Grieving Missed Pandemic Milestones

Like many people, I was really excited to hit the next decade of my life and had big plans for how my new-decade birthday might go. I figured 2020 would be a big year for me personally, and I was looking forward to the milestone birthday being one of many important transitions. I don’t think I need to tell you that the big party didn’t happen. The big vacation I planned didn’t happen.

But it didn’t bother me at the time. Seniors missed graduations and class trips, weddings were postponed or streamed on video. Plenty of other people missed birthdays and holidays and vacations. It felt for a while like we were all in this together, all sacrificing the things we were really looking forward to.

It still didn’t bother me in 2021 because things still felt up in the air. Sometimes events could happen, other times they’d be shut down or postponed yet again. Some people were having parties, but other people were still keeping things small out of caution.

This year has been different. One of my best friends is about two years younger than me and she’s now hitting the decade milestone that I missed in 2020. And she gets to have the party and go on the special vacation. I’m jealous in ways I didn’t expect.

I’ve heard similar from people who had to skip their graduations or have them virtually. They can go and walk this year to make up for it, but they’ve moved on in their lives and it feels weird to go and walk in someone else’s graduation just because you missed yours. But the feelings of sadness and jealousy are still there.

So how do we deal with these feelings? How do I watch my friend have an amazing party and then follow it up with a fun long weekend away? How can I be genuinely happy for her while missing the fact that I wanted those things for my milestone birthday too?

And just like it feels wrong to walk in someone else’s graduation to make up for the loss of mine, it also doesn’t feel right to have that party two years later simply to make up for lost time. All that’s left is for me to bring these thoughts and emotions up with acceptance. I missed my birthday party and the vacation. I didn’t feel sad at the time, but I’m sad now and that’s okay. I’ll have another birthday this year, and that can be good enough. I can plan a new vacation this year, and that can be okay. I’ll never get back all the time in 2020 that I lost to the pandemic and all the restrictions, but I need to accept that as a fact in order to move on.

Acceptance doesn’t mean I ignore my sadness or my jealous thoughts. My sadness is real and an important part of me. I can accept what happened and accept my sadness. The jealousy is different. I can tell from sitting with it that it comes from a place of feeling like things were unfair and I deserved better. Those emotions are valid, but they’re ultimately unhelpful. Focusing on the sense of unfairness doesn’t help me feel better, it keeps me in a cycle of feeling angry and jealous and focused on what I’m missing.

Does this make sense? My sadness is helpful because it allows me to acknowledge what I lost. My jealousy is unhelpful because it keeps me focused on myself as a victim of circumstance. Moving through this grief, it’s not helpful to allow myself to dwell on the jealousy, but I do need to hold and sit with my sadness so I can feel it fully and journey through it.

Grieving missed milestones and memories from the pandemic looks like sitting with your thoughts and feelings with a posture of acceptance. From there, you can decide which thoughts and feelings are helpful or unhelpful and decide how you want to proceed with intention, acceptance, and self-compassion.

Did you miss a milestone or major event during the pandemic? How did you handle it? Does the method I used sound like it might make sense for you or did you use a completely different way?

When do we return to normal?

In the beginning of the pandemic, we all experienced a collective event that hit many people as a trauma. And as a predictable result, many of us got brain fog, lost confidence, experienced physical changes in our bodies, and difficulty keeping up with the rapid changes in policies within our companies and cities.

But most of us expected to be better by now. It makes sense that you’d react to a sudden shift in lifestyle by getting stressed, sleeping poorly, missing deadlines, and gaining weight. After years, it seems like we should be adapted by now. The continued stress and trauma only added up, they didn’t get better. And the longer this goes on, the more we lose confidence in ourselves and our ability to bounce back.

Our inner critic is the key here. It’s bad enough to be stressed and going through a collective trauma, but when your inner critic piles on the shame, you add the sense of ongoing failure to the list. It’s the inner critic who keeps you from being resilient and accessing your strength because it keeps you in the mindset of comparison, shame, and failure. Even when we know consciously that these are normal reactions, the inner critic’s blame and shame tell us the story that it’s okay for everyone else to be struggling, but it’s not okay for you to struggle.

