Private Practice Psychology

It is the end of our fourth session and Ming gets up and walks to the door. After the customary “see you next week,” she adds:”Thank you so much for these sessions. I really feel a lot better afterward.”

Uh oh.

A common misunderstanding about therapy is that its function is to help us “feel better” each week. Many equate psychotherapy with the day spa where we enter with tension and leave feeling relaxed and refreshed. Sometimes this is the case. But much of the time we leave with a greater understanding of the gravity, severity and prevalence of our issues. We think we have one problem but realize we have five. This does not always feel better; it can feel much worse.

That is why my response to Ming’s comment is “uh oh.” If she is expecting to always feel good after her sessions, she may be setting herself up for disappointment.

In the first few sessions the therapist and client are getting to know one another and explore the issues. If there is a good connection between them, clients often feel relieved, supported and hopeful. The issue they have held inside is finally being addressed, the therapist seems to care and understand without judgment, and there is a real sense that progress can be made. This feels good.

As the work continues, things often get worse before they get better. In his book The Heart of Psychotherapy, psychologist George Weinberg writes:

“In the course of psychotherapy, we help the person see the generality of his problem…As patients see, ‘This problem is more pervasive than I thought,’ they are occasionally disheartened somewhat…And to the extent that the problem was broader than they thought, the gain is greater when it is resolved.” (p. 18)

Ming entered therapy to better understand her difficulty with dating. She describes herself as a “serial monogamist” who dates men until her suspicions lead her to believe he is untrustworthy. In these first three sessions, she has been able to tell her story, vent a bit about her lousy relationships, and feel that I am working to understand and assist her. She truly feels better after the session because she was heard and supported. But our future sessions may go into uncomfortable territory.

We might discover that her suspicions have cost her many friendships as well. We could find that painful events in her childhood made trust very difficult to maintain. We might even find that her issues extend to herself - that she has a hard time trusting her own thoughts and feelings, and she projects this onto other people. These harsh realisations will not leave her with a spring in her step. This is the “disheartened” feeling Weinberg mentions.

I have seen many clients get to this point in therapy and decide to stop. We have opened several cans of worms and they simply feel overwhelmed. I do not blame them for feeling this way, but encourage them to stick with it. This is the pain we endure to achieve the gain. I equate this process with a person organizing a long-forgotten basement or closet - when you start pulling stuff out it is easy to feel overwhelmed by the clutter and sheer volume of material.

Leave it now, and you are stuck with a big mess on your hands. But push through and you will see gradual progress and eventually a more organised space.

I believe the goal of psychotherapy is to help each client grow in awareness, understanding, responsibility and acceptance. Rather than helping her “feel better” an hour a week, I hope therapy helps Ming know who she is, why she does what she does and feels how she feels. I hope it helps her realistically appraise her strengths and limitations, giving her the freedom to choose relationships, jobs and activities that bring her joy, accomplishment and contentment.

Recent research has linked lack of sleep to a wide range of ailments, including memory problems and obesity. Learn more about some of the top reasons why you should get a good night’s sleep.

Sleep May Help You Learn More Effectively

Researchers have long believed that sleep plays an important role in memory, but recent evidence suggests that getting a good night’s sleep can improve learning. In one study, researchers found that depriving students of sleep after learning a new skill significantly decreased memory of that skill up to three days later (Winerman, 2006). Known as the memory consolidation theory of sleep, this notion proposes that sleep serves to process and retain information learned earlier while awake. While there is research both for and against the theory, many studies have shown that sleep can play an important role in certain types of memory.

Research Suggests Sleep Deprivation May Contribute to Obesity

In addition to affecting memory and learning, lack of sleep has been linked to body weight. In one 2005 study published in the Archives of Internal Medicine, overweight participants were found to sleep less than participants of a normal weight (Vorona et al., 2005). Brandon Peters, About.com’s Guide to Sleep Disorders, reports that poor sleep at age 30 months can predict obesity at age seven. While researchers do not yet understand exactly how sleep disruption impacts appetite and metabolism, getting a good night’s sleep certainly can’t hurt your weight loss or weight maintenance efforts.

Sleep is Important for Managing Stress

According to many experts, most people need between seven and eight hours of sleep each night. What happens when you don’t get enough sleep? Symptoms such as moodiness, anxiety, aggression and increased stress levels can result. About.com’s Guide to Stress Management, Elizabeth Scott, suggests taking “power naps” to combat drowsiness, reduce stress and increase productivity. While sleeping more certainly won’t eliminate all stress, it can help increase your readiness to cope with the stress of day-to-day life.

Sleep Can Help You Make Better Decisions

Have you ever found yourself struggling to make relatively simple decisions after a night of poor sleep? In addition to reducing such things as response time and accuracy, lack of sleep has also been linked to difficulty making good decisions. In one study published in the journal Sleep, researchers found that sleepiness has a serious impact on the ability to make effective decisions (Roehrs, 2004). Another study suggested that sleep impairs decision-making when gambling by increasing expectations of potential gains while minimizing losses. If you’re facing a challenging decision, make sure that you are well rested so that you will be at your best.

References

_{American Academy of Sleep Medicine (2007, May 5). Sleep Deprivation Can Threaten Competent Decision-making. ScienceDaily. National Sleep Foundation. (2008). Longer Work Days Leave Americans Nodding Off On the Job.}

_{Peters, B. (2008). Why so fat and tired?}

_{Roehrs, T., Greenwald, M., Roth T. (2004). Risk-taking behavior: effects of ethanol, caffeine, and basal sleepiness. Sleep, 27(5), 887-93.}

_{Vorona, R. et al. (2005, Jan. 10). Overweight and Obese Patients in a Primary Care Population Report Less Sleep Than Patients With a Normal Body Mass Index. Archives of Internal Medicine, 165, 25-30.}

_{Winerman, L. (2006). Let’s sleep on it: A good night’s sleep may be the key to effective learning, says recent research. Monitor on Psychology.}