September 16, 2019

Why is therapy so slow to change?

Let’s face it, if you’re going to spend eight years going to school you’re going to want to use what you learned. Even if the material is 30 years old or your schooling was 10 years ago. For some reason we understand that we’re constantly learning new things and technology and even in medicine. And yet we don’t seem to expect that of psychology. This is really erroneous thinking on our part. There’s new research being done on the brain, DNA, nature vs nurture, and various techniques used in psychotherapy.

One of the most researched techniques, cognitive behavior therapy, shows some real promise in areas of therapy we thought wasn’t possible to fix. There are certain mental illnesses that were thought incurable, as if they were some kind of brain deformity. Now we’re learning even if the brain has had issues, or there has been trauma, we can teach coping skills to provide a more fulfilling and rewarding life. But the industry itself is slow to change. You don’t have to go back very far when people just shut away those with a low IQ or mental illnesses that were treatable.

It grieves me to hear people talking about how long, or even impossible it is to recover from traumatic events or years of abuse. It does take effort, and it can be painful.  It does take time, even with brief therapy your brain doesn’t change instantly, but certainly there is hope for recovery. I don’t believe in some magical formula. What grieves me is the idea it is going to take years and years and there are only little changes, little advancements. I’ve not found to be the case in my experience. And I have colleagues who’ve found that’s not been their experience with their clients either.

So why aren’t all new therapists doing things differently? Many are. That’s the good news. Every week I meet new colleagues who are embracing a more effective way of doing therapy. There are more and more people going into the field who want to see their clients get better quickly. Who believe that there’s a lot of labels in the mental health industry that are not useful and possibly even wrong.

Unfortunately, not all therapists are trained the same. Unlike other professions where there is a very specific set of diagnostic and treatment tools, in psychotherapy and psychology there are many of theories, many ways to do “therapy” and much subjective debating. Even the DSM-V is under fire by some experts. The general public is not always aware of all this. First of all we can get in trouble with our associations if we say things that make others in our profession look bad. But it’s important we not hide from the facts. We need to embrace change and propel this industry into the future with success. Peoples lives are at stake. So I’m willing to take the risk because I think it’s unethical not to make a stand. Our profession needs to change. There needs to be more accountability. And regulations and associations are not cutting it. I get that that’s a starting place but without some kind of unifying documentation to show what works and what doesn’t we’re all sitting around a table arguing theory.

What does this mean to you as an individual? It means don’t give up. Don’t fall for the rhetoric you see on TV and don’t be afraid to try more than one therapist or counsellor if you’re not finding recovery and success. That being said your therapist can only provide so much without you investing in a willingness to change yourself. That leaves me to number three.

Of course I don’t have all the answers, nor am I the perfect therapist. I don’t even have a doctorate like many others in psychology.  I only know that without awareness we can’t move forward. We have to be able to analyze what’s going on right now. What’s working? What isn’t working? And the only way to do that is to have data. The only way to have data is to do testing. Many aren’t ready to go that route. They think it will interrupt therapy, cause a break in empathy. The evidence I have seen so far is the opposite. Testing actually brings us closer to the patient. (burns podcast) We can’t read minds.

No matter how skillful therapist is they can’t possibly know what a patient is actually thinking and feeling 100% of the time. If one thinks they know something they don’t improve. They think they’ve got it figured out. In school we are told if the client is not improving that’s transference and it’s some kind of psychological issue the client has. Or the client has some incurable mental issue. The reality is more likely if a client isn’t improving it’s likely the therapist who has the problem. Either they’re not creating enough empathy and therapeutic regard, or they’re jumping into methods too soon, or they’re using the wrong methods for that client, or they haven’t dealt with the clients resistance to change, or the pushing the client to change something the client is not willing to change.

Mental Health does have many subjective components so how do you collect data? What is happiness? How do you define that? What does the client mean when they say I feel desperate? In medicine it was thought pain was too subjective to measure. For years pain management was done by doctors analyzing the source of pain and use a calculated average based on nerve endings, function, non-verbal cues, etc. But we’ve learned that, while pain is subjective, it is relevant to the person who’s going through it. And now pain scales are used in hospitals all over the world on a regular basis to test patients and collect data to determine a course of action. Yes, observational tools are still also used but medicine did just throw up its hands and say, it’s too subjective to test and treat, so each doctor can just do whatever they feel is right.

