Taking risks in therapy

   

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We all have something that we don’t like to talk about. While therapy is an appropriate setting to explore these issues, we sometimes hold back on certain things — even in that context — out of fear. “Will I sound crazy?” “Will I be believed?” “What will my therapist think of me?” “What are the consequences of saying this?” “Will my therapist think less of me?“ These questions and more prevent us from being completely open in our treatment. 

But if you never take risks, you won’t progress when it comes to those issues. In fact, they may become worse as feelings of shame, embarrassment, guilt, hostility and unworthiness fester inside of you. The fact that you won’t talk about the topic becomes an issue in and of itself. 

The first obstacle you need to pass is trusting your therapist. You can read more about that here. In short, developing a strong therapeutic alliance in a safe relationship allow you to be more open. Keep in mind the ways in which your therapist has been trustworthy in the past. If you remind yourself of these things, opening up might not seem quite as impossible.

Still, even with trust, it can be hard to explore certain topics. I spent a lot of time trying to figure out how to talk about a series of events that happened a few years ago. I had been seeing the same therapist I’m seeing now at the time these things happened and my irrational fear was that I’d remember things wrong and become discredited. But I have yet to find a way around those fears. So what could I do?

It got to a point where my only options seemed to be to keep quiet and never heal or to take a risk and see what happened. After years of deliberation, I decided to just go for it and see what would happen. For me, that meant telling the story regardless of my fears. So I did. 

I was not prepared for how well that went. At first, I addressed my concerns about how he might remember things differently than I did. I asked my therapist to not go back and read his notes from the time in question and he agreed to follow my request. This removed a lot of pressure. 

It’s going to take a while to get through everything. And that’s okay. Breaking the larger story into smaller segments allows me to do a little each week. This way I get insight into each part, which helps me understand the larger context at play. While the content is very difficult and, at times, triggering, I’m feeling better about myself and am more realistic about my role in those events.

Jumping in is not always the solution, but I’m pretty sure that at this point in the post, you have a specific issue or situation in mind. Test the waters. See what happens. Be honest about your concerns. You can discuss them before you get to the actual content. But when you’re ready, opening up despite fear can be extremely healing. I know it has been for me.

What risks have you taken in therapy? How did it work out? Tell us about it in the comments.

Rule of Thumb: Getting Involved

In some ways college students are more connected than ever. Social media has provided multiple methods of staying in touch with friends and sharing information and content. Gaming has also provided a venue of being connected with others and having fun at the same time.

But in other ways many students are not connected at all, and they struggle with "face-time" that is real and not just virtual. Many living environments are both heavily wired and private; if one chooses one may isolate for huge chunks of time and "communicate" widely, yet not actually interact with anyone at all. This is a recipe for diminishing mental health.

So here is a rule of thumb to protect against that deterioration: at least twice a week, get involved in something that takes you out of your living environment, puts you in physical contact with others, and has nothing to do with class, work, or partying. This simple strategy incorporates crucial skill sets which, once learned, will benefit you for a lifetime. The skills also promote good mental health and are also related to retention and academic success.

So what kinds of things can you do? Most students had interests and hobbies in middle and high school, but they may have drifted from them in the excitement of starting college. Consider returning to them, or perhaps be more adventurous and take up new ones. Psychologists believe that learning new skills every five years or so is actually protective of brain health, so it will be good for you on that score as well. On most campuses there are dozens if not hundreds of student organizations, covering topics such as sport, politics or advocacy, environmental awareness, outdoor recreation, art, and so on. If you can't find one that suits you, start your own. You can also see some ideas on this list. There is really no excuse not to try something.

On the other hand, there is no need to get over-involved, as this can lead to meaningless activity and burnout. Trying new activities also does not have to lead to long-term commitment. Simply try some and if they don't feel like a good fit, move on and try another. Frankly, what you pick does not matter. What matters is that you pick something in the first place, and that you expand your skills and relationships. This is part of the recipe for feeling satisfied and in good emotional health, and generally your grades will improve too. That's hard to beat!

5 techniques for the moment you are overwhelmed

We all have those moments where we are hit with something overwhelming. Whether it be an argument, a panic attack or a piece of bad news, our gut reactions aren’t always the most helpful. That’s why it’s important to have coping strategies for those first few moments. Try one of these techniques the next time you need to stay calm while dealing with a big emotion.

1. Use breathing techniques

There’s a breathing trick I have been using lately to help calm down and refocus. First, you close your eyes. Feel everything that’s inside you and pick a word that best describes your emotions. Now, forget about that while you breathe in for four counts, hold for four counts and breathe out for eight counts, thinking only of your breath (or, if you’re like me, the counting). Do this three times, then check inside again and label your emotion. You should be seeing at least some improvement. Keep doing this as many times as you feel necessary.

