Intro to Self Care

Self care. This word has become popular on social media and in progressive spaces, especially with the new presidential administration, but there’s still a lot of confusion about what it is. Literally self care about taking care of yourself, physically, emotionally, etc. A way I like to think about self care is learning how to be in a relationship with yourself. Learning yourself and what your needs are. Being honest, kind, and considerate to yourself about what you realistically can and cannot do. Our society prides constantly being on the grind and never sleeping to secure the bag, but eventually you’re gonna burn out. Non-stop work is not working smart. Meaning the kingdom you’re trying to build will be made of weak foundations if you do not learn balance. Learning to take care of your body and mind while you are working to achieve your goals will keep you going for longer and healthier. Invest in yourself. Maintain yourself. Burning out after constant grinding is not the wave and repairing yourself from that takes more energy and time than doing things on a regular basis to take care of you.

 Self Care Is…?

There’s a lot of misunderstanding about what self care even is and what it can look like. I asked Twitter for some common misconceptions and I’m gonna take some time to debunk them right here.

Myth: But Ain’t Self Care Like Doing Nothing/Like a Spa Day?

There are many different ways to do self care. When most people think of self care, they think about face masks and drinking lemon water. That works for some people, but that’s not all that self care is. Self care literally depends on each individual person and what they need/want at that given moment.

Some other examples of self care: blocking/muting someone, buying your favorite snack every Tuesday, going for walks alone, going out with friends, reading your favorite fan fiction at home, setting an alarm to take your medication everyday, rock climbing, limiting how much time you spend around certain family members, being kind to yourself when you feel like a failure, etc.

Myth: But Ain’t Self Care Selfish?

Nah, it’s a part of your larger health. No one would call taking care of your physical health being selfish. It’s sad: the way this society treats mental health care. It would be weird and insensitive to call someone selfish for walking away from a stressful situation because of their high blood pressure or heart issues. Or if they cancelled hanging out because they caught the flu. Also mental health and physical health are connected. You, your mind, and body need some love to function. Taking care of yourself will affect your whole body and make you stronger. And if you’re worried about looking or feeling selfish while you also deal with all your other obligations: How can you take care of others if you’re running on fumes? Take care of yourself.

Myth: But Ain’t Self Care Like a Cure-All?

Self care isn’t magical. It isn’t a cure. You might not notice huge changes in your life after a few weeks or even a month. It’s an investment in yourself. Like brushing your teeth. It doesn’t exactly cure dental problems, but it prevents larger issues from happening if you take care of your teeth little by little every day. Slowly, over time you’ll see changes in your mood, ability to sleep, life satisfaction, etc. The impact depends on the kind of self care you decide to do.

Myth: But Ain’t Self Care Always Easy to Do and/or Always Fun? 

Sometimes self care is boring and monotonous. Sometimes it’s not easy to do. But at the end of the day, self care is always good for you. Some examples of times when self care is more for the greater good and less because it’s fun to do: taking some time to sit in your feelings/self-reflect, doing homework earlier, cutting ppl off, drinking more water, getting tested for STIs every 3-6 months if you are at all sexually active with anybody, flossing your teeth, etc. Again, you do it because it is an investment in yourself and you’ll feel better in the long run.

Myth: But Ain’t Self Care Expensive?

Self care ain’t just for those with extra money to spend. Self care doesn’t have to cost money because you decide what self care looks like for you. It’s interesting that taking care of yourself is seen as something that has to cost money and has to be expensive. That says a lot about capitalism and our society that people think being able to take care of oneself is only for those with money. Self care can be going to bed on time. That’s free & priceless at the same time.

Doing For You

Y’all should know by now that I’m Team Self-Reflection. Learn yourself. Ask yourself some questions. Know yourself. Here are some questions to get you started:

Relationship with yourself:
  1. How often do you do stuff for you? Just for you?
  2. How much sleep are you getting? What’s the quality of your sleep?
  3. How is your appetite? How does what your eating make you feel?
  4. How are your boundaries? How easy is it to say “No” when you need to?
  5. What are 5 small things you could do today that would make tomorrow a little easier?
  6. How’s your health? Are you taking your medication regularly as prescribed? Do you have a primary doctor? How often do you go get checked? How often do you get tested for STIs?

All sexually active adults need to get tested for all bacterial & viral sexually transmitted infections every 3-6 months. 1 more time: if you are “sucking and/or fucking” someone, you need to be getting tested every 3-6 months.

Social circle:
  1. Who can you call if something popped off right now?
  2. What kind of support do you need? How are you getting those needs met?
Coped in the past by:
  1. Being alone?
  2. Being with loved ones?
  3. Distracting yourself with activities, events, school, work, etc?
  4. Using relaxation exercises (deep breathing, meditation, etc.)?
  5. Using substances (marijuana, coke, coffee, cigarettes, adderall, etc.)?

I don’t judge. Substance use in and of itself isn’t a problem (it being illegal aside). If the substance use is stopping you from functioning (EG: can’t pay rent and/or severe difficulties raising children) and/or if it causes you distress then it becomes a substance use disorder. A substance use disorder is a symptom of a larger issue and how someone is coping with a deeper problem. Trying to deal with the substance use disorder without dealing with the root issue is cruel because you would be leaving the person with the original problem AND 1 less coping skill to deal with that problem. Long-lasting change happens when you address the root problem first. Generally, the person will use substances less over time until it is no longer a substance use disorder.

