May 30

Therapy Quotes (Humor)

The following therapy quotes find the humor in what clients and therapists experience.

My therapist says our sessions are a safe space, a judgement-free zone, but I think she only told me that to see how I’d react. Avery Edison

My therapist gets so upset when she walks into her waiting room and finds me treating her other clients. Jenny Mollen

Do you ever feel like your therapist is the priest from the Exorcist who catches your demons and then jumps out a window? Trevor S

Dear creators of every new fall sitcom: I am sorry your parents were so noisy and shitty, but can’t you punish a therapist instead? Dave Holmes

I go to therapy just so someone will talk to me without looking at their phone. Patrick Walsh

Next time I try therapy I’ll bring up how I’ve never been more than once since my need to please makes me feign recovery after 1 session. Erin Whitehead

Can anyone recommend a bad therapist? (I need a good scapegoat). Josh Comers

˝Gonna talk about you in therapy today˝ -21st century romance. Jake Weisman

Therapists are the atheist’s confessional. So long as you tell your therapist about it, you can keep doing it with a guilt-free conscience. Erin Whitehead

Therapy hasn’t really made me feel any better, it just made me understand why I feel bad. Corey Pandolph

i go to therapy to deal with people who don’t go to therapy. Lauren Ashley Bishop

I like to call therapy baggage claim. Aparna Nancherla

my therapist gave me homework to do before our next session so now I can never go back to therapy maura quint

Among other therapy quotes I’ve found is this one from Laura Munsons memoir, This Is Not the Story You Think It Is…:A Season of Unlikely Happiness:

Probably the wisest words that were ever uttered to me came from a therapist. I was sitting in her office, crying my eyes out. . . and she said, “So let me get this straight. You base your personal happiness on things entirely out of your control.”

Also, from Sofiya Alexandra‘s Tumblr:

“Ten Things My Therapist Says That Make Me Angry,” Sofiya Alexandra

  1. “Exercise does wonders for depression!”
  2. “You’re of course aware that alcohol is a depressant?”
  3. “Maybe we should consider medication.”
  4. “It seems like your boyfriend had a point.”
  5. “Maybe we shouldn’t consider medication and just stick to exercise.”
  6. “It’s warm in here, isn’t it, I’m going to turn up the air.”
  7. “You’re of course aware that marijuana can be a depressant?”
  8. “You seem angry.”
  9. “This is going to require a lot of patience and hard work.”
  10. “I no longer take Blue Shield.”
May 24

Short-Term Therapy Vs. Long-Term Therapy

Is short-term therapy better than long-term therapy? Or is it vice versa?

It depends who you’re asking.

If it’s clients, on one end of the continuum are those who prefer the briefest of therapies (à la Bob Newhart‘s “stop it!”)—or even no therapy at all—while, on the other end are those who love having a therapist to see over the course of their lifetime, if not continuously at least on an as-needed basis.

But then there’s the money factor. For some without means (underinsured, uninsured, or unable to pay) it doesn’t feel like a choice: short-term therapy is a cost-saver and therefore preferable.

Enrico Gnaulati‘s Saving Talk Therapy: How Health Insurers, Big Pharma, and Slanted Science are Ruining Good Mental Health Care (2018) cites a number of other factors that work against longer-term therapy. They include Big Pharma‘s pushing of psychotropic medications directly to consumers via TV and other ads, the ability to get such medications from one’s physicians versus having to see a mental health practitioner, and the fact that health insurers push quicker treatments (again, the money issue).

Gnaulati believes (Psychology Today) talk therapy is “seriously under threat; at least as it applies to varieties of talk therapy that are relatively non-directive, time-intensive, in-depth, and exploratory in nature—typically under the psychodynamic and humanistic umbrellas of care.”

The newer trend, indeed, is to provide “evidence-based” treatments, which according to Gnaulati are “CBT-type, short-term psychotherapies supposedly tailored to reduce the symptoms associated with a given diagnosis.” He regards the studies that tout such treatments as somewhat misleading, however:

Evidenced-based treatments such as these are problematic because they measure progress strictly in terms of symptom reduction over the short term, not greater social and emotional well-being over the long term.
It turns out that evidenced-based really is evidenced-biased because the bulk of current empirical evidence substantiates that ‘contextual factors’ in psychotherapy are most predictive of positive outcome—empathy, genuineness, a strong working alliance, good rapport, favorable client expectations. And when you survey clients they overwhelmingly want a therapist who is ‘a good listener’ and who has a ‘warm personality,’ not someone skilled in the latest techniques.  So, CBT-type evidenced-based treatments should not be monopolizing the field right now in the way they are.

Whether shorter or longer, talk therapy, I agree, does need to be saved. “Fifteen Facts About Mental Health That Show Why We Need to Save Talk Therapy” was posted by Gnaulati’s publisher, Beacon Press. A sampling:

  • 90% of people claim they would rather meet with a therapist to talk about their problems than take medications.
  • Only about 3% of Americans ever enter psychotherapy, even though roughly half the population meet lifetime criteria for a serious emotional problem.
  • Of the approximately 49,000 psychiatrists in the United States, the vast majority exclusively prescribe medications. Fewer than 11% provide talk therapy to their patients.
  • 58% of emotionally troubled people take medications only, with no psychotherapy. About 10% of emotionally troubled people attend psychotherapy only and opt out of medication usage.
  • 50% of research articles in the field of psychiatry are ghostwritten in some shape or form, penned by outsiders and published under the names of prominent academics, all whom draw paychecks from pharmaceutical companies.

