Menstuff® has information on Therapy.
Is It Time to Confront Your
How To Encourage Someone To See A Therapist
Obstacles to Awareness of Men's Issues
More Mental Health Issues
What is Family Therapy for Addiction, & How Can It Help MY Family?
People Who Talk to Themselves Arent Crazy, Theyre Actually Geniuses
How do I know if my child has oppositional defiant disorder (ODD)
Therapy Prevents Repeat Suicide Attempts
Please Don't Visit This Type of Doctor Unless You Absolutely Have to
The Marketing of Madness - DVD
Active Minds gave me the strength and power to start going to counseling. I am proud to tell people that I have a counselor and now encourage friends to go to counseling. I help them understand that even if they don't have a mental illness, they do have mental health that needs to be cared for.
Is It Time to Confront Your Demons?
I almost turned around and walked out. It was that bad. Beige walls, ambient mood lighting, decorative bamboo shoots, and on the coffee table in front of me one of those miniature Zen rock gardens. There was also an incessant trickling. I peered into the gloom of the waiting room and saw its source: one of those plug-in waterfalls with a craggy slate cliff. There was no receptionist, so I took a seat. I picked up Mother Jones and put it down. I picked up the rock garden and started raking pebbles; then I realized what I was doing and put that down, too.
What was I doing?
Therapy, psychoanalysis, counseling . . . call it what you will. I'd always called it a sham, a cop-out, an excuse. Granted, I don't come from a touchy-feely family. When I was a teen, my parents divorced, my mother moved in with a woman, my father remarried a widowed socialite, and my brother and I were shipped away to school. Yet none of us even considered therapy. Imagine that happening today, in this era of self-help books and life-coaching seminars. What's happened to America? When did we stop solving our own problems? We've all gone soft, and I wanted to find out why. So I booked a session with a shrink.
Okay, there's more to the story--a personal side. Truth be told, I was curious. As I'd crept through my late 20s and early 30s, the number of people I knew who were in therapy had grown to the point at which I found myself in the minority. And everyone talked about it! Dates came bustling into restaurants, apologizing because their shrinks had kept them late. Married friends mentioned how counseling had helped their sex lives so much, as if I wanted to know.
And it was not just a New York phenomenon. My therapy-devoted friends were in Atlanta and Los Angeles, in Kalamazoo and Fort Lauderdale. They were bankers and housewives and salesmen. They were older and younger. And most interesting of all? There was nothing wrong with them: no severe anxiety or debilitating depression, no strange phobias or suicidal tendencies. Sure, they had their issues--who doesn't?--but they were hardly head cases. Yet they looked forward to their weekly sessions the way I look forward to poker night. Therapy was their escape.
It was Sigmund Freud who, in the late 1800s, first theorized that psychological problems are rooted in the unconscious mind. The techniques he developed to bring those problems to the surface have, over 100-plus years of refinement, become the foundation of modern psychotherapy. But none of my therapy-attending friends ever mentioned the analysis of dreams or the cataloging of Oedipal impulses. No, it seemed they just spent their time ranting about scheming bosses or annoying spouses while their shrinks sat there quietly, feigning interest, fighting sleep. If things turned worse--if the sadness or anxiety became constant--perhaps the doctor would write a prescription or call another doctor. Therapeutic solutions and chemical cures. Life without mental illness--it's a powerful idea.
Popular, too. According to the National Center for Health Statistics, the number of American adults who visited mental-health professionals jumped by more than a third between 1997 and 2005, to almost 24 million. That's just over 10 percent of us. And the patients aren't all women: 38 percent of today's therapy seekers are men, presumably emboldened by James Gandolfini's Tony Soprano and Robert De Niro's Paul Vitti.
David Gardner, M.D., an associate clinical professor of psychology at Georgetown University hospital, traces the roots of the trend to the introduction of Prozac in 1986. "But drugs are only part of the story," he says. "Celebrities are the ones who erased the stigma attached to psychotherapy. Take Oprah. She talked openly on her show about her weight problems and history of sexual abuse, and ever since then there's been an explosion of self-revelation. It's really quite extraordinary."
