What happens in therapy?

[azarrah]

Hi all,

I've been absent for the last few months as the anxiety I was experiencing for the first half of this year finally died down. Yay!

Unfortunately, in the last few weeks, it's reared its ugly head back up again. This time, it wasn't so severe as I knew my physical symptoms are a manifestation of anxiety, and that I wasn't to drop dead from some hideous disease (OK, there's still a part of me that thinks that, but at least it's not overwhelming anymore.) Nevertheless, I'm tired of just dealing with it, and I want to be more proactive in getting anxiety under control. I don't want to feel dizzy and spacey and foggy anymore, don't want to be shaky and out of breath, don't want to find myself hyperventilating and almost passing out when I get too excited or sad. I feel like I keep myself within this tightly regulated box, so that I don't feel super bad, but it's really not a great way to live and I think I need a better strategy.

When I was first diagnosed, my doctor offered to refer me to a psychologist, but I refused at the time. Now I wonder whether it would be helpful. I know absolutely nothing about psychologists, except that you're supposed to talk to them about your feelings, which does not particularly appeal to me (but I'll do it, if I have to). It would be nice to get some clarification on the whole situation, because this is really a foray into the unknown for me. How does therapy work? What do you do? How do the sessions run? What should one do for it to be most helpful? I would really appreciate some enlightenment!

Many thanks,

Az

[Mathy]

Hi Azzarah and welcome back. As you can see, I’m newer than you, but I have experienced a couple of different types of therapy with regard to the whole anxiety issue. I found CBT to be the best for me, in terms of producing results. I’m a logical, science based kind of person, so for me, I want to get results, and I found CBT easy to work with. However, you need a GOOD Psychologist, preferably with a sense of humour - well, that’s my opinion.

How does it work? Well, you explain what happened, and you might be asked what you were thinking about when you panicked, or whether you thought your panic/anxiety attack related to something in particular. Then, you would explore the ins and outs of that - there is no right or wrong, it’s YOUR panic/anxiety attack, and your input is going to be most valuable. Obviously, on a first visit, there will be some story telling about how you’ve arrived at the point you have.

What should one do for it to be most helpful? CBT usually involves challenging yourself in gradual steps. So you will experience a challenge in a session, and then go away and practice, it’s all baby steps. By challenge, I don’t mean jumping 6 foot high fences, but challenging with respect to whatever you’re working on. For some, that might be learning meditation. For others it might mean learning how to be assertive. It’s all relative to the root cause of the fear that causes the anxiety. Best results are achieved by doing the homework as best as possible, communicating if it’s difficult and why, etc., so that the sessions can be structured better - it’s all bite sized chunks.

CBT is great for helping people to overcome anxiety and poor self esteem, which can lead to improvement in depression. I’m not sure about it’s usefulness for PTSD and some other disorders, but definitely for anxiety it’s great for motivated participants, because it is generally the quickest way to achieve a result for anxiety/panic.

Hope this helps, I’m sure there will be some other useful opinions offered, cheers M 🙂

[geoff]

hi Az, a good question and answered very well by Mathy so I don't have much to add, however what I want to say is that any type of counselling will only work if you feel comfortable with, otherwise the hard questions won't be raised or even asked, let alone feeling as though you want to discuss these important issues.
You maybe afraid about raising a point so write it down on a piece of paper, then hand it over to them, and there's nothing to stop you from noting down that this particular point worries you, you maybe asked why or they may try and find out by what you say, but you have to remember that these even as painful as they are could be the reason why you feel depressed. Geoff.

[romantic_thi3f]

Hi azarrah,

Thanks for your post.

Gosh there's been some great answers already!

Therapy can vary from person to person and nobody experiences therapy the same way. Different therapists use different approaches and the relationship between person to therapist also makes things a bit different. I also like someone with a sense of humour!

How does therapy work?

The first session (or two) is usually about getting to know you. It's important for you to click with them so that you can feel comfortable enough to open up. They're also getting to know a bit about your situation; like if you're working, where you are living, relationships etc. Therapy is not like it is in the movies. People ease into it as quickly or as slowly as they feel like it.

What do you do?

Hugely depends on what's going on since there are so many different types of therapy. Mathy mentioned CBT which is hugely effective in thought processes like that anxiety about dropping dead from a hideous disease, or what might be going through your mind in a panic attack.

Another thing that can help with anxiety is called Exposure Therapy. This is where we look at what's really tricky for you or most anxiety provoking. Are there things that you avoid because of your anxiety? The idea is looking at them like a staircase, taking one tiny step at a time just enough to get out of your comfort zone but not too crazy so that you can start to do the things you were once afraid of.

How do the sessions run?

Depends on the therapist! Generally for about an hour but some are as short as half an hour but they can go up to 2 hours (pretty rare though). This also depends on how they work and how the care plan/finances fit in (it can be expensive).

What should one do for it to be most helpful?

Ask questions! You're doing this now which is great, so keep doing so. Feel free to ask the therapist questions do; they're there to support you in this not tell you what to do! I think the biggest thing though is knowing why you're going to therapy - it sounds like your priority here is to get this anxiety under control but in order to do that you might have to be willing to get out of your comfort zone a bit; talking about anxiety and doing things that might increase your anxiety can be so uncomfortable but it's also worth it in the end. Short term pain, long term gain.

Hope this helps!

[azarrah]

Thank you all for your helpful and informative responses. My uni offers free counselling for a certain number of sessions, so I'm not concerned about costs at the moment. I do need to confirm with them that they're happy to fit me in. I'm also sceptical about how good they are, but you never know unless you try, right?

I very much hope I can speak to someone with a sense of humour, as I have a rather (dry) one myself. I'm pretty self-deprecating, in a totally harmless way, and I wouldn't like the poor listener to get the wrong ideas.

I particularly liked what romantic_thi3f said about ) "short term pain, long term gain." That's a good perspective on it.

[Mathy]

Hey Azarrah,

Good to hear back from you 🙂

As it happens, I’m about to go back and see my psychologist from 14 years ago. She does have a great sense of humour, but more importantly, the ability to inspire confidence. I’ve been reflecting on this, and I would rate “inspires confidence” very highly in the qualities of a good psychologist. This woman has a voice that just inspires confidence, which I know sounds silly, but people like that do exist. So, if I had to go with a “gut feeling” choice, that’s what I’d go with.

Psychology is not a medical model. This person is going to be more like a mentor/coach, so you need to able to let them be your leader and trust that they will allow you to grow and support you if you fail - more of a “sporting analogy” than a medical cure type situation. “Short term pain, long term gain” is a classic sporting metaphor 🙂

It is possible, if you approach with the right mindset, to enjoy and have fun, if you have the right psychologist. Don’t feel bad about cutting one off after a session if you don’t think they’re a good fit. You should know very quickly if you’re going to have some sort of a bond.

GL, looking forward to seeing how things go for you, best, cheers M 🙂

[azarrah]

Thanks, Mathy. I know what you mean about a voice which inspires confidence. It's hard to articulate why a certain person comes across the way they do, but you know it nonetheless.

I'm planning on walking over tomorrow to speak to reception. I hope they're not booked out until the end of semester!

[Mathy]

Hi Azarrah, that’s it, seize the day, hope you can get an appointment quickly, best, M 🙂