Understanding OCD: Prevalence, Symptoms, and Effective Management

Introduction to OCD

Obsessive-Compulsive Disorder (OCD) is one of the most misunderstood mental health conditions. Often reduced to stereotypes or casual mentions in conversations about neatness or perfectionism, OCD is far more complex and challenging than many realize. For those living with OCD, it’s not just about being overly organized or detail-oriented; it’s about navigating an exhausting cycle of intrusive thoughts and compulsive behaviors that can be incredibly time consuming and interfere with daily life.

In this blog post, we’ll dive into what OCD really is, unpack the science behind it, and explore how individuals can find hope and healing through evidence-based treatments. Whether you’re looking to support someone with OCD or gain a better understanding of the disorder, this article will provide insights into its impact and the paths to recovery.

How Common is OCD?

Obsessive-Compulsive Disorder (OCD) affects millions of people worldwide, but its prevalence is often underestimated. In the United States, the National Institute of Mental Health estimates that approximately 1.2% of adults experience OCD each year. Globally, the prevalence rate is similar, affecting about 1-2% of the population. While these percentages may seem small, they represent millions of individuals grappling with the disorder’s challenges daily.

Who does OCD Affect?

OCD is a condition that knows no boundaries, affecting people of all ages, genders, and backgrounds worldwide. It often begins in childhood, adolescence, or early adulthood, with the average age of onset around 19. Research shows that about 25% of cases start before age 14, and early onset is more common in boys. However, by adulthood, OCD prevalence is slightly higher in women compared to men

How to Know if You Have OCD

OCD is characterized by two components: Obsessions and Compulsions. Obsessions are repeated thoughts, urges, or mental images that are unwanted and upsetting or anxiety provoking. Common obsessions can include:

• Fear of Contamination: Concerns about germs, dirt, or chemicals that might cause illness or harm.

• Fear of Causing Harm: Worries about unintentionally hurting others, such as through negligence or accidents.

• Intrusive Thoughts: Unwanted, repetitive thoughts, sometimes about taboo topics (e.g., violence, religion, or sexuality).

• Fear of Losing Control: Distress over potentially acting on aggressive or inappropriate impulses.

• Fear of Saying or Doing Something Embarrassing: Obsessions about being judged for actions or words, even if trivial.

Compulsions on the other hand are repetitive behaviors that a person feels the urge to do, often in response to an obsession. In response to the examples of obsessions above, a person might engage in the following compulsions:

• Fear of Contamination: Excessive handwashing, cleaning surfaces repeatedly, or avoiding public places.

• Fear of Causing Harm: Checking locks, appliances, or driving routes multiple times to ensure no accidents have occurred.

• Intrusive Thoughts: Repeating phrases, prayers, or neutralizing thoughts to "cancel out" the unwanted intrusive images or impulses.

• Fear of Losing Control: Avoiding sharp objects or situations where the person fears they could act impulsively, such as crowded areas.

• Fear of Saying or Doing Something Embarrassing: Mentally reviewing past conversations or events to ensure nothing inappropriate was said or done.

Compulsions are a double-edged sword. While they may provide temporary relief from the distress caused by obsessions, they inadvertently reinforce the very fears they are meant to alleviate. By acting on compulsions, individuals strengthen the belief that the feared outcome can only be avoided through these repetitive behaviors. Over time, this perpetuates and deepens the OCD cycle, making it harder to break free. This self-reinforcing loop highlights the importance of professional treatment, such as Exposure and Response Prevention (ERP), which helps individuals confront their fears without relying on compulsive actions.

How to Deal with OCD

Fortunately, effective, evidence-based treatments are available for OCD, offering hope for those struggling with the disorder.

• Exposure and Response Prevention (ERP): As a specialized form of Cognitive Behavioral Therapy (CBT), ERP is considered the gold standard for OCD treatment. This approach gradually exposes individuals to their fears (obsessions) while preventing them from engaging in compulsive behaviors. By doing so, ERP helps to reduce anxiety over time and disrupt the OCD cycle, teaching individuals that they don’t need compulsive actions to relieve their fears. Numerous studies consistently show ERP’s effectiveness, with many people experiencing significant symptom improvement.

• Cognitive Behavioral Therapy (CBT): While ERP is typically the most effective approach, general CBT also plays an important role in treating OCD. CBT works to address the irrational thoughts and cognitive distortions that underlie OCD, using techniques like cognitive restructuring to help individuals challenge unhelpful beliefs and develop healthier responses to intrusive thoughts. This treatment aims to reshape thinking patterns, reducing their impact on behavior and emotional well-being.

Both ERP and CBT have proven to be successful in helping individuals manage and reduce OCD symptoms, with CBT techniques often being part of a broader treatment plan for long-term recovery.

