Hi! I'm Misty Smith :) I'm a licensed therapist in Michigan and I love talking about the benefits of therapy and answering questions about therapy. Ask Me Anything!

My insurance will only pay for a very limited number of sessions focused around coaching me and coping mechanisms. I try to explain that I dont want that—I want therapy. But it seems the value of long-term open-ended relationship-based therapy is not accepted by the US healthcare system. Do you see this changing anytime soon, and what should I do in the meantime?

Hi! So this is a problem in the US for sure. It's all about money. Insurance companies want a "quick fix" and they want to limit therapy to avoid having to pay for open-ended sessions. I think it's awful- most of my clients have been with me for years- but it's definitely something that needs to change. Many insurances are covering longer-term therapy, but some are still behind the times.

Do you help your clients, if they are with you for years?

Absolutely. The focus shifts to different things but we continue to do the work. And I have a strong addiction background so some of my long term clients are in recovery.

Hi - I went through a period of therapy with a therapist who I thought I connected with quite well. However, I felt that the experience was really ineffective. I didn't learn much, I didn't grow or make any changes, but it was nice to have someone to talk to.

When I mentioned my concerns to my therapist, I was immediately dropped as a client, which was quite shocking to me. I reached out for clarification and was told that their "clinical judgment" was that I needed specialized treatment. I feel like they are using this retroactively as an excuse to justify why they were unable to help me since it was never mentioned to me at any time prior. Its been a very confusing and disturbing process for me.

I'm left feeling like therapy is a scam and that I'm being gaslit. However, I don't really have any recourse, and it's been really frustrating to try to navigate this situation.

My questions are: What should I have done when I felt like I wasn't making any progress? If a therapist knows they can't help a client, why would they continue to see them? How can I go about asking for a refund since they didn't actually help me, and it seems like they knew they couldn't from the very beginning?

Hi! First and foremost, I am so sorry that happened to you. It's incredibly frustrating when people have negative experiences in therapy because truthfully it can be a really awesome and powerful process.

To answer your question, first, you did NOTHING wrong. Not all clients have the therapy experience or knowledge to know what to expect or that they have alternatives for making progress. That therapist should have talked to you about what progress you want to make, what they can do to help facilitate that change, and worked with you to make the situation better. And then if it still wasn't enough, offered a referral to someone better. Making you feel like you were the problem, and then ditching you, was completely unethical. I'm so sorry you had that experience.

Yeah so its seems to me like the way they treated me is the same way you responded.

Thank you for your kind and validating reaponse, but, all you did was validate me without answering my questions. It makes me feel nice, but it isnt actually helpful. Maybe i am unique in actually wanting concrete answers and progress instead of just empathy and validation?

Thanks for tryin, i guess.

Hi! I appreciate your response, and I think it brings up a very good topic. Therapists oftentimes are incredibly affirming but don't always provide concrete solutions. This isn't because we don't want to- it may be because we don't have enough information or the client isn't yet ready to do the things necessary so we have to guide them along. In terms of your direct questions, I stand by my statement that you did nothing wrong. If the therapist felt they weren't a good fit they should have expressed that to you inste6of dragging it out. Why did they do that? I, unfortunately, can't say. I am not that therapist. In terms of a refund, again I can't say. If insurance paid for it then it would be difficult. If you paid out of pocket you can request a refund but I'm going to be honest that you likely won't get it. You could try to sue but I don't know on what basis. Unfortunately bad service isn't typically a reason for legal action.

I do hope you find a therapist that can provide more structure. I actually giggled a little bit at your response - not out of disrespect -but because I typically am a very direct therapist and I am definitely one that tells my clients explicitly what I think they need to do. But please understand it's very hard to do something like that over the Internet because I don't know you and I don't know your situation so far be it for me to speak out of term. With that said I absolutely wish you luck!

If you're not too exhausted yet, I have a difficult one for you.

I'm seeing a psychologist and psychiatrist for ADHD through my country's health service. I'm in a rural area and they are the only ones available in my area. There's absolutely no possibility of seeing a different psychologist - I've begged and pleaded with my doctor, but it's not possible. My psychiatrist will only continue my medication if I see the psychologist, but to say our relationship is poor is an understatement. I've never been in a more harmful patient-provider relationship in my life - and not only because I've never been in a situation like this before.

What steps can I take to protect myself as this woman picks apart and judges my life (I assure you, she openly does), while also seemingly cooperating (something my psychiatrist brought up recently as a condition of further treatment as I'd taken to speaking as little as possible)?

I know this is a tough one but I've gone from good mental health to deep depression since starting sessions with her, and I can barely stand to go to appointments, but I need my medication. I really need advice.

Thank you for taking the time to read this!

Hi! This is complicated, and a lot of it is going to depend on your insurance, where you live, and frankly your willingness to be stubborn LOL First, if the therapist is being judgmental or causing you more emotional harm, that's unethical. The problem is that she's tied in with the psychiatrist, and she knows it.
Couple of thoughts: is there a telehealth psychiatrist you can see from a different location? It's a thing, especially since COVID. Second, are your psych meds something a PCP can prescribe, at least in the interim until you get another psychiatrist (not all PCP's will but some do). Third- take notes of your sessions, and document what she says. You can also record sessions. Some therapists have rules and policies against this, but a lot don't, and it's well within your right to ask to record your sessions. And finally, in terms of being cooperative, I think being open about the problem is important, and shutting down isn't going to help in this moment (although I understand and respect why that's happening). I think you can continue to work through daily, surface-level issues while working on these other things on the back end. Good luck!

Thank you for your response. I'm not in the US, so there's no insurance company involved. It's a nationwide health service and I've been trying for over a year to see someone else. I've been told I either see those two or no-one, and in my country general practitioners aren't allowed to prescribe methylphenidate.

I've tried, several times, to discuss our relationship, but she isn't willing to discuss it. I've also tried to bring it up with my psychiatrist but her response was that I could either continue with the psychologist or stop treatment.

I'm not a native speaker of the local language, so I tried to take notes in the past, but she refused to continue the session as long as I had my notebook out.

I've tried bringing the focus of sessions back to the difficulties I'm having with ADHD, as diagnosed by the psychiatrist, but she tells me that I'm wrong and it's anxiety and refuses to discuss anything about ADHD, including techniques I can use to manage the difficulties I face because of it. She focuses instead on my past and relationships, but won't even discuss my work as "I don't want to encourage your obsession (with having ADHD)", despite this being a problem area for me.

