The [....]‘s Guide to Getting a Therapist Masterpost

I ran a series last week about the finnicky steps of getting a therapist. This is the masterpost, with links to every part of the series. It will end up as a new tab on the top of every G&H page as well.

The [....]‘s Guide to Getting a Therapist: Getting Started

The [....]‘s Guide to Getting a Therapist: Reaching Out

The [....]‘s Guide to Getting a Therapist: Your First Session

The [....]‘s Guide to Getting a Therapist: Miscellaneous

Go forth and sit on couches!

The [......]’s Guide to Getting a Therapist: Miscellaneous

Fun fact: searching around for creative commons licensed couches results in lots of couches on fire. Is this a Thing?

Note: For decreasing the amount of language confusion in this post, I’m using ‘therapist’ as a blanket term to mean ‘someone who practices therapy’. In fact, this is not precisely accurate, though it seems to be colloquial use. For sorting between psychiatrist, psychologist, and therapist, take a look at the Terms section in Part I.

<< Previous Post: Your First Session

Part IV: In which forgotten things are unforgotten.

I am not a therapist! However, lots of people ask me a lot of the time about getting therapy, and are often willing to keep me updated on what worked and what didn’t. This four-part guide, which is essentially the sum total of every bit of advice I could think of, and a few I didn’t come up with (thank you, proofreaders and feedback-givers!) aims to make the therapist-getting part less mysterious and more accessible. 

—-

If you have had previous experiences where you found it hard to tell someone in person what had been going on, you might consider bringing in writing or notes. I have done this! It was very helpful, and meant I didn’t accidentally get too tangled up in my emotions and forget something important. Write poetry or journal in the moment and feel okay sharing it? Also a thing. Even my clinical training scenarios have included stories of clients bringing in such things, and if it means giving your therapist a clear picture of the issue it seems worth it. With one therapist, I showed up to our first meeting with data: a calendar reflecting how often I’d had trouble with my ED and significant events around each episode.

I’ve found it very helpful to avoid scheduling therapy between daily tasks. Sometimes there are surprise!emotions and I’ve felt much better when I had an hour or so to process the experience before interacting with people.

Despite liking my therapist(s) and seeing improvements as a result of therapy, I’ve often been tempted to skip sessions when I was having especially bad brain days. (If this sounds like a terrible plan, you’re correct!) My solution to getting around this was twofold. First, I set up a reminder in my phone to go off an hour before I had therapy. It read something like “Past-Kate wants you to remember that therapy makes you feel better and is worth doing” Secondly, I asked my partner to, if he ever thought of it, remind me of times when I felt really great after therapy, or point out progress I’d made. So far: success!

Sometimes insurance only covers a certain number of sessions (or your budget will only get you X amount of meetings.) I strongly encourage telling a therapist about this up front or as soon as you know—it can give them important information about structure and prioritizing how you meet, as well as allowing them to prepare you for termination of treatment.

What else would you add?

—-

<< Previous post: Your First Session


I am actively looking for things I’ve left out, so if upon reading any section, you have unanswered questions–even if you think they are trivial or might mean you’ve missed something, please let me know. I would much rather spend time responding with “no, that’s in paragraph two” than have a whole subset of people think they didn’t read properly and not tell me I was unclear. Further, many thanks to Rita Messer for checking over the advice within. 

The [......]’s Guide to Getting a Therapist: Your First Session

Fun fact: searching around for creative commons licensed couches results in lots of couches on fire. Is this a Thing?

Note: For decreasing the amount of language confusion in this post, I’m using ‘therapist’ as a blanket term to mean ‘someone who practices therapy’. In fact, this is not precisely accurate, though it seems to be colloquial use. For sorting between psychiatrist, psychologist, and therapist, take a look at the Terms section in Part I.

<< Previous Post: Reaching Out

Part III: In which couches are sat upon, forms are filled out, and intake is had.

I am not a therapist! However, lots of people ask me a lot of the time about getting therapy, and are often willing to keep me updated on what worked and what didn’t. This four-part guide, which is essentially the sum total of every bit of advice I could think of, and a few I didn’t come up with (thank you, proofreaders and feedback-givers!) aims to make the therapist-getting part less mysterious and more accessible. 