This belief creates a sense of isolation from others. It’s hard to look at someone else who seems to be doing so much better and admit that you’re struggling. And it’s equally hard to be around friends who are struggling and resist the pressure to put on the face of doing just fine. This isolation keeps you from accessing the community, mutuality, and support you need to actually bounce back.

We return to normal only when we can accept what happened, admit to ourselves and others when we are not doing okay, and enter into supportive community in order to truly heal.

Lent Intersecting Therapy

Lent is usually a season of giving up oppressive habits and taking on new patterns of living. We often think of Lent in terms of giving up chocolates or coffee for a time, but when we think of Lent in the broader sense of observing and breaking the chains that lead us on a negative path, we can see how it plays into our mental health.

This year, I’m going to stop drinking coffee because I’ve noticed I get irritable and am prone to withdrawal headaches if I don’t get my morning cup. Coffee is a good thing, but it’s become a weight on my life- I have to have it, I’ve grown dependent on it.

Similarly, I’ve noticed a pattern of thinking that’s unhelpful. When I’m worried or have a concern, I’ve fallen back into ruminating on all the possibilities. This makes me feel tense, and I can feel it all through my body. And when I start to feel the anxious tension in my body, the mental distress escalates which again turns back to mental chatter. It’s a vicious cycle and I don’t like it at all. So this year, I’m also giving up anxious thinking.

Breaking a thought pattern is very different from breaking a physical habit. I can stop drinking coffee by simply not picking it up or ordering it. But thoughts are often unconscious, and there’s not an option to simply not think at all or to filter your thoughts to block out the ones you’re trying to avoid. Wouldn’t that be nice?

In the Christian tradition, we’re told to “take every thought captive” (2 Cor 10:5) and “think on things that are true, noble, pure, right, admirable, and lovely” (Phil 4:8-9). These suggest two key points: first that thoughts happen unconsciously, and when they do, we have a choice about that to do with them when we notice them. Second, that we can consciously direct our thoughts, and we are not entirely at the whim of our unconscious minds.

Taking unconscious thoughts captive starts with awareness. We can’t capture a thought that we don’t know is even happening. And awareness starts with slowing down and paying attention. Most of our life happens on autopilot. And most of the time that’s okay. You don’t need to pay close attention to every detail of your commute, and it’s normal to want to zone out a bit after a busy day. But sometimes autopilot goes wrong, and our default thoughts turn toward the negative.

That’s what happened to me- I consciously managed my anxiety years ago and haven’t been super prone to anxious thoughts for a while. But lately, it’s crept up again, and it’s important to deal with it early so it doesn’t get out of hand. My autopilot has turned to worry, and that’s not okay with me.

You may be surprised to hear this from a therapist, but I’m not the best at noticing my emotions. It’s something I’m working to get better at through this conscious practice of noticing and increasing my awareness. I usually notice my anxiety when my neck and shoulders start feeling tense and I notice the shift in my breathing. Once I notice these physical shifts, I can usually trace them back to the frantic thoughts. Taking time throughout the day to check in with my thoughts, emotions, and body feelings is so helpful in allowing me a chance to notice in advance what’s going on in my mind before it starts affecting my body.

But what to do with anxious thoughts once you notice them? They feel like they’re racing so fast, they almost have a life and power of their own. I think it’s enough to simply say no to the thoughts. No, I’m not doing this right now. No, this isn’t helpful. No, you’re just going in circles and getting nowhere. No, no, no. Some theories say that it’s helpful to debate the thoughts or analyze them to see if they’re true. And if that works for you, go for it! But that doesn’t work for me.

I’ve mentioned before about how a tree branch fell on my car in a windstorm and I would get super anxious when it got windy with the thought that another branch could fall again. It wasn’t helpful to challenge those thoughts because my anxious mind doesn’t care that a branch fell only once in the ten years I’ve lived here- it happened once and could happen again. The only thing that truly helped was saying no from a place of acceptance. Yes, the tree could blow around so hard that another branch falls on the car or the house or a person. But my worry thoughts can’t stop it. If I stay up awake at night worried about what the tree might do, that won’t keep it from falling if it’s going to.

