Therapy, Counseling, Mental Health: Things That Put Me OUT of Work

My last piece of course is begging for a follow up.  If there’s semi-tangible things that put me in a job, there should be some things that will put me out of a job, so to speak.  Ideas, principles, behaviors that clients do that get them and keep them out of our offices, clinics, and hospitals.  Again, we as clinicians talk about them fairly often, but I rarely hear/see them showing up in discussions outside of our colleagues.  In all fairness, as with all professions, there’s arguably some things we don’t agree on or see a little differently, but if we’re really endeavoring to be socially responsible and progressively-minded about our responsibilities, I think we ought to be transparent about some of these things.

Should mention some of the spirit of where these ideas come from.  One day at a hospital I was hired to create dual diagnosis programs at, it dawned on me that there were a lot of suggestions that most clinicians of all types, gave to clients of all diagnoses/problems, in an effort to be helpful.  I created a beginning list of these as I saw them, and asked different psychiatrists, therapists, social workers, nurses, and recreational therapists to add/change/delete parts of the list.  After compiling 60 or 80 different items or so, we began using this as a resource tool for the clients.  The list below is some of those ideas, but am leaving some of them out for brevity’s sake.

They’re not really new.  Most of these appear not just in different forms of therapy, but some religion, philosophy/worldviews and the like as well.  It should also be said that they ought to be useful for most any problem- not a panacea, but consistent across categories of problems… depression and sadness, low self esteem and shame, anger, pain, grief and loss, abuse, “thought disorders”, affective disorders (depression, bipolar disorder, anxiety disorder, addictions, etc).

As with my last blog, would suggest that these might take deeper explanation and guidance, and hence, some of that work is beyond this medium.  That said though, I think that some of these ideas are extraordinarily useful (despite their age… ;-p  ), and can be applied a lot of places.  Some of these are simply ideas that I think “getting a handle on” and using them as a start for problem-solving is really helpful.  Not an exhaustive list, but as a start…

  • Knowing who we are and how we are is one of the most important things- and arguably the basis for dealing with a lot of our problems.
  • Have a “congruent affect” (affect is “feeling” or “emotion” in this context)… let your outsides match your insides.
  • Learn how to identify feelings, and share them with supportive/healthy people in ways that are easy to understand.  Might want to try using the “six basic feelings” of mad, sad, glad, afraid, ashamed, and/or hurt.
  • Don’t treat all feelings as facts.
  • Have “boundaries”.  Know where we each “start and stop” mentally, emotionally, “spiritually”, and physically.
  • Eat healthy, exercise, regulate sleep.
  • Remove thoughts/behaviors that put distance between us and us, us and others, or are used as simple distractions.
  • Being “right” is not necessarily more important than being loved.
  • We have to “have” something to “let go” of it.  This arguably applies to how we feel.
  • Is there another choice besides acceptance?
  • Mindfulness.
  • Using critical thinking.  Skepticism, defining terms, consideration of alternate interpretations, considering how an idea might not work/go wrong, resisting oversimplification/generalizing, comparing/contrasting with other people’s ideas…
  • Have a “resource group”… people with whom we exchange ideas, get support, do critical thinking with etc that have experience and/or education with the things we struggle with.
  • Treat happiness as an inside job.
  • Avoiding self-medicating with drugs, food, alcohol, shopping, gambling, sex, TV, etc.
  • Be self-supporting through our own contributions, mentally, emotionally, “spiritually”, and physically. (this particular item is a lot deeper than it may seem at first blush)
  • Don’t just read literature related to our problems and difficulties- actually try the ideas contained.
  • Give up comparing our insides with other people’s outsides.
  • Delay gratification.
  • Know and work on our “issues”.
  • Consider and act on “love” as a verb.
  • Get out of abusive relationships, maybe even relationships that are “potential” rather than “actual”.
  • Stop trying to control other people, places, and things.
  • Be of service.

Again, this is a painfully truncated list, some of the ideas are certainly arguable, and none are a substitute for working with a professional for learning how to do them if they are going to be useful.  My experience though, is that my clients who take up these things, with a pro, have a pretty common experience of feeling and behaving better themselves.  In some ways, it’s hard to imagine doing treatment without these things.  Of course, a lot of these are hard to do, but not impossible, and easier if made practical- things we can measure and point at.  Would love to hear ideas from other folk about things that they think are fairly indispensable, and might work for a lot of folk in a lot of different circumstances…

2 Comments (+add yours?)

  1. Cathy
    Apr 17, 2012 @ 16:10:40

    Great list of things. I found writing really helped me. My therapist loved to see the things I wrote during the week. I have been fortunate to have had two amazing therapists in my life. If she had told me “feelings are not facts” one more time I would have had to throw something. LOL Glad I found your blog.

    Reply

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