Five months ago Virginia got started on changing her life. She was tired of eating so much she couldn’t move, being in a relationship which was going nowhere, having lots of ideas but taking no action. Virginia wants to have children and time is running out.
Like many who come to see me in my psychology practice she was highly motivated and determined to make a change. Her therapy began by her telling me her relationship and family history. Whatever we spoke about, Virginia pursued with curiosity and courage outside my office between sessions.
In my role as her therapist I recommended she ask herself just one question, every time she was about to eat.
“Am I hungry?”
This question made her laugh at first. How amusing that a serious psychologist would suggest she ask herself this question. After all, Virginia had rarely been hungry at all in the past 20 years since she had begun binging. [...]
Disclaimer: The following case is based on my professional experience. For obvious reasons, all names and any information that could be used to identify the participants have been changed.
Claire came to therapy overworked, feeling bad about herself and sleeping poorly. She wanted help to figure out her problems at work. Was her boss right? Was she really badly organized and inefficient? She was always running yet she could never catch up. Was there something wrong with her? Highly experienced, ten years in a field she loved, Claire felt overwhelmed and confused. What could she do to feel better?
The psychology of stress shows us that the distinction between “good” and “bad” stress is subjective. A certain level of challenge keeps us alert, on our toes and brings us the “good” stress that makes us feel alive. Beyond a certain threshold, however, when the intensity of an experience or requirements and requests surpass our capacity to adapt, our inner warning bells ring. This “negative” stress is the distress that motivated Claire to come in for help. [...]
Disclaimer: Names and details have been modified for confidentiality. The article below is brought to you with the full consent of the patient.
An impressive number of people have contacted me over the past few years in my capacity as a psychologist asking me to help them through a sticky situation. Some have come through the Counseling Center at the American Cathedral, others via a French public health network and others via their general practitioner or psychiatrist.
The patients I am referring to have had one thing in common: a work or personal dilemma with legal overtones.
Vanessa arrived for her therapy session huffing and puffing, plopped down into her armchair across from mine, and blurted out, “Am I going crazy or what? I am so tired.” She grabbed for a couple of pages in her purse and began reading her manifesto: “A cry for justice!” which she wanted published on Youtube. [...]
Christine writes her own shows but her creativity somehow dried up years ago. She’s seeking tools that psychology today can offer and is consulting with me to overcome her inhibition.
In Part 1, with Christine we did the preparation work for the EMDR treatment.
In my role as an EMDR therapist, I guide Christine so she can begin the therapy work for this session.
She selects a situation which she describes in detail where she feels the inertia which is disturbing to her. She hones in on the image of herself, sitting on her living room couch, looking at piles of papers on the floor.
She feels paralyzed and amorphous. She feels depressed, frustrated, frightened and angry.
Physically she feels a tremendous weight on her shoulders preventing her from budging. The task of tidying the papers seems overwhelming. [...]
Social psychologists study groups. Experimental psychologists do research, in order learn more about animal and human behavior. Vocational psychologists help people make career decisions and find work. Finally, clinical psychologists aim to understand people and their problems, and help them solve their difficulties.
You can select a psychologist according their specialty areas (depression, trauma, relationships, etc.), the kind of approaches and techniques they use (EMDR, family therapy, etc.) and according to the groups their usually treat (children, teens, individual adults, couples).
I’m a clinical psychologist. I work with individual adults and couples. The approaches and techniques I use include a psychodynamic approach (also known as insight-oriented), systemic therapy (also known as family or couples therapy) and EMDR.
This series in three parts started with 15 Ways on How To Choose Your Therapist Part 1 and Part 2.
Make sure you don’t just find any therapist close to your home or work, find one that works for you. This might take a little time and experimentation, but finding the right fit is important for your therapy to be efficient and successful.
I encourage you to consider the following ideas. Look for a therapist who:
(11) Is results-oriented. Helps you achieve relief as well as your therapy goals. Gives you feedback and helps you track your progress. You and your therapist should be setting ultimate and intermediary goals, and should be striving to reach them. However, be wary of a therapist who “guarantees” results or “predicts” exactly how many sessions your therapy will take. Time spent and number of sessions is not a good indicator of the success of your therapy. Focus on the goals. [...]
