How to Be Your Own Therapist : A Step-by-Step Guide to Building a Competent, Confident Life

Self-help tools that work with--or without--the aid of a therapist How to Be Your Own Therapist provides tools for those who want to replace unhealthy behaviors with actions that bring satisfaction and success. Drawing from her 20 years as a licensed therapist, Dr. Patricia Farrell has developed an approach that enables individuals to manage their own lives by reclaiming the personal power to take action. With intelligence and insight, Dr. Farrell shares the innovative techniques and exercises that promote successful results in her own patients--patients whom Farrell quickly enables to move into independent problem-solving action. Also included here are dozens of proven self-assessment tests, compelling case studies, and helpful symptom-identification sidebars. Her "power tools" include how to: Fire one's parents Quit whining Make lots of mistakes Stick up for oneself

Excerpt

CHAPTER 1

Seeking the Answers Within or Without

Things do not change; we change.

Henry David Thoreau

What's been on your mind lately? Has something been bugging you, tugging at you, getting stuck in your consciousness and refusing to let go? Maybe something's getting to you about a relationship you're in: you're tired of the craziness of being with someone who doesn't seem to want to be with you—you're at the point where you want a partner who really wants you. Or perhaps you're tired of taking care of someone when what you really want is a true equal who can meet the ups and downs of life head-on with you.

Maybe you're ready for a change in the communication, the conflict, or the chaos in the relationship. Then again, perhaps it's work that's getting to you. You no longer feel like tolerating a boss who talks down to you, takes credit for your work, chastises you like a toddler when you make a mistake, or simply ignores your contributions—and you're fed up with yourself because you do tolerate it. You know you could be more successful, yet every time you seem close to that big achievement, somehow something goes wrong. It might be your family, a great bunch of people, but too close for comfort; or they're more distant than you'd like. Or maybe they're mixed-up, a crazy collection of oddballs who would never have chosen to know each other if your parents hadn't gotten together all those years ago (and then there's that whole area, one you're not even going close to!).

Here's the reality: I can't know what's going on in your life, but I can be pretty sure of one thing. You want a more satisfying life, happier or easier or more successful relationships, a better job or a greater sense of accomplishment from the work you already do, and less stress or more pleasure in your family life. In other words, there's something about your life that you want to change. Let me reassure you that if anything I've just said rings true for you, it doesn't signify a problem. Instead, it just makes you like 99 percent of the rest of us.

You're not misguided, you're not bad, and you're certainly not crazy. In fact, I'd guess that your life is even working out pretty well—if not in general, at least in some important areas. And by the way, if it's not—if things are feeling too crazy for comfort—that's okay too. You can't expect a smooth ride all of the time when you're dealing with reality. There are going to be times when it seems that everything might come crashing down around you, and there will be other times when you feel on top of the world, in control, and taking life's challenges and difficulties in stride like the champ you are.

But you're ready for a change. You're ready to take charge of your own life and quit complaining. You've had it with feeling dissatisfied and wishing things were different, even as your life continues to roll along, the same as yesterday. You might not have admitted it to yourself yet, but you've made a decision: no more standing by shaking your fist out of a sense of futility or frustration because your life isn't turning out the way you want it to.

This life is the only one you've got, the single chance you have to get it right, and the fact that you've picked up this book and started to read sends a signal that can't be missed. You're going to get it right, and you're going to get it right for you—not to please your parents, not to be more successful than your siblings, not to keep your boss happy and quiet. The key to getting your life right lies, first, in recognizing that it's your life, and, second, on accepting the fact that there's only one person who can define "right" for you: you. Defining "right" and getting it "right" are exactly what this book is going to help you do.

Before you can do either, though, it's essential that you accept that there's nothing wrong with you because you now feel the way you do. On the contrary; it's a good sign! When the day arrives that you discover yourself ready for "out with the old and in with the new," it means you're stronger than you've ever been, whether you feel it yet or not.

Part of what's happening to you—part of what caused you to pick up this book, in fact—is that you've outgrown your old coping mechanisms, the ones you developed years ago. You're also facing new challenges, as everyone does throughout life, challenges for which you haven't yet had a chance to develop coping mechanisms. Think of it as if you're wearing clothes from the 1960s or early '70s. Not only do they not work in today's world—those red vinyl go-go boots are particularly awful—but they don't even fit you anymore. You've grown, you've changed; your life is different now. It's no wonder that you sometimes feel frustration, irritation, confusion, or even despair. You're trying to make a date with someone at a new millennium party—while you're wearing a white leisure suit. What are your chances for success?

Lugging around your set of old behaviors, some of which work and some of which don't, and facing frustration when they don't, you fall into one of three groups of people. In the first group, you'll find the people who have considered seeking professional help but haven't done so for a variety of reasons. In the second group—which contains an estimated 20 plus percent of the population—you'll find those who have tried therapy or some sort of professional mental health care. Then, there's the third group: it is comprised of the people who haven't given professional help a second thought (or even a first thought, for that matter!). The members of this group would no more consider therapy than they would an elective amputation.

