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Therapy is a very unique type of service, and is often misunderstood in our current cultural landscape. In a world where we simply “change the channel” or, swipe on something we no longer want to engage in, therapy invites us to sit and to consider; to wonder; and to work in a thoughtful manner to design a better outcome for our life.

If you aren’t already familiar with the process of therapy, you may not be accustomed to the idea of paying someone for this special service. Alternatively, perhaps you’ve tried therapy before, but didn’t feel you had positive results. This is where it can be helpful to understand further the value exchange since therapy services can range greatly in terms of cost and quality. If you’ve tried therapy but didn’t feel you had positive results, this may be due to many factors. Reasons for unsuccessful treatment can vary, but might include that the therapist of choice didn’t have the right level of experience or training to help. Or, that for some reason, the client was struggling to actively engage or commit to the effort required to yield more desirable results.

As a therapist who has been trained to help others sit with emotion and to help emotionally strengthen others in a profound way, “the swipe left/ right culture” is in direct opposition to how I operate as both a human being and a provider. It has been sad to see large-scale telehealth companies using the line ‘change therapists at any time, no questions asked’ as a type of marketing point as if that’s some sort of indication of an overall positive thing. This is not to say choice isn’t a good thing, but it is to say: perhaps we are rushing through and running from something instead of facing the thing and committing to the work.

The current “anything goes/ instant results” landscape seems to go against the true essence of good and effective therapy and its purpose. I believe therapy is most useful and effective when the therapist is responsibly holding the frame and facilitating the course of treatment which includes clear communication, clear expectations, and a commitment to the work on both sides.

Why therapy?

Having doubts or concerns about starting therapy is completely normal. Most of us are not used to investing in therapy–meaning it might not be a part of our typical monthly or annual routine/ budget–and so as a result, we don’t have any context in which to place the investment in our mind’s eye…

There’s no denying that therapy is an investment of time, energy, and money, and so it’s important that you choose a therapist wisely. It also requires a willingness to explore the self and a commitment to the process which can feel challenging at times. Especially since it requires you to carve out time to show up each week.

As a therapist, I believe ‘the goal of therapy is to end therapy.’

While each situation is a little different and there are circumstances and situations that may require more long term support and care; generally speaking–therapy is most often a time-limited pursuit. I think of therapy as a course of treatment designed to help you make important improvements to your life (whatever form that may take). Therapy can help you heal from unresolved traumas, family of origin wounds, and gain awareness into any vulnerabilities that are keeping you stuck or struggling in some way.

Through a caring, individualized therapeutic alliance, that is designed to provide both a comforting and challenging environment, your therapist helps you to see yourself from a more authentic and compassionate stance while helping you to take meaningful action toward your desired outcome(s).

Therapy is an investment in your relational and emotional well-being designed to have a lasting positive impact.

While experience isn’t the only factor that goes into making the therapist effective, it can certainly make a big difference in the treatment and helping you work toward your goals. An experienced therapist who is fully licensed and who has been practicing for several years will have a breadth and depth of clinical experience and knowledge that newer therapists would not yet have been able to cultivate given their lack of experience. This is not to say that newer therapists are not helpful, however, you may find the lack of experience to inhibit progress in some important ways depending on your situation and presenting issues.

Understanding the landscape of mental health treatment in general…

The mental health system is a broken one. While there can be many positive aspects to our healthcare system in a broad strokes sense, there are also many challenges. Meaning that as a system, it isn’t functioning all that well and a lot of people struggle to get the right care they need when they need it. Providers do their part to create more accessibility in general and offer services on a sliding scale basis as well as group work. Companies are beginning to tune in more deeply to the importance of mental health overall and offer resources and stipends to their employees. And in general, there’s less overall stigma and people are more educated on the many benefits of therapy and the ways it can significantly improve their quality of life. In addition, there are also many helpful resources that have been developed to help improve access to high quality mental health services, which I will share at the end of this article. While the landscape has significantly shifted over the last ten years, there is still much work to be done. By truly valuing the service of therapy, we continue to move in the direction of truly valuing our peace, well-being and our relational health. 

Another factor impacting the overall landscape of therapy services is the low in-network insurance reimbursement rates for providers. As a result, many experienced therapists opt not to take insurance directly (in-network) because they simply wouldn’t be able to sustain themselves. Licensed therapists, similar to doctors and attorneys have spent many years training to become competent in their chosen field often taking out loans to complete their studies. Once a therapist completes graduate school, there are several more years of training required in order to become fully and independently licensed. This failure to acknowledge and respond to the realities of the cost associated with becoming an experienced and highly trained professional therapist contributes to the discord and disjointedness of how services are seen and utilized.

But I’ve never considered therapy to be an important investment…

Lots of folks don’t, and that’s part of the issue. We tend to value therapy only when we are in crisis, but not so much during regular times. Think for a moment what you spent time and money on over these last three months…as you reflect, how did your spending serve you? Do you have any regrets? Do you feel positive about what you seem to deem valuable? What might you change moving forward?

Therapy is the type of service often not thought about until you are feeling “in need of it,” which can impact how we think about investing in it. It can be helpful to contextualize therapy as a unique service and view it as a more time-limited expense rather than a long-term one. It can also be helpful to view therapy as a co-constructed course of treatment with a beginning, middle, and end. The therapist, who is trained to help with the specific issues you are facing, serves as a helpful guide on your unique journey.

Isn’t it like going to the doctor?

Similar but different. As the field of therapy moved over to primarily being controlled by managed care (insurance companies), the way psychotherapy services were offered drastically shifted as the insurance companies moved in to take ownership over the entire experience. As a result, the insurance companies deem how much services should cost and how long a person should be treated for–which can be limiting for many seeking the right care. For this reason, many therapists opt not to contract with insurance companies directly.

In addition, psychotherapy involves the development of an ongoing therapeutic relationship which involves the client sharing personal details about their life that is unique to the service when compared with other types of treatment providers.

