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The Truth About Therapy

If what you know about psychotherapy comes from TV or the movies, you may have some misguided notions about what goes on in a practicing psychologist's office. Make sure you know the reality instead of the myths so you can benefit from all that psychotherapy has to offer.

Myth:

Only crazy people go to psychotherapy.

Reality:

Untrue. People seek psychotherapy for a range of reasons in everyday life. Some pursue psychotherapy for treatment of depression, anxiety or substance abuse. But others want help coping with major life transitions or changing problem behaviors: the loss of a job, a divorce or the death of a loved one. Yet others need help managing and balancing the demands of parenting, work and family responsibilities, coping with medical illness, improving relationship skills or managing other stressors that can affect just about all of us. Anyone can benefit from psychotherapy to become a better problem solver.Stigma connected to getting help for psychological or behavioral concerns used to be a strong deterrent for people. But getting help is now seen as a sign of resourcefulness. Researchers continue to find new links emphasizing the value of taking care of mental health to ensure good physical health, often called the mind-body health connection. Emotional problems can show up as physical symptoms. And when we are physically ill, we may develop emotional issues. Even the federal government recently recognized the value of mental health treatment with its passage in 2008 of the mental health parity law. 

Myth:

Talking to family members or friends is just as effective as going to a psychologist.

Reality:

Support from family and friends you can trust is important when you're having a hard time. But a psychologist can offer much more than talking to family and friends. Psychologists have years of specialized education, training and experience that make them experts in understanding and treating complex problems. And research shows that psychotherapy is effective and helpful. The techniques a psychologist uses during psychotherapy are developed over decades of research and more than “just talking and listening.”Psychologists can recognize behavior or thought patterns objectively, more so than those closest to you who may have stopped noticing — or maybe never noticed. A psychologist might offer remarks or observations similar to those in your existing relationships, but their help may be more effective due to their timing, focus or your trust in their neutral stance.Plus, you can be completely honest with your psychologist without concern that anyone else will know what you revealed. The therapeutic relationship is grounded in confidentiality. (There are a few exceptions where a psychologist has a duty to inform others, such as if you threaten to harm yourself or someone else. But that’s something your psychologist will clarify with you.) In fact, people often tell their psychologists things they have never before revealed to anyone else. If your difficulties have been ongoing without any significant improvement, it may be time to seek help from a trained psychologist.

Myth:

You can get better on your own if you just try hard enough and keep a positive attitude.

Reality: 

Many people have tried to solve their problems on their own for weeks, months or even years before starting psychotherapy but have found that that it’s not enough. Deciding to start psychotherapy doesn't mean you’ve failed, just like it doesn't mean you’ve failed if you can't repair your own car. There may be a biological component to some disorders, such as depression or panic attacks, which make it incredibly difficult to heal yourself. In reality, having the courage to reach out and admit you need help is a sign of strength rather than weakness — and the first step toward feeling better.

Myth:

Psychologists just listen to you vent, so why pay someone to listen to you complain?

Reality:

A psychologist will often begin the process of psychotherapy by asking you to describe the problem that has brought you into his or her office. But that's just psychotherapy's starting point. They will also gather relevant information on your background, as well as the history of your problems and other major areas of your life, and the ways you have tried to address the concerns. Psychotherapy is typically an interactive, collaborative process based on dialogue and the patient's active engagement in joint problem-solving.Your psychologist may give you homework assignments so that you can practice new skills between sessions or reading assignments so that you can learn more about a particular topic. Together you and your psychologist will identify problems, set goals and monitor your progress. 

Myth:

A psychologist will just blame all your problems on your parents or your childhood experiences.

Reality:

One component of psychotherapy might entail exploring childhood experiences and significant events impacting your life. Relating information from your family background can help you and your psychologist understand your perceptions and feelings, current coping strategies, or see patterns that developed. The point of wanting you to look backward is to better understand your present and make positive changes for the future.However, in some instances your psychologist will choose to focus mainly on the current problem or crisis that brought you into treatment and not delve into your past at all. You’ll learn how to incorporate techniques and use tools that will help change your current thoughts or behaviors contributing to your problem. Psychologists who use an eclectic style of psychotherapy will know how to guide the session to include discoveries about your past with reflections on current problematic thoughts or behaviors.

Myth:

You’ll need to stay in psychotherapy for many years or even the rest of your life.

Reality:

Everyone moves at a different pace during psychotherapy — it’s a very individualized process. In one study for example, half of patients in psychotherapy improved after just eight sessions while 75 percent had improved by the six-month point. It’s something you and your psychologist can talk about in the initial meetings when developing a treatment plan. Your psychologist's goal is not to keep you on as a client forever but to empower you to function better on your own.

Myth:

If you use your health insurance to pay for services, your employer will know you're in psychotherapy.

Reality:

Untrue. Remember that psychotherapy is bound by the rules of confidentiality. Only you can release your health records to an outsider. The only ones who know about your psychotherapy sessions are you, your psychologist and anyone to whom you give the written approval for your psychologist to talk (such as a physician or family member). The strict rules of confidentiality your psychologist is bound by aren't the only protection. In most states, mental health records receive an even higher level of protection than medical records. 

