Demystifying Therapy: Preparing for Your First Session

Preparing for your first session with a new therapist can be a bit nerve wracking. Sharing your pain and vulnerabilities with a perfect stranger can feel foreign and even daunting. So if you notice yourself feeling nervous, don’t worry, it is totally normal. But don’t let those feelings get in the way of getting the most out of it.

Here are some tips on how to prepare for your first session with a new therapist.

You Have Nothing To Lose – Be Honest

While compassionate and caring, the therapist is not your “friend”. The relationship with your therapist is different than any other relationship you will ever have. You are guaranteed complete confidentiality and an environment free of any judgment or criticism. It is structured this way purposefully to allow for the total emotional transparency that might otherwise feel unsafe.

So while it is normal to feel inclined to censor information when we talk to someone new, this contradicts the whole purpose of the therapeutic relationship. Your therapist is not there to judge you, he or she is there to support you in your pain (and even help you diminish the shame you feel). You are not going to get the most out of the process if you are not being totally transparent. So even though it might feel a bit like swimming upstream, push yourself to be brutally honest with your therapist so you two can address the real issues head on. If you don’t, you may be wasting your own time and money.

Come With A Direction In Mind, But Be Open To A Detour

Think about what you most want to get out of the process before you arrive for your first session. Your therapist will work with you to determine what your goals in working together will be, but don’t rely on the professional to do all the work for you – this therapy is for you and about you. Remember that you are the expert on your own experience and that expertise is essential in ensuring that you are on the right track.

At the same time, be open to seeing new things and considering other directions. The beauty about therapy is that the objective lens of the therapist, paired psychological expertise, will allow him or her to see some things that are not visible to you and together you can work to co-construct a plan that best meets your needs.

Focus On How The Relationship Feels

The most important factor in the effectiveness of therapy is the client’s willingness to change. The second is the relationship with the therapist. So needless to say, ensuring you get the most out of the experience has a lot to do with the relationship you build with this person. Though you may feel uncomfortable at times during the first session (which is normal), overall you should feel a sense of safety and that this is someone you can imagine building a strong rapport with. Hopefully, the therapist will check in to make sure it feels like a good fit for you. If in the end you leave feeling judged or unsafe, it’s time to go back to the drawing board and find another clinician to work with.

So now hopefully you are feeling a little more ready to embark on that first appointment. Keep an open mind, take a deep breath, and take some risks. Good luck!

Are You Confusing Mixed Signals For Something Else?

Ever notice how the relationships that are the most confusing and unpredictable seem to be the ones that spark the most intense attraction? We tell ourselves where there’s smoke there’s fire. But sometimes, it’s just smoke, with no sustainable flame. That’s because we’ve mistaken our own anxiety about the relationship for passionate chemistry.

It can be easy to mistake the anxiety or mixed signals generated by an unhealthy relationship for passionate chemistry. For example, when you are crushing hard on someone your body responds in certain ways. You may get butterflies in your stomach, feel your heart beating faster, or you may become hot and sweaty when you’re around that person. These physical sensations can be the sign of something wonderful to come, but they are also the same symptoms our body experiences in the face of fear or anxiety (also known as fight or flight).

Making matters more complicated, if we’re dating someone who is unpredictable and inconsistent, we can start to confuse the chronic cycle of pre-occupation followed by relief with the euphoria of a magical love.

When unclear signals are sent we frantically try to sort out how the other person feels and how we can keep them close. When they finally send some reassurance our way, we’re relieved and something that might usually just be perceived as common courtesy is experienced with euphoria. The feelings of elation are so intense compared to the fear and doubt that the experience becomes confused with intense passion.

And it makes sense that the crumb someone throws you when you’ve been starving is far more exciting than a balanced meal you eat everyday. But who wants to spend their whole life waiting for crumbs? The answer is no one.

If you’re finding yourself in a situation like this know that you’re not alone. I once broke up with a very handsome, successful, and kind man because he was “boring.” But in reality, he wasn’t boring at all. The problem was me. I found the lack of drama and the fact that he was very clear and consistent about how he felt about me to be boring. I had mistakenly fused excitement and passion with unavailable and inconsistent partners who always kept me on my toes, wondering where I stood in the relationship.