Can I afford it?

This is a unique question because it also invites the question what are you willing to spend time and money on and why? Therapy might not be where you want to skimp and here’s why…

• it’s temporary (in most cases, though not all)
• it’s an important investment
• it can significantly improve the quality of your life
• cost is often influenced by therapist’s level of experience and training

Will insurance help pay for it?

In many cases, if you have insurance that covers out-of-network coverage, the answer is likely yes. You will want to contact the number on the back of your insurance card to find out if your contract covers out of network mental health services. You can also ask about the specific codes: 90791 (initial psychiatric assessment), 90847 (family/ couple work), and 90834 (individual psychotherapy) to learn more about the specific coverage of each. This can help you to make informed decisions regarding your care. In most cases, an experienced and highly trained therapist may be a more costly option, but you may find the work is more succinct and helpful overall—resulting in less time, energy and money spent in the long run. Ultimately, it’s important to consider your own specific needs and resources and make an informed decision from there.

What if I can’t afford it?

If you’re finding that the cost is out of reach after considering your personal situation in the context of the landscape of therapy, don’t lose hope. There are many wonderful resources that provide high quality care at low or no cost. You may have to do some research and provide some details about your income, but there are great options out there which I have outlined below. While the most important qualities to look for in a therapist are training and experience, the next most important quality is how comfortable you feel with them. (Studies show the effectiveness of therapy depends on a high quality therapeutic relationship!)

Ackerman Institute for the Family (NY- based)

Institute for Contemporary Psychotherapy (NY- based)

Alma 

Loveland Foundation -provides assistance for Black women and girls seeking therapy services.

Open Path Collective 

While the initial efforts involved in starting therapy can feel a bit cumbersome at first, therapy is work worth doing. Taking the time to address struggles and tend to our personal barriers helps us grow stronger in the long run. Taking active steps toward the life we desire to live is a powerful form of self-love!

The post Curious About Therapy, But Not Sure Where to Begin… appeared first on Modern MFT.

“We desperately need a more open dialogue about how severely heartbreak impacts our emotions and functioning. And for such discussions to be productive, we have to disavow ourselves of the notion that there is something childish, embarrassing, or inappropriate about feeling severe emotional anguish when our heart is broken because heartbreak is devastating at any age.” –Guy Winch

Dealing With Heartbreak…

Breakups can be one of the most painful emotional experiences whether or not you initiated it or even when they’re mutual. Often they involve many complicated emotions all at once—maybe you didn’t want it to end, and so you feel a deep and painful void. Or maybe you feel it was right that it ended but still deeply miss the person or aspects of the relationship you shared together.

Overwhelming Grief…

It might even feel like the loneliness can only be resolved by being with the person again. You might have regrets, unanswered questions, and many worries about the future–this is normal and to be expected. The grieving process can be overwhelming and feel like a double whammy in some ways—you might miss the person and then also the life you built together. You might know it’s for the best, but feel a deep sadness inside. Healing is possible and it starts with self reflection.

Deepening Self-Awareness…

Breakups bring a new beginning that we might not feel ready to step into fully. If you’re lucky, you may have had the chance to process your emotions together, but so often relationships end without this opportunity. When we honor our unique process of healing it allows us to move forward with greater clarity and intention.

You can learn to acknowledge:

“I am in pain, how can I allow myself to be curious about this experience?”

“How can I take care of myself through this rough patch?”

Allowing yourself the space and time to grieve, to reflect, and to use your supports can help you move through the pain and build greater awareness for yourself as a partner. We often want ‘resolve’ emotional pain ASAP, but our hearts just don’t work that way. Often, there is important work to engage in around this ending so that you can be available, receptive, and ready for your new beginning. Dating with intention is a unique process. It can be worthwhile to check in with self and make any updates as necessary.

How Therapy Can Help…

When we take the time to explore our inner world and address past hurts, we experience a powerful shift. To help begin the exploration process, you can ask yourself:

What are my beliefs about relationships?
What constitutes a healthy relationship?
How do I make space for my needs?
What are my own personal goals in life? What are my dreams and why? How do I want to feel in my relationships?

Relationship beliefs can be both helpful/ unhelpful, here are a few covered in the evidence-based Seeking Safety model by Dr. Lisa Najavits:

Helpful beliefs:
Seeks understanding, not blame
In healthy, close relationships, anything can be talked about
While losing a relationship may be painful, I can mourn and move on
A good relationship requires effort but is worth it
It is better to be alone than in a bad relationship

Unhelpful beliefs:
I am always wrong, the other person is always right
Good relationships are easy
I must be liked by everyone
The other person has to change
Bad relationships are all I can get

Which ones resonate for you?

In healing yourself and addressing problematic patterns/ behaviors, you create new pathways of relating–which in turn can lead to greater relationship satisfaction. If you are going through a difficult breakup, perhaps MAPs For Life Transitions can help! This unique program helps you deal with major life transition so you can experience relief and a sense of hope for your future. To get started, call 917.708.7088.

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Frequency and Presentation:

It is estimated that depression affects approximately 16% of the US population.

Depression can feel like seeing life through dark sunglasses, making it hard to find any joy in daily life. You might feel withdrawn and desire to isolate more and more. Depression can look like prolonged sadness, loneliness, irritability, lack of motivation, sleep issues, frustration, anger, resentment, and can lead a person to isolate and pull away from connecting with others; inadvertently worsening the feelings of depression. Life then, can become a self fulfilling prophesy–you feel depressed and then you don’t take any action and because you don’t take action, you continue to feel depressed.

Sometimes it can feel so apparent that something needs to change, but actually taking that first step of asking for help feels like the hardest part. 

