When should you seek a therapist?

I was reading a blog post on Psych Central about when a person should seek a therapist.  It can be a difficult decision to make as I’ve found on some web boards where people ask about choosing therapy or whether or not to go.  People think that since they are shy or have a hard time talking to strangers that therapy won’t work.  As a therapist, I’d like to say that I won’t be a stranger to you for long – part of my job is to get to know you and to have an alliance between us.  Others worry about being judged.  This is not my job.  I’m not there to judge you.  What I am there to do is help you move in a healthier direction and we’re going to do it side by side in collaboration.  Others have been raise to just ‘buck up and get over it’.  I know that feeling.  Really.  In my family, we were raised to deal with physical illness that way (and I still fight it sometimes).  Sometimes you just need someone who will listen and work with you to find a new direction.  Someone who isn’t part of your personal life (like a friend or parent).

So, once you have figured out that you might possibly, maybe, think about going, when should you go?  I like the list that Psych Central came up with:

1.   The problem causes significant distress in your life.  Is it coming between you and your friends, your significant other?  Are you struggling to do work at school or in your job?  Have you stopped doing the things you love?  Yup, it’s time to seek help.

2. Nothing you’ve done seems to help.  I get it.  I try everything I can think of before I seek out my GP.  I don’t want to acknowledge that I can’t handle the pain.  But sometimes you have to acknowledge that the problem is bigger than you and someone else might be able to help.  Yup, it’s time to seek help.

3. Everyone in your life is sick of listening to you.  Are you becoming a broken moaning record?  Are people seemingly avoiding you because all you can talk about is your problem?  Can you focus on nothing but your problem?  While most people have friends or family who would love to help, sometimes a problem is too much for them to handle.  And that’s okay.  That’s what therapists are here for.  We won’t get sick of listening to you, and we’re trained to help.

4. You start using or abusing someone or something to alleviate your problems.  It’s tempting to have just one more drink.  It feels like it covers the pain.  But it doesn’t make it go away, and you may start to use that alcohol more and more.  Or you may feel anger.  And take it out on a significant other.  Yup, it’s time to seek out therapy.

5. People have noticed and said something to you.  It’s easy to discount what other people say…they don’t know your life.  But if you keep hearing it or you hear it from someone you have always trusted, then it’s time to look within and figure out if they are right.  What are they noticing that is so concerning?  Is it something from the above 4 reasons?  Perhaps, it’s time to find a professional to talk to.

This decision can be hard, but you can learn so much about yourself and the way you work.  There are so many possible therapists and therapies out there.  Talk to your GP, talk to a friend you know who’s seen a therapist in the past, check out the professional associations to see who is recommended.  But if you need therapy, find someone.  You don’t need to live with the pain.

Using Thought Records

One of the most useful tools in CBT is a thought record. Why would this be helpful? In CBT, the belief is that thoughts, feelings/emotions, behaviours and physical symptomology are all tied together and influence each other:

Unhelpful thoughts can trigger unhelpful behaviours, emotions and physical symptoms. So if you change those unhelpful thoughts (sometimes called irrational thoughts), you will end up changing your emotions, behaviours and physical symptoms.

In the beginning of CBT, most therapists will ask a client to fill out a simple thought record. Here’s an example:

By filling this out, the therapist will get to have an idea of what unhelpful thoughts a client has.  Then in session, they may begin to work with these thoughts and see if there are more helpful alternatives.  Here’s an example of an unhelpful thought that I had the other day (because, honestly, we all have them…but they may not be so bad or so numerous as to influence our mental state): “I am so clumsy.” It was not helpful as it didn’t add anything to my life but it made me feel slightly less good about myself. I had tripped and the thought came to mind. It wasn’t a huge deal as it was just one random thought and after I thought it, I countered it with something else (which I can’t remember, but was probably something along the lines of ‘yup, and that’s okay cause you’re still good at sports’.)

As the client gets practiced at it in session, the client will then be asked to fill out a more intensive form and do the work on their own, trying to find evidence for and against the thought, and then coming up with a more helpful thought.

Even if you are not doing CBT with a therapist, you can use these forms to help yourself. There are several self-help websites, but the one that I’ve found most helpful is http://www.get.gg/. If you are really struggling, I would seek out a professional to help you with your issue. But if the problem seems to have just begun or you are in a long wait for a therapist, you could use these resources to start looking at how your thinking might be influencing your life in a not so great way. Another fabulous resource is a book called “Mind Over Mood” by Greenberger & Padesky. It’s a book that I’ve suggested to clients who I can only see for a few sessions so they can continue to work on their issues on their own.

A Mindfulness Exercise

Many times we find that our thoughts disturb us.  We begin to believe that our thoughts define us.  We begin to feel stress, may not sleep well and can’t concentrate.  In CBT, we end up talking through a lot of these thoughts and try to find alternatives to the thoughts.  Along with this, if your practitioner uses mindfulness, you might also use the Leaves in the Stream meditation.  It’s a great way to release the thoughts that are making you suffer.  It may be difficult at first but that’s okay.  It’s hard to remain mindful and present.  But the more you practice it, the easier it becomes to let go.

The Leaves in the Stream meditation: 
Sit quietly. Focus on your breath, going in and out. Start to notice the thoughts and images that come into your mind. As you notice each thought, imagine putting those words or pictures onto a leaf as it floats by on a stream. Put each thought that you notice onto a leaf, and watch it drift on by. There’s no need to look for the thoughts, or to remain alert waiting for them to come. Just let them come, and as they do, place them onto a leaf.

Your attention will wander, particularly so at first, and that’s okay – it’s what our mind does. As soon as you notice your mind wandering, pay attention to your breathing and then focus back to the thoughts, and placing them onto the leaves.

After a few minutes, take a few more deep breathes, and relax.