Why Choose a Psychologist?

When you’re looking for help with a psychological difficulty, it can be overwhelming to sort through the many options available to you. There are psychologists, psychiatrists, social workers, and now hundreds of psychotherapists and life coaches. So how do you choose?

I would say that this choice is particularly hard because it’s not really clear what differentiates the different types of therapists. So I thought I would take a moment in this post to delineate the reasons to choose a psychologist.

  1. Training: So, in my opinion, one of the strongest reasons to choose a psychologist is that we are very highly trained in psychotherapy. Registered psychologists (with few exceptions) have PhD’s, which means we completed four years of undergraduate training in psychology, then two years in graduate school completing a Master’s degree, then another 5-7 years of graduate school completing a PhD, and finally another year of supervised practice before we are fully registered as psychologists. During this training, we are supervised closely, and we learn a wide-range of therapeutic techniques as well as the ability make our clients feel comfortable and understood. To my knowledge, no other group of practitioners goes through this level of supervised training before they are licensed practitioners. Trust me, it’s not always an easy process to be constantly under observation as one is honing his/her skills, but it leads to individuals that are highly and consistently competent at the end of the day.
  2. We’re Effective and Efficient: We are trained to quickly assess and diagnose an individual’s difficulties (in fact, psychologists and psychiatrists are the only groups providing psychotherapy who are able to offer diagnoses to their patients), which means we are equipped to help you both understand and treat your problem quickly. Our sessions may cost more on average than other psychotherapists, but anecdotally, I have had many clients finally come to see me after having seen unregulated psychotherapists for years without getting anywhere. They often say that it was nice talking to the person, but it felt more like talking to a friend and they just weren’t being given the skills to actually change things. In my practice, I find that my patients experience significant improvement within the first two or three sessions, even those who have spent years with other therapists not improving. So it likely that, although we may cost more each session, you will probably spend less overall because your problem will be treated efficiently and effectively. As well, our services are often covered by extended health insurance plans so some patients receive full courses of treatment without paying anything out of pocket.
  3. Research Ability: As we hold PhD’s, all clinical and neuropsychologists are academics in addition to being clinicians. We complete at least two massive independent research projects (a Master’s thesis and a PhD Dissertation). As well, we are involved in other research studies throughout and often beyond our training. What does this mean for you? It means your therapist will be not just interested in keeping up-to-date with the current research being published on psychological issues and improvements in treatment options, but s/he will also be able to critically assess this research and synthesize it so that s/he can transmit the important findings to you, either directly (by explaining new findings) or indirectly (by using new techniques to help you improve faster). She will also be consistently evaluating your progress in therapy (whether formally with self-report measures or informally through observation) and tweaking things so that you improve as quickly as possible.
  1. How We’re Regulated: Often to the frustration of some of us sometimes, our regulatory body (or the people who decide what we can and can’t do if we want to continue to call ourselves psychologists), is extremely strict. In order to be able to practice in a specific area (for example, with children, or families, etc.), we have to demonstrate an intense amount of course work and supervised experience working in that area. So unlike other professions who can decide on their own if they want to start seeing couples, for example, we need to demonstrate to our college that we have the training AND the supervision (which often requires a year of supervision in addition to all the supervision we received during our graduate school careers). What does this mean for you? It means that if you see a psychologist or you send your child or adolescent to see one, you are guaranteed to know that that person has the skills and experience to be able to work efficiently and effectively.

I could go on further, but I don’t want to make this list too long. I hope it has been helpful in terms of at least giving you an idea of who psychologists are and what we do. Please feel free to post or email any comments or questions.

Worry (Part 3)

Worry (Part 3)

We left off the last post talking about identifying worries as current vs. potential problems and focusing only on the problems that are currently in our control. If you’ve been able to do that, that’s wonderful and I expect that you’ve probably found your worry has decreased a lot. However, as simple as the advice might sound, it’s actually really difficult to put it into practice and I would venture a guess that you haven’t always been successful just targeting your worry thoughts. Indeed, what happens to most of us is that worry behaviours start to get in the way.

Now, as I stated in the previous post, I consider worry itself to be a behavior, and we need to learn to limit the amount we engage in it. We’ll learn how to do this using mindfulness meditation techniques in a future post.

However, before we go there, I think it’s helpful to target some of the worry behaviours that are more outwardly noticeable (because other people in your life can actually help you work on these).

So, if you remember from where we left off, our worry tree has grown large and we find ourselves trying to problem-solve every worry we think of. How do we go about trying to do this? Well, ultimately what we’re most scared about in the worry scenarios is probably not the actual event happening, but the uncertainty about whether it will happen. Indeed, people who tend to worry a lot also tend to be very uncomfortable with uncertainty in general. If I don’t like uncertainty, and it causes me anxiety, I will try to get rid of it by reducing uncertainty, right?

