Definitions Of Depression

What is Clinical Depression?
    Clinical Depression (also known as major depression, major depressive disorder, and unipolar depression) is classified as a mood disorder by the DSM-IV-TR (a clinical reference manual for mental disorders).  This is an abbreviated definition of a Major Depressive Episode from the DSM-IV-TR: At least 5 of symptoms from the list below must have been met for at least a two week period and one of the symptoms must have been either 1) depressed mood or 2) loss of interest in pleasure.

1) Depressed mood the majority of the time.

2) Loss of interest in pleasure.

3) Significant weight loss or weight gain.

4) Significant increase or decrease in sleep.

5) Psychomotor agitation or retardation.

6) Fatigue.

7) Feelings of worthlessness or excessive guilt.

8) Diminished ability to think or concentrate.

9) Recurrent thoughts of death or suicide.

     The symptoms must cause significant impairment in social, occupational, or other important areas of functioning.  The presence of two or more Major Depressive Episodes would constitute Major Depressive Disorder, Recurrent (clinical depression).

• What is the difference between Clinical Depression and Situational Depression?

     Situational depression is more commonly known as sadness related to an unfortunate  event or situation that may occur in everyday life.  Situational depression is normally temporary or short term and has little to no interference with one's normal life and daily functioning.  However, situational depression can lead to a more severe case of clinical depression if it is not treated or dealt with in a healthy and timely manner.

     Clinical depression is characterized by overwhelming feelings of loss, hopelessness, helplessness and despair that is more long term (at least 2 weeks or more) and interferes with one's normal life and everyday functioning.  Pyschological treatment is strongly recommended for clinical depression.  Pyschiatric treatment in the form of psychotropic drugs may be needed in some cases.


For more information, please visit: www.thoughtperspectives.com

Help Me, I'm Depressed: Questions Answered Regarding Depression.

Depression Statistics: 

• 14.8 million (6.7%) adult Americans are affected by Major Depressive Disorderin a given year.  (Archives of General Psychiatry, 2005 Jun; 62(6) : 617-27)
• Women experience depression at twice the rate of men.  (Journal of the American Medical Association, 1996)
• Depression is the cause of over two-thirds of the 30,000 suicides reported every year in the U.S.  (White House Conference on Mental Health, 1999)
• Despite its high treatment success rate, nearly two out of three people suffering with depression do not actively seek nor receive proper treatment.  (Depression And Bipolar Support Alliance, 1996)  

      As you can see from the statistics presented above, the pervasiveness of depression is highly significant among our population and it only gets worse as time moves forward.  I would like to start this series out by looking at why people with depression do not seek treatment or why they wait until the level of severity becomes so intense that it becomes much more difficult to treat.  

Question: If depression has a high treatment success rate, then why do people forego treatment? 

• When people are depressed, the motivation to seek help can evaporate.

     The paradoxical nature of depression is perhaps one of its most debilitating characteristics.  A person who is truly depressed can experience an almost complete reversal in behavior and personality traits.  When depression hits, instincts for self-preservation disappear, the panacea of sleep diminishes and biological drives such as sex and hunger become irrelevant.  Any enjoyment in life is replaced with the drive to intensify emotional pain and suffering.  For example, the depressed person will intentionally avoid engaging in behaviors or activities that will improve their situation.  Exercising, eating healthy and seeking out counseling or therapy are just a few things that will be avoided even though they are known to be helpful.  Escape, avoidance and withdrawal consume the depressed person.

     The motivation to seek help is absent because those experiencing depression become enraptured by pessimism and negative thought patterns. This in turn engenders beliefs that they deserve to be miserable and that they are undeserving of a happy and fulfilling life.  In other words, they do not seek help because they do not believe they are worthy of being helped.       

• Stigma in seeking help is still present.