Make sure you don’t just find any therapist close to your home or work, find one that works for you. This might take a little time and experimentation, but finding the right fit is important for your therapy to be efficient and successful.
I encourage you to consider the following ideas. Look for a therapist who:
(6) Maintains clear and healthy boundaries. Your therapist as well as you should avoid blurring the boundaries between your therapeutic relationship and personal lives. Run if your psychologist starts giving you accounting advice or tips for your next vacation. You want your accountant to do your accounting, your travel planner to plan your trips and your psychologist to assist you with your emotional distress. Maintain clear and healthy boundaries. [...]
Make sure you don’t just find any therapist close to your home or work, find one that works for you. This might take a little time and experimentation, but finding the right fit is important for your therapy to be efficient and successful.
I encourage you to consider the following ideas. Look for a therapist who:
(1) Has the training and education to help you. Degrees aren’t always indicative of competency. However, just as you for a doctor, seek out a therapist who has a degree and specific education and training. Training and education modalities may vary from state to state or country to country. [...]
She writes her own shows and has been on stage but somehow her creativity dried up a few years ago. She wants therapy to overcome this and came into my psychology office a few weeks ago complaining, “I used to be able to write. Now I’m blocked. I always start projects but never finish anything. I have to first clean up everything in my apartment if I’m ever going to succeed. Don’t you agree?”
We do agree to use EMDR, a psychotherapy approach named for the back and forth eye movements often used within this therapy to stimulate brain function.
To begin I have Christine find and focus on a scene where she can really feel the blocked feeling. The image is key: she sees herself sitting at home on her couch, immobile, with her files in front of her on the floor. [...]
Usually there is relief and often positive results. A therapist cannot guarantee the exact benefits that you will derive from therapy. Can a doctor? A therapist who guarantees results is not being honest with you.
“Simple gifts” is an old Shaker tune that became known around the world when Aaron Copland used it in 1944 in the score for a ballet called “Appalachian Spring.” It pops into my mind and I find the notes forming and resonating within my voice box when something delightfully simple occurs and strikes me as worth singing about.
Breathing-relaxation is just one of these “simple gifts”. It is one of a variety of relaxation techniques I may teach you to use when you come see me in my psychology office. You learn to give yourself a break, both physical and mental, a breathing space. In a few minutes time you enhance the benefits of therapy and take home a weightless tool which you can bring conveniently along with you anywhere you go. [...]
No. A couch is typical of the psychoanalytic approach where the person in analysis lies down. I am not a psychoanalyst. I do not use old fashion hypnosis techniques.
In an EMDR session I use special techniques which are excellent for treating trauma. EMDR stands for Eye Movement Desensitization and Reprocessing.
The technique looks odd because it includes alternating bilateral brain stimulation where your eyes look right and left following an object I will move in front of you (Eye Movement). Although the technique was named for these eye movements, the bilateral brain stimulation may also occur using other sensory channels. For instance, I may use vibrating buzzers you hold in your hands, snapping sounds in headphones or my tapping on your hands. The alternating brain stimulation may have a soothing effect, which favors a calming and distancing process (Desensitization). Within the specific treatment approach, you will revisit and rethink through the traumatizing situations (Reprocessing).
(Disclaimer: Names and details have been modified for confidentiality.)
Nina came rushing into my psychology office and barely seated, exclaimed: “I’ve never seen a psychologist before. How do you work? Can you help me figure this out?”
Most evenings and weekends her French husband was in front of the TV with a beer in his hand. It went without saying that Nina had to handle all household tasks, take care of her 8-year-old son, do her housekeeping job for another family and be a tender loving wife at night. She had long been able to meet her husband’s expectations but recently her mood had been slipping. Her employer was alarmed and recommended she see a therapist. Nina’s husband’s drinking had worsened and he’d tried to hit her and insulted her regularly with little cause. She was getting depressed from the relentless tasks with no relief in sight, the lack of dialogue, the fear her husband would strike her. As the violence increased, she was shrinking. [...]