  

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2. Accept the situation

There are things we simply cannot change. They happen and we have to deal with them. Instead of thinking thoughts like, “This can’t be happening!” or “That’s completely wrong!”, try just accepting it. Your outrage is not going to change the situation. Accepting is not the same as agreeing. Accepting means facing reality for what it is instead of delving into your own pathology. By trying to make something different than what it is, you are wasting your time and mental resources. Make the decision to accept whatever happened and then see how you can have a helpful reaction.

3. Take a break

There are some situations that have to be dealt with immediately, but often you don’t actually have to respond at once. When you are overwhelmed, step aside from the incident until you can gather yourself. You can tell the others involved that you need a moment, but you can also take a timeout without letting on why. Just go to the bathroom or say that you need to check that you turned off the stove. Anything is helpful. Another trick for smaller breaks is to have a drink with you. When you need a moment, just take a sip. It’s amazing how big of a difference a few seconds can make.

4. Ask for help

If someone else is in a position to be helpful, just ask. If it’s difficult for you, it’s often difficult for someone else, too. They’ll understand and do what they can. You can call a sister and vent, go out on the town with a friend or simply ask your therapist to hand you a tissue. Feeling alone in a situation can make it so much worse, so showing yourself that you are loved and cared for can be very calming.

5. Express yourself

Sometimes, feelings demand action. Some of the options that occur to us are healthy; some are not. Pause to make sure your action is appropriate before you act. Punching a wall might sound therapeutic, but you can hurt yourself and/or the wall.  You could hit a pillow a few times instead. If appropriate, you could also respectfully state out loud what you are feeling and experiencing. If you don’t have the option of expressing yourself in the moment, make a mental note of how you will do it later. This could be journaling, exercising or talking to your therapist, for instance. Knowing that you have an outlet later can help you better focus in the moment.

What do you do in the moments you are overwhelmed? Give your own tips in the comments.

Mental health myths: Intelligence

Sometimes, I take the opportunity to discuss mental health myths and the truths behind them. There is so much misinformation out there and we all need to do our part to help others see the truth about mental illness. This time, I’m talking about intelligence.

Myth: People with mental illnesses are less intelligent.

Fact: Mental illnesses, learning disorders and intellectual disabilities are not the same thing.

   

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While psychologists diagnose mental illnesses, learning disabilities and intellectual disabilities, they are not the same thing. What we commonly refer to as “mental illness” generally means the emotional disorders, with symptoms such as depression, anxiety, psychosis and so on. These are what I talk about most of the time on this blog. They don’t, however, have anything to do with how intelligent you are.

Learning disorders are when you have a problem with your cognition that leaves you on unequal footing with your peers when it comes to your capacity to learn. These include, for instance, dyslexia, math disability and, depending on who you ask, ADHD. These are caused by the way your brain processes information. But they still aren’t a measure of how intelligent you are, just the way you learn and what you struggle with.

Intellectual disabilities are about intelligence. While the actual diagnostic criteria are a little more complicated, they are generally considered to be associated with an IQ of 70 or lower. Since the average IQ is 100 (more or less), this puts someone with an intellectual disability at a serious disadvantage. For comparison, above average intelligence is generally considered 110 and higher. That means that the difference between average and gifted is smaller than that of average and intellectually disabled. An intellectual disability therefore means that you have very real struggles in your day-to-day functioning. 

So how do they all relate? 

• Mental illness is not correlated with IQ.

• You can have a learning disorder without having an intellectual disability.

• Intellectual disabilities and learning disorders can influence each other, but one is not a measure of the other.

Think of the whole “crazy genius” archetype, if nothing else. There have been enough people with extraordinary intelligence and a mental illness for that idea to even exist. Anecdotally, some of the smartest people I’ve met have struggled with some form of mental illness or even a learning disorder. People considered intelligent are just as likely to have a mental illness as those who are less intelligent. 

Intelligence is also not measured perfectly by IQ testing. Artistic aptitude, for instance, is not measured on standardized tests. Neither are your ability to build something with your hands or your social intelligence. The truth is, intelligence comes in many forms. And here another archetype comes into place: the idiot savant. There are people who struggle with overall intelligence, but are geniuses in a specific area. These individuals can have just as much to offer as anyone else, just in a very specific way.

Whether someone has a mental illness, a learning disorder, an intellectual disability or none of these at all, everyone deserves respect. Don’t treat others as if you assume they are “stupid.” Differences in intelligence are a part of human existence, just like race, sexuality, religion, physical illnesses and so on. And remember that emotional disorders have nothing to do with intelligence. They happen to the best of us.

What has your experience been with mental illness and intelligence? Share your stories in the comments.