—-

Your first session:

The first session is an extension of the “Do you want to tango?” testing-each-other thing. The therapist wants to know if they can help your particular case, and you want to know if you feel comfortable/matched with them. It’s a first ‘date’ and if they’re metaphorically rude to the waiter, or you just don’t click, it’s okay not to start a relationship.

You might have to fill out some forms. This can vary a lot from place to place, but generally forms can include:

-acknowledgement of the confidentiality policy: therapists will keep nearly everything confidential, but they are bound by law and ethics in some very specific circumstances. If you want an idea ahead of time, here’s the gist.
-if you have medical or other psychiatric information that they might want or need, there’s a potential for signing releases to allow them to have this information. I’ve signed releases so that my medical info was accessible to my therapist and releases to allow therapists to have my previous therapists’ files on me. I was glad I did both these things, but you aren’t required to do so.
-In larger establishments like a health services center or such, it’s common for there to be initial diagnostic questionnaires, like a depression measure.

This session will likely involve very little Classic Therapy ™. Your therapist will be trying to get a feel for your issues and circumstances and might asks things like “Can you tell me what brought you here?” and ask about your previous mental health history.  I’ve also been asked if I was suicidal or had a history of suicidality and whether or not I had a history of being sexually assaulted or raped. The latter might be as a result of where I was seeking therapy—a women’s center, but I’m not certain.

The therapist should tell you about their approach and training. The American Psychological Association has a list of questions your therapist should be able to answer in your first session here—I highly encourage you to seek this information (and take it as a great sign when said therapist provides it without me asking.)

Therapies can also look quite different from practitioner to practitioner–one might be very structured and use lots of forms and worksheets (not necessarily a downside–I like these!), while another might be more informal or conversational. You can ask things like “What does [X therapy] look like in practice?” to get a better sense of this.

—-

Some thoughts on the experience of getting therapy for the first time:

Intake–the first session or the pre-first session–is exhausting. It’s telling all of what makes you need therapy and answering a fair number of invasive questions. I strongly recommend that people plan something relaxing and low stress (if you’re introverted, something that does not involve human interaction) for afterwards. Even thought I usually know what intake should feel like and have done it multiple times, I have to spend ~3 hours decompressing afterwards.

Most of the rest of therapy is not like this, but in order to have the relevant information, the therapist needs to have lots of starting knowledge about you. This is well worth it, but if at all possible, do not put your first therapy session between other scheduled and important actions.

—-

Some things to notice:

Does the medium therapist communicates with you in align well with how you prefer communication? I had phone-phobia for a while–therapists who didn’t use email weren’t worth it, because I’d never be able to get around the ugh field to call them and reschedule.

Does the therapist let you direct the session or do they initiate most angles or discussion? There’s not a One True Way. I prefer therapist-initiated angles of conversation (though I will sometimes point out that I’d like to focus on something time-sensitive), some people prefer the opposite. Noticing what you prefer here can improve future therapy.

 

Next post: Miscellania
<< Previous post: Reaching Out


I am actively looking for things I’ve left out, so if upon reading any section, you have unanswered questions–even if you think they are trivial or might mean you’ve missed something, please let me know. I would much rather spend time responding with “no, that’s in paragraph two” than have a whole subset of people think they didn’t read properly and not tell me I was unclear. Further, many thanks to Rita Messer for checking over the advice within. 

The [......]’s Guide to Getting a Therapist: Reaching Out

<< Previous Post: Getting Started

Fun fact: searching around for creative commons licensed couches results in lots of couches on fire. Is this a Thing?

Note: For decreasing the amount of language confusion in this post, I’m using ‘therapist’ as a blanket term to mean ‘someone who practices therapy’. In fact, this is not precisely accurate, though it seems to be colloquial use. For sorting between psychiatrist, psychologist, and therapist, take a look at the Terms section in Part I.

Part II: In which emails are sent, scripts are given, and therapists are contacted.

I am not a therapist! However, lots of people ask me a lot of the time about getting therapy, and are often willing to keep me updated on what worked and what didn’t. This four-part guide, which is essentially the sum total of every bit of advice I could think of, and a few I didn’t come up with (thank you, proofreaders and feedback-givers!) aims to make the therapist-getting part less mysterious and more accessible. 

—-

So you have a therapist (or several) in mind:

An introductory email or phone call is your next step. I find emails take less activation energy for me, as I can use the same default text over and over, and send them at any time. (update: see this comment)

You want to convey these things in your initial contact:

Who you are. (Not the deep philosophical version of this–your name will suffice!)
What you’re looking for (presumably, an appointment, but possibly a referral)
A general sense of your schedule (particularly important if you only have a few set times you are free)
A general sense of what problems you have, if you’re comfortable disclosing
Your insurance type and any other payment concerns.

