mental health

The Great Sand Dune, Point Mugu

I may prescribe psychiatric medications, but the one treatment I advocate for the most is psychotherapy.

Psychotherapy = general term for talk therapy, counseling; meeting with a mental health clinician for support, insight, and development of coping skills for life challenges.

Patients often ask me whether or not I think they should see a therapist.  My general answer: “I think everyone can benefit from therapy.  I think therapy will help you for (insert reason I believe patient will benefit from psychotherapy here based on my formulation of his/her issues).”  However, despite my recommendation of therapy, the more important question is: “Are YOU ready for therapy?”

Here’s a few reasons why I believe this question is so important:

– Therapy can be challenging.  As humans, we develop defenses to help prevent us from feeling the full extent of deep, emotional pain.  Therapy may lower your defenses, which allows you to experience and process painful emotions in a safe environment.  The well-known phrase “no pain, no gain” applies to therapy as well.  With pain = growth and healing.

– Talking about yourself can be uncomfortable.  You might feel like you’re being judged, which is especially difficult.  And if you’re one who loves talking about yourself, perhaps talking about yourself (and not acknowledging others) may be the reason for your problems (a good therapist should be able to point this out).

– You can never predict what might come up in therapy, so being open to the process can lead to development of great insights.  There might be times when you want to stop therapy or may question if it’s even helping.  Being open to processing your resistance may lead to great insights as well (i.e. any material that comes up in therapy may have meaning and be subject to processing during session).

I write this post not only as a clinician, but also as one who has experienced all I mentioned above in my own therapy process.  Even as a psychiatry resident physician, I resisted starting therapy because I feared what I might learn about myself.  I grieved the loss of my grandfather, struggled to adapt to my move to Oregon for residency, and felt depressed because I wasn’t performing as well academically, and various other reasons.  In effort to avoid therapy, I first turned to exercise, shopping therapy (not the best on your credit card), and talked to friends, which helped temporarily but didn’t help me learn to better cope with my issues.  I eventually gave in, faced my fears, and as a result I’m much more self-aware, insightful, and comfortable with myself as a person.  I’m also a much better psychiatrist to my patients (nothing makes you more empathetic towards your patients than putting yourself in their shoes and sitting in the patient’s chair).

P.S.  Not all therapists are the same.  If you don’t have a connection with your therapist, don’t give up on finding the right one! (stay tuned for a future post on how to find the right therapist)