slogan
Blue Mountains
Blue Mountains

Common Questions

 

Is therapy right for me?

There are many reasons why people come to therapy.  Sometimes it is to deal with long-standing psychological issues, or problems with anxiety or depression. Other times it is in response to unexpected changes in one's life such as a divorce or work transition.  Many people come to therapy without a specific "problem" but realize that something is "wrong" and that there is more to life than they are currently experiencing.   Working with the right therapist  can  help you discover potentials and develop skills that will help you on own personal exploration and growth as a person.  Having a consultation to look at your situation with a new perspective can be helpful in itself.

A person may seek therapy for a variety of reasons.  Most important to recognize: It is not a weakness.  Many people were taught in growing up  that they should take care of these feeling and thoughts ourselves. Many individuals have learned that one's deepest feelings are not to be shared.  What this misses is the fact that
our brains grow in relationships.  When a person is in "sync"  with another person that creates an atmosphere where the maximum growth can occur.  

It takes great strength to acknowledge the pain or conflicts that you are facing.  And it takes  great courage to face the thoughts and feelings that come up as you resolve conflicts and improve your life.  If there weren't these anxieties and struggles people would just change automatically. 
I will try to answer your specific questions and concerns and also explain what options and possibilities I see that are available to you. 

Working with a therapist can help provide insight, support, and new strategies for all types of life challenges.  Therapy can help address many types of issues including depression, anxiety, relationship difficulties,  stress management, self image issues,
lack confidence, overwhelming challenges and learning to live better despite the disappointments and losses that occur in life.


Should everyone be in therapy?

I believe that we are always a work in progress and that we can always deepen our understanding and become more aware and appreciative of the life we have. 
Therapy can certainly be useful to help with immediate suffering or long-term problems.  But in addition, it can help with changing those patterns of behavior and thinking that limit us.  These limitations are sometimes so ingrained in our lives that we do not realize how else out lives might be.

 When I was 10 years old there was a school wide vision test.  The result was I got glasses for the first time.  Prior to this test I had been a happy kid, played with my friends after school, watched TV (I liked to sit close even though my mother said I would ruin my eyes by doing that).  I rode my bike on adventures and enjoyed camping.  But when I got glasses for the first time in my life  I was overwhelmed by what I saw.   The world was vibrant and so crisp.  What i saw had edges.  Not everything was in soft focus.   I had never seen life so clearly.   I remember being stunned by the clarity and vibrancy of everything I saw.  I could not believe that this had always been there.  
We can live our lives this way, never being fully aware of all that is possible and unaware of the depths and subtly and vibrancy of all that we can experience.   We can miss out on the richness of life without ever realizing it.

So I do believe that therapy beyond  just treatment for a specific “problem” or issue can be helpful for anyone who is curious and interested in enriching the quality of his or her life.   I think that by creating a greater self-awareness of ourselves and how we truly affect others and how we are affected by the world we can develop a clear view of the world and a deeper and richer life for ourselves.    Developing clear vision  we can then work more effectively, think on levels that we were unaware of and be more compassionate, supportive and kind to others. 

 

 

Do I really need therapy?  I can usually handle my problems.

The fact is that as wonderful as life can be at times...Life is also filled with real difficulties and disappointments. Everyone goes through challenging situations in life and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it.    In fact, therapy is for people who have enough self-awareness to realize they can benefit from help from another person.     When I first started seeing patients over 30 years ago I thought of myself as a coach.   And sometimes a good coach can help you see that you can do much more than just overcome the current problem.  

Karl Menniger, MD was a famous psychiatrist who said”  Psychotherapy is too good a process to only be used with the mentally ill. “    

In therapy you can discover and develop the ability to recognize and overcome  behaviors and attitudes which have restricted growth and diminished your vision.  In a healthy therapy environment your awareness can be expanded and you can awaken potentials within you that have been dormant.
Independence  and self-reliance are necessary strengths to be developed.   However as with coaching one person can ofteh see what another person can not see. 

Therapy can provide immediate relief and long-lasting benefits and help you develop resilience by helping you discover the tools and the skills that enable you to see more clearly how you are living your life.    Knowledge that can help you avoid trigger and automatic responses that may have inhibited and block your own growth.
 