I realise there's no magic wand here, but I just want to be able to walk out of her office without being in such a state that I can't work for the rest of the day - sometimes days

What a shitty situation! I can't even imagine the stress. I wish I had a magic wand to help but honestly I don't. International therapy/laws/etc is not an area of expertise for me but I would perhaps get in touch with local mental health authorities? Their version of DHS or something like that. There has to be someone, somewhere who can help.

There probably is, but I'm having a hard time finding anyone to talk to, and my Spanish isn't great. It's not bad, but it's poor enough for me to feel uncomfortable writing such an official complaint. You're right though. I should. I'll see what I can do. Thank you

This may not be applicable but what about finding a US based therapist? There are many telehealth therapists who work with clients internationally.

I did have a therapist online for a while, but at the moment I'm skint. As in, double-digits-to-my-name skint right now. And my psychiatrist wouldn't accept that as an alternative to seeing her psychologist. I asked.

That therapist also recommended making a complaint.

I would be curious what the relationship between the psychiatrist and the psychologist is. It's not unusual for psychiatrists to have a couple of mental health professionals that they refer out to because they trust their clinical judgment but it seems unreasonable that the psychiatrist won't allow you to go to any other psychologist. Perhaps this is a cultural thing and obviously it may be different there but I'm just bit bowling ideas

While I am great at doing things for other people, I'm terrible at self-motivation and doing tasks for myself. I'm a good friend and employee, but when I remember I need to do something for myself, I immediately put it off. Even if it's something simple, easy, fast, or there's no reason not to do it. My friends with ADHD talk about this as "executive dysfunction", which feels somewhat accurate. I feel like I'm wasting my life in front of a screen when I could be doing so much more. If I could take a magical motivational pill, I would. Should I get tested for ADHD/ADD, or are there other options?

Hi! This is a really good question and it doesn't have a simple answer. It does sound like there might be some executive dysfunction going on here but the truth is it could be a lot of things. It could be people pleasing tendencies that make it easier to complete tasks for other people but you don't prioritize self. It could be lack of self worth or low motivation. ADHD is definitely at the top of that list but it depends on what your other symptoms are. I think it's really important to recognize it could also be beginning signs of depression or maybe even some anxiety that's causing the people pleasing part of it.

What are your best tips for connecting with a therapist early on?

I have had therapists that seemed like nice and competent people, but who I felt weren't really on the same page as me as far as what I wanted out of it. I've continued to see them for weeks/months hoping that more information about me would inform them how to best treat me. But at some point I feel like I'm just wasting our time and resources, and leave. And on that note, what do you think is proper protocol for breaking up with a therapist?

Hi! When I tell you that this is a fantastic question believe me that it is. LOL1First and foremost you wanna make sure that you have a therapist that is a good fit and I always tell clients that within those 1first 2 to 3 sessions if they don't feel that we are vibing then that is indication that maybe we aren't a good fit. There isn't necessarily one specific thing that I can point out other than do you feel safe, do you feel heard, and do you believe that they Are capable and competent to help you with the issues that you're presenting. If the answer to any of those are no then it is perfectly OK to ask for a referral and let them know that you just don't believe that you're a good match. The truth of the matter is- and I know this is going to sound kind of bad but honestly - therapist work with so many people that a really good seasoned therapist isn't going to take offense when you tell them that they just aren't the right therapist for you. It's kind of like a dating app -you just happened upon somebody That took your insurance or was in your area or whatever the case may be and you hoped that it would work out but that's not always the case. So never feel pressured to stay on longer than you feel comfortable with- A good therapist will understand.

Hi Misty,

Therapy seems like a big deal with high costs and stigma. What issues do you see that seem like a typical part of life, but greatly benefit from therapy?

Hi! This is a fantastic question! You are absolutely right that there is a stigma around the concept of going to therapy and it's not typically a cheap service. A lot of my clients come to me with what I would consider to be everyday stressers. Things like taking care of kids or communicating with your partner. Work stress or relationship stress that you don't have anybody else to talk to about. A lot of people have mild to moderate mental health issues including anxiety or depression and need coping skills in skills and solutions to help manage those things. A lot of my clients want tips on how to effectively communicate instead of constantly fighting with their spouses. A lot of them want parenting suggestions because they have kids that they just can't seem to "get control of" And they need some skills to help them better communicate with their kids. The pandemic really amped up a need for services. People have been isolated for 2 years away from their families, away from their friends, and let's be honest the political climate has not helped in any way shape or form. So a good chunk of my clients come to me with everyday family stressors related to the pandemic or politics or worries about their own future and we process through those things in real time.

What do you do when your therapists keep saying you're too fucked up for them and you need a specialist and the specialists say the same thing?

Hi! Without a lot of context this is hard to conceptualize but here's what I can tell you. If you have significant mental health that requires an area of specialization perhaps you have specialization perhaps EMDR or IFS, for example, or another treatment modality then I would say find someone that specializes in those areas. A therapist and a psychiatrist or specialist should never tell you that you are beyond help. Instead they should help you to find the specialists or people that can help you because they do exist .

Hi, I'm (40M) finding recently that after a divorce and lot of change in my life I'm left kinda...aimlessly floating. I have a good steady job but no goals. I'm secure in my daily life but again, no goals. I'm just kinda here and not sure where to go or if I even WANT to go anywhere. I've also lost interest in pursuing what I used to like and I just kinda go along with what my gf and her family do.

I'm happy to seek therapy but I've no clue where to start or if it's even needed. Any insight?

This Hi! I think therapy could be a really good benefit for you to just help realign your goals and understand how the divorce has changed your life. Someone of what you're describing sounds like maybe a low level depression evil depression or what we would call in the therapy world adjustment disorder which is a really fancy way of just saying you're struggling with managing how things have changed since the divorce. I think that therapy would Really benefit you because you would be able to process through your emotions as well as gain some direction and clarity in your life.

Finding therapist can be daunting but hear a few tricks. The 1st thing you're gonna want to do is do a basic Google search for therapists that live in your state. If you're interested in telehealth then that opens the field a little bit but if you want to see someone strictly in person then you're gonna want to search someone that's within a reasonable driving distance for you. Secondly you're gonna want to go to their website or psychology today profile. Most therapists have short bios that tell you about themselves and what they're approached at therapy is. If they sound like they'd be really good match then you can reach out via email or phone call and see what you can get set up. I encourage you to do a free consultation with any therapist that you find. I offer free consultations with potential clients so they can take a moment to get to know me, talk about any barriers to therapy and decide if we'd be a good fit together. The best places to find therapist is obviously a simple Google search but also therapy platforms like psychology today, therapy den, or mental health match.Additionally if you want to use insurance most of the time the insurance companies will have lists of the providers that are in network and you can call your insurance company and they can give you the names. I would also suggest asking your primary care doctor or other trusted people because usually they will have 1 or 2 people that they suggest and refer.

