Psychotherapy

The counseling process allows us to examine all aspects of our lives in a safe and confidential setting with a trained professional. The specific approach used by the counseling professional depends on their theoretical approach and educational background.

The training a counselor receives enables them to uncover meaning and understanding from our thoughts, feelings, behaviors and choices that would be difficult to achieve on our own or with someone who knows us. Learning new skills to manage and direct our emotions and behaviors in a way that supports our well-being is part of what helps. Having a neutral person to process with can be invaluable to those seeking to change their lives in a healthy, balanced way.

Therapy is an effective process that assists in developing skills and healing sources of pain that affect daily life and relationships. It helps in making choices that lead to a more fulfilling lifestyle. Similar to getting in shape physically, successful engagement in therapy requires regular work and a willingness to face our pain and discomfort. There are different kinds of therapies; counseling and psychotherapy are just two of them.

Counseling, when applied exclusively, focuses primarily on defining problems, problem-solving, decision-making, education, guidance and advice.

The exclusive application of psychotherapy involves in-depth analysis of an individual’s psychological makeup through the application of analytic therapies.

Many mental health professionals, however, combine counseling and psychotherapeutic methods of therapy, which explains why it’s often difficult to differentiate between them. I use both in my work, which allows me to tailor my approach to meet the needs of each client.

For many people getting started in therapy is the hardest part. Since you are reading this you have taken the first step. It can be helpful to get a referral from a trusted friend. You can simply call or email the therapist. You know what concerns are going on in your life and the therapist can guide you on how to go about the process.

There are five core dissociative experiences. I will briefly describe each below.

1. Amnesia
2. Depersonalization
3. Derealization
4. Identity confusion
5. Identity alteration

Amnesia refers to the inability to recall important personal information that is so extensive that it cannot be due to ordinary forgetfulness. Amnesias are often important events that are forgotten, such as abuse or a troubling incident, lasting from minutes to years. Other amnesias, sometimes referred to as micro-amnesias, are more commonly reported to me by clients who have amnesia as a symptom of their dissociative disorder. These micro-amnesias create the experience of engaging in a discussion and the discussion is not remembered, or the content of a conversation is forgotten from one moment to the next. I have had clients who do not remember a phone call with me, or a therapy session, or whether they even came to their appointment.

Depersonalization is the experience of seemingly being detached from, or “not in” one’s body. A profound alienation from the body such as a sense of not recognizing yourself in the mirror or not recognizing a body part are common. In my experience people can find it hard to articulate the experience. I have heard it described as, “I know I am in my body, but I do not feel connected to it.”

Derealization is the sense of the world not being real. I have heard it described as, “It’s like I’m watching my life sort of like a movie.” In other descriptions people say the world seems unreal, foggy, distant, or as if seen through a barrier at a distance. Many people report experiencing these two dissociative phenomena in combination.

Identity confusion is a sense of confusion about self. These individuals have difficulty maintaining consistency in choices because their preferences, values, and opinions are unclear or change drastically at different times. For example, this can result in a person making a decision to use drugs when at other times it would be repugnant to them.

Identity alteration is the sense of being markedly different from another part of oneself. A person may shift into an alternate personality, become confused, and not know who they are talking to or where they are. The person may experience distortions in time, situation, and place such as believing they are years younger than they actually are, believing they live in a different city, or not realizing a family member has died. Other observable changes include using a different voice tone, facial expressions, range of language, or an accent. Though sufferers of this condition may or may not be able to confirm the experience of identity alteration, they usually can confirm becoming confused about their behaviors, speech patterns, demeanor, body language, feelings, or perceptions.

Typically we will have talked on the phone prior to our first appointment. In our first meeting, we spend time discussing and creating a mutual understanding of our work together. This generally involves discussion of the following:

First, I want to provide any additional information you need about my training, experience, and the types of treatment I can provide, as well as clarity on what I am not able to provide. I also answer any remaining questions you have about therapy, review confidentiality and the exceptions to it, and our shared responsibilities and obligations in working together.

Second, I want to get a basic understanding of the concerns or problems that bring you in and the goals or desired changes you have for our work together. We want to assure compatibility with your treatment goals and my ability to help you achieve them.

Finally, I will provide you with feedback and my initial recommendations based on the information you provided. I will answer any questions you have about my recommendations. Together we will decide if moving forward and entering into a treatment agreement is a good fit.