This brings us to the second part. You may have heard the saying “Life abhors a vacuum.” This is equally true of our thoughts. It’s not enough to simply say no to the anxious thoughts, we have to replace them with something else or another thought will quickly come up from our unconscious minds.

Whatever is true, whatever is right…
The “what-if” thoughts aren’t true. They’re hypothetical. They’re future focused. The best way to think of what is true and right is to turn your attention to the present. Give direct, focused, mindful awareness to who you are, where you are, and what you’re doing.

Whatever is pure, whatever is noble…
The “worst case scenario” thoughts aren’t pure. Pure means “without unnecessary elements” or “without contamination.” Worry adds to your reality with all the ways things could go wrong. And again, the antidote is present focus, getting back to what is currently happening without the added extras that the anxious thoughts are focused on.

Whatever is admirable, whatever is lovely…
Anxious thoughts often take us to the lowest place. Thinking of things that are admirable or lovely helps to lift us back up. When we set our minds on higher things, we are reminded of the good things in this world. Lately, I’ve seen articles of studies that show how good it is for people to experience things like awe, wonder, beauty, and glory. Whether it’s going out in nature, experiencing art, or simply marveling at the majesty of the world, focusing outside ourselves helps us get out of our minds and back into a proper perspective of who we are and how we fit into the world.

As we approach the beginning of Lent, I hope you consider how Lenten practices can intersect your personal work in your thoughts and habits. If you have a similar experience or want to join me on this journey, leave a comment and share your perspective!

The Benefits of Failure

Nobody likes to fail, especially in front of others. But failure carries with it two implications- first that you were willing to try something, and second that you have a chance to learn. These are the benefits of failure.

For some of us who have at least one area in life where we are at least moderately successful if not highly proficient, we are faced with the temptation to stay within our realm of competence. This is a key danger in life because once we develop a core competence and choose to remain within it, we can shut down from novel and difficult experiences. We can keep ourselves safe from not knowing, not being very good, being the worst, but only at the cost of our ability to learn and grow and explore.

So failing in itself isn’t necessarily the benefit. But failing means that you tried something outside of your core set of competencies. It means you were willing to stretch yourself and be open to the many different possibilities that could await you. Any time you want to learn how to paint or try a yoga class or sew your own clothes, you probably won’t be a master the first time you do it.

The way out is through acceptance. When you try something new, you might fail. You might look silly. Other people might form opinions of you and your capability. Let me share a story from my life to illustrate.

My Inner Critic is deeply focused on worrying how I’ll do at physical activities. When I was about ten years old, I thought about asking my parents if I could start taking karate lessons like many of my friends did. I never asked because my mind told me that ten was just too late to start learning karate and I’d be behind all the other kids who started even younger.

Looking back, it seems objectively silly. As an adult, ten doesn’t seem to old to learn a new skill. But in the moment, my mind had convinced me it was way too late. Of course, everything seems more obvious in hindsight. The real trick is to be able to notice in the moment when my mind is telling me an untrue story.

I think of some of the things I was interested in but didn’t do. That cookie decorating class- why didn’t I go? That book group- why didn’t I sign up? I can tell myself that the class was too expensive, but in reality if it were half the price I still wouldn’t have gone because what if everyone else is there with a friend and they notice I’m by myself?

Shame says: I don’t want to be the fattest, weakest, and least flexible person in the Pilates class!
Acceptance answers: You might be! But you’ll be doing something you’ve been wanting to try for years.
Shame says: I should have started ceramics years ago if I wanted to be any good.
Acceptance counters: But you can’t start years ago. You can only start now.

I can choose to think back on some of the times I did go to a class alone. I met new people, and others in the class were happy to include me even though they came with friends. I can remember how it felt to finally try karate in college and I did struggle compared to some of the other students but I got stronger and learned a lot, and nobody was as hard on me as I was on myself.