Optional other information:

Previous experiences (have you seen a therapist before? Do you have prior diagnoses? Are you currently on psychiatric medication?)
Did you get a recommendation from someone?
Specific parts of your identity that might be worth disclosing (language preference, if the therapist speaks several, sexuality, etc)

Therapists sometimes aren’t taking clients or might not have experience in your relevant issue. For instance, if you write that you have trouble with OCD, and the therapist knows they haven’t got relevant skills, they might not want to take you on as a client.

Further, since therapists have a set of people they see with some regularity, they might not have a free space to add you. I’ve found it helpful to think of the initial interaction as asking someone to dance. You say “Hi, would you like to tango?” and sometimes they say “Tango? Fantastic!” and sometimes they say “Mmm, you seem lovely, but I only know the waltz.” or even “I love to tango, but I only know how to lead, and you only know how to lead and this sounds like it would be a problem.”

Scripts for contact:

(As a general note, therapists are Mr/ Ms/Mrs., psychologists and psychiatrists are Dr.)

Sample email (feel free to duplicate)

Hi [therapist],

I’m [name] and I’m interested in an appointment. Are you taking clients? [Because clients often are seeing a therapist weekly or every two weeks, timeslots can fill up, and therapists occasionally aren’t able to accept new cases]

I am experiencing trouble with [issue, with as much or as little detail as you’re comfy starting with/previous diagnosis]. Do you take [insurance type]? OR Do you negotiate sliding scale payment rates?

I have [work/school] on [days] but could do [general sense of free time, such as “weekends” or “Monday-Thursday afternoons”] If you’re not accepting clients, do you have suggestions for other therapists who might serve my needs?

Please let me know,

[name] [additional contact info if you prefer a phone call, etc]

Here’s an adapted version of an email I’ve actually sent:

Hi [therapist]

I’m [Legal Name], and I heard about you from [Campus Service]. I’ve had previous problems with an eating disorder (anorexia, currently well-managed EDNOS), and I’m looking to do some additional work on my coping mechanisms. I’ve had lots of success with CBT, and you list this as a modality you use. I was seeing [therapist at location], but with the new school year, am in need of a new therapist.

I have school on Monday-Thursday from 8-3, but am free after that and Fridays and weekends if you take weekend appointments.  My insurance is [Name of Insurance], and you list this as one of the ones you take.  Do you have availability? If you’re not accepting clients, do you have suggestions for someone else who might serve my needs?

Please let me know!

Kate

Next post: Your First Session
<< Previous post: Getting Started


I am actively looking for things I’ve left out, so if upon reading any section, you have unanswered questions–even if you think they are trivial or might mean you’ve missed something, please let me know. I would much rather spend time responding with “no, that’s in paragraph two” than have a whole subset of people think they didn’t read properly and not tell me I was unclear. Further, many thanks to Rita Messer for checking over the advice within. 

Boring, Small Things, That Made My Mental Illness Less Bad

apps apps appsBuying cheap or free apps for my smartphone. 

It took some work, and plenty of the apps were used for a few days or a week and then discarded as unhelpful or useless, but at a grand total of 99c spent across six or seven apps to find two gems (Self-Help Anxiety Management and Recovery Record) that massively improved my quality of life? Well worth it.

Sometimes the apps were mental illness specific, for anxiety or meal-tracking. But I also use Annoyster to send me random alarm reminders, (“Therapy is helpful and worth going to,” reads my most recent one. “Eating mindfully is a new habit I’m developing.” and “Have you had a glass of water recently?” have been previous alarms.) Fitocracy* to gamify exercising without obsessing over calories burned, and PepperPlate to make menus for the week.

Fidget rings and other fidget objects

Having something to play with or occupy your hands in conversation can help with dermatillomania, trichtillomania, nail biting, and a host of other nervous/anxious habits. Fidget/spinner rings are especially nice for professional situations–where you can’t pull out buckyballs or rubberbands, etc. A friend and I bought gorgeous, matching ones, and I’ve toyed with mine during interviews, therapy, and particularly boring lectures. Almost immediately after purchasing, I ended up with long enough fingernails to paint–I wasn’t biting or tearing at my nail beds constantly.