Sitting in the waiting room, pondering the craziness of the "crazy" craze, I thought back to the night when this all started for me: at my 35th-birthday dinner. A group of friends began talking about how invaluable therapy had become in their lives, and when I raised a dissenting voice, I was quickly shouted down.
"How can you know what you're talking about if you've never tried it?" my friend Haley asked. The rest of the table jumped in. I was surrounded, outnumbered. And they had a point. A few days later, I called Haley to request her therapist's number and ask what the woman was like.
"She's laid back but tough," Haley said. "She doesn't just sit there and ask questions. It's more of a conversation."
"But I'm fine," I insisted.
"Oh, honey, no one's fine. That's the first thing you'll learn.
Those words stuck in my head. Was I really fine? Certainly there were things that bothered me--inconvenient corners of my life that I tended to ignore or explain away, phrases that emerged in arguments with girlfriends, bad habits that never quite died. But the big picture still looked rosy. I lived in a great city, was surrounded by supportive friends, and now had something I could legitimately call a career. So why was I really sitting in this waiting room? It wasn't just because I was culturally curious. Or because of my friends. It was the birthday . . . 35. It felt like the end of something big. A graduation into adulthood.
But I wasn't an adult--not in any conventional sense. I wasn't married. I didn't have kids or a car. I owned no real estate. I didn't even have health insurance. And yet all of this seemed perfectly normal. I'd chosen a certain life and was now living it. A successful book, a film deal . . . what a great year it had been for me. So why hadn't I had fun? Why had my girlfriend and I broken up? Why did I run off to Europe for 2 months to get away from everything?
I looked up. She was smiling: a thin, stylish woman with wavy hair and a pleasantly disarming bohemian glow. I shook her hand and followed her to an airy office at the end of a long hallway. She pointed me toward the couch (yes, there really was a couch) and sat down in a chair facing me. I'd dreaded this moment. How do you confide in a complete stranger? How do you share the thoughts you've never shared with anyone else? Yes, this woman was trained (and paid) to listen. Yes, it was supposed to be easier to talk about your life with someone outside of it. But I didn't actually buy any of that. I mean, seriously. The entire setup was so artificial. How should I play along? Where would I begin?
Well, at the beginning, if you're Freud. First memories and all that. But so far, this had nothing to do with Freud. She hadn't asked me to lie down or recount dreams. No, we just started talking. This and that. Occasionally, she asked a pointed question. Sometimes she wrote things down. On my book tour, I'd grown tired of talking about myself, so I created a kind of persona, a second, more public version of myself. It was a phenomenon I hadn't pondered or discussed with anyone because, well, that would be even more self-serving. And anyway, who in her right mind would listen?
It took me a moment to realize I was saying all of this out loud. In less than an hour, I'd delved deeper into my, what, unconscious than at any time in the past year. And this I told her, too.
"I'm not sure we've reached your unconscious yet," she said. "But we have awakened some of the bats that were sleeping."
At my next appointment, I came rushing in, frustrated by all the small aggravations of life. I slumped into a chair and took a deep breath, and the outside world began to fall away. I could no longer ignore it: I'd been looking forward to coming back. Last week's visit felt like something worth pursuing--an intriguing first date or an adulterous affair. And I was cheating on the part of me I didn't like. I just started talking: women, work, goals I should be pursuing--
"You're saying 'should' a lot," she said.
"Yes. As if you have a preconceived notion of yourself. Some other possible life you're battling against. Tell me, what do your parents do?"
"Is this the Freud part?"
She laughed. "Maybe, a little bit. We all have different versions of ourselves. And they're rooted in our pasts."
"They're both lawyers," I said.
"Oh, dear. This may take a while."