This is totally doable in the Mental Health industry too. Dr Beck started it with his depression inventory in the late 70’s. There’s been some other surveys and assessments out there and there’s new ones coming out. They’re not always done with skill. Anyone can write a survey, but unless you understand how statistics work, you can create questions that skew the data. This leads to conflicting information and the conclusion we really can’t understand the brain so we have to go by instinct alone. But in my mind this is unacceptable. We can go over data, we can see where we’ve made mistakes, and we can continue to refine it and prove it. We can combine the art of therapy with a more trained, objective process.

Let’s continue to explore and learn. We don’t want to get stuck in the dark ages when it comes to mental health. Let’s embrace analyzing what works and what doesn’t. We don’t have to be tricked into thinking it’s not possible. We really can put a number on it and find healing.

August 18, 2019

Why is TV therapy stuck in the dark ages?

And not just TV, but the general public’s beliefs about therapy as seen in various media. By dark ages, I mean the earliest ideas, such as those by Freud and others in that era. There is some knowledge that is still relevant but come on, why are we using techniques in TV for mental health that are over 75 years old?

One of the things we see in the media is ONLY the most severe cases get therapy.  This is very frustrating to me! Like you’ve got to have it really bad before you should go get help. Honestly that’s ridiculous. You might have just one minor nit picky feeling of shame that you want to deal with that’s totally OK to get help for. You don’t need to be traumatized to see a counselor.  Another thing shown in TV land that is from ages past is you have to see a therapist for years and years to recover. Especially if it’s OCD, PTSD, or major depression.  But research shows brief, solution-focus and/or CBT, therapy is far more effective than the old ‘couch’ approach. And lastly, some of the tools used in TV therapy make for great scripts but are not very effective in real life. Spending session after session talking about your mother won’t cure your fear of heights!

It really bugs me because we don’t see actors using bloodletting on modern medicine shows, yet we keep showing therapy from the 1950's, with the couch and never-ending weekly sessions. Why is that? Well I’ve got a few ideas.

First of all, confidentiality. Many don’t want others to know some of the stuff they’ve had to face. And even if they are thrilled with the results of recovery, it is completely unethical for us to use any testimonials.  So the mental health industry looks silent and closed off. While we see ratings and reviews for all other services, counsellors and therapists avoid this (even anonymous ones) because we’ve been programmed to thing that is unethical.  So, the real stories and rates of recovery are hidden from view.

Secondly, quick full recovery is not as common as it could be and hit and miss from practitioner to practitioner. Therapists are not all trained the same, they are left to ‘be congruent’ with themselves and do what comes ‘naturally’. Unlike other trades or professions where there is a very specific set of diagnostic and treatment tools, in psychotherapy and psychology there is all kinds of conflicting theories, many ways to do ‘therapy’ and much subjective debating. More on this next article.

Third reason we don’t see lots of recovery stories or effective therapy on TV or in the media is most people like the status quo. Believe it or not most of us don’t want to change. Actually, there’s lots of reasons to not change, some of them actually quite positive. But in any case, we want to believe we can’t change because then it gives us complete 100% permission to just stay the way we are. Even those with severe depression or crippling anxiety. Maybe It’s become part of who they are and they’re afraid that somehow if they let go, they will lose a part of themselves. Maybe we feel it’s unfair we have to change when we are the victims. Which is totally true! It’s not fair. In fact, I’ve gotten flak for posting articles on how to improve your life because some feel that’s victim blaming. It would be wonderful if all the perpetrators of hurtful things had to take on the responsibility to change. But unfortunately, the way we are designed, it doesn’t work for someone else to fix us even if they are responsible for the hurt.  

Fourth reason, we don’t want people to feel bad if they don’t recover. If there are shows on TV where someone can go to therapy and recover from the PTSD in a few sessions, people will feel everyone should recover quickly and that would lead clients to be disappointed if they didn’t.  

Fifth. The writers don’t know better. Yep, full recovery with brief therapy is still pretty new. And there’s a lot if old shows and reruns out there. Plus new ones created from novels written decades ago. Just like it took Hollywood quite some time to get leading female roles on major motion pictures I think it’s going to take time for Hollywood to catch up with modern therapy.

Lastly, there are still plenty of therapists practicing old school therapy like you see on TV.

Don’t let what you see on TV discourage you!!!  You can get successful results for minor or major issues with a good therapist. Many counsellors offer free consultations and you can talk to them about what to expect. We can’t give you a timeline or guarantee but you can find healing for most issues if you are willing to put in the work to change and ready to face your inner demons.  It’s not always easy but it’s totally worth it!

August 5, 2019

Can People Really Change?