What do you think about the resurgence of psychedelic assisted therapy? Would you consider using it?

Hi! I think it's an interesting area of psychology and has shown some promise. I have never utilized, nor would I without very specialized training. But I can see the merits of it!

Thank you for answering! :)

Hi! Absolutely!

how do i distinguish a good therapist from a bad one? Currently seeing one due to work related stress in a very high pressure environment/culture. Every time i meet with my therapist, he notice him yawning very often (maybe hes also overworked?) and a lot of awkward silences and “yeahs” coming from him. I dont think i am benefiting my sessions with him

So this is one of my favorite questions! First, your therapist should always be engaged and interactive with you. I yawn, too, (we all do!) but when I'm with a client they have my full attention. If your therapist appears checked out, then it's not a good fit. Some therapists use techniques like silence or reflection to get you to be more open or talkative, but if your instinct is that the therapist just simply isn't paying attention, that's a problem. A good therapist makes you feel seen, heard, and validated.

Hi , I’ve been going through depression for many years now and it gets worse day by day and its especially because of stuff that happened years ago for ex: Loss of friends as well as family. About 1 and half year ago I started having multiple mood swings everyday and it still happens today , there were times I had resorted to self harm (a year back) and it was just twice and nothing major it wasn’t even cuts it was more of scratches as I was too scared but im over self harm now and will never try ever again. I was also told I may have borderline personality disorder or rapid cycling bipolar and tbh I don’t really know what as I can’t go to therapist. About the mood swings: Everyday its just that im extremely happy and that happiness turns into anger in few hours and then sadness and multiple emotions on repeat. I’ve even had appetite loss towards the end of 2021 which resulted in a good amount of weight loss. So yea I just would love to know whats up with me? Thank u :)

Hi! Thank you so much for sharing, and I know how hard that must be. First, let me start by saying bipolar and borderline have some similar traits but they are very different diagnoses. The mood swings you describe can be a part of both, or another depressive disorder. It would require a good, thorough assessment to determine. What I will say is while a diagnosis is important for appropriate medication and understanding exactly what is happening to you, at the end of the day diagnoses are just words on paper. They don't help you. I would suggest tracking your moods daily- you can actually find apps that do this (daylio is a good one). This will help you understand your moods, when they occur, and start making connections. For instance, do you find yourself in a bad mood at night? Is it when you're with your family? Etc. Understanding the triggers will go a long ways in helping to identify and cope. You mentioned some things that have happened to you- it's also entirely possible you have some trauma, which I know is a big word but it just basically means something negative happened and your mind/body struggled to process it. It impacted you. PTSD (Post-traumatic stress disorder) oftentimes manifests with mood swings, emotional dysregulation, sleep disturbances, issues with appetite, memory issues, flashbacks, along with a host of other things.
So basically, I can't provide a diagnosis without actually seeing you but those are some things that come to mind. Do some research on your own and find out what fits for you, and you can google coping skills and such. Find blogs from therapists who talk about those topics (I have some on my website that might be helpful but there are hundreds out there).
I'd also think about finding a therapist. I know you mentioned you can't go to therapy- is there a particular reason why? Is it because of finances or insurance or availability? Oftentimes you can find therapists through a simple online search.

Thank you for ur response and yes actually this time especially now im feeling better because I cope up with my depression with music and video games and next month im gonna be starting university as I just finished school and its a new chapter of my life so hoping for the best and about therapy its just that when it comes to depression im not open about it with my parents so can’t really ask for therapy but on the bright side I have great kind supportive friends who im able to talk with so that hows ive been coping up the past few years and once again thank u for ur response :)

Absolutely! I'm so happy you have a strong support system and I think getting into a fresh environment will be a much needed change. Good luck!!

Hi Misty,

Thank you for doing this. So, I had a bad experience with my last therapist. I felt misunderstood, misrepresended, dismissed, like he did not care about me, would not even go through the trouble of pretending to care, and betrayed., Specifically by him but also the clinic at large. Since this was at a clinic, I also felt quite trapped with him and like there was no support system/outside perspective I could relax on for a different (professional) perspective. I 'finished' therapy with him because it is very frowned upon by the insurance to cancel therapy and might lock you out of further therapeutic work. Ironically enough that same experience now hinders me in seeking further help - the reason I stayed on in the first place. The feeling of betrayal simply sits to deep. Do you have any tips on how to overcome this?

First, I'm sorry. Shitty therapists make something that's already difficult even more difficult. In terms of tips to overcome, yeah- I have a few ideas. First and foremost, recognize this was a "him problem" and not a "you problem." You didn't deserve that, and he should have treated you better, but my guess is you are one of many that he treated that way. You just happened, "to be the person in the room." That's shitty, and it hurts to even say it. But unfortunately it's probably true. Recognizing you did nothing wrong, and recognizing you can't control how he responded to you, goes a long ways to healing.
Second, do some really stellar research before you find another therapist. Schedule free consults and spend 30 minutes or so getting to know them- ask questions about their approach and their beliefs and how they help facilitate change with their clients. If your Spidey-sense tells you something is off, don't work with them!
Third, and I know this is NOT easy, but recognize therapy can be a valuable tool for growth and change if you have the right fit. This one didn't work out, and left deep scars, but there are plenty of us out there that truly care and want to help :)

Hi! I’ve done light considerations about therapy; I pretty much know that could benefit from it, but haven’t looked into it, daunted by potential cost (yes I have insurance) and also finding time. I find (and my wife agrees) that I am pretty good at coping (burying) my stressors, emotions, ect enough to work, and do my job well. Outside of work, it’s hard to do anything. It’s hard to accomplish projects or even do things I enjoy. It’s very easy to shut down, and get annoyed by my family, mostly because I’m just mentally fatigued with pretending everything is fine 10 hours a day. I do know I have ADHD, but I’m pretty sure more is going on at this point. My pcp didn’t have much advice at all (If it’s not effecting work I wouldn’t worry about it). So at this point I’m not really sure where to start. Should I be as afraid of cost as I am?