 

What am I supposed to do in therapy?   How do I know if I am with the right therapist ?

Every therapy session is unique and every therapist is unique (as every patient is unique).   What can occurs depends on what the patient wants and needs.  There are various approaches and "techniques" but I believe the bottom line is that the patient should first feel the therapist understands them, respects them and has their best interest at heart.  And of course you must feel that  the therapist comments and responses extends your thinking and are useful.

If the patient doesn't understand or doesn't feel comfortable with what or how the therapist is dealing with them he/she must tell the therapist immediately.  THE MOST important element of therapy is the honesty between patient and therapist.  (I personally don't think total honesty with everyone is essential for healthy living)  (but Absolute Honesty with oneself.... YES) (honest self-awareness is essential for mental health! )

BUT absolute honesty is also essential in therapy between patient and therapist if the therapy is to be really useful and productive....  otherwise it is getting advice and handholding.   Support is necessary.  Insight is useful.  But that is not all that therapy can be.    Seeing how your attitudes affect others and how you deal with emotions is essential. Actually deciding what you wish to change and  making changes is what growth is.    Insight never cured anyone.   Using that insight to make changes and then make other changes is what growth is all about.  We all make mistakes.   

But another level of therapy occurs when the patient (and the therapist) are willing to examine all the feelings that occur between them.   What occurs in therapy can often mirror parts of life and understanding that can lead to real understanding of how one is living in the world now.

The patient’s job is to talk about what is on his/her mind and to be willing to be open and courageous to talk about all their thoughts and feelings.   Even if you  don't have evidence or understand why you  are thinking or feeling something it needs to be brought up.   In our development we are too often first trained to not be aware.  Actually the process of earliest mental growth is often a process of closing off possibilities.  The flood of stimuli as an infant would overwhelm us so we learn and develop mental process that filter and limit our experience.   This process of not being aware of closing off or shutting down often continues past when it is necessary.   In many ways therapy tries to reverse this process and help us become fully aware of ALL those parts of our mind (our unconscious) that influence us without our being aware of their impact.

My approach may be quite different than other therapists.   I have found that over the years what helps people the most in therapy is the development of an extraordinarily honest and open relationship between patient and therapist.  A relationship where any and all feelings can be discussed and whatever difficulties or conflicts do occur (ones that prevent that relationship from deepening) are subject matter and are attempted to be resolved. 

Sometimes the patient may think that this is NOT the right therapist for them.  They maybe absolutely right.   One of the great tragedies in therapy is people sticking with the wrong therapist.   The other great tragedy is quitting a therapist who is pushing (encouraging) you to face things that you do not want to face.  How to decide? 

If you are feeling uncomfortable or the therapy doesn't seem to be helping, do not automatically think it is you or them and just give up.   Although you should consider that you might bring something to the problem you should also consider that the therapist might not be right for you.    How to determine this is not easy and I want to write more about this later.   For the moment my short answer is to simply bring up the issue with the therapist and spend some time talking about it that problem with as much openneess and honesty as you can.  This usually requires more than one discussion.   Try to remain open to how the therapist explains how he sees the situation  but also being open and honest to the whole range of feelings and thoughts that occur within you.  You need to make your own decision but this should be done with as much information and understanding as you can by open discussion with the therapist.   In the end you may decide that it is not a good fit and you should terminate that relationship.  But you should not give up your own growth.  Recently in my own family we had to go to several surgeons to get their views on what needed to be done .  Three physicians were not  helpful and it was difficult to keep looking when you are feeling overwhelmed  but it is important to keep looking and in the end we were overwhelmingly impressed and found a match.

Of course the therapist and patient both have to be honest enough to acknowledge any of the million feelings that occur between people.   In the best of situations everything can be discussed and explored honestly.  The reason for this is that we ALL tend to hold onto and transfer our earliest feelings and experiences  to people during the rest of our lives.  We are not always smart and we often generalize and assume from the past.  If we had parents we never could please, we might assume that authority can never be pleased and however we dealt with that as children often continues in our adult life.  Other variations of this problem could be:  always trying to be pleasing or the opposite: always defying authority at all costs all out of the early experiences of and how we learned to cope with those feeling then. 

