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Misconceptions About Therapy

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Kaia Kordic is a licensed Marriage and Family Therapist, who splits her time between building her own private practice here in Humboldt County, California and working with the county foster care services. Kaia works with families, children, teenagers and adults who have ADHD, depression, anxiety, and who are going through relationship conflict, break-ups and divorces. She sat down with us to share some common misconceptions about therapy and offer advice to those who may be considering therapy.

Therapy is not a sign of weakness

While many believe that therapy is a sign of weakness, Kaia couldn’t disagree with that assessment more. Therapy is not about something being wrong with you, it’s about courage and personal development.

“All of my patients seek personal growth. They recognized that something in their lives is not going the way they want it to, and chose to do the work to change that. That’s powerful,” says Kaia.

While some may prefer to do it on their own or fail to understand why a loved one would seek the help of a stranger, those who choose therapy are simply utilizing all the best tools available to them. “Therapy IS ‘doing it on your own.’ If you’re cooking a meal for yourself, you’re doing it on your own, but first, you need to get the right ingredients together, figure out the process. Therapy is somewhat similar, but with higher stakes. Clients decide that they need to work on something, so they want the right resources to help them figure out the process,” says Kaia.

Finding A Therapist

Kaia has some advice, “Find somebody who is a good fit and trust the process. It takes a lot to make that first call and even more to make that first appointment, and it’s rarely a good fit on the first call. So, people get discouraged. They give up and miss out on a very important resource. You should keep looking for the right fit. It is worth the effort.”

Once you make a choice and schedule the first appointment, Kaia recommends giving the process a chance to work. “Unless you have a bad feeling, give it three sessions. You may feel unsure at first because you and your therapist are just getting to know each other. If it’s not right after that, continue your search.”

You can try finding a therapist through Psychology Today, your insurance, Yelp, and friends. Kaia says you can even ask your therapist. “You can say, ‘Hey I realize and I appreciate our work together, but I feel like I would fit better with a male or someone of the same ethnicity. Do you have any recommendations for that?’

Visit counselingpotential.com for more information about Kaia Kordic and her practice.

How Trauma Can Affect Our Body

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Before San Francisco-based psychotherapist Krishan Abeyatunge chose his current profession, he was helping people heal through his Bay Area practice of holistic medicine. It was during those years that he noticed an ever-increasing number of patients that would come in repeatedly for the same physical ailments or pain because of trauma.

His investigation to identify the culprit behind these chronic maladies led him to discover the connection between our psychological well-being and our physical health. This realization compelled him to make a career change so he could focus on exploring the core source of all our joys and sorrows – our psyche.

Trauma Can Result in Physical Pain

When we fail to work through our trauma, it manifests itself in other ways. Specifically, Krishan points out that psychological trauma and anxiety can frequently manifest as physical pain and illness. He shares an eye-opening experience he had with a former patient – a 275lbs former football player, who survived a car accident that ended his father’s life. During massage therapy, Krishan stumbled upon an old back injury the client suffered in the accident. Unaware of the injury or its history, Krishan applied pressure to the spot, evoking in his client an intense urge to cry. “Just let it out,” offered the doctor and the client did. He began to cry. When they spoke after, it became clear that the trauma the accident survivor has been carrying in that spot extended far beyond physical injuries.

Abeyatunge swears that this sort of physical manifestation of early, sustained or even acute trauma is more common than most people realize. What’s even worse, it can be self-perpetuating.

“If your mind is set to that channel, then there’s plenty to look at that’s not great in the world. We live in the paradox of lots of beautiful stuff and lots of suffering. So, depending on where your channel is set to, you can notice a ton of either,” says Abeyatunge.

He notes that major research institutions like Stanford and Harvard have documented the connection between emotional/mental wellbeing and physical health. Check out this book titled Waking the Tiger by Peter Levine if you’re interested in learning more about the phenomenon.

Living With Anxiety: How To Communicate, Ask for Support & Common Misconceptions

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This week, we sat down with the founder of Huddle.Care, Dr. Maggie Perry, to learn more about living with anxiety and the difficulties in communicating the experience of anxiety to others. After getting her doctorate degree in clinical psychology from Loyola University of Maryland and training at the Anxiety and Stress Disorders Institute of Maryland, Dr. Perry has committed her life to helping her clients learn to treat themselves with a balance of mindfulness, self-gentleness, and self-discipline.