Here’s your challenge- think of something that you’ve wanted to do but just haven’t managed. Explore your reasoning and question deeper to see if the surface reasons are covering over some internal shame or Inner Critic narrative. And then try it. Just once. Just to show your Inner Critic that you’re strong and resilient, that you don’t want to be trapped by worry.

Exploring Motivation

Motivation seems fairly straightforward on the surface, but when you don’t have the motivation to complete basic daily tasks, it suddenly becomes complicated. And it can be frustrating to know that you’re on top of everything you need to do at work and at home but feel like you don’t know how to get yourself to want to work out every night when you get home.

Motivation is huge in therapy. Many people come to therapy looking to regain the motivation they used to have, to explore why they can’t seem to do the things they want to do, basically how to get yourself to want to do the things you have to do.

Motivation is also a bit of a paradox. My clients who are depressed, lost, and frustrated are all looking for the motivation to get them going in life. But my clients who are high functioning don’t see motivation as a relevant factor. They don’t work out every day because they want to, but because it’s built into their routines.

Structure and habit seem to be the key to bypassing motivation. If you only get out of bed when you want to, there will be some days when you simply don’t feel like it. But if you get out of bed every morning when your alarm goes off, you don’t have to check in with yourself to see how you’re feeling first.

This is why many unmotivated people can do well at work but are unable to follow through on what they would like to be doing with their personal time. The external structure of work creates certain obligations- be up and ready by a certain time in the morning whether you want to or not, do your routine job tasks regardless of how you’re feeling, attend meetings when they’re scheduled even if it’s not your preference. At home it’s flipped. You want to start reading more, take up a new hobby or craft project, do a puzzle. But then the “I’ll just watch one episode with dinner” becomes a few episodes, or you’re comfy on the couch and it feels easier to stay seated than to get up and do some yoga.

How do you motivate yourself? By creating a habit. By creating a new narrative of how your evenings go. By deciding that I am a person who works out every day after work whether I feel like it or not. By deciding that every night at 9pm all the screens go off and I’m going to read until it’s time for bed.

The narrative is the key. It shapes your new identity as someone who does these things instead of someone who wants to start doing those things someday. Identity stories are powerful. When it’s 5am, an identity story of “I’d like to be a runner but I’m not there yet” isn’t going to get you out of bed. But when you decide “I’m a morning runner,” you find that your motivation shapes itself to the identity that you declare for yourself. Of course it isn’t as simple as naming yourself a runner, but that’s often the first step.

Try it on with something you’ve been meaning to start or get better at.
“I’m the kind of person who……”
“I ……….. every night after work.”
“I like to ……….. at least three times a week.”

These decisions are powerful. If you work out every day after work and have that as part of your narrative of who you are as a person, it shapes your schedule. When coworkers ask if you want to get drinks after work, you can draw on your identity story to protect your time and let them know you’ve got to work out first and you’ll join them after.

As you shape these identity narratives into a habit, the action becomes routine. Motivation is not a relevant factor. You wake up early to run because that’s just what you do. Think of other routines you have. Severely depressed people often don’t shower or brush their teeth because they can’t motivate themselves to get up and take care of their hygiene. But most people don’t even think about it. They brush their teeth at certain times of the day whether they feel like it or not, even when they’re rushed or exhausted.

Focus on motivation isn’t helpful because it requires you to be monitoring your internal state which is naturally highly variable. You will not always “feel like” doing things you need to do. Deciding that you want to take on a new habit means that you decide that you will do things regardless of your internal feelings about the new routine.

Here’s the lesson: if you’re focused on motivation, you’re looking for internal resources to create an external structure. Try it the other way instead. Create the external structures- scheduling, habit forming, identity narrative- and don’t worry about waiting until you feel like following through. Because once you’ve created that habit, it doesn’t matter if you internally want to keep going, it’s just something that you do.

Developing a Philosophy of Wellness

Your philosophy of wellness shapes your expectations of what you want to get out of your time in therapy. In the first few sessions, I try to get a picture of what my clients are looking for. Most give an answer like this:
“I want things to go back to how they were before”
“I just want to feel normal again”
“I want to feel good and for everything to be okay”

Many people have a philosophy of wellness that looks something like the above examples. They have some idea of a time when things were going well, and they want to have that feeling all the time. There are two problems with this kind of philosophy. First, it’s not realistic to expect that things will be good for you all the time if only you can reach a particular point of wellness. Second, the idea of “good” and “normal” is undefined and nebulous, and it’s hardest to hit a moving target.

