How Do I Know If I Need Therapy?

Natalie Mills San Francisco Psychotherapy and Coaching, San Francisco Counseling, San Francisco Therapy, San Francisco CA Therapists, San Francisco CA Therapist, San Francisco CA Couples Counseling, couples therapy san francisco ca, couples therapist san francisco ca, San Francisco Marriage Therapy, San Francisco Marriage Counseling, San Francisco Coaching, EMDR therapists in San Francisco, EMDR therapist in san Francisco ca, EMDR therapy in San Francisco CA, psychologist in san francisco, female psychotherapist san francisco, psychotherapist in san francisco, marriage and family therapist in san francisco, relationship therapy in san francisco, help with intimacy therapy san francisco, help with intimacy San Francisco, parenting issues san Francisco therapy, help for depression in san francisco, depression treatment san francisco, anxiety treatment san Francisco, help for anxiety san francisco, addiction treatment San Francisco, alcoholism treatment san francisco ca, help with substance abuse san francisco, eating disorders, help with anorexia san francisco, help with bulimia san francisco, help with binge eating disorder san francisco, learning self-care, EMDR, Eye Movement Desensitization and Reprocessing, self-compassion therapy san francisco, family therapy san francisco, eating disorder therapist in San Francisco ca, eating disorder specialist san francisco, pre marital therapy san francisco, couples therapy san francisco, couples therapist San Francisco, pre marital counseling san francisco, recovering from an eating disorder san francisco, help with eating disorder san francisco, treatment for anorexia san francisco ca, treatment for bulimia san francisco ca, treatment for binge eating san francisco ca, addiction treatment san francisco ca, treatment for substance abuse san francisco, eating disorder treatment San Francisco, mental health san francisco, mental health therapist san francisco, mental health professional san francisco, healing from shame san francisco, recovering from infidelity san francisco ca, career counseling san francisco, trauma recovery san Francisco therapy ca, trauma treatment san francisco ca, mental health support in san francisco, treatment for shame san francisco, secual abuse specialist san francisco ca, treatment for sexual abuse san francisco therapy, trauma treatment San Francisco, PTSD therapist in San Francisco ca, therapy for PTSD in San Francisco ca, trauma specialist san francisco, PTSD specialist san francisco, treatment for obsessive compulsive disorder san francisco ca, anger management therapy san francisco, stress management therapy san francisco, help with communication san francisco, performance enhancement coaching san francisco, attachment-based therapy san francisco, attachment-based therapist san francisco, mindful meditation therapy san francisco, sex therapy san francisco, sex therapist san francisco, sexuality specialist therapy san francisco, treatment for sexual abuse san francisco, psychospiritual therapy san francisco ca, grief therapy san francisco ca, feminist therapy san francisco, treatment for Narcissistic personality disorder san francisco, treatment for borderline personality disorder san francisco, marriage counseling san francisco, attachment-focused therapy san francisco, internal family systems therapy san francisco, internal family systems therapist in san francisco, choosing a therapist in san francisco, choosing the right therapist in san francisco, how to choose a therapist san francisco, find a therapist in san francisco, female therapist in san francisco, finding the right therapist san francisco, ethical non-monogamy affirming therapist in san francisco ca, ethical nonmonogamy affirming therapist in san francisco ca, polyamory affirming therapist san francisco ca

“So about how long should it take until I feel better?” “How long do you think I’ll need therapy?” “How many sessions should I expect to attend before my problem is solved?” I have asked all of these questions during time spent on the other side of the couch. I know what it’s like to want concrete answers and expectations met. Everyone wants a sure thing in the face of so much uncertainty.

Therapy is not exactly a sure thing. Surely, it can and does help, but it’s not as simple as basic input of time and results yielded. Results depend on client honesty (with themselves and the therapist), right fit with a therapist, client’s commitment to the work both in and out of the therapy office, and right fit with whatever therapeutic modality is used.

Therapy is almost never a quick fix, but there are quicker-fix type/brief therapeutic modalities available. Whether or not these protocols are right for someone depends on a lot- personality, history, diagnosis, whether or not a person has experienced complex trauma. Even in the best of scenarios, it still requires the practice of skills through time to maintain results.

