The process of starting therapy can be daunting, and a major part of the stress is selecting a good therapist. It can be difficult to know with whom you will have a positive experience. The tips below are intended to help guide your search.

Tips:

1.) Take the time to research. Looking into potential therapists will give you a sense of who it is you’ll be working with. Check out the provider’s website, Psychology Today profile, other online directories, and/or call their office and ask questions directly.

2.) Request a consultation. Most therapists offer a free meeting where potential clients can talk to the provider directly and see if the therapist will be a good fit for them. Consultations are about 30 minutes and can be done over the phone or in the therapist’s office.

3.) Learn about the therapist’s specialty. Therapists are like doctors in the sense doctors are very specialized. If you have a heart problem, you see a cardiologist. If you have cancer, you see an oncologist. If you have a stomach problem, you see a gastroenterologist. Therapists specialize in certain diagnoses, populations, or therapy modalities. Find someone that specializes in the issue you want to address. If you have been through something traumatic, find a trauma therapist. If you struggle with addiction, find a substance abuse specialist. If you have panic attacks, find an anxiety therapist. If you are looking for therapy for an tween or teen, find a therapist that specializes in adolescence.

4.) Learn about the therapist’s theoretical orientation. Therapy can be done a multitude of different ways. It’s important that your therapist is working from a theoretical framework to bring consistency and efficacy to therapy. It may give you even more peace of mind if the orientation is “evidence-based” meaning significant research has been completed that suggests the orientation is effective. Learn how the orientation will play out in sessions-What does it look like? What can you expect? What’s the purpose of the orientation? How does it produce change?

5.) Consider gender, age, years in practice, etc. These items can help ensure comfortability with your therapist. If you are generally uncomfortable being open and vulnerable with men, then a female therapist will likely suit you better. If you are young and have a hard time relating to older adults, you may want to look for someone who is younger.

6.) Notice professionalism. If you call or email a therapist to learn more about them, do they respond to you in a reasonable amount of time? Do they respond at all? If not, these can be signs the provider is unorganized, unprofessional, or doesn’t have good office systems in place which can translate to a poor experience in therapy for you.

7.) Don’t prioritize convenience over quality. Insurance and location are two conveniences that potential clients can over-emphasize. If you find the perfect therapist, but he/she doesn’t take your insurance, it is very likely worth paying out of pocket for services and checking into your out of network benefits to see if you can get reimbursed. If you find the perfect therapist, but they are not located close to you, the commute is worth it. Plus, you’ll get some extra time in the car on the drive home to reflect further about your session.

8.) How did you feel when you interacted with your potential therapist? This evaluation requires a bit of intuition. Were you comfortable? Did you feel like this person could help you? Were you concerned about their professionalism? If you left the interaction with all your questions answered and feeling good about the therapist, that’s a good sign you will work well together.

9.) Don’t settle. If you had high hopes for a potential therapist, but they left you feeling like something was missing, don’t ignore that concern. Keep the search going. Even if you start with a therapist, and you’re a couple sessions in, if you don’t like the dynamic, you are able to end therapy at any time and look for another provider.

If you have questions about finding a therapist and/or what to look for, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

“Just breathe.” We hear this expression a lot, especially when we’re worked up. But why do we encourage breathing to calm down? Turns out there is a physiological process that happens when we focus on our breath that can truly calm our emotions and bodies.

A Crash Course in Anatomy/Physiology

Your autonomic nervous system is comprised of two components: the parasympathetic nervous system and the sympathetic nervous system. Each is responsible for a different function. The parasympathetic nervous system is responsible for feelings of calm and relaxation while the sympathetic nervous system is responsible for agitation and arousal. This is where the fight or flight response lives. Both branches of the autonomic nervous system can’t be activated at the same time. It’s one or the other that is operating at any given moment. Breathing is a means to activate the parasympathetic nervous system and induce relaxation.