Even if you’re not the anxious type, I recommend them as a way to get respite in a conversation or interaction. More socially acceptable than looking at your phone, they give me something to focus on when I need a few seconds of space or distance. Here are some on Etsy, and cheaper variants on Amazon.

Though I haven’t used it personally, some friends use what I know as massage putty, but I’m sure the expensive stuff could be replaced with some cheap, dollar store putty. Build hand strength, make weird shapes, copy newsprint.  Rubik’s cubes are favorites of my friends, though I’ve never picked up the appeal.

Books, books, books

Books can add up in cost more than a phone app, but honestly, if a single book is cheaper in time and money than therapy….it’s well worth it. Though I’ve had access to free therapy for years now, books have been where I developed coping strategies, learned to recognize failure-mode patterns of thinking, and have me the words to explain what was going wrong in my head. And these haven’t been highly technical books–I’d just wander into the psychology section of a bookstore and find the ones that seemed to be less about spirituality and bad tropes and more about science, particularly ones that talked about coping strategies, evidence-based therapy, or didn’t rail against medication on the back cover.

Finding people with other mental illnesses. 

I actually don’t seek out people with eating disorders–it can put a real strain on me if we’re not at similar levels of recovery. But spending time around people who are used to having bad brain days that make socializing hard has taken a lot of the pressure of social interactions. I wasn’t trying to hide my coping mechanisms, and I got praise and reward for little victories (I ate a snack! I decided not to go to the gym today and felt good about it!) that wouldn’t mean much to a neurotypical observer.

*For over a year, I’ve encouraged friends and, well, strangers on the internet to use Fitocracy for their non-shamey system. Recently, the emails from the site have been all about weight loss and fat burning. I’ve solved this by disabling all emails, but the trend from site-for-people-who-want-to-feel-good-about-exercise to site-for-people-with-also-some-guilt is annoying. 

Counterintuitive Underreactions and Overreactions

I love Pride and Prejudice but this is the image in my head for Bad At Serious Conversations.

The quality of not reacting in an upset way to new information has been on my mind recently. People seem to tell me things regularly—a driving force, if not the initial impetus behind my career choice–and something I’ve noticed as a skill is knowing when to react strongly to emotionally-loaded information…and when to treat an offhand remark like a plea for help.

That is, how do you decide when the reaction to–

“Yeah, sorry I’m late on this piece of the project–I had some friend trouble last week–but what if we scheduled a meeting on Tuesday and went over this section right now?”

–should sound like:

“Oh, that sounds [expression of sympathy], I’m so [sad/apologetic]! [Tell me more/how have you been handling it]?”

And when the appropriate response to–

“Yeah, I’ve had some struggles with depression and repeated hospitalizations meant I had to take an extra year of college.”

–is best phrased as:

“Oh, okay, [brief smile] [topic change, offer of ice cream, return to task at hand]“

My initial impulse was to say that a good heuristic is “the weirder/more emotional the information, the more noncommittal the response” But this breaks down very quickly. For one, I hang out in a social group that is almost definitely breaking my Weird and Emotional Information Disclosure alarms. Casual references to hallucinations and depressive episodes are par for the course, and dissecting how one feels about a surprise phone call is the norm.

Each time I try to break down exactly how I decide which of these to do in what situation–because sometimes ‘I had some friend trouble’ is an offhand aside, and ‘struggles with depression and repeated hospitalization’ does call for processing and discussion of current feelings–my brain comes back with ‘well, it was obvious in the situation!’ Thank you, brain, for that helpful contribution.

And then there’s another complication: what if in attending to this; in trying to figure out when to be noncommittal about Serious Things and take parenthetical remarks as openings for Deep Conversations, you do more harm? If you maintain even mediocre relationships, it seems high-risk to play around with how you respond to disclosures. If the learning curve means messing up a few times in large ways, you might be better served by not accidentally tanking your friendships.

And these interactions can and do make or break relationships and friendships. I can hear it now (in part, because I have heard it before):

“I confessed my deepest secret to her, and she just asked if I still wanted to go bowling!”

or, from my own life:

“Every time (this is only slightly hyperbolic) I offhandedly mention that my parents recently divorced, everyone thinks it’s The Worst Thing In The World, and I have to convince them I think it was a good idea. And then when I say I’m glad, everyone assumes I had a horrible home life. Now I just never mention it.”