The good news is that you can turn this pattern around, and this is precisely what I’ll be covering in my Mend Class “Decoding Mixed Signals” I’ll help you discern if you are confusing chemistry with mixed signals, discuss the common reasons why we do this, and discuss how we can change this pattern so that you can find the happy and fulfilling relationship you deserve. See you there!

How Therapy Can Help After A Breakup

As a therapist, and a survivor of several breakups myself, I know therapy can be particularly essential when a relationship ends. It can be difficult to be rational or objective when your heart is aching and you may feel hopeless, anxious, or depressed. A therapist’s office offers you a safe place to process the grief, loss, confusion, and disappointment you are experiencing so that you can feel grounded and like yourself again.

Despite the fact that many people see, saw, or will see a therapist at some point in their lives, seeking help from a mental health professional remains a surprisingly stigmatized topic. Let’s face it, people would rather talk about seeing their gynecologist, rabbi, or even their ex before admitting to seeing a shrink. Many of my clients walk through my door feeling heavy with shame and report that seeking my assistance makes them feel embarrassed, indulgent, or weak. It’s as if needing therapy is a sign of their failure as humans, a scarlet letter on their hearts. But really, we all struggle with breakups and you should not feel ashamed if you need some extra support during this difficult time of transition.

The following are my top 6 reasons why therapy is not just helpful, but essential after a breakup.

1. Don’t Carry the Baggage of Your Last Relationship into Your Next One

People often run from one failed relationship to another in a desperate attempt to forget the pain in the arms of a new love. But if we don’t seize the chance to really process the grief from a breakup, we are likely to bring it with us into the next relationship. We may project feelings and memories onto our new partner that have nothing to do with them. For example, your ex may have severely broken your trust and as result you are constantly suspicious or accuse your new partner of deceiving you even though they are not. This is likely to result in you walking away from someone wonderful, or pushing that person away. Therapy can help you clear the marks of your last love and give you a clean emotional canvas to work with.

2. Own What Is Yours and Let Go of the Rest

I see many patients who incorrectly blame themselves for the relationship not working out. They are so busy feeling bad about themselves that they fail to take responsibility for the way they actually did contribute to problems with their ex. It is important that you are able to examine what happened with someone who can help you see it objectively. It is essential that you stop blaming yourself for things that are not your fault, because sitting with blame and shame weighs us down and keeps us stuck. It is also important that you uncover the problematic behaviors or patterns that you did engage in that were not helpful. A lot of the problems that came up in your last relationship probably existed long before you ever met your ex. That is because we have internal dynamics in place for understanding ourselves and relating to others that have been in place since childhood. It is essential to untangle this web before you step into the next relationship so that you don’t repeat the same patterns again.

3. Your Friends and Family Aren’t As Helpful As You Think

You may have friends that rival Carrie Bradshaw’s crew of supportive gal pals, but even they got sick of hearing about Mr. Big and eventually sent Carrie off to see a therapist. Leaning on friends and family is a great tool to have in your arsenal, but it’s not quite enough. Your friends may have some good advice, but they are not trained experts in mental health, communication, or relationships. The advice and support of loved ones is biased by their relationship with you, and their own motivations and needs. Sometimes talking to friends can be like walking through a house of mirrors. The objective lens of the therapist allows us to see ourselves and our situations more accurately. Additionally, we can alienate people we love by relying on them too heavily to handle emotional matters that are outside the scope of their capacity. When we have a therapist to talk with about our emotional struggles we have the capacity to maintain a more balanced relationship with the other important people in our lives.

4. Re-Discover Your Identity As a Single Person and Learn to Love Yourself

A large part of coping with the loss of a relationship is learning how to be single again. This involves learning how to be alone and really getting to know and love an independent you. Skipping this step can lead to dating people who are not right for you as a way of filling an empty hole in your heart. We often lose parts of our identity in our relationships, and therapy can help you connect with your truest self and put the pieces back together. In order to really love someone else, we must learn to love ourselves. Therapy can help us uncover and remove the barriers that prevent us from tapping into this essential self-love.

5. Communication Is Hard. Really, Really Hard.

I would consider myself an expert in effective communication strategies and I still mess it up. Effective communication is hard. It is both an art and a science. Communication problems are often the number one culprit in a failed relationship. A large part of what I do as a therapist is help my clients shift their communication styles from problematic—passive, aggressive, passive-aggressive, or altogether non-existent—to effective. I teach people how to express themselves in a way that honors their voice and desires, but does not alienate or harm others. I often find that there is nothing wrong with what people are trying to say, it’s how they are saying it (or what they are afraid to say) that is getting them into trouble. Therapy can help you shift problematic communication patterns so when that next special someone walks into your life you are less likely to make the same mistakes again.