Hi! Thank you for your openness. So a couple of things. First, while avoiding/burying emotions/stress is effective at being able to avoid and do the everyday things (work, school, etc), it's not actually coping. To truly process emotion you have to lean into it and effectively work through it from root cause. Not accomplishing projects, feeling overwhelmed or mentally fatigued, are all signs that something is "off" and points to some emotional and mental dysregulation. I think finding a good therapist is important. As for cost, if you have insurance, and you can afford any copays, then don't sweat it. I wonder, and I could be totally wrong, but I wonder if the fear of cost is a subconscious avoidant technique? Just a few thoughts.

Oh, I have no doubt I am using avoidance techniques, but we have had a few things we have put off just assuming we wouldn’t afford it lol. I will eventually have to push myself and find out what I can do. I already know I don’t have a healthy relationship with myself, and i know I probably won’t be able to keep up my current ‘routine’ forever. Thank you!

If finances are genuinely an issue one thing you can ask is for a sliding scale fee which is basically an agreement between you and the therapist that you will have a reduced cost. Additionally some therapists will wave any copays as an additional financial benefit.

Hi, I'm in New England and I'm looking for a therapist. I'm trying to find one that specializes in sexual trauma. I have sexual trauma in my past but I'm having a hard time finding it in the list they offer of their specialties. Am I missing something?

Hi! So a couple of thoughts- oftentimes therapists don't necessarily specialize in any particular version of trauma- so oftentimes on their websites it might just say they specialize in trauma and PTSD. Couple of things I'd recommend- therapists who use EMDR oftentimes are well educated in trauma, and EMDR is a FANTASTIC therapy approach for trauma, so perhaps looking for someone who specializes in that? I'd also look at local survivor's groups or find blogs/videos by therapists that discuss the topic.

What is EMDR?

It stands for Eye Movement Desensitization and Reprocessing. It's a complicated name for a pretty unique therapy. I'm not certified but cliff's notes: EMDR is a way of distracting the brain while also helping the client visualize and mentally "go to" a safe space in which they are able to talk about and process traumatic events and emotions that previously lead to too much emotional/mental dysregulation.

Interesting. Would this be effective for someone who has a hard time picturing images in their head?

Yup. I'm not an EMDR expert but I don't see why not. The safe space, while definitely using imagery, is more than just a picture in your head. So I think it could work.

Hi, I’m currently struggling with getting my partner to do work around the house or help with our pets. I work remotely and she works retail 7-3:30, she says she too exhausted and/or stressed to do anything to help so she just sits on the couch and watches tv or plays video games. It’s been about 1 year of this and I’m getting to my breaking point, I’m stressed out with having to care for our pets and take care of the house on my own. I’ve given up expecting anything from her, even if I give her small tasks to do to help out she doesn’t do them. How can I be more understanding of how she feels but also get her to understand where I’m coming from and have a productive conversation with her?

I think it's important to verbalize your wants and needs and recognize that by allowing her to engage in those behaviors you're not prioritizing yourself. Perhaps there's underlying mental health- depression, anxiety, etc, that's impacting her and making it difficult/draining to perform everyday tasks. But that can't be at your expense because you're a team. I would have a conversation using I-statements. "I'm feeling overwhelmed and frustrated because I don't feel my needs are being supported. I need help with the animals." Clear and assertive communication.

If someone decides to start therapy, how do you help them open up?

Hi! Great question. For me, I'm a very conversational therapist. I will talk about anything- sports, pets, work. So when I meet with someone new, I let them guide the session. I also am an open book and allow my clients to ask questions about me, the process, or anything else to help them feel more comfortable. Validate their feelings and make them feel heard.

Hi Misty, what are the necessary qualifications to become a therapist in Michigan? Do you have to go to uni?

Hi! Yes- you need a master's degree in a mental health field (counseling, psychology, social work) and sit for a licensure exam. Then you can apply for licensure. There are some exceptions. For instance, an addictions counselor doesn't necessarily need a degree- they can get what's called a development plan and work towards gaining experience and education and then, once they have demonstrated experience, education and passed an exam, they can get what's called a CADC (certified addictions counselor). But typically, yes, you need a master's.

Hi Misty! I just got my LMSW and will be starting work as a therapist soon. What advice can you give me as a new therapist? I can already feel the imposter syndrome coming upon me 🫣 Thank you and sending love from one therapist to another 💖💖💖

Yayyyy!!! Congrats! First of all, take a deep breath and recognize all the hard work 😊 Second, realize you will always be learning and growing. You will make mistakes and that's ok. Some clients will love you and others won't, and that's okay too! Self care self care self care!!! And don't work harder than the client. That will cause burnout.

Hello, please tell me what you think of my hypothesis regarding the primary cause of anxiety and depression. My feeling is that our dependence on money to survive and keep our place in this world is the cause of a major disconnect with experiencing satisfaction. Before the existence of world economy we depended on the tribe to survive. Now we’re guarded against one another and are often prone to undermining each other and hoarding resources. The faculties to survive which are built into our dna are no longer pertinent in today’s world. My feeling is that these are obvious reasons for the general unease. Combined with the destruction of our environment, and the campaigns of fear, hate and greed that propaganda of governments force upon its people. Doesn’t it seem fairly rational that only marked dissatisfaction can result from this? I mean, nothing about our evolution prepared us for a reality where our survival depends on hoarding fake little pieces of paper issued by the government. What are your thoughts on this?

What an interesting concept and I'll be honest- I'd need to give it much more thought. I do agree we have evolved to a populous of people more likely to be anxious, depressed, etc, but as to a root cause, that is an interesting theory. Great question!

What are some common reasons people may be hesitant to start therapy?

Hi! Some of the reasons people are hesitant about therapy oftentimes involve money because of the expense. They're worried about judgment. They're worried about whether their therapist will be a good fit for them. And oftentimes they don't really know exactly how to express themselves and they're worried about what therapy is going to uncover. It's not unusual for people to know that they have some issues that they need to resolve but change is scary and it can be hard to do that deep dive and therapy.

Hi Misty! I really struggle to gain a benefit from therapy because I always feel I can't be entirely honest about my problems. Is that something you encounter a lot, and how can I get around it?

Hi! Absolutely! I find a lot of clients struggle to open up and be honest for a variety of reasons. Fear of judgment, fear of legal trouble, fear of doing the hard work, among others! I think it's important to remember your "why". Why did you start therapy? What do you need help with? What are your goals? Refocus on why you are doing this and remember the therapist can't fully help you if you're not open and honest throughout the process. I would also make sure that you are working with a therapist that makes you feel comfortable. A really good therapist will help you to be honest and open about what you are going through and if you are struggling to open up with your therapist it makes me wonder if they are truly a good fit for you.