The problem is that reality changes, other people are not your parents, and you are no longer the helpless child.  But we don't change or learn as fast as we are capable of.   I do not mean to blame parents or state that everything that is not right in your life is due to what they did or didn't do.    

Concerning parents, I never met a family where I didn't feel the parents were doing the best they "could" at that time.     That is not to say that  severe problems and painful situations did not develop.  But parents came from their own families.  
We all do the best we can at the time. 

Mistakes are always made; we can continue to get better.  Parents (and all of us) may have been limited in their knowledge and in their capacity to be giving or loving or available but I truly believe that in all the parents I have seen.  The overwhelming marjority did the  best they could.   

I know I made mistakes as a father and I have my regrets (my children like to remind me from time to time of some moments that I would like to forget ) and I am not a perfect husband (my wife laughs when she read this.)  And as a therapist I keep learning from my patients' openness about their own lives and their honesty with me.   Hopefully we continue to remain open and learn and change and don't repeat the same mistakes (too often).  


Back to the therapy situation. 
The bottom line between patient and therapist is to get these attitudes, beliefs, and habitual responses out in the open.  And the way to do this is to be committed to bring up whatever feelings or thoughts occur so that they can be discussed openly between patient and therapist.  It is the essential element in good therapy and allows for the most important growth to occur.  In many ways just having the strength and courage  to take the risk of talking about difficult issues is growth in itself.


I should underline that the patient should expect as much honesty from the therapist.  Therapists are human.   As I said we all can be somewhat blind at times or have limited ways of living.  All of us are the product of "imperfect" childhoods or have suffered trauma and loss. 

 

In my approach if you feel the therapist is unaware or unwilling to look at themselves and their contribution to a problem then maybe he/she is really not the right person for you.  But you should not give up and think all therapists are the same.  You should  be an educated consumer and see what type of approach and what type of person works best for you by visiting other therapists.   Although the usual response to this suggestion is that it is costly and time consuming.  My answer is that you lose more money and more time by staying in an environment that does not truly maximize the type of growth that can occur. 

 



What am I supposed to do in therapy?

Every therapy session is unique and every therapist is unique (as every patient is unique).   What occurs depends on what the patient wants and needs and who the therapist is and what they believe.    There are various approaches and "techniques" but the bottom line is regardless of the treatment approach,  the patient should first feel the therapist understands them (gets who they are) , respects them and has their best interest at heart. 

 

Beyond feeling understood and supported the patient should feel that the therapist challenges the patient in a way that expands the patient's thinking. 

 
If the patient doesn't understand or doesn't feel comfortable with what or how the therapist is dealing with them he/she must tell the therapist.   THE MOST important element of therapy is the honesty between patient and therapist.  (I don't think total honesty with everyone is essential for healthy living)  (Absolute Honesty with oneself.... YES)  honest self-awareness is essential for mental health!  But not necessarily in all relationships.

Absolute honesty is essential in therapy between patient and therapist if the therapy is to be really useful and productive....  otherwise it is just getting advice and handholding.   Support is important and it is necessary.  Insight is valuable and useful. 

 

But that is not all that therapy can be.    Seeing how your attitudes affect others and how you deal with emotions is essential. And making changes is what growth is.  But another level of therapy occurs when the patient (and the therapist) are willing to examine all the feelings that occur between them.  What occurs in therapy can often mirror parts of life and understanding that can lead to real understanding and clarity.

Developing a healthier relationship with the therapist adds to your own growth and health.  

The type of therapy that I do focuses on the current  interpersonal relationships and the thinking and feelings that occur.  The patient’s job is to talk about what is on his/her mind and to be open and courageous to talk about all their thoughts and feelings.   Even if they don't have evidence or understand why they are thinking or feeling something it needs to be brought up.  Part of therapy is increasing our vision to be more aware of our own feelings and states of mind. 

 

In our development  from childhood we are too often trained to be less aware.  Actually the process of earliest mental growth is often a process of closing off possibilities.  The flood of stimuli as an infant is overwhelming so we learn and develop mental processes that filter and limit our experience.   This helps us navigate the overwhelming world we are plopped into.