So, let’s dive right in.

Communicating Your Struggle to Others

Living with anxiety can be a very lonely experience when those around you struggle to understand and empathize with your challenge. But it’s important to remember that what you’re going through internally may not be obvious to the outside world or even to you! According to Dr. Perry, you must understand your own anxiety before others can begin to get on the same page with you. 

Learn it. Do your best to educate yourself on what is taking place inside your brain when you feel the sensations of anxiety. Therapy, books and anxiety-focused communities are all good resources. Try to identify your triggers. How do they make you feel? How do you respond to anxiety-inducing stimuli? What is the brain chemistry behind these feelings? Fully understanding, on every level, what happens when you feel anxious will make it easier to explain your anxiety to those around you.

Do it. Improving your understanding of anxiety alone won’t actively change your brain’s response. As you become more self-aware, it is important to start putting what you’ve learned into practice. This can involve rebuilding your emotional groundwork for dealing with anxiety, working through exposure therapy, and/or simply practicing mindfulness a little more each day. Taking small steps towards facing your triggers will eventually lessen their grip on you.

Teach it. In order for others to understand what you’re going through, it is necessary to calmly and positively relay your experience to others, so the next time you experience anxiety around others, they’ll be able to recognize it and know how to react. As you help your loved ones learn more about your struggles, by teaching someone about your experience you will improve your own self-awareness.

Supporting Someone with Anxiety

Living with anxiety on your own can be isolating, but asking for help can be tricky. If someone close to you struggles with anxiety, simply asking them how you can help can make a huge difference. 

Understanding. First, it is very important to understand the problem. Because anxiety is so often confused with stress and regular worry, it is important to set aside your assumptions and listen with an open mind.  “The ideal case is that the community would learn what anxiety is,” says Dr. Perry. “Research shows that psychological suffering is not so much about the situation, but how a person is responding to it.” Simply understanding a person’s response to their own anxiety, through research and conversation, is one of the best ways to help that person.

Acceptance. “The ideal way to make an anxious person feel comfortable is to help them keep a willful attitude towards their anxiety. Listen and allow yourself to be taught about what exactly is happening in those situations. Discuss it with the anxious person while exhibiting a relaxed attitude, humility, understanding and even humor towards it,” says Dr. Perry. Humor, in particular, may be the most valuable tool of all. “After a while, it can become a game—a humorous part of life that becomes completely disarmed,” rather than something to feel shame or self-consciousness over.

What NOT to do. While it is essential to understand how to take positive action, knowing what not to do is just as important. It is best to talk about it and establish exactly how the anxious person wishes to be treated. “Both, shaming and reassuring can be confusing for the person and can make them unsure of how they are supposed to react,” explains Dr. Perry. So, attempts to dispel their anxiety by pointing out that everything is ok and trying to make them see the “bright side,” can feel like you’re oversimplifying a complex issue that they struggle with daily and can lead to further alienation and dispair. Remember, if it were that obvious and easy, they wouldn’t be needing your help.

Common Misconceptions About Anxiety

False: “Acceptance” is just another word for “giving up.”

A common misconception that is prevalent among people living with anxiety is that accepting your anxious feelings, rather than trying to fight them, is in itself a passive response. However, this could not be further from the truth. In accepting that you experience anxious sensations in different circumstances, you are consciously—and actively!—retraining your brain to temper its response to triggering stimuli.

“Acceptance is actually a really active stance because you’re telling yourself that the thoughts and feelings you have are actually inconsistent with what you value—they’re not true, they’re not worth acting on, they’re not dangerous to you. You can choose to accept the fact that the thoughts and feelings are there, but you’re still able to do the things you care about,” says Dr. Perry. “Over time, this will eventually teach the mind not to be worried about those things anymore, and eventually the mind will not have that sensation anymore.”

False: You simply need to face your fears.