How to Breathe Mindfully

We breathe all day every day, and it’s such an automated process, we hardly notice it. This type of breathing isn’t going to make us feel calmer. When we breath to relax, it’s an active process that requires attention and focus on our breath. This type of breathing is called mindful breathing. Our minds like to wander and sometime race with thoughts. In mindful breathing, our mind is attentive to each individual breath and attune to every sensation involved. We notice the air entering our nose, filling our lungs, expanding our rib cage, and exiting our bodies. When our mind wants to wander, we notice, and bring it back to focusing on the sensation of our breath.

Options for Mindful Breathing

Mindful breathing can be done in a variety of ways. Below are a few options you may want to experiment with:

• Some people engage in mindful breathing with counts. They count slowly 1-2-3-4 to inhale and slowly 1-2-3-4 to exhale. Other people like to breath in with a count of 1-2-3-4-5, hold the breath for a count of 1-2-3, and breath out for 1-2-3-4-5. The options for counts are limitless. Create a count pattern that feels good to you.
• Words/mantras paired with mindful breathing can increase relaxation as well. Some people like to breath in, say a peaceful word like “calm” or “relax,” breath out, and repeat the word.
• Picturing a peaceful scene can also be relaxing. Some people focus on an image in their mind of a tranquil scene as the engage in mindful breathing.
• There is also the most basic version of mindful breathing where we just observe. We don’t try to change or influence our breath. We just let it be and notice if it’s short or long, deep or shallow.

If you have questions about mindful breathing or want to engage in training, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

“Unprecedented,” “Scary,” “Overwhelming,” “Surreal,” “Uncertain,” and “Stressful.” These are the words used most commonly by my clients to describe the impact of Coronavirus. Everyone has been affected by Coronavirus in some way, and some people have been impacted more than others. The concerns Coronavirus has created are profound, and one of those concerns is the impact of this pandemic on people’s mental health.

The Risks

The new world we are living in comes with elements that can contribute to mental health issues:

• Stress-Stress is a precursor linked to several mental health problems including depression, anxiety, and PTSD.
• Unemployment-Work gives us structure, purpose, connectedness, and even enjoyment. With these benefits gone, people can feel like there is a major void in their lives.
• Financial Concerns-Especially if you’ve lost your job, there is concern about how to pay rent, bills, or unexpected expenses.
• Isolation-Social distancing is the new norm, but isolation or minimal connection with others feeds depression and anxiety.
• Loss-We feel disappointment and sadness from all sorts of cancellations including trips, school, weddings, graduations, family events, etc.
• Illness-When we don’t feel physically well, our mental health tends to decompensate as well.
• Damaged Relationships-If you’re quarantined with others, you may be getting on each other’s nerves which can lead to hurtful statements and conflict. For other relationships outside the house, decreases in contact may compromise the connection.
• Worry-Whether we’re concerned about ourselves, family members, our communities, or the world, worry is a form of stress that can take its toll.

Appropriate Concern vs. Anxiety

The current circumstances warrant concern. Concern is appropriate, whereas anxiety is unhelpful. Unfortunately, people have a tendency to amplify their concern and induce anxiety. As a Cognitive Behavioral therapist (see August 2019 for a quick introduction to CBT), I help clients examine what it is they are saying to themselves that is causing unnecessary anxiety. We work to change those thoughts to be more neutral or objective, and thus the restructured thoughts produce less anxiety or a different feeling altogether. Let’s look at an example:

Anxiety-Producing Thought: Coronavirus is an utter disaster. We will never get out of this. This is going to destroy our world. I can’t handle this!
Feelings: anxiety, panic, hopelessness, despair

Restructured Thought: This is a challenge, but we have faced adversity and been resilient in recovering from it. This will end at some point, and we can heal from the damaged that’s been caused by Coronavirus.
Feelings: hope, motivation, calm

As you can see in the example, the restructured thought acknowledges the challenges of Coronavirus, but imparts a message of getting through this tough time. On the other hand, the anxiety-producing thought, does nothing but fuel negative feelings and make us feel powerless in this situation.

Is Therapy Even an Option Right Now?

The short answer is yes. Some therapists are seeing clients in-person with precautions (extensive disinfecting, sitting more than 6 feet apart, and not trading items that could have germs on them). Attending a therapy session is considered a “Healthcare Operation” which falls under an “Essential Activity.” Essential activities are exempt from the Larimer County stay-at-home order. So, long story short, people can visit their therapist’s office if they’d like.