(Disclaimer: Names and details have been modified for confidentiality.)
A husband or wife calls up the psychologist and asks me a now-familiar question in a pained voice: “Can you help us? I just found out my partner’s been having an affair. He (she) is willing to see a therapist. Should we come alone or together? How do you work?” After a call or two, we find a time where usually the couple and I meet in my psychology office.
Dan and Maria thought they probably wanted to stay together but needed immediate counseling to handle the challenge of recently released intense emotions: pain, anger, guilt. They had thought they were happily married. Maria was plunged in fear and jealousy, and Dan was awkwardly seeking how to act to restore calm amidst turmoil. [...]
Psychology and therapy are for you if you feel like you are suffering from problems which may be personal or interpersonal in nature. For instance, you may be anxious, feel depressed, be in mourning for an unusually long period of time, have relationship problems at work, think that your couple is at risk, etc. In these and other circumstances, you may consider seeking the help of a psychologist.
For some people, psychotherapy is not advisable. In certain circumstances, these people may require a treatment setting like a center or a clinic where various mental health practitioners are available. As a psychologist, if upon evaluation I believe you need such treatment, I will inform you of treatment possibilities better suited to you.
You are tired of the consequences and have made a gut decision that you are going to face your procrastination. Having become more aware of the mechanism and the meaning behind it (see The Psychology of Procrastination – part 1 and part 2) you are ready to try some tools from therapy.
Alone or with the help of your psychologist, you will learn how to cut the target down to size. Rather than giving the task you have postponed inordinate importance, you are going to lower the stakes. You may take a new look at your thinking and behavior thanks to cognitive therapy. You will learn to chop your goal down into do-able matter-of-fact steps so that you can bypass your anxiety alarm system. [...]
“I am ashamed of seeing a psychologist. What if my family, friends or coworkers find out?”
Shame is an emotion that will be explored and treated in therapy. Your consultations are totally confidential, and nothing will be communicated to anyone else without your prior authorization. In extreme circumstance, such as child abuse or violence, there can be a legal requirement on my part in which case I will also inform you.
I always get this question and I wouldn’t be surprised if you’re asking yourself the same thing: “I’m a busy person! How often am I going to have to go see my therapist?”
It depends.
Treatment plans often include consultations on a weekly basis to be most effective. When you first begin therapy, the intensity of your motivation to change will foster your progress. The keyword here is intensity.Building your relationship with me, the psychologist, from week to week, also greatly enhances your ability to get better.
Adaptations however may be preferable and should be discussed with me. For instance, imagine you come in to see me with your spouse in couples therapy. Meeting on a weekly basis does not necessarily give you and your spouse enough time to consider and practice what you’ve worked on in the therapy session. [...]
Understanding why you procrastinate may help you overcome procrastination. Have you ever wondered why you procrastinate?
It may be the unacknowledged meaning you give to what you have been postponing that has made it so daunting for you to tackle it. Or the tacit sense, referred to in psychology 101 as a self-fulfilling prophecy, that you are trapped in your habit of procrastination, unable to modify this view of yourself and to overcome your annoying inertia. Part of my task as a therapist is to counter your negative mindset and help you harness your under-used ability to move forward past your obstacle so it becomes a thing of the past. [...]
If you are suffering from problems you have not been able to solve yourself, consulting a psychologist can bring a fresh perspective. What helps is the insight of a professional not involved in your personal life.
A psychiatrist is a medical doctor, who then specializes in the branch of medicine on the mind and relationships. A psychiatrist can prescribe medication and hospitalize patients if necessary.
A psychoanalyst uses an traditional form of psychotherapy developed by Freud, stressing dreams, associations and transference. The psychoanalyst learns this treatment approach in special psychoanalytic institutes.
A psychologist has a university degree, involving five or more years of study, and specializes in the mind and relationships. Most psychologists use one or more treatment approaches and are sometimes certified practitioners in specific therapy techniques. Learning and training continues on an ongoing basis during professional practice. A psychologist has a broad conceptual base in order to use the appropriate approach to help clients.