I'm not going to hold you in suspense! Yes & No! No, there are somethings we can't change and Yes there are many things we can! I’ve witnessed it over and over. One of my biggest pet peeves while watching TV, especially dramas based off of best-selling books, is this idea that people can’t change. That people are just who we are and that’s all there is. That we really don’t have much choice, we are just let about by DNA and circumstances. Bad people are bad and good people are good is a common thread throughout much of television.

 Here’s the thing, we see evidence of the opposite is true, we see people changing every day! Of course, we can also find examples of people staying the same as well, and I don’t have a problem with that. My issue is the “it’s impossible for people to change” concept.  Remember I said this is a Yes & No answer? There is personality, you know your favourite colour, whether not you like cats and dogs or prefer a fur free zone, whether we are task oriented or motivated by relationships, if you are generally serious or silly, if you like your schedule structured or spontaneous or both. These kind of personality traits are more fixed and there’s some evidence that those kind of things do stem from our DNA and upbringing.

What I am talking about is can we be free from certain things that plague us that people often lump into the 'personality' thing. For example anxiety or phobias, or if we are impatience or get angry a lot.  Most people are not born with phobias or anger management problems (I know some kids have more temper tantrums and we can be more PRONE to anxiety or anger issues by DNA and circumstances). Sometimes trauma can trigger a phobia as well. That doesn’t mean you have to live with it's effects forever. Also, there are things we are born with, predisposition if you will, that we can still change in terms of choice and behaviour.  For example, you might be a natural introvert but you don't have to have social anxiety. You can be an introvert and not be anxious around crowds, chatting with a small group, or presenting in front of people. 

Why this is so frustrating is because there are many who could have freedom, but they don’t know it. They are told it’s just the way it is. you’re going to have to go through years of therapy to deal with your trauma and maybe you’ll be able to cope with your phobia but really we can't change. But there’s evidence that this is not true. Not only in my own experience, but I hear from colleagues and clients too. Stories those recovering from phobias very quickly, sometimes within a few sessions, while for others it takes a few months, yet they gain recovery in the end.

I think we’re so used to hearing the stories that someone has been/done X their whole life. They never changed. We all know people who "have been like that their whole lives." We don’t think to question it. But, if you look and listen you will hear many stories about growth and change. People who go from being lazy to productive, angry to calm, unhappy to finding joy, or like in my case full of anxiety to peace.  This isn't to say one never experiences it again. It's the bent of the character, the daily experiences that change.  We will have off days, set backs, relapses but what is the majority of your experience? 

Let's meet Joyce (name and circumstances changed to protect identity, she has passed away now).  Joyce grew up in a poor family in small rural town. She had very few friends and suffered emotional and physical abuse as a child.  Times were tough growing up and she remembers nights with little or no food.  In high school she was told by a teacher since she was beautiful she should just try the street to earn a living.  Her mother had a severe mental illness and her parents divorced when she was young.  She found herself in a constant battle between trying to be independent and looking for approval from others.  She clung to money since she had little growing up. Perfectionism plagued her to the point of attempting suicide.  But she found she had a choice.  She had been a Christian, but it took her some time to realize she didn't experience the peace it offered because she held onto her past, her self-defeating beliefs of perfectionism and to feel valued she needed approval of others. She didn't get therapy or find enlightenment in a single moment, but she did change and find that peace.  She became one of the most generous people I know.  While still stingy with herself, she would give and give to others. Time, money, or things, didn't matter she loved sharing. She had a spark of joy.  Of course, like the rest of us she had bad days and relapses. Times where she started to worry about what others thoughts, but these would pass. Like us she had victory in some areas of her life and needed growth in others. Had Joyce be able to use the TEAM-CBT tools I am 100% confident she would have turned the corner far more rapidly and been able to conquer some more of the things she wanted to change in herself.  But whether change takes you sometime or happens quickly over a few weeks or months, it is possible, just like with Joyce.

I would be amiss if I didn't talk about spirituality and God. I realize this is getting to a taboo subject even with an emphasis on freedom and acceptance. But it would be unethical of me to share the single most powerful way to experience change, following a healthy spiritual journey.  I believe God is involved in your life right now whether you believe in Him or not. We are told all good things come from God and that includes recovery from painful emotions and traumatic events. This was Joyce's experience. And how much more powerful can we get if we add the effective mental health tools, like CBT, with spirituality. Amazing results!!!
It’s sad the recovery stories are seldom talked about in the media. Why is that? Tune into my next post for the answer. BUT for right NOW if you want to move forward and there’s something holding you back I encourage you to book a free consultation here.

Why is therapy so slow to change?

Let’s face it, if you’re going to spend eight years going to school you’re going to want to use what you learned. Even if the material is 30...