Other therapists are offering telehealth or teletherapy services. Telehealth is like Skype where you can interact with your therapist through your phone or computer. With this format, you can stay in the comfort and safety of your own home and still participate in counseling services.

People need support more than ever right now, and therapists are prepared to help you through this difficult time. At Evolve Counseling Services, we are offering both in-person sessions with precautions and telehealth.

If you are struggling with the stress of Coronavirus and want to work through it in counseling, we’d love to offer my support and help. Please give our office a call, and we can discuss further.

-Lindsey-

The main therapeutic approach we use at Evolve Counseling Services is Cognitive-Behavior Therapy (CBT). If you need a quick introduction to this modality, check out our blog from August 2019 titled “Cognitive Behavior Therapy.” In CBT, clients examine their problematic thoughts and work to restructure them to decrease the frequency and intensity of negative emotions. Cognitive distortions are patterns of thinking that are inaccurate, harsh, or negative. It’s important clients recognize these distortions in their thinking and work to dispute them. A brief list of common cognitive distortions is outlined below. Do you recognize any of these patterns in your thinking?

Common Cognitive Distortions

Selective Abstraction

You ignore the total context of situation by only focusing on the negatives and discounting the positives.

All or Nothing Thinking (Black or White Thinking)

You see things as absolutes; there are no in-betweens.

Mind Reading

You assume others are thinking the same thing you are (that they share the same critical thought you’re having), or you assume you know what others are thinking (that they hold a negative evaluation of you).

Double Standard

You hold yourself to a higher standard than everyone else.

Catastrophizing

You expect the worst case scenario to play out consistently.

Labeling

You make a global assessment of yourself and label yourself negatively.

Magical Thinking

You think everything will be better when ___________ (you’re thinner, smarter, richer, when you get a new job, and so on).

Should Statements

You judge yourself and criticize yourself for what you should be doing (usually an unrealistic expectation)

If you recognize these patterns of thinking in your thought process and want to work on them in counseling, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

In honor of Valentine’s day, I thought devoting a blog to relationships would be in order. It’s important to know what you need in a relationship to make it work, but it’s as equally important to know what to keep out of relationships to keep them healthy. This is essentially a blog about what not to do in relationships based on the work of John Gottman.

John Gottman is a leading researcher in the field of relationships and divorce. He has studied couples for decades and identified several behaviors that will kill a relationship. He calls these “The Four Horsemen of the Apocalypse.” The more often these appear in the relationship, the more likely it is the relationship will end.

1.) Criticism

Criticizing is attacking your partner at the core of their character. It’s a global assessment of them as a human being (i.e. “You’re selfish!”). It makes the recipient feel assaulted, defensive, rejected, and hurt. Criticism can become pervasive, and when that happens, it sets the stage for the other horsemen to appear.

2.) Contempt

Contempt will follow if there is frequent criticism in the relationship. This is the most damaging of all the horsemen. The purpose of contempt is to hurt, and it manifests itself with mean-spirited communication including disrespect, mocking, sarcasm, ridicule, name-calling, eye-rolling, and scoffing. The recipient will feel despised and worthless. Based on Gottman’s research, contempt is the single greatest predictor of divorce.

3.) Defensiveness

We all do this. It’s generally a reaction to criticism where we feel unjustly attacked. We make excuses, deny, or play the victim. This strategy is not usually successful and can escalate frustration in our partner. It sends the message we won’t take accountability for our mistakes and don’t take their concerns seriously.

3.) Stonewalling

Stonewalling happens when the listener disengages from the interaction, shuts down, or stops responding to their partner. This tends to appear as a response to contempt. Stonewalling indicates a person has hit their limit and reached a level of emotional and physiological escalation that they can’t continue in the interaction in a productive way.

