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“Smile, breathe, and go slowly.” – Thich Nhat Hanh
Interested in learning a bit about perinatal anxiety - or anxiety in pregnancy and the postpartum period? I created a Facebook Live introductory video. Grab a warm cup of tea and learn a bit about what's happening and how to respond! Yours in wellness, self-care and compassion, Shana Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.  It's data time! If you're just tuning in, last year I created an informal survey to collect information about real moms' real emotional experiences with pregnancy and postpartum life. If you're a truth seeker and want these insights sent right to your inbox, sign up here.
 Why talk about postpartum mental health?
It's thought that about 80% of women experience the “baby blues,” a short term (about two weeks) bout of sad-weepy-moodiness brought on primarily by hormonal shifts. A smaller percentage of women have more serious, but highly treatable, mental health concerns, commonly known as Perinatal Mood and Anxiety Disorders or PMADs. Neither the blues nor the PMADS are openly talked about (yet), likely because we're all walking around believing pregnant women and new moms are meant to be basking in the glow of impending or new motherhood. And there are are amazing, tender, hard-to-put-in-words, heart-bursting pieces of the experience. But, like with anything, pretending the hard parts aren't there when they really are just makes everyone secretly feel like they're doing life wrong, making us even less likely to be honest and open. It's not hard to see how easily the cycle is perpetuated, and the consequences are shitty at best (holding shame and self-judgment) and dangerous at worst (having untreated mental health issues that impact you and your child). So let's get educated first. Later, you get to decide if you would like to be honest about your own experience with those you decide are supportive and deserving of your story. Getting to know the tougher end of the spectrum. Below is information about the most common PMADS. These statistics and symptoms are taken directly from the Postpartum Support International (PSI)'s extremely informative website, edited to fit in one space so you don't have to click around. The links within will take you to more elaboratate descriptions in “plain mama English” on the Postpartum Progress website. More on both of these amazing organizations later. Depression: `Occurs in ~ 15% of postpartum and ~ 10% in pregnant women Perinatal depression is the most common complication of childbirth. Symptoms include:
Anxiety: Occurs in ~ 10% of postpartum and ~ 6% of pregnant women. It may be experienced alone or in conjunction with depression. Symptoms include:
OCD: According to PSI, "Postpartum Obsessive-Compulsive Disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal disorders. You do not have to be diagnosed with OCD to experience these common symptoms of perinatal anxiety. It is estimated that as many as 3-5% of new mothers and some new fathers will experience these symptoms. The repetitive, intrusive images and thoughts are very frightening and can feel like they come “out of the blue.” Research has shown that these images are anxious in nature, not delusional, and have very low risk of being acted upon. It is far more likely that the parent with this symptom takes steps to avoid triggers and avoid what they fear is potential harm to the baby." Symptoms include:
Psychosis: Occurs in ~ 1 to 2/1,000 deliveries, or ~ .1% of births. Onset is typically sudden, usually within the first 2 weeks postpartum. Symptoms include:
Got it. Now what? Okay, now you know the general scoop on these disorders. So what if you notice symptoms in yourself or someone you love? Below are options depending on severity.. You can loosely think about what category you fall into and/or take this valid and reliable depression inventory, which has anxiety items on it as well (this won't screen for other PMADS). Of course, calling me (or abother practicioner in maternal mental health) is a reasonable option regardless of severity, but let's make sure you have the full range of appropriate options. Severe (it's real bad, even if it's hard to admit; score of 19 and above): Call your doctor and let her or him know what's happening for you. Yes, this will be hard. Yes you should do it anyway. There is no perfect time. If you have a hunch that it will help, make the call. *Important Note: Postpartum Psychosis is a medical emergency and needs to be treated right away. This means you need to get