Monthly Archives: August 2009

Reasons to Leave your Therapist, Part I: The Good Experience

Ok. So I lied: not ready to “go fishin'” yet. You see, it’s August, the traditional month most therapists take off (hit a beach on the Cape and you’re apt to see yours in a bathing suit). I, on the other hand, generally stay in the city and see patients. I figure just because most therapists take a break in August, psychological needs and interpersonal issues don’t necessarily.

So here I am, with a lighter load (many of my patients are off for part of August, too), thinking about the process of therapy. What helps, what makes it less effective, and, today especially, how to manage and understand the breaks: illness, vacation, I-think-I-need-to-try-this-alone-for-a-while. And ending therapy.

How in the world do you know when to end therapy? There are a number of scenarios, depending on you, your therapist, and your course of treatment. So let’s start with:

Part I: Leaving a good therapeutic experience. You’ve been in therapy what seems like forever. You look forward to your regular Monday afternoon sessions with Dr. Whoever. You save up stories during the week to share, you note things you need to discuss or get opinions on, you’re comfortable and always enjoy your sessions. You trust your therapist, even like your therapist (except, maybe, for that horrible taste in office furniture). So why in the world would you even think about ending therapy (we call it termination – but since neither of you are not terminating your life, just the therapy, it’s not a word I find myself using…).

If therapy’s gotten too comfortable, and you find yourself sharing views on the markets’ rise or fall, discussing the relative merits of one sort of restaurant (car, clothing line, gardening tip…you get the drift), or inviting your therapist to your son’s middle school graduation, it’s time to reassess. Maybe, hold on, even time to leave your therapist.

What! Leave, just when I’ve gotten comfortable, when I really trust this person?

Yes, leave. Graduate, perhaps. Or switch to another therapist with a fresh take, a different style, maybe even a different approach.

Therapy requires trust, a level of comfort, and communication to be effective. But really useful therapy, the kind that helps you learn about yourself and change, becoming more and more the you you want to be, that kind of therapy starts there, but moves on to so very much more. It’s not enough to get support, to feel understood and accepted. Crucial, but you can do better. And you should.

You should leave your sessions often feeling challenged to think in different ways, uncomfortable because you’ve felt emotions you haven’t in years, awkward because you are trying out new behaviors, angry because you’ve been pushed to confront something you’ve been avoiding, teary-eyed because your therapist ‘got it’. More than comfortable: growing, learning, taking therapy into real life, facing the hard stuff, sharing your fears and taking risks.

If that’s no longer happening in your treatment, bring the subject up in your next session. What have I learned and accomplished so far? What work remains to be done? What are my goals? What issues haven’t we tackled – and why? Do you think you can help me with the next phase, or have we done all we can together?

And then decide. Ending therapy. Ending therapy with this therapist and beginning anew. Getting a consultation. Or just taking a break and giving it some thought; maybe even with the help of the meditation you’ve been practicing.

Part II: The Not So Good Experience to come…stay tuned…

Copyright © 2009 Marlin S. Potash. All rights reserved.

On Glasses Half Empty and Half Full. Part V: An Optimistic Attitude Bodes Well

glasshalffullcloudy mountains

STORM COMING IN, OR BLUE SKIES AHEAD?
WHAT DO YOU SEE?

Another positive health finding for learned optimism: According to a study published in the August 10 issue of Circulation, women who have a more optimistic view of life, who are more cheerful and trusting, are less likely to develop heart trouble than those who take a pessimistic view of life.

The report of The Women’s Health Initiative, which has tracked more than 97,000 postmenopausal American women between the ages of 50 and 79 for more than eight years examined psychosocial and social factors and their effect on the health of postmenopausal women, among other factors. Optimism was measured by a questionnaire on whether a woman agreed with such statements as “In unclear times, I usually expect the best.” The questions measuring cynicism asked about agreement with such statements as “It is safer to trust no one” and “I have often had to take orders from people who did not know as much as I did.”

Women within the highest 25 percent of optimism scores had a 9 percent lower chance of developing heart disease and a 14 percent lower chance of dying of any cause. Women with the highest degree of cynical hostility were 16 percent more likely to die than those with the most trust in their fellow humans.

There are several possible explanations for the new finding, according to lead author and University of Pittsburgh researcher, Dr. Hilary Tindle. Money might well be involved, since “optimism is associated with higher income and education,” she said. But curiously, “the level of socioeconomic status when a woman was young was better associated with outcome than current status,” Tindle said. 45191

Three broad categories off possibilities beyond that are posited by Dr. Tindle:

Lifestyle factors. “Optimistic women had more stable risk profiles, with less high blood pressure and diabetes. They didn’t smoke as much and tended to exercise more. So their lower risk might just be associated with living healthier.”

Optimists may be more likely to follow their doctors advice more faithfully. “Previous studies have shown that optimists tend to follow the diet they are told to follow.”

A woman’s outlook on life might affect how she responds to stress. Pessimism and cynical hostility might lead to higher blood pressure, higher heart rate and other physical risk factors.

Is it possible to change one’s outlook? To become a more optimistic, less cynical and hostile person? To go beyond ‘anger management’ (so in vogue these days) to a more essential change of world view? Because this study certainly suggests that would be one terrific idea. Now!

Absolutely. Two requirements:

The lightbulb has to want to change: you need motivation and the desire and ability to stick with it.
You need to follow a consistent practice: committing to a good program, therapist, teacher who can teach you techniques designed to be effective for you.

Change of this nature takes practice and time.

But there’s increasing incentive. As Dr. Tindle notes, “One’s view of the world and your perspective can play an important role in your health. This study demonstrates the role and significance of the connection between the mind and the body. Its just another reason to try to look at the bright side of life.”

Copyright © 2009 Marlin S. Potash. All rights reserved.

Wake Up and Smell the…

coffeebeans Pay attention.
Think. Deal.
Do something about it.
It may be later than you think,
but there’s still time…
almost enough time…
for the things that matter:

Dinner and conversation at Elaine’s last night.
Espresso and Grand Marnier.
Friends and ideas.
Writing and reading.
Learning and sharing.
Living in the real world.
Difficult, perhaps, but what other game’s even remotely as interesting, important or – dare I say – fun?

Copyright © 2009 Marlin S. Potash. All rights reserved.