Conclusion

OCD can be a deeply challenging disorder, but with the right treatment, recovery is possible. Evidence-based therapies, such as Exposure and Response Prevention (ERP) and Cognitive Behavioral Therapy (CBT), have been shown to significantly reduce symptoms and help individuals regain control over their lives. ERP, in particular, is considered the gold standard for treating OCD, helping individuals confront their fears while learning to resist compulsive behaviors. Meanwhile, CBT works to reshape harmful thought patterns, further empowering individuals to manage intrusive thoughts without resorting to rituals or behaviors.

If you or someone you know is struggling with OCD, you don’t have to face it alone. At Gofman Therapy and Consulting, our experienced team is dedicated to providing compassionate, evidence-based care tailored to your needs. Whether through ERP, CBT, or a combination of both, we are here to guide you on the path to recovery. Reach out today to schedule a consultation and begin your journey toward healing. You deserve to live a life free from the grip of OCD.

What is Stress? Understanding Its Impact on Your Mental and Physical Health

Introduction

Consider these scenarios: a young woman stepping into a new managerial role in her job, a college student balancing a full course load with a part-time job, and a working professional caring for an aging parent. While their situations differ, these people share a common thread – they are all experiencing stress. But what exactly is stress? How is acute stress different from chronic stress? What toll does it take on our mental and physical well-being? And crucially, how can we effectively manage it? In this post, we'll delve into these questions, exploring the nature of stress and its impact on our lives⁠.

What is Stress?

While we often think of stress as something negative, and spend so much time trying not to feel stressed, it’s important to appreciate that stress is a deeply hard-wired response in all of us that may actually be the reason why human beings are still around today. From an evolutionary psychology viewpoint, we can think of stress as a “threat-detection system” that developed in humans as a way to handle threats and stay safe. Back in the days of our hunter-gatherer ancestors, experiencing stress meant gearing up to either fight or escape a dangerous situation—like facing off with a wild animal or an enemy. This "fight-or-flight" response gave people a quick burst of energy and focus, which was crucial for making it through life-or-death situations.

Today, the threats we experience are much more often emotional than they are physical; instead of wild animals, we’re dealing with work deadlines, money problems, final exams, or relationship issues. But our bodies interpret these situations as threatening and still react the same way, increasing our heart rate, releasing adrenaline, and going on high alert. Even though these stressors don’t require physical action and aren’t life-threatening (like that wild animal our ancestors encountered) our body doesn’t know the difference and so it treats them the same way.

So now that we know where stress comes from, lets unpack the two main types of stress: acute stress and chronic stress. Acute stress is short-term, and is what you feel when you're facing a challenge right now. It usually goes away once the situation's over. Take a big exam for example. You might feel super stressed about it beforehand, but it's temporary and once the exam is over, your stress about it will go away too. In fact, you may find that some stress in these situations is beneficial! Low levels of stress has been shown to help make people sharper and more focused. Chronic stress, though, is long-term stress. It sticks around because of ongoing problems or pressures that just won't quit. Think of something like money troubles that never seem to end, or a job where you're always under the gun with tight deadlines. In these situations, there is no quick fix or big event that will end and take the stress with it. When dealing with these chronic stressors, we can find ourselves stuck in a fight-or-flight state.

Our bodies weren't built to stay in a state of stress long-term, so the same response that helped us survive in the past can actually wear us down over time. When we stay in a state of stress for a long time, it can have a major impact on our mental and physical health.

Mental Health Effects of Stress

Chronic stress isn’t just about feeling tense or overwhelmed for a little while; it can really take a toll on mental health over time. When you are in a state of chronic stress, your mind and body stay on high alert, which leads to a whole range of effects like constant anxiety, irritability, and even a sense of burnout. Over time, your brain actually gets used to being stressed, which makes it harder to relax and switch into “rest mode,” even when you have a chance to unwind. To stick with our example pf taking an exam, instead of feeling calm once the exam is over, you may notice that your mind starts looking for the next thing to worry about. Maybe you start worrying if you wrote down your answers correctly, or begin going over your answers again and again, or you may start thinking about an assignment in another class that’s coming up. This can mess with your sleep, drain your energy, and leave you feeling mentally exhausted.

On top of that, chronic stress can make it tough to manage emotions. Little annoyances start to feel like huge problems, and you might find yourself reacting more intensely than usual. For many people, this stress also leads to feeling disconnected from friends and family, or even to feeling hopeless. Left unchecked, chronic stress can also increase the risk of more serious mental health issues, like anxiety disorders and depression.

Physical Health Effects of Stress

Chronic stress doesn’t just mess with your mind—it takes a real toll on your body, too. When stress is always hanging around, your body stays in a state of high alert, which means markers like your heart rate, blood pressure, and cortisol levels are constantly up. Over time, this can lead to some serious health issues. For example, high blood pressure and a constantly racing heart can increase the risk of heart disease, while all that extra cortisol can mess with your immune system, making you more likely to get sick.

