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What should I tell my new counsellor?
October 24, 2011 7:55 PM   Subscribe

I'm considering therapy for the first time. How to clearly express what I want to work through there, and what to expect? Snowflake details inside.

I'm a grad student in Canada, with access to free therapy on campus. I've been thinking about therapy for some time now, and the end of a relationship and the approach of winter have given me the push I need to just go already. Basically, I have two concerns, and I'd like to know whether I should be addressing both of them, or only one, and working through the other in different ways.

The first is dealing with, possibly, SAD. I'm from Western Europe, but I've lived in Canada for six years and in this city for nearly four. I find the winters here terribly long (the weather is dark and wintry well into May), and dealing with it seems to get a little harder every year. This year I've decided to be proactive in fighting it. Starting in September I've taken up jogging, am eating better, have committed to going out with friends at least twice a week, am taking vitamin D and am trying to find a cheap lightbox should I need it. Would therapy be helpful and appropriate in allowing me to discuss strategies to overcome negative thoughts and lack of hope during the winter?

The second is dealing with anxiety. I've dealt some degree of anxiety and obsessive worrying about one thing or another for most of my life. It's never stopped me from functioning, and I've actually become much better and more mellow since coming to Canada, and in particular over the last year or two.

However: I suspect that I've inherited it from my dad, who worries constantly about the most trivial things, and in particular anything to do with me (e.g. even now that I am 27, he will ring me up in the middle of the night, his time, because he starts to worry that a throwaway comment of mine means that I am ill/I am having problems with a friend/Something Is Wrong and becomes unable to sleep). He has always had a bit of an anxious temperament, but focused strongly on me as the target of his anxieties when I was born (I am an only child). We are very close, and I love him, but has been hard for me to draw and enforce boundaries about privacy with him because he becomes miserable when he can't assuage his worries. Therapy is out of the question for him: to a person of his age and culture, it simply isn't done.

I'd like to have kids someday, but even though I'm dealing well with my own anxieties, I'm a bit afraid that I'd going to turn out like him and become a big ball of crazy worry were I to become a mother. This has sort of been at the back of my mind for a while, but dating (and breaking up with) a guy with his own anxiety disorder made me feel that I should talk to someone about it now while I can still get the free campus counselling, and before I get into my next relationship. Basically I'd like to get advice on how to get a good reality check, and how to avoid lurching into paranoia in situations (like raising children) where erring on the side of caution is usually a good thing.

Would my uni's counselling centre be useful for dealing with both things? Am I making a mountain out of a molehill for either one? I've found out that counselling starts off with a half-hour triage-type session to determine what kind of counselling will be needed; what should I say? And what should I expect?
posted by anonymous to Health & Fitness (6 answers total) 2 users marked this as a favorite
 
Take your free therapy.

Say what you just said here. Let the therapist decide what you need to pursue. Don't withhold things from them because you don't want to "work on it" -- you're a person, not a collection of unrelated symptoms.

From my experience, therapists just listen to you talk and ask you follow-up questions, but that varies tremendously depending on the therapist.
posted by modernserf at 8:02 PM on October 24, 2011 [2 favorites]


"I've been thinking about therapy for some time now, and the end of a relationship and the approach of winter have given me the push I need to just go already. "

Good on you! The first step to getting counseling is hard to do, and all too many times people can put it off until they are referred there by school officials who have seen problems in a student's performance. Being proactive and going now is a great step. Maybe you are worried that you waited too long, or are worried because you are jumping the gun and maybe you don't actually need therapy, and that so many other people need it more. Put that out of your mind right now, and focus on getting what you need out of the time commitment you are putting towards counseling.

"Would my uni's counselling centre be useful for dealing with both things?"

Almost certainly. On campus counseling by definition specializes in the issues that are most likely affecting students on campus. While everyone's problems are unique, anxiety runs rampant in graduate school. Also, Seasonal Affective Disorder (I assume that's the SAD you refer too) is a top complaint. I'm at a more southern latitude than you, but I know my school's counselors are also very well versed in students from out of state who aren't used to the challenges of a great-lakes winter.

"Am I making a mountain out of a molehill for either one?
"

Only way to find out it to talk to someone. If something is affecting you, affecting your ability to have the life you want, affecting your ability to succeed in school, then by all means, the solution can be 'talk to someone.'

"I've found out that counselling starts off with a half-hour triage-type session to determine what kind of counselling will be needed; what should I say?"

What you've said here. Being in a graduate program means you're likely fairly bright and articulate, this can remove some of the obstacles that people starting therapy run into. Feel free to write down notes before you get to your appointment so you remember to say everything on your mind.