At the same time, filing this as a skill that some people have and some people don’t, and one for which there is no ability to intentionally jump from one camp to the other just grates on me. Most of my social skills are learned, and I pick up new ones best from explicit instructions and scripts that I, over time and testing, adapt. They’re social skills, after all, not social I can just miraculously do it and you can’t so pbthhh.

So….how? Accept that straining some friendships is the price for being a slightly better friend overall? Try some other heuristic for how to react? What do you do?

[Sunday Assembly Chicago] Talk Notes, Citations, Oddments

[General version of what I'm saying at Sunday Assembly Chicago today. Yes, the footnotes start at 2. I edited and didn't want to go fix all superscripts at 6 am this morning.]

Good morning!

I’m Kate Donovan, and in about two sentences, I’m going to stop talking. I’m going to smile (see?) and stare pleasantly back at you, but I won’t speak for thirty seconds. I ask you to wait, without checking your phones, and urge you to notice how comfortable or uncomfortable you are.

[0:30]

You probably tolerated that because I’ve been asked to speak today. I was introduced, I’m standing up here in front of you, and my name’s in the program.

I spoke clearly, said what I was going to do, and I’ve been practicing doing this for the past two weeks, so I wouldn’t accidentally combust from the awkward slowly congealing in this room.

And it was palpable, wasn’t it? Some of you fidgeted, tried to guess how much longer. I spent about half that time counting down.
20 seconds.
10.
….okay, now I can talk.

The first iteration of this talk didn’t have that introduction. I was going to walk up here, smile at you, and stare for thirty seconds. In the end, I changed it. I was too afraid that you would think little of me, or that someone, assuming I had stage-fright, would try to rescue me.

Because that is the human impulse, isn’t it? To fill the spaces? In research into conversations, a conversational lapse was three seconds. I just made you sit ten times longer–an order of magnitude longer.

We’re susceptible to what Cialdini called the click, whirr2. Conversational silence? Fill it. We do it more quickly than we can recognize that it’s bothering us. For those of you in the audience who choose your words slowly, you might recognize what I’m talking about easily–you take a break to pick the next sentence and and someone else steps in for you. If you’ve ever had or have a stutter, people will try to give you words as you work on them.

Sitting with silence? Uncomfortable.

Think back to the beginning; hold on to that discomfort for a little while longer–we’re going to play with it.

What does it feel like? For me, it’s a pressing feeling of wrongness, the sort that feels like “do something, do something, do something” It’s not that things are uncomfortable, it’s that if I don’t do something right now, I’m failing.

And unfortunately, that do something impulse is actually what leads me to pick the Wrong Thing.

I’m going to borrow an example from Allie Brosh here. She writes in her fabulous book/blog about her experience of telling people about being depressed…and describes it like a conversation about dead fish with tenuous connection to reality.

Allie: My fish are dead.
Person: Oh, but have you looked over here?
Allie: But they’re dead.
Person: Let’s keep looking!
Allie: Looking is for lost fish. My fish are dead.

This is, well, a hyperbolic example. It’s emotional incongruence. Allie says something she feels is sad/negative/not good, and Person responds with something far too offbeat. Allie wants acknowledgement that her fish are dead–Person is uncomfortable with dead fish, so opts to start a search party of possibly-lost-but-definitely-not-dead fish.

Let’s pull a different example from the same story. Allie is suicidal. She’s decided she needs to tell someone about it. And so she does. And suddenly the person is SO UPSET AND ISN’T THIS AWFUL. And Allie finds herself comforting the person, who is so uncomfortable with her suicidalness that they have to show it and Allie just needs them to stop showing it, but argh.

And, not-unreasonably, we chuckle at the let’s-make-a-map-and-find-those-fish person. Of course the fish are dead, mapmaker, we say. Except, it’s quite likely that the mapmaker was sitting with similar discomfort to us five minutes ago. They’d heard something terrible (Allie had depression/her fish were dead!) and they wanted to fix it! Right then! Because they loved Allie and depression is bad and they didn’t want Allie to be in a bad place!

Similarly, the person Allie told about being suicidal felt bad. You don’t react flippantly to someone wanting to kill themselves, do you? That’s upsetting! So they got upset.