If you are struggling with a relationship and want to work through it in counseling, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

Our therapist, Ben has extensive experience working with men from adolescence to later adulthood. He has developed a specialization in Men’s Issues that will be a focus of his clinical work at Evolve Counseling Services in addition to working with clients who are dealing with depression and anxiety. Below is a summary of how Ben approaches therapy with men:

1. We will talk like regular people: Men often speak in ways that are down to earth and to the point. No need for vague, flowery statements. I always thought of what I do as just a sincere conversation between everyday people, no different than friends catching up during a lunch break. Humor is often a part of my time with people. Not everything needs to be serious and learning to laugh at something is often good for us.

2. Keep it practical: Men often think in practical, cause and effect terms. When our car breaks down we don’t “feel” like the head gasket is blown, we understand the mechanical relationships between all of the parts and see what isn’t working. Problem solving for personal challenges are no different. It will be obvious how any tools used in therapy can make your situation better.

3. A hyper-focus on emotion is not essential: Two common stereotypes about therapy. 1.) Therapy works by being intensely in touch with your emotions. 2.) You have to talk about the hardest and most personal things in your life for therapy to work. Let’s address these. A high emotional focus may work for some people but there are so many more options to improve your life that don’t involve intense connection with feeling or dwelling on the past.

4. Talk about what you want to: Your time in therapy is just that, YOURS! I’m here to help you with the projects that you want to tackle. No need to talk about things that are too personal. I’m not here to “fix” you for someone else. I’m in your corner. Period.

5. An understanding of men’s issues: It is statistically supported that men do face unique challenges. For example, men more commonly receive threats of physical violence, work dangerous jobs, and spend more time away from family for work. Being a man has its benefits and burdens but the fact that men are facing such daunting challenges speaks volumes to our nature and implies we experience stress unique to us. Not only have I taken the time to understand what is unique to men, but I have lived much of it myself.

If you are interested in addressing Men’s Issues and working with Ben in therapy, we’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

This time of year can be tricky. It’s been labeled “The Most Wonderful Time of the Year,” but for a lot of people that doesn’t seem to be the case. Many of my clients note increased stress and depression this time of year. Here are a few things you can do to help keep joy in the season.

Lower Your Expectations

So many of us get caught up in throwing the perfect get together, or finding the perfect present, or cooking the perfect meal that we’re inadvertently putting intense pressure on ourselves. That pressure builds, and what’s supposed to bring happiness, ends up being an exercise in stress. Things don’t have to be perfect. It’s OK that they are decent or good enough. The pursuit of perfection will make you overlook the real purpose of what you’re intention is-nurturing relationships and enjoying your loved ones. Instead of focusing on perfection, focus on the connection with others, and if the holiday meal is overcooked, oh well.   

Be in the Present

Because this time of year demands so much from us, we tend to get caught up in everything we have to do, and life becomes a never-ending checklist. Before we know it, the season is over, and we feel like we missed it. As much as possible, try to be in the present moment and focus on what’s going on in front of you. Yep, I’m talking about mindfulness. If you need a quick refresher on mindfulness or a brief introduction, read the blog from June 2019 titled “What’s Mindfulness.” This skill is particularly helpful during this busy season. It will keep you enjoying the present moment instead of being subjected to all the stressors floating around in your head.

Reconnect with what the Season Means to You

This time of year means different things to different people. For some, it’s about spending time with loved ones and deepening relationships. For others, it’s an especially spiritual or religious time that requires additional devotion. Whatever the reason, try to clarify what this season means to you and live those values. When we have meaning attached to things, we tend to feel more fulfilled. Instead of a season of stress and aggravation, focusing on purpose can bring a sense of satisfaction and contentment.

If you are struggling with holiday stress and want to work through it in counseling, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

Coincidentally, many of my clients have been dealing with grief recently. This prompted me to learn more about it, so I picked up The Grief Recovery Handbook by John W. James and Russell Friedman to see if there would be anything helpful for my clients contained in their writing. Several concepts stood out to me, and I believe they are essential to understand when dealing with grief.

What is Grief?

This is a tough question, and there is no one universal answer. James and Friedman conceptualize grief as the normal and natural emotions one experiences in response to a loss event. These can be any emotion, and often, they are contradictory. For example, it’s quite common to feel sadness as well as relief when a loved one dies as the result of a chronic illness. The authors highlight there is no “normal” grief process. Grief is unique to each individual, and whatever that person feels is appropriate.