Exposure therapy is a method that involves deliberately seeking anxiety-triggering situations in an effort to learn how to respond when anxious sensations occur in order to lessen that anxiety over time. For people struggling with anxiety, one of the most common—and harmful—misconceptions is that all you need is a ‘just do it’ attitude. “Many people think, ‘I just have to force myself into situations and then eventually my fear will go away.’ If someone, who’s afraid of bridges, goes over a bridge fifty times but is bracing against her thoughts and feelings the whole time, she’s going to continue to feel afraid. They have to do it in the right way,” Dr. Perry explains.

Contrary to popular belief, it isn’t about the act of exposure to anxiety. It is the willful attitude toward anxiety that will inspire and affect change in the long run. “There has to be a pretty active self-talk because the person will still be afraid,” says Dr. Perry. “The uncertainty and fear are still there, but they’re saying ‘I’m taking a leap of faith—it’s okay for me to have these anxious feelings and still do the triggering behavior because I don’t believe I am actually in danger.”

False: Your anxiety is a character flaw.

Perhaps the most frustrating misunderstandings occur between those who struggle with anxiety and their close circle. Friends and family members may believe that anxiety-fueled behavior is simply a reflection of a person’s personality, just like honesty, friendliness or a sense of humor.

“You are not your anxiety. Anxiety is just something that happens to you,” reminds Dr. Perry.

“Not everyone is taught that anxiety is related to the makeup of the brain, that it’s not necessarily a personality characteristic, even though it may feel that way after they’ve suffered for so long,” says Dr. Perry.

Anxiety Management Tip

Dr. Perry states that quick, in-the-moment journaling can be extremely beneficial to someone with anxiety. She says that “any type of thought record detailing ‘these are my thoughts, these are my feelings, these are my sensations,’ can help see what needs to be done in the moment.”

When inklings of anxiety begin to arise, take a step back, consider all aspects of these sensations and write about them as they happen. This is a good technique for reconciling your anxious feelings with what you’ve learned about your anxiety and what you know to be true. In other words, do not believe everything you feel. Journaling provides an opportunity to examine and challenge your feelings.

“There are other times, like life transitions, in which just having someone write for thirty minutes each morning about what they think and feel about that transition will bring down their stress, bring down their anxiety, and make them more resilient against depression because they are more self-aware.”

Visit huddle.care to learn more about to learn more about Dr. Perry’s work!

Interested in more posts around living with anxiety?  Read “What is anxiety“, “Ovecoming anxiety” or “The 7 types of Anxiety”

 

Millennials & Mental Health: How To Cope

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It’s a hectic, increasingly insane world out there. For the younger generations hanging on can be a challenge. To help us understand how Millennials experience and cope with stress and anxiety, we sat down with therapist Tara Griffith, who is also the founder of Wellspace SF, the San Francisco community of licensed therapists, nutritionists and certified coaches. In addition to psychotherapy, Tara’s organization specializes in working with young adults, providing life coaching, career coaching, nutrition and health/wellness coaching.

Describing the Millennial patients she frequently works with, Tara explains that many of their mental health stressors are tied to technology and entrepreneurship. “What’s really unique about millennials, especially in San Francisco, is there’s a lot of integration of socializing and work. There are bars in certain start-ups and you’re encouraged to do all these outside activities together, so the work/life balance becomes a little messy sometimes,” says Tara. “The quick growth of companies creates some stressors in how to work with your colleagues or be a good manager or employee. Many people that are in management positions are sometimes really young. They are learning to navigate a quickly growing industry.”

 

Tara feels that integrating or learning easy, yet effective stress management tools is important. And so is scheduling time for self-care, and being able to set boundaries. “For urban Millennials, the pace of life can be so fast today that we often just go, go, go. They don’t really schedule the time for self-care. They’re just reacting in the moment instead of sitting down and reflecting on the next step or who they want to be.”

Communication and feeling a connection with other people is also a unique challenge for Millennials according to Tara. “Technology has made it so much easier to disconnect from people. In the past, you may have to meet someone face-to-face or pick up the phone and have a difficult conversation. Now you just disappear without ever having to be accountable. The face of dating and communication is definitely changing.” That’s where Tara sees technology – and Millennials’ affinity for it – having the greatest impact, “And not necessarily in a positive way,” says Tara.

