“It’s for you!”

Over the last ten years in my private practice, I occasionally hear this request from new clients.

“I want a therapist to call me on my shit…”

“Are you the kind of therapist who will call me on my shit?”

“Yes, I am,” is the short answer. But how I do that may not be exactly what you have in mind. The longer answer includes a few variables that I’ve learned really matter in this endeavor, such as:

• how long we’ve been working together
• how strong our therapeutic alliance is
• whether or not you are in a crisis or you’re in a more stable place in your life

As someone who has a semi-objective (I mean, who can really be fully objective, in these human bodies with all of these accumulated experiences, anyway?) point of view, I may be able to sense some of the patterns you’re perpetuating or some of the defenses you’re displaying more easily than you can. As your therapist, it’s my job to take note of these and to reflect them to you in a way that is empathic and understanding. It’s also my aim to provide you with some alternatives.

What Does Calling You on Your Shit Look Like?

For different people, the answer may look very different. If being “called out” is important to you, are you specifically looking for one or more of the following from me?

• Tough questions
• Specific coping skills
• Help with identifying the problems (the pattern of thoughts or behaviors)
• Highlighting inconsistencies in your values and actions or reflecting “bad” choices
• Challenging the excuses or justification you typically use
• Help developing a plan of action

The Issue of Accountability

Sometimes, when we rely on others to keep us accountable there may be some challenges with our own responsibility-taking. Strengthening this personal challenge to step up to the plate and take accountability on your own is a perfectly worthwhile therapeutic goal.

Developing your own sense of insight, or an understanding of how or why you’ve chosen (often unconsciously) the actions or patterns in your life is an important aspect of any therapy.

I am here to support and guide you in this process, and until you are able to do that work on your own, yes, that may look like me, calling you out, on your shit. 

Seeking out therapy for depression in North Carolina can be challenging, but finding the right therapeutic fit can be a transformative experience.  

I provide support to many people suffering from low-grade, chronic depression. When it comes to the individual factors that contribute to depression, however, people can find themselves at a loss for how it originated with them. Let’s look deeper at the roots of depression. 

Where does depression come from? 

Depression is an incredibly challenging state of being. It drains your energy, takes pleasure out of everything you do, and convinces you that there is no point in anything.

While it sometimes seems that depression arises out of nowhere and slowly takes over our psyches, the true roots of depression can come from a number of places. Let’s look at these three common sources:

• Unresolved Trauma
• A harsh, demanding or punitive Inner Critic
• Unexpressed anger that has been turned inward on the Self.

Unresolved Trauma

I recently listened to an Attachment Theory in Action podcast in which Howard Steele Ph.D. provided some phenomenal definitions for trauma. He says:

Trauma is an experience that occurs when there is a gap between the demands of a situation and the resources available to handle that situation.

 

Traumatization is when children are overwhelmed with information or experiences they cannot understand. When this occurs, their self development suffers and they are traumatized.

Steele goes on to talk about how the most vulnerable years of life are the first 18 years. That children are really the most vulnerable population in need of advocacy and protection.

When we, as children, have experiences that are overwhelming and incapable of being fully understood, processed, and integrated, we are susceptible to traumatization. When this happens repeatedly, we are left alone to make sense of our experiences and, due to false attribution, we tend to misassign ourselves the blame. This alone can cause depression.

Trauma can be healed. It takes time to unpack and explore the many layers we’ve built over it, but it may be the most important thing you ever do.

A harsh, demanding, or punitive Inner Critic

How you talk to yourself is everything.

Do you realize that you talk to yourself? Because we all do it, all day long and even (or, rather, especially) in the wee hours of the night. There are many people for whom that idea is foreign, but once we start to get quiet and bring our attention inward we can hear the stirrings of a voice that is always there, just below the surface.

This is why mindfulness is such a powerful practice. Because it gives us a structure and a way to gently “drop in” on our own self-talk and be curious about it.

Once we’re there what we sometimes find is a relentless authority figure whose mission is to keep us in line, prevent us from making a fool out of ourselves, or keep us small and unnoticeable. That voice is generally negative, demeaning, or cruel.

Hearing how you speak to yourself is sometimes a shock, and often a revelation. If you had an actual nay-sayer following you around 24/7, it’d make sense that you generally felt down.

Since this part of you never leaves (and often exists beyond your conscious mind) it can be incredibly challenging to change what is causing your pain. The good news is that Inner Critics are capable of being tamed and transformed from masters to servants with clear intentions, guidance, and practice. Getting the right therapy for depression is possible.

