Recently, a client in my psychotherapy practice was reflecting on her experience in therapy after what she described as three productive years of treatment. Laura was originally referred by her family physician when no medical cause could be identified to explain her various physical complaints and disrupted sleep, among other difficulties. She struggled with depression, was frequently anxious, and described herself as a chronic worrier who saw the world, essentially, through a bleak lens. She reported general unease with matters of daily living and appeared to have a hard time finding joy and satisfaction in her personal life or in her professional life as a museum curator.
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Road and Sideline Rage
We've all seen them (or maybe some of us have been one of them). The driver on the highway who cuts us off or denies us entry into his or her lane when it seems like such a reasonable, even necessary thing to do. Or, the driver who makes various hand gestures at us when they – rightly or wrongly – believe that we have acted provocatively toward them while driving. What happens to so many of us that leads us to rant and rage on the road, thus behaving in ways that we normally condemn as unacceptable and inappropriate adult behavior? And, is this any different than the behavior of the parent who becomes angry and aggressive at his or her child's soccer game?<
Resilience
If you accept the notion that resilience is a quality that can be cultivated, as opposed to seeing it only as a genetically determined quality, you might be inspired to strengthen your ability to become more resilient. People often have considerable capacity to build strength and better coping skills, although they often are not sufficiently aware of this.
Personal Decision-Making
In a recent treatment session, Kelli (not her real name, of course) wanted my help in deciding whether or not she ought to continue dating Greg, the new man she met through an on-line dating website. At first, this seemed like a perfectly reasonable and appropriate issue to raise in therapy and invite my input. I listened intently as Kelli reported the conversations she had already had with many family members, friends, and colleagues about what she should do about her 'problem.' Not surprisingly, Kelli had become quite confused and more doubtful when she discovered that her respondents were about evenly divided regarding whether and how she should proceed with Greg.
Too Little Sleep
Whenever I conduct an initial interview, I ask several questions about a client's general health, lifestyle choices and habits, and overall physical well being. These questions are asked also of clients with whom I have an ongoing relationship. This inquiry includes questions about smoking, drinking, drug use, eating behaviors and sleep. With regard to the last of these, I am interested to know whether there is too much (a common sign of possible depression), too little, and what a person's attitude is about sleep. Also, I want to know whether there are sleep-related difficulties (e.g. difficulties falling asleep, staying asleep, and waking up) that might need attention.
Locus of Control
There is a concept in the psychological literature known as locus of control that is unfamiliar to most people, even though, once defined, is probably commonly understood. Locus of control is an individual's belief system regarding the causes of his or her experiences and the factors to which that person attributes success or failure.
Coping with the Effects of Trauma
A common and strongly held belief on the part of mental health professionals and others is that everyone needs to express their feelings following a traumatic event in order to recover from its effects. Following the terrorist attacks of September 11, 2001 in New York City, many organizations urged or even required their employees to attend mandatory group sessions in order to help the healing process. Many found that sharing their feelings and listening to the feelings of others to be helpful. Some, however, found it unhelpful or, in fact, harmful in their efforts to cope with the event in their own way. Simply put, not everyone copes with the effects of trauma in the same way and so should not feel compelled to talk about it if they wish not to.
Easier or Better
Several years ago, I was invited to teach a course in the doctoral program at the school of social work where I earned my own doctorate; an honor I was eager to accept. The course I was to teach was similar to one that I had taken earlier as a student in the program.
Hidden Depression
It is commonly understood in our society that depression is a disorder of epidemic proportions that too often is unrecognized, misdiagnosed, or improperly treated. The symptoms can run the gamut from headaches and chest pains to memory loss and extreme apathy. Many people with physical symptoms of one kind or another never realize that their complaints emanate from depression. As a result, many depressed people never bring their problems to medical attention and those who do typically see doctors who are not specialists in mental health.
Hindsight, Insight, and Foresight
As a clinical social work psychotherapist, I am often asked a number of very understandable and meaningful questions by clients: “How exactly do people change?” “How will I know when I am really different?” Questions like these often provide an excellent opportunity to clarify the objectives of the treatment. This will help both clinician and client keep a sharp eye on the process so that the goal of eventual change is not lost.