Seven Strategies for Successful Teletherapy

There are upsides to doing therapy from your home.

Seven Strategies for Successful Teletherapy

A FEW TIPS TO MAXIMIZE YOUR SESSION

So, you are thinking about talking to a therapist. But you’re not sure.  When you think about revealing your personal feelings and emotions, it’s hard enough, because you already don’t know the person you will be talking to.  On top of that, you are meeting them through a screen. Awkward much?

I just want to tell you, I hear you.  Because when I started doing teletherapy, I felt weird about it, too.

Before the COVID-19 Pandemic, like most therapists, I was doing therapy exclusively in my physical office.  I did know people who did teletherapy, but it wasn’t the bulk of their work, and they seemed to be in the minority.  It wasn’t really a thing that most therapists I knew were doing.  And to be honest, it felt sort of strange to me.  Why talk to someone on a screen instead of in-person?

But COVID-19 changed all of that. Now, most therapists that I know do teletherapy. Since   concerns about health and safety became an issue, I have gone to doing therapy completely remotely. Like many, I had to quickly adapt, but sometimes, that’s how we learn. And I was pleasantly surprised that my clients and I adapted pretty quickly, so now, it’s become pretty normal to me.

The good news is that online therapy for individuals is showing to be just as effective as in-person therapy.  Even couples are benefitting.  Since I work exclusively with individual adults and occasionally, couples, I can’t speak to its efficacy with groups or kids.  But if you are 18 and over and thinking about therapy now, that’s a plus.

The downside is, of course, that we don’t get to see each other in person in the same physical space, and there is still something to be said about the in-person connection.  Privacy is more stable in-person. I can set up the therapy environment when you come see me

 But right now, I’m not one of them.  I foresee doing teletherapy for the rest of 2020, at least.  Even when I resume work from my physical office, I will likely keep teletherapy as an option, which will be he helpful to clients with long commutes, health issues, or physical challenges.

 

  1. A good Wifi or ethernet connection. The last thing you want is to be winking in and out of the screen while you are discussing your issues and emotions. So make sure that you have good bandwidth where you are.
  1. A laptop, tablet or smartphone. You will get the best view and largest screen on a laptop, but if you need to use these other devices, they will suffice.  The benefit of the latter two is they are more portable if you need to do therapy in a more unusual place.  More on that later…
  2.  A stable surface to place the device.  This will give your hand and body a rest, and give the therapist the ability to focus on you, without your head/body bouncing around.
  3.  Privacy. Now that many of us are doing therapy sessions from our homes, it’s a mixed bag. Some of you have plenty of space where you can be private and secure, with a door that closes and if needed, locks.  Others, not so much. It can feel awkward to discuss an issue about, say, your child, when said child is in the other room and may be able to hear you. Here are some options:

A closet.  If you really feel there is more privacy there, go for it. As long as we can see your face clearly (so you’ll need a good light), it doesn’t really matter if you are surrounded by your wardrobe or shoes. 

A white noise machine.  These can be purchased at office stores or online and can run the range of prices.  Nothing fancy is needed! Just a “fan” sound helps.  Place it outside the door of the room where you are having your session, turn it on, and you now have some sound-proofing and privacy from others hearing you, whether deliberately or accidentally. 

Your car, if you have one!  If it’s really impossible to have privacy in your home, go ahead, sit in your car.  If you really don’t have any of these options above, you can even go to a park, although that carries the risk that others nearby can hear you.

  1. Limit distractions.  If you have kids, try to make arrangements for someone to hang out with them during your therapy sessions so you can focus on YOU. Not only will your sessions feel more productive, but doing this sends kids a powerful message that you are worthy of self-care this way, too.  Turn off or mute your cellphone.
  1. Be dressed in some way. I don’t mean, super-groomed, like you are going to work or a party.  One of the benefits of being at home is that you can be casual, in pajamas or work-out clothes, so that’s fine with me. I just mean, have a shirt on and any intimate parts covered up.  
  1. Be on time. Ideally, your therapist will be on time, too.  If for some reason either of you are delayed, you can let each other know via text or phone.  That way, you get the benefit of your full hour, and neither of you has to wonder or worry that something happened to the other person.