6. Cause You’ve Tried Other Strategies and You’re Still Struggling

You’ve read half the books in’s breakup section. You’ve attended “meetups” for “single and fabulous” locals. You gave up gluten and started practicing yoga. Yet despite all of this, you still feel like you are running in place with the same emotional demons from your relationship. If you feel like you have given everything else a shot and nothing has worked, it might be time to try something else. Albert Einstein is often quoted as saying that the definition of insanity is doing the same thing over and over again and expecting different results. If we want different results, we need to shift our cognitive approach. By providing specific tools and interventions for coping with loss, therapy helps people remove obstacles that have prevented them from truly healing in the past.

Now What? 

Hopefully, you’ve begun to see that therapy is an important piece of your healing process. The next step is finding a good therapist. Unfortunately not all therapists are created equal. On Monday I’ll share my insider tips on how to find a good therapist. Until you find that person who can help you on the next step of your journey, take good care of yourself, take lots of deep breaths, have faith in your potential to heal and move on, find gratitude for the good things in your life, and remember that no matter what YOU WILL GET THROUGH THIS!

If you’ve missed previous articles in this Demystifying Therapy series, be sure to get caught up below.

Part 1: How It Can Help

Part 2: Beginning Your Therapist Search

Part 3: How To Find The Right Fit

Three Ways to Shift Your Mood in Two Minutes

The mind-body connection has been well documented for decades. Medical research has consistently shown that our emotional experience (stress, anxiety, anger, sadness, etc) can have a negative impact on our health. The good news is that, when harnessed correctly, we can use our mind to help heal the ailments of the body. The reverse is also true. When we are in emotional distress, we can use the body to shift our feelings.

Take Back the Reigns – Harness the Power of The Mind-Body Connection

When we are stressed, scared, or sad, common feelings after a breakup, the brain sends cues to the body that danger is present and the body assumes it’s natural fight or flight response. This can result in muscle tension, increased heart rate, increased body temperature, indigestion, shortness of breath, etc. This fight or flight response is very helpful when there is actual physical danger present (i.e. help us run from a potential predator), but rest of the time it just sounds a fire alarm in the body even though there is no smoke. However, we can send a message back to the brain that things are actually safe by making subtle, yet powerful shifts in the body. Through adopting different postures, changing our facial expressions, or even placing a hand on our heart we can slow the body’s stress response and start to sooth the emotional pain we may be experiencing.

Smile – Especially When You Don’t Feel Like It

When Buddhist teacher Thich Nhat Hanh said “Sometimes your joy is the source of your smile, but sometimes your smile can be the source of your joy” he was really on to something. Turns out that there is evidence to validate his assertion. Research by Tara Kraft and Sara Pressman at the University of Kansas demonstrated that smiling can alter our stress response in difficult situations. Their study indicated that smiling, even if one is not feeling happy, can slow heart rate and decrease perceived levels of stress. Smiling sends a signal to the rest of our body that things are okay, it’s safe to let down our guard. So next time you are feeling overwhelmed, try smiling, even if you don’t feel like it. It might just make a difference. (Tip: If you really can’t get yourself to smile, practice holding a pen or a chopstick in between your teeth. It mimics the same expression as a smile and can produce the same effects.)

Posture – Sit up Straight and Take up Space

Shifting our posture can also shift how we feel. A study by Brion, Petty, & Wagner in 2009 reported that sitting up straight positively influenced peoples feelings of self-confidence, while slumping over had the opposite effect. Additionally, research by Amy Cuddy and Dana Carney at Harvard University has shown that holding “power postures” for 120 seconds can create a 20 percent increase in testosterone (helping to boost confidence) and a 25 percent decrease in cortisol (reducing stress). In order to reap these benefits try assuming an open and expansive posture. Take up space, put your hands on your hips and spread your feet (think wonder woman) or lean back in a chair and spread your arms. Hold the posture for at least 2 minutes. For more info on Cuddy’s research you can watch her Ted Talk “Body Language Shapes Who You Are.”