Under the psychotherapy umbrella, there are five really (really) broad categories we use to organize treatment strategies:

Psychoanalysis and Psychodynamic Therapy:

Makes the unconscious conscious, insight oriented. Emphasis on client-therapist relationship. Brief therapy model (20 session maximum) is not the rule, but is available for single-incident trauma like an attack, rape, catastrophic event, targeting a single life shift.

Examples of Psychodynamic Therapy: Jungian, Dream Work, Attachment-based

Often used for: Increasing self-compassion, improving self-concept, self-actualization, mood disorders, relational problems, trauma, developing insight to identify and manage internal conflict, shifting external locus of control to internal locus of control, couples, families,

*Psychoanalysis: Multiple times per week. The therapist is a blank slate onto which client projects their beliefs and experiences. Relies heavily on free association.

 

Behavior Therapy:

Focuses on conditioning new behavior. Uses brief therapy model.

Examples: Applied Behavioral Analysis, Aversion Therapy, System Desensitization

Often used for: Phobias, Addiction, Anger issues, Impulse control problems, self-injury

 

Cognitive Therapy:

Focuses on changing thought pattern. Uses brief therapy model.

Examples: Rational Emotive Behavioral Therapy, Cognitive Behavioral Therapy

Often used for: Phobias, Addiction, Schizophrenia, Bipolar Disorder, Suicidal ideation, Anxiety disorders

 

Humanistic Therapy:

Focuses on cultivating personal accountability and reaching highest potential. Emphasis on free will. Uses both brief and long-term therapy models.  

Examples: Gestalt, Client-Centered, Transpersonal, Solution-Focused, Adlerian  

Often used for: Improving self-concept, self-actualization, improving communication with others, cultivating self-awareness, shifting external locus of control to internal locus of control, couples, families, existential crises  

 

Integrative or Holistic Therapy:

Often referred to as “Eclectic Therapy.” (Some practitioners will basically fight to the death in disagreement over whether or not Integrative is also Eclectic.) Uses various modalities depending on what is indicated for each client. One therapeutic modality combines various features of the previous four categories. Uses both brief and long-term therapy models.  

Examples: EMDR, Narrative, Cognitive Behavioral, Dialectical Behavior, Internal Family Systems, Gottman Method, Transactional Analysis

Often used for: All of the above

 

Some people prefer to see the same therapist for various issues they’d like to target while others seek out a different specialist to treat each issue. There’s no right way to do this, just whatever feels like it’s working for the client. Some clients come with an agenda and leave when their goals have been reached. Some stay for a while after because they like having a professional to talk to who’s all about them. Plenty of people try therapy and find it difficult to give themselves over to the process, take a more passive route to treatment, get frustrated and give up. Sometimes this is because traditional psychotherapy is not a good fit for them right now, maybe ever. There are so many other great therapeutic options. Traditional psychotherapy is not the only way to heal or feel better.

 

I know it’s overwhelming to look for a therapist and decide which kind of therapy would be best for you, especially when you’ve been dealing with a problem for years, and you’ve finally decided to take the plunge and ask for help.

 

If you describe the issue and a little bit about yourself, many of us will be able to direct you in the right direction. There are plenty of therapists who won’t do this because they are sure that they can handle it regardless of their training and orientation. While I would like to believe that this is mostly the exception rather than the rule, it happens. If you feel too overwhelmed or busy or exhausted to educate yourself on various therapeutic tools and modalities, remember that you can interview multiple therapists at a time to see who feels like the best fit for you. (You can also do this regardless of your stamina to self-educate.) Once you start seeing a therapist, you can audition us. If you’re not feelin’ it for some reason, you can switch. It’s ok not to like your therapist or to like them, but feel like they’re not actually helping you. Therapy is an investment, and you have the right to switch providers at any time for any reason. If you’re feeling like you need to discontinue treatment, I usually recommend addressing this with the therapist; sometimes it just takes a little direct communication to shift things. Even if you don’t plan on continuing your work with the therapist, honest feedback is good for both sides.

 

If you’d like to talk more about this, please email me or call and I would be happy to answer any questions. This is one of my favorite subjects!

 

Love and Be Loved,
Natalie

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