Context

In my experience, depression, and more generally speaking mood related issues, also manifest differently based on an individual’s identity, background, socialization, and environmental factors that are experienced as being “out of one’s control,” making it difficult to identify mood concerns as depression. One example of this was found in a recent study published by the Journal of the American Medical Association which found that when men are depressed they may experience symptoms that are different than what is included in the current diagnostic criteria. Although men were likely to experience many traditional depression symptoms, men were much more likely to report symptoms of anger attacks/aggression, irritability, substance abuse, and risk-taking behaviors over symptoms such as withdrawal from friends, sleep problems, and feelings of complaintiveness. (JAMA Psychiatry)

Depression may manifest as a major impairment or in a more mild form which prevents you from actively working toward your goals and living with more intention. If left untreated, depression can be quite damaging to your sense of self, perceived competence, and your ability to maintain satisfying relationships.

Finding Relief…

Therapy for depression includes constructing a plan to relieve symptoms which also involves developing a deeper understanding of how to feel empowered within the contextual factors that contribute to what you’re experiencing. A holistic, 6-part approach has been known to be effective when treating depression: 

• Brain Food– evaluating your diet and making changes to help support your mood and overall functioning can help to improve moods. I often collaborate with other providers such as your primary care physician and nutritionist in order to help you make improvements in a healthy and responsible way.
• Action-putting into place a plan that is doable. Setting achievable goals and following through with them is part of managing depression. Through therapy, we will also help you to put outside supports in place and create a sense of community for yourself.
• Exercise– studies have shown that just 35 minutes of working out even in the form of a simple brisk walk, can be just as impactful as medications for depression so it’s worth giving it a try. In therapy, you will be able to make a plan that works for your lifestyle so you can make realistic progress.
• Exposure to light-bright light stimulates the brain’s production of serotonin, which is crucial to our well-being. Serotonin is a neurotransmitter with widespread effects on mood and behavior. (The Depression Cure)
• Sleep-is critical to our overall well-being and worth working on to improve. Here are a few tips to help you make some adjustments (list adapted from the book The Depression Cure, by Dr. Stephen Ilardi):
  • Set the scene for sleep. What does your bedroom look and feel like? Is it peaceful and conducive to rest? If not, what small improvements can you make to help set the scene? Studies show that cooler temperatures and a dark room facilitates higher quality sleep.
  • Anytime you’ve been lying awake for fifteen minutes, get up, leave the bedroom, and do something relaxing until you feel drowsy enough to return to bed.
  • Avoid getting into bed anytime you aren’t drowsy.
  • Anything you do to increase your drowsiness should be done somewhere other than the bedroom.
  • You can make an exception in the case of sex.
  • Avoid sleeping anywhere other than your own bed (i.e.- sofa, guest room, recliner).
    • Also helpful: get up at the same time every day, avoid napping, avoid bright light at night, avoid caffeine and other stimulants, avoid alcohol at night, if possible, keep the same bedtime every night, avoid taking your problems to bed with you (try a brain dump in a journal before getting to bed for example), don’t try to fall asleep.
• Cultivate healthy, reciprocal connections/ let go of toxicity-connection heals and combats loneliness. All of us are born to connect. When we don’t feel meaningfully connected to others, we inevitably suffer. The late researcher, Dr. John Cacioppo developed the following acronym to help people with the process of cultivating connection. He believed it was important to EASE your way back into social connections…
  • The first E stands for “extend yourself,” but extend yourself safely. Do a little bit at a time.
  • The A is “have an action plan.” Recognize that it’s hard for you. Most people don’t need to like you, and most people won’t. So deal with that, it’s not a judgment of you, there’s lots of things going on. Ask [other people] about themselves, get them talking about their interests.
  • The S is “seek collectives.” People like similar others, people who have similar interests, activities, values. That makes it easier to find a synergy.
  • And finally when you do those things, “Expect” the best. The reason for that is to try to counteract this hyper-vigilance for social threat.  

Hope

Therapy can be instrumental in making important shifts when it comes to managing depression. In my practice, I work with folks to help them honor what their depression may be trying to communicate and set a realistic plan to create a healthy routine and connection. Together we’ll work to help you gain a sense of stability while creating a more sustainable path forward. Treatment will take into consideration your history, past coping mechanisms, overall health and wellness, and your current support system and aim to strengthen these areas. Therapy is a unique type of service in that it requires you to be active both inside and outside of the therapy office. With that said, therapy requires a commitment to the process and a willingness to try something new and different.

Lisa A. Martin, PhD¹; Harold W. Neighbors, PhD²; Derek M. Griffith, PhD^3,4

JAMA Psychiatry. 2013;70(10):1100-1106. doi:10.1001/jamapsychiatry.2013.1985

The Depression Cure by Stephen Ilardi

**This post is meant to provide general educational information regarding the management of depression; it does not take the place of therapy or medical advice from your doctor.

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While browsing a local museum shop a while back (so much love for museum shops!), this nature-inspired pottery caught my eye. While I loved the colors and craftsmanship, I was most struck by the description of the artist…

The description mentioned where the artist ‘takes classes.’ This took me by surprise since I would have expected it to read where she might teach classes instead of where she is a student…I got to thinking about the value of maintaining a beginner’s mind as we move through life…

The value of a beginner’s mind…

There are so many “firsts” in life. The first time you go on a date, the first time you start to date someone seriously, the first time you experience heartbreak, a new job, a new city, a new position, a new life experience such as becoming a parent. All of these “firsts” naturally involve A LOT of not knowing — and not knowing can be difficult, scary, and highly unpleasant.

In an attempt to control the discomfort, we may become defensive or agitated or frustrated throughout the process. Or, we might shut people out because we can’t tolerate the idea that perhaps we might look a little sloppy while we are learning…

‘New’ implies there is a neediness, and needy can be a difficult emotion to navigate.

But perhaps there is value in shifting the perspective.