So I might start double-checking things to make sure that I’ve done them correctly, and maybe as I do that, I’ll start questioning whether I’ve really checked accurately, so I recheck…and recheck…and maybe people start getting frustrated with me because I’m taking a lot of time to leave my house (“Did I lock that door?” “Did I turn off the stove?”), or I’m asking them the same questions of them over and over (“You’re going to pick up the kids from school, right?” “You won’t forget?”).

Along those lines, maybe I start asking for reassurance wherever I can get it. So if I’m waiting for test results from my doctor, maybe I’m asking my family members over and over whether or not they think things will be okay, or what it means that the doctor has/has not called. And while they’re telling me everything is okay, maybe I’m spending all my time preparing for the worst by googling (one of the worst things anyone can do if they’re feeling anxious, by the way), because it’s not enough to hear from one, two, or a hundred people. I need to keep seeking the reassurance.

Speaking of preparing (and overpreparing), maybe I’m planning a dinner party and want things to go perfectly, so I try to plan things down to the minute and I create contingency plans for every possible emergency that could arise. Maybe things do go well, but I might not enjoy it the way I’d like because a) I’m already exhausted, and b) I have to be on edge in case something goes wrong at any second.

Already you can see that things get tough when there’s uncertainty, so maybe I don’t just engage in behaviours that reduce uncertainty when it’s here, but maybe I actually preemptively start to avoid situations that could cause uncertainty in the first place. So that means avoiding traveling, because there’s so much to plan. Avoiding applying for a new job, even if I’m not so happy in my present one because “better the devil you know than the devil you don’t.” Maybe I don’t even bother to get involved in romantic relationships because what if it doesn’t turn out in the end?

Along these lines, people who worry also tend to procrastinate a lot. This might seem counterintuitive, given they also tend to overprepare and overcheck things, but it’s actually completely in line with these: “I just don’t have the hours (or the energy) it’s going to take to get this project completed, so I’ll wait to start it.” Of course, the longer one waits to start, the more pressure is on the task, the more worry and uncertainty, and the more one wants to put it off.

Do any of these sound familiar to you? The first thing I’d like you to notice about them is that they make sense, if one’s effort is to reduce uncertainty/anxiety and feel slightly better. Each time a person checks their front door and sees that it’s locked, s/he feels a rush of relief.   When s/he gets reassurance from others s/he feels better. When s/he avoids a challenging or uncertain situation, s/he sighs a breath of relief. So the behaviours work in the short term, and that’s part of the reason we keep doing them.

However, we also keep doing them because the behaviours actually sustain themselves. Every time a person overchecks or overprepares, they actually reduce their confidence in themselves and their ability to handle uncertainty. Every time they check that front door again to make sure it’s locked, they are telling themselves that they can’t be trusted to take care of that task. Whenever they overprepare and things go well, they say to themselves it was only because they did so much preparing in the first place and they reduce their belief that they would have been able to pull it off even if they winged some of it. Every time they seek reassurance from someone else, they are doubting their own instincts. All of this leads to a belief that they couldn’t handle something that came out of left field (which would be something uncertain), and they are more and more driven to try to control things to avoid catastrophe, and more and more likely to envision worst-case scenarios in advance so that they can prepare for them (i.e., worry).

See where I’m going with this?  The worry leads to behaviours that try to reduce uncertainty and deal with the worry, but they just lead to lower confidence in your own instincts and abilities and more tendency to worry as a result. Not a great cycle.

So how do we break this? Well, as difficult as it can be, we need to stop the worry behaviours. They might seem like they’re helping in the moment, and granted, they will likely give momentary relief, but in the end, they will only perpetuate the problem.

What would this look like? Well, the first step is to notice and write down your worry behaviours. I would recommend taking a week and just paying attention to the things you do when you’re worrying. You don’t have to change them at this point. When you’ve got a good sense of them though, experiment a little with not engaging in them and see what happens. Likely you will experience more anxiety at first, as you’re not doing the thing that you believe will reduce the anxiety and, therefore, not only are you possibly fearing that the something terrible that you’ve been envisioning is now more likely to happen, but you also may be just scared of the feeling of anxiety and feel like it will never go away unless you act on it. Truly, in my opinion, most of our psychological distress comes from this: a desire and effort to not experience negative feelings. And this is where mindfulness techniques are extremely helpful. Through them, we can learn to be more tolerant of our negative feelings and not fight so hard to get rid of them. Somewhat ironically, the less we fight our feelings, the less we tend to have them. But that is for a future post…

For now, have a look at what you’re doing, and if/when you can try to stop yourself from doing it and see what happens. If you prepare a little less for the meeting at work, and things still go fine, what will that do to your confidence in yourself and your ability to attend a meeting successfully? Would you be as likely to overprepare for the next meeting? If you don’t engage in worry behaviours and you have a little more anxiety for an hour, but then it goes down on its own, what will that start to say about your feelings and how much they need to be controlled?