     Even though counseling and psychotherapy have become much more accepted and mainstream since their inception, the stigma to seek out mental health services still presides.  Most people do not have a problem seeking out medical services when they are physically ill or having a medical crisis.  The same cannot be said for people experiencing mental illness or emotional crises.  Perhaps it is because people see that medical problems are outside their locus of control whereas emotional problems are not.  When it comes to emotional difficulties, many people feel that they should be able to handle them on their own without any outside assistance.  On a similar note, some even feel that they have some how failed in their personal lives if they have to ask for emotional assistance.  Not too many people feel guilty or ashamed to ask for help when they are afflicted with medical conditions like diabetes or cancer.  The fact remains that those who can humble themselves to seek help for their emotional and psychological problems are more likely to make improvements in their lives. 

For more information on depression, please visit http://www.thoughtperspectives.com.

Should I Go To College Or Find A Stable Job?

     I believe many people struggle with the same dilemma after graduating from high school.  Many feel pressured to decide what they are going to do with the rest of their lives as if their entire lives will revolve around that decision.  That is not necessarily the case.  I have met several people that have changed their majors in college or that have changed jobs several times before they finally settled on something they were content with.  Sometimes experience is the best teacher.  We do not always know what we want until we figure out what it is we do not want.  I guess what I am really trying to say is that it is OK to make mistakes as long as you learn from them. 

Suggestion 1- Figure out what it is you want for yourself and not what others want for you.

     This can be one of the most difficult things to decide for some people.  It is imperative that you choose a path that is personally satisfying to you.  There is a clear difference in the people that are employed doing something they really enjoy compared to those who dislike their jobs.  The ones who are doing something they love actually look forward to their work and feel they are making a difference in the world.  Those same people are usually much more productive because they are more motivated to do what it is they love.  This in turn make their lives more satisfying.  Life is too short to be stuck doing something that makes you miserable. 

You can start the process of figuring out what you want by asking yourself these questions:

• "What am I good at?"  
  "What are my natural gifts and talents?"
• "What do I like to do in my free time?"
• "What are the things that I definitely do not want to do?"
• "What are the things that I feel I am not very good at?"
• "What type of work would make me feel good about myself?"
• "What type of work would make me feel as if I am giving back?"
  "What kind of work environment would suit my personality type?"

     More times than not, the people who are satisfied with their professions are those that have a genuine love for their work in combination with having some amount of natural ability to perform the job.

Suggestion 2- Set some goals.

     Once you figure out what type of career you would like to pursue, the next logical step is to figure out how to get there.  Setting some goals is one of the best ways to do that.  You now need to ask yourself, "What is required to become whatever it is that I have chosen?"  Does it require a college degree?  Does it require experience in the field?  Does it require training through a trade school?  Find out the requirements and then come up with a plan to achieve those requirements.

Suggestion 3- Do what it takes to achieve your goals. 

     Figuring out what you want to do and actually following through with it are two very different things.  Those that have the will to set goals and follow through in achieving them will always have a much better chance of getting what they want.

     While deciding what you want to do and setting goals may seem like difficult tasks, following through with your plan will probably be the most difficult.  Are you prepared to make the necessary sacrifices?  Depending on what you choose to do, certain sacrifices might include; working and going to school simultaneously, sleeping less hours, socializing less, financial hardship and feeling stressed out or overburdened.  Life is not easy and by default, neither is starting a career.  If you have the drive and integrity to work for what you want, then you can make it happen.  It will just take time, patience, hard work and sticking to a well thought out plan to make it come together.

     In closing I would just like to say that there are many people that become successful by going to college and utilizing their degree.  There are also people that do not reach any level of success by getting a college degree.  There are also people that are extremely successful and satisfied that work in the trades and service industries.  In the U.S., most people seem to be encouraged to attend college in order to find a good job.  That is not always the best plan for each person.  Every person is not suited for college.  Some people make great livings by doing things that are not taught in colleges. 

     Going to college just to "go to college" will probably not do much good if there is not a plan in place for utilizing the degree.  Asking yourself, "Will this degree help me to do what I want to do?" is a very useful and important question to ask.  If a college degree will not assist you in attaining your goals then a different path should most likely be taken.