Pros and Cons:
  1. Compare the risks and benefits of each coping skill and order them by the ones with most benefits to least. It would be real useful to get rid of the ones that are the least beneficial and replace them with new ones with less negative side effects.

Example: Drinking when you have diabetes. Even though alcohol is legal and even if you may be technically drinking a relatively average amount of, let’s say, beer with your friends. Your health (i.e. diabetes) means your body cannot process glucose (sugar) in your body and alcohol turns into glucose and will raise your sugar levels. Having a couple beers a night might be cool for other people’s lifestyles, but for you, it could mean serious health issues (kidney issues, loss of limbs, teeth issues, etc). So you could weigh the pros and cons and decide that the potential negative effects of alcohol on your body outweigh the social or numbing benefits of drinking.

Think about your life. Think about what you can do to show yourself some love. Think about the people and things that drain energy without giving anything back. Think about the things that bring growth into your life. Think about the things in yourself that you wish were different or about the life lessons you have a hard time learning. These are the areas where you should focus on taking care of yourself. The world is harsh enough. You don’t need to be hard on yourself too. It won’t actually make you stronger. It will eventually burn you out though. In these days and times we’re living in, burning out should be avoided. Take care of yourself now for whatever will be coming later.

Thanks for reading. Next post will be the part 2 of the corporal punishment/public shaming 2-part series on 3/25/18.

How to Know If/When You’re Depressed

Before I start I wanna say that it’s legit ok to feel sad sometimes. Humans are not supposed to be happy all the time. That’s impossible. Humans are supposed to feel a wide range of emotions. Even emotions that can be very uncomfortable or just plain suck to feel. That’s life. Hiding from those emotions or pretending you don’t feel certain emotions doesn’t fix a damn thing or make you a more evolved person (but that’s another post for another time). So what’s the difference between being sad and being depressed? Mental disorders, in many cases, are more extreme/intense (aka outside of the average person’s experiences) versions of everyday emotions and experiences. Anyone who has ever taken an abnormal psychology course probably has heard of the 4 Ds method of thinking about mental disorders: Deviance, Distress, Dysfunction, and Danger.

  • Deviance: Whether someone’s behavior is acceptable in their specific culture (or cultures) and society. For example, “disorganized speech” (where someone is impossible to understand due to a disorder in how their thoughts are put together) is a symptom of schizophrenia. It is incredibly important for therapists (and all mental health professionals) to understand someone’s background/context before diagnosing them. The situation changes completely if the person was speaking in tongues while praying. In that case, speaking in tongues would not be considered disorganized speech aka a symptom of a mental disorder because it is an appropriate part of that religion/culture. See what I mean?
  • Distress: Do the symptoms this person is experiencing cause them (or the people around them) clinically significant distress (EG: a lot of anxiety, sadness, pain, etc)? If you’re wondering why causing other people clinically significant distress in written into the diagnosis: For certain mental disorders (personality disorders, etc) and in other situations, a client may not notice their symptoms or the impact these symptoms have. This is called having “poor insight”. But just because the person can’t tell that anything is off/wrong, doesn’t mean that their loved ones and others around them aren’t affected. Example: A spouse who is currently having a manic episode and impulsively spending all the rent money. A therapist could still use this information to diagnose their client.
  • Dysfunction: Do the person’s symptoms affect their ability to function in society (hold a job, pay bills, maintain social relationships/obligations, personal hygiene, etc). This does not mean the person’s whole life has to be dysfunctional. Symptoms could affect 1 area of someone’s life so much that it qualifies. For example, social anxiety symptoms that affect a person’s ability to go on successful job interviews, but don’t come up when hanging out with friends would still count.
  • Danger: And finally, do the person’s symptoms cause them to be a danger to themselves or others. [Note: Danger alone does not mean someone has a mental illness. Lemme say that again: violence, abuse, and any other kind of danger (emotional, physical or otherwise) alone does not mean someone has a mental illness. So stop saying every person who is engaging in violence has a mental disorder. That’s NOT true at all. It adds to the stigma against people living with mental disorders (who are more likely to be victims of crimes/violence/abuse/neglect and therefore are always shafted in terms of healthcare and treatment because of this stigma). And it lets people who engage in violence, and this society that enables them, off the hook instead of really addressing root causes of violent behavior.

A given mental disorder does not have to have all 4 Ds, but usually will have at least one. The 4 Ds method is a nice guideline/tool for thinking about what makes something a mental disorder.