Hello and thank you for the AMA! I have a question that has been bothering me since I've read somewhere an interview with a psychiatrist that mentioned male mental health is very often pushed to the side in your field of work. Did you notice such tendencies? If so, could this be because there is still that stereotype among general population that men shouldn't talk about their feelings and just deal with whatever issues they have silently without "bothering" anyone? Male suicide rates are going up from what I know and that seems like something that should be looked into and adressed.

Hi! Excellent question and this is unfortunately true :( I'd like to think in my profession therapists don't push male clients to the side or have different approaches with them when it comes to emotional regulation, but I can say that is a societal norm. Men are taught to be tough and "boys don't cry." Which makes it hard to talk about mental health. That's why I advocate for my male therapists to be open with their mental health journey and really be an advocate for other men to begin the normalization process.

I’m 35/F recovering from a freak accident that required a craniotomy in July. After about 17 phone calls I found a therapist who had an opening. She asked me on the phone what I am looking for and I told her I didn’t know and just started crying. I have a slew of medical professionals already, hoping this helps my recovery somehow, it will be my first time ever with a therapist. Any thoughts or recommendations?

1st of all I am so sorry to hear about the accident.. 2nd I think therapy is gonna be a really big benefit for you. I think that it's important to process everything that's happened since the accident and the surgery and just all of the things that have obviously changed in your life because of this. I would take it day-by-day and just talk through the things that are going on and bothering you everyday. Really work on processing the emotions and coming to terms with what happened.

Thank you. I have two toddlers and very supportive hubby. Also taking OT and PT from seizures. It’s never ending. I appreciate your advice and backing this decision. I’m nervous but feel like it can only help.

I think it will be a great thing for you. When I was 1st getting licensed in the field I actually worked in traumatic brain injury and most of my clients had brain injuries from accidents such as car accidents or falls. It can be really hard to adjust and having to return and redo your entire life is not easy. I'm so glad that you have some good support and I think that that's gonna be really important moving forward.

As a therapist, I imagine you’re exposed to all sorts of shit, and the worst parts of human society. How do you cope with it, and maintain an attitude of positivity, and the will to keep helping?

My clients will tell you that I am always a ray of sunshine and that I can find the positive no matter how negative the situation is. The truth is it definitely is hard to listen to people tell me their deepest secrets, especially when those secrets involve horrible things that have happened to them in their lives. But I feel that it's my job and my privilege to help them find the positivity and bring about positive change. I also really work hard to not bring my work home with me. I love my clients and I'm always thinking about them and what's in their best interest but the truth of the matter is I have my own life and my own family and my own mental health to take care of and I can't internalize their problems or needs or mental health. So I really separate myself from my clients and my work for that reason.

Do you think about people's problem and how much they suffer? Once you are done with the session?

Absolutely! I try very hard to set boundaries and not allow my work to completely encompass my own metal health but the truth of the matter is it's really hard not to think about your clients outside of session. I'm constantly looking for new ways that I can help them or coming up with solutions or ideas that might work during our next session. I just sent out a blog post to all of my clients that are working on anxiety because I thought it might help them. And constantly trying to do better for my clients and find new and innovative ways to help them with their needs and so yes I am constantly thinking about them Even when I try to set boundaries with myself to not be so focused on work. I do think about their pain and how they are feeling and it's not unusual for me to reach out in between sessions just to check in and make sure that they're doing OK especially for those that need it the most.

How do you feel about religion as a coping mechanism? That has always helped me. I'm just a normal guy raised in the church. Nothing extreme, no cults. Grew up in the 60s and 70s. Religion helped me avoid drugs and at risk behavior. Sometimes I need some quiet time to reconnect to my roots, to make things better for me. So much bad publicity about money hungry televangelists and predatory Catholics, I don't mention what works for me.

If it helps you then I think it's great. I'm all about finding what works for you and for some people connecting with religion does that.

Is it acceptable to inquire about if they've been abused before? I think I need someone that has similar experience as I do, therapy has not had enough results for me in years and it feels pointless to try. If it isn't acceptable, how do I go about finding someone that I feel I can trust/understands me? Pickings are slim in my area.

You can absolutely ask but a lot of therapists may not be open about it. I don't agree, personally, and I think it would help build connections but every therapist is different. I'd seek out someone with a strong trauma background and specialization. Perhaps someone certified in EMDR, which is a trauma therapy.

If you're thinking about therapy, should you just take the plunge?

IMO, absolutely! But make sure you know what it is you're looking for and have some goals in mind.

Thank you for being a therapist to begin with, I benefit from it highly. I have a hard time holding grudges, and I’m working on that. Why is it so easy for some people to hold a grudge, and not others?

Hi! This is a really interesting question. I think that at its core when we hold grudges, we do so because we have perhaps have bits of validation and self esteem issues, and we take what the other person did very personally. In other words, we internalize their words or behaviors and it causes us to not be able to "let go" so to speak. Now there's a lot of information that I can give on this and there is a whole lot of work that can be done to help overcome it but at its core I think it comes down to a need for validation and feeling that you are respected and seen and heard. People who don't feel heard Oftentimes find that they hold grudges or linger in anxiety longer than they should. If I am working with a client who tells me that they're having trouble letting go or that they're holding a grudge with someone, one of the things that I talked to them at length about is the concept of control. When you allow someone else to have so much space in your mind that they are constantly on your mind or make you feel some type of way, then they have control over you. And the goal is for you to regain that control over yourself. And you do that by processing through the emotions and recognizing that you can't control their actions or words But you have 100% control over how you respond.

Thank you so much for your reply, I really like the concept of not letting others “control” you. Sometimes I get really jealous of something they have achieved/have that I don’t have. There is a lot of nepotism where I live, and when someone works outside of their family’s business (typically worth millions in this area) I really respect that. Fairness is very important to me.

Hi! Absolutely!! I can understand that frustration. I live in a place where everybody knows everybody and if you don't have the right last name that you aren't gonna get anywhere. And it can be frustrating. But at the end of the day we can't control that period I wish we could but we can't. What we can't control is how we respond to it and how we allow it to affect our lives.

