Does your therapist have a secret wish list of things you should do to optimize your therapy?
If you’re one of the millions of people in the United States who sees a therapist, you may have had this exact thought.
To answer that question, we asked five psychologists -- Melanie Greenberg, PhD, Laura Kauffman, PhD, Craig Malkin, PhD, Simon Rego, PsyD, and Scott Symington, PhD -- to share their lists of things they’d like to see their patients do. They were all pretty consistent, making frequent references to mindfulness, self-compassion, self-awareness, healthy lifestyle adjustments, and work on positive relationships. Here’s their advice:
1. Practice mindfulness
Mindfulness is not an exotic technique: It’s simply about being present in the moment without judgment, says Dr. Rego, director of psychology training at Montefiore Medical Center and associate professor of clinical psychiatry and behavioral sciences at Albert Einstein College of Medicine in New York City.
“Our minds are built to jump around, back and forth, especially in today's multitasking world,” he says, but “there's a great deal of research supporting the mental and physical benefits of learning to be more mindful.”
Dr. Greenberg, a clinical psychologist in Mill Valley, California, who blogs forPsychology Today and is the author of the upcoming book The Stress-Resistant Brain, says that mindful self-awareness is “building an observer perspective on yourself and your life,” and that it’s one of the most important early steps a person can make toward change.
One way to practice mindfulness is by focusing on awareness of your breathing, says Dr. Symington, a clinical psychologist in private practice in Pasadena, California. “You close your eyes and follow your breath for a specified period of time,” he says, which helps lower stress levels and improves your skill at detecting internal sensations, like feelings of tension.
2. Be kind to yourself
Greenberg calls this sidelining your inner critic. “Seeing yourself with loving eyes doesn’t always come naturally,” she says, and talking back to your inner critic takes practice. “Change happens when you drop perfectionism and give yourself permission to be a human being who makes mistakes,” she explains.
Dr. Malkin, a psychologist and psychology instructor at Harvard Medical School, and author of Rethinking Narcissism, echoes Greenberg’s recommendation. “Many of my clients berate themselves for each and every mistake,” he says. But research shows that this kind of self-punishment is the worst way to change behavior. “We’d all do much better celebrating our moments of success than laying into ourselves for our ‘failures,’” he says.
“Question [your] thoughts,” advises Rego. “All too often, we buy into our thoughts without challenging them.” You need to be willing to consider that your initial reactions to things may be wrong, especially when those reactions are extremely negative, says Rego.
3. Practice Self-Observation and Evaluation
While you need to counter self-punishment, you also need to be willing to examine yourself realistically. “Be willing to be uncomfortable,” advises Greenberg. “Therapy works by helping clients access their thoughts and feelings about difficult or painful experiences.” The more you avoid going to these painful places, she says, the slower things will go.
And try not to be too impatient with yourself as you navigate that process. “No matter how hard we work to change, old habits occasionally creep back in,” says Malkin.
You shouldn’t see the return of something you thought you’d resolved as a failure, but as an opportunity to ask questions of yourself, says Malkin. For example, you might ask yourself, “What made it harder this time for me to skip the drink, or use a gentler tone with my partner, or exercise when I felt panic coming on?” he says. “There’s always an answer -- and finding it often leads to tremendous growth.”
Understanding what triggers a return of behaviors is important, says Symington, adding that self-knowledge can help you plan for these vulnerable moments in your life. “Identify the pattern and then make a plan for the challenging space you know is coming.” Your plan might include having healthy distractions available for when you may need them, or preparing ahead of time to encourage a friend or hug a loved one.
When it comes to children in therapy, Dr. Kauffman, a child psychologist in Menlo Park, California, says that parents may need to be observers for their child. “It’s incredibly beneficial to have an update and a heads-up from parents before a session,” she says, because children often forget to share “fairly significant events.”
4. Do What You Can to Stay Physically Healthy
Sleep well -- period. “This is the lowest-hanging fruit in mental health,” Malkin says.
And keep a food diary, suggests Symington: “Just the act of recording meals often improves our diet.” Most people are surprised, he adds, about how much their diet affects their mood and behavior.
Exercise has many proven benefits: It boosts mood, reduces anxious energy, and promotes good health overall, says Symington. “Put it on the schedule and make it non-negotiable,” he advises.
“Increasing activity levels … has been shown to directly improve [symptoms of]anxiety and depression,” agrees Rego.
5. Make and Strengthen Healthy Relationships
“We live in a network of relationships that either hold us back or push us forward,” notes Malkin, “and people don’t always like our efforts to change.”
Greenberg agrees that as you find self-improvement in therapy and learn to be assertive and set boundaries, “People in your life may push back or be angry at you.” She says that you need to be ready for these changes, and you may have to move away from unhealthy relationships to allow room for healthier ones.
“Change is hard,” agrees Symington, who advises sharing the struggle with a friend or spouse, and advising others you’re close to of your goals.
Building and strengthening social networks is also critical, notes Rego. “Strong, healthy social networks serve as an excellent buffer for life’s stresses and can help decrease the impact of psychological disorders,” he says.
For parents whose child is in therapy, however, the advice is a little different. Children must choose their own comfort level with sharing, which is something most parents understand, says Kauffman.
“Some parents can't help but probe and question about the content of therapy sessions,” she adds. “It’s important for parents to understand the value and power of the safe and confidential therapeutic space for a child.” If something comes up that parents do need to know about, she works with the child to explore ways of communicating the information to the parents.
Outside the Therapist’s Office
Once you unlock therapeutic achievements, it’s time to take the lessons with you in life, says Greenberg. Stay the course, recommneds Malkin, adding that it’s important to keep doing what feels right regardless of what outside sources, like well-meaning but ill-informed relatives, might say.
Rego, who focuses on cognitive-behavioral approaches, has one final recommendation that’s familiar to most of us, whether children or adults: Do your homework.
“Therapy should teach people skills that they can use to improve their symptoms and their lives,” he says. “The best and fastest way to build a skill is to practice as much as possible.”
5 Things Psychologists Wish Their Patients Would Do was originally published on Everyday Health.
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