Myth #4: There’s no time for therapy

“Self-care” is quite a buzzword lately.  Therapists are told we need to be proactive about taking care of our mental health to avoid burnout, vicarious trauma and just generally to shelter your personal life from the burden of being a part of daily trauma. 

But self-care is kind of bullshit because we don’t have time for it.

It’s not that self-care is actually bullshit – but employers and organizations use it as a way to reduce their own responsibilities to their employees’ mental health.  Here’s how it works: studies state that mental health and emotional well-being has a long-term impact on the success of a company (because of higher health insurance rates or higher turnover or many other reasons).  Because companies want to reduce this long-term impact (the positive interpretation) and/or gain positive PR (the cynical interpretation), they begin offering mindfulness classes periodically or cover meager amounts of mental health care.

But a work environment and culture doesn’t change overnight.  How many times have you seen an email come across offering a free, conveniently located mindfulness course just to decline the invitation because you just “don’t have time” and what would people think if you weren’t working and available because you were practicing breathing? Often, employees who engage in the services are subtly shamed for being self-indulgent or lazy or not committed to “working hard.” 

Physical exercise went through a similar cycle a few decades ago.  There was a time where it would have been unheard of to use your limited free time to go running.  Then, some older folks started to experience the health effects of a sedentary lifestyle and now physical exercise is now generally accepted as a useful endeavor.  (Law firms are still behind on the times on this, I know.  I can probably count the number of truly fit lawyers I know on one hand.)  So now, when we want to be healthy, we make time for physical health.  The same can be true for making time for mental health. 

The revolution is coming for mental health.  Our children will probably be part of a workforce where their colleagues will be awed and impressed by their commitment to use their lunch hour to see their therapist the way we currently feel about the ones who make it to the gym regularly.  But for now, how do you counteract the (valid but unjustified) guilt when you set aside an hour a week on your calendar for therapy? 

In the next post, I will go over the difference between a justified and unjustified feeling, and how the recognition of the difference can help you choose a different behavior.  But for now, I will stick to this limited instance of guilt.  The feeling of guilt is justified (or, in other words, helps guide your behavior) when you have done something that violates your values.  If you believe that you deserve to work on yourself and therapy can help you do that, then taking time to do that doesn’t violate your values.  You may still feel guilty but if it’s not justified, then you don’t have to act on it (i.e. ignore the importance of your mental health).

On to practical tips for how to make time and commit to improving your mental health: follow the advice and guidelines that people tend to use for physical health.  Start thinking about your emotional well-being as a long-term investment.  Find a support network of like-minded people who will encourage you and gently keep you accountable to your own goals.  Choose your support network to set you up for success.  For example, if you were training for a marathon, you shouldn’t choose a novice runner with no interest as a running buddy.  Similarly, look for friends and family who are interested in mental health and start building self-care and therapy into your regimen.  The effort you put in will pay for itself as your relationships improve and you learn to use your time more effectively.

Myth #3: Lawyers can't go to therapy

Alternatively titled “Therapy doesn’t work on lawyers.”  Or “What would my coworkers think?”

Surprise! Lawyers do go to therapy, therapy works for almost everyone (if done well and with the right person), and your coworkers don’t care.  That last one might not be true yet but we’re moving in the right direction.

I wish there was an easy answer to this one.  It’s undeniable that there is a stigma against mental health in our society and law firms tend to be behind the cultural curve in all ways.  Law firms are getting better about it and are beginning to offer mindfulness courses, which ostensibly shows that they value their employees’ mental and physical health, since mindfulness has been shown to reduce physical symptoms of stress.  But how many lawyers out there really know how to use mindfulness and/or self-care effectively?  It’s not just about taking five minutes to breathe when you’re upset or going out for dinner during a stressful week.  Mindfulness is a practice that constantly runs in the background to monitor your emotional state, even when (or especially when) your emotions are not running high.  Self-care requires active self-awareness to know when you need to take a break or, even better, to anticipate when you might need a break later. 

But how can you learn these skills?  Certainly not by a lunch hour seminar you can attend only once.  Therapy is the obvious answer but we run into problems because a law firm is not a single person to whom you can explain that, for you personally, going to therapy once a week is going to make you a happier person and a more productive employee.  Instead, we have to work within with a culture that has a long-established set of values that is small-data driven and managed by people who have less business experience than a multi-million dollar company is usually run by.  (For ethical reasons, law firms and medical practices can only be owned by licensed lawyers and doctors.)  And, as we all are all-too familiar with, the easiest way to quantifiably measure a person’s worth is with numbers: Number of clients, number of billed hours, number of hours in the office, etc.  I have had very long conversations with a law partners about all the ways they are losing money by focusing on these numbers, but that’s not why you’re here.

