I'm considering psychotherapy - where do I start?

This is an incredibly well done and comprehensive article from The Cut about what to look for when you're looking for a therapist.   It covers not only what to look for but also what are some red flags. 

HOW DOES THAT MAKE YOU FEEL

DECEMBER 1, 2017 6:00 AM

A Beginner’s Guide to Finding the Right Therapist

By Kristin Wong

During my first-ever therapy session, I noticed my therapist glance at my hands. This worried me. Am I fidgeting? What does she think about that? Should I keep my hands still? Yes, I’ll keep them still. Is that weird, though? I was so anxious that my therapist was analyzing my every word and movement, but of course, that was her job: to observe and analyze. It can be strange to be vulnerable with a complete stranger, but over time, the nervousness and awkwardness wear off and therapy can help you cope with your most pressing emotional issues.

In order to get the full benefits of therapy, though, you have to put your mental health in the right person’s hands. Even the professionals we talked to agreed that there’s no one-size-fits-all approach to therapy, and the professional that works well for someone else might not work as well for you. There are important considerations to keep in mind through every step of the therapy process.

Before the Consultation

If you’re new to the world of psychotherapy, you’ll probably start by asking friends for referrals or searching online. When researching possible candidates, you want to make sure they have the tools to solve your issues. At the very minimum, a therapist’s website should include information about their education, certifications, and specializations. There are different kinds of mental health accreditations, and a counselor’s certifications will be different than, say, a psychiatrist who can prescribe medication. That doesn’t make them any less skilled at what they do. A counselor or social generally offers more affordable therapy than may be available through your insurance plan. The specific credentials you should look for are licensed professional counselors (LPC) who have a master’s degree in counseling, psychology, or a related field, a licensed clinical social worker (LCSW) or licensed social worker (LSW). You might also work with a licensed educational psychologist (LEP), licensed professional clinical counselor (LPCC), or a licensed marriage and family therapist (LMFT), or a licensed clinical psychologist (LCP). You can verify a therapist’s credentials on the Department of Consumer Affairs website for your state.

As Laurie Eldred, a licensed master social worker and therapist in Grand Rapids, Michigan, pointed out, “It’s important for people to read the therapist’s website or online directory profile to see what they’re saying about their area of expertise.” Therapists typically specialize in specific areas, like substance abuse, family therapy, couples counseling, or even financial issues. These areas should be listed on the therapist’s website.

A therapist should also communicate what kind of approach they take to therapy. Perhaps there are researchers or scientists whose work they follow. Perhaps there are specific techniques they use in their work. Many therapists will include this information on their website, which can give you an idea of what to expect once you’re in a session. At this stage, try to keep an open mind, suggested Dr. Darin Bergen, a psychologist in private practice in Portland, Oregon. “There are many different approaches to therapy, and there is little evidence that any one therapy is better than another.” For example, there’s cognitive-based therapy, mindfulness-based stress reduction, acceptance and commitment therapy, and so many more.

Online reviews can help you find a good therapist, but they can also be problematic, writes Dr. Keely Kolmes, a psychologist in Oakland, in the New York Times. Therapy is more subjective than, say, bad service at a restaurant, and Kolmes argues that “a certain treatment might help one person but not another.” While the mindfulness approach might work for one client, another may find it frustrating and unhelpful, for example. Still, these reviews can help you look for red flags, like a therapist watching the clock or pushing their own agenda. Just be discerning when you comb through them and understand that, as Kolmes writes, “something that works for one patient at a particular point in therapy might not work for him later, when his needs change.”

During the Phone Call

Once you’ve narrowed it down to a few therapists who look promising, it’s time for a quick consultation call. Before committing to an actual appointment, reach out and ask to chat on the phone or send some questions via email. “Many of us provide free phone or even in-person screenings before setting up an appointment to feel out each other,” Bergen said. These consultations typically last 15 minutes, and you’ll want to share a bit about your background, the specific issues you’re struggling with, and what your goals are with therapy.

“During the consultation, you also have the opportunity to ask the therapist questions that are important for you to know about that therapist,”  said Alisa Kamis-Brinda, a licensed clinical social worker and licensed psychotherapist in Philadelphia. “Some people are interested in knowing where the person went to school or what certifications or licenses they have. For others, knowing about their experience with their particular issue and the therapist’s success rate are more important.” This is probably a good point to ask about fees and availability, too.

