What Happens in Therapy?

What happens in therapy?

Depending on the therapist answering, there will be a range of responses and theoretical orientations to consider. I practice family systems, and view things in terms of the family and how coping strategies pass on from generation to generation. It also depends on how long a person has with a therapist. Goals will vary because of time limitations. These time limitations impact how deeply a therapist can explore the inner workings of a client's past and individuality. 

Some of us only need brief check-ins, and some of us need to "shop around" to find the right-fit therapist. Each therapist can offer a different set of skills to help you heal and grow. These are all viable options in therapy. Seeking help is not only for the severely mentally ill.

Therapy can help lots of us. Having a non judging presence can help support those with questions about relationships, how to perform better at work, or those seeking some additional coping skills for occasional sadness or anxiety.  

If therapy is short term, services may be more solution-focused where homework is given right away, and behavioral tools are given to the client. Longer-term therapy may involve more uncomfortable situations where unresolved issues are addressed in session. Over time, there will be transference issues that can help improve the therapeutic relationship. Transference is when feelings for a person in the client's past are redirected to the therapist. This is a very powerful tool for healing and change in therapy. When both are able to acknowledge this process, or at least handle it with care, a client can develop skills to stop perpetuating the past. 

• Do we perpetuate the past?

This is a complex issue, and the TL;DR response is: Yes, we do. There are some things about being comfortable with what we know, even if it isn't good for us, and repeating past patterns even when the current situation does not call for these behaviors. Family systems and other types of therapy view things in terms of acknowledging past roles, traumas, and coping skills that were used in moments of chaos. These maladaptive behaviors stay with us at times, and impact our relationships with others, ourselves, and even our performance with work or school.

It may not appear like we repeat our pasts, but with some exploration, we may be able to uncover good and not so good behaviors, or ways of coping that were modeled to us growing up. Out of this with therapy, are goals to find strengths, and encouragement to forgive oneself to move forward.

It's not your fault for continuing to repeat past patterns, but with awareness, and support from a therapist, healing and gradual changes can occur. 

Coming to therapy is advocating for oneself. It is a big deal to wake up, get out of bed, and come to therapy. When your depression or anxiety stops you from doing so much, coming to therapy is a huge strength. 

• So, what do therapists really do?

This response will also vary depending on the person responding. In general, therapists can help clients repair the past by healing in the present. What does this mean? The relationship with the therapist is the most important indication of a successful healing process. So, if you like your therapist, it's a good thing. The therapist may likely represent an important figure in the client's life where this repetition of the past can be given a new meaning and alternate ending. 

An example could be someone who has a history of abuse and continues to seek relationships with those who mistreat them. Seeking a therapist can help bring awareness to this cycle, which includes education on abuse, and education on how relationships and the body are affected by abuse, introducing and practicing coping skills together, and listening to a client's story over and over. A therapist may also recommend or help find support groups to socialize if it is a goal for the client. Support groups can also a different path towards healing when people who have gone through similar things can offer their words and empathy. 

A caveat for this would be working with children. Sometimes interventions may be more behavioral without digging too deep into the meaning of things. There could also be more art or play-based interventions with clients. Parent coaching/consultations may also be part of the process. It depends on the therapist's approach, as well as what is needed at the moment for the client. 

• How does talking really help? (Why is it different from talking to a friend?)

Our culture does not promote the sharing of vulnerability or intense emotions. We are constantly told to get over it or we're being weak for feeling. Other times, people might judge us, or get uncomfortable when we need to talk about emotionally intense things, like death, panic attacks, or depression. It's not that they don't care, it's just that this culture does not prepare most, if not, all of us, for helping others without getting overwhelmed ourselves. When you have to tell your story over and over again, people may get annoyed. They may disappear because they don't know how to help, and may interpret your sharing as complaining instead of seeking change.

There is purpose with sharing your story.

If something is important, and if something continually comes up in conversation, it is important in some way. Whether it's affected you positively or negatively, or both, it is important to be heard. Therapists can offer a safe space for you to share what matters to you, with some nudges to heal, reflect, and adopt new coping skills. Therapists are not like friends because there is no history of pain or judgement in the relationship. It starts from zero, and a therapist and client can work together to help a client create a present and future that is not controlled by the past. 