There is a moment in therapy--if it's going well--when you decide to tell the truth. For me it was the middle of the fourth session. And I don't mean I'd been lying until then. It's just that I hadn't come completely clean. This was, after all, a relationship of sorts. The person sitting across from me was someone I'd quickly come to value and respect. I wanted her to like me. I wanted her to be impressed. And yet I was playing that coy game we all play. When she said she was looking forward to reading my book, I told her she must have better things to do. The false modesty was pathetic. I'm sure she saw through it, even if she didn't let on.
She changed the subject. I changed it back.
"About the book," I said. "Of course I want you to read it."
"So why did you say you didn't?"
"I don't know. Why does anyone say anything?" And then I caught myself again. I did know. "Okay, I didn't want to sound self-involved."
She leaned forward slightly. "You're very hard on yourself. You should want your work to be read; otherwise, why do it? You can't just stay silent, hoping to be noticed. Not in this day and age."
I almost said that flagrant self-promotion was part of what had made "this day and age" so superficial in the first place. But this was psychotherapy, not philosophy. And I'd just made a small breakthrough of sorts, peeled away a layer of myself. She knew it, too.
Suddenly, we were off and running. She poked and prodded. I reacted and explained. For the first time, I could imagine these mini-realizations leading to a larger, life-altering discovery.
The following week I came armed with a question.
"Tell me, where does all this end?"
"What do you mean?" she asked, looking up from her notes. She smoothed the wrinkles in her skirt.
"You don't like it when I ask the questions, do you?"
"Therapists have their own therapists for that," she said.
"Oh, that makes me feel better."
"That you have someone to vent to."
"I think you know this is about a lot more than just venting," she said. "We're on a journey. And the end is never as important as how you get there."
"But if we keep peeling off layers, there may be nothing left."
She laughed at this and was silent for a time. I thought back to that first day in the waiting room and of all those ideas and misconceptions. Psychotherapy wasn't what I had thought it would be. It was instead a reflection of who I was. It wasn't spiritual or New Age, because I'm not spiritual or New Age. But something positive was happening, so why not give it a chance? Was I going soft? Maybe a bit, or maybe I'd been hard-edged for too long.
I realized then that I was staring out the window. When I turned back, she was regarding me curiously, her brow slightly furrowed. And then, as if reaching a decision, she opened her notebook and clicked her pen.
"I think you're ready," she said. "So let's start at the beginning. What are your first memories?"
Find the Right Therapy for You
Psychotherapy works -- but only if you visit the right kind of therapist. Here are five common reasons men visit shrinks, and the recommended therapy for each problem.
1. Depression: Cognitive Behavioral Therapy (CBT)
When men believe they have no reason to be happy, they turn away from activities they enjoy. "The cognitive part helps patients identify their negative thoughts, and the behavioral aspect pushes them to stay active," says Greg Simon, M.D., a psychiatrist in Seattle.
2. Phobias: Exposure Therapy
"Contact with the feared event is critical to overcoming it," says Jeffrey S. Berman, Ph.D., a University of Memphis professor. Exposure therapy slowly desensitizes you. Say you're afraid to fly. Over a few months, you visit an airport, sit on a plane, and taxi around. Then you're cleared for takeoff.
3. Substance Abuse: 12-Step Programs
Alcoholics Anonymous and Narcotics Anonymous are still the key treatments for alcohol and drug abuse. A 2006 study in Addiction found that people who sought treatment by using a 12-step program were 44 percent more likely to be clean and sober 3 years later.
4. Anxiety: Psychodynamic Therapy
CBT is the standard treatment for anxiety. But a recent study suggests that psychodynamic therapy, which raises awareness of unconscious motivations, is a great alternative. In the study, patients had a 153 percent greater reduction in symptoms after 12 weeks than those receiving relaxation training.
5. Marital Troubles: Family Therapy
"Family therapy treats relationships, not individuals," says Jacques Barber, Ph.D., a professor of psychology at the University of Pennsylvania. The goal is not to pinpoint the cause of a problem -- i.e., place blame -- but to reveal how the couple's interactions feed it.