In sum, as a talk therapist myself, I don’t believe one size (of therapy) fits all. Medications may be all some people need, while others may need to talk things out, some over a longer period than others. When talk therapy is the choice, the relationship between each particular therapist and client is what often matters the most. And last but not least, money should not have to be an issue—needed therapy should be made affordable for all.

May 02

Depression Memoirs and Research

The following books about depression are recommended. All are memoirs, at least in part.

I. Alex Riley, A Cure for Darkness: The Story of Depression and How We Treat It (2021)

A psychiatrist reviewing A Cure for Darkness on Goodreads concludes: “What Riley successfully demonstrates throughout this book is that depression is an incredibly complex and diverse clinical condition. He shows how our understanding of the biological, psychological and sociocultural mechanisms underpinning depression has improved, alongside the sometimes empirical, sometimes scientific treatments. By doing so, he sheds light on the reasons why successful treatment of depression can be such a huge challenge for clinicians and patients alike.”

II. John Moe, The Hilarious World of Depression (2020)

Public radio personality John Moe, who has a podcast called The Hilarious World of Depression, is a funny person; he’s also been depressed most of his life.

Moe likes being able to put mental health issues out in the open, easing stigma for “saddies” while also educating the “normies.”

III. Lauren Slater, Blue Dreams: The Science and the Story of the Drugs that Changed Our Minds (2018)

Psychotherapist and writer Lauren Slater knows all too well the benefits and disadvantages of taking psychotropic drugs. Diagnosed with depression and bipolar disorder, she’s not only been on Prozac (she authored the bestselling Prozac Diary in 1998) but also various other medications over the years. She believes there are physiological tradeoffs to taking these.

What may bring hope in the future, she notes, are the psychedelics, such as LSD, MDMA, and “magic mushrooms.” In addition, there will be “neural implants that provide a ‘malleable and reversible form of psychosurgery’” (Publishers Weekly).

IV. Johann Hari, Lost Connections: Why You’re Depressed and How to Find Hope (2018)

Journalist Hari tells readers his own long-term depression has been blamed on a chemical imbalance in the brain. However, at some point in his therapeutic process “…he began to investigate whether this was true – and he learned that almost everything we have been told about depression and anxiety is wrong.”

Hari’s research led him to this basic conclusion (HuffPost): “I learned that there are in fact nine major causes of depression and anxiety that are unfolding all around us. Two are biological, and seven are out in here in the world, rather than sealed away inside our skulls in the way my doctor told me…I was even more startled to discover this isn’t some fringe position – the World Health Organization has been warning for years that we need to start dealing with the deeper causes of depression in this way.”

V. Natasha Tracy, Lost Marbles: Insights into My Life with Depression & Bipolar (2016)

This is a collection of articles Tracy has written and previously posted at Bipolar Burble and Breaking Bipolar.

In an interview conducted by Leslie Lindsay Tracy states, “I don’t believe in the concept of ‘stigma’ per se. What I believe in fighting is prejudice and the inevitable discrimination that follows it. I believe that by making people with mental illness three-dimensional people with real emotions and real struggles, we actually start to sound just like everyone else – just amplified.”

VI. David Blistein, David’s Inferno: My Journey Through the Dark Wood of Depression (2013)

Blistein’s reference point is The Divine Comedy of the poet Danté, who was familiar with “both depths of despair and manic visions of rapture.”

Caroline Carr, author of Living with Depression: How to Cope When Your Partner is Depressed, calls David’s Inferno “(w)arm and compassionate, often hilarious, and full of hope and encouragement.”

VII. Andrew Solomon, The Noonday Demon: An Atlas of Depression (2001)

For a deeper look at this groundbreaking memoir, see my previous post.

Apr 12

Resilience: How to Cultivate This Trait

When we began our study, we assumed that resilience was rare and resilient people were somehow special, perhaps genetically gifted. It turns out, we were wrong. Resilience is common and can be witnessed all around us. Even better, we learned that everyone can learn and train to be more resilient. The key involves knowing how to harness stress and use it to our advantage. After all, stress is necessary for growth. Without it the mind and body weaken and atrophy. Steven M. Southwick, psychiatrist, in The Huffington Post

Trauma experts Steven M. Southwick and Dr. Dennis S. Charney, a professor of psychiatry and neuroscience, are the brains behind Resilience: The Science of Mastering Life’s Greatest Challenges. In other words: how to bend, not break.

The authors conducted their own research, reviewed other related research, and interviewed many survivors of severe trauma. From this they came up with 10 factors that help people recover most effectively:

  •  Optimism
  •  Flexibility
  •  Core value system
  •  Faith
  •  Positive role models
  •  Social support
  •  Physical fitness
  •  Cognitive strength
  •  Facing fears
  •  Finding meaning in struggles

Southwick states that a couple of these—social support and optimism—are particularly powerful.