Bergen added that your therapist should also be able to give you a general idea of the treatment plan for your specific issue. “Ask your potential therapist how they suggest treating your problem,” she said, “and make sure they have a response that makes sense.”

Of course, your therapist should be a good listener, and you can get an idea of this during your phone consultation. Just remember that “good” listening is somewhat subjective. Sure, a good therapist is typically compassionate and nonjudgmental, but “some people prefer a therapist who does a lot of listening while you vent and process, while other people prefer a more active therapist who teaches coping skills and offers more feedback,” Brinda pointed out. “Consider your gut feeling to see if it feels right talking to this therapist,” she said, but generally, “you can tell if a therapist is a good listener if you feel heard and understood when talking with them.” Beyond feeling understood, the therapist should be able to communicate that they’re knowledgeable with your issue through training and experience. You can simply ask, “Can you tell me about your training and experience in this area?” Their answer should make you feel confident they can handle your issue, but “I would recommend that people focus more on how it feels talking to them,” Brinda says. “Research has shown that the relationship between the therapist and the client plays a big role in the success of the therapy.”

If you don’t like what you get in your 15-minute consultation, be willing to shop around, suggested Dr. Jim Seibold, a licensed marriage and family therapist in Arlington, Texas. “The research has been clear about this — a good rapport with the therapist is vital to success, so make sure you find one you are comfortable with,” he said. “Ask about their expertise, education, experience, style, fees, cancellation policies, and other office policies.”

During Your First Session

Especially if you’ve never been to therapy before, the first session can always be a little awkward. You don’t exactly storm into the office, plop down on the couch, and declare, “Okay, doc, fix my intimacy issues!” The conversation typically emerges more organically. Your therapist might ask how your week has been, then dig into the issues from there. Either way, you should feel comfortable and heard as the session progresses.

“Good therapists demonstrate good boundaries,” Seibold said. “They keep the relationship professional by limiting the personal information they share about themselves. They stay awake and alert throughout the session and do not answer their phone or check their text messages.”  During your session, you should never feel that your therapist is pushing his or her own agenda or professional goals, like selling a book. They should work to support the goals of the client, Seibold said. He added that part of establishing solid boundaries means acknowledging when they may not be able to help with a specific issue you might bring up during therapy. “Good therapists refer clients who are experiencing issues outside their area of expertise,” he said.

At this point, you and your therapist should agree on a treatment plan with specific goals and objectives. The plan should include strategies that your therapist believes will help you reach those goals and might even include a time frame for getting there. Before treatment, your therapist should also ask you to sign an informed-consent document, which includes information about your rights and responsibilities as well as theirs.

After a Few Weeks

You should notice that you feel supported and hopeful after your therapy sessions, said Jonathan Alpert, a psychotherapist in New York City and author of Be Fearless: Change Your Life in 28 Days. In an article for the New York Times, Alpert writes:

… if the therapist does nothing more than nod his head and provide vague utterances of reassurance like “I see” or ask questions that might seem dismissive (like the classic ‘And how does that make you feel?’), then move on. This type of therapy proves ineffective while a more positive and engaging therapist is better able to help a patient achieve optimal results.

He added that after a few weeks of therapy, you should begin to feel at least a small sense of control and change. If you don’t, it may be time to move on.

That isn’t the only red flag, of course. If your therapist constantly watches the clock, makes you feel guilty for quitting, or threatens that you’ll “plunge into depression” if you stop going to therapy. Those are surefire signs that you might not be getting the help you need, Alpert writes. “If the therapist does not seem understanding about this or tries to pressure you into becoming a client, be firm and do not go back,” Seibold warns. “If they don’t respect your need to be comfortable and confident in the professional relationship, they are not likely to respect your goals and objectives either.”

Brinda listed a few other red flags that it may be time to ditch your therapist:

• The therapist is talking more than you.
• The therapist is interrupting you often.
• Any inappropriate behaviors from the therapist (sexual or otherwise).
• The therapist has violated your confidentiality.

It’s worth pointing out that the last two red flags are also reportable offenses. You can file a complaint with the board of psychology or board of behavioral sciences for your state.