Credit given to the American Psychological Association


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Supporting a Loved One with Serious Mental Illness

Learn how to help a loved one through diagnosis and beyond

Mental illnesses are disorders that affect a person’s mood, thoughts or behaviors. Serious mental illnesses include a variety of diseases including schizophrenia, bipolar disorder, panic disorder, obsessive-compulsive disorder and major depressive disorder. Although they can be scary, it is important to remember that these disorders are treatable. Individuals diagnosed with these diseases can live full, rewarding lives, especially if they seek treatment as needed.Being diagnosed with a serious mental illness can be a shock — both for the person diagnosed and for his or her family and friends. On the other hand, finally obtaining a diagnosis and treatment plan can sometimes help relieve stress in the family and start moving recovery forward. Family members can be an invaluable resource for individuals dealing with serious mental illnesses. By learning more about the illness, you can support your loved one through diagnosis and beyond.

Encouraging a loved one to seek help

While symptoms of serious mental illnesses vary, the following signs are among the more common:

  • Social withdrawal.
  • Difficulty functioning at school or work.
  • Problems with memory and thinking.
  • Feeling disconnected from reality.
  • Changes in sleeping, eating and hygiene habits.
  • Alcohol or drug abuse.
  • Extreme mood changes.
  • Thoughts of suicide.

If you’re concerned a friend or family member is exhibiting these signs, try to stay calm. It’s easy to imagine the worst-case scenario, but signs of mental illness often overlap with other problems. Consider whether there are other circumstances that might be affecting the person’s mood or behavior. Did the person recently experience a shock, such as the death of a loved one? Have they recently lost a job or started a new school? Regardless of your answers to those questions, don’t let your fear of a diagnosis prevent you from encouraging your loved one to seek help. Start by talking to him or her. Express your concerns without using alarmist language or placing blame. You might say, “I've noticed that you seem more stressed than usual,” or “I've noticed you don’t seem like yourself lately.” Then back up those statements with facts, pointing out changes in hygiene or daily activities, for example.Encourage your loved one to talk to a trusted health care provider. If he or she is hesitant to see a mental health specialist such as a psychologist, suggest a visit to a general physician. Offer to accompany them to the appointment if they’d like. If your family member doesn't take you up on your offer, consider alerting his or her physician’s office with your concerns. Though the physician may not be able to share information with you due to privacy laws, it will give the doctor a head’s up to be on the lookout for signs of mental health problems.If you feel your loved one is in danger of harming himself or herself, or harming someone else, that’s an emergency. Don't hesitate to call 911. If possible, ask for an officer trained in crisis intervention — many communities have officers on staff who are trained to diffuse a mental health crisis in the best possible way.

A flurry of emotions

It’s entirely normal to experience a flurry of emotions when a loved one is diagnosed with a serious mental illness. Guilt, shame, disbelief, fear, anger and grief are all common reactions. Acceptance can take time, both for the diagnosed individual, for you and for other family members and friends. That acceptance happens at a different pace for everyone. Be patient with yourself and others.One of the most important things you can do to support a family member with serious mental illness is to educate yourself. The more you learn about what to expect, the easier it will be to provide the right kind of support and assistance. Familiarize yourself with the symptoms of the disease so that you are able to recognize when your family member might be showing signs that his or her illness is not well controlled. Remember, too, that there’s a lot of information on the Internet. Some of it is accurate. Some is wildly incorrect. Find trusted sources of information, and don’t believe every horror story. (See “Resources” at the end of this article.)

Balanced support

Medications can be helpful for controlling symptoms of many serious mental illnesses. But they might take a while to become effective, and medication alone is often not enough to keep these diseases in check. Encourage your loved one to take advantage of other resources, such as peer support groups and individual and/or group psychotherapy such as cognitive behavioral therapy or social-skills training. When a loved one is living with serious mental illness, it’s easy to want to take charge. That’s often especially true when the person is your own child or partner. But taking on complete responsibility for him or her isn't healthy for either of you. Individuals with serious mental illnesses are more likely to thrive when they are allowed to take appropriate responsibility for their own lives. Instead of driving your loved one to every appointment or errand, for instance, help him or her get a bus pass and learn the routes. Rather than preparing every meal for your loved one, teach him or her how to cook some simple, healthy meals.Individuals with mental illnesses still have an identity, and they still have a voice. Engage your loved one in open and honest conversations. Ask what they’re feeling, what they’re struggling with and what they’d like from you. Work together to set realistic expectations and plan the steps for meeting those expectations. Recognize and praise your loved one’s strengths and progress. Research shows that compared to offering positive support, repeatedly prompting or nagging people with serious mental illnesses to make behavior changes actually results in worse outcomes. Unfortunately, people living with serious mental illness still experience stigma and misconceptions. While that can be a difficult reality, the fact is that people diagnosed today can expect better outcomes than ever before. Medications have improved, and new evidence-based psychotherapeutic interventions can have powerful and positive effects. So try to stay positive. One of the most important things you can do to support a loved one with serious mental illness is to have hope. 

Resources

Thanks to Shirley M. Glynn, PhD, Karen Kangas, EdD, and Susan Pickett, PhD, for contributing to this article.


Credit given to the American Psychological Association.