To address these problems, we can safely say that we need to develop a philosophy of wellness that accounts for the normal ups and downs of life. Your definition of what it means for you to be and feel well can’t depend on your life circumstances always being positive. And your understanding of wellness should include specific, measurable targets that are well defined and understandable.

With that in mind, what does it mean to be well? What does it look like in terms of how I behave? How does it feel mentally and emotionally? How do I handle negative experiences when I am well? I’ll show you how I answer these questions and how I use them to develop an overarching philosophy of wellness.

To me, being well means that I am okay with just being. When I am unwell, I tend to rush around and have a sense of striving in hopes of working myself into wellness. When I am well, my actions show it by the pace. Instead of a frantic energy, my behavior is characterized by a centeredness that shows even when I am working quickly. When I am well, this centeredness allows me to be more patient with my family, more open to my friends, and more able to respond to events rather than react. My feeling mentally and emotionally is calm and open, and when I am doing very well, I am curious, creative, and energized by new ideas. When I am well, I handle negative experiences thoughtfully without being derailed by anxiety or panic. I am able to process and analyze the situation, asking for help without feeling frantic or shutting down. I am able to deal with catastrophic thoughts without being caught up in them.

My natural tendency is toward anxiety, so my philosophy of wellness is focused on my ability to move away from my unwellness- frantic, striving, rushing, catastrophizing- toward its opposite. For me, that means calm centeredness, openness, curiosity, and creativity. I feel it mostly in my chest. The sense of striving feels tight and hot, and I notice it in my breathing. I also feel it in my mind. The thoughts move from swirling, ruminating, overwhelming, catastrophizing into stepping back, watching the thoughts without being swept up in them, taking time to think clearly.

So while there’s nothing really wrong with saying that you want to feel normal again, or back to your old self, I’d like to challenge you to really dig into those statements. Make them more specific. What is it that you’re feeling right now that you’d like to manage differently? How would you prefer to handle difficult circumstances? What was different about your behaviors, thoughts, and emotions in the past? How do you know when you’re feeling well or unwell based on your physical sensations in your body, your behavior, and your thoughts?

The Equalizing Power of Grief

Grief therapy is fundamentally different from other kinds of therapy for a few reasons, a primary reason being that both the therapist and the client have had their own experiences with grief and loss. In other therapies, the client may have a problem that the therapist has never experienced, so the therapist is operating purely clinically with no personal interjection.

This different way of doing therapy can feel odd to those who are more comfortable in a therapeutic experience that is more one-sided and hierarchical with the therapist being the expert on treatment and the client bringing the issue to be treated. With grief, we are all in the same boat. Not that your therapist will give great detail about their own story- therapy should always center on you as the client- but there is a different sense of community, a feeling like right now it is you going through this grief, but we have both been there and we will both be there again at many points in our lives.

And so, grief therapy is a process grounded in a horizontal relationship of equality rather than a vertical relationship of hierarchy and expertise. We are truly traveling together on the journey of grief. This is a collaborative process of digging into the meaning and purpose of life in the face of our mortality and limits.

Grieving Body Changes

Whether from aging, medical treatment, or an accident, our bodies change. Like other forms of grief, the story we tell ourselves about how and why these changes happened is the source of our peace or distress.

Body changes are often our most public changes. When we start a new habit or learn a new language, others can’t tell just by looking. But the people around us take notice when chemotherapy leads to hair loss, an accident takes an arm, or aging makes us need glasses at work.

Medical treatments can cause some of the most extreme body changes. Treatments may cause us to gain or lose a significant amount of weight, we may lose a limb or an eye, we may lose our reproductive capability. Even when these treatments were medically necessary and we understand logically that this was the best path, we still grieve these losses.