What we are told about grief

Grief is complicated by the fact that societally, we are not well-trained to handle it. Typically, well-meaning friends and family will try to provide comfort and reassurance by making statements that are not helpful. James and Friedman distill the messages we receive about grief into the following:

• Don’t feel bad
• Replace the loss
• Grieve alone
• Just give it time
• Be strong for others
• Keep busy

They explain that these messages stifle the grief process. How many of these messages look familiar to you? What have you been told about grief?

The G Word

Many of my clients express guilt after a loss and beat themselves up for actions or inactions they took. I hear consistently “I should have…” or “Why didn’t I…” James and Friedman call guilt “The G word” and explain many people experience it after a loss; however, guilt is not needed in these situations. They break down the definition of guilt which includes INTENT to hurt someone. If there is no intent, they argue that guilt is not warranted and does nothing except exacerbate an already painful situation. They explain that people may wish they had done things differently or have regrets. There are things they wish they could have said or actions they would take back. However, as long as there was no intent to hurt their loved one, guilt does not need to be a part of the grief process. James and Friedman point out this piece of information is generally helpful for grievers to know as they can free themselves of the guilt and focus on healing from their loss.

If you are struggling with grief and want to work through it in counseling, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

We all know sleep is important, but it’s especially important for good mental health. There is a wealth of research that indicates good sleep practices can improve mood and are part of an overall healthy lifestyle. Average adults need about 7-8 hours of sleep per night and children/adolescents need about 9-10 hours. The tips below can help you establish good sleep practices and get the rest you need for optimal functioning.

• Go to bed at the same time every night and wake up at the same time every morning to establish consistency with your sleep schedule.
• Do not nap during the day. Let your tiredness build so you are good and sleepy at bedtime.
• Don’t consume caffeine 6-7 hours prior to bed. Usually that means don’t have any after 3:00pm.
• Avoid alcohol, nicotine, and other drugs as these substances can disrupt sleep tremendously.
• Avoid screens (computer, phone, and TV) for an hour or so prior to bed. The light from the screen wakes up your brain.
• Make your bedroom comfortable. Keep it cool, dark, and free from noise.
• Refrain from exercise and eating large meals prior to bed.
• Only use your bed for sleep. Avoid watching intense TV, eating, doing work, or engaging in other stimulating activities as your bed needs to be associated with rest and nothing else.
• If you have trouble falling asleep or wake up in the night and can’t go back to sleep, get up and do something minimally interesting until you feel tired. Staying in bed and stewing about stressors will be aggravating and make going back to sleep difficult.
• Consider doing a relaxation activity prior to bed like taking a warm bath, using progressive muscle relaxation, engaging in meditation, or listening to a visualization exercise.

If you are struggling with sleep and want to work on it in counseling, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

Change is all around us. It happens constantly. The Evolve Counseling Services office is moving locations this month, and this transition got me thinking about change. Not to mention, the pumpkin spice latte is back-a sure sign the seasons are changing and summer is giving way to fall.

Why We Don’t Like Change

I don’t know many people who welcome change with open arms. We seem to resist it if possible and desire to stick with what we know. Some people are more adaptable to change than others, but overall, change is hard for us. I started thinking about why we don’t like change. I informally interviewed colleagues and friends about this topic. This is what we came up with:

• Change comes with uncertainty, and we like to know what’s going to happen.
• Change threatens our sense of control. We may not be in the driver’s seat for a moment.
• We like routine and stability.
• There is comfort in consistency.
• Change contains risk, and it not might pay off.

The Reframe

Yes, we can choose to fear the unknown and view change as scary. But, we have another option. We can reframe change as opportunity. It can be the start of something great. It doesn’t have to be a looming monster we fear. If we accept change and choose to see it as an opportunity, hope replaces fear.

Come See Our New Office

As I mentioned, the Evolve Counseling Services office is moving locations. I’m framing this transition as a wonderful opportunity and looking forward to getting settled in. We’ll be hosting an open house for the community to come see us. Hope to see you there. Details to come.

-Lindsey-