So what is Depression? Because I refer to the kitchen in my home as “my kitchen”, I find it the easiest to think about mental health disorder diagnoses like recipes. Every recipe needs ingredients and these ingredients have to cook for a certain amount of time before the meal is ready. To make a major depressive disorder, you need to cook at least 5 of the following “ingredients” for at least 2 weeks [These symptoms must cause distress or dysfunction and the symptoms must not be caused by anything else like medication/drugs or another medical condition]:
Must Have At Least 1 From Here:
  • Feeling depressed (or other people think you look depressed) nearly every day; Kids might look irritable instead of depressed
    • Translation: Feeling shitty, cranky/irritable, down, etc so intensely that it causes distress and/or dysfunction, etc
  • No longer interested or no longer enjoying all or almost all activities most of the day, nearly every day
    • Translation: You just don’t care about the stuff you used to or the same stuff doesn’t make you feel good anymore. You might find yourself pulling away from people and being social
And At Least 3-4 From Here To Meet The 5-Ingredient Minimum:
  • Huge weight loss/gain or appetite decrease/increase
    • Translation: Eating can either feel like a chore, be your new best friend, or all of the above depending on the context. The important part here is that your usual behavior has changed
  • Insomnia or hypersomnia nearly every day
    • Translation: You have problems falling sleep and/or staying asleep or you sleep for hours more than you usually do
  • Psychomotor agitation or retardation nearly every day that other people gotta be able to see
    • Translation: Agitation – Looking agitated (think restless movements like nail-biting, skin-picking, pacing, fidgeting, etc) to people or Retardation – Looking as if your speech, thoughts, and physical movements have slowed down, taking longer than usual to react, and/or you are talking much less, much quieter or with much less feeling. Psychomotor retardation is what can make doing every day activities (showering, cooking, household chores, paying bills, answering emails, doing homework, work, etc) feel impossible to do because it feels like you are physically incapable, almost like there are invisible weights/pressure on and all around you.
  • Feeling fatigue or loss of energy nearly every day
    • Translation: Feeling tired to the bone. Even the smallest activities might make you feel exhausted and you don’t get shit done the way you usually do
  • Feeling worthless or excessively/inappropriately guilty nearly every day
    • Translation: Holding yourself to unrealistic expectations, constantly ruminating/reviewing past mistakes, and/or seeing everything as evidence that you ain’t shit or blaming yourself for things that couldn’t possibly be your fault
  • Difficulties concentrating or indecisiveness nearly every day
    • Translation: Feeling distracted often, having trouble remembering things, and/or making even small decisions feels incredibly hard
  • Repeatedly thinking about death, thinking about suicide, thinking about suicide with a specific plan on how to do it, or attempting suicide
    • Translation: Passively wishing you could go to sleep and not wake up and believing that others would be better off if you weren’t alive on the lower risk end of the spectrum and constantly thinking about committing suicide, having a specific plan of how to do it, and/or attempting suicide would be on the higher risk end of the spectrum

I’m telling you all this, not so y’all can run around diagnosing people on the internet or IRL. Diagnosing a whole human being is not something you can do after reading a few pages in a manual. There’s so much work that goes into diagnosing a client: proper information gathering, taking into account the many parts of what makes each disorder, how the disorder develops in theory and in real life, risk factors, cultural issues, gender-related issues, and then comparing similar symptoms within multiple disorders to make sure that the diagnosis is as accurate as possible, etc. Basically, y’all, what I’m saying is take these good tips I’m giving you at face value and stay in your lane before you cause damage trying to diagnose or read someone’s mental status. Thanks!

This information is to build self-awareness so you can recognize possible signs and symptoms in yourself. Having a clear understanding of the symptoms and what makes those symptoms flare up is key. This post does NOT give you the ability to self-diagnose a major depressive disorder. Unless you have been diagnosed by a mental health professional, you cannot say you are clinically depressed (I should write a post about the overuse/inappropriate use of mental diagnostic labels & how it’s used as a shortcut to actually using more accurate/descriptive words for how you feel. And how people being uncomfortable delving too deep leads to using labels that don’t fit…). Again, what this post does do is help you identify any potential symptoms and give you a basic level of understanding. The first steps to healing are education and awareness. From there you can think about your options: using coping skills, asking for support from loved ones, looking for treatment, etc.

If you are experiencing these symptoms and want to access mental health treatment, places to start could include calling your insurance company to see what is covered, going Open Path Collective‘s website, filling out an intake for free/low-cost mental health services at nearby nonprofit organizations/community-based organizations, speak to your doctor about referrals, or checking directories like Psychology TodayNational Queer and Trans Therapists of Color Network, Therapy For Black Girls, etc.

 

If you feel like you want to hurt yourself and need someone to talk to, here are a few suicide hotlines (in the United States):
  1. National Suicide Prevention Lifeline – 1-800-273-8255 (1-800-273-TALK); Available 24/7
  2. The Trevor Project Hotline (LGBTQ youth) – 1-866-488-7386; Available 24/7; TrevorText: Text the word “Trevor” to 1-202-304-1200; 7 days a week 3pm-10pm EST; TrevorChat: Click this link for the chat portal; 7 days a week 3pm-10pm EST
  3. Trans Lifeline – 1-877-565-8860; Available 24/7
  4. Mental Health Hotline – 866-677-5924
Depression doesn’t make you a failure. You aren’t a bad person. You aren’t weak. You aren’t a sinner. You just going through some shit right now. You don’t have to go through it alone. Hope this helps. Let me know if y’all want more of these kinds of posts in the future. Thanks for reading.
Next post will be about workplace relationships among coworkers and employers “dating” employees on 2/11/18.