A psychotherapist has training and is certified as a practitioner in a specific treatment approach but is not required to have a university degree. Although psychotherapists may be good with the specific treatment approach they learned, they may constantly use the same tool regardless of your specific situation. [...]
Many years ago a patient came regularly to my clinical psychology office and did in-depth individual therapy working on her childhood, her work life and her love life. She made progress in psychotherapy, her life improved and she stopped coming.
Then one day I bumped into her at the supermarket. Several days later she called to ask if it would be possible to do couples counseling alone with her. Her French husband felt uncomfortable about seeing a psychologist but still wanted my help as a therapist to weather their marital crisis.
The wife came in alone and brought me up-to-date on how her life had been since terminating psychotherapy years before. Quickly we focused on the couple’s difficulties which by the following session were totally out in the open. Parents of two small children, yet thinking they would have to divorce, husband and wife began to inventory their furniture to split it between them. At the next session, she recounted that they both broke down in tears and expressed their commitment to use therapy to transform their marriage. [...]
You would like to have the answer to this question. You might want the answer to the question right away when you call the therapist or come in for the first time. After all if you leave your car with the mechanic or your slacks with the tailor, they will tell you how long it will take and when it will be ready.
Therapy is different.
If a psychologist gives you an exact answer to this question, you might want to go elsewhere for therapy. In psychology, part of the therapist’s job is to glean all the information possible to help you solve your problems and feel better. Therapists may even gather sufficient information quickly. Another part of the therapist’s job however, is to help you discover what you need to know at the right pace for you. [...]
Many patients of mine who are in therapy complain about their inability to organize piles of papers, books or clothing. Others know they need medical attention but don’t call for a doctor or even a psychiatrist’s appointment. Others list their major life decisions they never get around to making. Here is where the therapist can help.
Procrastination, putting off to later what seems impossible to do now, is an often used reflex mechanism in psychology to reduce uncomfortable feelings. The discomfort aroused by the sight of the papers, the thought of the medical concern or the major decision that must still be made is temporarily reduced by a distraction. Doing something else simply feels better. These pleasant if short-lived feelings reinforce the habit of procrastinating, of never doing whatever seems difficult. [...]
Showing signs of depression, tense, discouraged and tired from disturbed sleep, a teary-eyed man came into therapy for the first time and told me about his impossible job. With neither education nor training to meet the expectations placed on him, he was supposed to manage, despite inadequate software, complex regulations, an understaffed office and a hiring freeze, the pay and promotions of about 2000 salaried workers. Workdays were often eaten up by managerial meetings or phone calls from irate workers, behind in their pay.
How could he use what we know about psychology to handle this work stress? As a therapist I used a wide array of techniques from counseling and psychotherapy. He learned and used stress reduction techniques and tools adopting the ones best-suited to him. EMDR, cognitive re-framing including an on-going dialogue about his professional and personal strengths, brief relaxation methods and visualization techniques were helpful. A daily walk going to work, a long swim every weekend, a warm bath to relax in the evening and a tad bit of medication countered anxiety, promoted calm, optimism and better sleep. Using his leisure and vacation days to thoroughly relax and making small changes in his work methods further improved his state of mind. [...]
People sometimes make a statement that startles me and leaves me reflecting on how I can help them clear up their thinking.
In response to a piece of good news a terribly unhappy young woman once told me,“I should be happy” obviously omitting the tacit end of her statement, “but I am not.” The good news alone could have brought happiness but did not because of her life circumstances. Instead, the result was a flood of tears. The contrast between her rational mind’s idea “I should be happy” and the reality of her overwhelming sadness, left her confused and paralyzed.
Emotions like happiness are not products of rational will. Emotions arrive unannounced as agitations of the mind, feelings or passions. The main families of emotions are anger, sadness, fear, enjoyment, love, surprise, disgust and shame. Implicit in each emotion is the impulse to act. By accepting and patiently investigating her emotions, she will be able to gather useful information motivating her to take appropriate action to construct for herself a truly happy life. [...]
Schedule your appointment
Debra Berg, Psychologist
7 rue Edgar Quinet
92240 Malakoff
Tel. 01 46 55 96 96
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