Okay, so, you’re always going to lose right? Someone tells you something sad like being depressed, and you’re too upbeat. Someone tells you something sad, you’re too sad in response. And how the heck were you supposed to know that the right response to a suicidal person was to be noncommittal and the same person’s depression needed a sad response?

There’s a solution! And it involves science! (I didn’t want to wander off onto this track in the talk, but while this sounds gimmicky, it replicates over3 and over4 and over5 and is taught as a microskill to therapists Aren’t footnotes fun?)

Instead of reacting in the way that removes your discomfort, take a deep breath. You might have to sit with it, at the price of seeming more empathetic

Mirroring. Are they taking long pauses between words? Try that in return. Pitch? High? Low? Do what you can to match it.

[A demonstration exists here--it stretches the abilities of my creative punctuation use to convey.]

What about their hands and legs? Posture? Do they have both hands on the table? In their lap? Legs crossed? Make like a mirror and match. In fact, the nonverbal part seems to convey empathy and caring even more strongly than verbal. Lean forward a little.

(A single exception–arms crossed over the chest–you likely don’t want to mimic the universal body language for “I’m deeply uncomfortable.” I usually go for loosely cupping my opposite forearms, which sounds extraordinarily weird. In practice, if you can’t picture that, I look like I’m cradling something.)

And look, it will probably feel a little stilted and weird to do, like acting a part. Remember the discomfort at the beginning? We’re still sitting with it in the pursuit of serving others. In fact, you might consider being even more explicit about it: “I’m not sure how you feel about this. Do you want me to offer advice? or commiserate with you? because this situation sounds like it would make me pretty upset”. There’s an important distinction there–I’m not performing or showing that upsetness at the person–putting them in a position where they’ll click, whirr into comforting me–I’m telling them what my current picture of their emotions is, and then letting them correct me.

[personal anecdote I'm going to leave off this blog]

Okay! But what if you have a slightly different problem. You’re getting overwhelmed by people and charities and everyone else who wants to tell you about their problems or have a serious discussion over dinner or just have the amount of money you would have spent on a cup of coffee.

And who says no to these things? (or, at the very least, a guiltless no?) One of my favorite writers, a Chicagoan who goes by the nym Captain Awkward writes about how “No” is a full sentence. And it is. It’s just a nearly impossible sentence to utter in isolation.

You’re supposed to want to help grieving friends, right? Give to charity? Support ill relatives? The thing is, I’m totally on board with social pressure pointing in this direction. I want people to do these things! Except that I want them to do these things in ‘enough but not too much so that they burn out’ increments, and also not feel resentful and guilty.

Burnout, that feeling of emotional exhaustion–not being able to find any well of empathy or caring or energy to dredge up investment in others–isn’t, as many people conceptualize it, from having lots of contained crises. While those will certainly exhaust you, they’re the terrifying spice of life, as it were. What overwhelms people, we’ve found, is the chronicity of stress. Of having people lean on your day in and out. And once emotional exhaustion has set in, it’s near impossible to give yourself the space to recover. It’s too easy to feel guilty from stepping back…and then there you are, without many emotions left but bone-deep tired and guilt.

But that discomfort! That do something do something do something!

I’m going to ask you to sit with it again.

You’ve got a friend who’s had a traumatic breakup and wants to talk. A relative who’s collecting money for a charity that supports an illness they’ve had.

Do something do something do something! Say yes! Write a check! Spend hours listening!

Deep breath.

Yes, by all means, do something! But do something effective that gives you emotional range to spare for yourself, for the next friend with a life crisis and that other charity you care more about, or next month’s rent.

Create an emotional buffer. Be nice to your future self, and arrange for some space. That charity Cousin James wants to tell you about? You’re really busy, but could he send you an email? You want to talk to work friend, but you’ve been having a really overwhelming week–what if they scheduled an hour to tell you all about it over coffee next week?

The goal here isn’t to give you space to ignore the email or never hear about the breakup–it’s to get space in a way that sounds like “I want to hear about you in ways that mean I can serve you best”

You can sit with that discomfort. You did it for me fifteen minutes ago, for far longer than it takes to ask for an email, mimic the posture of the person across from you, squash your impulsive emotional reaction, schedule coffee for another day.

We’re here at Sunday Assembly, nonreligious but waking up early and inconveniencing ourselves with the CTA here because we want to create an intentional community. Let’s make it one that keeps us coming back, that nourishes one another without burning out, that says, you’re hurt? Let me sit with you.