Give it a shot and let me know how you’re getting on!

 

(By the way, I was just about to read through this post again to check for typos, spelling mistakes, etc., but then I thought, maybe this is a good opportunity to just assume it’s probably good enough and leave it as it is. It’s uncertain, but I’m pretty sure it will work out in the long run).

Worry (Part 1)

Why Worry?

So one of the biggest things people struggle with is getting caught up in thoughts. We’ve all been there at one time or another, where we have a distressing or scary thought and we just seem to replay it and the possibilities that (could) stem from it over and over in our minds. “What if I can’t complete that project I’m working on. What if I get a bad review? What if I end up losing my job from it? What would happen to my family? My marriage? My kids and their futures?” etc. I call this a worry tree. It starts with the trunk of the tree, which is usually an actual problem that needs to be, and can be, solved (e.g., “I need to finalize the analyses on my project tomorrow.”). Unfortunately, if we have any worry tendencies, that worry will branch into unsolvable, “potential” problems (e.g., “What if I can’t complete the project and I lose my job?” “What if I’m an embarrassment?”) and each of these thought branches can spawn new worry branches (e.g,, “If I’m fired, I’ll never get another job.” “I won’t be able to afford to educate my children.” “My wife my leave me.”). And I think it’s important to notice that these worries usually run laterally, existing sometimes all at the same time in our minds, with our conscious awareness bouncing from one to the next.

So why is this happening? Well, there are a lot of levels to this answer, but the first piece is that we tend to see worry as pretty helpful. For example, we may think that it allows us to be prepared for the worst-case scenario happening. Or maybe we think it protects us from bad things happening. Or we may feel that not worrying about something would mean we don’t care about it or the people potentially involved in it.  Finally, worry also serves to try to decrease the anxiety that comes along with whatever bad thought started this cascade of thoughts in the first place. We’ll get back to this, but it’s important to realize that, although worry feels like an emotion at times, it’s actually a behavior meant to distract away from anxiety. Funny enough, people who tend to suffer the most worry are the ones who tend to have the most positive beliefs about why worry is helpful.

Before reading on to the next part of this series, ask yourself about your own beliefs about worry.  Why do you do it?  What kind of dangers could arise if you didn’t do it?  What would not worrying say about you as a person?

And over the next day or so, have a look at whether your brain is creating any worry trees. We’ll learn more about those in the next part.

Please feel free to share your answers or thoughts about the post in the comments.

The Beauty of Therapy, for Both the Client and the Therapist

In a recent yoga class, I was speaking to one of the other students who I had just met. She asked me what I did for a living and when I said I was a psychologist, she said that must be an interesting job, but it must be so hard as well, since I must be burdened by having to listen to people’s problems all day long.  I’ve been reflecting on this conversation ever since.  Yes, it’s absolutely true that this profession can be “heavy” in terms of the subject matter I work with.  But I’ve been doing this for ten years and I don’t think I’ve really ever thought of it as a hard job.  In fact, I would say that I’m more uplifted by my work with clients than brought down by it.  Why?  Because people don’t stay down for long!  And it is truly a pleasure to watch as people, who first arrived in my office in pretty tough situations, learn about how their thoughts, feelings, and behaviours have all been interacting to perpetuate their circumstances.  And then the beauty and courage they show as they change up these thoughts and behaviours and become more accepting of their emotions is all the more inspiring.  Truly, in a given day, I would say that no more than 30% of my clients are typically in really dark places.  And even when they are, I don’t feel discouraged or brought down because I know that I will be able to help them find the way out, and I hold that hope for the both of us.  So although I can completely understand why one would think this would be a really tough job, it’s really quite the opposite most of the time!

In thinking through this, I was inspired to finally start this blog (which I’ve been meaning to start for quite a while).  I thought that through it, I could share some of the insights and strategies for dealing with the wide variety of issues that walk through my office door in any given year.  In my opinion, mental illness is not an issue of kind, but rather of degree, so I hope that you can find something useful in the posts, even if you aren’t struggling with clinically significant difficulties.

Please feel free to share your thoughts, reactions, or suggestions for future posts.  You can post them as a comment or send them to me directly at drcarmenweiss@gmail.com.

And thank you for reading.