 

Making the Most of Your Time While Unemployed

So you lost your job. Whether you were fired, quit, asked to resign, etc., loss of a job is still a significant, routine-altering change. I mean you already had your lunch spot set up for months, even years. Even if your workplace was toxic, you were sipping the poison slowly and what didn’t kill you…made you incredibly unhappy, but let’s move on. Well, regardless, it is finally over and you might be wondering what to do next. For many, sudden unemployment is a life or death situation in this economy, especially for marginalized people struggling with low incomes, no generational wealth, debt, and job discrimination. Hopefully, you are able to secure unemployment insurance (for as long as it exists). And to be real, until you make sure you have stable housing, finances, and food situation, it’s gonna be very hard to focus on anything else. So I’m moving forward with this post, assuming that your basic survival needs are being met and you are able to focus on other needs.

Loss of a job is like any other kind of loss. You now have to adjust to this change and move forward. I would like to offer some suggestions on how to make the most of your time while unemployed:

Allow yourself some time to get your bearings.

This is especially the case if the way you left your former job was rocky or if the job was overall a toxic place to be. In many ways, it may feel like leaving an abusive relationship and you may have to heal from that. Or if you had to leave a job you enjoyed, you may need space to mourn that loss. Some people have to leave due to an injury or disability and that is another kind of loss and huge change to deal with. Many people are also living with depression, anxiety and/or many other mental health concerns and the stresses of unemployment can heighten these symptoms. I would suggest at least week or 2 of just letting yourself be. No pressure to accomplish anything (beyond applying for unemployment or whatever other social service benefits you might need while unemployed). Take this time and do some emergency healing. What helps you escape significant stress? How do you cope? Do you like to hide away? Cool, stay home, hibernate, text your friends, and watch movies until you feel more like yourself. Do you need a change in scenery? Maybe sleep over at a friend’s place for a week, like you’re on a vacation. Whatever you choose to do for at least a week or 2, do it for you with no shame. Giving yourself time to rest and recover from your last job is not only good for your mental health, but it will also strengthen you for the job hunt ahead.

Process what happened.

Whether you were fired or quit, having to leave a job unplanned sucks at best. Whether you feel relieved, overjoyed, angry, sad, resentful, exhausted, etc., there is nothing wrong with wanting to talk about it. Find consenting people to vent to about this or write about it in a journal, on your blog, etc. You’ll feel a lot better once you get some time to talk through what happened. And depending on how things at your job ended, you might need to talk about it a lot while you are adjusting to this change. That’s ok.

Structure Your Days

Part of what makes being unemployed difficult is the psychological piece. In this capitalistic society, work gives people a sense of purpose and on a basic level, work literally sets the schedule for people’s lives. It can be comforting and comfortable for many people to wake up at the same time everyday and know exactly what you have to do. Once you lose your job, that piece of comfort and certainty disappears. Now, you (and your body) have to figure out when to sleep, when to eat, and how to spend all the hours in the day. In the first few weeks, it is very easy to fall into an unemployment blackhole, especially if the situation at the last job did not end on good terms. Many of us have found ourselves laying on the bed/couch, feeling without direction. Fill up your day with stuff that feels fulfilling & healing. Set an alarm, apply for jobs, pick up hobbies, clear up your Netflix queue, maybe make a checklist, but be careful that it doesn’t become an obligation.

Go Outside

This can be really hard for more introverted people or people dealing with depression symptoms for example. However, finding a reason to get out at least 1-2x a week is medicine for the mind and body. Even if it’s taking an extra long walk back from the corner store or doing laundry. Some other suggestions: go to the gym, visit friends, go to the library, check out any free/low cost activities in your area, etc.

Ok…Now, What’s Next?

Think about where do you wanna go from here. Did you learn anything from your last job experience? What do you want to leave behind or take with you for the next job?

This is a great time to reflect on the choices you’ve made up to this point. Is there anything you’d do differently? Do you need to refocus/regroup?

With self-reflection, comes growth, y’all.

Maintenance

Once you give yourself time to heal, took some time to process your emotions until you feel lighter, got your schedule down, and find time to go outside at least 1-2x a week, now you’re ready for the hardest part of unemployment: maintenance. It could take months for you to find a new job in this economy. There could be days when you feel more hopeful than others. There could be days where you feel hopeless or lose confidence in your skills. Or days where you feel so frustrated and angry that you feel like doing something reckless. It could help to plan for those days. In therapy, this is called a safety plan. You hope for the best, but it’s always good to have your backup plan in place for when something pops off.

Some questions to ask yourself when planning for the worst:

  • What are some signs that let you know you’re starting to feel hopeless, sad, frustrated, etc? Do you feel it in your body? Do you get headaches? Do your hands shake? Or is it more in your head/thoughts? Do you get racing thoughts, for example? It’s good to be aware of yourself.
  • What are some things you can do to cope with these feelings/this situation? What are some barriers to (aka what stops you from) you using these coping skills and how could you overcome those barriers?
  • Who can you contact for support?
  • What kind of support do you want from them?
  • Do you feel comfortable calling emergency services? What hospital would you want to go to in a worst case scenario? Do you have any suicide hotlines handy?

