Entries Tagged 'Self-Help' ↓

By:  Suzanne Maiden, M.A., LPC 

Years before I became a therapist, I began my own therapeutic journey.  My first therapist, Ed, said something so profound I never forgot.  I was depressed and felt hopeless.  I thought about suicide.  I didn’t have a plan or anything, but it surely seemed as a possible option at the time.  Although I felt deep shame about my suicidal fantasies, I knew I needed help, and confessed to him.  I asked if my thoughts were normal - did everyone think about suicide at some point?  Was I crazy?  Ed calmly answered, “Suzanne, if someone has never thought about suicide - they are not paying attention.  Life is hard!” 

I sighed with relief.  I was, at least in that moment, normal.   Well, whatever defines normal - and that’s a whole other blog post.  Ed validated my suicidal thoughts and feelings as being within the normal spectrum of human emotions.  Today, as a practicing psychotherapist, the majority of my patients, at some point, express some suicidal ideation.  That’s the psycho-babble clinical jargon for suicidal thoughts.   According to Swiss psychiatrist C. G. Jung, when someone feels suicidal - they have the right idea!  Yes!  Jung used to tell his patients, in his thick Swiss accent, “Thank God!  You understand now that something needs to die!”  Jung meant that something needs to die psychologically for the patient - not physically.  Suicidal feelings signal something very big within us needs addressed and resolved - not physically killed.  A popular saying by therapists who assist suicidal patients is, “Suicide is a permanent solution to a temporary problem.”  According to SAVE - Suicide Awareness Voices of Education:

• Suicides take the lives of almost 30,000 Americans each year
• Over half of all suicides are completed with a firearm
• For young people, 15-24, suicide is the third leading cause of death
• The highest risk factor for suicide is depression
• 80% of people who seek treatment for depression are treated SUCESSFULLY!

If you or someone you know struggles with suicidal thoughts, please seek immediate medical attention at your local emergency room, call 911, or call: 1-800-273-TALK (8255).  There is HELP.  There is HOPE.  There is HEALING.  

By:  Suzanne Maiden, M.A., LPC

Only the bravest of the brave go to and stay in therapy - the psychological kind.  THERAPY IS HARD WORK for the patient.  Therapy (you know, the counseling kind), requires an enormous emotional and financial commitment.  Then there is that pesky time factor, ideally, the patient should attend 1 session per week - more if they’re in crisis.  Who willingly adds three extra hours of work to their week?  How is it three hours?  Well, on average, the commute alone is about a two hour roundtrip, add in the therapeutic hour - which is actually 50 minutes - and 3 hours are gone!  Therapy is expensive.  Many providers are moving towards private pay because dealing with insurance companies is ridiculously time consuming and not cost-effective for the therapist.  Depending on where you live and the providers credentials, therapy rates may vary from $75.00 - $350.00/hour.  Ouch!   

The emotional expense for the patient is initially pricey.  At first, therapy may seem like a high-cost-low-yield investment.  One of the biggest surprises for the client - therapy doesn’t always feel good right away.  Immediate relief is no guarantee.  Why then, would anyone in their right mind engage in this?  Yes, I know what you’re thinking: ‘Well it they were in their right mind, they wouldn’t need therapy…’  Not so.  I’ve NEVER, never ever, met anyone who could not benefit from some therapy.  I stay in therapy.  We all need a good therapist.  Why?  Because we are all wounded.  Life is hard.  We all have an innate need to be deeply understood.  We all have an innate need to be heard and witnessed and loved.

After several multiple sessions, and depending on their level of functioning, the patient begins to heal.  How?  Because a competent therapist helps the patient identify wounds and traumatic events which contribute towards current dysfunctional behaviors.  This is a process.  It cannot be rushed.  Patients often ask: “I’ve been coming here for 6 weeks?  How come I don’t feel any better?  I actually feel worse!”  Why?  Because it takes years for our psyche to create and maintain defense mechanisms - the emotional blocks we create to avoid feeling pain.  Therapy is like a gentle exfoliation of ‘dead’ or necrotic emotional tissue.  It is hard for the patient to let go of the very structures that have been their emotional glue.  It hurts.  Therefore, the therapist’s role is to facilitate a balance between challenging the patient vs. allowing them freedom to go at their own pace.  A good therapist is constantly negotiating this holding the tensions-of-the-opposites.  Therapy is more like a marathon vs. a sprint. 

Therapy is hard work for the patient - but it is the best investment anyone can make in themselves.  The final dividends are richly fulfilling and yield increased emotional well-being.

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By:  Suzanne Maiden, M.A.

I was pleasantly surprised to see the Today Show with Dr. Nancy Snyderman and the Editor in Chief, Ann Shoket, of Seventeen Magazine, discuss cutting behaviors in young women.  ‘Cutting’ is the layperson word for Self -Injurious Behaviors (SIB).  Why would I be happy to hear this touchy topic be talked about on mainstream T.V?  Because cutters and why they cut are grossly misunderstood.  I wrote my graduate thesis on SIB.   Many medical personnel and mental health professionals find cutters’ behaviors troubling, treatment-resistant, and plain disgusting.  As a practicing Family Therapist I have successfully treated many cutters.  I appreciate your bringing awareness to this issue.  I would like to offer just a bit more insight based on my experience.