Hi! This is a really interesting question. I think that at its core when we hold grudges, we do so because we have perhaps have bits of validation and self esteem issues, and we take what the other person did very personally. In other words, we internalize their words or behaviors and it causes us to not be able to "let go" so to speak. Now there's a lot of information that I can give on this and there is a whole lot of work that can be done to help overcome it but at its core I think it comes down to a need for validation and feeling that you are respected and seen and heard. People who don't feel heard Oftentimes find that they hold grudges or linger in anxiety longer than they should. If I am working with a client who tells me that they're having trouble letting go or that they're holding a grudge with someone, one of the things that I talked to them at length about is the concept of control. When you allow someone else to have so much space in your mind that they are constantly on your mind or make you feel some type of way, then they have control over you. And the goal is for you to regain that control over yourself. And you do that by processing through the emotions and recognizing that you can't control their actions or words But you have 100% control over how you respond.

My wife has been wanting therapy for us. Not a terrible marriage, she just wants someone to share with, her social interaction is super limited. Her social circle is toxic and sahm doesn't lead to rich social interaction. I struggle to see the value of therapy. What do we hope to achieve. She can go but I've not seen a convincing argument to separate me from my cash. From my perspective almost every therapist I've known by definition has been soft biased from my perspective where "everyone is right, everyone's opinion is valued" I've not reached a point in my personal development where I would every agree with that as a blanket statement. Not everyone is right, and opinions are that, you have one and you have a right to have one. It can still be wrong and invalid.

How do you approach a client like me?

Hi! Well the 1st thing I would do is ask you, do you want to be happily married or do you want to be right? That's not a rhetorical question. Oftentimes I meet people who don't believe that therapy has any value and don't believe that there are things that they could be working on in their marriage or in their individual lives. And that's fine. If you have nothing to work on and you don't feel that there is any benefit to it than more power to you to not engage in therapy. However it sounds like your wife does have some things going on and that there are issues she wants to talk about, and I suspect part of that is not feeling that she has Open communication, whether it's with you or Other social circles, and that is something that she values. So in terms of how would I deal with a client like you? Honestly I probably would ask you what it is that you want to get out of the process and if you have no goals or ideas then I wouldn't. And that's not a disrespectful statement. It is always about the client's needs. It is always about what the client wants to get out of the process. If there is nothing that you want and nothing that you feel you can work on then the truth is it is pointless for you to go to therapy because you're not going to make any progress. However if your wife wants you to do it with her because it's something that she values, Then I think it may be important for you to open up a little bit and allow her that expression in that ability to try to connect with you through therapy. But again that is totally your call.

I also think there is a difference between saying that everyone's opinion is valid and saying that everyone is right. Not everyone is right. And my clients will tell you there have been plenty of times when I pointed out to them that the decision they're about to make or the things that are coming out of their mouths are not right. Or a good direction. It is important for therapist to validate a client and to help them feel hurt but it shouldn't be to the detriment of the client or their progress. I had a conversation with the client this morning where I told her that she was about to make a stupid decision. And while I support that decision if that's what she decides to do, I want her to understand the ramifications of that decision.

I think for me is I don't see the benefit. Functionally that's what I was asking. Not to be disrespectful or belittling it's about how do you help clients like me see the value. What I took away, is that beyond supporting my wife which I told her I would go for her: I need to have my own goals that I think therapy can help me with. Absent those, I may not get much.

Your probably right, our communication is fairly solid. But I travel a lot, and I'm not much of social talker, I get super irritated talking about other people who aren't important to me, or about what some other kids parents did at the game that was inappropriate, etc etc.

I feel this to my core!! I may be a therapist but I'll be honest that my social battery isn't always that full. Sometimes I struggle to engage in everyday life with the people around me because I spend all day everyday engaging with people. And I love it! But that doesn't make it always easy. I think you're absolutely spot on that you need some of your own goals. And they're completely whatever you want to work on. And if there isn't anything that you can think of then simply be in there and supporting her may be you're role.

I'm working with a client right now who reminds me of you in this particular context. He doesn't care necessarily about his wife's work friends or what their kids did or what college they're sending them off to - and he can get really frustrated with her because he frankly doesn't care. So we spend a lot of time working on improving communication and recognizing that even though it's not important to him, it might be important to her, and SHE is important to him. So even though he doesn't want to have this same old conversation a 100 times over, it is important for him to listen to her and it is important for him to give her that time. Maybe it's the same for you.

Hey, Misty, FNP working in rural acute care here. I recall an article a few years back about a mental health urgent care opening in Michigan. Do you have thoughts on that? Is this a model we should be striving for? It seemed so hopeful to me but not something I’ve heard more about.

Hi! If it is staffed appropriately with enough resources and a truly effective model I think it's a fantastic idea! My worry is that it would just turn into a med-dump place for people to get meds without therapy.

How do you feel about the use of Psychedelics in therapy? Many trials/studies are showing patients making years worth of improvements in just a couple sessions. Thoughts?

Hi! I responded but I think it ate it LOL Basically, I think it's very promising, and an interesting field. I don't know that there is enough evidence, either way, right now, but I'm paying attention to long-term studies.

What is your approach with narcissistic personality disorder? Are people told they are diagnosed as narcissists? How do they react to that? I work with a lot of youth with problems but in Canada certain things (psychopathy, certain PDs) cannot be diagnosed before 19 but jeebus are some of these kids on that path.

Hi! So I don't typically work with this diagnosis because it's not my area of specialty and as you know it requires a certain type of finesse. That I honestly don't possess lol having said that I know some people who work really well with that population and basically it's all about constant affirming care, letting them feel like they're in charge, feeding into that ego just enough to get them to trust you and be able to do the work. I know a therapist who works with people with that diagnosis and she does open up and tell them that she thinks they have it and some of them are able to hear that and others struggle with it. I think it all depends on how you approach the client.

Hi Misty! Do you have any tips for how to care for oneself after a productive but rough therapy session? Do you ever find yourself personally judging clients (I’m afraid my therapist thinks I’m ugly or something even though she’s awesome and we work great together)! And, what are some of your most enjoyed books both psychology and non-psychology related? :)

Hi! Self care is incredibly important. I suggest doing some Journaling to aid the processing and really lean into the emotions. Write down things you gained and insights you had during session. Play music or do something creative yo stimulate the mind. Have I ever judged a client? No. I never judge a client in a negative way (their looks, their beliefs, etc). I'm an avid reader so that's a tough question! My favorite therapy related book is "The Body Keeps The Score" by Bessel Van Der Kolk. It's about trauma. Outside of psychology books I'm a sucker for murder mystery and suspense. Anything James Patterson. I'm also a Twilight fan. ....don't judge me 🤣

I am not sure if you are done answering questions, but I recently got this statement or whatever you call it which would cover most of my therapy costs (I live in Finland) and my psychiatrist suggested I try therapy. I had rough childhood which I have come in terms with and I could talk about the situation with my close friends also I am kinda lost in life regards to what I want to study or do the rest of my life, but I have had support from people who are close to me. So what could therapy do for me if I personally feel like I have come in terms with of my past and current issues?
If it matter I take Concerta and Atomoxetine for ADHD and Lamictal for low mood.