How long therapy lasts varies depending on the person; it may take months or years until you feel that your therapy is complete and you’ve reached your goals. Ultimately, therapy is complete when you feel confident that you’ve developed the skills and tools to cope with the emotional challenges that brought you to therapy to begin with. This is also why it’s important to develop a clear treatment plan at the beginning of your therapy. After all, therapy is also expensive. You want to make sure you’re getting your money’s worth. “You know therapy is complete when the client can say their goals are met or if they feel therapy is no longer leading to personal growth,” Bergen said. “We know from the outcome research that the relationship between the client and therapist is one of the most important factors for a good outcome.”

 

https://www.thecut.com/2017/12/a-beginners-guide-to-finding-the-right-therapist.html?utm_campaign=nym&utm_source=fb&utm_medium=s1

Finding Inspiration

We all need a bit of inspiration sometimes and, for me, today was one of those days.   So I put on some good music and I look to the free-thinkers, ground-breakers, earth-shakers who have acted on their visions to make things happen.  

These are some quotes that are resonating with me today…….

1. “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” —Maya Angelou

2. “You can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something - your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.” - Steve Jobs

3. “The most difficult thing is the decision to act, the rest is merely tenacity.” —Amelia Earhart

4. “She is free in her wildness, she is a wanderess, a drop of free water. She knows nothing of borders and cares nothing for rules or customs. 'Time' for her isn’t something to fight against. Her life flows clean, with passion, like fresh water.” -  Roman Payne

5. “Always tell yourself that you are as good as anyone that breathes; that you have two hands and a brain, and a little time in which to use them. But they are enough, and no one has any more. And if you train and force them to serve you well, you can reach any height to which you aspire. But to waste any of them is to betray yourself.” - Robert M. Stroud

6. “Whatever you think you can do or believe you can do, begin it. Action has magic, power and grace.” - W.H. Murray.....I can't even begin to tell you how much I LOVE this one - "Action has magic, power and grace"  there's so much power and positivism in those words.....

7. “When I dare to be powerful - to use my strength in the service of my vision, then it becomes less and less important whether I am afraid.” - Audre Lorde

8. “People do not wander around and then find themselves at the top of Mount Everest.” - Zig Ziglar

9. “‎As I get older I see that running has changed for me. What used to be about burning calories is now more about burning up what is false. Lies I used to tell myself about who I was and what I could do, friendships that cannot withstand hills or miles, the approval I no longer need to seek, and solidarity that cannot bear silence. I run to burn up what I don't need and ignite what I do.” ― Kristin Armstrong, Mile Markers: The 26.2 Most Important Reasons Why Women Run

10. “You can't build a reputation on what you are going to do.”  ― Henry Ford



Chocolate Dipped Coco-nutty Macaroons

I was craving something sweet and this totally hit the spot.   So easy to make - aka no oven required :) and they really truly are good for you.   They're made of good fats, all the great powers of pure unsweetened cocoa powder, and for those of you who are keto, LCHF, paleo, grain-free, gluten-free or bulletproof, this recipe has you covered, and besides all that, they're delish!

Here's the Recipe - 

For the Macaroon part: 

  • 2 tablespoons coconut oil
  • 1/4 cup nuts (I used a combo of pecans and almonds, but you can use whatever you like or have on hand)
  • 1/2 teaspoon vanilla
  • 1 teaspoon stevia
  • 1/4 cup unsweetened shredded coconut

Put it all together in a food processor just until combined.  Use your hands to shape in rough balls about 1 tablespoon in size then put them in the freezer to firm them up a bit while you make the chocolate. 

Chocolate Topping

(FYI - you could just melt some good quality dark chocolate and dip them in that, but I wanted a lower sugar option, which is why I used stevia instead)

  • 3 teaspoons stevia
  • 1/4 cup unsweetened cocoa powder
  • 2 tablespoons coconut oil

Put the ingredients above in the food processor (after you cleaned it from making the cookie part) and whirl.   This chocolate dipping is not very sweet, so you can always add more stevia if you feel it needs it. 

Then remove your chilled macaroons from the fridge, dip each cookie into the chocolate sauce and you can garish with a sprinkle of pink Himalayan sea salt, or a bit of coconut then put them back in the fridge to firm them up again.   Makes about 10 bite sized cookies.  Keep them stored in the fridge and take them out a couple minutes before serving so that they soften up a little before eating. 

