest that it takes at least 5-6 sessions to start to experience deeper therapeutic gains and other studies that say it may take up to 40 sessions to achieve the changes you are wanting to make.
Therapy is a bold endeavour to self-examine the state of our lives, develop understanding, and hope for growth. I’m continually left in wonder, awe, and reverence at the courage of those enter therapy and display this level of humility, vulnerability, and courage.
AN ATTITUDE TO DEVELOP
I want to end with another fundamental of therapy that might help your mindset going into each session.
Bill Gates once said, “Your most unhappy customers are your greatest source of learning.” In the same vein, Richard Schwartz, a seasoned therapist, encourages all of us to develop an attitude of openness and receptivity to the many excellent teachers that we have in life. He writes, “I’m not talking about the gurus, priests, professors, or parents, although they can certainly help you learn your lessons if they’ve learned theirs. I’m talking instead about the difficult events and people that trigger you—your tor-mentors. By tormenting you, they mentor you about what you need to heal.”
This gets at a deep truth that undergirds therapy as a whole: within the mess of our greatest challenges, discomfort, or pain, is the potential for transformation and growth. “But wait, I want to get rid of those very problems!” True, we do want change and that involves hoping for peace and order. However, the way forward is often not what we initially expect. When we are able to befriend these tor-mentors we find our pathway to healing and growth. When a seed dies, new growth breaks through. After a field has laid fallow, will it be ready to be planted again. The treasure is hidden behind the guarding dragon. The promised land comes after the trek through the desert.
Think of the wise people you know in life, have they had an easy life without challenge or suffering? No, quite the opposite. These people persevered amidst great adversity. Navigated complex messy obstacles.
This is the posture that will also aid your therapeutic journey: edge towards facing the given challenges we have, the internal limitations we have to admit, confounding situations we are plagued with and from that place we attempt to develop a posture of receptivity to these tor-mentors.
Deep breath. This seems like a lot, and it is. And that is why we don’t do this alone! We need a safe companion for the journey. Therapists can prove helpful companions to enter into this journey of growth, resilience, and change.
If you’ve been on the fence about trying therapy, we’d love to hear from you. Starting therapy can be an intimidating thing – we’ve all been there. If this post is resonating with you, give us a shout and we’d be happy to sit down with you.
by Jonathan Hers | Mar 27, 2024 | Children, Communication, Connection, Encouragement, Mental Health, Parenting, Teens, Tips
What does Family Systems teach about being Parent-Oriented?
Let me paint a fictional yet very real picture:
“I can’t take it! This yelling is killing me,” Trish cried out to her husband in frustration.
Trish: 41 years old, married to Owen, mother of two boys (Jake, 9, and Sam, 14), and working part time at a Marketing firm – sat down with her head down.
She went on, “I’m exhausted… and feel more tyrant than parent! I can’t take much more…”
So much for the classic Christmas exclamation (yes, I’m still in the Christmas/New Years reflective mode) we wish we could all shout from the rooftops: “It’s a wonderful life!”
Trish’s internal dialogue:
What an absolute battle! Shouldn’t swimming lessons be fun? Nevermind my lovely intentions for him to make some friends, something he is clearly struggling to do.
Our internal critics can be ruthless in their judgements:
The tone you used was too intense! What sort of mother screams like this at her kids? Hopefully none of the neighbors heard that. It’s hopeless! I cannot stop this yelling. Am I just a bad mother?
It’s one of those moments when you have intrusive thoughts about how you wish you could escape all the commitments you have. You are trying to uphold an image of order and yet the cracks are forming and your will power is running dangerously low.
If this is you, breathe in and out deeply. Right now. Try it. It helps. Slowly breathe in and out again. Take your time. I’ll explain in a second. This is important.
There is hope.
There are new dance moves to learn! New songs you and your family can move to.
There is hope.
Do you sense a little doubt rising up? If so, go ahead and acknowledge that part of you that is skeptical. Take a moment, and acknowledge that inner skeptic. Listen to what it’s saying. Makes sense. Change is difficult. We’ve gone down this road too many times. Hope often feels out of reach.
Well, as a therapist and fellow human (who is new to the parenting game), I want to encourage you and share some steps you can take to become that peaceful presence you long to be within your family.
Take the First Step.
I want to encourage you: walking up those stairs to confront your child, to investigate the brewing chaos, or to engage in the struggle to get your kid to swimming lessons is so important. Being a parent is a sacred duty. As much as I can through the medium of a blog, I want to say this: Well done! Parenting is so important.