So now what? Unless and until your work culture has progressed, it might be in your best interest to keep your private life private.  Look for a therapist who offers evening and weekend hours or is comfortable doing phone sessions. 

If you’re wondering – how can a therapist recommend hiding therapy?  Isn’t giving in to the stigma part of the problem? 

And that’s true; as a therapist and a mental health advocate, I fight against the stigma and the shame.  But as I said in an earlier post, the therapist’s first priority is the client’s goals and well-being.  If you work in an environment that punishes openness about mental health, then you have three choices: (1) to be open and punished, (2) to find a different environment, or (3) to maintain your privacy.  When those are your choices, I think it’s more than understandable to leave the stigma-fighting for someone else.

tl;dr Therapy works for lawyers and the reason you haven’t heard about it is because no one is talking about it until they leave law.

Myth #2: People who need therapy are “crazy”

Your only exposure to therapy might be through TV and movies.  In the past, these depictions were mostly limited to crime and suspense (think The Sopranos or Silence of the Lambs).  The Golden Age of Television has brought us a wonderful number of TV shows and movies that show mental health issues from a much less stigmatizing and more humanizing perspective (such as Netflix’s Atypical).  But these are still meant for entertainment and the therapist is usually only shown when the client is super-dramatized or the therapist has done something wrong, thereby creating a plot device for the character with mental illness (such as Netflix’s Thirteen Reasons Why and Atypical).

It makes sense, then, that therapy isn’t shown at all for folks whose issues aren’t entertaining enough for prime time. Just like a legal drama doesn’t show young associates clicking through document review for hours on end and medical dramas don’t show doctors filling out paperwork before bed, TV shows and movies aren’t going to show a therapist working with a high functioning client who just wants to improve their quality of life a little bit.  And yet, those clients are the most common clients. 

The confusion actually lies in the idea of what therapy is, rather than what “crazy” looks like.  The same techniques that help a client who loses their job because they’re too scared to leave their house can also help a client who is doing just fine but wants to lessen their mild social anxiety so they can take on new tasks at work.  But the stigma of being someone who “needs help” can be so strong that it can prevent people from checking out their options.

Fortunately, things are changing.  Mental health is becoming a more common topic of conversation and interest.  There can be downsides to this interest.  For example, even though Netflix’s show Thirteen Reasons Why gave a huge platform for people to discuss mental health, it also gave a harmfully inaccurate depiction of depression, especially for the impressionable teenage audience.  The upside, however, is that it is becoming easier than ever to access therapy and that allows clients to hopefully find a better therapeutic fit, which has shown to make up as much 40% of the success of psychotherapy.

Myth #1: A therapist is just a friend you pay for

A few years ago, a lawyer friend of mine was going through a messy breakup and career transition that also came along with financial concerns.  After a few months I noticed that her heightened emotional state didn’t seem to be subsiding with time (that is to say, she was still really upset).  When I suggested therapy, she said, “Why would I pay to talk to someone when I can talk to my friends?” 

The most and least obvious difference between a friend and a therapist is the same: my friends are biased and aren't likely to give objective feedback or validation.  On the one hand, this is absolutely lovely!  My friends like me and so they are more likely to be on my side.  On the other hand, it can be difficult, rude and unwanted for a friend to give you honest feedback, even if that’s what you need.  Even if you wanted honest feedback from your friends, they aren’t likely to be trained on how to have that conversation in the most effective way.

Another reason a friend is a bad therapist is because everyone has their own goals and desires and your friend’s may very likely be different from your own, which is completely understandable.  For example, let’s say your best friend at work moved to a job somewhere else and now wants you to join them.  Maybe that move is what’s best for you and maybe it’s not, but either way, it’s likely that your friend will be, at least a little bit, biased because they want you to join them.  Natural, lovely and, unfortunately, still biased.

A friendship is a two-way relationship with all the complexities that comes along with that.  (Family relationships are even more complex, obviously – your mother is definitely not a good therapist for you.)  A therapist, on the other hand, has only one priority and is especially trained to prevent their own biases from influencing the work.  The therapist’s job is to explore the client’s goals and help the client achieve those goals.  The therapist is trained to deal with any conflicting or confusing feelings that come up, with the client’s well-being as the highest priority. 

If this seems a bit like having a relationship in a vacuum, that’s because it is.  The therapeutic relationship allows the client to work out real world issues in a place that is safe from repercussions.  This is a place for the client to take risks, learn new skills and practice those skills (and fail at them) without an audience.  Then, when you are ready, your therapist helps you take your new skills out in the real world. 

This is a role that is nearly impossible for a friend to fill.  And I say that having many friends I would love to therapize*.  But I know that my friends are better off seeing a therapist who can remain objective.

*Not a real word.