Aging-related changes can be difficult to accept, particularly in cultures that value youth and appearance over age and wisdom. Even though we all know that we will age every year, some people fight hard against the reality of growing older.

Accidents are the most likely to result in complicated grief for the simple reason that they are not something we might choose (like medical treatment) or reasonably foresee (like aging). And accidents often have someone to blame, whether that’s yourself or someone else.

Blaming narratives lead us down a path of grief that is likely to keep us stuck in a vicious cycle of negativity. Blame helps us hold onto anger at the person or situation that caused our grief and keeps us away from taking productive action toward the present and future.

Grief that keeps us stuck in the past can be resolved through work around changing your story of what happened and why. Even when someone is clearly at fault, your narrative needs to incorporate the facts in a way that acknowledges what happened while still allowing you to accept your present reality so that you can continue to create your life moving forward. We need to balance our natural desire to know the reason for our suffering with the fact that there are some things we need to accept that we will never fully know.

As you notice the changes in your body, try to also notice the thoughts you have surrounding the changes. Notice if you are worried what others might think, if you are missing your ability to do a particular activity, or if you tend to blame someone in particular for your loss. This noticing allows you to begin to be aware of the narrative your mind has already created about the situation. These narratives are instinctively formed from your past experiences and your emotions. Notice with compassion and non-judgment, but also notice where your automatic narrative might be creating additional problems for you.

Once you’re aware of your narrative, you can work to shift it in a way that leads you to peace and mental freedom. Your reality is the same, but your thoughts and perspective can move from a focus on the past and what you lost toward acceptance of your current situation and a hopeful future.

Understanding Loss is Losing Trust in the World

We all have automatic assumptions about the way life works, how things should be. In general, we tend to see the world as generally fair. If you work hard, good things will happen. If you are kind to people, people will be kind to you. Mean people will get what’s coming to them. 

So when something big happens, and it feels fundamentally unfair, we start to question our automatic assumptions about how life works. We as humans like having a connected story about how and why things happen around us. We like stories that make sense and connect the dots. So when a lifelong addict dies of an overdose, we feel sadness and empathy but the story generally fits. And when someone dies of old age after a full life surrounded by family, we may miss them but we see death as a natural conclusion. 

But it’s more difficult to wrap our minds around the story when a child dies, or an otherwise healthy person gets a cancer diagnosis, or a spouse decides to leave a relationship that felt like it was going well. We have to confront the reality that there is no factual basis for our assumption that life will be good or fair or fit our stories of how things should go. 

How do we make sense of the world when we realize the fundamental unfairness? What kind of story can we tell ourselves about life when something truly awful happens? Can we find meaning and purpose in a world where children die, good people lose everything, and kind people get cancer? The fact is, we will have to find a way to understand the awful, unfair things that happen in life so that we can keep going and not lose our way. 

The two extremes here are either to bury our heads in the sand and insist that things will work out despite all evidence to the contrary, or to maintain a stark awareness of how unfair life is and stay in a state of despair that we will ever be able to progress in the face of deep injustice. Of course, we want to find a middle way. We need to know that life is not fair, that goodness does not protect us from bad things. But we also need to know that there is hope, that our choices toward goodness still count for something, that it’s worth trying and striving in the face of an unfair world. 

As someone going through loss, you will naturally find yourself wanting to construct a story of grief. Your mind wants to understand what happened and why. Sometimes, these answers are given to us- if you have a genetic predisposition to Huntington’s Disease, it doesn’t matter how healthy or unhealthy your lifestyle is. It doesn’t matter if you volunteer with at-risk children or give generously to charities, you have a certain likelihood of inheriting the disease based on your parents’ disease status. Sometimes, the answers don’t come easily- why children get bone cancer, why the car crash happened at that moment, who is at fault for a workplace accident. 

Walking the middle path means retelling these stories in a way that accounts for the fundamental unfairness of life. Yes, your disease might be genetic, but it was a chance that you were born to those particular parents. Yes, sometimes children get cancer and other serious illnesses, and sometimes they die after only a short life. Our story of how life works has to be able to make sense of these things without assigning blame or coming up with a secret agenda working against us. We have to learn how to see tragedy as something that happens to good and bad people alike without them deserving it. 