Coping Mechanisms

Tara lists a few essential coping skills that she frequently works on with her clients:

  • Try to schedule time for self-care in your calendar. “If it’s not scheduled its often the first thing to go,” says Tara.
  • Learn more about mindfulness and meditation and incorporate that into daily life.
  • Identify one’s inner critic and understand how that contributes to your stress level.
  • Learn how to speak with yourself in a nicer, kinder and gentler way; refocus perspective on the positive.
  • Utilize tools like gratitude journals and affirmations.

Gratitude Journals

While useful for everyone, Tara explained that gratitude journals are particularly helpful for Millennials. This forces them to take time out of the day to focus on what’s going well in their lives. “The way that we think about the world is going to contribute to your anxiety. It’s very rare that we spend time thinking about all the great things in our life,” explains Tara. “Spend time each day really reflecting on the positives in your life and what they mean to you. By doing that you reshape the way your brain works, and you start to notice more positive things in your life, instead of skewing toward the negative.”

Mindfulness and Living in the Present

Mindfulness and intentionality are traits commonly attributed to Millennials. “Doing my own work on myself and seeing the benefits – of particularly the mindfulness — and how that has significantly impacted my own life…I can be very passionate about it because it’s something that works. It’s not just something I’ve read about in a book.”

Explaining her own work, Tara notes that “I am not the type of therapist who’s just going to sit back and nod their head and say, ‘tell me how you feel about that.’ I don’t spend too much time in the past, which other therapists might. I’m really focused on the here and now. The present moment,” says Tara. “We can spend years and years sitting on the couch talking about how your mother ruined your life. My personal opinion is that we can talk about that but I don’t want to stay there.”

Tara’s personal connection to her work and her patients reflects the kind of purpose Millennials are hungry for. As Tara explains about her approach: “Sometimes people look at a therapist as an expert or a know-it-all, but we’re people with our own struggles and heartaches and challenges and most therapists get into this because they can really empathize with other people’s struggle. And I think that’s what I try and let my clients know about me. That I’m just like you.”

Learn more about Tara’s work at wellspacesf.com, Facebook and Instagram!

Mental Health and LGBTQ Community

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The lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) community, historically one of the most marginalized segments of society, have made impressive advances in their struggle for equality. From increased visibility in pop culture to halls of influence and power (including the United States Congress), queer identified individuals have seen rapid gains in acceptance. So much so, that it can be easy for some to forget the extent of the bigotry and vitriol that continues to be directed at the LGBTQ community. We wanted to learn more about the ways in which the prejudices and biases queer people experience might impact the mental health of LGBTQ people, and how this impact might manifest as anxiety among many queer-identified people.

The State of LGBTQ & Mental Health

Lindsey Rogers is a second-year doctoral student studying psychology at the University of San Francisco and currently completing her practicum at an LGBTQ clinic in San Francisco’s Castro neighborhood. “All of my clients are queer-identified. Some identify as gay, lesbian, bisexual, transgender, questioning, intersex, or just queer. The ages are anywhere from 25-years-old to about 50-years-old. Some of the clients are people of color and come from different cultural backgrounds. Many come in for substance abuse treatment, and anxiety, depression, trauma, often related to their queer identity and the oppression and marginalization that they experience in the community,” says Lindsey. The National Alliance on Mental Illness (NAMI) notes that LGBTQ individuals often experience worse mental health outcomes as the result of prejudice and other biases they struggle against and the accompanying trauma they experience.

Lindsey shares NAMI’s assessment that the LGBTQ community suffers poorer outcomes related to mental illness overall, but to avoid sounding as though there is something wrong or unhealthy with being queer itself, she makes it clear that their being queer is not generally the cause.“One’s queer identity isn’t necessarily the cause of their mental health concerns. There are so many other causes for their mental health issues than their sexual orientation or queer identity,” says Lindsey. Rather, it’s often the way that society perceives or treats queer people that can be the root of any number of mental health problems found within the larger LGBTQ community.

While the same causes of mental illness among straight and cisgender individuals are also at work among LGBTQ people, there is no denying that the additional stress of marginalization and for some, brutalization, translate to significantly higher rates and poorer outcomes within the queer population. It has been documented that fear of coming out and subsequently facing discrimination for one’s sexual orientation or gender identity, can lead to depression, posttraumatic stress disorder, thoughts of suicide and substance abuse.