It truly doesn't matter which group you're in when it comes to dealing with day- to-day life and the frustration and confusion it can sometimes bring. I'm here to tell you that not one of the groups I've mentioned corners the market on the "right" answer to facing life's challenges: professional help, self-therapy, coffee, and deep discussions with a neighbor, or any other approach. The fact is, there isn't a single correct answer that applies to everyone. The question of how or even whether you should make changes to your life is highly individual, and the answers in most cases are even more difficult to generalize. You'll discover the right answers for you in this book, even as you see that the answers you come up with are right in large part because of how very individual they are.

In Chapter Three we'll discuss the generalities that do apply—and that might mean you should seek professional help. I strongly urge you to make note of them. Although it's unlikely that you'll see your own life struggles and challenges reflected in any of these generalities, it's critical that you be aware of the distinctions. It would be irresponsible of me—and irresponsible of you toward yourself and your own well-being—to ignore the fact that there are certain instances in which professional intervention is warranted. In most situations, it is unnecessary or optional, but we'll specifically address the distinctions that identify the types of problems that call for the help of a qualified mental health professional.

TAKING ON LIFE'S CHALLENGES

For the moment, though, there is a question that applies to everyone: When the challenges of life feel like they're catching up with you, or when you're ready to change a part of your life for the better, what is the best way to go about it?

This question addresses a number of factors: whether you need professional intervention, what types of help are available (including self-therapy), how the assistance is offered (including how you go about helping yourself), and what kind of beliefs and behaviors influence your potential for success.

That there are options available is a positive sign, an indication of how much our society has changed its views toward mental health and personal growth. Until the mid-1960s, mental health was typically something that only psychiatrists and embarrassed families talked about, and then only in the context of sanity and insanity. Mental health was thought of as the reflection in a mirror of a dirty little phrase—"mental illness"—which was cloaked in shame, secrecy, and stigma. For most of us, mental illness isn't the issue; at times we have problems or challenges, and we always have psychological needs. But in the past, conventional wisdom, pride, and self-esteem contributed to the belief that life's problems or challenges were best addressed in the privacy of your own home or, in a pinch, over coffee with a trusted friend. Better yet, you would deal with whatever needed attention without breathing a word of it to anyone. That tough, pioneering spirit, the pull-yourself-up-by- your-bootstraps philosophy, prevailed.

Fortunately, as our society became more open and emotionally aware, the stigma surrounding mental health issues began to fade. In fact, in some circles a stigma developed if you weren't in therapy! It became hip to get help; if you didn't have an analyst, who were you? Think Hollywood, think mid-town Manhattan. The pendulum has swung back and forth plenty of times since, adjusting itself to the tenor of the times. Unfortunately, with each sweep of the pendulum, the most important point about seeking help, wherever you might seek it, seems to get buried deeper.

The real point is that it doesn't matter what's hip, what's in or out or today's newest trend; what really matters is how you can create the best life possible, the life you want and deserve.

Can you create this life in a therapist's office, or can you find it over dinner with a friend? Can you get what you need by letting off steam with strangers in a chat room on the Internet? What about helping yourself? Is it possible to arm yourself with a toolbox of methods for taking on the ups and downs of life and emerge stronger, better, healthier?

You've read this far, so you know my answer by now, but indulge me as I repeat it once more in case there's any confusion. You know yourself better than anyone else knows you. With few exceptions, that makes you the best candidate for the living room couch—instead of the therapist's couch—when you're seeking someone to help you face current difficulties, or when you simply want to learn new ways of coping with the inevitable challenges that arise in life.

THE NEED FOR PSYCHOLOGICAL INTERVENTION

Over the 20-plus years I've spent in the field of mental health , I've developed and refined my belief in the power of what I call "self-therapy," the practice of serving as your own therapist. My early personal experience with a "helper," for instance, was one of the foundations of this practice. Personally, through my work, and more theoretically, through research, I have come to believe in the benefits of and need for self-therapy up close. I have seen firsthand the profound need for the ready availability of psychological intervention of some kind in our world today.

One reputable estimate finds that approximately 20 percent of all Americans have a mental disorder of some type, and nearly one-third of those people are turned down for treatment, typically because of the refusal of insurance companies to pay. Other research shows increasing rates of depression, with almost 10 percent of the adult population suffering from depression and an estimated 16 million Americans from 18 to 54 years of age experiencing anxiety. Psychological problems are costing the United States as much as 148 billion dollars annually. These statistics alone indicate a clear and significant need for mental health treatment that is easy to access, affordable, and comprehensive. This has perhaps never been truer than it is today, given the increasing stress of living in such uncertain economic and political times. In fact, research shows that rates of anxiety, depression, insomnia, and other mental health disorders and symptoms have more than doubled since the 9/11 attacks on the United States.

Obviously, the reasons people seek help vary drastically, from depression and anxiety to relationship problems, self-doubt, or an inability to make satisfying or successful choices about jobs, friendships, or other areas of their lives. The reality is that for every person who is in therapy, considering therapy, or simply feeling dissatisfied or frustrated with some aspect of his or her life, there is a highly personal, wholly individual motivation for seeking change. In your case, that motivation led you to a book about changing your life, in ways both large and small. It could be the beginning of the most important journey of your life.