     For more information on counI believe many people struggle with the same dilemma after graduating from high school.  Many feel pressured to decide what they are going to do with the rest of their lives as if their entire lives will revolve around that decision.  That is not necessarily the case.  I have met several people that have changed their majors in college or that have changed jobs several times before they finally settled on something they were content with.  Sometimes experience is the best teacher.  We do not always know what we want until we figure out what it is we do not want.  I guess what I am really trying to say is that it is OK to make mistakes as long as you learn from them. 

Suggestion 1- Figure out what it is you want for yourself and not what others want for you.

     This can be one of the most difficult things to decide for some people.  It is imperative that you choose a path that is personally satisfying to you.  There is a clear difference in the people that are employed doing something they really enjoy compared to those who dislike their jobs.  The ones who are doing something they love actually look forward to their work and feel they are making a difference in the world.  Those same people are usually much more productive because they are more motivated to do what it is they love.  This in turn make their lives more satisfying.  Life is too short to be stuck doing something that makes you miserable. 

You can start the process of figuring out what you want by asking yourself these questions:

• "What am I good at?"  
  "What are my natural gifts and talents?"
• "What do I like to do in my free time?"
• "What are the things that I definitely do not want to do?"
• "What are the things that I feel I am not very good at?"
• "What type of work would make me feel good about myself?"
• "What type of work would make me feel as if I am giving back?"
  "What kind of work environment would suit my personality type?"

     More times than not, the people who are satisfied with their professions are those that have a genuine love for their work in combination with having some amount of natural ability to perform the job.

Suggestion 2- Set some goals.

     Once you figure out what type of career you would like to pursue, the next logical step is to figure out how to get there.  Setting some goals is one of the best ways to do that.  You now need to ask yourself, "What is required to become whatever it is that I have chosen?"  Does it require a college degree?  Does it require experience in the field?  Does it require training through a trade school?  Find out the requirements and then come up with a plan to achieve those requirements.

Suggestion 3- Do what it takes to achieve your goals. 

     Figuring out what you want to do and actually following through with it are two very different things.  Those that have the will to set goals and follow through in achieving them will always have a much better chance of getting what they want.

     While deciding what you want to do and setting goals may seem like difficult tasks, following through with your plan will probably be the most difficult.  Are you prepared to make the necessary sacrifices?  Depending on what you choose to do, certain sacrifices might include; working and going to school simultaneously, sleeping less hours, socializing less, financial hardship and feeling stressed out or overburdened.  Life is not easy and by default, neither is starting a career.  If you have the drive and integrity to work for what you want, then you can make it happen.  It will just take time, patience, hard work and sticking to a well thought out plan to make it come together.

     In closing I would just like to say that there are many people that become successful by going to college and utilizing their degree.  There are also people that do not reach any level of success by getting a college degree.  There are also people that are extremely successful and satisfied that work in the trades and service industries.  In the U.S., most people seem to be encouraged to attend college in order to find a good job.  That is not always the best plan for each person.  Every person is not suited for college.  Some people make great livings by doing things that are not taught in colleges. 

     Going to college just to "go to college" will probably not do much good if there is not a plan in place for utilizing the degree.  Asking yourself, "Will this degree help me to do what I want to do?" is a very useful and important question to ask.  If a college degree will not assist you in attaining your goals then a different path should most likely be taken.

     For more information on counseling & psychotherapy or to schedule an appointment, please visit: http://www.thoughtperspectives.com.

Why Do Relationships Seem To Be More Satisfying Before Marriage?

     This is a a question that I could probably write an entire book on but, for the sake of this blog, I will limit my answer to a couple of key points.  Before I answer the question I do want to point out that not all marriages are less satisfying than their preceding relationships.  We all hear about failed marriages, unhappy marriages and the high divorce rates but, there are happy and fulfilling marriages out in the world.  There are people who learn to make marriages work and who get a great deal of satisfaction out of them.  It is a shame we don't hear more about those marriages.     