How To Encourage Someone To See A
Its hard to watch someone you care about struggle with their mental health. Its even worse when you know they could benefit from professional help. Approaching an individual and encouraging them to seek therapy can be a tricky situation. If done the wrong way, you could aggravate the person or turn them against the idea entirely. However, there is an effective way to have this conversation.
Here are some steps you can take to tell your loved one about the benefits of seeking therapy.
Misconception about mental health and therapy has intensified stigma in society. Your loved one may be aware that they need help, but may be afraid to seek it if they think you will judge or treat them differently. Therefore, it is essential to use non-stigmatizing language when talking with them about their mental health. Assure them that you will support them through the therapy process.
Demi Lovato is one of the most vocal celebrities about her mental health issues. She mentioned on multiple occasions how important it was for her to have people around that really care about her wellbeing. She credits her support group for being able to go through everyday life. Demi asks for advice from her loved ones and asks them to let her know when they feel somethings off: "So whether it's with my management team or with my friends, every choice that I make, I run by people. And that's what's really helped mevocalizing what you need."
Be Sensitive To Timing And Place
Talking to someone about mental health requires emotional sensitivity as well as physical sensitivity. The where and how the topic is presented may determine how a person reacts to your suggestions. Your loved one may not be as bold as Kesha when she shared her condition and struggles with the world while receiving an award.
Dont start this delicate conversation in front of other people or where others can hear as this may cause discomfort. And avoid grouping up in an intervention-style conversation as people do on TV shows. Allow the person struggling to decide whether they want others to know. This way, they feel respected and in control of their own treatment.
Also: Avoid talking to someone when they are in a bad mood, tired, have tight deadlines at work or if theyre doing something important. They may dismiss you or disregard the weight of the topic. Approach the person when theyre in a good mood, relaxed and undistracted. Try as much as possible to keep the conversation private, friendly and relaxed.
Prepare For Resistance
Not all people who hear about therapy will be willing to try it out. You need to be prepared to make your case if your loved one resists your suggestion. Here are some ideas that you can use to highlight the importance of therapy:
Offer To Help
You can try to embolden someone to go to therapy, but unless you are willing to offer meaningful support, its not going to encourage them. Some people do not know where to start when seeking help. Guide them in finding a suitable therapist in the area, depending on their preferences. You can contact offices on their behalf or research various professionals, their credibility and reviews.
Some people are scared of seeing a therapist alone or signing up for group therapy. Offer to go with them until theyre comfortable. You can sit in the waiting room during their first few sessions. Make sure to assure them that you wont ask prying questions about the counseling unless they want to share.
Seeking therapy is one of the best steps that a person with a
mental health condition can take. However, its an effort that
requires great strength and courage. Share your suggestions as openly
as possible and leave them to make the decision that best suits their
needs. Above all things, assure them of your continued love and
support throughout the process.
What is Family
Therapy for Addiction, & How Can It Help MY Family?
You may have heard of counseling, or psychotherapy, to help someone with an addiction. Family Therapy is just that, except that the one going to therapy is not just the individual struggling, but the entire family.
While individual therapy focuses on the thoughts, behaviors and emotions of one person, family therapy focuses on the relationships, and aims to understand and validate the experiences of all family members. The goal of family therapy is to bring clarity to all relationships, and to foster repair and closeness if family members choose. Family therapists believe that problems exist between people, not within people.
In the addiction context, a family therapist will explore with the family how substance use is embedded in a cycle of interaction within the family. For example, many young adults and parents are in what we call a fugitive/detective dynamic. The more the young adult acts like a fugitive (hiding, lying) the more a parent acts like a detective (snooping, chasing) and visa versa. In addition, family therapists can provide additional education about substance use for the whole family and support family members in reducing their unhelpful behaviors and increasing their effective behaviors.
Family therapists help identify new skills and then coach family members in the practice of these new skills.