to an emergency room ASAP, and once there be real honest about what's happening for you, including all the scary and harmful thoughts. Until you've connected with the appropriate support, you should be accompanied at all times. And remember, as intense as this is, it's treatable. This level of scary won't last forever. Mild-Moderate (this is not normal for you and it's getting in the way of you feeling like yourself*; score of 13-18): Call me or another provider educated/skilled in maternal mental health. The recommended treatment for mild to moderate postpartum depression and/or anxiety is therapy. For moderate – severe, medication is recommended, and there is a variety of other non-medication options as well, such as light therapy and acupuncture. Note: If medication is presented as an option and your first thought is “but I'm breastfeeding,” I'm linking you to two sites that can give you sound information about that. There are some medications considered safe options while breastfeeding, which is good to know even if you decide it's not for you (i.e., you can help spread the word so other mamas don't make uninformed choices!). LactMed is the National Institute of Health's huge inventory of info on the subject and Mind Body Pregnancy is the brainchild of a San Francisco psychiatrist, passionate about getting this information out to the masses. Mild (symptoms are pesky and in the way of feeling like your best self*; score of 10-12): Call me or another provider educated/skilled in maternal mental health and/or create or check in with your personal wellness plan. Are you doing the things that you know work on better days, such as getting movement, talking with trusted friends, resting, eating well, praying, or whatever your specific tools are? Are you letting the helpers help? Do you need different ones? Do a quick assessment and see what you see. Remember, this is the biggest adjustment you've ever made, and it's challenging at its core. Of course feeling well is going to take more effort and resources. *even the concept of feeling like your best self should be taken in the context of adjusting to your new mama self. On Online Resources: Click wisely As you probably know, when it comes to the internet, the line between staying informed and getting overwhelmed is thin. For the sake of your emotional health, I recommend that you, first and foremost, tune in to your inner wisdom or that of someone(s) who knows you well enough to have a fair say in what's happening when your wisdom is overshadowed by overwhelm, self- criticism, sleep deprivation, or simply the hardcore newness of this whole thing. In terms of the web, it's my personal opinion that you focus on the aforementioned online maternal mental health resources. Postpartum Support International is like the kind, giving grandmother of this family, who tells it like it is, without a lot of “extra.” In addition to the basic information provided above, she has answers to your frequently asked questions, a warm line that you can call in times of need (not for use in a medical emergency.), and the numbers for who to call in your city, state, or country to find an appropriate resource. She's the one who teaches many of us clinicians about this work and also offers stories from countless women just like you on the PSI blog. Postpartum Progress is also a wellspring of information, but has more of the tone of your sassy aunt who's like “Oh honey, come here, I got you.” She's super smart and is on a mission to “create healthier families by raising awareness, reducing stigma, providing social support and connecting mothers to help for perinatal mood and anxiety disorders like postpartum depression.” The best way to see all she has to give is by starting here. One of the sweetest offerings is a year's worth of daily hope emails. Of course, of course be open to other resources that are helpful to you. What I caution against is Googling all your symptoms and noticing four hours and 17 chatrooms later that you still aren't quite sure what's happening or what you need. Okay, I think that's enough for now, yes? If you've gotten this far, go ahead and thank yourself for staying informed. It's truly half of the work, mama. Now, go take a nap. xoxo Yours in wellness, self-care and compassion, Shana Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.  I recently shared several ways to know when counseling during pregnancy may be right for you. I wanted to write you a short list of why pregnancy is the absolute perfect time to seek counseling. I wanted it to be cute and catchy. I failed.