Long-term stress can also show up in ways that might seem unrelated at first, like headaches, stomach problems, or even muscle pain. That’s because stress triggers inflammation in the body, which can aggravate pain and digestive issues. On top of that, many people dealing with chronic stress have trouble sleeping, which only makes things worse. Without enough rest, the body doesn’t have a chance to recover, leading to even more physical exhaustion and health problems.

When to Seek Professional Help for Stress

When stress starts to become unmanageable, it usually shows up in ways that make everyday life more difficult. You might feel drained all the time, snap at people over small things, or find it hard to focus on tasks that used to be easy. Physical signs can pop up too, like headaches, muscle tension, pain, or stomach issues. Emotionally, it might feel like you’re on an emotional roller coaster, or you may notice yourself pulling away from friends and family.

Conclusion

Chronic stress can feel overwhelming, but recognizing its presence, and its impact, are the first steps toward taking back control. Small changes in how we handle daily pressures can make a big difference in both mental and physical health. Whether it’s setting aside time for relaxation, seeking support from friends or a therapist, or building healthier routines, managing stress is about finding what works best for you.

If your stress is feeling unmanageable, our experienced therapists at Gofman Therapy and Consulting are ready to help. With our expertise in treating both the mental and physical impacts of chronic stress, we will help you find balance and build the tools you need to feel like yourself again. Reach out today and take that first step toward a healthier, more resilient you.

Tug of War with Monsters - Understanding the Inevitability of Being Anxious

Introduction

Have you ever felt that knot in your stomach or that racing heartbeat when faced with a challenging situation? Well, you're not alone! While you may believe that most people don't feel anxious (or at least not in the way that you do), and that Anxiety is something that you uniquely experience, Anxiety is actually a universal experience that touches each and every one of us at some point in our lives. In this blog post, we will explore why it's perfectly normal to feel anxious from time to time, and talk about some strategies that you can use to manage anxiety when it comes up.

Defining Anxiety: It's More Than Just Jitters

Anxiety is often used as an umbrella term to describe a wide range of experiences, from mild worries to intense fear. It's crucial to understand that anxiety is a normal and adaptive response to perceived threats or stressors. In other words, it's your brain's way of alerting you to potential dangers and preparing you to take action.

Imagine you're walking alone in a dark alley, and suddenly, you hear footsteps behind you. Your heart starts pounding, and your body tenses up. This is anxiety at work, activating your fight-or-flight response to help you stay safe. In this scenario, anxiety serves a valuable purpose by heightening your awareness and increasing your chances of survival.

Monsters in the Mind: Unmasking the Causes of Anxiety

Now, let's talk about the monsters that lurk in the shadows of our minds and trigger our anxiety. These monsters can take various forms, such as:

1. Uncertainty: The fear of the unknown can be a powerful anxiety generator. When we're unsure about the outcome of a situation or can't predict what might happen next, our minds tend to conjure up worst-case scenarios, which in turn triggers anxiety.

2. Past Trauma: Past traumatic experiences can leave a lasting impact on our mental well-being. When reminded of similar situations, our brains may react with anxiety as a defense mechanism, aiming to protect us from potential harm.

3. Social Pressure: Human beings are inherently social creatures, and the fear of judgment or rejection can be a significant source of anxiety. We may worry about what others think of us, strive for perfection, or fear embarrassing ourselves in social situations.

4. Overthinking: Have you ever found yourself caught in a never-ending loop of worrying thoughts? Overthinking can trap us in a cycle of anxiety, as our minds get caught up in analyzing every possible outcome, often blowing things out of proportion.

The Tug of War: The Battle Between Anxiety and Rational Thinking

Anxiety can sometimes feel like a tug of war between our emotions and our rational thinking. It's like having two opposing forces pulling at us from different directions. On one side, anxiety pushes us towards worry, fear, and avoidance. On the other side, our rational mind tries to provide reassurance and perspective.

The key to managing anxiety lies in finding a healthy balance between these two forces. Here are some strategies to help you keep anxiety in check:

1. Recognize and Accept: The first step in dealing with anxiety is acknowledging and accepting that it's a normal part of being human. Instead of fighting or suppressing it, try to understand what triggers your anxiety and how it manifests in your body and mind. If you experience a surge of anxiety, research suggests that simply acknowledging to yourself that "this is anxiety", can actually help turn off your fight-flight response, and decrease the intensity of the anxiety you're experiencing.

2. Stop the cycle: Most of the time we aren't "just" anxious. You may experience a surge of anxiety, but then you quickly begin to worry *about* the fact that you are feeling anxious. Now you're anxious about being anxious! Stopping this cycle is a key step to managing anxiety. To do so, notice the sensations in your body that come up when you feel anxious, and allow them to just be there. Remind yourself that anxiety is normal, and let go of any ideas about trying to interpret the anxiety, or to predict the future about what your experiencing anxiety will mean.