Some of the biggest names in psychology and parenting – Gordon Neufeld and Gabor Maté – together wrote a book called Hold Onto Your Kids and they repeatedly highlight the importance of our children being attached or connected to us as their parents. Perhaps this seems obvious but, in fact, researchers are seeing a trend of children becoming increasingly more attached to their peers than their parents. This means our kids are getting their cues or primary validation from their friends over us, their parents. Do your kids lean towards being peer-oriented or parent-oriented? A helpful sign is who do they turn to when in crisis? Or this: when your child is freaking out at you it’s a sign of their safety with you.
Whatever the answer may be, your involvement is critical. And that means walking up those stairs over and over again.
I think of the movie It’s a Wonderful Life where George Bailey doubts whether his life has made any difference in light of the chaotic forces of big business creeping in and widening the inequality gap. In a moment of despair George wishes he had never lived! The classic parental exclamation: “is anything I am doing making a difference!?” Spoiler warning. George Bailey gets his wish to see what his community would look like if he never lived…and what does he discover? His life, in fact, has positively impacted countless lives. This movie is a beautiful witness to the power of a life well lived. The takeaway? Our lives, our love, and each little decision we make has a significant impact in ways that, more often than not, we will never see.
Your attention, your love, your concern for your kids, even if it comes across not perfectly, is worthwhile, essential and life changing.
Take the Next Step.
So back to our main question: how do we end this seemingly endless screaming match and attain that wonderful life we all want?
Deep breath in. And breathe out slowly.
Here’s an answer according to Family Systems research:
One of the best things you can do for your kid is to focus NOT on your kids but to focus on yourself.
What? This is a strange invitation indeed.
Hal Runkl, a seasoned family therapist, puts it this way, “We all feel incredibly anxious about our kids, and their choices, and we don’t know what to do about it. We fret and worry about how our kids will turn out. Inevitably, we’re so focused on our kids that we don’t realize when this anxiety takes over—and we get reactive.” (Runkl, 2009, p. 9).
Hal continues, “First, it’s a given that there are things in this world we can control and things we cannot control. Now ask yourself this question: How smart is it to focus your energy on something you can’t do anything about, something you cannot control? Answer: Not very. Follow-up question: Which category do your kids fall into? In other words, are your children something you can control or something you cannot control? Here’s an even tougher question: Even if you could control your kids, should you? Is that what parenting is all about? And what if it’s not the kids who are out of control?” (Runkl, 2009, p. 11).
Compelling right? Take a moment to think about that paragraph. Not fully sold yet? That’s okay. Stay with me just a bit longer so I can paint a picture of what this sort of parenting might look like.
So the natural next question to ask is: what does it look like to focus on ourselves as parents?
Take A Different Step.
It means doing what I got you to do above.
First, breathe in. Breathe out.
Then, acknowledge the parts of yourself that rose up (the inner skeptic we acknowledged earlier).
And then finally, move towards your kids.
Hal Runkl puts it this way: calm down, grow up, get close.
This sort of parenting is less about mastering the available parenting techniques but harnessing what Edwin Friedman (another family therapist) calls a “non-anxious presence.” It’s less about skills to learn and more about managing our anxiety. It’s difficult but doable. And it works!
The power of harnessing a non-anxious presence is that if change occurs in one part of the family system, it affects the entire system. When anxiety rises in one person, it instantly impacts the entire family system. Like certain house heating systems: if the temperature drops, instantly the heating system alters to adjust the temperature. Thus, as the parent, when one lowers their own anxiety (perhaps through our three steps – calm down, grow up, and get close) you will immediately impact the entire family. In fact, our heightened anxiety often creates the very outcomes it seeks to prevent (check out counterwill and Otto Rank for more on this).
This is why the first step of harnessing a non-anxious presence is breathing or getting calm. This aligns with new research that teaches us about mirror neurons which activate in those around us in response to our emotional state (Rizzolatti & Craighero, 2004). Our brains are beautifully programmed to be really good at mirroring, or “getting in tune” with those around us. So, as you manage your breathing in high intensity situations, it will impact those you are around. So, first: calm down. Breathe.
Think Things Through.
Some questions to ponder related to our first step: what situations with your children make you the most reactive? What is said that typically triggers you? What are you feeling at that moment? Have you ever remained calm in the midst of family chaos? How did that affect those around you?
The second step – grow up – is about how we handle the anxiety that is inherent in our families. It’s about avoiding speedy responses (emotional reactivity), increasing our self-awareness, and taking time to really think.
Can you, in the heat of the moment as you walk up the stairs in response to the apparent chaos brewing, acknowledge the sadness, anger, and anxiety in you that is rising up?