A Hand on Your Heart Is Not Just for the Pledge of Allegiance

Touch is also a very powerful healing tool. When we are sad we often turn to others for a hug or to be held. We can actually provide ourselves with some of the same benefits. During a particularly distressing moment try placing a hand on your heart, rubbing your own arms, or massaging your own head. May sound cheesy, but it actually can be very helpful in slowing the body’s stress response. Pairing this with the self-compassionate thoughts such as “This is really painful right now, but this too shall pass” can help sooth the discomfort of the present moment both physiologically and mentally.

So next time you are feeling overwhelmed by whatever is arising for you emotionally try standing up straight, smiling, or putting a hand on your heart. For a super boost, try all three.

How to Find the Right Therapist

So far in our series on “Demystifying Therapy” I’ve covered why therapy can be helpful during a breakup and how to start your therapist search. Now, let’s cover my top three tips for finding the right fit once you have a few therapists you’re considering.

Interview People Who Might Seem Like A Good Fit

Once you’ve narrowed down your list of potentials, give them a call. Get a feel for what they are like on the phone. Do you feel comfortable talking with them? Do they seem interested and empathetic? One of the things people often say to me is “I feel like you really get it.” This may be a lot to ask for in a 20 minute phone call but you should at least feel heard and not judged. In addition, I would suggest asking the following questions:

What is your style like?  This is important. Even if someone is a very skilled therapist, his or her style may not jive with yours. Try to get a feel for what it would be like to be in the room with the person. For example, as a therapist I am very active and engaged with my clients. It is much more of a two way conversation — a game of verbal Ping-Pong. While I don’t explicitly give advice, I offer feedback and suggestions. Some therapists have a style that is more focused on holding back, listening, and reflecting. One is not better or worse, you just need to know what feels good for you.

Do you have experience working with breakups? If we were working together on this issue what can I expect? You want to make sure that the therapist has familiarity and is comfortable working with the issue that brought you to therapy. Additionally, you want to get a sense of how the therapist might approach working with that concern. Here you might learn more about the therapist’s theoretic orientation (there are many – see some styles listed in parentheses below). Will they be using primarily talk therapy, free association, and dreams to look at the unconscious roots of your current and past symptoms (psychodynamic)? Will they be helping you to identify and challenge problematic thoughts that are preventing you from moving on or that contributed to problems in the relationship (Cognitive Behavioral Therapy)? Will they help you focus on creating acceptance around the breakup so you can dedicate your energy towards living a life more aligned with your values (Acceptance and Commitment Therapy)? There are many different ways to approach healing from a breakup, and while you may have no idea specifically what style you want, make sure that what the therapist is proposing something that feels aligned to your needs.

Are you licensed?  You want to make sure that you are working with a licensed professional. Some people who claim to do therapeutic work do not actually have degrees or valid licenses to practice such work. There is a big difference in training and education between a licensed therapist and a life coach or other kind of healer. All of them have valuable tools to offer, but if it’s therapy you seek, then make sure to find a real therapist. Some unlicensed therapists see clients in private practice as a part of their training in preparation for licensure, and if you choose this option, make sure you ask questions about who is supervising their work. Some professional designations you might see after a licensed therapist’s name are LCSW, MFT, LPCC, PhD, PsyD, and MD. (I would encourage you to seek out a licensed therapist who has been practicing for at least 7-10 years. From personal experience I can attest that the longer you practice the more you grow and the more tools you have to offer your clients.)

The Relationship Is More Important Than the Resume

Don’t be overly focused on finding someone with long list of accomplishments. Just because a therapist may have written several books on breakups, be a featured relationship blogger for The New York Times, or have a busy public speaking schedule, it doesn’t mean that they are the right fit for you. The number one determinant of the success of therapy is the client’s motivation to change, and the second is the relationship with the therapist. It is essential that you have a safe and strong connection to your therapist. So ignore the resume and focus more on what really matters here: how you feel in the room with the person.

A First Appointment Is Not a Commitment to Ongoing Treatment

Think of the first session as a trial run. See how you feel interacting with the therapist. If you don’t have a positive experience or feel safe with the person, then you should start the search over. It might feel a little uncomfortable or awkward to disclose intimate details to a stranger at first, but you should get the sense that you would eventually feel at ease with this person. You should feel that they are easy to talk to, understanding, and non-judgmental. It’s okay to set up several first appointments with different people who you connected with on the phone. Think about which experience you felt you got the most out of and make a decision from there.