Enjoy!

xx

Katherine  

Chocolate Avocado Protein Shake

Chocolate Protein Shake.png

I'm pretty much all about this protein shake.    Don't let the avocado scare you off, it doesn't taste avocadoy at all, it just adds good healthy fat and fiber and gives it a nice and creamy texture.  It's really easy to whip up, super healthy, packed with protein and healthy fat and it also satisfies my sweet tooth :).  The key is that it's made with healthy real food, aka no chemically tasting artificial  protein powder here, the protein comes from hydrolyzed collagen which has a ton of health benefits (here is a great article about the benefits of collagen and how to incorporate more of it into your diet).  

Chocolate Avocado Protein Shake

Ingredients

  • 1/2 hass avocado
  • 2 tablespoons hydrolyzed collagen (psst....you can buy it on Amazon
  • 1 cup maple water 
  • 2 tablespoons unsweetened cocoa powder
  • 1 teaspoon stevia (use a bit more if you like it sweeter)

Toss all the ingredients into a blender and you're done!  You can also top your shake with a sprinkle of cinnamon and sprig of mint just for a little extra flair. 

For those of you counting macros it breaks down to - 

  • 200 calories
  • 15g Protein
  • 13g carbs (but only 4 net carbs!)
  • 13g fat

Enjoy!

xx

Katherine

 

How to Become a Morning Workout Addict and Love It

I know, you totally just rolled your eyes at the mere title, but bear with me, because I used to roll my eyes at the idea of a predawn workout session too.  That was until 3 years ago when I
realized that my workout routine had fallen off to the pressures of a demanding job with long hours and daily scheduling challenges.   My routine (or lack thereof) vacillated between spotty and nonexistent.  It wasn't that I didn't WANT to workout, I did, I just truly could not for the life of me figure out how to fit it into my life.   I would get to the gym about twice on weekdays after work and maybe get a run in on the weekend if I was lucky.  I was inconsistent, doing sub-par workouts, wasn't getting the results I wanted and didn't feel good about my body.  Once I realized my own frustration about my own inconsistencies and took ownership of those inconsistencies, I found that the only time that I could find in my life that could be completely uninterrupted were early mornings.  After a bit of trial and error I now workout consistently 5 days a week with 5 am wake ups and I have been at it over 2 years.

Here are some tips that helped turn me into a Morning Workout Addict & Love it -

1.  Re-frame it - change your focus.  Working out is more than half mental and if your mind is focused on how much a morning workout is going to suck, how exhausting it's going to be and how little sleep you got - guess what? Your workout is going to suck.  So change your focus and spend your mental energy focused on how good you're going to feel when you're done, how empowering it is to make your physical health a priority.

2.  Make a workout plan. You should be doing this no matter what time of day you get your workout in, but it's especially important to be  doing this when you're doing a morning workout.  Having a plan in mind helps to set your mind-frame of what you want to accomplish that morning and keeps to motivated to power through and crush your workout.

3.  Go to bed earlier.  I know it's nice to relax and decompress in the evenings, catch up on Netflix or read a book but getting enough sleep is vital not only to feeling energized when you wake up in the morning but also to weight loss.   Truthfully, even if you don't start out going to bed earlier it will probably happen naturally if you're consistent with your wake up times, because you'll be tired earlier, but it will be a bit harder to keep waking for those workouts, so make your life easier and just go to bed earlier.  If you find it really hard to turn off your phone and turn out the light much earlier, start out slowly by going to to bed just 15 mins earlier each night until you're getting enough sleep (somewhere between 7-9 hours a night, or whatever amount allows you to wake up feeling energized).

4. Preparation, preparation, preparation! Get everything ready the night before and I mean EVERYTHING.   Workout clothes with socks, sneakers and even hair elastics laid out, (I've heard of some people taking it as far as sleeping in their workout clothes, personally I don't,  a sports bra is too constricting for me to sleep in).  Put out your music/headphones out if you use them.  If you're going to shower and dress for work at the gym all that stuff should be packed up and ready either by the door or already out in the car.  Fill your water bottle and keep it in the fridge.  If you're a coffee addict, program your coffee maker so that all you have to do it pour it into a mug before you fly out the door.   Bonus - if you live where it gets super cold in the winter - get a remote car starter - trust me it'll be worth it on those dark cold January mornings.

5. Think about breakfast. Breakfast is also about preparation but for me it falls into it's own category.   Breakfast is tricky for a lot of people, personally I find that morning fasted morning workouts powered by just some black coffee works great for me.  If you've never done a fasted a workout I would encourage you to think about trying one, you may find that you actually feel better and have a better workout without having food in your belly.  However if you must have food before you workout, plan ahead and make something that's easily digestible like a shake the night before, or all prepped so you just have to throw it in a blender.   Also, if you're like me and prefer to eat afterwards, prep your breakfast the night before things like, chia seed pudding made with coconut milk, nuts, green smoothies, fruit and protein shakes all work great for an easy post workout breakfast.