Michelangelo’s famous last words “I am still learning” or “ancora imparo” in Italian are wise and powerful because they remind us that even a master can admit they don’t know it all, that they are still being influenced by new information; new relationships. Relationship researcher, Dr. John Gottman found that being open to influence is essential in satisfying intimate relationships. And in order to be open, we must first accept that we don’t know it all.

Why do we resist?

People can have a complicated relationship to being new at something because it naturally implies that things will “be out of sorts” for a time — messy; uncomfortable; unpredictable and usually frustrating. We might lack confidence and feel uncertain and struggle with the experience of lacking proficiency. This can be very challenging for some of us as it might be difficult to tolerate feelings of uncertainty or vulnerability.

However, as hard as it might be, there is beauty in being a beginner. There are many important relationship lessons to learn from the experience of being new at something…

It’s human nature to want things to make sense and to fit. Being new at something challenges all of that! We might want to make something concrete when in fact, it just isn’t –  it’s more abstract, and it requires us to tolerate ambiguity and uncertainty while we grow to understand it further. Or, it challenges us to tolerate the discomfort of personal struggle. I see this a lot in my work with new parents. It can be incredibly challenging to adjust to a new identity where so much is unknown. There is so much that is expected of you while simultaneously, you are charged with learning as you go. It’s overwhelming!

What’s it like to admit you don’t know something?

What’s it like to sit with your unique learning process when you are new?

What’s it’s like to remain curious with someone you’ve known for years?

This can be challenging for all of us!

It might feel extremely uncomfortable – incredibly vulnerable even, you might even perceive it to be unacceptable. Sometimes, certainty and being 100% sure is what’s encouraged/called for; it might go against the culture in which you’re immersed (think being a surgeon for example). Perhaps it’s difficult to admit when you’re wrong or when you’ve made a mistake because mistakes are viewed as unacceptable. This might be part of our conditioning too – depending on our experiences in our family of origin.

What we can learn from being a beginner…

There was a time even the most experienced among us were once new at our craft—feeling scared, incompetent, uncertain, and afraid. But things are always changing. “No feeling is final” -Rainer Maria Rilke

In practicing having needs, we get to be vulnerable and we can seek out and receive comfort, help, and support. As a beginner, we get to practice important relationship skills like asking for help, articulating our needs, the experience of being vulnerable; we get to work on the art of receiving and leaning on others.

To practice being okay with not knowing is to practice being open and vulnerable. These are critical skills in communication and in relationships because they allow us to practice being present and honoring where we are at — wherever that may be.

Here are a few valuable lessons that can come from being a beginner and why they can produce important results:

Learning how to receive…

Cultivating a healthy sense of entitlement is so important! We need to allow ourselves the beautiful gift of receiving. This can be a vulnerable experience for many of us because it requires that we allow someone in to play a role in our lives. If we pride ourselves on being independent and self-sufficient, this can feel especially out of our comfort zone. Receiving can be tricky. It’s an acknowledgement that we have needs and desires. Learning how to receive and prioritize pleasure in your life is essential for satisfaction in intimate relationships. Many folks struggle with this and it is worthwhile to explore what is keeping you stuck or preventing you from seeking out or allowing yourself ‘to receive’ more often in your relationships.

Asking for help

Similar to learning how to receive, asking for help can be a challenge too. It implies we don’t have it all together and that we need others. When we ask for help, we are allowing someone to be there for us. Asking for help is a sign of strength not weakness. No one knows it all, and no one knows you better than you know yourself.

In order to connect with others in an authentic way, we need to know where we tend to get stuck. If we came from a background where it wasn’t safe to ask for help or we felt rejected by our caregivers, we might never have learned to reach out and make our needs known. This can lead to an internal sense of loneliness. It can be a struggle to unlearn this; to allow yourself to shift perspective and try something new.  Asking for help requires that we identify and articulate our needs. In relationship, this is necessary when it comes to experiencing intimacy and connection. 

Understanding vulnerability

Vulnerabilities are important to understand because they can get in the way of cultivating genuine connection. Getting to know and understand your unique vulnerabilities requires self-examination. Sharing yourself authentically with others and allowing others to do the same with you is the foundation for building intimacy.

Vulnerabilities can form as a result of many life experiences including traumatic events, chronic patterns in our families of origin, painful experiences in prior love relationships, poverty, stigma, oppression, illness, physical limitation, and disparities of power imbalances between partners.

When we are new at something, we might feel especially vulnerable because we are more likely in a position of relying on others for help. In intimate relationships, ‘helping’ can be a way to show love and it can be difficult to do at times because it means admitting that we don’t have all the answers or that we we need others.

“Whenever we love we must deal with feelings of vulnerability and risk in relation to the loved person. We must grapple with the possibility that our hearts can be broken and that we can lose the loved person to betrayal, rejection, divorce, or death. Ultimately we do not have control over their feelings and actions. At the same time, on a daily basis, we must trust that the beloved will be there for us. In order to sustain a relationship over time, we must handle these existential contradictions of adult love by managing our fears and vulnerabilities in ways that are not detrimental to the relationship.” -Michele Scheinkman, The Family Process

The chance to practice self-compassion (when it counts the most)

Self-compassion helps us to navigate the rough terrain with kind attention and care. In deepening our empathy for ourselves and our own experience of being human, we learn important lessons that can help us to have empathy for others too. This is an essential skill in relationships. Self-compassion helps to promote personal growth. We can learn to say: “that was tough, and I didn’t have all the answers, but I made it through; I am a resilient person.” Or, “I understand myself differently as a result of that experience; it taught me more about what I actually want.”

Why self-compassion can be a challenge?

If we grew up in an environment where it was best to suppress our true feelings in order to survive, we may have learned to be harsh with ourselves to get through difficult times. Self-compassion might not have been seen as valuable or important and so we never learned to practice it. You can improve self-compassion with practice. You can start by noticing when you say harsh things to self and then work to shift the statements to a more empathic view. This can help you to grow stronger because you are allowing yourself the space to be imperfect with kindness. This is what all children need to feel in order to be encouraged and to develop strong self-belief. However, we often have some inner child healing work to do in order to get better at offering it to ourselves.