Anxiety, anger, frustration and a deep worry often interfere with parents renovating their approach to family life. Family therapists can also put the substance use in a different context by addressing other challenges and highlighting other resiliencies in the family for example, understanding what is working in the teens life, or asking, If we werent here to talk about this persons substance use, what would we be talking about as a family?
Many research projects demonstrate that Family Therapy is very helpful, although there are time-based and/or economic barriers as to why its often not offered, implemented or practical.
In our work at CASA, weve been engaged in a research project attempting to distill the core elements of family therapy from evidence-based therapies, and have identified four of the most important components of these family therapy models: Family Engagement, Relational Reframing, Family Behavior Change, and Family Restructuring.
The first element is Family Engagement, as enhancing family members involvement and investment in the therapy of the young adult who is struggling is key.
For example, for a parent who feels reluctant to engage in therapy, a therapist might share something like: You and I together are trying to help her not go under. This isnt going to be easy, but Im going to push you to hear her point of view and youre not always going to agree. Im going to help her bring things to you, and to help you hear her.
For a teen who is feeling unsure about the value of family therapy for them, a therapist might share something like: Your mom seems upset about your grades dropping. Thats important and we will spend time talking about it, but Im just as interested in hearing how you feel things are going for you. I want therapy to be a place where you can talk about what you think is going well, going not so well, and what you would like to be different.
Family Engagement interventions typically take place during the initial phase of treatment, though investment and goal setting are continually revisited in family therapy.
The second element, Relational Reframing, consists of interventions designed to move away from individual ways of defining problems and generating solutions, and toward an understanding focused on relationships. These interventions also aim to remove irrational descriptions and attributions for family members behaviors, and instead focus on understanding motivations for behavior based on those relationships.
For example, a family therapist may want to expand a description of a parent from someone who is critical and judgmental to one who is simply worried by sharing, I take it that when you are yelling at your daughter about her coming home late, you are actually worried about her safety and well-being, rather than just being angry with her.
A family therapist may also want to transform an understanding of a teens substance use from one that blames them to one thats a more meaningful understanding of their problem by saying something like, I wonder if because of what has happened in the past, everyone in this family is a little bit anxious, and everyone has different ways of dealing with that anxiety, and a lot of the ways arent really working for you. Maybe you are using substances and staying in your room a lot, but I bet youre all feeling pretty scared.
Family Behavior Change
The third core element, Family Behavior Change, aims to shift the behavior of family members. These interventions aim to teach concrete new skills and encourage individual behavior changes that will allow for improved family relationships. New skills and behaviors are positively reinforced and coached, for both individuals and the entire family.
For example, new skills that a family therapist might teach a family could include assertive communication skills, enforcing limits, negotiation of rules and boundaries, expressing feelings more effectively, and others.
The fourth element, Family Restructuring, aims to change the way the family system is governed; that is, to shift underlying beliefs, premises and family rules.
For example, there may be a trend in the family that when someone is upset, they dont talk about it and are meant to handle it alone. A family therapist might help the family become aware of this premise, and might introduce new beliefs about the value in speaking with each other about difficult feelings. There may also be beliefs about different roles two different parents occupy, and family therapists can help identify a shared way that both parents can respond to their child.
Family members are encouraged to understand the dynamics of their family, and how these dynamics are linked to the problematic behavior. It ends up prompting shifts in attachment and emotional processes between family members.
Even without formal family therapy, parents can begin to think about how they can be resources for their teen, and how relationships could shift in their families to better support a teen who is struggling with substance use. Parents should be curious about their son or daughter and his/her life in a non-judgmental manner.
We know that engaging in these conversations can be very difficult, so parents shouldnt be afraid to seek support on their own to do so, or be discouraged if it at first it doesnt feel successful when they aim to engage in a more skillful conversation with their teen.
If a parents approach to substance use is based on punishment, the teen is less likely to talk about their substance use and whether they are worried about themselves or a friend. This does not mean that behavior doesnt have consequences, but that parents should position themselves as resources for their teens rather than act as probation officers. Limit setting is important, and consistency is the most important part of limit setting for example, if your child misses curfew and the consequence is a week of being grounded, its very important to follow through as opposed to just grounding him or her for a day or two. We also know that the most effective way to change behavior is through positive reinforcement, so in addition to boundaries and consequences for less healthy choices, parents can look for opportunities to positively reinforce the healthy choices the teen is making in their everyday life.