Hal puts it this way, “the only way to retain a position of influence with our children is to regain a position of control over ourselves” (Runkl, 2009, p. 16). Part of growing up, and thus infusing peace into our families, is our ability to embrace the emotional intensity present, the painful words unleashed, and the immediate discomfort for long-term pay-off. This is the process of maturity: our sacred responsibility as parents.
“I hate you!” “You’re no fun… I want to go out Friday night.” “I don’t know how to do this homework!”
Cue anxiety. Do you feel it in your shoulders? This anxiety leads to two usual responses: Scream or avoid! Instead, each time this anxiety rises up it is an opportunity for us to grow up. And this process of pausing, thinking, and becoming aware of our own emotions, gives us enough space to think and respond from a non-anxious position… or as close as we can get to it.
So, the second step is to grow up: embrace your own anxiety, name the thoughts and emotions that come up, and take a moment to think.
I’ll keep the third step simple. The final step is to get close, which simply means remaining connected. From this place of calm move towards your kids.
The Take Home Message.
Let’s put this all together:
Your kids are fighting upstairs. Your heart rate starts to increase.. Angry thoughts start to arrive: “I’ve got dinner to make…I just put out five different fires today and now this kid is at it again!” These intrusive thoughts and more flood your brain.
Here is what you need to do.
Walk upstairs… slow your pace… (unless danger is truly on the table… but it probably isn’t)…. Breathe in and out… attempt to slow your heart rate… even a little bit. Become aware of the part of you that is angry… where do you experience it? What is its job for you? Then, enter the room…
In conclusion, peace enters our families not in the way we expect, not through focusing on our kids – something we cannot or shouldn’t control – but through focusing on ourselves. Calming down, growing up, and getting close.
References
Neufeld, G., & Maté, G. (2004). Hold On to Your Kids: why parents need to matter more than peers. Vintage Canada.
Rizzolatti, G., & Craighero, L. (2004). The mirror-neuron system. Annu. Rev. Neurosci., 27, 169-192.
Runkel, H. E. (2009). Screamfree parenting: The revolutionary approach to raising your kids by keeping your cool. Broadway.
by Jonathan Hers | Jan 3, 2024 | Connection, Counselling, Guidance, Mental Health
New to Counselling?
Are you new to this counselling thing? Are you contemplating giving it a try? Do you need to go to counselling? Or just curious as to what the fuss is all about?
Well, here’s my attempt at giving you a little glimpse into the beauty of this phenomenon that is growing in its cultural acceptance and perhaps this can help you figure out whether signing up for counselling is the next right move for you. I speak as a fellow human who has attended counselling and as a therapist who has sat opposite to many who have courageously sought out help through the medium of therapy.
Here are some stats to gain a wider picture:
- Statista conducted a survey of 1,650 people ranging from 18 years and older in 2020 via telephone interview. They asked the respondents, “in the past 12 months, have you received any counseling or treatment for your mental health?” 43.7% of respondents from British Columbia said “yes.” New Brunswick wins (or loses depending on how you look at it…) at 60.1% of respondents responding with “yes.” Manitoba was the lowest at 27.7%.
- Another study found that between 2019 and 2021 the percentage of adults who had received mental health treatment in the past 12 months grew from 19.2% to 21.6% (Terlizzi & Schiller, 2022).
- Statistics Canada found that in 2018 17.8% of Canadians aged 12 and older reported needing some help with their mental health. This is around 5.3 million people. That’s a lot of people! Out of that 5.3 million, 43.8% reported that their needs were either not met (they did not go to therapy) or were partially met (they went to therapy but it was not enough).
What do these three sources tell us?
Simply put, therapy is being accessed more and more. Perhaps, we are catching on to the fact that our mental health is worth investing in. It really is. Gone are the days when therapy was reserved for those that we lazily labeled (or diagnosed) with words like “crazy” or “problematic.”
5.3 million Canadians acknowledged the need for assistance with their mental wellbeing.
Deeper than just being accessed more, these studies are perhaps a helpful reminder that you are not alone, not part of a small fringe group, but… dare I say… human. Not yet got this “life” thing figured out. Normal? I think so.
What Does Therapy Look Like?
So, if you’re new to this or not yet bought into it, give me a moment to paint a picture of what it looks like:
You arrive in a cozy office, sit in the waiting room, another fellow human – your counsellor – will arrive and call your name, together you’ll enter a room with a couch and perhaps a few chairs. You sit down. And then…
This is what you may see on the outside but so much is happening internally.
You are setting out on a grand adventure.