• Conflict & Crying

It will not always happen, but many times there will be a vulnerable moment where a client will cry in session. It is an honor for the therapist to be present and trusted enough to witness these emotions. Sometimes it's a few tears, and sometimes it'll be the boogers all over your face, wailing, and can't talk in between sobbing kind of crying, and the therapist will still be present to empathize with your process. This is not easy. Going to therapy is hard work. It is not for the weak. It is for those who are ready to explore the uncomfortable, and for those open to trying something new when a history of doing the same thing wasn't working. 

There will also be times when your therapist makes mistakes. They might say something that upsets you, or ask you to try something when you're not ready. These are moments of conflict that can be safely addressed in therapy. Of course, it is up to the readiness of the client, but when the therapeutic relationship changes suddenly, a therapist may be required to check in to ask what happened. It is a delicate situation where learning how to speak up for oneself, as well as respectfully stating how one was hurt, can help develop new meaning in the present. This also depends on how strong the relationship is between the client and therapist is in the first place. If there is no rapport, it is common for clients to leave without explaining why. So, when possible, and when the relationship has a solid foundation, it's okay to bring up uncomfortable things the therapist did in session. These attempts to repair can help strengthen the relationship over time. These practices can overflow into outside relationships as well.

• Catharsis & Anger

Some of us have never or rarely have the time, space, or people to encourage us to feel how we feel. Therapy can offer a safe space where your bottled and unexplored emotions can be released. This can be a gradual process where those of us who were never given permission to be angry can finally get angry, or those who were taught to be strong and push the feelings inside can learn how to be comfortable with feeling a wider spectrum of emotions. These experiences can help increase our tolerance of emotional experiences over time, so we don't get overwhelmed or shut down. This can also help increase our compassion for others when being able to develop a larger emotional vocabulary in therapy.

• Challenging Clients to Do Stuff!

This also depends on the therapist's approach, and in general, there are reflections and observations made that can help a client increase awareness of their situation. When a therapist develops a strong relationship with a client, and has given small steps toward healing over the sessions, there may be a period of time where a client gets comfortable and stops growing. This is very normal. It's comfortable doing what we know, and if things change too quickly, it can be overwhelming. There may be contradictions in how a client sees themselves with how they really are. This may be in terms of self esteem or strengths. A therapist may challenge these views by mentioning all these things a client has done that displays strength. A therapist may also challenge a client's thoughts on being weak, or imperfect, by bringing up examples that contradict these ideas. This is a process, and it takes instillations of hope and optimism over time. 

• Giving Advice 

Most of the time, therapists will not give advice. They try to help clients visualize options, and may make recommendations, but it is rare that therapists tell clients what to do. In certain cases, like child abuse, therapists may directly give advice on what they deem appropriate for the safety of children. This is a case by case basis, and the intent of not giving advice, and merely shedding light on options is to empower clients to take ownership of their lives. It's a lot easier to have people tell you how to live because the consequences are not your own. 

It may appear that therapists tell clients what to do, but wording is important. A therapist may say something like: 

• How often do you think you can write in your journal this week?
• Do you think you can check in once or twice this week with your deep breathing?
• Out of the strategies we used today, which do you think you can try again sometime this week?

Giving homework is not the same as advice. Based on the session and client goals and readiness, the therapist may assign things for the week to help expand coping skills outside of the session.

• Awkward Silences

Our culture is fast-paced, and encourages the ignoring of intense, negative emotions. When we cry, or need to talk about something serious, lots of us don't know what to do. It's not taught or valued to listen in silence. Lots of us want to fix things and move on. Sitting with negative feelings takes time and practice, and it can help increase our abilities to cope through moments of pain without reacting. Having a therapist present while a client feels intense emotion can be a very healing moment. Instead of being told to stop feeling, a therapist can help show that this emotional part of them is as important and valued as other parts. Therapists can be present when others have not. 

