Tag Archives: Therapy

The Nice and Not-So-Nice Therapist: Who is Really Nicer?

NICE ?

How nice should a therapist be?

Nice. Someone pleasant, agreeable.  “He’s such a nice guy,” we say, imagining someone good natured, kind-hearted.  Or  exacting, evidencing great skill:  “Nicely done!”  Or scrupulous, exacting, hard to please:  “Give me a nice piece of corned beef” – which really means “give me your best cut, extra lean!  Nice can mean trivial, easily dismissed: “that’s nice, but”  or treading carefully, behaving delicately: “be nice to your cousin!”  And then there’s making nice, acting as if one were feeling all those good things, somewhat hypocritally.  Oh, and the ironic nice, a nice that means not nice at all:that’s a nice way to say thank you!”

How can one word mean such different – even antithetical – things?  Its origin provides hints.  Originally Middle English, it meant stupid or foolish, deriving from the Latin nescius ignorant, by way of French.  It meant coy, reserved, and by the 16th century fastidious, later still  fine, subtle (considered by some the ‘correct’ sense, and on to the current pleasant, agreeable.

What happens when conflict and confrontation-avoidance masquerade as being nice?  When does acting nice not only not equal being or feeling nice, but actually serve as a cover for feelings that are anything but nice?  When is being nice a cop-out for not dealing with the difficult and messy – but important – stuff?

Which brings us to the question of the day:  Exactly how nice should your therapist be? How nice is therapeutic?

Therapy’s not about appearance, but substance.  And when it comes to the therapy experience,  there’s often a difference between nice and helpful.

If the therapist’s prime motivation is to be liked, well, then, she’s got to act nice to be seen as, thought of, as nice.  When being nice is crucial, gratifying the patient is crucial,  first and foremost, pretty much always.  Even if it means avoiding the tough stuff; especially if it means avoiding the tough stuff that doesn’t feel so, well, nice

But if the therapist’s prime motivation is to promote learning – to provide tools for a better life, to help her patient become all s/he can be, to heal – real trumps nice every day of the week.  It may not always feel nice.   But if your therapist  goes beyond skin-deep nice, if together you do more than scratch the surface – explore and understand and accept what’s real – you’ve got a shot at goodReal good.  Which has a whole lot more healing power than some ironic nice.

Copyright © 2012 Marlin S. Potash. All rights reserved.

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Reasons to Leave your Therapist, Part III: Therapy Love? How about Therapy I’m starting to Hate?

September is back to school, back from summer vacation, and for many the beginning of a new year and a new beginning.  In our lives, some things are always beginning, and some ending, but it often takes contemplation to know which should be which…

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. Leaving the good experience can be tough; ending a not-so-good, or a downright bad, therapy can be even more difficult.

Ending before you begin:  What’s a fair amount of time to decide if this is the (right) therapist for you?  What if you get a funny feeling early on?  What if you’ve been given a referral by someone you trust, and you have a terrific initial conversation, only to find something comes up early on that really bothers you?  Should you start with a therapist when you’re not so sure she’s the right one for you?

Yup.

Here’s a shortcut to what I think is the right balance:  you should feel comfortable enough to speak openly and honestly, but not so comfortable you feel as if you’re having coffee with a friend.  Go with your feelings.  If it feels right, dive in, if not, keep looking.

Ending in the middle:  You’ve hit a speed bump.  Maybe your therapist did something you didn’t like, or has turned out to have shortcomings you hadn’t seen before (I have certainly been guilty of both, and no doubt will again).  Maybe your therapy’s veered in a direction that doesn’t quite feel on the mark.  Maybe there’s something you just can’t bring up, maybe even bring yourself to face – about the problem that brought you in to therapy in the first place, about your feelings toward your therapist, about your thoughts or conclusions. 

Bring it up.  No matter what it is, whether you are “right” or “wrong” think you “should” feel this way or not, might “hurt feelings” or “make her angry.”  Bring it up.  Because that accomplishes two things:  you get it out and realize you’re still alive (hopefully with a tour guide who’s calm and compassionate), AND you get to see how your therapist reacts.  Does she minimize what you say, make you feel small or silly or just plain wrong or bad?  Or does she listen, take you seriously, consider her part in your discomfort and work with you to get over (not around) the bump?  Because that will tell you all you need to know.  Can’t avoid the bumps, I’m afraid; can avoid feeling afraid to talk about the bumps with the therapist who’s meant to help you do so.

Ending when it feels as if you’ve been going forever.  If therapy’s been uncomfortable and unproductive for a long time, if you find yourself leaving each session wondering why you bother,  if you keep trying to communicate something but your therapist really doesn’t seem to get it/you,  if you feel increasingly frustrated (maybe even angry), it’s time to reassess.

If, after months, maybe even years in therapy, you are feeling that you’ve hit a wall, chances are you have.  If, after months, maybe even years in therapy,  you are feeling unheard, you’ve got to wonder:  what will it take for this therapist to get me?  Actually, maybe you’ve got to stop wondering, and just start saying your goodbyes.  Because if you’ve invested months and years in treatment and your therapist still doesn’t get it, or you’ve stopped learning anything significant about yourself long ago, or if you’ve gotten stuck in the land of diminishing therapeutic returns: it is time to go.  Maybe time to end therapy, maybe just time to end therapy with this therapist.  Doesn’t mean it hasn’t been real, useful, important; just means it hasn’t been for a while.  A dry spell is one thing – every therapy relationship (geez, every relationship) goes through those – but a dry spell that lasts for weeks and months is more than a dry spell.  It’s a dessicated therapy experience.  And that is none too therapeutic.

Copyright © 2012 Marlin S. Potash. All rights reserved.