Unemployment does not have to be a hellscape. Just like after any other loss, there’s room for healing and change. Following these suggestions can help you proactively make the most of your free time, focusing on healing and personal growth. Changing this usually unpleasant experience into a period of transformation also allows you to reflect on any lessons learned and re-examine your wants/expectations while you’re in the process of figuring out your next move.

Be kind to yourself. Invest in yourself. You might be surprised by all the things you are capable of.

Thanks for reading. Next post: “How to Know If/When You’re Depressed” on 1/28/18.

Finding the Right Therapist for You – Part 2: Your Role as a Client (Written in 2014)

Please check out Part One of this two-part series. This post is about your role and rights as a client. As I said in the previous post: therapy should not be something that is done to you. Rather, it should be something you do together with your therapist. For the sake of self-disclosure, I will remind you of my personal theoretical approach. My approach to therapy mainly comes from a postmodern client-centered approach (with some cognitive therapy interventions). If you remember from the first post, my theoretical approach dictates how I see a client, how I see my role as the therapist and what kind of techniques and methods I will use in therapy. My belief that clients should be active co-participants in a therapeutic relationship is influenced by my theoretical orientation. Basically, keep in mind throughout this post that not all therapists will agree with everything I say here. These are my beliefs and these are the things I stand for.

As clients, I believe that you are the consumer and the therapist is providing a service for you. Therefore, it is important to find a therapist that is best suited to be able to provide the best possible service for you. Finding the right therapist is like finding a partner. There should be chemistry. This potential therapist should work to gain your trust and create a safe space for you. And the both of you should be compatible enough that it is possible for the both of you to effectively work together to accomplish your therapeutic goals. As stated previously, this is the time to pay attention to the therapist’s theoretical orientation. Additionally, there is another factor to focus on: the therapist’s personality. Therapists are humans with all the accompanying strengths and flaws. If the therapist’s personality grates on your nerves or simply does not complement yours, you’re going to be distracted from accomplishing your goals in therapy.

Relatedly, think about coming out to the therapist during the intake process, aka that first meeting where the therapist asks you a lot of questions about your past, your personal life and the reasons why you decided to seek therapy. I know the idea of coming out to a therapist as queer, trans*, polyamourous, kinky, etc. may feel nerve-wracking and scary as all hell, but it is actually very helpful in the long-run. A therapist cannot provide care that is designed for you if they do not know enough about you. It is important to ensure that a therapist has the experience and the skills necessary to help someone from your community or communities. Even if, let’s say, your gender does not play a role in the presenting problem (the problem you are coming to therapy to deal with), if a therapist has negative biases or is ignorant about these issues, their ignorance may block them from being able to provide effective therapy. It would be hard to feel comfortable discussing your phobia of talking on the phone if your therapist somehow blames every problem you’ve ever had on the fact that you are genderqueer. Also it is impossible to provide effective therapy to a client without understanding them in their proper context. How can I possibly fully understand a client’s needs and goals if I don’t understand how being Chinese, queer or an immigrant interacts and influences their perspective? How would I be able to tell the difference between reasonable anxiety that comes from being a person of color in a racist society from a maladaptive anxiety that comes from an anxiety disorder without understanding their subjective reality? That said, your potential therapist does not have to be an expert on everything. That would be impossible. A therapist just needs to be open-minded and empathic. Your potential therapist may not know everything there is to know about being polyamourous and that’s fine. However, this therapist should be willing to do some research. You are not obligated to school your therapist on poly-101. It really is not that hard to go look it up on the internet and it would distract from therapy if your therapist kept asking you to explain how you can possibly date more than one person every other session. A therapist should be able to admit when they are not knowledgeable about something and should be willing to put in some work for the sake of the therapeutic relationship.

So congratulations, you bravely walked into their office, filled out the intake forms and then came back a second time for a therapy session. Damn right, good for you. Now that you have chosen a therapist, don’t feel like you are locked in. Do not be afraid to switch therapists and walk away from one if they are not meeting your needs. I have talked to some people who stick with incompatible therapists for much longer than they should because they feel as if they can’t leave. Your therapist is not your parent. You have power. You are the consumer. You can always find someone else if this therapeutic relationship isn’t working out. That’s not to say that you should just leave if there’s a bump in the road. Therapists are not perfect. I’ve bumped heads with my former therapist a couple times. The sign of a good therapist is their willingness to be flexible and their ability to apologize if they have made a mistake. Another thing to keep in mind is that there is a difference between feeling uncomfortable because you are dealing with your issues in therapy and discomfort because a technique or therapist simply is not working for you. If you are feeling uncomfortable or upset, talk it out with your therapist. They should be willing to talk about what is going on between the two of you in session (aka metacommunication). If a technique isn’t working for you, your therapist should be willing to modify it or scrap it altogether. A therapist that is not willing to be flexible and talk to you as if you are a competent adult isn’t a therapist that I would want personally.