It’s too important y’all. Why? Because if you’re reading this you are either in the process of, or considering bringing a new little human being into this world. It’s the start of a miraculous marathon and you will get pooped the f___ out, period. But if you warm up, pace yourself, and anticipate obstacles, you’ll be in a better position for the long haul, to avoid injury, if you will. So I’m fleshing it out, point by point, starting with benefit 1: You will get to know your triggers, which will help you, A, cope when they arise, or B, avoid them altogether. We're all swept into difficult emotions from time to time, be it sadness, worry, fear, anger, and even rage. During pregnancy you may notice that this happens more frequently or perhaps more, um...surprisingly - as in why do I feel like I could shoot fireballs out of my eyes when my partner forgets about our prenatal appointment? Or, why am I weeping behind my desk after my manager gives me a piece of constructive criticism? While hormones are a huge culprit in this heightened sensitivity, that doesn't mean there isn't useful information in your emotional experience. When you get intentional about paying attention, patterns emerge. Let's go back to weeping behind your desk. You explore the reaction, noticing your thoughts, feelings, and physical sensations. When you got the feedback you felt ashamed and defeated, your heart felt heavy and you thought "I am incompetent." You start noticing other times this has come up for you, and get to work disentangling the experience, and finding a more balanced view. Perhaps you had a critical parent, a one-time humiliating school experience, or have a long time propensity towards perfectionism that never went challenged because it served you in some way(s). Regardless of the reason, with some effort towards compassionately bringing awareness to your experience, being consumed by feelings if inadequacy transforms into something like "sometimes getting feedback triggers feelings of defeat and incompetence.” Now you have a bite sized piece to work with. Perhaps naming it takes away half it’s power. Maybe you do a strengths search and identify the times you had a strong sense of feeling competent. Or you learn how to bring loving touch to your body in that moment and let the wave pass. Just like that you have options. Which one is right for you is to be determined. That’s why starting the conversation is key. In addition to learning what you need when in the face of your triggers, there may be some that you avoid altogether. No, you can’t necessarily avoid feedback at work (nor would that help your larger need for growth, right?), but perhaps you have some toxic relationships that you’ve been having trouble drawing boundaries around, and now feels like a good time. Or you notice some of your triggers are not people or settings, but sensations, such as being hungry. You don’t like that she-devil or anxious-annie who appears when you’ve waited too long to eat, so you learn to gnosh every couple hours, or whatever suits your mind-body needs. While avoidance as a defense mechanism can be unhealthy, avoiding things that are actually harmful to us is excellent self-preservation, for yourself and your growing baby. Your objective during this time-limited, opportune phase is to figure out what you are better off living without and what you choose stay in contact with, but relate to differently. The next installment will discuss more about not what is happening, but how you are relating to it (spoiler alert: you have options there too!) Yours in wellness, self-care and compassion, Shana Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call.  Pregnant or not, the decisions to seek counseling can feel like quite the inner-battle. You are feeling overwhelmed, worrying about the same things over and over, and your stressors are outweighing your current coping mechanisms. You’ve thought about seeking counseling for months, maybe years, but actually doing it feels next to impossible. And yet, everyone you talk to who sees a therapist (if they’re willing to share) says it’s been a game changer. The line I’ve heard most over the years is “Why doesn’t everyone do this”? Also common: “I wish I’d come sooner.” I’m not going to try to convince you, because I know you need to exercise your right to choose what’s best for you. I know my own voice of I-don’t-wanna is strong, and I have to honor her position (though do try not to give her the last word too often). BUT it is my passion to inform women of their choices, big and small, and feel strongly that being emotionally empowered while walking the reproductive path is crucial. It can mean difference between feeling connected versus isolated, self-compassionate versus guilt-stricken, and resourced versus confused about what or who can help during the time(s) you need it most. Okay, so how do you choose whether counseling is right for YOU? Now that you’re pregnant - or even if you are planning to be soon - therapy or supportive counseling may be helpful if you:
*Risk factors include:
Does any of this resonate with you? I'll be adding more in coming weeks about the specific benefits you gain during this unique and time-limited experience, but if you're ready, go ahead make that call. (More on finding a therapist here, here, and here). Yours in wellness, self-care and compassion, Shana Think I may be the right fit for you or a loved one? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546 for a free 20-minute consultation call. Want lots more education about PMADS and access to maternal mental health support anywhere in the country and beyond? Check out Postpartum Support International!  You've made it so far in your search for a therapist.