Being new is something to celebrate not avoid!

While the feeling of not knowing or being inexperienced is uncomfortable, it is necessary for our personal growth and can teach us important relationship skills. Deepening our sense of self-compassion as we learn can help us experience greater intimacy in our lives.

The post What’s Your Relationship to Being a Beginner? appeared first on Modern MFT.

I often cringe when I hear: “finding a therapist is a lot like dating…” While it’s a unique relationship and does involve a level of fit, it is not like dating, and here’s why…

First, I’ll preface this post with the acknowledgment that yes, finding a therapist is a task and involves a process. And yes, it involves finding a “right fit,” but it’s not like finding a date or a partner. You’re not swiping left or right or trying to impress your potential therapist.

If you are seeking therapy, there is an important reason. Most likely, you are hurting or deeply dissatisfied in some critical way and you are seeking help to address these very important areas of concern.

With so many “helping/ healing practitioners” out there, you need to do your research on their educational and training background so you can be well-informed on what you can expect from the service and how it is designed to help you improve or move forward. Nowadays in the age of “influencers” and very costly social media ads, this is more important than ever. Do your research and take the time to become informed.

An important investment

You are not dating your therapist. You are paying your therapist for a highly specialized professional service that has legal and ethical standards in place. Your therapist possesses a license, advanced clinical skills/ knowledge, and several years of graduate and postgraduate training that allows them to deliver effective care to you.

They are trained to help you to make forward movement in your life toward a meaningful outcome. The therapeutic relationship is not a friendship nor should it ever feel like one. It is not a reciprocal relationship. While it can be a warm relationship and you will feel cared for, it is NEVER sexual! This is highly unethical due the nature of the therapeutic relationship.

What does “right fit” mean? 

There’s a lot of nuance to ‘fit’ in my experience. Here are my thoughts based on my work as a practicing therapist in NYC:

Experience

This is an important area, especially if you are getting ready to invest in high quality treatment. You do not want to waste your time or money. An experienced therapist will have likely worked in several settings over the years. They will have been exposed to many other medical and mental health professionals and will be able to offer you the benefit of their experience. In addition, an experienced therapist is often trained in different modalities and interventions so they will be able to integrate all that they know in helping you through the issues you are struggling with. This is crucial because providing effective therapy is both an art and a skill. If you are specifically interested in a private practice setting, be sure to read the bios carefully, as many practice owners employ less experienced therapists to work for them.

Training and skills

To become a therapist requires A LOT of training. An experienced therapist has spent many years training and developing their competence as an effective clinician. It is an intensive endeavor that requires a huge investment of time, money, effort, and energy in order to become a licensed and well-versed therapist.

A therapist has undergone rigorous and specialized training to be able to become licensed. For example, I myself completed my Master’s program at Syracuse University in 2011 (which included three clinical internship placements). After graduating, I worked for several years as an clinician in hospital and outpatient settings throughout CT. This allowed me to obtain the required clinical hours and supervision hours necessary to sit for the national exam in my field (marriage and family therapy).

From there, I worked at Columbia University Medical Center prior to opening my own practice in 2014. I have been operating a full-time private practice in New York City since then. Throughout this time, I continued to train. I have completed certificate programs at the Ackerman Institute for Family Therapy, the Gottman Institute, the New York Center for Emotionally Focused Therapy, and the Institute for Contemporary Psychotherapy.

My participation in several long-standing supervision groups here in NYC has been invaluable to my professional development. These advanced level training groups with highly experienced clinicians and renowned trainers have enabled me to offer the highest quality care to my clients.

When you pay for an experienced clinician, you are paying for their wealth of experience and their unique clinical knowledge. It goes way beyond simply “liking” your therapist.

You feel comfortable sharing things honestly with them

Again, you are not going to be friends, although you may feel a lot of warmth toward your therapist. And while they may experience warmth toward you too, it is not a reciprocal relationship. You don’t have to look the same or be into the same things in order for the therapeutic relationship to be effective. The therapeutic relationship is a one-sided, professional relationship. As a result, you don’t need to mesh with your therapist as if you are planning to date them. You just need to feel like they are competent to treat you in order to do your important work. This is critical to keep in mind as you sort through profiles that “catch your eye.” Since you are there for important reasons, make sure you are paying attention to the aspects of the therapist that really matter.

A well-trained therapist is skilled in working across differences and is experienced in helping individuals and couples of varying backgrounds. An advanced-level therapist of this sort has spent a significant amount of time in diverse professional circles over many years, so they will be able to navigate important conversations having to do with your experiences in a sensitive and well-informed way.

Scheduling a first session to get a feel…

The best way to assess fit with a potential therapist is by scheduling a session with them. In COVID times, that means virtually. So often, folks might want to try and assess fit over the phone, however, this isn’t the best approach. While you get to hear their voice, the purpose of the initial call is really for you and the therapist to talk briefly to gain a better understanding of the reasons that are bringing you in. If it seems to make sense to work together (the therapist treats those issues), you will schedule a first session so you can get a sense of what work might feel like with this particular therapist. If you are the type of prospective client who enjoys learning as much as you can first, I recommend checking out their website where you can read up on their specialties, training, and approach.

You can see yourself developing trust 

Trusting your therapist helps you to feel comfortable in the work. Feeling a sense of trust with your therapist will likely take some time to sense. How do you sense trust? You might feel trust when you perceive them to be a competent and boundaried clinician. Here are a few other things to notice about your therapist:

• returns your calls and emails in a timely manner
• helps you to receive your out of network reimbursement benefits
• takes the time and effort to collaborate with other providers who are also helping you
• follows up with you as necessary and is on time for your sessions each week

A good therapist will challenge you, and you’ll feel you are working toward important progress. If you are noticing these traits and interactions, that’s a very good sign.