Another thing to keep in mind: a therapist is not supposed to give you advice. It is not their place. A therapist is supposed to help you become independent by, for example, providing you with coping skills, teaching you techniques, and/or making you aware of your own inner strengths. Giving a client advice fosters dependence on the therapist by creating a situation in which the client feels like the therapist has all the answers. The client may not think they can come up with answers to their problems on their own and feel as if they would be incompetent without their therapist. This is not the kind of situation a therapist should encourage. If a client has a problem, an effective therapist would help the client brainstorm ways to resolve the situation on their own so that if they ever find themselves in a similar situation, they will be able to handle it without their therapist’s help. I would be incredibly wary of a therapist who dispenses advice or tries to “fix” your life.

Again, please don’t forget that, as the client, you have agency. The therapist is not your lord and master. They are not better than you. They are not smarter than you. You are the expert on your own life experiences and they are the expert on therapeutic approaches/techniques. You deserve respect for your expertise. In my opinion, a therapeutic relationship should be based on mutual respect, collaboration and trust. Don’t be afraid to stand up for yourself and seek out what is best for you. You are important and you deserve the best.

If you have questions or suggestions for future topics, please feel free to send an email to me at queeringpsychology@gmail.com or tweet to @QueeringPsych on Twitter.

Finding the Right Therapist For You – Part 1: Theoretical Approaches (Written in 2014)

This is part one of a two-part series regarding how to find the right therapist for you. A number of people have been requesting these posts for months and I am finally able to put this up. In this post, I will give very brief and basic descriptions of some of the more prevalent theoretical approaches that therapists work from. Knowing a therapist’s theoretical orientation/approach is incredibly important. All therapists are not the same. I have heard the following statements countless times from people: “My therapist is so awful! This proves therapy just doesn’t work for me!” Then I usually say, “Damn, I’m really sorry your therapist didn’t work out for you. What theoretical approach was your therapist working from?” And then I usually get a blank stare. Theoretical approaches determine how a therapist views you as a client, their role as a therapist, their relationship with you and what techniques they will and will not use. Think of theoretical approaches like a pair of glasses with which your therapist views the world. As a client, I think it is very important for you to know the theoretical orientation of a potential therapist. It is something that you really should consider when you are trying to figure out if a specific therapist is right for you. Do you want to simply focus on your anxiety symptoms? Do you want to talk extensively about your childhood? Do you want to figure out your place in the world? Different approaches focus on different aspects of life and different aspects of human psychology. Finding a therapist whose theoretical approach fits with what you are looking for can help avoid being with a therapist who simply is not compatible with you.

In this post, I will describe each approach by asking the following questions: “How Does This Approach View Clients and/or Humanity?,” “How Does This Approach View the Role of the Therapist?,” “How Does This Approach View the Therapeutic Relationship?,” and “What Are the Overall Goals of This Approach?”. I am only describing some of the many approaches and, as stated earlier, these descriptions are basic. This post is meant to serve as a diving-board for your own research.

Classical Freudian Psychoanalytic Therapy and Modern Psychodynamic Therapy

Psychoanalytic therapy is basically what first pops into everyone’s head when they think about therapy. Sigmund Freud is the founder of psychoanalytic therapy and his work influenced all of modern psychotherapy. Every theory that came after Freud’s was either inspired by or in retaliation of psychoanalytic theory. Psychodynamic therapy is the more modern version of Freud’s classical psychoanalysis.

How Does This Approach View Clients and Humanity?

  • In Freudian psychoanalytic therapy, human behavior is motivated by unconscious and irrational urges. Freud believed that humans are inherently savages that were reined in by society.
  • Human psychology can be split between things we are aware of about ourselves (the conscious) and things we are unaware of (the unconscious). Becoming aware of the unconscious parts of ourselves is the main goal of psychoanalytic therapy because with this awareness comes choice and change.
  • The experiences people have early on in their childhood have a huge impact on who they are as adults.

How Does This Approach View the Role of the Therapist?

  • The therapist is the expert and is the one who will provide the insight. The therapist makes insightful interpretations based on what the client has told them so the client can grow and change. Interpretations include calling attention to and explaining the meaning behind a client’s behavior.
  • In classical Freudian psychoanalysis, the therapist tries to remain anonymous and emotionally detached from clients to encourage transference (a client’s unconscious rehashing of old feelings and reactions from past significant others onto the therapist). The therapist explores these feelings and reactions as a window into the client’s unconscious thoughts and feelings. This approach assumes that the client acts in similar dysfunctional ways with the therapist as they do with other people in their lives.

How Does This Approach View the Therapeutic Relationship?

  • Classical psychoanalytic therapists want to remain emotionally detached from clients in order to provide insights and interpretations. In contrast, modern psychodynamic therapists see a solid and healthy therapeutic relationship as an important part of creating change.
  • The psychodynamic approach views emotional communication with clients as another way to learn more about the client and to build a connection with the client.
  • Sessions are fewer and shorter than traditional Freudian psychoanalysis (nearly every day of the week for many years).
  • In the current psychodynamic approach, clients and therapists sit face-to-face, instead of lying on the couch.

What Are the Overall Goals of This Approach?

  • Making the unconscious conscious (classical Freudian psychoanalysis).
  • Increasing the client’s ability to function in society.
  • Reducing symptoms and resolving internal conflicts.

Adlerian Therapy

How Does This Approach View Clients and Humanity?