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Thank you

Hi! Sounds like you've done a lot of the work already, which is great. Therapy can be an added benefit to help you manage ADHD symptoms and just work through those life transitions. Figuring out what you want to do with your life can be difficult and sometimes it's hard to navigate. Having a neutral person can help put things in perspective.

Thanks for the answer. I guess I will try it... I guess you could say I have done some of the work already like some years I ago I read few books aimed at medical professionals and it gave me an angle to think like I had this issue where I would get eletric shock if I looked people in the eyes and then I got an idea from a book to think what could be the reason for that and then I realized my abusive father always yelled at me if I looked him in the eye like "WHY ARE YOU LOOKING ME LIKE THAT?" then if I did accidentally longer or soon again then I got my ass kicked, so I realized it was because of childhood trauma and my friends started to help me to train my eye contact and nowadays there is no such issues.

I think therapy works somewhat similarly even though I have never been in therapy, but I think it could give me new insights and tools to work with issues related to ADHD, thanks for answering.

Absolutely! I'm hopeful you are able to get some really great benefits out of it. Good luck!

Do you have any tips for students when it comes to mental health?

What’re your thoughts on how mental health is treated in the corporate world and in education?

Hi! Yes, I can think of a few things. First, look at local resources. A lot of schools or universities have mental health counseling centers or school counselors. Take advantage. Join groups that apply to you and talk to teachers/professors about how your mental health impacts you.

I think it's highly stigmatized and unfortunately corporate America and the education system do a piss-poor job of prioritizing mental health. We live in a society where, "tough it out" is praised and taking time to process and heal is criticized. It's unfortunate but that's why platforms such as reddit are so amazing- to give a platform to all of these topics and elicit discussions.

Do you think that someone could be so traumatized or have had such a difficult life that they are essentially beyond help?

No. I believe some people require more specialized care, and more time and effort. But nobody is hopeless.

I’ve noticed a lot of therapists pursued that way of thinking to make sense of their own issues. (Saying this from having a 2 year relationship with one) Everyone I talked to working where she was didn’t see a therapist? How common is that? Do you see a therapist?

It's true that many of us got into this field to better understand others and ourselves. And I would say a good chunk of therapists do see their own therapist, at least sometimes throughout their career. And yes, I have a therapist I work with about once a month just to keep me grounded.

I have been seeing a therapist for about 4 years now, I am on the spectrum, and she specializes in people on the spectrum.

Why is it that therapy is beneficial, what is she actually doing that helps to benefit me? A cleaner version of the question, What is it a therapist does that benefits the client?

This answer varies from therapist to therapist. The "classic" answer is that a therapist helps the client to understand themselves and facilitate change. I'm a very confrontational, direct therapist. I'm here to help my clients get from A to Z. For someone on the spectrum its about helping learn skills to manage and also maintaining skills.

Do you often encounter folks who want help, but the therapeutic process, here I'm assuming CBT, just doesn't work?

Absolutely. Some people need other forms of therapy like DBT, EMDR, IFS. It's not that it doesn't work, perse, but it's not as effective on it's own.

How do you know if your behavior is a coping mechanism due to past abuse and trauma, or if you are just an asshole? Serious question. I have multiple reasons I may be acting out, but what if that is just the way I am?

Hi! This is a really good question and 1st and foremost I wanna say that any kind of acting out has some kind of a stem reason. I know people say this all the time but the truth is nobody is born an asshole so to speak. You developed maladaptive coping skills that serve the purpose of protecting you from the trauma and the people that hurt you. The best way to discover how the coping mechanisms and the trauma has affected you is by looking at the outcome. Is it serving your purpose in making your life better or is it helping you to deflect and avoid dealing with everything that you have been through question mor? There is a book that I highly highly highly recommend. In my opinion it is the best book that has ever been written about trauma and it talks extensively about how the trauma affects our mood , our mind, and our bodies. It is called " the body keeps the score" and it is by Bessel vander kolk.

How do you convince someone that they should seek therapy? I have a relative who is a textbook narcissist and compulsive liar. Her behavior is destroying her relationships but I'm not sure how to help someone like that who doesn't recognize that the drama in their life is self inflicted.

Hi! This is a really good question and unfortunately there isn't a really good answer. The truth of the matter is if somebody doesn't recognize they have a problem or isn't willing to seek help then there isn't much that you're going to be able to do other than to continue to encourage them and set your own boundaries with them so that you are not are not a byproduct of their dysfunction. Oftentimes some of the best ways to deal with family and friends that have mental illness is to draw boundaries and not subject yourself to them more often than what you're comfortable with . You can continue to support them and encourage them to get help and I would highly encourage you to do that but the truth is at the end of the day if they're not willing or able to get help then that's their journey.

Why is it so hard to get in? I want to go to therapy in part because I'm feeling really overwhelmed with no work-life balance. I call a bunch of places when I have a break in between patients at work and can't get any to answer. They call back when I'm working. I have been emailing back and forth with one therapist who will send me one or two time slots that don't work, and it's hard to remember to stay on top of the email thread and keep responding back until we find something. One time I got through to a place listed on my insurance website and they didn't take my insurance. Other places have months-long waitlists. I've been trying for months now and still haven't been seen :(

Hi! I am so sorry that you are having such a difficult time finding the therapist. The truth of the matter is it's a really under saturated field right now and there just aren't enough good qualified therapists out there. A lot of this has to do with covid and frankly some changes with insurance but the unfortunate byproduct of that is there just aren't enough professionals to go around for all of the people that need help. I would suggest Going on platforms like psychology today, therapy nest, therapy den, and mental health match. Usually those therapists will have openings. You can also look for group practices that accept your insurance and have rotating admissions.

I've tried psychology today already with no luck but will look at the others you suggested! Thanks! I live in a rural area too so there aren't a ton of options.

Hi! Check them out and see if you have any luck. Also Favebook groups- Online Therapist group is a good one to find clinicians.

Hi Misty, thank you for this AMA. I've always wanted to know, how can I tell if it's time to find a new therapist or if the 'tension' I'm feeling is just regular 'birth pains' with talking to someone about very deep, sensitive, personal issues?