Unexpressed anger that has been turned inward on the Self

We all get angry. It is part of our evolutionary design. When we feel that an injustice has occurred, or that we have been violated in some way, our adrenaline starts pumping to mobile us so we can take action. We are supposed to take action.

However, for those of us who have been conditioned to not take action, for example, those of us with a Subjugation or Self-Sacrifice schema, we do not express our anger. We pretend that everything is fine, and our anger gets swallowed down deep inside of us. It lives there, inside our bodies, and festers. It often changes form from anger into resentment and sometimes, it becomes depression.

The good news here is that it is never too late to express what has been unexpressed. The rage from the injustices you saw or experienced as a child, or at any point in your life is still there. Expressing it can be an important part of your healing journey. As you release the pent-up energy and make space for something new, you may find that there is a world of sadness, grief, or creativity that awaits.

If you are seeking therapy for depression in North Carolina, reach out to me today if you’d like to get support.

How often should I see my Therapist?

“How often should I plan to come see you?” This is a question I often get from prospective clients early on in our work together. My answer: every week.

Therapy is a unique relationship, and has the potential to be one of your most powerful relationships. A psychotherapeutic relationship holds the possibility for transforming lifelong patterns of relating to others in ways that ultimate don’t serve you. Do you:

• Tend to get into conflicts with the people closest to you and later regret how you handled the situation?
• Ghost your friends or intimate partners when things get tough?
• Feel emotional overwhelm when stresses are high?
• Choose not to share your needs with others out of the fear of being a burden?
• Feel abandoned when others don’t respond to your efforts to connect immediately?

These are all ways of relating that can be hard to recognize in ourselves and even harder to change. Often, exploring these dynamics, or ways of relating, is a part of the work of therapy.

The key word when it comes to therapy is relationship.

There is a saying among therapists “it’s the relationship that heals.” The saying was coined by Irvin Yalom, a therapist and author, and it speaks truth to how therapy actually works.

The wounding that causes individuals to reach out for help in the first place was caused in a relationship. And the healing for that wound takes place within the context of a relationship.

And relationships take time to build, effort to maintain, and must be valued as a priority if they are going to be effective at upending long-standing patterns. 

But what if I can only afford to visit my Therapist every-other week? 

First, I would encourage you, if you are in this position, to really soul-search on this one. Can you truly not afford to go to therapy weekly, or does the idea of having to meet your therapist every week inspire anxiety or dread? Does it feel too intense or overwhelming? 

If this is the case, consider sharing this information with your therapist so they can help. Perhaps making weekly meetings something you can work toward could be beneficial while also allowing you to go at a pace you can feel comfortable with to start. 

If you can afford it, I strongly encourage you to commit to it. You will feel more progress, sooner. Psychotherapy is not necessarily something that one is meant to enter into forever more. It is intended to be a healing, supportive, or skills-based training experience for a period (or many periods) in your life. Make it a priority in your budget if and when you are feeling that you need it, and when that piece of work is complete (that issue has resolved, that pattern is upended, or that goal has been attained), suspend your therapy for as long as you like. 

Reading the Headlines

One analogy I often use involves coming to therapy twice a month is like reading the news headlines. You come in, “read me the highlights” and we get caught up just in time for our session to be complete. Then you’re off for another two weeks. There isn’t enough time to read through the entire story of what’s happening, nor is there time to really explore how what is happening is affecting you and how we might work to manage or mitigate those impacts. 

I often say to my clients “I would rather see you for six-months doing weekly sessions than for a year of every-other week.” Why? Because we can go deeper, accomplish more, and you’ll get more out of it. 

I know this from my decade of working in private practice and experiencing both weekly and bi-weekly schedules with my clients. 

But what if I can only come to therapy monthly? 

Monthly visits are not in-depth psychotherapy. They are check-ins. And check-ins are fine under certain circumstances: 

• If you have been doing weekly therapy for months or years and want to continue your meetings with your therapist to feel the benefit of continued support after making significant strides on your goals. 
• When you have a very specific issue that you want to consult about with your therapist. 

 If you are just starting out in therapy, monthly meetings are likely going to prove frustrating and the odds that you’ll stay the course long enough to see the benefits are slim. 

What if I want to come to counseling more frequently? 

Occasionally I meet with people more than once a week. If you find yourself in a situation that is deeply distressful and you feel that you’d benefit from multiple sessions a week, let me know. 

Are there resources for low-fee therapy so that I can work weekly with a therapist whose rate is within my budget? 

Yes! Check out Open Path Psychotherapy Collective to find therapists offering sliding scale spots for therapy in the range of $30-$60. 

Questions for me about my practice? Contact me today!