 

Unfortunately too much of a useful process can be not helpful.  Especially as we grow older and develop new abilities to navigate the complex social world we live in.    In many ways therapy tries to reverse this process and help us become more aware of those parts of our mind (our unconscious) that influence us even without us being aware of their influence and impact.


My approach may be quite different from other therapists.   In my experience, I have found that what helps people the most in therapy is the development of an honest open relationship between patient and therapist.  A relationship where any and all feelings can be discussed and whatever difficulties do occur (ones that prevent that relationship from deepening) are attempted to be resolved. 

Sometimes the patient may think that this is NOT the right therapist for them. They may be very right.   One of the great tragedies in therapy is when people stick with the wrong therapist.    The other great tragedy is quitting a therapist who is pushing (encouraging) you to face things that you do not want avoid.

 

How to decide?  If you are feeling uncomfortable or the therapy doesn't seem to be helping, do not automatically think it is you or them who is not good at this.   Although you should consider that you might bringing something to the problem you should also consider that the therapist might not be right for you.   

 

How to determine this can be easy or very difficult. (I to want to write much more about this later).   For the moment my short answer is to suggest that you simply bring up the issue with the therapist and spend some time talking about what you are feeling and what is missing or what you are uncomfortable about.    

 

Try to remain open to how the therapist explains this and how you are really feeling.   The important point is to be open and honest to the whole range of feelings and thoughts that occur within you. 

 

You need to make your own decision but with as much information and awareness as you can allow.

Sometimes your gut knows things that your mind hasn’t been able to process.  Listen to it.

Of course the therapist and patient both have to be honest enough to acknowledge any of the million feelings that occur between people.   In the best of situations everything can be discussed and explored honestly.  The reason for this is that we ALL tend to hold onto and transfer our earliest feelings to people during the rest of our lives. 

 

We generalize and we assume.  If we had parents we never could please, we might assume that authority can never be pleased and however we dealt with that as children often continues in our adult life.  Other variations of this problem could be:  always trying to be pleasing or the opposite: always defying authority at all costs. Our earliest experiences do shape us and give us a context to frame our experience in.  We label things the way our parents did…. Or sometimes we do just that opposite.

 

The problem is that reality changes, other people are not your parents, and you are no longer the helpless child.        I have to add this. I do not mean to blame parents. I know I made mistakes as a father  (my children remind me from time to time lest I forget) and I am not a perfect husband (my wife points this out,  I try to listen.)  And as a therapist I keep learning about how I respond and affect people

We all do the best we can at that time!     

 

Hopefully we continue to remain open and learn and change and don't repeat the same mistakes (at least nor too often).    Concerning parents, I never met a family where I didn't feel the parents were doing the best they could at that time.  Mistakes are always made; we can continue to get better.  Parents (and all of us) may have been limited in their knowledge and in their capacity to be giving or loving or available but I truly believe that there was no malice meant in the parents I have seen. 

Back to the therapy situation.  The bottom line between patient and therapist is to get these attitudes, beliefs, and habitual responses out in the open.  And the way to do this is to be committed to bring up whatever feelings or thoughts occur so that they can be discussed openly between patient and therapist.  It is the most important element in good therapy and allows for the most growth to occur.

I should underline that the patient should expect as much honesty from the therapist. Therapists are human.  As I said we all can be somewhat blind at times or have limited ways of living.  All of us are the product if "imperfect" childhoods or have suffered trauma and loss.  If you feel the therapist is unaware and unwilling to look at themselves and their contribution to a problem then maybe he/she is really not the right person for you.

 

 


Why medication?   Is it necessary?  (" I am not crazy")

In some cases a combination of medication with the therapy is the right course of action.  Our brain is the most complex biochemical organ of the body.  And just like your thyroid or pancreas it cannot function at its best without a proper internal balance.   Medications and supplements can facilitate how your brain is working.  Just like some individuals require additional thyroid or iron to function with optimum health.  

Of course how you are actually thinking and the choices you make have a great effect on the mind and on the brain itself.  Yes our thoughts can effect our body chemistry. 
But sometimes like all organs of the body our brains may need supplements temporarily.  It does not mean you are crazy.   Some people need insulin 3 times a day to maintain the correct balance of sugar in their body.  Other people need to lose 20 lbs and they are not considered diabetic.  Psychiatric drugs are not meant to dull an individual's awareness, they are meant to help the person function at their maximum and be more aware of what is important.