You've decided it's time and identified what you need. You came up with a budget and have found a name or two (or more!). There's one more big step. Making the call(s). What do I say? One of the biggest obstacles people describe getting in the way of asking for what they need is “not knowing what to say.” Then it ends up in the expansive category of I-don't-know-the-perfect-way-to-say-it-so-I'll-say-nothing. Calling to set up therapy is no exception to this. I'm queen of the fumbly phone message and have found that scripts are helpful. So, here I give to you the simple script to follow when leaving a voicemail for a potential therapist (you will rarely catch someone live): Hi, my name is _______. I am looking for a therapist and got your name from _______. I was wondering if you are taking new clients. My phone number is _______ and the best time to reach me is _______. That's it. A lot of people report feeling a bit better just by making the call. So, now what can I expect? This can range. Ideally, the therapists will call you back and let you know if they are taking new clients or not. If they are, most therapist offer a free consultation call, ranging from 10 to 30 minutes. In the real world, not every person will call back. This is annoying, but is not personal. As someone who frequently helps callers find therapy, even if it's not with me, I used to get very self-righteous when I heard of therapists who don't call people back. Until I accidentally did it myself once or twice. Each time I knew I wouldn't be able to take the person AND I was so busy that finding a time to call was hard AND THEN so many days had gone by that I felt like calling would be intrusive. It was totally lame, totally accidental, and had nothing to do with the caller. If you don't get call backs, keep going down your list. Try not to lose momentum. What happens during a consultation call? During this call you talk a bit about what's happening for you, and you can feel what it's like to talk with this person. You might grow emotional, especially if you've been holding back for a while or if you are feeling particularly raw. Totally normal.You will also discuss logistical information and fees. This may be enough for you to decide, but if you are wanting to know more, a great question you can ask to get at the style of your therapist is, “how do you work”? As I mentioned in part one, looking for a therapist of a particular theoretical orientation is a bit tough unless you are already familiar with the multitude of theories out there. But if you ask about how a therapist works, you can get a sense of what they value and how you may spend your time in the therapy room. This is what I say: I don't see any two clients as the same, so my approach varies from person to person – based on need. In our first sessions I'll get to know what you're experiencing and get a bit of history. Then we'll choose long-term goals and start gathering tools for you to use right now. My experience is that healing doesn't work in a straight line, so we'll likely hop around from focusing on the present and the past, as it feels relevant. A lot of my work focuses on how you are talking to yourself about what's happening – which is often unkindly – and teaches ways to relate with more compassion. I believe this exemplifies my value of people's unique differences, the winding path towards healing, empowering clients to continue the work outside of my office, and the power and strength of self-compassion. Now what? Now you get to decide who sounds like a good fit for you and you schedule your first appointment. Congratulations on your willingness to getting this far. Even though this isn't necessarily easy, you did it. I wish you the best on your adventure. Yours in wellness, self-care and compassion, Shana Think I may be the right fit for you? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546.  The time has come to search for your therapist.
You've identified your needs, specified your criteria, thought a bit about your budget and are ready to get some names. Congratulations. I'm going to tell you some of the most common ways to get a list going, add a touch of inside scoop, and then you can decide what feels best for you. Word of mouth Getting recommendations from people you know and trust is a wonderful place to start. What does this sound like? Whatever fits with your style of asking. “I'm looking for a great therapist. Do you know of anyone”? “I'm having a really hard time since mom died. I think it's time to talk to someone. I know your wife went through this last year. Can you recommend any specific resources”? Of course, you have to feel comfortable telling people you're looking for a therapist, which in an ideal world wouldn't be a second thought. But if if you are feeling shy about asking around, you're not alone. It's not you, it's stigma. While I personally think those asking for help and allowing themselves to be vulnerable are the bravest people out, for the sake of getting what you need, there's always: “My friend is looking for a therapist. Have any recommendations”? There is something special and subtly community-building about word-of-mouth referrals. I've been on every side of this. My love-of-a-therapist for years was recommended whole-heartedly by a colleague of my mom's when I was 17 years old. I, in