• Playing Games & Laughing

Clients who work with me may play games or laugh in session. Does it happen each time? No, of course not. Sometimes there are serious things that need addressing, care, and attention. Other times, interventions can be weaved into our interactions while playing a card game or talking about art or music. There may be this vision of laying down on a black sofa and having a therapist interpret your dreams when it comes to thinking of therapy. Lots of people practice this way, and it works for them and their clients. For the playfully inclined, and the whimsical artists, with sensitive hearts, I can offer something different. If I can't offer what you're looking for, I can try finding someone who is a better fit. 

For children, we can talk about our favorite video games, books, cartoons, and draw comics. We can also share about our toys while your parents learn more about you and your world. We can learn how to talk to each other in a way that explores your goals, and some past situations that might make it difficult for you to make some changes. You can show me your art work, favorite YouTube videos, and we can figure out how to develop some new skills for you to be more successful as a student, friend, child, or sibling. 

Tending Your Garden to Heal & Grow

black rose aeonium  all the leaves/petals were eaten by a squirrel;

There's this squirrel that keeps eating my succulents in the patio. I didn't think it was a big deal until half my plants' leaves were gone because of a hungry critter. I was very upset. These plants were important because of all the memories they hold, and the people I think of when I garden. 

When I found these Black Rose Aeonium barren, I was disheartened. It took months to have them root, and settle with the wind. It didn't make sense for me to be so upset at a squirrel, so I took time to reflect. This is what Black Rose Aeonium is "supposed" to look like. 

This succulent's first leaves wilted off because it didn't adjust to the cold quickly enough. it is now sprouting..

Gardening is a wonderful activity to heal, and reconnect with the earth. It is also the best metaphor I can think of for how we humans develop, heal, and grow.

 

Plants are amazingly resilient. They can thrive in the harshest conditions: freezing temperatures, arctic winds, scorching heat, and predatory creatures attempting to steal their lives. There are plants that thrive in cracks in the concrete to yield gorgeous flowers. There are majestic trees whose roots break asphalt, or wrap around hundreds of years' worth of historic architecture. Somehow, they find a way.

It isn't always easy, no. Yet somehow, they find a way.

this little guy had almost all its leaves eaten off. he's a fighter, and is sprouting leaves everywhere

Some plants get lucky. They are sown in beautiful greenhouses with regulated temperatures, have perfect nutrition in the soil, enough sun, and enough water to thrive and blossom quickly. They are also intentionally and safely pruned by experts. Other plants? Not as lucky. They have to fight to live. These plants are the ones being chopped at the side of the road, eaten by squirrels, attacked by infections, and barely have enough water to maintain. These plants toughen up over time, and can learn to use the resources they have. It does take time, and the odds are stacked highly against their survival. 

Many of us are as resilient as these plants; even more so. Do you know why? (Let me tell you why)

We are even more resilient because: we can choose to find a new environment. We can choose to ask for help. We can choose to be vulnerable, get hurt by others, and try again. We can pack our things, and move to an environment that can support our healing and growth. We don't have to stay in an environment that hurts us. We can also adapt very quickly to what we're given.

The succulent in the middle got bitten by squirrels, and has a home in a tin can. it's not the most elegant home, and yet, it is growing more leaves than its fancier peers

Does this mean changing everything we've ever known from our pasts to heal and grow? No, not always. It means that as humans, we can adopt new tools, and little by little, we can heal while the scars remind us where we came from. These succulents, after having their leaves eaten or torn off, will never look like their "perfect" counterparts. But, they don't have to look pristine to have beauty. Their struggle and unique growth are meaningful, and they remind me to honor that in myself and others. We each have a story and environment that shapes us, and sometimes neglects to nurture us. Our individual growth and presence in the world varies, just like the lives of each plant. Sometimes they grow to encompass large areas of land, and blossom endless flowers to decorate the landscape. Sometimes a beautiful flower blossoms only once, which makes it genuinely rare when it does happen. Each flower and each person can offer unique beauty to this world, and that beauty carries meaning however it occurs. 

Tend to your garden; there is an innate beauty only you can offer this world.

black rose aeonium, ready to grow and thrive in their own imperfections

Fine Motor Development for Young Children

Stringing beads can help with fine motor development, Organized Messes

Early education curriculum promotes the development of the whole child. Part of the whole child is fine motor skills (fingers and hands). This is important because strong fingers can be the foundation for strong writing, and confidence in learning.