Here are some optional things, now that we are getting into shorter days and less light:

A ringlight.  I got one on Amazon.  This is because if your only source of light is a lamp in front of your face, that’s harsh on your eyes.  The ring light is way easier on your eyes, and the one I got has three kinds of light, plus a dimmer switch, to modify the intensity.  BTW, this is a great option for any online meetings where others need to see you. 

A stand for your device.  Like I say, your therapist does need to be able to see your face fully at eye level during your session.  You can place your laptop or device on a stack of books, a tray, or even a portable stand, to do this. 

I’m not endorsing any particular brands, nor do I get any compensation for my recommendations here.  I just want to share with you things that work for me, because I want you to feel that therapy is a successful, positive experience for you, whether online or in-person.

So now that you know the basics of making teletherapy work, call me to schedule!    

*  There are some therapists who at this time are seeing people in physical office spaces for a number of reasons.  If you decide to do this, I recommend you ask about their hygiene/safety protocols.  It is then up to you to decide that you are willing to adhere to them, and whether you are comfortable with whatever health risks might by posed by seeing someone during this time.

It’s So Easy to Stay Mad: When You’re So Done With Everything.

When you’re so done with everything.

These days, it’s so easy to get mad, and stay that way.
I was just thinking this after an intense Labor Day weekend. Most of it was fun.    My family and I went hiking to forest preserves and biking around town. Hints of Fall are creeping in, with shadows getting longer and a slight chill in the air in the morning and at dusk.
The weather is getting more tolerable, now that it’s a wee bit cooler. The Pumpkin Spice Latte and those good caramel drinks are back at the coffee places.  
School is on again . In Northern Virginia, kids are mostly going online.  We’re six months into the pandemic and it’s getting old.
Opinions differ on what we should do, how much we should worry, when and how to go back to work and socializing.  Sometimes, we get unsolicited opinions and advice, and we feel invaded or judged.  And, well, tensions build. I was driving down my street on the way home yesterday and passed a neighbor’s house. The guy outside turned toward my car, looked at me, and gestured with his hands flat, pushing downward. I waved at him. A minute later, I realized what he was signaling. It looked like his gesture meant, “slow down”.
And I got VERY annoyed. After I pulled my car into the driveway, I had an urge to storm over there on foot and start lecturing him about who does he think he is, telling me to slow down, when he and his family and friends are always out there without masks, but of course it’s all about them, etc. Words to that effect.
I’m glad I didn’t actually do it. But I did envision it. In that moment I was aware of my anger, accepted it, sat with it for a minute…But thankfully, I didn’t act on it.
So maybe he was being annoying. And maybe I was driving a bit fast for our relatively quiet street. It didn’t hurt me to slow down.  But, still.
 Do you feel sometimes that your moods are swinging more?  Like even if you are overall doing well, having a good day, but then something happens, your mood takes a nose dive? If so, you’re not alone.  Whatever life concerns we already had have been exacerbated by working at home (that is, if our jobs and school even allow us to do that) and being with our families or roommates almost constantly. We are saving lives and health, but it’s hardly ideal for our kids to be learning remotely. And to top it off, it’s an Election Year. Not exactly things that contribute to calm and cool living.
It’s understandable that you feel on edge.
There’s a whole lot of stuff to be charged up about.
So what can you do?

The things you read about with unplugging from news and social media?  They really help. The internet can be a double-edged sword. Right now, we are relying more on these outlets for resources, work, and social connection. But they can also be hotbeds for angry discourse and hurtful statements.  The psychologist

Brene Brown

 once aptly referred to the “comments” section of something she posted,  “the cesspool.”

I find that if I spend too much time scrolling through social media and news, my mood starts to tank. So, its really important to limit screen time and keeping interactions this side of civil. I have a better day if some chunk of it is spent in 3-D.

Here’s a good adage that helps me when it comes to potentially tense interactions: 

Is it kind, necessary, or true?