turn, recommended her to a few of my closest friends over the years, and they to theirs. On the therapist end, I notice that when client's are referred from people who really know me, they are more open and trusting right from the beginning. There is nothing wrong, of course, with being slow to warm up, but my point is that there is something comforting about having even a distant familiarity with a person, even if that means your brother's neighbor's daughter's friend was greatly helped by her or him. Insurance/EAP Lists These. Are. Long. Don't let that deter you. Since you've narrowed down some of the specifics you're looking for, you can whittle this list as well. You can take this list from 100 to 10 just by plugging in your needs. You can usually search by preferences, such as zip code, gender, language capacity and/or specialty. Whoever pops up should have a little “about me” blurb. Once you've found a few good options, you may be ready to start calling, or you may want to do a little more research online. Internet Search We all know it's a vast world online, so searching the web for a therapist can be intimidating if it's your starting point. However, if you've already found some names, it's one way to check them out further. If you are starting from scratch, here are some good things to know. Search Engines Of course, you can do a quick Google search and see what you see. But when I type “San Francisco Therapist,” up pops 19,000,000 results in .52 seconds. The top ones, of course, are those with paid advertisements, followed by links to popular therapy directories. While you may stumble upon a website you like within that search, it might be more helpful to simply start with a directory. Online Therapist Directories Psychology Today, Good Therapy, and Therapy Tribe are some of the most popular online directories, and each will give you some sense of your potential therapist's style. If you're specifically looking for a low-cost option, Open Path Psychotherapy Collective provides just that. Again, you can plug in your preferences and numerous options will appear. These sites are typically more fleshed out than the online insurance lists, so, cross-referencing may bring you a fuller picture of who you're looking for. Here you can see how therapists describe their work in a nutshell, how long they've been practicing, and their general price range. You can see their faces and, more often than not, links to their websites. If reading each and every detail is what helps you decide, do that. If you have a gut instinct about one or a few (perhaps you like one woman's smile, perhaps another one's sense of humor), great. Go with it. Yelp Aah, Yelp, every business owner's frenemy (an outdated, but perfectly descriptive term). For those seeking services it's, of course, enticing to receive information not presented by therapists, but by those who know them, either as consumers or colleagues. I would probably not recommend this domain as your starting point, but more as the finishing touch on your search. I say this largely because, unlike other types of businesses, it is actually against ethical standards for therapists to solicit testimonials from clients, for reasons beyond the scope of this article. This, in and of itself, leads many therapist to not want to add their businesses to Yelp. Basically, it's not a representative pool of therapists. When you do see therapists on Yelp, they typically have reviews from colleagues, recipients of services that are not therapy per se (workshops, consultation, coaching, etc.), and some clients who have found them and volunteered reviews. (Here's a link to mine, for reference) This is an excellent way to see what others have to say. Maybe someone's description really resonates with what you are seeking. Perhaps it's the last detail you were needing to hear in order to move forward, which is great! If there are negative reviews, look for a pattern and/or a substantive critique. If someone has one negative review because they didn't call someone back or there was some kind of misunderstanding, I wouldn't necessarily count that person out, if there are other factors that appeal to you. Note: When therapists have a lot of reviews from clients, it's typically because someone has found a way around the basic ethical standard. Perhaps it's a group practice that has the administrative capacity to solicit testimonials in another way. This is a smart business move, but it's important for the general public to know that it is just that. Again, tons of useful and true information in the content of the reviews, but not a representative pool of your local therapists, just a small business savy cross-section. Okay, about sums it up on searching for a therapist. Hopefully using one or more of these methods with get you a short list of possibilities, and next we'll go over what to say and expect when you call. Yours in wellness, self-care and compassion, Shana Have a question or comment? Feel free to share in the comments section. Think I may be the right fit for you? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546.  You've decided you want therapy and have narrowed down your criteria. It's almost time to start your search. Let's pause here for a moment to talk about money, because your budget will make a big difference when you start reaching out.