Double the Stigma

Like other communities, LGBTQ individuals do not often talk about mental health and may lack awareness about mental health conditions. As Lindsey points out, “stigma around therapy influences the queer community just like it would anyone else.” This can sometimes prevent people from seeking the treatment and support that they need to get better.

LGBTQ people must confront prejudice on an almost daily basis. And for those with mental illness, they must also deal with the societal bias against mental health conditions. The effects of this dual stigma can be particularly harmful, especially when someone seeks treatment. Often termed “minority stress,” disparities in the LGBTQ community stem from a variety of factors including social stigma, discrimination, prejudice, denial of civil and human rights, abuse, harassment, victimization, social exclusion and family rejection. Some examples of traumas frequently faced by queer people that Lindsey sees at her clinic include:

  • Physical and sexual abuse
  • Hate crimes
  • Sexual harassment
  • Negative interactions with medical providers, which can prove quite traumatic, especially for trans individuals

Rates of mental health conditions are particularly high in bisexual and questioning individuals and those who fear or choose not to reveal their sexual orientation or gender identity. “This may be because belonging to a community can help insulate a person from the effects of widespread bias,” says Lindsey. But those that do not identify as a part of that community are often left to struggle against discrimination alone, an experience that is frequently isolating and damaging to one’s mental and emotional wellbeing. Though not all queer people will face mental health challenges, discrimination or violence, many people report less mental wellbeing and satisfaction.

Disparities in Care

The history of mental health treatment for LGBTQ populations is a painful one, and until quite recently, many psychiatrists believed that homosexuality is itself a mental illness. Historically, gay men and lesbians were often subjected to treatment against their will, enduring traumas like forced hospitalizations, aversion, and electroshock therapy. Fortunately, there have been great strides made in the nearly 35 years since the American Psychiatric Association removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders, or the DSM. Despite this, there are still disparities and unequal treatment among LGBTQ groups seeking care. In fact, NAMI notes that some people have reported hiding their sexual orientation from those in the mental health system for fear of being ridiculed or rejected.

Though more therapists and psychiatrists today have positive attitudes toward the LGBTQ community, people still face disparities in the quality of the care they receive, due in large part to a lack of training and/or understanding among providers. Mental health providers still do not always have up-to-date knowledge of the unique needs of the LGBTQ community or training on LGBT mental health issues. Providers who lack knowledge and experience working with members of the LGBTQ community may focus more on a person’s sexual orientation and/or gender identity than a person’s mental health condition, which can often be counterproductive.

How You Can Help LGBTQ Individuals

For those who are not LGBTQ, it can often be challenging to know when or how to engage as an ally to LGBTQ individuals. Lindsey, who is sympathetic to this struggle, offered the following ideas for how you can get involved.

  • Start by educating yourself on the proper terminology to use with the queer community – i.e. asking a trans-identified person what their preferred gender pronoun is.
  • Avoid expecting that a queer person will or can explain all things queer to you. Being asked to do this can itself, often be retraumatizing.
  • Advocate for queer people’s rights within policy or join/donate to a queer organization.
  • Even just talking to a friend and letting them know that you are a nonjudgmental ear that they can share their experiences with.
  • Combatting or pushing back when others express misconceptions or when you see an act of oppression.

Tips for Finding and Talking to a Provider

While it’s not always easy to find, a supportive or allied mental healthcare provider, there are many great resources available to help individuals through this process. In fact, NAMI has a list of suggestions for individuals looking to locate an LQBTQ-inclusive provider:

They also provide a list of recommendations for how to talk to your provider:

  • If you feel comfortable, come out when you meet with your provider.
  • Ask questions about the provider’s experience working with LGBTQ people.
  • Be confident about disclosing relevant information about your sexual orientation and/or gender identity.
  • Be open about your thoughts and feelings of depression, suicide, anxiety, fear, and self-harm.
  • Ask for more information about any health-care-related referrals, including to other therapists and psychiatrists.