In an interview in Time, Southwick says of the former: “It looks like social isolation has as powerful an effect on longevity as smoking and [heavy drinking] and lack of exercise. It’s very bad for you. There’s lots of neat connections between social connectedness and ability to handle stress.”

And of the latter, states Charney: “It’s important to note that it’s realistic optimism we’re talking about. You need to have a very clear eyed view of the challenges you’re facing.”

Another resource is Supersurvivors: The Surprising Link Between Suffering and Success by David B. Feldman, a psychologist, and Lee Daniel Kravetz.

Amazingly, even in midst of trauma, people continue to smile, to love, to celebrate, to create, and to renew. In making this observation, we absolutely do not mean to belittle the impact of traumatic times or the suffering many have endured and continue to endure. Suffering is real, but resilience is also real. It is an incredible and encouraging fact about human nature that, contrary to popular belief, after a period of emotional turmoil, most trauma survivors eventually recover and return to their lives. They bounce back.

As defined by the authors, supersurvivors “are those rare individuals who, in the aftermath of great tragedy and turmoil, reassess their priorities, redirect their focus, and accomplish extraordinary feats—they break records, win awards, and meet the seemingly unattainable goals they set for themselves.”

According to the publisher, this book will help readers “discover why certain delusions can be healthy, why forgiveness is good for the body, and why reflecting on death can lead to a better life. And, perhaps counterintuitively, we learn how positive thinking is not always a strategy toward the good.”

What are the five factors that most serve to help trauma survivors experience “post-traumatic growth”?

  • hope
  • personal control
  • social support
  • forgiveness
  • spirituality

Note that hope and social support are also highlighted by Charney and Southwick.

Some reviews have emphasized that whereas this book may be short on analysis, it’s long on true-life inspiration. Kirkus Reviews: Supersurvivors is(h)ope for the endurance of the human spirit in the face of tragedy. Artfully described…intensely powerful…riveting…uplifting.”

Apr 05

“How Not to Kill Yourself” by Clancy Martin

Philosophy professor Clancy Martin, author of the new book How Not to Kill Yourself: A Portrait of the Suicidal Mind, has said the following about suicide (Yakimaherald.com): “Suicide, for most people, is a process. Sometimes that process starts at a very young age. The writer David M. Perry talks about his own suicidal ideation beginning at age 9. I have a former student who first attempted suicide by riding his tricycle through a window as a toddler. My own desire to kill myself is among my first memories.”

Indeed, Martin has tried and failed over 10 times to take his own life. How does he feel about this? Via Emily Gould, Vulture: “’I’ve lived all my life with two incompatible ideas in my head: I wish I were dead and I’m glad my suicides failed.’ This sets the tone for the book, which encompasses philosophical and literary musings about the history and meaning of suicide as well as detailed autobiographical accounts of Martin’s own struggles with his mental health, addiction, and suicidality.”

Several years ago Martin’s viral essay “I’m Still Here” detailed much of the background that led to writing How Not to Kill Yourself. An excerpt:

I was already thinking about suicide in a daily way when I was 3 or 4 years old, and this didn’t stop until I was in my early thirties. Every day, for as long as I could remember, I fantasized about suicide. When I was young, I imagined that I might even get to watch the funeral and the aftermath. As I grew older, I accepted that it was not because I wanted to see what would happen, but because I was sure I wouldn’t have to live any longer. Essentially, I started with the ‘Fame’ version of suicide and transitioned to the ‘Consolation’ version…

On “the only really persuasive reason I’ve ever heard for not killing myself”: “A psychiatrist once told me: ‘Don’t not kill yourself because your children need you. They do need you, but they’ll be fine without you. Everyone’s parents die sooner or later. Here’s the real reason you shouldn’t kill yourself. Think of the example you’re setting for them.’”

A Publishers Weekly review snippet:

In three sections, Martin addresses societal conceptions of self-slaughter, his own struggles with alcohol and the times he hit rock bottom, and how to chart a path toward recovery. Along the way, he touches on famous suicides from Seneca to Anne Sexton, and historical and philosophical cases considering or even justifying the act, from philosophies as distinct as Bushido, pessimism, and stoicism. Funny but never flippant, Martin takes into account throughout the weight of his subject, even when describing his own grisly attempts, or those of his friends, without platitude or sentiment…

More from Kirkus Reviews on How Not to Kill Yourself:

Married three times and the father to five children, Martin harbors a deep understanding of others who suffer with the same dark feelings of despair, including several suicidal relatives in his deeply dysfunctional family…While experts impart captivating psychological explanations, Martin’s perspective inspires the most incisive and disquieting passages. Sections on his murky descent into alcoholism smoothly dovetail with accounts of the author’s candid, heartfelt work toward making peace with life and pages of proactive ‘tools for crisis’ for anyone considering suicide…

David Shields, author of The Thing About Life Is That One Day You’ll Be Dead: “The most honest, complicit, searing, and discomfiting book I’ve ever read about suicide (and I’ve read quite a few—out of purely scholarly interest, of course).”