I have worked with children in the education setting for over ten years. There can be limited confidence in writing because lack of practice in activities that encouraged the development of fine motor skills. Fine motor development can be an aspect of a child we easily overlook. Intentional development can help children learn to: tie their shoes, eat with utensils, write more confidently and clearly, draw, button and zip their clothes, and be more independent with self care.

Here are some ways to promote fine motor development:

• Allow toddlers to eat with their fingers: This is something that may have a cultural component. Many parents feed their children until they are four or five years old. Allowing young children to use their fingers with the "pincher grasp" can help strengthen the finger muscles. 
• Individual Self Care (taking clothes off/on, brushing teeth, combing hair, etc.): This is something that will take time and patience. Young children are learning how to care for themselves and help around the house. This can be messy, and it is a learning experience. Slowly giving children more autonomy to care for themselves, even if it's not perfect or takes more time build confidence for a task in the future. If we rush to put their clothes on (all the time), it's difficult to learn how to do it when we ask them to. 
• Drawing and coloring: It may seem like kiddos aren't learning, but making art is an essential part of developing fine motor skills. Children get to practice holding crayons and making lines on paper. It doesn't have to be perfect, and children can feel accomplished for making something.
• Play doh or goop: Sensory activities can help strengthen fingers with some feedback. The activity can calm a child, while improving fine motor skills.
• Zippers and Buttons: Young children love to help! Asking them to help with zippers and buttoning your clothes can help them feel useful and indirectly develop finger strength.
• Arts & Crafts: With your supervision, children can use their fingers to pick up beads, coins, and other small objects and string them along a thread, count them, or place them in jars.
• Tongs of eye droppers: Squeezing and holding onto objects can help improve hand resistance and patience in children. 
• Bubble wrap: When you receive mail, popping bubble wrap can be a fun and exciting way to develop fine motor skills. It will most likely lead to lots of giggles as well! 
• Turning pages & Tearing paper: Reading is essential! Asking little ones to turn the page can help improve confidence to read and fine motor skills. Tearing paper can be a great activity with junk mail, and papers that are going to be recycled. Kids can learn about helping the environment, while developing a necessary skill.
• Spray bottles and water guns: Summer is coming up, and water guns will very much help develop fine motor skills. Remind kids it's okay to take breaks if their fingers start to hurt. Sometimes little ones keep going and get blisters.
• BLOCKS: Larger blocks can help little ones start to develop fine motor skills by learning to take the blocks together and apart. Mega blocks are perfect for toddlers and preschoolers. When their fine motor skills are more developed, Legos are more appropriate.

Of course, supervision is important with these activities. Using these moments as bonding experiences can also help encourage the frequency of practicing. 

5 More Things Gamers in Your Life Want You to Know

PERSONAL VIDEO GAME LIBRARY, JIM PICARDO, INTP

1. We don't want to disappoint you

Relationships are important. As we age, we can become more particular with the people we choose to keep in our lives. When it comes to family and romantic partners, gaming can sometimes make it difficult to connect. We don't want to disappoint you when you see us gaming. It hurts us to see you disappointed. When you tell us to get off the computer, or to stop playing games, it can hurt, and sometimes angers us. Gaming is a really important part of our lives, and it's hard to figure out how to play and not disappoint you. 

2. We don't know how to explain

Some of us gamers have an easier time expressing ourselves than others. For those of us who can't, we might get stuck with feelings of hurt, sadness, or anger when we're being told gaming isn't important, or to stop playing. Our emotions might lead us to yell or shut down, so it's hard to explain why gaming is important with so much going on. Maybe we've tried explaining before, but our communication didn't work, so it's frustrating for us, too. 

3. Gaming gives us a community to belong to

There are stigmas with gaming. There are stigmas with liking certain things "too much." There is an entire generation born into video games and internet culture, so there are likely to be misunderstandings and arguments on how important gaming is. Not all of us are social butterflies, sports fanatics, or (insert expectation here). Gaming is our interest, our hobby, and it offers us a sense of belonging. It may not always seem like we are connecting with others, but gaming is something we can talk/chat about with peers online, or with people we meet in person. It is our language and community to build on our own terms. It helps make us feel like we are not alone. 