Also, if you're like many people, one of the biggest questions you may have is How am I going to pay for therapy? Luckily there are options for every budget and what follows are some common examples. Using EAP benefits (cost: free!) First, let's talk about the free option you may not be aware of, and that's the one offered through your employer's EAP, or Employee Assistance Program. Your employer may or may not offer one, but if this sounds familiar, you may have glanced at an EAP worksheet when signing your new hire paperwork, or perhaps you delete their monthly wellness newsletters. EAPs typically offer, among other things, three to five counseling sessions per issue. So, say you are having anxiety about your impending wedding. You can get approval for one set of sessions with an approved EAP therapist. Now say that after a month of meeting, you receive an eviction notice. You can get approval for another set of sessions following the first. This is a great option if you want or need to talk with someone, but don't have a big budget and aren't interested in longer-term work. It's also a great choice for those who are action-oriented and want to explore some solution-focused conversations with a professional. Paying Out of Pocket without Insurance (cost: $0-200) This category affords you the most therapist options and a huge spectrum of price points. Sessions are limited only by your wants and needs. Paying purely out of pocket, weekly sessions can still range from $0 - $250, the lower end being in clinics, in which therapists are still in training, the higher end being PhD level clinicians with many many years of experience. There are talented clinicians at each point on this spectrum. I like to remind people that every wonderful seasoned clinician was at the start of her career at some point. In San Francisco, you're going to see many Masters level clinicians (MFTs and LCSWs) with a full fee in the $150 – 200 range. Of those, many offer a limited amount of sliding scale slots, either based on income or category (e.g., students). If thinking about paying on the mid- to higher end on a weekly basis feels overwhelming, you are not alone (if you're feeling so tense that you want to stop reading and you have insurance, especially if you have a PPO plan, I urge you to simply skip to the next session or consider a lower-fee clinic option). Paying for therapy can be an adjustment and may require some reprioritizing of your funds. It may help to consider some of the ways you are currently spending money, particularly if you're doing it in a way that makes you feel good in the short term, but isn't helping in the long term (read: copious online shopping, expensive dinners out, drugs/booze, etc.). On a more meaningful level, if you peek back at the elements of your emotional life that you're looking to nurture, you can also ask the question Can I afford not to make a change? Picture moving through the next five, ten, twenty years feeling weighed down by the same feelings, habits, and relationships you currently struggle with. Picture retiring and having time to be with the self that is struggling. Imagine next what it would feel like to lighten that load. Picture being in a phase of life where you not only feel comfortable in your own skin, but have chosen the right people to be in your circle. Envision that you've made meaning of your past, can be present in the present, and look forward to the future. These are a few key areas therapy can help address. The short term investment may uncover a priceless part of you. Therapy is absolutely not the only way to make a change, but it's one good option. I heard one woman recently described her weekly therapy as “a gift to herself,” which I thought was a lovely perspective. Using Your Insurance (cost: varies, $5 - 100+) Let's move on to talk about insurance, so we can put it all together. This option will open the door to lower weekly payments and a moderate range of therapist options. Sessions may be limited to certain number per year, but some insurance companies are quite generous, so it's worth checking out. In the post that follows I will give you key questions to ask your insurance provider in order to get the details of your plan. But here's a general run down of how it works. If you have an HMO plan you will have the least amount of options, as you'll have to choose from only in-network providers. However, you may pay a co-payment of $10 - $40 per session, with many in the $20 range. If you have a PPO plan, you'll likely have options for in- or out-of network providers, and this opens you up to a lot of possibilities. You may have a deductable to meet initially, ranging from a couple hundred to a couple thousand dollars, but then you may have either a co-payment or co-insurance (in network, I've seen as low as 10%, out of network 30 – 80%). In this set up, you will likely pay the fee and then be reimbursed by your insurance company. With so many clinicians offering the option to pay via credit card, you should be able to use your reimbursement to pay a portion of it off. Looking back up to the numbers, let's say your therapist's fee is $120. Depending on your plan, once reimbursed you will instead be paying in the range of $12 - $36 - $96. That's a range of overpriced sandwich to mani-pedi to dinner with friends having ordered that second bottle of wine to share. I've said it before and I'll say it again: Perspective is everything. The majority of my clients fall into this category and I've learned about these terrific insurance benefits through my direct experience with them. As a bonus, many use FSA/HSA accounts to pay for sessions (better explained here than by me), but essentially these accounts use pre-taxed money to pay for medical expenses, and therapy fees are often covered. Okay, I know it's a lot to digest, but now you have some basic information about paying for therapy. Take a little time and think about what option (or options) suits you best, all things considered (including sandwiches). Yours in wellness, self-care and compassion, Shana Have a question or comment? Feel free to share in the comments section. Think I may be the right fit for you? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546.  So you have a sense that you could benefit from starting therapy, but the whole concept sounds pretty...big.