Point 1  Negative patterns have not yet been identified as problematic. 

     While negative patterns can develop at the start of a relationship, it usually takes a while for the patterns to be recognized as a problem.  The early stages of a relationship are sometimes characterized by each member of the couple being so enraptured by the other that they overlook the behaviors that might normally be considered irritating or problematic.  Even if troublesome behavior is noted, it is often cast aside as trivial.  This can be due to the mystifying nature of being in love.  Being in love can alter the vision of a person to only focus on the positive attributes of their mate.  When negative behaviors are not dealt with early in the relationship, they will most likely surface later on (such as in the marriage) as a problem.  What was once considered "cute" or "quirky" behavior in a partner could eventually be considered highly frustrating or irritating behavior.  It is important even in the beginning stages of a relationship to figure out what behavior patterns or personality traits in your partner might cause issues for you down the road.  Bringing those issues out into the open and working through them early on prevents turmoil down the road and starts improving the relationship right from the beginning.

Point 2  People sometimes stop trying to impress each other after marriage.

     Before marriage, partners in a relationship are usually trying to impress each other to the extent of getting the other person to like them enough to consider marrying them.  People go to great lengths to impress the person they are interested in marrying.  They try to act on their best behavior, look their best, and meet the other person's needs as best as they can as well as many other things.  All too often husbands and wives stop trying to impress each other after marriage.  Once they get married, they no longer put in the same amount of effort into the relationship, they no longer go the extra mile to satisfy their spouse's needs.  

     I compare this situation to the difference that sometimes occurs between college athletes and professional athletes.  Some people prefer to watch college athletes instead of professional athletes because they feel that the college players play with more integrity.  The college athletes are trying to look their best in order to make it into the professional leagues.  In short, they want to impress the professionals.  Just like some married couples who put on a great pre-marriage show and drop the ball during marriage, there are some athletes that are phenomenal college players and turn out to be lousy professional athletes.  The final goal set by some is just to become a professional athlete or just to become married.  The problem arrives when that final goal is attained and there are no further goals to achieve.  If there is no goal to have a lifelong marriage that is satisfying to both partners then, most likely there will not be one. 

     Marriage takes a lot of effort to maintain.  Some people think that they can stop working at the relationship once they get married.  The people that have successful marriages are the ones that start trying even harder once they get married! 

     For more information on counseling and psychotherapy or to schedule an appointment, please visit: http://www.thoughtperspectives.com.

How Important Is Premarital Counseling?

     Premarital counseling is perhaps the most important thing a couple can do to prepare for marriage.  For those that are serious about fulfilling the needs of their loved ones and making marriage last, premarital counseling needs to become a priority. 

     Over the years I have encountered many couples that have been reluctant to initiate premarital counseling for numerous reasons.  Some couples believe that they know each other so well that there is nothing a counselor can say to improve their relationship.  To those couples I will say that all couples can benefit from having an objective evaluation done by a well trained counselor.  Not all couples going into marriage need a complete relationship overhaul but, even those with minimal problems could benefit from some tweaking.  I feel that is better to be over-prepared than to be under-prepared when it comes to making life changing decisions like getting married.  Other couples shy away from premarital counseling because they are afraid that the counseling process might illuminate the faults in their relationship.  They would rather go into the marriage blindfolded and hope that their problems will magically work themselves out, in which case marital discord or divorce is imminent. 

     Lastly, there are couples that feel premarital counseling is just too expensive.  I have heard statements like, "We just don't have the money for premarital counseling with all of our other wedding expenses".  The average cost of a wedding in the U.S. is approximately $30,000.  The average cost of a wedding in Farmington Hills, MI is about $40,000 with an upward range of $50,000.  Those numbers do not even include the cost of the engagement ring and the honeymoon.  The typical couple also budgets for less than 50% of what they spend on a wedding.  People spend a superfluous amount of money on churches, halls, cakes, gowns, photographers as well as many other things for a wedding and they conclude that they cannot afford premarital counseling.  They have their budget completely upside down.  Couples need to start their budget with premarital counseling.  After all, is not the marital relationship the most important part of the marriage?