4. We're sorry for getting mad at you when you asked questions about gaming

Sometimes it's hard to share about gaming because we get caught up in other events of the past. Perhaps people made fun of us, yelled at us, or told us we were disappointing because we gamed so much. When someone asks about gaming, sometimes it's a bad time. Maybe it's a really hard level, or moment in the game, and there's a lot of pressure to focus. That's not the best time for us to share about gaming because we might be stressed out. We don't want to hurt you, and it makes us feel worse when it happens. 

5. Gaming is an investment of time and energy, so it can be a huge loss when it's taken away unexpectedly

Players can log hundreds or even thousands of hours gaming. It takes time and care to level up characters, build efficient and successful teams, and learn diverse skills or maneuvers for end-game scenarios. Gaming can be our tool to process the day, or to redirect negative energy. Lots of us consider gaming proof that we can do well. Our avatars can represent our diligence to commit to a cause and team. The game represents our ties to others on a team, and the relationships we've made battling together, and helping each other over time. When it's taken away, it is a lot to deal with. It's not just losing a game for many of us; it can be a loss of friendships, confidence, or coping tool. 

Click here if you missed the first 5 things gamers want you to know.

Perfectionism

We've heard this term before: "I'm a perfectionist." What does it look like, and what are potential consequences for having such tendencies? A child can experience perfectionism differently from an artist, or a professional who requires precision to detail. Context matters, and yet, there are some similarities that connect those who suffer from or excel due to perfectionism. Here are some possible views on being perfect:

The Perfect Child

There may be circumstances that guide children to become focused on being perfect. There might be chaos in the family, which sometimes makes children feel burdened with the responsibility to be perfect. No one tells children these things, but they pick up roles to somehow maintain a balance when things aren't always so calm. Sometimes parents ask their children to be perfect. Perfectionism affects their homework, attempts at new things, fears of making mistakes, and redoing things over and over again. 

This need to be perfect creates a world view that love is conditional; a child's self-worth is paired with being imperfect, which is impossible, so their perceptions of self may be poor. 

Children who are perfectionist may also learn to excel very early in life. They may be hypervigilant, and learn how to use this as a gift to read others well, get along with their peers, while excelling in academics. 

The Beautiful Person

"What a pretty princess!" "You're so beautiful!" These are wonderful praises, in small doses, and in ratio to praises on other intangible aspects of a human being. When certain people are praised only for their appearances, they may conclude that their only worth as a person is their appearance. (This is not a bad thing, but it can limit possible choices of being for an entire lifetime). Pretty people can be smart, smart people can be gorgeous. Focusing on physical appearance may create anxieties and perceptions on self worth. 

Seeking perfection with appearance may correlate with eating disorders, or a distorted perception of one's body. This can lead to a hyperfixation with appearance, beauty, and minute "flaws" in one's body. These messages of self worth and beauty can repeat over and over again in one's thoughts. 

Beautiful people may also learn to utilize their appearance for benefits. Many young people pay their ways through college by modeling. They may also adapt to social expectations without feeling judged; they've developed a thicker skin because of all the messages over a lifetime. Many beautiful people may also use their appearance to establish celebrity, which in turn is used to speak on the behalf of others. 

The Promising Intellectual

When gifted individuals are constantly being told they are more intelligent than their peers, and they are going to make huge contributions to society, it can be a huge burden. It may feel overwhelming to be given this responsibility, especially at a young age. There may be hundreds or thousands of ideas, but perfection can easily stop the process of trying or creation. Personal expectations to succeed are so high that it self sabotages an individual's abilities to perform. They are frozen with fear. This may be why there are stereotypes that geniuses are lazy. They would rather not try so they don't fail.

Many gifted and talented people may question their abilities, and feel like imposters who cannot live up to their unrealistic expectations. It can be a lonely life being trapped within one's perfection. 

Some intellectuals may be encouraged by their perfectionism to create something that will change this world. We have young inventors helping those across the planet with tinkerings and ideas made in the kitchen, or collaborations with other gifted thinkers. Their expectations to do well inspired them to do more with their gifts. 