3. Challenge Anxious Thoughts: When anxiety takes hold, it's common for irrational thoughts to flood our minds. Take a step back and question the validity of these thoughts. Ask yourself if there is any concrete evidence supporting them or if they are simply products of your imagination.

4. Practice Self-Care: Engaging in activities that promote physical and mental well-being can significantly reduce anxiety levels. Exercise regularly, get enough sleep, eat a balanced diet, and engage in hobbies

Are you struggling with Anxiety in your life? We can help. Set up a free phone consultation today with one of our expert therapists

Learning to Say No: Strategies for Setting Healthy Boundaries in Relationships

Photo credit @wildlittlethingsphoto

Introduction:

Setting boundaries in relationships is essential for maintaining mental and emotional well-being. In this post, we'll explore strategies for learning to say no and setting healthy boundaries in relationships.

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5 strategies for setting healthy boundaries in your life:

1. Understand your priorities

Before you can effectively set boundaries, you need to understand your own priorities and values. Make a list of your top priorities and use it as a reference point when making decisions about how to spend your time and energy.

2. Practice saying no

Saying no can be challenging, especially if you're used to saying yes to everything. Practice saying no in low-stakes situations to build your confidence.

3. Be clear and concise

When setting boundaries, it's important to be clear and direct. Avoid making excuses or justifications, and stick to your boundaries even if the other person doesn't like it.

4. Practice self-compassion

Remember that setting boundaries is an act of self-care and self-respect, and it's okay to prioritize your own needs. Practice self-compassion by being kind and understanding to yourself, even if it feels uncomfortable at first.

5. Communicate clearly and respectfully

When setting boundaries, it's important to communicate clearly and respectfully with the other person. Use "I" statements to express your own needs and feelings, and avoid blaming or attacking the other person.

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Conclusion:

Learning to say no and setting healthy boundaries takes practice, but it's an important step towards maintaining mental and emotional well-being. By prioritizing your own needs and being clear and respectful in your communication, you can build stronger and healthier relationships with others.

Are you struggling with boundaries in your life? We can help. Set up a free phone consultation today with one of our expert therapists

5 Easy Ways to be More Present in Your Life

The world we live is not designed to help us to be present. Whether it’s notifications from your email, text messages, or social media, the TV in the other room, or just the never-ending list of things to do, it can feel like the whole world is built to keep us out of the present moment as much as possible. While there are definitely no shortage of distractions in our daily lives, there is still so much that we can do to increase the amount of time we are in the present moment, and to ultimately live a fuller life.

One simple change that you can make is to infuse small moments of mindfulness into your daily life. Mindfulness is the ability to maintain awareness of what is happening in the present moment without judgment. I’ve written about some of the benefits associated with Mindfulness in a previous post, but the idea is that the present moment is the only place where life actually happens. Those times where we are lost in thought, ruminating about the past, worrying about the future, or getting habitually hooked by an app or notification, are times where our lives are passing us by. Finding moments in your life to intentionally cultivate mindful awareness can be an empowering way to, as I like to say, “live life on your terms”. Finding small pockets in your day to bring a present-focused attention to can be a great way to experiment with mindfulness if you don’t have much experience with the practice, or if the idea of “meditation” feels intimidating. Even I f you are a consistent mindfulness practitioner, it can be easy to lose touch with the power of taking moments in your day to pause, and to be with what you are doing outside of a formal practice time.

It can be striking to think about how often we all go about our days wishing we were doing something other than what we are doing in the moment, or that a situation were different than it is. This dissatisfaction can often be driven by the belief that whatever it is that we wish were different would allow us to be fully engaged and present; that if only we weren’t stuck in traffic, then we would be happy. But happiness is often much closer than we think, and the ability to be present with whatever is here now is something that we can do at any time that can have a profound impact on our well-being in the present moment. By consciously bringing moments of mindfulness into our days, we are better able to find peace and satisfaction in our lives as they are, even in the myriad of repetitive, mundane tasks that often fill our days.

Here are just a few of the ways that you can infuse some spontaneous moments of mindfulness into your daily life.

Wash the dishes

Washing the dishes is one of those tasks that you can’t out-run. Believe me, I’ve tried. Sooner or later the dishes need to be washed, and in many homes it falls into the category of “things that need to be done but that no one wants to do”. Because of this, washing the dishes can be a common place where we do everything in our power not to be present. Whether it’s putting on a podcast, a TV show, music, or calling a friend, it’s common to find ourselves looking for a distraction; something interesting to take our mind off of the task so that it gets done “faster”.