What you do with the contents of this book will determine the extent of change you experience. If your life just needs a little fine-tuning here and there, that's what you'll get. If you're looking for a sweeping change, a "make-over" that transforms you into the person you've always imagined you could be, you'll find that too. You are the driver here, in charge of determining the starting point, the destination, and which stops to make along the way.

PROFESSIONAL INTERVENTION

Before we continue, a few points should be made about professional intervention. Earlier, I said there are three groups of people—or kinds of approaches—when it comes to dealing with the challenges of life. There are those who will go into therapy, those who will consider it but decide to take a shot at developing answers on their own, and those who wouldn't dream of seeing a professional to discuss their life issues or challenges. Although I'm a strong proponent of self-therapy—a process I've created, in which individuals define and solve their own problems—I want to emphasize that I am not antitherapy. There are many for whom "traditional" therapy has led to wonderful, life-changing and affirming experiences. I applaud the therapists in those cases, as I applaud the clients; both are responsible for the positive outcome.

At the same time, I have seen and heard much about unethical therapists, inflated fees, breaches of confidentiality, and therapists who were more concerned with power, sex, or their own emotional shortcomings, among other things, than they were with their clients' problems. I've had dinner where the background noise was the voices of a group of psychiatrists at the next table over, gossiping about their famous clients' peccadilloes. Once, I nearly lost my lunch overhearing the angst of two therapists trying to decide if it was wrong for one of the therapists to be "dating" a client's spouse.

I mention this—the helpful therapists as well as the unethical ones—because to make an informed choice about self-therapy, you need to be aware of the advantages and disadvantages associated with traditional therapy.

What follows are some factors that led me to develop self-therapy as an alternative or adjunct to traditional therapy:

• My own early experience with a therapist who was misguided.

• The many accounts I've heard about therapists and approaches to therapy that were about something other than the client's best interests.

• The economics of therapy: for many people the expense of professional intervention is simply prohibitive.

• Confidentiality: I have seen client's anonymity destroyed and their confidentiality breached too many times to trust the process entirely.

• The powerful effects that insurance and managed care can have on the process, confidentiality, and outcome of therapy.

• The labeling that can be a by-product of traditional therapy, and that can follow you into your workplace or elsewhere.

• The time commitment that some therapists expect from their clients: implying or stating outright that the therapy will not be successful unless it takes place weekly or even more often, involves an additional meeting in a group therapy setting, and the like. All of this, of course, also adds to the expense. Similarly, professional intervention can often move at a crawl, turning change and growth into long-term goals instead of immediate, workable solutions.

• My ongoing concern about the professional qualifications—or lack thereof—of some of the people providing therapy. The variation in the requirements for licensing and qualifications from state to state is far too great for my comfort.

• The "one-size-fits-all" approach to therapy that some therapists use, which doesn't quite fit and may not focus well enough on your individual situation.

• The questionable or downright atrocious ethics practiced by some therapists, including intimate involvement with clients, using interventions that are not quantified by research—and may even be dangerous—and breaking client confidentiality by "telling tales out of school" to colleagues or friends.

Considering the above, you might think I advocate the self-therapy approach because I believe that traditional therapy is always harmful or unnecessary in some way. In fact, what I am opposed to is not therapy as a field or therapists as a group; I am instead opposed to the largely unregulated brand of therapy prevalent today. I call this type of professional intervention "vending machine therapy." It's the type of "help"—a misnomer if ever one existed—that is provided by charlatans or "gurus" who are more concerned with getting your quarters (or just about anything else) than with the quality of what they give back. Here's what you can be sure of: it's not about you. It is because of the prevalence of vending machine therapy that I advocate the alternative of self-therapy; it gives you the tools you can use for a lifetime of positive outcomes, and it does so while ensuring that the focus remains on you.

I encourage you to keep a sense of balance about the positives and negatives of therapy as we go on to discuss the myths and potential drawbacks of some therapy and therapists. You can think of it like this: if you've ever had surgery, you know that beforehand the doctor warns you about the things that could go wrong—every last one of them. Do these things go wrong for most people most of the time? No. If they can or do happen at all, though, professional ethics insist that the dangers be shared with the patient, a practice that should relate to traditional therapy as well. After all, both surgeons and therapists are digging into some pretty vulnerable, tender areas!

I wish I could say that the negative occurrences and outcomes in traditional therapy are as rare as the deaths that result from surgery for an ingrown nail, or as uncommon as losing the use of your legs after having a hair implant. Unfortunately, I can't. The fact is, while traditional therapy has tremendous potential, it's a potential that can go in either direction. When therapy works, it has the power to help you make important discoveries about yourself and to affect positive changes in your life. When it doesn't work, for whatever reasons, the harm can be negligible—or it can be incalculable.
(Continues...) Excerpted from How to Be Your Own Therapist by Patricia Farrell. Copyright © 2003 by Patricia Farrell. Excerpted by permission of The McGraw-Hill Companies, Inc..
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