I hope this post has been helpful as you begin to navigate your important journey. Therapy can be a life-changing experience with the right therapist so it’s important to invest in the right therapeutic relationship. In my practice, I offer both short-term therapy and more traditional weekly therapy services. I work with individuals and couples and I also facilitate groups.

Ready to get started on your unique healing journey? Let’s talk! 917. 708.7088.

The post Why Finding a Therapist is Not Like Dating… appeared first on Modern MFT.

I hope you are safe and well as we continue to navigate these uncertain and scary times together. 

I wanted to take a moment to share a few thoughts/ resources in the hope that it spreads some hope and serves as a gentle reminder that we have the capacity to exercise some control as we go through our days in the context of this unprecedented time due to COVID-19.

Creating a sense of control…

If there is any possible silver lining to self isolation, it may be that it is allowing us to reflect more deeply on how we spend our days. Perhaps this can help us to evaluate our intentions and be more present with our choices, our boundaries, and the people we choose to keep close. However, in addition to social distance, some of us may also be tasked with actually caring for loved ones who fall ill as we are all being significantly impacted in a variety of ways. Let’s not forget that we are all in this together. Kindness, curiosity, and small acts of care can go a long way!

There is no point in sugar coating: crisis mode is scary. Uncertainty can leave us with a feeling of losing control — unable to act in constructive ways. Sometimes it helps just to share with someone any strong feelings we might be having so that we can allow ourselves to receive some support and comfort.

Let’s not forget that there is so much healing energy in just listening and feeling heard. You can do this for a partner, a friend, a neighbor, a family member, or a colleague. You can also do it for yourself – through journaling or meditating, for example.

Making adjustments…

As we continue to adjust to social distancing, new work schedules, and increased time at home alone or with family, it’s important to keep a sense of structure to our days. If we have small children, this is especially important. In maintaining a schedule, we can have a sense of normalcy and take the necessary steps to move through our days with a sense of purpose and control. 

When we are in a space of extreme unknowns, fear can trigger our stress response cycle. It can take a toll and leave us feeling stuck if we don’t respond to it and work to stabilize ourselves. 

In working to stabilize, putting supports in place, and creating new routines, we can do what we can to maintain a sense of inner peace, self-control, and normalcy when facing the uncertainty of the outside world. 

Start small…

When feeling overwhelmed, start very small – even just focusing on our breath can have a significant impact on helping us to calm down so that we can become more effective. Just taking three deep breaths in and out, calmly and very slowly can help us regulate. 

It takes our bodies approximately 20-minutes to calm down from a heightened state of arousal, think: when we are upset with someone, in an tough argument with a partner, or when we are feeling frustrated or triggered by something. This is because the stress hormones that are released when in fight, flight, or freeze mode need time to leave our bloodstream. We need to calm down in order to be effective. So take some time today (individually or with a partner) to do some deep breathing and get to a more settled place. 

Creating an action plan to stabilize ourselves (as best we can), our relationships, and our family can help. There may be many feelings of fear and worry swirling around and this is a perfectly normal response to what has been unfolding as a result of the pandemic. These emotions are to be expected while experiencing a collective community/ global trauma. It’s important to honor any feelings that might be coming up by processing them so that you can feel supported in making a plan that works. It may be a good idea to take some space to gain clarity and talk through the worries by preserving some space in the coming weeks to unpack them in a thoughtful manner. 

Setting boundaries + intentions…

You may find that, in order to stabilize, you have to take certain steps to help you sustain yourself and this may involve making tough decisions too.

This might include talking through how to care for older family members, how to navigate childcare, finding time for good virtual social supports, and managing time for both work and personal while at home. 

If you are living with a partner, you may find it’s important to preserve some alone time along with your together time so that you can maintain connection and balance in your relationship while self-quarantining. 

Taking time to open up about these important areas can be incredibly helpful when it comes to feeling more in control and maintaining a sense of calm. In discussion, you have a chance to better understand yourself and what action steps you may need to take to feel more grounded. 

You may find that you will need to sort out a more constructive way to work from home so that you can maintain your projects and responsibilities. This may also involve evaluating your present boundaries and updating them or making some small adjustments. 

Take some time to organize yourself and get clear on how best to proceed given your unique situation. This is a unique circumstance where self-compassion is critical.

Give yourself a break…

Moving through COVID-19 is stressful! Save all the harshness for another time. (Better yet, just get rid of the harsh self-talk altogether!) 

You will not have everything perfectly sorted in a day. It might take a little time to work out a good system for yourself and loved ones and that’s okay. 

There is no right way to start, we just have to start. 

Fear has a way of robbing us of our ability to make good decisions and act rationally. From a grounded place, we can set the stage for the right action steps to take in order to maintain a sense of personal control and stability. 

A few simple suggestions to help you move through the coming weeks:

Create cozy moments in your day

It might be preparing a special meal, listening to music, lighting a candle, or using a special body oil. Shifting the atmosphere – even in a small way, can help promote a sense of calm and improve our mood. 

maintain at least 20 minutes of physical activity a few days per week

With many gyms closed and most of us staying indoors for much or all of the day, workout routines are significantly disrupted. Perhaps you can do a few reps of strength training or floor exercises to help you get moving. You may want to put on some music and just dance for 20 minutes or even join a virtual dance party. Any movement can help to significantly boost mood, complete the stress-response cycle, and help promote a sense of calm. 

Be thoughtful about nutrition and especially processed sugar intake

While we are more restricted with our days, it seems even more important than normal to pay close attention to our nutritional intake and maintain high doses of fruits and veggies now. Perhaps take a little special care to add in a few more servings of the good stuff over these next few weeks. You may want to use some time to pay a little more attention to meal prep in general. 