  • Human are motivated by their desire to relate to others in society.
  • Humans have agency in their own lives, but their ability to make choices is limited by biological and environmental factors.
  • It is our feelings of inferiority and insecurity that motivate us to become better.
  • Clients are not sick. They are discouraged by life and this discouragement results in dysfunctional behavior.

How Does This Approach View the Role of the Therapist?

  • It is important for a therapist to be able to see the world from the client’s point of view. It is essential that an individual be understood in the full context of their life.
  • The therapist takes on the role of teacher and encourages the client by making them aware of their strengths.
  • The therapist helps the client create goals for therapy.

How Does This Approach View the Therapeutic Relationship?

  • The therapeutic relationship is collaborative, as the client and the therapist work together to create change.

What Are the Overall Goals of This Approach?

  • Encourage discouraged clients.
  • Help clients better understand how they see themselves and the world, which should avoid the repetition of symptoms.

Existential Therapy

How Does This Approach View Clients and Humanity?

  • This approach asks the question: “What does it mean to be human?”
  • Humans are constantly changing in response to the conflicts of life.
  • This approach focuses on how humans deal with being alone in the world and how they handle the anxiety that comes with it.
  • Humans are free to make decisions within the environmental and social limitations of life. Humans may not be able to control exactly what happens to them, but they can control how they deal with it.
  • This freedom comes with responsibility and the choices people make comes with consequences. Trying to avoid one’s responsibilities or trying to avoid making choices results in existential guilt and anxiety.

How Does This Approach View the Role of the Therapist?

  • The therapist helps clients explore their current values to see if these values are benefiting them.
  • The therapist confronts clients with the fact that they must become their own person and not allow others to define who they are. Clients are encouraged to accept responsibility for their actions.

How Does This Approach View the Therapeutic Relationship?

  • The therapeutic relationship is seen as a sample of other relationships in a client’s life.
  • A caring, respectful therapeutic relationship is more important than being an objective, detached professional.

What Are the Overall Goals of This Approach?

  • To help clients see the ways they are not living fully authentic lives full of freedom and responsibility.
  • To help clients face their anxiety and create meaning lives.

Person/Client-Centered Therapy

How Does This Approach View Clients and Humanity?

  • People are trustworthy and are capable of creating constructive change.
  • Clients already have the strengths and assets within them to overcome their problems.

How Does This Approach View the Role of the Therapist?

  • The expertise, clinical knowledge and techniques of the therapist are not as important as the quality of the therapeutic relationship. It is the therapist’s ability to connect with the client as a person and their ability to be present for the client that truly matters.

How Does This Approach View the Therapeutic Relationship?

  • The therapeutic relationship is incredibly essential. A good, solid relationship allows the client to feel safe enough to explore thoughts, feelings and behaviors that they have not been able to express otherwise. This leads to clients being able to become their own healers and create their own positive change.

What Are the Overall Goals of This Approach?

  • Help clients recognize their strengths and become independent so they can handle problems on their own.
  • Create a safe space that will give clients the freedom to explore parts of themselves they may have been too afraid to explore previously so they can live whole and authentic lives.

Gestalt Therapy

How Does This Approach View Clients and Humanity?

  • Clients have the ability to make positive change when they are fully aware of themselves and their environment.
  • Clients have an active role in therapy as they find their own insight.

How Does This Approach View the Role of the Therapist?

  • The therapist is a guide who encourages the client to change by discovering and accepting themselves and their environment.

How Does This Approach View the Therapeutic Relationship?

  • It is a collaborative relationship in which the therapist and client share their experiences in therapy together in the here and now.

What Are the Overall Goals of This Approach?

  • To expand the client’s awareness of themselves and the environment in the current moment because change comes through awareness.
  • To help the client accept themselves.

Cognitive-Behavioral Therapies

Cognitive-Behavioral Therapy is an umbrella term for many different theoretical approaches. All CBTs use techniques/interventions that focus on the cognition (thoughts) and behavior of clients as a way to create positive change. CBTs also tend to be short-term therapies that focus primarily on reducing psychological symptoms. I chose Albert Ellis’s Rational Emotive Behavior Therapy (REBT) and Aaron Beck’s Cognitive Therapy (CT) because they are the most well-known of the CBTs.

How Does This Approach View Clients and Humanity?

  • REBT
    • People are born with the potential for both rational and irrational thinking.
    • They learn irrational beliefs from childhood and actively reinforce these beliefs throughout their lifetime.
    • Blaming the self or the world is the root of emotional problems.
    • Life experiences and events do not cause psychological issues (i.e. anxiety or depression). It is our beliefs about the event that impact our emotions and behaviors. For example, according to REBT, you are not depressed because your father died. You are depressed because of how you perceive your father’s death. Your perception therefore influences how you behave and the emotions you feel. If your perception was changed, you would feel better.
  • CT
    • Humans have core beliefs about themselves and the world that they maintain all throughout their lives. When these beliefs are not accurate, psychological problems occur.

How Does This Approach View the Role of the Therapist?

  • REBT
    • The therapist is the expert and teacher, who models rational behavior for the client.
    • The therapist disputes the client’s irrational thinking and teaches them techniques to independently dispute and replace irrational beliefs with rational ones.
  • CT
    • Therapists encourage clients to turn their core beliefs into hypotheses to be examined. Clients conduct experiments to test the validity of their beliefs.
    • The therapist asks open-ended questions to encourage clients to find their own answers to their problems.