I think of using medication like getting the right prescription for your eyeglasses.  Finding the right prescription to correct your vision doesn’t solve all your problems.   
You just have more clear vision to see what is going on and evaluate what you are going to do.   Just having good vision doesn't automatically help you get good grades in school.  Conscious effort is required

As a psychiatrist I can determine what medications I think might help "your vision".  I can explain the scientific basis of these choices and follow the medications and adjust them as necessary to maximize their effectiveness.

I do not believe that the long-term solution to mental and emotional problems and the suffering  they cause can be solved solely by medication. 
Our brains are too complex and our learning, our attitudes and beliefs are deeply ingrained even wired into the brain creating learned patterns 

If these ingrained patterns and beliefs are not modified through conscious efforts  they will continue to affect us and shape our view of the world, our reactions and decisions (often without our awareness) and limit our lives.

I believe good therapy is a part of optimal living.

 

Why medication?   Is it necessary?  (" I am not crazy")

In some cases a combination of medication with the therapy is the right course of action.  Our brain is the most complex biochemical organ of the body.  Like your thyroid or pancreas cannot function at its best without a proper internal balance.   Medications and supplements can facilitate how your brain is balanced and working.  Just like some individuals require additional thyroid or iron.   I require glasses to see things clearly. And I see medication as helping the brain be at its most balanced.

 

Of course how you are actually thinking and the choices you make have a great effect on the mind itself as well as on the brain itself.  But sometimes like all organs of the body our brains may need supplements (sometimes only temporarily/other times for longer periods.)        It does not mean you are crazy

 

 Some people need to take insulin 3 times a day to maintain the correct balance of sugar in their body.  Other people need to lose 20 lbs and they are not considered diabetic.  Psychiatric drugs are not meant to dull an individual they are meant to help the person function at their maximum.

I think of using medication like getting the right prescription for your eyeglasses.  Finding the right prescription doesn’t solve the problem.    You just have better vision now to see what is going on and evaluate what you are going to do.   Just having good vision doesn't automatically help you get good grades in school.  Conscious effort is required

As a psychiatrist I can determine what medications I think might help "your vision".   I can explain the scientific basis of these choices and follow the medications adjust them as necessary to maximize their effectiveness.

I do not believe that the long-term solution to mental and emotional problems and the pain they cause can be solved solely by medication.  IN FACT I think some physicians do a patient a disservice by just giving them medication.    Even though this may actually work.   However it may be symptom relief.   Feeling a splitting headache and having  a fever may actually be help or just  improved by taking asprin.   These medications do work.    However they must be monitored and coordinated with psychological changes that occur.       I think splitting the therapist and the person who can manage the medication is NOT the best way to help a person grow.     We are one body one mind.  All is connected.

 

These ingrained patterns and beliefs need to be modified through the direct and conscious involvement in therapy or creating an atmoshere where the unconscious is being made to be more accessible and the healing power of simply being in a healthy environment and have a positive effect. )

 

I believe psychotherapy is the best tool to help people learn how to develop and maintain long term changes and growth.

 

Call for an appointment and consultation    202-232-8608      LMD@drdrell.com

Contact

Please do not hesitate to ask questions.     Please contact me for further information.

 

 

Practical Issues
It is common to schedule a series of weekly sessions, where each session lasts 45 minutes. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues or ongoing personal growth. There may be times when you are asked to take certain actions outside of the therapy sessions, such as reading a relevant book or keeping records to track certain behaviors. It is important to process what has been discussed and integrate it into your life between sessions. For therapy to be most effective you must be an active participant, both during and between the sessions. People seeking psychotherapy are willing to take responsibility for their actions, work towards self-change and create greater awareness in their lives. Here are some things you can expect out of therapy:

  • Compassion, respect and understanding
  • Perspectives to illuminate persistent patterns and negative feelings
  • Real strategies for enacting positive change
  • Effective and proven techniques along with practical guidance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 



 

Schedule Appointment

Start your new path in life and be the change today!

CLICK HERE
Helpful Forms

Click here to view and print forms for your appointment.

CLICK HERE