 

It should ideally be at least 2 out of these 3 things if you engage with someone.  I don’t know who said it. I just find it helpful.  
In the moment, I could really have let off steam by snapping at my neighbor. I could maybe have said things that were true (at least from my point of view), but they wouldn’t have been kind or necessary. And there are times when these folks have done me good turns.  It’s been years since we’ve chatted, but that counts for something.
And even if they hadn’t….What would I have added?
I haven’t always responded mindfully. None of us are perfect, and we get mad and let it out sometimes. The issue is, is it getting to be your modus operandi? Does it help?
But pushing your feelings down only helps for so long. So, what do you do with them? They are still there. They came from somewhere, and they can still take up time and energy.

As I’ve discussed on my videos, it always helps to just step back and observe your thoughts and feelings. 

Tara Brach

describes a nifty process to work through difficult feelings with a technique called R.A.I.N. 

We need to first know what’s there, before we can work on it.  This can be true of just about anything that is causing you anger, hurt or pain.    And sometimes, we want to talk to someone. The main thing is, even now, you don’t have to go at it alone or bottle it up.    
But you also want to talk to someone who won’t judge you. You want to let it out, but be understood. You want change.
This is where therapy can help. Especially if you find yourself with thoughts and feelings that are so powerful that they are getting in the way of your functioning, and they make it that much harder to be in the present. I’m especially big on the kind of work that I am doing, LSR and TIR. We start with what is charged for YOU. It might be something recent, or something from long ago. If your attention is on it, it’s important.
I don’t challenge your viewpoint. I help you look at the stuff that is charged in a way that will bring you relief and resolution. I believe in this method, not only because I’ve been trained in it, but I’ve been on the receiving end of it, too, and I can tell you that it works. It has helped me.
Sometimes, we just get plain tired of pushing things down that are charged. It costs us. We need to work through these things, but in a way that helps. This work gives you an opportunity to bring it up and look at it in a contained, guided way, so you get relief without all the fallout and kickback that can happen of we just react in daily life.
And this can lead to a better, more self-aware existence.   Yes, even during a pandemic and an Election Year!  To me, that’s totally worth it.

What can you do?

Call me

I’ll give you a free, 10-minute consultation.  If we decide to go ahead and schedule, we”ll  work together to bring you relief and resolution for a better quality of life.

Want more? Subscribe to my FREE blog and get regular news, updates, and resources every month!

 

 

 

“Sometimes, we want to talk to someone. The main thing is, even now, you don’t have to go at it alone or bottle it up.”

 

What’s Being Exposed is What Will Help Us Grow: Racial Bias and Trauma.

The world feels like a hard place to be in right now.

I’ll go ahead and say it.  The world feels like a hard place to be in right now.    We’re all tired of this pandemic, of racial injustice, of anger, of people just not hearing each other or themselves. Tired of being tired.

“When life gives you lemons, make lemonade.”  That sounds great.  It is definitely something to strive for. But sometimes, we need to step back and acknowledge the lemons. So said Donna Oriowo, educator, therapist and author, at a recent webinar I listened to.

The lemons haven’t been the same for everyone. The death of George Floyd ignited international outrage.  It laid bare the kind of treatment that People of Color have told me they have often been aware of as a possibility, or a reality, but it has rarely entered the consciousness of most White people in this country.  It was one brutal incident that was filmed, among many others that weren’t.

Even if you haven’t been physically brutalized, maybe you have still experienced trauma, humiliation, or stereotyping on the basis of your skin color or ethnicity.  The events of this past month may have triggered past traumas that are the result of racism on systemic and interpersonal levels.  That is your story, your experience, and I don’t want to tell it or interpret it for you.  Nor do I want to assume that that is even the same story for everyone.

But I am here to listen your experience, whatever it may be.

What ARE your lemons?  That’s what we take time to look at in therapy.

The lemons are the bumps. The hurts, the stressors.  The roadblocks that get in the way of us being fully present in our lives. They could be experiences you’ve had with being sized up and treated a certain way, and as a result, you felt ashamed, powerless, or humiliated. 