Dedicate some time to have a few stress-reducing conversations with a partner or a friend 

Social support and connection are essential to our well-being and especially in times of significant uncertainty. In stressful times, we need to experience both giving and receiving in order to help maintain feelings of closeness. A stress-reducing conversation helps you feel calm and cared for, try it out!

Plan some virtual dates with friends/ family

Get together with people! Just because we are limiting our time out doesn’t mean we have to stop socializing altogether. Schedule some time to talk to your people. We are all in this together and maintaining connection matters.

Maintain a normal routine/ schedule of activities, naps, mealtimes for kids

Kids need structure to thrive. If you have little ones and they are used to going to school or daycare, you will need to help recreate their activities and schedule so that they have a sense of what to expect day to day. It can help to have a few activities on hand similar to the activities and experiences your child may be involved in when going to daycare or school. You can help them to transition smoothly to being at home full-time by planning ahead to structure their day in a way that feels familiar and comforting. 

Protect your energy levels

It’s important to preserve a sense of peace as best we can. Let the news update instead of dominate. This can be tough when it feels we are constantly bombarded with the latest stories. However, it’s important to set limits and boundaries around how much exposure is necessary and helpful. You may find it’s helpful to try and balance staying informed with disconnecting by a certain time. Or, perhaps setting a time to stop checking for updates can be a helpful boundary. 

Get adequate rest and prioritize your sleep

Creating rituals to shut down your day can be helpful. If sleep has been a challenge more recently, perhaps you can just start with one small adjustment like making some soothing tea about 30-minutes prior to sleep or setting a time to put down all screens to start your bedtime routine. If you find yourself worried about your to-do list before bed, you may want to try a ‘brain dump’ exercise where you write down all the things you’d like to get to in order to release it. This can help you to psychologically give yourself permission to rest. 

These small behavior changes can go a long way in terms of creating the right atmosphere to help sleep come more easily. Remember, you don’t have to have it all figured out right away, you can just start with one small thing to help you move closer to the goal. If sleep has been problematic, here are some great tips to help you along.

A few news break distractions/ helpful resources:

The Tribeca Film Festival, like so many cultural/ community events, has been put on hold for the time being. However, you can still enjoy some entertaining shorts when you sign for their newsletter. You can check out their latest one here.

If struggling to get more organized at home, check out this great article featuring Karin Bohn’s design tips for how to set up a work space at home (when used to working in an office).

This interesting interview featuring Lori Gottlieb about her new book: Maybe You Should Talk to Someone – where she journeys into her experience both as a therapist and as a client. 

If you are feeling particularly tense, take a few minutes to listen to some running water or the sounds of a forest…check out the Mindfulness Coach app for a variety of brief meditations to help you relax and ground yourself. The nature sounds can be found under practice now—> all —> mindful listening. 

In addition, I’ll be hosting a free (ongoing) virtual mindfulness group on Mondays from 11:30-12:00. So if you’d like a little FaceTime with a familiar face where we practice some skills together, please join me! You can sign up here.

In keeping with the present safety measures, Modern MFT is now offering virtual sessions so we have the chance to meet face to face in the comfort of home. If you find yourself needing some additional support, please don’t hesitate to reach out.

Well, I do hope there’s something useful in here for you; and feel free to share this with others if you think it might be helpful. These are anxiety-provoking and uncertain times, so please treat yourself kindly. And remember the words of Winston Churchill: ‘When you’re going through hell, keep going.’

Sending you peace and positive energy. 

Warmly,

Jennifer 

The post Coping With COVID-19 Stress appeared first on Modern MFT.

You should sit in nature for 20 minutes a day…unless you’re busy, then you should sit for an hour – Zen saying

Our relationship to nature can be a complex one. Exploring more deeply our personal experiences and what constitutes quality time in nature can help us to be more intentional when it comes to prioritizing our mental health and wellness. 

Many of us might feel stuck at a desk for most of the day and struggle to prioritize an adequate amount of time in nature. It’s important to consider not only how much time you spend in nature but also the quality of that time. Recent studies demonstrate that regular, meaningful contact with nature is correlated with greater mental and physical health, just as minimal or no contact with nature is associated with symptoms such as depression, anxiety, a sense of malaise, feelings of emptiness, attention problems, poor sleep, obesity, heart disease, and hypertension (Barton & Pretty, 2010; Martyn & Brymer, 2016; Weng & Chiang, 2014).

At the American Family Therapy Academy’s national conference a few years back, I heard a wonderful and thought-provoking talk about taking an eco-informed approach to therapy which left a major impression on me.

The presenter, Dr. Tracey Laszloffy, emphasized the importance of helping clients to not only take inventory of how much time they spend in nature, but also helping them to assess the quality of their time in nature. So for example, if we are “in nature” but glued to our phone the entire time, are we truly experiencing the many benefits of nature?

In modern times, it is not unusual for many of us to be without much time in nature for weeks or even months at a time.

In a newly published article in the Journal of Marital and Family Therapy, Dr. Lazsloffy and her colleague Dr. Davis share:

Our hope is to invite a consideration of the role of nature in one’s life (and vice‐versa), prompt a sincere reflection on one’s values about nature, and commit to assessing for and encouraging regular involvement with nature should clients so desire. (Lazsloffy & Davis, 2019)

Although the journal article is geared specifically toward mental health professionals, these insightful questions can help anyone to take a closer look at their relationship to nature and begin to explore it further: 

• What kind of interactions did you have with nature as a child?
• How did you play or not play outdoors?
• How much or how little did your parents engage with you in outdoor activities?
• What thoughts and feelings did you have about nature as a child?
• What thoughts and feelings do you currently have about nature?
• How would you describe your relationship with nature?
• What, if any, value does nature have to you?
• How much time do you currently spend outdoors each week?
• Is this amount of time acceptable to you? Does it meet your needs? If not, what prevents you from having more time?
• What effect does interacting with/spending time in nature have on you?
• Where are your favorite outdoor places and spaces? Why?
• What are your most feared or disliked natural places/spaces? Why?
• To what extent are you able to derive comfort and healing from the natural world?