6. Make yourself accountable. Signup for an early am class, plan to meet a friend, or even just tell people your plan.   It's a lot harder to hit the snooze button when you know that you'll be letting down a friend you were supposed to meet, losing the money you paid for a class or knowing that when you get to work your colleagues will be asking you about your workout.  

7. Don't forget to make time for stretching/foam rolling.  Delayed Onset Muscle Soreness (DOMS), ie next day muscle soreness, will make it super tough to get out of bed the following morning when you feel like you got hit by a truck.  One way to prevent DOMS is to  make sure that you plan your workout session to include time for a cool down, stretching and foam rolling- this is crucial because when your'e crunched for time this is often the first thing that gets left out but then you find yourself sore with tight muscles leaving you uninterested in working out again the next day.

8.  Be proud! Getting up for an early morning workout isn't always easy and it requires true commitment, so be proud of your hard work and dedication.   Feeling that sense of pride and accomplishment will be your greatest internal motivation to keep you going.   

Zucchini Basil Fritters

Fritters are one of my favorite things to make with all the lovely zucchinis we pick up at the farmers market.  They're so simple, very easily made gluten free/grain free/LCHF/Paleo, and the flavors can be switched up by adjusting the recipe with a couple tweaks.

Here's how to make them - 

  • 1 large zucchini (I used one that was about the length of my forearm)
  • large handful of chopped fresh basil
  • 1 garlic clove minced
  • 3 TBS of coconut oil for cooking - approximate
  • 1 large Egg - lightly beaten 
  • 1/4 c of coconut flour
  • Pepper to taste

Start by shredding the zucchini either with a hand grater or with the attachment on your food processor.  Put the shredded zucchini in a bowl and sprinkle with about a tablespoon of salt. The salt draws the water out of the zucchini  so this part is crucial to helping the fritters brown up nicely.  After about 10 minutes put the zucchini into a cheese cloth or a clean dry dish towel and wring out the zucchini (if you're particularly sensitive to salt you can gently rinse the zucchini in water before wringing it out).   

Mix together the basil, garlic, coconut flour, pepper and egg in a large separate bowl then add the zucchini.  MIx.   Heat the coconut oil on medium heat then using a 1/4 cup measure out the zucchini mixture and add to the pan.  Gently flatten with the 1/4 cup heaps with a spatula.  Cook until they're nicely browned on both sides then transfer to a plate with a paper towel to drain off any excess oil.  

Serve alongside your favorite alioli or they're also delish topped with a fresh tomato salsa. 

Enjoy!

xx Katherine  

Juice it Up! Purple Energy Juice

Purple Energy for the win!  

Starting the day with some fresh juice is so refreshing and energizing.  This a one of my go-tos because I usually have everything on hand plus it's chock full of healthy refreshing goodness.  Beets are full of nitrates that your body changes into nitric oxide which helps with blood flow and blood pressure, plus it's also been found to help with maintaining endurance during exercise.  Carrot juice is super high in beta carotene as well as vitamin A.   Cucumbers are high in vitamin K which helps with blood clotting but it also is a great source of copper which helps make neurotransmitters which are the chemicals your brain cells use to talk to each other - basically cucumbers are great brain food.  Besides adding a bit of spiciness to the juice that I love, ginger is wonderful for digestion.  I like to add lemon to finish most juices that I make because it adds some brightness to the juice but it also is wonderful for cleansing the liver and has immune boosting powers.  

  • 1 beet- make sure you peel the rough outer skin off first if the greens are attached juice 'em up too - if not, no worries, you can also cut them off and sauté them with some garlic and butter for an easy dinner side
  • 1/2 a cucumber - my cuc this morning was HUGE so I only used half but if yours are on the smaller side use the whole thing
  • 3 carrots - as you can see from the pic mine were on the long skinny side so adjust as you need to
  • ginger - about 1-inch peeled - more or less depending on your love of the spice!
  • 1/2 lemon - my juicer doesn't do citrus very well but if yours does, throw that right in there with everything else, alternatively you can just hand squeeze it in there at the end like me :)

Juice it Up and Enjoy!

xx Katherine