And on that note, I’ll ask you to pause with me for a hair longer.

Thank you.

[ack. I fiddled with the ending up to the last minute. Will update afterwards.]

General Notes: There were a LOT of things I couldn’t fit into 15-20 minutes, including:
-More thoroughly discussing ego depletion
-forced choices in response to distressed people you want to help
-I didn’t even consider trying to make a talk that covered all the above and this, but effective altruism. I’m also wildly underqualified to discuss, but it’s easy to find information. Google away!
-possibly some of the above stuff I’d planned to talk about, who knows–this was prepared ahead of my talk

Other Sources for This Sort of Thing:

Real Social Skills
Captain Awkward

Citations:

2. Cialdin, R. B. (1984). Influence: The psychology of persuasion. New York, New York: William Morrow and Company, Inc.

4. Feese, S., Arnrich, B.,  Troster, G., Meyer B., & Jonas, K. (2011) Detecting posture mirroring in social interactions with wearable sensors. In proceeding of: 15th IEEE International Symposium on Wearable Computers (ISWC 2011), 12-15 June 2011, San Francisco, CA, USA

5. Trout, D.L., & Rosenfeld, H. M. (1980) The effect of postural lean and body congruence on the judgement of psychotherapeutic rapport. Journal of Nonverbal Behavior, 4, 176-190.

6. Maurer, R. E. & Tindall, J. H. (1983). Effect of postural congruence on client’s perception of counselor empathy. Journal of Counseling Psychology, 30, 158-163.

Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. New York, New York: The Guilford Press.
(specifically the Interpersonal Effectiveness Handouts)

Antonides, G., Verhoef, P.C., & van Aalst, M. (2002). Consumer perception and evaluation of waiting time: A field experiment. Journal of Consumer Psychology, 12, 139-202.

Maslach, C. (2003). Burnout: The cost of caring. Englewood, New Jersey: Prentice-Hall.

 

[Repost] On Running Out of Feelings, and What to Do Next

[This is a repost from when I was co-blogging with Ashley. It seemed appropriate, as I'm feeling a wee numb myself, and with school starting and winter coming, this seems to be a shared feeling.]

Hello, internet.
This is where I come to spill my secrets, right?

Sometime between last week and this one, I went numb–ran out of feelings. I think it was somewhere after the third friend in forty-eight hours contacted me with questions about leaving abusive relationships, between finals and Steubenville and painful anniversaries and suddenly having a living situation that went from Absolutely Planned to Horrifyingly Tenuous. Oh, and it’s my last day of therapy this week.*

And that’s the simple stuff.

Add in friends who need a Social Kate who smiles and has opinions and wit and does not resemble a posed block of wood. Sprinkle in academics, and taking a quarter off to work at a small agency that expects a lot from me.  Roll it all in the stress of attending a competitive university where everyone Accomplishes Things that can be itemized on a resume–things that don’t contain scary words like atheist…and feeling anything outside Ron Weasley’s teaspoon involved too much work.

So I just started feeling numb.

It’s awful. I hate it and I go round and round between being irritated at not feeling anything, and getting angry about it…and then giving up because even anger feels muted and exhausting. It’s not terribly unusual–when you run out of emotional energy, that’s how it goes. It sucks, and I know I’m not the only one who gets this. So here’s how I minimize suckage. (The technical term, ya know.)

Lists

An idea stolen from someone–either the indomitable Captain Awkward or Keely. Each day gets two lists. List One: everything I have to accomplish that day in order to prevent the week from crashing and burning, and nothing more. Anything else you accomplish goes on List Two.

List Two starts out empty, and you have no obligation to fill it. It can be empty at the end of the day, and you will still have survived and accomplished important things and can sleep easily. If there is anything on List Two, you get to feel proud of it. You have gone above and beyond. Congratulations! Well done, you.

Excuses ahead of time are your friend.

Because the socially appropriate answer to a concerned “How are you feeling?” is almost never “My brain is being awful and I can’t feel anything and also everything fell apart last week.”, stock phrases are your friend. Among my favorites:

I haven’t been sleeping quite right, thanks for asking!
Because this is true even if it means you’ve been sleeping constantly and your brain feels like fuzz.

Oh, you know, long week. [Tired smile.]
Where a “long week” is defined as any set of days where life was hard and not worth explaining.