How Does This Approach View the Therapeutic Relationship?

  • REBT
    • According to Albert Ellis, a warm therapeutic relationship is not necessary for success and can actually be harmful to the client. He believed that it could cause clients to become dependent on the therapist.
  • CT
    • A collaborative, empathic relationship is incredibly important, but it is not the only thing needed to create change. Techniques are needed too.

What Are the Overall Goals of This Approach?

  • REBT
    • Teaching clients to accept themselves, flaws and all.
    • Teaching clients how to change dysfunctional thoughts, emotions and behaviors into functional ones.
  • CT
    • Helping clients analyze their core beliefs and change them if necessary.

Postmodern Therapeutic Approaches

Postmodern theory is a reaction to modernism, which believes that there is one true, objective reality that can be studied and known through the scientific method. Theoretical approaches based on modernist thinking are founded in the idea that people who seek therapy have deviated from some objective norm and need to be put back on the right path. Postmodern theory disagrees, believing that there are multiple valid and subjective realities. Each person lives in their own reality that is influenced by the time, place and society in which they live. There is no single objective truth and, following that, there is no single right way to live.

I will describe two postmodern therapeutic approaches: Steve de Shazer and Insoo Kim Berg’s Solution-Focused Brief Therapy (SFBT) and Michael White and David Epston’s Narrative Therapy.

How Does This Approach View Clients and Humanity?

  • Both postmodern approaches agree that clients are the experts of their own lives.
  • SFBT
    • SFBT believes that clients already have the strengths within them to resolve their problems, but sometimes people lose their way.
    • Clients are not reduced to a diagnostic label.
  • Narrative Therapy
    • An individual’s life is made of up stories, regarding how they perceive themselves and the world. These narratives dictate how clients live their lives and shape their realities. Psychological problems can come from the internalization of the narratives from the dominant culture, which takes away the personal agency of the individual. Modernist theoretical approaches would encourage clients to conform to the dominant narrative or simply help them to cope with the socially constructed “truth” imposed upon them by society.
    • Clients are not reduced to a diagnostic label.

How Does This Approach View the Role of the Therapist?

  • SFBT
    • The therapist helps the client become aware of their strengths so they can use these strengths to create their own solutions.
    • The therapist guides and encourages the client towards change, but does not tell the client what to change.
  • Narrative Therapy
    • The therapist has an active role, guiding the client toward change.
    • The therapist helps the client detach themselves from the dominant narratives they have internalized so they can create their own stories.
    • The therapist asks questions to assist clients in coming up with their own answers.
    • The therapist helps the client work through their problems and helps them take steps to solve them.

How Does This Approach View the Therapeutic Relationship?

  • SFBT
    • The relationship is very collaborative. Therapists are not the sole experts in the therapeutic relationship. Clients are the experts in their own lives and therapists are experts in the therapeutic process. Together, they both bring their sources of expertise to the table.
    • The therapist strives to create a relationship based on mutual respect and open communication.
    • The client sets the tone of therapy and of the relationship.
  • Narrative Therapy
    • The client and the therapist work together as experts to solve the client’s problems.

What Are the Overall Goals of This Approach?

  • SFBT
    • Goals are specific to each client and are created collaboratively by the client and therapist.
    • Goals are small and well-defined so clients will not become discouraged.
  • Narrative Therapy
    • To make clients aware of how the dominant culture’s narratives impact their lives.
    • To invite clients to create their own stories and take back their agency.

Integrating Approaches

Some therapists (myself included) prefer an eclectic approach to therapy. Meaning they combine aspects of theoretical approaches and techniques in order to fit who they are as therapists and to do what is best for their clients. Self-disclosure time: I personally work from a postmodern person-centered theoretical approach with some cognitive therapy interventions. Meaning, the way I see the world, my clients and my role as a therapist is influenced by post-modern and person-centered approaches. That said, I also see the value of some of the techniques from cognitive therapy in cases of anxiety, depression and phobias, for example. My specific theoretical orientation gives me a firm foundation to work from while also providing me with enough flexibility to work with clients as complex individuals and not as diagnoses. Integrating theoretical approaches can go wrong if not done properly. A therapist cannot just combine any theoretical approach and technique at random. The approaches and techniques must complement each other. If they conflict at their roots, the therapist does not have a proper clinical compass and is basically a ship lost at sea. No one would want that person to be their therapist.

The point of this post is to show you that all therapists are not alike. Each therapist works from a theoretical framework that seriously determines how they view you as the client, how they view themselves as the therapist and the techniques/interventions they will use. Do they see you, the client, as an equal partner-in-crime, as a student or as a patient who needs their insight? Do not hesitate to ask a potential therapist what their theoretical framework/orientation is. And then do a little research to figure out how this framework dictates the way they do therapy. This may be my personal approach showing, but do not think of therapy as something being done to you. Think of therapy as something you do with your therapist. You have power. You have agency. And I like to think that therapy works the best when both the client and the therapist work towards a common goal. Part two of this series will discuss your rights as a client.