It usually doesn’t help when someone asks you, “Are you sure that’s what happened?  Maybe it wasn’t (racism, sexism, harassment, ageism – insert your own perspective here).”  This likely well-meaning person is coming from the premise that it’s your own distorted perceptions that are keeping you stuck, and if you only changed this perspective, you would feel and do better.  

But when we are hurting, that’s usually not helpful.  It makes us feel more alone. Unheard. How do we trust someone if they can’t even hear us out? So we push that lemon down deep into ourselves, and keep on with our lives.  No judgment there – we do what we do to get through our days. But over time, with all those buried lemons, it’s kind of hard to make lemonade, isn’t it?

When I think back to the times when I was really hurting about something, and someone tried to be helpful, you know what meant the most to me?  When someone really listened.  Listened, without judgement, without trying to change my perception or my feelings.  That felt like compassion. 

And that meant the world to me.  It made me feel less alone. 

I think a lot of us need more of that, nowadays. People who can just acknowledge the lemons without trying so hard to make us “get over” them.

If you’ve been on the receiving end of racism, you have probably felt this for years, at different levels of intensity, but to survive, you may have had to suppress the parts of yourself that hurt or were angry because of this.  (And maybe you still do, at times.) Maybe those are your lemons.

If you have high-risk people in the home and are feeling anxious because you have committed to social distancing and/or isolation, while others around you have not, those might be your lemons right now.

So what do we do?

First of all, acknowledge the lemons.  The frustration, the pain. Accept that they are there, with compassion for yourself.

Some great authors to help you get started with that:  Tara BrachBrene Brown.   Resmaa Menakem.

Give yourself time for this.

Then, get help. I know I am not the only therapist out there.  There are options that are more affordable, and therapists whose way of working and being may be your preference right now.  But if you want to work on your stress and trauma in a structured but centered-on-you-in-the-moment way to get relief, that’s what I do.

I’m not here to decide what is “real” or not.  That’s not how trauma therapy or life stress reduction work. 

In fact, if you have done therapy before, you are probably used to a therapist giving you their opinion or interpretation of what’s happening in your life, and what to do about it.  That has its place, and if that’s the approach you prefer, go for it! 

It’s just not what I do, generally.  We will work to determine your lemons, YOU will decide with me, what they are and which ones you want to work on, and we will go from there.  It’s a process, and we will work on it together. 

It starts with acceptance of ourselves.  We don’t have to like every part of ourselves; just accept that these parts are there, lemons, lemonade, and all.   That’s where compassion starts.

Take care of yourself this month. You are worth it.

 

 

 

 

“When someone really listened… without judgement, without trying to change my perception or my feelings.  That felt like compassion.  “

 

Wouldn’t therapy be worth it?

 

 

 

If therapy could…

-help you feel less anxious, more calm

-add a supportive, non-judgmental person to your life

-help you get help with a trying life situation

-and, most importantly, give you tools for you to make some positive changes in your life

So that…

Instead of walking around feeling overwhelmed, alone, rudderless, you can feel calmer, supported, and focused on the here and now…

Wouldn’t it be worth it?

 


I’ve never heard anyone say they regretted doing therapy.

So you’ve been thinking about a particular issue, person, or big life change that may be on the horizon.  It’s weighing on you, occupying your mind, making you question yourself and your decisions.  You are thinking, you could use some help, maybe in the way of therapy, but you’re not sure therapy is the way to go.  Here are some reasons people say they are reluctant:

“I can’t afford therapy.”

Is that what you are thinking?  Most of us have spent money, time, and energy this Holiday season, or at many points throughout the year.  Understandably, you are trying to be watchful of your budget.

If the Holidays were fun and meaningful for you, I’m truly glad. Even if they were, maybe old issues, difficult relationships, or memories resurfaced with one or more people.  Maybe you used tips from my November blog post to get through the holidays, or other techniques to help you get through the tense times.