But what would it be like to, as Vietnamese meditation master Tich Nhat Hanh says, “wash the dishes to wash the dishes”? Maybe feeling the sense of groundedness of our feet on the floor, the warmth of the water, or the slipperiness of the soap on our hands, noticing the smell of the soap, and seeing the shine of the freshly cleaned dish. Noticing the droplets of water falling into the sink and the sensation of moving your hands and arms as the dish is dried.

Take a shower

The shower is another great space to bring present-moment awareness. How many times have you gotten out of the shower and not been sure if you used your shampoo or your body wash? It’s happened to me more times than I care to admit. The shower can so often turn into a satellite office for our internal personal assistant. Planning your day, rehearsing an important conversation you plan to have, trying not to forget what you need to do once you are done showering, and on and on it can go until the water gets cold and you wonder how long you’ve been in there.

Instead, the shower can be a wonderful place to contact the present moment; feeling the water rush through your hair, the warmth of the steam, bringing intentionality to each movement as you go through your shower routine. Rather than a place to keep our “planning mind” revved up, it can be a place to take a time out from all of the “doing” in your life, and to just be.

Red light time out

Another great place to bring some present-moment awareness is the car. While I don’t recommend practicing mindfulness when the car is in motion (better to keep your attention on your surroundings than on the sensations of your hands on the steering wheel!), being stopped at a red light can be a perfect opportunity to check in. Driving is another classic example where the “doing” mind is often in high gear. The very fact that we’re driving means that we’re going somewhere, and co-existing with other drivers on the road can create lots of moments where our systems get stressed. But at a red light, there is nothing to “do”.

The next time you find yourself at a red light, maybe explore running your hands against the steering wheel and really tuning into the sensations. Or check in with common points of tension in the body like the back, shoulders, and forehead, and invite those areas to relax. Maybe feel your feet, the contact with the brake, or the floor of the car. It won’t be long before the light turns green again, and maybe you’ll find yourself looking forward to the next red light when it does.

Just one bite

When was the last time you actually “just” ate a meal? I don’t mean when the last time was that you ate something, but when was the last time you really tasted even a single bite of what you were eating? The act of eating food is literally life-giving; it is the putting of energy into your body and providing your body with the nutrients that it needs to survive. Eating is also a vibrant sensory experience: full of tastes, smells, bodily sensations, thoughts, and emotions. And yet eating is so often squeezed into the margins of our lives. Whether it’s grabbing a bite of something while still standing in front of the open refrigerator doors, picking something up in a drive thru, or eating while driving or working, people often realize how infrequently they are present while eating food when they begin to pay attention.

Mindful eating often involves making changes to the “default” way in which we eat. No TV on in the background, or podcast to listen to, no working, driving, or “doing” anything other than tuning in to the sensations of picking up a utensil, moving the arm to collect a bite, bringing the bite to your mouth, noticing any smells as you bring the food into your mouth, chewing slowly and noticing the flavors, the textures, the urge to begin to collect the next bite before this bite is finished, the urge to swallow, and finally the swallowing itself, being aware of any residual flavors or sensations left in the mouth once the bite is gone. And this is just the first bite! Bringing mindful awareness to even just one bite of food can be a great way to infuse a drop of presence into your day, reminding you how much is there to be experienced if you pay attention.

Going for a walk outdoors

If you are like me, your days are not exactly set up to help you breathe in fresh air. In fact, if I didn’t have two dogs that I took for walks in the mornings and evenings, there are definitely days where the extent of my time outdoors each day could very easily be the time I spend walking to and from my car as I travel to and from the office. While so much of our time is spent sitting indoors out of necessity, it can also be making you feel more disconnected from the present moment than you realize. While natural light coming in through the windows can help orient you, how aware are you really of what’s going on around you when you are staring at a computer screen working, or watching TV, or cooking dinner? Probably not very. Taking even a few moments to get outside is a great way to bring yourself back to the present moment, and to find some presence in what John Kabat-Zinn calls “The Full Catastrophe” of our lives.

It doesn’t have to be a long time, even a walk back and forth on your porch can be rejuvenating in this way. As you step outside, take a deep breath and notice the differences in the air from where you just were. Do you feel your feet on the ground? What sensations do you feel on your skin? Do you hear any birds? Or traffic? A plane? A conversation in the distance? What phase is the moon in? What color is the sky? Can you see any stars? Notice how just asking these questions can transport you back to this moment right here, where you’ve been this whole time.

Concluding thoughts

Staying in the present moment takes intentional and consistent effort. But while it may sound simple, it is certainly not easy. Even with intention and consistency, we will invariably find ourselves on the rollercoaster of our habits and reactions to the world around us; lost in thought, swept away by emotions, swinging between the past and the future. But the more we are able to take moments to step back from the buy-ness of our lives, the more we are able to, as the Poet Natalie Goldberg says, “unroot the urgency”, the more fully we are able to live. In fact, you may even find that you are better able to handle what comes at you as you cultivate greater present-moment awareness.