You and Your Therapist: Part V. Take a Therapy Vacation

Hot time, summer in the city.  Thoughts go to the Cape, the Hamptons, the Jersey Shore…

Well, maybe not specifically, but the imagination does drift to escaping the city’s humidity at the beach, by the pool,  in the country. Oh, the lazy days of summer!  So, should you take a therapy vacation?

Who, you?  Your therapist?  Yup.

You:  You stop working in therapy, really;  you phone it in.  Oh, you show up – most of the time – but your head’s not into it.  You forget to do your homework (you were going to meditate, exercise, daily, remember?).   You’re finding it too hard to resist the long weekend away, the chance to catch the new movie in air-conditioned bliss on a summer Friday…

Your therapist:  Juggling everyone else’s summer vacation schedule and wondering:  take August off, since patients are out of town, or be one of the few therapists in town, available for patients?  Struggles with patient-envy:  patients enjoying being on vacation, therapists worrying if they’ll have a practice come autumn…

Sometimes, a vacation from therapy’s the way to go.  If you’re not going to fully invest your energies in the process (either patient or therapist), don’t waste your/her time and money.  If you’re running on empty, therapy becomes a matter of diminishing returns – something that’s often noticed only after that break.

So go for it.  Time for a break so you can return, refreshed, ready to work, learn, grow, change.  Time for a therapy vacation.

Just remember: you don’t want to lose ground or forget what you’ve learned so far.   A break from therapy – summer vacation – isn’t an excuse to forget everything you’ve learned in therapy.  And it certainly isn’t an excuse to forget to pay attention to what’s good for you – and what’s not.

Copyright © 2011 Marlin S. Potash. All rights reserved.

On Respect

a lot more than the girl in the pink Cadillac on the Freeway of Love who also sings about Respect” ~ Aretha Franklin, December 18, 2010.

All of us who hear her voice and remember where we were when.  All of us who sing along – out loud, radio turned up, windows rolled down.  All of us who ever called on the Queen of Soul to give voice to the big feelings, the ones that matter, to our soul.  All of us, sending all she made us feel right back to her now, wishing her a speedy recovery, now that’s respect.

Bob Herbert paid homage to Aretha Franklin in today’s NYTimes: “if you listened closely, if you paid attention, it would just thrill you, take you to a place of exquisite human feeling. A region of laughter and tears. Of love and joyous possibilities.”

http://www.nytimes.com/2010/12/25/opinion/25herbert.html

We all need it.  We all deserve it.

And we all might consider how little it really takes:

  • To treat one another with courtesy.
  • To approach with deference.
  • To hold one another in high regard.
  • To choose to esteem.  To admire.
  • To honor, even.

We can all afford that, can’t we?  We can’t afford not to…

Copyright © 2010 Marlin S. Potash. All rights reserved.

Keeping Your Appointment with Therapy – and What Happens While You Wait.

Time for your appointment.
(You can think about it all week, you can avoid it, you can remember…)

You can wait by the door, settle in, or avoid the waiting room like the plague…


You can watch the clock, pace, or read…

You can get there just on time, always early, or usually late…

You can run in, stroll in, or not come at all…

You can compose a list, kick yourself for not doing your homework, or wing it…

You can try to focus, avoid looking up, let your mind drift…

You can hide in the bathroom, compose yourself, open the door with your cell to your ear…

You can make small talk, look at your notes, or look at her legs…

You can try to remember where you were last time, cut to the chase, or feel what you’re feeling…

So exactly when does your therapy session begin?

Copyright © 2010 Marlin S. Potash. All rights reserved.

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 or Half-Full. Part III: Learned Optimism

glasshalfemptyLEARNED OPTIMISM. Master this and you can change, with or without therapy.

The Pessimist reacts to setbacks from a presumption of personal helplessness. His assumption: bad events will last a long time, will undermine what he does, and are his fault.

The Optimist reacts to setbacks from a presumption of personal power. His assumption: bad events are temporary setbacks, isolated to particular circumstances which he can overcome by his own abilities and effort.

Martin Seligman, Ph.D., Director, University of Pennsylvania Positive Psychology Center, is the psychologist generally credited as the founder of the field of Positive Psychology. Positive Psychology focuses on the empirical study of positive emotions, strengths-based character, and healthy institutions.

Research has demonstrated that positive psychology interventions can decrease symptoms of depression and allow people to feel more satisfied, to be more engaged with life, find more meaning, and have higher hopes,

An Exercise in Learned Optimism. Do try this at home:

1. First, you must know what situations get to you. Identify adverse situations or events you routinely face. Which ones typically bother you, creating negative emotions?

2. Note (and record) beliefs about those events that come to mind (the “recordings” you play in your head). What do you tell yourself about why what is happening is indeed happening?

3. Note the consequences of those beliefs (and write them down). How do those beliefs affect such things as your energy, emotions, and will to act?

4. Dispute those beliefs. Disputation can involve challenging the usefulness of the belief, focusing on evidence that contradicts or undermines the negative belief and supports a more positive interpretation, challenging negative implications on which harmful beliefs rely, and generating alternative explanations.

5. Distract yourself. Use distraction to stop the repetition – and recitation – of negative beliefs. You might take a breath, or snap a rubber band on your wrist and say “stop” when a negative belief comes into your mind. Writing down worrisome beliefs and fears to consider at a future time can leave you free to act.

6. Notice what happens to your energy and will to act when you dispute negative beliefs. With practice, disputation becomes more rapid and effective, as the energization it creates serves as a reward for your effort. With practice, the positive explanatory style becomes your default response.

Practice, practice, practice. And let me know how it works for you, ok?

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