As indigenous communities have long understood, and as a growing body of research is beginning to demonstrate, an essential component of health and wellness involves having regular, meaningful contact with nature. (Besthorn, Wulff, & St. George, 2010; Louv, 2011; Pretty, 2004; Weng & Chiang, 2014).

Given the commitment that family therapists have to contextualizing our understanding of human experience, it only makes sense that we would include the ecological context in our consideration. (Laszloffy & Davis 2019)

If you’d like to increase quality time spent in nature, what are some of your obstacles? What’s one step you can take this week to help you move closer to your wish?

References:

Besthorn, F. H., Wulff, D., & St. George, S.(2010). Eco‐spiritual helping and postmodern therapy: A deeper ecological framework. Ecopsychology, 2(1), 23–32.

Louv, R. (2011). The nature principle: Human restoration and the end of nature‐deficit disorder. Chapel Hill, NC: Algonquin Books.

Pretty, J. (2004). How nature contributes to mental and physical health. Spirituality and Health International, 5, 68–78.

Weng, P., & Chiang, Y. (2014). Psychological restoration through indoor and outdoor leisure activities. Journal of Leisure Research, 46(2), 203–217.

Barton, J., & Pretty, J. (2010). What is the best dose of nature and green exercise for improving mental health? A multi‐study analysis. Environmental Science and Technology, 44(10), 3947–3955.

Martyn, P., & Brymer, E. (2016). The relationship between nature relatedness and anxiety. Journal of Health Psychology, 21, 1436–1445.

Laszloffy, T. A., & Davis, S. D. (2019). Nurturing nature: Exploring ecological self-of-the-therapist issues. Journal of Marital and Family Therapy, 45(1), pp. 176-185.

For more information on this topic, you can check out the following resources:

Videos

A playlist of TED talks focusing on reconnecting with nature: https://www.ted.com/playlists/398/reconnect_with_nature

Podcasts

http://www.npr.org/2013/09/27/216098121/everything-is-connected

The post Exploring Your Personal Relationship To Nature… appeared first on Modern MFT.

Trust is essential when it comes to intimate relationships – trust in ourselves and in others. It can be very difficult to learn to trust again after a betrayal in a relationship. However, it’s important to recognize that betrayal pertains not only to relationships with others but also in relationship to self. Self-betrayal might look like a lack of congruence or when our actions and words and feelings are out of alignment.  So how do we deepen and sustain trust?

When trust has been broken in some way, or we are struggling to feel a strong sense of trust, it disrupts the entire ecosystem of a relationship. Understanding trust helps us have a language around the specifics so we can hone in and work on certain areas and also ask for what we need in relationships.

Brené Brown is a leading researcher and author on several topics regarding the human condition. Her contributions have been incredibly valuable as she delves deep into helping us understand important and difficult-to-talk-about-topics like trust, vulnerability, courage, shame, and their impact on human connection. In a recent talk, she shares:

“If braving relationships with other people is braving connection, self-trust is braving self-love/ self-respect.” -Brene Brown

What does is mean to truly value and respect ourselves? What does that look like? What does that really feel like? *Journal prompt for self discovery: take a piece of paper or a journal and write out the following prompt: If I truly valued and respected myself, I would:

In a recent podcast, Dr. Brown discusses her acronym BRAVING to describe in greater detail what allows us to trust according to her years of research. Something that was striking to me was her focus on the importance of self-trust first.

As I was listening, I was also struck by how challenging this might be at times…what do you think might get in the way of building or deepening self-trust?

If this experience of self-trust wasn’t emphasized in our family-of-origin or our caregivers didn’t operate with self-trust themselves, how can we begin to develop self-trust as adults? Or, perhaps we’ve had a history of self-haring behaviors or tendencies toward self-sabotaging behaviors – which is common among adults who have experienced trauma, how then does that impact our ability to practice self-trust on a regular basis? How can we nurture a robust sense of self-trust so that we can also practice this in intimate relationships?

First, what is meant by trust?

According to Charles Feltman, author of The Book of Trust, “Trust is choosing to make something important to you vulnerable to the actions of someone else. Distrust is what I have shared with – that is important to me – is not safe with you.”

According to Dr. Brown, self-trust can be defined and explored using her acronym BRAVING:

Boundaries—”Am I honoring my own boundaries?” “Am I paying attention to them when it comes to my self-care and relationships?”

Reliability—“Can I count on myself? “Am I following through on what I say I will do?” Am I consistently responding to my own needs? This also involves being clear and honest with yourself so that you don’t over deliver on your commitments.

Accountability—“Am I holding myself accountable?” Am I willing to accept responsibility for my mistakes or where I went wrong? Can I acknowledge when I have made a mistake?

Vault—-“Am I protective of my stories?” Maybe there are parts of yourself you want to keep private until a person has shown you they are worthy of  hearing your story? “When do I decide to let someone in and why?” “When does it feel safe to feel close and why?”

Integrity—-“Did I stay in my integrity?” Brené Brown defines this as:
1. choosing courage over comfort/not taking the easy way out
2. choosing what’s right over what’s fun, fast, or easy
3. practicing your values, not just professing your values

Non-judgement—“Is it okay if I fall apart and ask for help sometimes?” “Am I judging myself harshly without any compassion?”

Generosity—“Do I give myself the benefit of the doubt?” “Can I assume the generous thing about my words, intentions, and behaviors?”

How does all of this land for you? What do you think?

If you are struggling with self-trust and you are looking to learn and practice skills and deeper self-awareness, you may want to consider joining my upcoming Seeking Safety group starting in October. The group focuses on healing from trauma and self-harming tendencies. To register or to learn more, please contact me at 917.708.7088.

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