"And what should I expect?"

Every counselors/therapist/psychologists style is different. If you are talkative and articulate you may do most of the talking, and the counselor may just listen to see where you go. He or she may take notes, or she may not, or she may use a tape recorder (with your permission, of course). I am not sure if Canada is different in this regard, but in the states most university counselors are not able to prescribe medicinal therapy, so they may ask if you're interested in seeing a psychiatrist at the student health center.

They will also ask your expectations. Depending on the school, they might have a different process for the next step. Some schools may refer you to a student intern (a person training at the schools counseling/psychology graduate program) who will do the counseling under the supervision of a professor. The professor him or herself may do most of the counseling. But they will answer all your questions at the triage appointment.

And if your expectations aren't being met, talk about that too. Counselors are human, and they easily get into habits that may not be conducive to their patient's progress. If they talk to much and you need them to interrupt less, tell them. If personal anecdotes help you, tell you counselor this and they include more stories from their experience as a therapist. If you do not get a long with your counselor, tell them. Different styles work for different people.
posted by midmarch snowman at 8:27 PM on October 24, 2011 [2 favorites]


About your last questioning concerning motherhood... HA!

Worrying about the well-being of your child is a fucking terror I NEVER understood until I became a parent. I thought I was pretty well sorted out by the time we had our first. Turns out, not so much!

That said. Most people get through this particular terror (I can't even label it "fear" because it goes so much deeper than that.)

A. I redirect my thoughts every time I get obsessive images in my brain about future Danger! Danger! Honestly, I picture my son as a happy, healthy, and thriving Adult. But it is a conscious effort, a practice.

B. You will never stop worrying about your children. See point A, above.

----

Put the work in now and you will be a GREAT mom when the time comes. Be gentle with yourself when you find yourself worrying, because that worrying is inevitable.

My current and future plan is to not let it show.

YMMV.
posted by jbenben at 9:53 PM on October 24, 2011


"Basically, I have two concerns, and I'd like to know whether I should be addressing both of them, or only one, and working through the other in different ways."

Remember that you are in charge of your therapy. There are many different approaches to therapy, and many different types of therapists, and with the opportunity to try out therapy for free, it's a good way to determine how the process works for you.

Don't worry that you're not approaching your concerns in the way you "should" for therapy. You get to decide what it is you cover and you'll work with the therapist on how to cover it.
posted by xingcat at 4:10 AM on October 25, 2011


At college, your therapist may be close to your age (or younger). This is neither good nor bad, usually, but if it bothers you, request someone else.

1) SAD: "Would therapy be helpful and appropriate in allowing me to discuss strategies to overcome negative thoughts and lack of hope during the winter?" Yes. Almost certinaly. I think you are doing a good start on the countering SAD, but having someone else there to point out when the SAD might be slipping up on you will be helpful.

2) Dad + anxiety. Your dad, to my American, independent and not terribly close to my parents mind, is, in fact, a little too axious. It is not surprising that some of this might have rubbed off on you... and that his behavior can cause you difficulties. Definitely something I would want to work on.

Just be honest and open with your therapist. They are usually good at their jobs.
posted by Jacen at 8:53 AM on October 25, 2011


I'm about your age and recently started therapy. I feel like I've had anxiety and minor depressive episodes all my life, but never completely debilitating or long term. I'm also pretty proactive and would try different strategies, self-help books, diet solutions and journaling to get myself out of bad moods or anxiety.

I have to say that I LOVE therapy. My parents would also never encourage or support it (for them it's a cultural taboo) but it's really empowering to feel like you can make a decision about it for yourself. It is REALLY helpful to have a professional put your emotions, anxieties and moods into a larger context of your developmental phase, your current life situation (which they'll learn from listening to you), and specific stimuli you're experiencing (Canada winters, etc). I feel like it makes me much better at articulating my own patterns and letting them go or doing something proactive about them.

As far as looking for a therapist, I knew that I wanted a woman (I would find a female therapist more comforting) and a counselor (not a psychologist - I'm not interested in medication or "analysis"). Be honest about the kind of service you're looking for. Therapists often refer to people as who see them as "clients" as opposed to "patients." Even though that's a little weird at first, it's also positive to think of it as a service that should meet your needs. If you're someone who's generally inclined towards self improvement (it seems like you are based on your strategies for overcoming SAD and hopes of becoming a good parent), think of your therapist as a personal trainer/coach who can push you to be better than you can be by yourself. It's so nice to make an appointment to work on yourself every 1-2 weeks.
posted by larva at 10:08 AM on October 25, 2011


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