Maybe a big transition just happened or is on the horizon.  Job change, concerns about a friend, partner or relative?  You are worried about it, and it would really help to talk about it, but you aren’t sure these are concerns you want to lay out with someone in your personal life.

Maybe you did talk to friends, and it helped to get their support.  That’s something! But you may still be confused and this issue is hanging over you. You really don’t have huge amounts of time or energy. So for now, you are just hanging on, going with the flow and seeing what happens.  That can work  — for a while.

But sometimes it is MORE costly to put therapy on the back burner.  Namely, in quality of life and in the frustrating things that never seem to change, so that you lose sleep, or feel irritable, less energetic to deal with what needs dealing with.  This is especially true of trauma and severe stress. We actually spend more energy trying to “push down” our strong feelings. Or, they come out in a way that is not helpful, like temper outbursts, body/headaches, chronic distraction.

If therapy could help you feel less anxious, add a supportive, non-judgmental person to your life, get some ideas for help, and, most importantly, give you tools for you to make some positive changes in your life, so that instead of walking around feeling overwhelmed, alone, having no idea how to proceed, you can feel more calm, mindful, supported, and focused on what you need these days…Wouldn’t it be worth it?

“I’m super busy.  Who has time?”

It’s true.  You, like so many people, have work, parents, kids, school, and any number of responsibilities. 

You may want to try a person close to your home or work (or other place that you frequent often).  I typically see clients once weekly, but may see someone more frequently than that for trauma sessions.  It’s best to find someone close to your comings and goings. I’m in the City of Fairfax, Virginia, not far from George Mason University.

Pick a date and time with your therapist and make it part of a weekly routine. This will actually make it easier to stick with it.  Look at this as part of your “healthcare” routine and as something necessary you are doing for yourself.  And by the way, you send a very good strong message to your loved ones when they see that you are making this time for something important to you and that you stay with it.

For those of you who travel a lot or have health issues that make traveling difficult, teletherapy might be the way to go.  I don’t offer that at this time, but it is out there.  I’d rather you get the help you need and be honest with you about where to get it.

If your schedule needs to change, by the way, discuss this with your therapist. Most of us know that can happen. We try to work with you on this.

“I’ve done therapy.   I already know what my problems are. There are some things I just can’t change, and they are in the past, so I really don’t want to talk about them.”

I am not offering a “magic wand” that will make all your problems go away.  (And if anyone is doing that, they are not being straightforward with you, especially if there is a complex or ongoing life situation like a chronic illness in a loved one, chronic workplace upheaval, and such.  These things happen and I get that they don’t magically disappear.)   But I DO offer methods that will help you deal with these problems in a way that is calm and proactive, instead of dealing with them being terrified and reactive.  And those things that happened and are in the past?  The trauma therapy I do works on changing the memory, so that it does not affect you the same way.  It works.

Imagine having a game plan or a shift in your attitude in dealing with a person in your life who has often caused you stress or worry. Imagine how that would change things.  Instead of feeling like a powerless, out-of-control person, you will begin to feel more centered, deserving of good treatment and respect. (Respect is not fear, by the way.  Many people are in therapy because important people in their lives have confused these concepts.)  And when we believe we are worthy, things often begin to change.

So as you start out into the New Year, bearing the colder temperatures and looking ahead, think about the issues you would like help with.  If you read through this article all the way to this point, odds are, you are seriously considering therapy.  You know what it’s like not to do it. Maybe it’s time to try something different.

When you feel ready, call.

“Why can’t I get over this?” – When Trauma therapy Can Help

Happy September! 

Labor Day was yesterday, and summer is, for all intents and purposes, over.

You can feel the transition in the air. School has started, traffic is heavier, and the vibe is…well, stressful.

Yet, this can mean positives, too:  The weather is a wee bit easier to bear, especially for those of us in the DMV area, making it less of a chore to go out and about.  The structure of school gives many kids structure and purpose, so parents have some welcome relief from trying to plan activities all summer. 