I’m a little out of it right now. It’s probably [related thing that may or may not explain your actual problems.]
Poor finals. I’m constantly blaming them–this is my most used phrase. I actually rarely find exams overwhelming, but they’re a fabulous explanation for why I’ve developed the habits of your average hermit crab.

Sorry, I have a touch of a stomachache.
People with stomachaches tend to get all silent and huddle in the corner of any given gathering, trying to force their gastric juices to cooperate. I don’t particularly advocate lying, but if this gets you out of an nosy stranger’s headlights, I approve.

This terrible clip art is not the Feelings Police

This terrible clip art is not the Feelings Police

Numb is okay.
There are no Feelings Police. They will not come find you and lecture you into submission for not possessing the correct emotional range. Feeling numb is weird and uncomfortable and unpleasant, but it goes away and you can survive it. Give yourself permission to feel as bad as  you do, to nap as long as you need to, and to feel a little hollow.

Be greedy.

And along with that, be greedy. Will taking day off to paint your nails and consume only popcorn make you feel better? Do it. Will skipping that party to play videogames in your room feel better than pretending to feel social? You suddenly have new plans for the evening. Within the limits of your wallet and abilities, do whatever seems as though it could improve your day.

Hide in groups.
The thing about large groups of people is that you can get lost in them. Everyone else will jump about and make noise and try to figure out how to split the check when Susan ate half of the onion rings that Johnny ordered, David and Sarah split an entree, and Jacob only brought large bills.  And you can just sit there. Let everyone else have wild, sweeping feelings. There’s less pressure to say interesting things when everyone else is being exciting. You can tune out, drop in for the occasional murmur of agreement, and still be holding up your little corner of being social.

Update: Puzzles
Stephanie explains.

—-

So there it is. Ideally, these will work this time around, and I’ll kick the fuzzy-brain feels sometime before the end of my spring break.  What do you do?

* NU requires that I take the coming quarter off from classes to work Monday-Thursday, from 9-5. Therapy is only available Monday-Thursday, from 9-5. I’m sure there’s a witty name for the choice between skipping my lunch hour to get therapy and not having therapy for an eating disorder, but right now I can’t manage to find it.

Some Thoughts for The Therapist I’ll Be (Part 1)

I’m looking at grad school [gasps, slams laptop closed], and thinking about careers and plans and futures. (Adulting! It’s scary shit.) Which means lots of reflecting on what I’ve learned and heard about the good and awful things therapists can do. So, some notes, some things I want the future Therapist Kate to remember:

1. I will talk process.

Get an email from a potential client? Those are scary to send. Like, preventatively terrifying. And years from now, I will remember how hard it was to press ‘send’ this year. And then I will respond, right away. Even if it’s that I can’t help, that I’m not taking new clients, I will respond. Because it’s even scarier to have pressed send and never hear back.

2. I will continue to update and talk process in every step of the way.

Going to need a week to figure out my schedule? I’ll make sure to check in and update.

3. I will ask everyone pronouns and then use preferred ones in all notes and files.

Because really. This is just a habit worth developing.

4. I will have multiple avenues of contact.

Making my first therapy appointment involved no less than two websites for health services, three google searches, and one very very scary phone call. (Apologies to everyone who thought Moaning Myrtle briefly occupied the third floor bathroom that day. I didn’t have anywhere else to call from.) Then, to do intake? Another phone call. This time, a long one, conducted from my room. I had a roommate. Not to mention, this just about sums up my feelings about phones.

Email is easy! Email means clients can revise and edit and make sure they’re clearly stating what I need. They can write down lists and then give accurate pictures of their symptoms. I will have multiple ways to be contacted, because the barrier to entry shouldn’t be calling me. (Happy ending: my new counseling center takes–nay, encourages–scheduling via email.)

5. I will remember that I can’t help everyone. 

This is the stray cat principle. As nice as it would be to rescue every feline with big eyes and soft fur, you have a house, apartment, or commune of finite and inchangeable size. You know this. So which cats do you adopt? The ones who get along with your life. The ones who you think won’t tear all the drapes up every night and leave you stressed and angry and neglectful of other cats.

In the same way, I will remember that it’s both unethical and downright harmful to take on clients who have issues you’ve no experience in. It’s not acceptable to take on so many clients that I let them slip through the cracks. That I owe it to my clients to take care of myself, to make recommendations and decline and refer when I think I’m not the best practitioner.

Ideas? Put them in the comments!