     Divorce statistics alone should be enough to get people to engage in premarital counseling.  According to the Michigan Department of Community Heatlh, the average percentage of marriages ending in divorce in 2005 was 58% in the State of Michigan.  The percentage of divorce in the tri-county area (Oakland, Macomb, Wayne) reached 60% in 2005.  Premarital counseling was invented to prevent divorce and protect the marital relationship.  Those who think that you do not have to emotionally prepare for marriage are fooling themselves.  Premarital counseling helps couples prepare for the inevitable tough times and disagreements in marital life.  

     The decision to spend the rest of your life with someone can be an overwhelming thought, which is exactly why couples should not enter into a marriage without being completely prepared.  Couples in today's society face higher demands than ever before and they seem to have less support.  Managing dual careers and raising children at the same time requires that couples have a strong relationship which includes; well established abilities of communication, competence of conflict resolution and the facility to set goals together.  Every advantage is needed for couples to survive in today's marriages.  

     Comprehensive research on the effectiveness of premarital counseling has shown that couples who go through premarital counseling gain a 30% increase in overall relationship quality and interpersonal skills (Carroll & Doherty, 2003).  The same study also showed that the positive effects of premarital counseling can happen immediately within the relationship.

     For more information on premarital counseling or other types of counseling please visit http://www.thoughtperspectives.com.

How I Assist People Trying To Overcome Bad Financial Habits

     Anyone who has experienced the stress and pressure associated with the current economic downturn knows the importance of managing their financial situation.  One of my areas of specialty is helping people to understand the psychology of money.  The psychology of money shows how our finances are influenced by our beliefs, our feelings and our expectations. 
     The first point that I try to get across to people is that money itself is not the source of most financial and emotional problems.  Money itself is an inanimate object with no morals or beliefs.  In other words, people do not have problems with money itself, they have problems managing it.  The way people manage their money can also be a strong indication of how they manage other significant areas of their life.  It is not uncommon for someone who is impulsive with money decisions to also be impulsive with relationship or career decisions.  The current research on finances and marital relationships show that 80-90% of marriages that end in divorce are due to financial difficulties. 
     Next, I assist people in figuring out what money represents in their mind.  Money can be symbolic of happiness, freedom, control, power, security and many other things.  More often than not, the beliefs that people have concerning money and what it represents in their minds stem from the money messages they received during their upbringing.  It is important for people to learn what money represents in their own mind because they might perceive money as being more powerful and influential than it actually is.  In working through those unrealistic perceptions and beliefs, people can learn to manage their finances and the emotions attached to the finances in a healthier way. 
     These are some of the questions I assist people in answering: 

• Can money actually buy happiness? 
• Why does a person who is already wealthy want more money? 
• What causes me to be impulsive with money? 
• How is my self-control affected by my emotions? 
• How can I make better decisions with money? 

     I assist people in overcoming problems with impulsive spending, saving money, getting rid of debt and many other money related problems.  There are a plethora of books, infomercials and advertisements that promise to help people get out of the financial messes they have created for themselves by giving them the proper tools and techniques.  The problem with most of those schemes is that they do not delve into the psychological realm of the financial issues.  Having the proper tools and techniques will not do a person any good if they are not willing to change their behavioral patterns associated with their finances. 

     For those of you that may be having difficulty controlling your finances or your emotions related to your finances, please consider calling me to schedule an appointment.  I would be happy to assist you in freeing yourself from the financial and emotional burdens from which you may be suffering.  For more information, please visit http://www.thoughtperspectives.com.       

Are Body Image Concerns Starting To Equalize Between Men & Women?