Katie Stewart bravely shared her painfully private struggle with the Today Show .  In many ways, she represents the various women with whom I have worked – bright, beautiful, and the seemingly a “great kid”.   Unless one would see their scars, cutters do not fit an easily identifiable profile.  Outwardly, they present as very together.  Inwardly, they battle demons.  Most want to quit.  Many report extreme shame and guilt over their irresistible urge to self-injure and go to great lengths to hide their scars.  But why?  Why does anyone self-injure?  There are multiple hypothesis as to why people self injure to include:  1) non-validating environment, 2) poor attachment in childhood, 3) addicted to their own opiate release system, and 4) history of sexual abuse. 

The data strongly support the positive correlation between sexual abuse and future SIB.  Not every person who has been sexually abused will end up self-injuring.  Conversely, not every person who engages in self-injury has a positive history for sexual abuse.  However, in my personal experience, the majority of my clients who self-injure do report a positive history of prior sexual abuse. 

What’s sexual abuse have to do with self-injury?  The cutters who do have a positive history for sexual abuse frequently report that self-injury is the only way they know to access their pain – or express it.  Ironically, many self-injurers do not feel pain while actively self-injuring.  Why?  Because sexual abuse survivors tend to be very adept at the ability to dissociate.  That is, when sexual abuse occurs, the victim often mentally “checks out”.  This ability helps the victim endure the abuse when they cannot physically escape.  Many cutters report they are in a dissociative state when they self-injure and many do not realize the extent of tissue trauma until they “come back” mentally. 

Cutters are often the modern day lepers of emergency rooms and therapists’ office.  Nobody wants to deal with them and their self destructive acts.  However, their wounds are the physical manifestation of their internal suffering.  If they knew how to access their pain in a healthier way – many would.  Thank you TODAY Show and Seventeen Magazine for bringing this dark phenomenon into the light.          

 

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By: Suzanne Maiden

As a Family Therapist one question frequently asked is: “How do I find a good therapist?” Below are 5 basic components to consider:

I. Word of Mouth is still one of the best ways to find a skilled therapist. If you’re resistant to asking a friend, consider calling the following to ask for referrals:

* Primary Care Physician/Doctor’s Office
* Local church (call several)
* Hospice or Funeral Home (if grief related)
* Local Hospital Mental Health Unit
* School Guidance Counselor (s)
* Community Mental Health Center (often listed in the front of your phone book)
* EAP (employee assisstance program)

II. The First Call – What to Ask?

* What are your clinical specialties?
* What population do you enjoy working with most?
* Do you accept insurance? Will you consider a sliding scale?
* Do you have access to a competent psychiatrist if medications may be needed?
* Average length of treatment?
* Are you in therapy? Have you ever been?
Most therapists have the academic training to treat the full spectrum of mental health issues. However, as therapists we have our clinical strengths. For example, one of my areas of expertise is SIB (self-injurious behavior) or ‘cutters.’ Many therapists dislike working with this population for various reasons. I can work with cutters all day long. Don’t be afraid to ask. The last question surprises people. You want your therapist to have actively spent time working on their issues before they help you work on yours. I stay in therapy because I need a great therapist for me to be a good therapist. It’s like Tiger Woods continuing to take golf lessons – it keeps him on top of his game.

III. The First Appointment – What to Expect:

* You want the therapist to take a thorough history. Yes, I know, you or your loved one may be in crisis and you finally make it to the therapist’s office; you’ve got a lot to say. You don’t want to spend part of your 50 minutes by answering a lot of questions. But a thorough history potentially eliminates big future ‘uh oh’s’ and errors.  It’s imperative to your best treatment.  Nearly every time I compromise on initial history taking - I regret it because I inevitably miss a big piece of information that perhaps my client did not think was a big deal - but was key for correct diagnosis and treatment.
* Be honest about all medication use, especially recreational drugs to include alcohol.
* Make sure you understand confidentiality policies. Therapists are mandated reporters. Loosely, a mandated reporter is legally obliged to report suicidal/homicidal threats and physical/sexual abuse. This does NOT mean that if the client mentions suicidal/homicidal thoughts that they will be reported. Only, if the client presents imminent danger to self or others, then therapist must take appropriate action.

IV. Trust Your Gut – But Don’t Quit Prematurely

* Trust your gut whether the therapist is a good fit; BUT, give a new therapist 6 sessions before you bail. Rapport takes some time.
* It’s important that you like the therapist as a person; this doesn’t mean that you agree with everything they say, I guarantee you won’t, that’s OK
* It’s important that you feel confident in their ability
* It’s important that you experience the therapist as genuine, compassionate, sensitive, and non-judgmental of whatever you bring into the session

V. A Good Therapist Can Change Your Life:

The therapeutic relationship is one of the most intimate relationships you will ever know because it is supposed to be a safe haven to explore your inner world and deepest thoughts. It is completely about you - the client. Reciprocity does not, nor should it, exist. That is, the therapist is always in service of the client.

Lastly, the therapeutic role is to assist the client in exploring healthy life choices and identify barriers which may inhibit that process. Therapy can be one of the most growth-enhancing and healing events anyone can ever experience. Make that call.