You are escaping the noise and bustle of every-day life.
You are marching out into battle.
You are sitting by a warm fire on a stormy winter evening.
You are resolving unfinished business.
You are tending a wound that no-one around you sees.
You are aspiring and hoping for who you could become.
You are settling into who you are, becoming more at home in your own skin.
If you break your arm, you go to a doctor. This doctor will first assess your injury and then set you off on a path of healing and recovery – aligning your arm, bracing it, and advising you on what activities may or may not be achievable in light of your wound.
In a similar way, you may have experienced various psychological/relational/emotional challenges – a huge setback in your work life and left feeling fragile, recurring conflict in your most intimate relationships, abuse from people that were supposed to be your protectors – and the question remains: where do I go to sort through/respond/heal these challenges?
The added challenge of mental health is its invisible quality, which leaves us vulnerable to the pushback: “is this just in my head? Can I just push through and deal with this?” A broken arm just seems so simple and obvious. However, mental pain and suffering left unattended can fester in similar ways than an untreated wound. Though, it may come out in angry outbursts, tension in your shoulders (perhaps its not so invisible…), the inability to know what you feel, a low sense of self-worth, or intrusive thoughts that plague you every time you slow down.
This is where counselling becomes useful in attending to your mental well-being. It is true that humans are resilient and often, even after experiencing traumatic life events, people bounce back with courage and vitality. And yet, counselling is a protected space to address and tend to our relational, emotional, personal challenges.
How does counselling accomplish change?
At very least it accomplishes this through undoing our unbearable aloneness. Dr. Diana Fosha passionately declares that our relational, emotional, personal challenges largely stem from “being alone in the face of overwhelming emotion” (Fosha, 2000). Thus, therapy, at its best, works to undo aloneness.
Judith Herman, the legendary trauma therapist, writes that “the fundamental premise of the psychotherapeutic work is a belief in the restorative power of truth-telling” (Herman, 2015, p.181). In the presence of another human, can you share honestly how you are doing? Can you express, in detail and with clarity, the truth of your being? As you dive into the biggest challenges that seem to plague your life through this act of “truth-telling”, you are met with wise attentiveness and deep compassion.
Bessel Van Der Kolk, the medical director of the Trauma Center in Brookline, Massachusetts, says “being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives” (Van der Kolk, 2015, p. 81).
A Safe Relationship
Do you have relationships marked by trust, safety, honesty? How can you tell?
Bessell highlights the importance of each of us being heard and seen by another person in our lives. We need to be held in someone else’s mind and heart. He writes, “no doctor can write a prescription for friendship and love; these are complex and hard-earned capacities” (Van der Kolk, 2015, p. 81).
Do you feel a desire to be met with this sort of attentiveness and care? Does it feel too good to be true? Too simple? Fair responses. A helpful question to explore is what the costs are for not receiving this hard-earned capacities?
I know I need them. And as I step into vulnerability—this act of receiving and trusting—I find myself walking lighter, thinking with greater clarity regarding my relationships and problems, and feeling more at home in my body and in this world. Perhaps you could call it feeling mentally healthy.
I encourage you to find relationships that are characterized by these qualities. Whether or not they are counsellors. It will change your life. It’s changed my life.
Here at Alongside You, these quotes inspire our work; We offer award-winning counselling services that are shot through with these qualities: a safe context to be seen, held in the mind of another, and this “hard-earned” love that Bessell speaks about. If you wish to learn more, contact us to see how we can help.
References
Elflein, J. (2022, August 31). Adults who received past-year Mental Health Counseling Canada 2020. Statista. Retrieved from, https://www.statista.com/statistics/1328941/adults-who-received-past-year-mental-health-counseling-canada-by-province/
Facts and figures. Fraser. (n.d.). Retrieved from, https://vancouver-fraser.cmha.bc.ca/impact/influencing-policy/facts-and-figures/#:~:text=Between%2019.6%25%20and%2026.2%25%20of,a%20mental%20illness%20each%20year.
Fosha, D. (2000). The transforming power of affect: A model for Accelerated Change. Basic Books.
Herman, J. L. (2015). Trauma and recovery. Basic Books.
Statistics Canada. (2019, October 7). Mental health care needs, 2018. Health Fact Sheets. Retrieved from, https://www150.statcan.gc.ca/n1/pub/82-625-x/2019001/article/00011-eng.htm
Terlizzi, E. P., & Schiller, J. S. (2022). Mental health treatment among adults aged 18-44: United States, 2019-2021. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
Van der Kolk, B. A. (2015). The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma. Penguin Books.