     It is no secret how much pressure women are under to look good or even perfect.    Women are being plagued with anorexia and bulimia in an attempt to look like celebrities or fashion models.  I have also seen more women becoming addicted to plastic surgery. 

     However, problems with body image in males and females seem to be on the rise throughout the world.  Men are being tormented by something that has been referred to as "reverse anorexia" or "manorexia".  Those terms refer to the pressure men are feeling to workout incessantly in order to look like Greek gods or male models.  While women are trying to slim down and lose weight, many men are trying to bulk-up and add muscle mass. 

     There is nothing wrong with trying to shape up and look more appealing unless time spent in the gym or plastic surgery starts to consume or interfere with everyday functioning. Addiction to exercise is much like other addictions in that the person has difficulty abstaining from it even when it becomes unhealthy.  Exercise duration is not the only thing plaguing men. Steroids and nutritional supplements are playing their fare share as well.  More men are starting to take steroids and other supplements that are doing more harm than good just so they can improve their physical appearance or stamina. 

     As far as men's body image concerns rivaling women's, I don't think there is really a way to quantify that information to come up with an accurate answer.  However, body image concerns in men and women are definitely beginning to equalize in this day and age, more so than years past. 

     Whether you are male or female, if you are struggling with body image problems, it is imperative to seek help before it gets out of hand.  Counseling for body image problems can help in overcoming eating disorders whether you are overeating, malnourished or fixated on unhealthy diets.  It can also assist people to overcome addictions to exercise and plastic surgery.  In short, it can teach people how to live physically and psychologically healthy lives.  

     For more information or the schedule an appointment, please visit: http://www.thoughtperspectives.com.

Can Counseling Help People With Normal Everyday Problems?

     While the stigma of mental health has improved over the past fifty years, it is still abundant throughout the general public.  I am referring to the many people that are hesitant to seek counseling or therapy in fear that they might be labeled with a diagnosis or that they might be seen as “crazy” or “psycho”.
     Counseling has become much more acceptable in this day and age.  As a matter of fact, the majority of the clients that I see are much like you.  They are people without any diagnosed mental health disorders that are dealing with problems presented to them in everyday life.  Life itself seems to be getting harder to manage these days and there is no shame in asking for a little help from a trained counselor.  Most people go through life without being taught how to communicate effectively, how to have a relationship with someone else or how to solve some of their own personal issues.Counselors are trained to help people deal with issues like those as well as issues like time management and anger management.
     More and more people are seeking the help of counselors because they offer a non-biased perspective on your situation and they are trained to help you learn how to solve your own problems.  Listed below are only some of the ways in which counseling can be beneficial (for more information on the benefits of counseling, visit: http://www.thoughtperspectives.com.

• It can give you a place to vent your emotional pain and frustrations.
• It can help you to stop making the same mistakes.
• It can help you get through difficult life transitions.
• It can help you get to the root of your personal issues.
• It can allow you to discuss your personal problems in a safe and confidential environment with someone who is trained to listen.

   

Why Is Counseling & Psychotherapy Effective?

Listed below are three reasons why counseling and psychotherapy can be effective in helping people to overcome their relationship issues, emotional difficulties and/or their mental health problems.  This is not a complete list.  For more information, please visit my website at: http://www.thoughtperspectives.com.   

The fact that a professional counselor is not a friend or a family member is actually beneficial to the counseling process.     The fact that a counselor is not a friend or family member actually makes it easier for the counselor to help you.  The advice of friends and family members can often be colored with biases, judgments, or preconceptions.  Not only do counselors work to be objective and non-judgmental with their clients, that is what they are trained to do.  The goal of a counselor is to assist the client in getting what they want out of life not to assist them in getting what someone else wants for them.   

Counseling can help one to help oneself.      The goal of counseling is not to have the client become dependent on the counselor for answers and advice but for the client to eventually learn to counsel oneself.  A good counselor will teach clients how to think through their decisions before making them, to communicate their needs more efficiently, and to identify and manage their emotions.