Support & Resources

If you are experiencing a mental health condition, it’s possible to take control of your health care and improve your chance of recovery. There are several resources available:

Modernizing Therapy: Filling in the Gaps with Tech

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Each minute spent outside of a therapy session is a minute your client is experiencing life. When your client walks into a session, they anticipate spending time reflecting and discussing what has happened over the course of the last week. However, it’s not always easy to convey the exact emotions and feelings that they associate with those moments, as people naturally remember what happened yesterday more clearly than a week ago.  In addition, recapping the last week takes up a lot of time. Often, clients will not bring up what is really bothering them or the cause of their feelings until the last five minutes of the session.

Modernizing therapy, it’s time! Let’s consider how technology can be leveraged to fill in that gap while improving engagement.

According to Pew Research, 95 percent of Americans now own a cell phone of some kind – with 77 percent owning smartphones. A study by Dscout found that the average user interacts with their phone 2,617 times a day, and engages in 76 separate phone sessions. With this change in consumer behavior, therapists must consider how to embrace technological advancements and leverage smartphone fixation to motivate clients to do their homework in new ways and optimize their sessions by spending less time recapping their week.

Here are three ways that therapists can leverage technology to ensure their clients stay on track and help modernizing therapy:

1. Digital Journaling

Unlike talking or thinking, the process of journaling offers clients an opportunity to slow down, examine and reframe their thoughts. It can be a very personal and intimate process that can be done in a variety of different ways. It is proven to help clients make progress towards their goals and is an effective method for getting your clients to open up and become more self-aware. Journaling can also be easier for clients who generally have a hard time with trust and privacy to record their thoughts rather than share them with another human being. A lot can be revealed in a journal entry from the content’s sentiment to trending keywords.

With the access and availability of mobile devices, clients no longer need to carry a journal around with them everywhere they go. Instead, they are able to pull out their phones or tablets and jot down what’s on their mind. In turn, this enables therapists to have quicker access to what’s happening between their sessions. Take Therachat for instance. A secure, online platform where therapists can customize journaling prompts for clients, which they will get on their smartphone.

2. AI-Driven Chatbots

Journaling does not have to be one-sided. The way chatbots have modernized service-oriented industries (i.e. retail, travel and hospitality) leaves little surprise that it has become highly applicable to healthcare and personalizing patient communication and engagement.

As these technologies advance, look out for opportunities to empower your client with the necessary tools to engage directly with a chatbot that can converse, prompt questions and even offer valuable insights back to you in a consolidated report. Highly interactive chatbots will make the journaling process for your clients feel much more personalized and natural – any time of day.

3. Push Notifications and Alerts

Setting boundaries is important when working with therapy clients. To progress, your clients must develop the skills that enable them to cope with their feelings on their own, while receiving the right guidance and support along the way. Clients need to stay engaged throughout the week in order to reach therapy goals and not revert back to old habits. While journaling and self-examination are proven exercises for your clients to apply what was learned in each session, they are only as effective as your client’s willingness to participate.

Take advantage of the advancements in technology and the plethora of telehealth communication tools available today to encourage your clients to stay on track without crossing the line. Whether it is through push notifications, a mid-weekly newsletter or alerts hidden behind a chatbot, it is important to ensure your clients receive reminders to do their assignments and follow the plan set forth from the get-go. It is easy for a client to lose track, forget or even come up with an excuse as to why they did not complete an exercise. Each touchpoint is a reminder of their end goal and why you are in their life, and allows progress towards the steps needed to move forward.

Dedicating time to promote activities that will help your clients progress and also provide you with insight into what’s happening outside of your sessions will only help increase the bond and translate to a healthy long-term relationship.

About the Author

As CEO and co-founder, Kouris Kalligas leads the strategic and operational direction of Therachat. Kouris has a rich history of working on innovative products in health and wellness and helping companies grow and scale. Previously, Kouris co-founded Addapp and spent over six years at Sappi Fine Paper as a supply chain service manager and lead business development manager overseeing innovation projects. He received his B.A. in International Economics & Development from Democritus University of Thrace, completed the ERASMUS program in International Business at the University of Gavle and earned his M.A. in International Relations from the University of Warwick.

Read more tips & tricks

Find out how therapist Vivien is modernizing therapy and benefiting/incorporating technology in her private practice.  Read the full interview here.

This article was first published by HealthTechZone.com