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Looking for someone to talk to? We can help. Set up a free phone consultation today with one of our expert therapists

How to Find the Right Therapist For You

Deciding that you want to see a therapist can be difficult. Everyone has their own reasons that ultimately convince them that they need help, but whatever those reasons are, it’s not a decision that is typically made lightly. Once you make that decision, it would be ideal if there was an easy, streamlined way to find someone who can help you. Unfortunately, once you muster the courage to talk to someone, you may realize that finding someone to talk to might just be more overwhelming than what you want to talk to them about.

Going in you just wanted to find someone who “looked nice”, but Google searches only led you to a cascade of Psychology Today profiles and self-help articles that all just seem kind of the same. Why is this process so hard? How can you make sense of the information overload and find someone who can actually help you?

If this sounds familiar, you’re not alone. Fortunately, there are a few things that you can keep in mind that will hopefully make the process of identifying the right therapist for you a little bit easier.

1. know what you are looking for

   When beginning the process of looking for a therapist, it can help to clarify for yourself what you are looking for. You might not know exactly, but any ways that you can narrow your search early on will be helpful to you. To start, you can think broadly about the types of conversations and issues that you are wanting to address, and try to imagine the type of person who you would be comfortable speaking to about these things. Are they male or female? Closer in age to you or farther? Is it important for you to find someone who specializes in a specific presenting concern, or are your needs more general? Are you willing to see someone via telehealth, or is it crucial for you to be able to see them in person? Answering these questions, as well as any others that you may think of, can be a helpful starting point in your search.

2. Ask around

   Once you’ve got a sense in your mind of the type of therapist you’d like to see, consider reaching out to friends, family, or your primary care doctor for any recommendations. If you have a friend who saw a therapist — or has a friend who saw a therapist — that had a great experience, getting the name of that person can be a good place to start. If you don’t feel comfortable letting others know that you are looking for a therapist at this time, you can always feel free to skip this suggestion.

3. Speak to multiple therapists

   When looking for a therapist, particularly if you haven’t been in therapy before, it’s really important to talk to multiple potential providers before selecting one. Most therapists offer a free phone consultation where you can have a chance to talk with them a little bit about what’s going on, and get a sense of how they typically approach their work with clients who have similar goals. I know that when looking for a therapist there can be a strong desire to just find someone as quickly as possible, but giving yourself a few options to choose from — rather than just going with whoever answers the phone when you happen to call — can give you a chance to step back and more objectively evaluate your options, boosting the odds that you’ll make the choice that’s right for you.

4. Lean on your support system

   Talking to multiple therapists, especially when you are experiencing more acute symptoms of distress, can often feel like more than you can handle. In these cases, sometimes a relative or a close friend can step in and help. I’ve had a number of conversations with friends of prospective clients who wanted to learn more about my practice to relay the information to their friend who was struggling. I’ve left each of these conversations with a greater sense of confidence that, should they choose to engage in therapy, the individual looking for help stood a better chance of finding the right fit for them.

5. Select for authenticity

   In research examining the factors that ultimately influence change in the therapeutic context, the therapeutic relationship was found to be responsible for 30% of change, second only to the characteristics of the client such as their personality (40%). That’s a big deal! It has actually been found that the specific therapeutic approach only accounts for 15% of change. While this is still significant, it really drives home the importance of being able to form a strong relationship with your therapist, one where you feel comfortable being open, honest, and vulnerable with them. Once you’ve talked to a couple of different therapists and clarified what you are looking for, you can then use that information, along with your own sense of comfort in those conversations, to help inform your choice.

6. Don't give up if it doesn't work out

   Being willing to even see a therapist in the first place can often feel like a leap of faith. It takes courage, and because of that it can feel like there’s a lot riding on whether or not it will work. I strongly encourage anyone who has had a bad experience in therapy NOT to write off therapy altogether. Given the statistic above, finding someone who is the right fit for you has a big impact on the chances of your experience being positive.

   Rather than writing off therapy completely, try to use the experience as a learning opportunity. When I meet with clients who have previously had negative experiences in therapy, it’s always really important to me to hear from them what it was that they didn’t like about the past experience. I have found that through these conversations early on, I find that both of us are in a better position to have a different, more constructive relationship.
   

Finding a therapist should be easier than it is, but I hope that these suggestions are helpful to you in your search. By being clear on what you’re looking for, asking friends and family for recommendations, leaning on your support system when needed, selecting for authenticity, and being willing to try again if it doesn’t work out, I hope you’ll find yourself in a much better position to find the therapist that’s right for you.