Counseling can give one a place to vent emotional pain and frustration.     Sometimes people just need to unload their thoughts and emotions to someone that really knows how to listen and understand.  Well-respected counselors are excellent listeners that can also pick up on the underlying thoughts and emotions that are not verbalized.  A professional set of ears can be invaluable for helping people to release stress and figure out what it is they are actually feeling.

How Does The Counseling Process Work?

People tend to fear that which they do not understand.  Many people that I have spoken to over the past few years informed me that they were hesitant to seek counseling or psychotherapy because they did not understand how it worked.  Many were also afraid of divulging an abundance of highly personal information to a counselor or psychotherapist that they had never met before.   
While I could write an entire book on this subject matter, I will abbreviate it to a few key points.  Listed below are some my own personal thoughts on how counseling works: 

• Discussing Personal Issues in a Safe & Confidential Environment.

Those seeking professional help can be assured that anything they choose to discuss in counseling is supposed to remain confidential.  Professional counselors are bound by an ethical code to maintain confidentiality.  The counseling office is oftentimes viewed as a safe house where people feel free to discuss personal issues without feeling uncomfortable or embarrassed.  If for some reason the counselor has to breach confidentiality, they are obligated to notify the client first.  Counselors are legally mandated to notify the proper authorities if: 1) a client threatens to harm oneself, 2) a client threatens to harm someone else, or 3) there is reason to believe a child or an individual unable to care for oneself is being abused.  

• Let go of pain & unrealistic expectations.

One of the first steps one has to take in order to initiate the healing process is to unload pent-up emotional pain and mental anguish.  The positive effect of unloading can be felt immediately and can feel like a heavy burden lifted off of your shoulders.  Doing so with a professional counselor can be beneficial because they are trained to listen and provide emotional support.  Unrealistic expectations often hinder this process.  For instance, one might think that no one else should have to listen to their complaints or bear their burden.  This falls under the unrealistic expectation of believing that one should be able to handle all of their problems without help from others or believing that no one else has the desire to help them.  Counseling can provide a safe place to assist you in identifying unrealistic expectations and  help you change them to more realistic ones.

• Get Through Difficult Life Transitions.

Difficult life transitions can consist of: getting married, getting divorced, starting a new job, losing a job, retirement, starting college, or experiencing the death of a loved one to name a few.  Transitional phases are difficult because they are sometimes unexpected and they take people out of their comfort zones and force them to adapt to a new situation.
There are positive and negative ways to adapt.  For example, someone who loses their job could adapt positively by doing everything in their power to find another job.  Another person could adapt negatively by feeling sorry for him or herself and cease all efforts to find another job.  Those who have adapted negatively to a situation are the ones who should seek counseling.  The counseling process can help them to get back on their feet and re-adapt to their situation in a more positive manner. 

• Get to the Roots of your Problems.

Many times the only way to solve a problem is to get to the root of it.  This involves figuring out when it started, how it started and why it still continues to be a problem.  Counseling can assist the client in solving the roots of their problems which will then eliminate the symtoms attached to them.  This requires time and patience on the part of the person seeking help.
The previous examples are only a glimpse of how counseling and psychotherapy work.  For more information on this subject please visit my website at: http://www.thoughtperspectives.com.

How To Choose A Counselor Or Therapist

Here are 5 tips to keep in mind when choosing a counselor or a therapist:

• Find a counselor who can understand you and your needs: It is important that you find a counselor who can listen well and understand what it is that you are trying to convey.  Is the counselor asking enough questions?  Is the counselor asking the right questions?  If you feel like you are being misunderstood, then you might consider trying to find another counselor.   
• Find a counselor that will challenge you: One of the reasons counseling can be so effective is because it can make you look at your life more realistically.  If you have low self-esteem, a good counselor will challenge you to improve your self-image and not just flatter you in an attempt to boost your self-esteem artificially.  An effective counselor will be more proactive by giving you tasks and assignments to help you improve your situation.  If you feel like you are not being challenged, then maybe it is time to find another counselor.   
• Find a counselor that you can trust and connect with: It is imperative to find a counselor with whom you feel connected and with whom you feel safe.  One of the goals in counseling should be to intentionally let yourself feel vulnerable to the counselor.  While that might seem frightening, it an important step that promotes growth from learning that you can put your trust in someone without becoming devastated by the aftermath.  Enabling yourself to feel vulnerable means that you must have some feelings of safety and trust in the counselor. 
• Find a counselor that will accept your true identity: The only way that you can feel safe disclosing personal information to a counselor is to know that the counselor is not passing judgment on you.  No matter how ridiculous or repulsive you may think your thoughts or feelings are, it is the job of the counselor to accept you for who you are and not to dispense judgments or preconceptions.
• Finding the appropriate counselor may take patience and persistence: If you are interested in making progress in your treatment, then rule number one is not to settle for a counselor that you feel will not be able to help you to your fullest extent.  Just like any other profession, there are good and bad counselors in the field.  Several research studies have shown that the theoretical approach or even the credentials of a counselor or therapist do not matter as much as the relationship that is developed between the counselor and the client.  This analogy may illustrate the point better; it is possible to walk several miles in a pair of shoes that do not fit or that are uncomfortable.  However, walking several miles in the right pair of shoes will most likely get you there faster and make the whole experience more enjoyable along the way. 

What Should I Expect During The First Session?

 I briefly discussed the evaluation process in a previous blog (Expectations of Therapy: first Contact) but,  I will give a brief recap. 

 The evaluation is approximately 3-5 sessions depending on the nature of the problems and how many people are present.  During the evaluation, I would be gathering info about the nature and history of the problem.  I would also be asking questions about family history and previous therapy experiences.  At the end of the evaluation, I then give my thoughts as to what I believe is going on and what direction I believe would be most helpful.  The evaluation also gives the client(s) a chance to get some idea of who I am and, if we decide to continue, whether they would be comfortable working with me.  

The evaluation that I conduct is no different than an evaluation a medical doctor would perform.  If someone consulted a doctor for pain in their lower back, the doctor would want to first run a series of tests in order to find out exactly what the problem was before treating it.  The evaluation gives me a chance to learn about the nature and causes of the underlying problems rather than using conjecture and running the risk of misdiagnosis.


Listed below are some of the topics that I usually try to cover during the evaluation:

• The nature and duration of the presenting problem(s):  It is helpful for me to get the client's perspective on what they believe the problems are and when they originated.
• Employment:  I like to find out the nature and length of employment as well as how the presenting problem(s) may be affecting performance at work.
• Previous therapy experiences:  This will give me a good idea of one's familiarity with the process of therapy and what has and has not worked for them in the past.
• Expectations of treatment:  Right from the beginning of therapy, I implore my clients to think about what they want their lives to look like at the completion of treatment.
• Medical/psychiatric problems:  Certain medical problems, medical drugs, psychiatric problems and especially psychiatric medications can affect the process and outcome of treatment.  It is beneficial for me to know these things at the beginning  of treatment process.
• Family history:  I will usually ask about the family history of mental illness, addiction, and abuse.  I also ask clients to give me a glimpse of what it was like growing up in their family household as well as what their relationships were like with their parents and siblings. 

The first session is when I really try to get a good understanding of why the person decided to seek treatment at the particular time.  I also like to hear about the problems they have been struggling with and how they have tried to deal with them in the past.  My goal in the first session is to start establishing a trusting relationship with the client so they feel comfortable coming back to talk about further issues.  I also evaluate how comfortable the client is in the first session so I can taylor my approach and line of questioning to their level of comfort.  Everyone responds in their own unique way to therapy and I take that into consideration.  

The important thing in the first session is for the client to feel comfortable working with me and to realize that the treatment process is a team effort in helping them to create positive change in their life.