Finding a Therapist in 2021

Therapy has changed
In the past, most therapy was offered in person with only a few therapists offering online sessions. Now, many therapists have shifted to online sessions which opens up more opportunities for you to find a therapist who is a good fit.

What does it mean to have a good fit?
Based on research into how and why therapy works, we know that the specific method used (CBT, EMDR, ACT, etc) or the therapist’s credentials (MFT, MSW, PCC) don’t matter as much as the quality of the relationship between you and your therapist.

Good fit can include feeling comfortable with your therapist; feeling heard and understood; having shared beliefs, history, or experiences; and many more factors. If you’ve been in therapy before, it can help to think back about what helped you connect with your past therapists and what made it more difficult. If you haven’t been in therapy before, think about others you’ve felt comfortable with and why.

Because it’s so important to be able to be open with your therapist, consider every factor. Are you more comfortable with a therapist close to your own age or one who reminds you of an older figure in your life? If you’re having relationship issues, would you prefer talking to someone of the same gender or a different gender? Do you want a therapist who feels more casual or one who is more professional in session?

Reaching out
Once you’ve found a therapist you think could be a good fit, the next step is to make sure they have an available appointment time. Most therapists list a phone number or email address on their website, and many offer a free consultation call to get started.

Consultation call?
A consultation call is a 15-30 minute phone conversation between you and your potential therapist. During that time, they may introduce themselves, ask more about what you are looking for, and tell you a bit about their approach. It’s not a therapy session, but it is a time to ask any questions you have about them to help you determine if they’re a good match.

If everything goes well during the consultation call, they will usually ask you about scheduling an appointment. Therapy usually includes weekly appointments, so think about a time and day that typically work for you week to week.

Paperwork
After you’ve set up the initial appointment, your therapist will probably send you paperwork to complete before your first session. Each state has different requirements for the documents therapists need to get from each person before sessions can start.

In California, those will include informed consent about the risks and benefits of therapy, your therapist’s policies and procedures, and possibly also a questionnaire about your mental health history.

Some therapists prefer to go through the documentation and history during your first meeting together, so don’t worry if you don’t get a packet right away.

The first session
The initial sessions are all about getting to know each other in order to develop a working relationship. It takes time and trust to dig deep into your mental health, so don’t be surprised if the first few sessions feel like they’re only touching on surface issues.

If you come in with a mental health issue like depression or anxiety, or if you come in with a relationship issue, your therapist will probably teach you skills to manage that issue and practice them in session. Skills like deep breathing, assertive communication, and meditation help manage your mental health symptoms or relational conflicts. As you experience some symptom relief, therapy can stay focused on managing symptoms or move into insight-based work.

Skills vs insight
Skill-based therapy is entirely focused on teaching you how to manage thoughts, feelings, and behaviors that are bothering you or getting in the way of you living your life the way you’d like. Insight-based therapy is focused on exploring the factors in your history, environment, and internal world that are contributing to the issues you’re facing.

Therapy based on skills is typically short term. Therapy lasts for as long as it takes for you to learn and practice the right skills that work for your symptoms or issues. You’ll probably have homework between sessions to practice the skills so that you’ll be able to use them as you need when things come up in your daily life.

Therapy that’s oriented toward insight usually takes longer because you’re trying to describe and explore your internal world. You and your therapist will look at enduring patterns in your life and try to trace them back to a root belief, cause, or memory.

In my therapy work, I like to start with skills-based sessions so you experience some relief from the issues at hand. Then we can stick with skills or move into insight depending on your needs. In your consultation calls, you can ask your therapist if they work more with skills or insight to see if their focus matches your needs.

Ending therapy
If you are doing skill-based work, you can start talking about ending therapy when you feel like you’re able to use the skills you’ve learned to manage the issues that were bothering you when you started therapy. Insight work is more difficult to determine an exact ending, but you and your therapist should still be able to talk about what changes in your life will signal that things are better for you and you’re ready to move on.


Ready to get started? Call or text 831-531-2259 for a free consultation.