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Looking for someone to talk to? We can help. Set up a free phone consultation today with one of our expert therapists

The story of the two monks and the woman

A short story:

Two monks are walking along a path as they approach the bank of a swiftly moving river. As they get closer, they see a woman on the riverbank who appears distressed. The woman explains that she is unable to cross the river on her own due to the strength of the current, and asks for their help. This appears to put the two monks in a difficult position as their monastic oath prohibits them from touching women, but without missing a beat the older monk scoops the woman up in his arms, carries her across the river, gently places her down on the other side, and continues down the path. The younger monk, trying his best to hide his shock, quickly scampers across the river and walks alongside the older monk in silence for several minutes before communicating his distress. “Why did you pick her up?” he asks, “You know it is against our beliefs to touch women!” The older monk looks at the younger monk and responds calmly, “I put her down on the other side of the river, why are you still carrying her?”

We are all the younger monk in this story, or at least we all have the potential to be him. I return to this story often because it so clearly illustrates the human tendency to hold on to something mentally and emotionally longer than we need to. It shines a spotlight on the truth that when we are caught in our minds in this way, we are holding the keys to our own unhappiness. It serves as a reminder that if we are able to let go of what is no longer useful, we can become happier and more free.

Sometimes when we are feeling stuck or unhappy, we can see that there is something that we are holding on to that is keeping us in that state. Maybe we are still upset, as the younger monk was, about something that happened in the past. Maybe we have very strong ideas about how something “should” be, or strong beliefs about how someone we care about should be acting. “What am I carrying that I should have (or could have) put down a long time ago?” is an invaluable question that we can ask ourselves. By asking this question, we are able to see our unnecessary baggage more clearly, and we have the opportunity to let go of whatever we are carrying, or at least to loosen our grip.

Managing Anxiety in a Pandemic

COVID-19 is here, and our lives as we’ve known them have been changed indefinitely. This is an unprecedented set of circumstances that triggers all of our fight/flight responses, and challenges our abilities to meet the moment skillfully. In these uncertain times, it can be so easy to be swept away by the fear and anxiety that so naturally come up when we feel that our lives and the lives of our loved ones may be threatened. Because of this, I wanted to offer a brief reminder of a few skills and principles that can help us all stay a little bit more calm and balanced as we navigate this situation together.

Be Mindful

Whatever COVID-19’s presence in our communities is bringing up in you, try to just notice the emotions that are arising. It could be fear, doubt, or worry, anger, helplessness, or something else entirely. Whatever it is, can you take a moment to just acknowledge that these emotions are there with you right now?

Next, reflect briefly on your recent behaviors, and try to identify if there are any unhealthy behaviors you are engaging in to comfort yourself through this experience. Maybe you are eating junk food, watching too much TV, playing video games excessively, or consuming drugs or alcohol. Are you finding yourself more irritable or disengaging more from your loved ones? By being aware of the emotions that the pandemic is bringing up in us, we can also acknowledge and show compassion for ourselves. We can appreciate the real challenge of acting in the ways that we want to, while also re-committing to supporting ourselves in more wholesome ways.

Focus on what you can control

It can be really tempting to stay glued to the news and social media to try to stay up to date on everything that is happening around the world. Not only does this likely contribute to our sense of worry and helplessness, but it also pulls our attention away from what we can control. Social media in particular can make us susceptible to misinformation, and can cause us to copy the panicked decision-making of others.

Instead, try to stick to good information on the virus from reputable sources, and educate yourself on how the virus spreads. Read the CDC recommendations on what you can do to stay safe, what you should do to be prepared, and what you should do if you think you might be sick. Make sure you are following those instructions closely and provide loved ones with the same information.

Notice Cognitive Distortions

Cognitive distortions pop up in our minds all the time, but they are particularly persuasive in these moments because they feed on emotions like anxiety and worry. Here is a list of cognitive distortions to be on the lookout for. Go through the list and try to identify which distortions seem to be popping up most frequently for you right now. Once you’ve identified them, take a moment to think of evidence against each distorted thought, and remind yourself why it isn’t true.

While there is nothing that we can do to make COVID-19 go away, that does not mean that we need to be at its mercy mentally and emotionally while it is here. I hope that you find these suggestions helpful, and that you are able to regain a little bit of control and balance in your life through these turbulent times.

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Why Mindfulness?

As much as we’d like to believe otherwise, we can’t control our thoughts and emotions.

Despite this fact, we often identify with the emotions or thoughts that we experience, labeling them as “ours” and letting them define us and drive our behaviors. As I’m writing this for example, the thought pops into my head to take a sip of the tea next to me. Sure enough, my right hand lifts off the keyboard, reaches out, clasps the mug’s handle, and brings the mug to my lips. This simple action (or series of actions) was a direct response to some variation of the thought “I would like some tea right now”. While the thought to drink tea is innocent enough and there seems to be little-to-no harm in acting on it, we often experience thoughts and emotions that, when repeatedly acted upon, do have the potential to cause harm, or at the very least to move us away from the fulfillment and happiness we ultimately wish for ourselves.