If you’ve missed previous articles in this Demystifying Therapy series, be sure to get caught up below.

Part 1: How It Can Help

Part 2: Beginning Your Therapist Search

How To Find A Therapist

Therapy can be an essential part of the healing process when you are trying to mend a broken heart. However, in order to really get the most out of the experience it’s important to find the right therapist for you. Finding a good therapist is easier said than done.

After more than 15 years of seeing a variety of therapists myself, I’ve had my share of bad experiences. I once met with a therapist who greeted me at the door dripping sweat and dressed like Run DMC (sans gold chain), straight from the gym. And while I don’t think a therapist’s outfit is a reflection of competence, I do appreciate a person who cools down first and dresses in a professional manner. Then there was the therapist whose first question was “What’s wrong with you?” There is nothing more welcoming at the beginning of a session than judgment. Sheesh. And I still shiver when I remember the therapist who was consistently 10-20 minutes late to our early morning sessions, leaving me to freeze my butt off on the street waiting for him.

But don’t let me scare you off, I’ve also had amazing, life-altering, not-sure-what-I-would’ve-done-without-‘em therapists. So even if it sounds like you have to kiss a lot of frogs before you find your “theraprince,” the result is definitely worth it. Below you will find tips for starting your search. On Friday, I’ll dive into how to ensure they’re the right fit.

1. Factor Out Convenience and Cost Whenever Possible

Good therapy and convenient therapy are not the same. While it might be your instinct to ask yourself: “Who has an office near me? Who has appointments at times that are convenient for me? “How much do they cost?” this is not necessarily the best place to start. I’m not suggesting that you completely inconvenience and bankrupt yourself to get to therapy, but convenience and cost aren’t good enough reasons to choose someone. You wouldn’t pick a significant other or a job just out of convenience, would you? Then why would you pick the person you are going to trust with helping you heal the wounds of your relationship on convenience?

I encourage you to view therapy as an investment of time and money in the only asset you truly own: yourself. Most people don’t think twice about dropping dough on a gym membership, but are resistant to make the same financial commitment to their emotional health. Think of therapy as a gym membership for your mind. There are many more important selection criteria that can help guarantee a positive experience.

2. Ask People You Trust for Recommendations

Asking people you trust for recommendations is a great place to start. This could be a friend, family member, co-worker, or other health professional. If someone you trust can make a referral, this can act as a prescreening process. If your friend loves his or her therapist, but you don’t want to see the same person as your friend, ask him or her to ask the therapist for a list of trusted colleagues with a similar style. If you have a friend or family member who is a therapist, they would also be a good person to ask as well. Therapists tend to have good information about other reputable people.

3. Use the Web but Don’t Be Limited By It

The web is a great resource for locating and learning more about local therapists. Psychology Today has a very comprehensive listing of therapists and allows you to search based on several different factors. To be listed on Psychology Today, therapists must prove that they have an advanced degree and up-to-date professional license. You can read profiles or click through to websites to read more about who they are and what they offer. If you are immediately turned off by someone’s tone, listen to your gut and keep searching.

Just make sure you are looking in industry appropriate locations. For example, Yelp is great for restaurants but the same principle doesn’t apply to therapy. Finding a good therapist for you is a lot more nuanced than finding out which restaurant makes the best duck fat fried brussel sprouts. Most therapists do not have profiles or reviews on Yelp, and therapists who ask their clients to post reviews on Yelp are actually violating the ethics of the profession. Reputable therapists would never request that clients break their own confidentiality to grow their business (not to say that all people with reviews have specifically asked their clients to write them). If you rely on Yelp, you are getting a very small cross section of the good people who might actually be out there.

Lastly, some therapists, especially those who have been practicing for a long time, do not have websites. This doesn’t mean they aren’t good or don’t stay current with research, it usually just means that they stay busy enough without needing a web presence. So if you receive referrals you can’t cyberstalk, just pick-up the phone and ask them all of the questions you have.

Now that you are armed with some strategies for finding a therapist, I wish you the best of luck in your search. In the next Demystifying Therapy post, I’ll cover how to interview therapists once you’ve found them, and then I’ll share options for how to seek help with limited funds. Happy Therapist Hunting until then!

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