Because we know some teens do use substances, parents should encourage their teens to avoid drugs but also talk about reducing risk if they or people they hang out with do use drugs. Also, providing fact-based and honest drug education makes parents more credible and again more likely to be someone their teen comes to for advice or help.
The relationship with your child is the most important thing to
attend to dont lose sight of this core value when
youre legitimately concerned about your son or daughters
substance use. Stay focused on the positive relationship and your
lifelong bond with them, and offer compassion and love. It is truly
the most important thing and has the biggest positive influence on
Talk to Themselves Arent Crazy, Theyre Actually
Youre a genius.
I mean, this should be a no-brainer, right? After all, some of the smartest people in history talk to themselves: poets, writers, philosophers, every one! Even Einstein used to repeat his sentences to himself softly.
But now, we have proof. Proof, I say!
A study printed in The Quarterly Journal of Experimental Psychology claims that talking to yourself makes your brain work more efficiently. Authors Daniel Swingley and Gary Lupyan hypothesized that talking to yourself could actually be beneficial. Their first trial, in which they gave subjects an object to buy at the grocery store, seemed to prove their point. The people who were allowed to say the name of the item aloud were much more likely to find it than the ones bound to silence.
It turns out that talking out loud might not always be helpful, though.
Speaking to yourself isnt always helping if you dont really know what an object looks like, saying its name can have no effect, or actually slow you down. If, on the other hand, you know that bananas are yellow and have a particular shape, by saying banana youre activating these visual properties in the brain to help you find them.
Basically, if you know what an object looks like the banana, for instance then saying the word will help you find what youre looking for. But, if youve never seen a rutabaga, saying it out loud isnt going to be of any assistance at all.
Not that youd ever actually want to find a rutabaga, but in case you do, heres a picture.
It can be helpful for the indecisive scatterbrains among us.
Talking through things aloud can help organize your thoughts, as well as validate difficult decisions, according to psychologist Linda Sapadin
It helps you clarify your thoughts, tend to whats important, and firm up any decisions youre contemplating.
I mean, basically, its best to talk the big decisions out even if its just with yourself.
Talking to yourself about your goals also helps you attain them.
It turns out saying your goals aloud is even better for achieving them than making a written list, which can seem daunting. As Sapadin says,
Saying your goals out loud focuses your attention, reinforces the message, controls your runaway emotions, and screens out distractions.
Its exactly what we crazies who talk to
ourselves have always known were smart, and we give
great advice. Why not listen to it, out loud and wherever you
Repeat Suicide Attempts
Using detailed Danish government health records, researchers studied 5,678 people who had attempted suicide and then received a program of short-term psychotherapy based on needs, including crisis intervention, cognitive therapy, behavioral therapy, and psychodynamic and psychoanalytic treatment. They compared them with 17,034 people who had attempted suicide but received standard care, including admission to a hospital, referral for treatment or discharge with no referral. They were able to match the groups in more than 30 genetic, health, behavioral and socioeconomic characteristics. The study is online in Lancet Psychiatry.
Treatment focused on suicide prevention and comprised eight to 10 weeks of individual sessions.
Over a 20-year follow-up, 16.5 percent of the treated group attempted suicide again, compared with 19.1 percent of the untreated group. In the treated group, 1.6 percent died by suicide, compared with 2.2 percent of the untreated.
Suicide is a rare event, said the lead author, Annette Erlangsen, an associate professor at the Johns Hopkins Bloomberg School of Public Health, and you need a huge sample to study it. We had that, and we were able to find a significant effect.
The authors estimate that therapy prevented 145 suicide attempts
and 30 deaths by suicide in the group studied.
Someone's therapist knows all about you.