And at work, Fall can be a time when projects that have been in the works come to fruition. Such has been the case for me:  After a few months of planning, I am officially practicing at a new location, The Growth and Recovery Center.  This is quite a transition.  The new location is ADA accessible, so there are elevators and accessible restrooms.  Beyond just the physical space, the psychological change opened up channels for my practice, and my goal is to share my “growth process” as a clinician.

I am especially interested in trauma and how it affects us. Most of us are familiar with the concept, and we often think of trauma as resulting from a big, obviously terrible event.  No doubt, this is often true:  If you survived or were in a war, an act of violence, or assault, you may very well be suffering from symptoms of Post Traumatic Stress Disorder (PTSD).  But there are less obvious, more hidden forms of trauma.  It may have been bullying in your childhood, a betrayal you witnessed or experienced.  As Sydney the psychiatrist from M*A*S*H said, “It’s the little battlefields….The ponds, the bedrooms, the schoolyards…That can leave the worst scars.” 

The big question is, what do we do with it?  Well, talk therapy can be a good start.  You’d be surprised at how healing it can be to have someone listen to you.  I do this, but I do this in a slightly more structured way than you may be used to, if you have had more conventional talk therapies.  I still want to form a therapeutic relationship with you, of course. Yet I do this with something called Life Stress Reduction Therapy.  I’ll look at what is worrying or upsetting you together with you, no matter how big or small your issue is.  

Okay, so let’s say you have done conventional therapy and it did you some good. That is excellent. But some things that have happened either recently or ‘way back when, you just always have tucked away in the back of your mind.  Here are some “red flag” thoughts with trauma:

Or, “I know rationally this person/thing/situation can’t hurt me anymore.   I still don’t believe it.  It doesn’t help when people tell me that.  I still have nightmares or get anxious out of nowhere. I feel so stuck.”

“I am so tired of feeling awful about this thing that happened so long ago/last year/last month, so it feels stupid.  Maybe it wasn’t really that bad.  I want to move on with my life and get it out of my head. Why can’t I just do that?”

I’ll tell you why.  It seems like it’s just in your head, but the thing is, it’s in a deep part of your brain, and probably, in your body, too.  Trauma is stored in the deep, fight/flight/freeze part of your brain, and it affects your nervous system.  As Besser Van Der Kolk said, “The body keeps the score”. And  although you don’t realize it, you are probably spending a lot of emotional and even physical energy trying to “push down” these strong reactions, just to get through your day.  Understandable.  But maybe it’s time to do something else.

So you may want to consider targeted trauma treatment for this kind of thing, even if you think it’s stupid.  If you are in or around Northern Virginia, know that I and other practitioners do this therapy in the form of TIR (Traumatic Incident Recovery). What is hard about trauma therapy is that we will view the traumatic event. I know you don’t want to do that.  That feels intense, hard. But we will do it in a structured, safe way, so that you begin experiencing it differently and not feel so “pulled down” by it.  Plus (and here’s what I love about TIR specifically, and trauma therapy generally), I am not going to be telling you MY opinions, reactions, or interpretations about YOUR trauma.  I will be present, I will guide, but I will do it with YOUR stuff.  

It is worth doing, whether the issue is that you were yelled at when you were three, 10, 20 or 50 years old, or whether you experienced an assault of some kind.  The point is, it’s still often there.  If it bugs you, it’s worth looking at.

Many of you who have mustered up the courage or trust enough to talk to others a bit about your trauma know that you have heard things that were meant well, but are just not helpful:  “Don’t think about it”, “God doesn’t give you more than you can handle”, or “It’s over! Let it go.”  If anything, these statements activated your anxiety or feelings of isolation even more.  You felt like a freak because the thing was still affecting you.  Or, those responses may have made you not want to deal with sharing the trauma more with people who just didn’t get it.

I get that.  And during a TIR session, I’m not going to do that.  I will work with what does come up, instead of trying to push it down.  That way you “discharge the dynamite”, rather than push it down.

So, as you transition into this Autumn state of mind, think about what might be on your mind and emotions that you might want to work through in therapy, whether it is a current stressor, or a past one.