Hi! This is a really good question. I guess it would depend on the exact situation. If you've been working with your therapist for a while and you feel like maybe they aren't the best fit for you or they aren't helping you in the way that you need, then I would definitely say it's time to move on. However if it's new and your new to therapy it could just be your underlying nerves and worries about talking about those sensitive issues. If that's the case then I would say lean into those feelings and allow the therapist to understand what you're thinking and feeling And they can help you to further process.

Do you bring religion into the therapy? Are you an Atheist?

Hi! Interesting question. So for myself, no, I do not bring religion into therapy. There are plenty of counselors out there that use faith based practices but I am not one of them. I wear on my sleeve that I have no religious affiliation and most of my clients know this about me. However I will also say I've had clients who are religious and have asked me to pray with them And I'm always happy to do that- because of the end of the day it's about what the clients need and not my personal beliefs.

What are your thoughts on the writing of therapists in fiction? Any tips for writing a therapist's POV?

I'm especially thinking about relationship therapists because I have a story concept where a relationship therapist is the main character, but I'd be interested to hear your thoughts on fictional therapists in general too.

It's Hi! I am so excited and I think that is an awesome concept. I think typically therapists are misrepresented in fiction and the reason I feel this way is because most of the time they are represented as your stereotypical lay on my couch and tell me how you feel kind of therapist. And yes there are a lot of those out there in the real world but not all of us are like that. I also think that in media It's often forgotten that therapists are real people who struggle with everyday issues too. Just because we're therapist doesn't mean that we always make the right decisions or that we always use the best coping skills or that we don't have underlying trauma or defense mechanisms that create maladaped behavior in us as well. Being a therapist means we have insight but it doesn't necessarily mean that we've done all of the work. In my ideal book or movie the therapist would be an everyday person who had who has their own issues going on and struggles with everyday life but is also really affirming and wonderful with their clients. And I gotta be honest- I would absolutely love to see a therapist that does more than just parrot "how does that make you feel" over and over and over again.

Do you see benefits in speaking to someone once a month, even if the client isn’t struggling with anything in particular?

What are the best and worst parts of the job?

What’s the most interesting thing about therapy for you?

Hi! Great questions!

I think that seeing someone once a month can be beneficial but you have to be very careful particularly if you're billing insurance because the truth is insurance doesn't want to pay for therapy if there's not a designated need or a true diagnosis. So basically if you are checking in with your therapist once a month or using it as just kind of a chit chat session that no that's not necessarily beneficial and I wouldn't do it. However I do have a lot of clients who see me once a month because they don't necessarily have a demonstrated need for weekly therapy due to how A well they've progressed through therapy but they're Isn't need for ongoing assessment and so they will continue to see me on a monthly basis until they graduate from that level as well.

For me the absolute best part of the job is watching the change. To have someone come to me at a time that is probably the worst in their life and they feel so completely helpless and then be able to watch them grow. And quite frankly the opposite is true opposite is true for the worst part of the job. Seeing someone so much potential but they just can't figure it out and it does happen.

For me the most interesting thing about therapy is how we all have such commonalities but they manifest so differently from person to person and everybody's journey is different. I see people all day everyday and yet no 2 sessions are exactly the same, no 2 issues are exactly the same. And I absolutely love that

That’s awesome, thank you! Do you ever have clients that regress during your time with them? How do you deal with that?

Also, how do you deal with cultural differences or having clients that are queer or neurodivergent? Do you ever struggle to connect or understand what they go through?

Hi!

I do have clients who regress. In fact, it happened this morning! In those moments we reset, refocus and remind ourselves of the goals. I also remember it's not my journey, it's theirs, and any progress or regression is on them. That's not to pass blame, but to remind myself I can't internalize their experiences.

I identify as queer so I absolutely connect in that way. But when I have a client who is neurodivergent I think it's incredibly important to not assume I know more than they do and to also learn from them. And be honest about my shortcomings. I'm never afraid to admit I don't know about something or have the experience. My clients appreciate that. Sometimes I struggle to connect and in those moments I go back to basics. Finding common ground and identifying their goals.

Hey! Do u know things about child therapy?

Hi! It's not my area of expertise but I have a fairly good grasp on it. What specifically are you looking for?

I need help with helping my kid process me and her father not being together.

That's really tough. I have a couple of thoughts that come to mind. The 1st thing is helping the child to understand that regardless of your relationship status they are loved and safe with both of you. It's important to make sure they understand that it has nothing to do with them and they are not to blame. Kids have a tendency to blame themselves in these situations and assume that they did something wrong that caused their parents to no longer be together. It's important to normalize time together and spend as much quality time as you can and obviously to effectively coparent. It's OK that you and the father did not get along but you still have to manage your relationship enough to be able to effectively parent together and the child should be the 1st priority. I Would recommend seeking out a child psychologist that specializes in split families and they can help to navigate any emotional or mental side effects that are happening for the child.

I don’t know if you have ever dealt with it,but what are the best ways to deal with misophonia?

Hi! I have had clients who had it. It's a struggle but I've found headphones or ear plugs, noise canceling machines if they don't feed into it, and avoiding negative noise (not always possible obviously). I've heard of therapists using an exposure approach to see if it desensitized the client but I'm not sure I buy into that approach.

Do you agree that religious (Christian) therapists are problematic because they put "Honor thy mother and father" above helping the patient?

I think that any therapist who applies any type of judgment or assumption about a client is problematic, not just Christian/religious therapists. Same can be said for those who are homophobic, ethnocentric, misogynistic, etc.

I agree with you, but a whole lot of therapists do this in my experience.

Hi! Unfortunately you are right. I think that's why it's so important for the client to advocate for themselves and speak up. Don't continue to work with a shitty therapist.

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Hi! Thank you so much for the question. It is not easy being the partner for someone who has mental illness and oftentimes we feel like we end up being their emotional-support-partner instead of their partner-partner. I think it's important to recognize what boundaries are- a great mind once told me, "Boundaries are the space in which I can serve you and protect me at the same time" (Dr. Amber Lyda) and I think this is an amazingly accurate quote. You do want to be there for your partner, but not at your own expense. A relationship should provide value and benefit to both parties- if you find you're always working harder than your partner, or you're worn out from dealing with them constantly, then there's a problem. And it can be easy to switch into that "therapist mode" and want to fix them, but that's not your role. I think in those cases it's important to maintain a boundary, which might look something like encouraging them to attend therapy or couples counseling.