Note:  For more information on the ethical issues of  “dual relationships” see the links below:

http://drkkolmes.com/2009/07/13/demystifying-therapy-what-are-dual-and-multiple-roles/

https://www.goodtherapy.org/blog/psychpedia/dual-relationship-definition

Introduction to Myths About Therapy

There are lots of myths about therapy and some that lawyers buy into more than others.  My personal favorite is that we are mind readers or constantly analyzing other people’s behaviors.  Only one of the two is true. 

In following posts, I will delve deeper into specific myths that can give people an inaccurate perception of psychotherapy.  But first, why do myths and stigma exist at all?  After all, there’s no stigma against getting treated for cancer (at least not in the United States*), so why should there be stigma against getting treated for anxiety?  Many of the myths have to do with the fact that psychology and mental health can feel intangible and difficult to measure and, therefore, difficult to research.  You may have heard of the replication crisis** that is happening across all scientific industries and is most noticeable in the world of psychology.  

The idea of emotions and personality is tied up in our cultural understanding of ourselves and our learned values.  Confronting those beliefs, or being confronted by others, can be challenging and cause an understandable reflexive rejection.   Even those of us who embrace psychology and believe in its effectiveness can have strong and emotional opinions about things like causation versus correlation or how different techniques work and why.  In some sense, this reaction is the same kind of reflexive reaction based on our own personal experiences and culture.  (Therapists are, however, trained to prevent our personal opinions from negatively affecting our work.  More on this in a later post.)

These deep-rooted instincts make it easy for myths to spread, especially if we are used to cold, hard evidence.  We also know, however, that some things can’t be proven that way and yet are undeniably true.  Or at least mostly true (we try not to generalize around here).  Stay with me through the next few posts to explore different myths about psychology and psychotherapy.

* https://www.pbs.org/newshour/health/health-jan-june11-cancerstigma_06-15

** https://thewire.in/208014/replication-crisis-science/

For more information on the replication crisis, see the following links:

https://en.wikipedia.org/wiki/Replication_crisis

https://www.theatlantic.com/science/archive/2016/03/psychologys-replication-crisis-cant-be-wished-away/472272/

http://www.nationalreview.com/article/453748/medical-research-replication-crisis-growing-problem

https://fivethirtyeight.com/features/failure-is-moving-science-forward/

What is Therapy For Lawyers?

Obviously, “therapy for lawyers” is the same as therapy for everyone else.  Except that there are some things that aren't totally intuitive to non-lawyers.  For example, there is an upside to the billable hour: as long as we make those hours, we can make them on whatever schedule we want.  (The downside, of course, is that there are no off-hours.)  For another example, when we are stressed and complain about our job, it isn’t really helpful when people tell us, “Why don’t you just quit?”  As though we live in such a vacuum that we didn’t know just not doing it anymore was an option.

There are many reasons we don’t just quit.  Sometimes we like the work.  Sometimes we even like the people we work with.  Sometimes we like the people we work with so much we follow them from firm to firm.  Does that sound like the kind of job we want to leave behind entirely?

But if we don’t want out, then what is it that we want?  Or what if we do want out but we are so isolated that we can’t even imagine what else we could do?  I myself have used the phrase, “I have no other skill set,” many times.  Self-deprecating humor is a wonderful coping mechanism.  As is sarcasm.  (Sound familiar, anyone?)

This is where therapy can help.  Therapy can offer you an empathetic yet objective reflection to help you sort through the many different aspects that contribute to your specific situation.  On the one hand, there can be insights that will help you decide what is really important for you.  And on the other hand, there are techniques you can learn to deemphasize the negatives so you can keep what you like about your job and your life while reducing the rest.

Stay tuned for myths and misunderstandings that get in the way of finding the right kind of help.

Introduction to Valid and Justified

Welcome to my blog Valid and Justified.  I plan on using this space to offer information and insight into how and why therapy works, particularly for people who haven’t had a lot of exposure to it.  While the content in here may at times be geared towards lawyers, since that is my background, it will also be helpful to anyone who is interested in learning more about how psychotherapy works. 

The blog title, “Valid and Justified,” comes from a DBT concept that all feelings are valid (because, after all, if you are experiencing it, then it is real to you) and only some feelings are justified.  Learning the difference between the two can be the first step to accepting the reality of your emotions while also choosing which ones to act on.  These are concepts that I will delve into deeper on later posts but if you are interested in learning more about Dialectical Behavioral Therapy, please visit my website here: https://www.karenyehsf.com/specialties/

My one overarching goal in this blog is to help dispel the perspective that therapy “just wouldn’t work for me.”  There are many different factors involved in the success of therapy, including the right therapeutic relationship.  Over the course of this blog, I hope to give you the information you need to choose the right therapy and the right therapist for you.