Developing an awareness of the patterns of our minds and how these patterns influence our behaviors is the job of mindfulness, a term that has become increasingly popular in recent years. The benefits of practicing mindfulness —reduced rumination, lower stress, increased working memory, improved focus, increased satisfaction in relationships, and cognitive flexibility to name a few — are well documented, and seem to position mindfulness as a tool with the potential to impact almost every area of our lives. Mindfulness, defined by Dr. John Kabat-Zinn as “The awareness that arises from paying attention, on purpose, in the present moment and non-judgmentally”, could not be simpler on the surface. Hidden in this simplicity however, is the depth we are exposed to when we move from describing what it means to be mindful into the arena of practicing. What we find when we stop to observe what is going on in our minds is often uncomfortable and eye-opening.

As a first-year graduate student I became curious to explore for myself what mindfulness meditation was really about. When I first began I had a lot of lofty ideas about “finding myself”, “transcendence”, and images in my mind of young, athletic yogis sitting on the edge of a canyon cross-legged, the setting sun’s golden rays washing their smiling faces. After a few months of following a daily guided meditation in my basement apartment, I enrolled in my first silent meditation retreat; a three-day weekend at a small retreat center in Loveland, Colorado.

When thinking back on the first day of this retreat, I am reminded of a study published in 2014 where participants were asked to sit in a room with their own thoughts for 15 minutes. The participants were told that pushing a button on the table in front of them would administer an electric shock, and despite all the participants previously stating that they would be willing to pay money to avoid experiencing an electric shock, 67% of men and 25% of women in the study chose to self-administer electric shocks in that 15-minute period. The article published in Science Magazine, provocatively titled “People would rather be electrically shocked than left alone with their thoughts”, was a sentiment I was deeply sympathetic to on the first day of the retreat. Although I can’t be certain, I am fairly confident that if I had an electric buzzer with me that day I would have pushed it at some point. I quickly saw just how much was going on in my mind, and began to grapple with what it meant to have so little control over these thoughts and emotions. I also realized how much of my life I had been spending “in my head”, and began to wonder what it would be like to be in my head less, and in the world more. The importance of developing a way to help me be less reactive to what I was experiencing in a given moment, and to understand myself as being more dynamic than just a combination of thoughts and emotions, quickly became apparent as well.

It is important to recognize mindfulness not as an exercise in relaxation, but as an exercise in developing awareness. Too often our minds are lost in thoughts about the past or planning the future, and mindfulness is the conscious act of bringing ourselves back to the present moment; to reconnect and become aware of what is happening right now. Because the act of living our lives only happens in the present moment, it makes sense that we can increase our sense of autonomy and well-being by increasing the number of moments in our lives where we are able to be fully present.

As our awareness of our present moment experience improves, a number of options present themselves regarding what to “do” with the information. There are a wide number of therapeutic approaches that are explicitly centered around mindfulness, and a number of others where the client undoubtedly benefits from this increased awareness as well. While I do not offer mindfulness as the silver bullet it may sometimes be described as in the media, and I never require that my clients practice mindfulness, the potential benefits of integrating mindfulness into every day life are significant enough that most of my clients are willing to give it a try. Making your mind your friend is the journey of a lifetime, and is something we can all aspire to.

"Entering the Forest" - The beginnings of self-work

Everyone arrives at the beginnings of self-work in different ways. Some may embark by choice, while others may feel like it is not their choice at all. Sometimes our lives may appear great to an outside observer, but there is a sense internally that things could be better. Other times, there may be externally visible events that send us looking for answers, that make it clear that things are untenable as they are.

Borrowing the language of famous mythologist Joseph Campbell, I like to describe the beginning of this process as “entering the forest” of self-work. As Campbell describes it, “we enter the forest at the darkest point, where there is no path”. Embarking on a path of self-work requires you to make your own path. Any paths that are already there, he reminds us, are the paths others have created, and are therefore not ours.

To be clear, entering the forest is scary. The forest is full of unknowns, and we don’t have any idea whether we will even be the person we want to be when we come out. It is so tempting to follow the clean, well-marked paths others have already created, and while leaning on others is helpful at times, the real work in self-discovery and understanding must come from within. It is also possible that our tendency to follow the paths of others only leads us back out of the forest empty handed.

I often see the beginning of a therapeutic process as standing on the edge of a dark forest, far away from civilization. It is gloomy, scary, with thick brush and strange noises echoing out of it, but that doesn’t stop you from taking your first step in anyway. Because the thing you need most in your life is in that forest, and you are going to find it.

Campbell’s full poem is below.

You enter the forest

at the darkest point,

where there is no path.

When there is a way or path,

it is someone else’s path.

You are not on your own path.

If you follow someone else’s way

you are not going to realize

your potential.

- Joseph Campbell