Let's break it down so you feel like you know what you're asking for. Let's answer the question: “What do I need”? One sweet and simple way to answer this question is to ask yourself this: If I woke up tomorrow and was feeling better, what would be different? How would I know something had changed? Here are some common responses: If I woke up tomorrow and was feeling better . . . . . . I would have more energy. . . . I would not be obsessing about my relationship. . . . I would put myself down less and feel more confident. . . . I wouldn't feel so overwhelmed by my anger (sadness, jealousy, anxiety, etc.) What comes up for you? Maybe you have a few smaller items, or a single glaring one. Maybe you're mad or uncomfortable that your attention is being called to things you'd rather not think about. Perhaps you feel hopeful at the prospect of feeling better or different. Any response is a perfectly fine one. Now sit with what you came up with and consider that you've taken yet another step down the road towards getting support. You are clarifying the area on which you'd like to focus. So let's fill in some more details about the services you seek. These are a few common questions I ask when helping people specify what they're looking for:
(You may notice that I don't include a question about theoretical orientation or what “type” of therapist you want. This is because I believe there's a better way to get at that information, which I will talk about in a future post. I will also post on budget/insurance.) So, putting it all together, at this point you may have something like this: I want to get help with being so hard on myself and never thinking I'm enough. I want to see a female therapist in either the Richmond or Laurel Village area, and don't care about age, ethnicity, or religion. I could go Monday or Wednesday afternoons, and can pay $120/ week using my PPO insurance, which will reimburse me for either an in- or out-of-network provider. And just like that, you're ready to start your search. You can dive in knowing what you already know, or next up, I'll offer some insight on great starting points. Yours in wellness, self-care and compassion, Shana Have a question or comment? Feel free to share in the comments section. Think I may be the right fit for you? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546.  It's the last Monday of January 2016 - the first of the final seven days in which we can still ride the impetus of the new year towards personal growth.
On another day I might have felt like time was moving too quickly (It's the 25th? Seriously?), but today, perhaps because it's the fourth Monday in this generously long month, I feel like this week is a great opportunity. I want you to see it that way too. I really want you to see it that way if getting started with therapy is on your list of things-you-know-you'll-benefit-from-but-don't-know-where-to-start. Today I'm talking to you. Let's all widen the scope of this new year's intention thing and consider that the whole month can be used to decide what we want to cultivate and what habits we may want to put in the not-serving-me-anymore bucket. My sense is that people are naturally doing just that – thinking about these things, which is terrific in and of itself. It's really something to let into your consciousness that you'd like to hand over some heavy items you've been holding to someone you don't yet know. Or even to notice that the ways you've been coping – maybe numbing, overworking, blaming, intellectualizing – are neither sustainable nor satisfying. Sometimes, though, thinking turns into ruminating or looping and we feel stuck. And one of the quickest ways out of rumination is to step into action. But what action is the most appropriate for you? It's probably one of these three categories:
Over the next couple weeks, I'm going to walk you through some of this territory in an effort to help you find what you need. I will offer some questions to ask yourself that get at specifying what you're looking for. Next up will be multiple ways to search for a therapist, no matter what your budget. And finally, I'll offer support around reaching out, including what to say and what to expect in response. But for today, what if you locate where you are right now? What category do you fall into? Answering this question may be a bigger step than you even know. Yours in wellness, self-care and compassion, Shana Think I may be the right fit for you? Feel free to email me at contact@shanaaverbach.com or call 415-963-3546. |
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