The Tortured Artist

Artists are their own worst critics. They can hear praises and receive accolades for their work, and yet, feel inferior. They never feel good enough. A common saying among artists is, "An art work is never complete." It's a process. This can sometimes be seen as a means to avoid commitment or finality, because if there are "flaws" or "mistakes," artists can say that the work isn't finished. 

This compulsion to be perfect can create a fear of being criticised, where many artists won't show their work. These gifts are hidden away, because they are deemed inferior, and unworthy of public attention. 

Many artists use their vulnerabilities, and individual processes with perfection to create work that connects with other artists and their viewer. Part of their healing processes, or artistic development can involve creating work or performing with "flaws" or "imperfect" materials, and displaying the rawness of themselves that can be so humbling, calming, invigorating, healing, or inspiring. 

The SuperParent

There are schedules, and lists, and dates. For everything. The house is overflowing with laundry and dishes, and yet things are working. There is a flow. There's homework, and play dates, lessons, and tests to study for. Grocery shopping, managing bills, and handling the emotional conflicts within the home are their own epic battles. Within this, there are moments to breathe, and sometimes you can eat slowly and enjoy your meal. 

Having a home to manage and family to care for may lead to comparisons and shame. Parent shaming is a big deal, and even the best of us may feel like we're not doing enough for our family. This can make parents neglect their own needs to put their families first. It can lead to a burnout. 

Being a Super Parent can also drive a person to be the parent they didn't have growing up. A person can reflect on what was missing, and offer nurturing, discipline (instead of punishment), acceptance, and care to their children in the present.     

The Professional

It's a lot of pressure being a professional, and being responsible for the welfare of others. It's taken a long time to get here: lots of education, training, and hours of sleepless nights trying to get material ready for the next day. Some *cough* of us become burdened with feeling responsible for the outcomes of the entire team, or rushing to save others who aren't as prepared. We can start comparing ourselves with the accomplishments of others, and feel inferior when things aren't completed as well as planned. 

Professionals may feel judged or criticize themselves for not doing as well as their colleagues. It can lead to starting lots of projects, and rarely completing them. The stress created by perfectionist goals can limit quality of life where the focus is on success and recognition at work. Relationships may be ignored, or suffer because of similar, and unattainable high expectations.

Perfection at work can also guide a person to hustle where they won't need to work as hard in the future. There are consequences and timeframes that are considered when making decisions as important as how much time and energy to commit to work, 

Yes, there are other roles that can be affected by perfectionism. The underlying traits are high expectations, anxiety or stress, and poor self-worth that is based on external things instead of internal things. Some with perfectionist tendencies may have a harder time connecting with others because of fear of judgement, or not ever feeling "good enough." 

So, what do you do with perfection? 

Slowly, this process of self acceptance heals what perfection damages. Again, perfection isn't entirely bad for those who can channel it well. For the rest of us, it can be difficult. And this process sometimes removes a barrier that others sometimes perceive as confidence and control. Sometimes perfection taps into the insecurities of others, so it keeps them away from us. It can make it isolating and appear like competition is the only thing we have to offer others. Acceptance of oneself can heal.

Acceptance that you are worthy just as you are will allow perfection to release its power over you. 

Being vulnerable with safe people can help start this process. Allowing imperfections to take place in minor parts of your life can help.

• If your writing isn't perfect, send the letter anyways.
• If your eyeliner is slightly off, and only you will notice, leave it alone. 
• The fruit you cut, or that sandwich isn't even on both sides. See if you can let it be.
• The house isn't dusted entirely, and you only had time to clean part of the bathroom. Take a deep breath. 
• There are some books or cups left on the table. Your house looks like someone lives in it. 
• Dinner was off schedule by five minutes. You are still worthy, and you're feeding people to keep them alive. You are a hero.
• What about things like being compared to others, not getting the position, or disappointing yourself and others? Talking to a good-fit therapist can help. There are some things that take so much energy to do alone. It can be lonely struggling alone, too. If and when you're ready, finding a therapist can help with increasing self acceptance, and reducing some perfection in your life.