THINKING ABOUT SPEAKING WITH A THERAPIST

      Nagging questions about getting into therapy can stand in the way of choosing to schedule an initial appointment with a counselor. When information that could assuage fear or foster hopefulness in relation to taking this step is unavailable, a person is vulnerable to becoming mired in indecision. Prospective participants can find it tough to figure out whether seeking help is necessary or, upon imagining what it might be like to take the plunge, whether the experience will prove beneficial. Someone may recognize trouble is brewing but not be sure the danger is serious enough to warrant bringing a mental health professional into the picture. Contributing to uncertainty about the severity of an emotional problem is the barely perceptible manner in which the condition may devolve. While forceful psychological blows leave no doubt about their gravity, for a subset of people the slide downhill proceeds less dramatically. Issues with the potential to become truly threatening might not arouse at first much worry. And they could worsen only gradually, so that increases in their intensity can be absorbed without inducing a sense of alarm. By the time the subliminal problem grows sufficiently blatant that its realness is inescapable, resolving it may be beyond the grasp of the person caught in its clutches. In contrast to occasions when deterioration is occurring that one does not detect, there are situations where qualities or sides of oneself emerge that one does not want to face. Reduced awareness might even be in specific cases a desirable limitation, as when someone, upon catching sight of a personal flaw or an unbecoming pattern, veers from focusing on the unpalatable truth. Rather than leaving the problem behind by tackling it effectively, one has the troublesome matter disappear by not thinking about it at all. Selective blindness is achieved by wrenching one’s attention elsewhere; at other times, disconcerting thoughts exit consciousness without needing assistance. Part of what could spur a person to seek distance from the disturbing idea that something consequential is wrong is the scary realization, and the feeling of helplessness accompanying it, that a conception of the measures it would take to effect durable change is lacking. Ending up steeped in denial, however unpreventable this reaction may be, isn’t conducive to enlisting the support of a specialist to deal with faulty perspectives, character defects or gaps in competence.

Also complicating the inner debate regarding the necessity of seeking guidance is the presence of breaks in the continuity of one’s decline. The trajectory of the journey toward deeper hazard may not be utterly linear. A descent can be slowed by blips upward in the territory in which the difficulty resides. Adaptive conduct, coming after past ineffectiveness at controlling unhelpful thinking or behavior, may instill confidence by confirming that it remains possible to gain ground. Putting together a string of advances can create an experience of rising momentum, with each success fueled in part by the power derived from the gains preceding it. Strides forward that are the product of determination inspire the belief that one is capable of more than seemed likely before, with the enhanced sense of potential paving the way to further improvement. Earned optimism can support the attempt to boldly engage in fortifying action when, due to the heft of the undertaking or its complexity, making headway is not assured. For some people, a pair of misreadings, in which the persistence of new accomplishments is too readily assumed and the arduous work lying ahead is underestimated, can set the stage for an unforeseen reversal. Taking useful steps toward mastering a problem that has reigned supreme might leave a person feeling overly heady, which, when coupled with an unrecognized dearth of understanding of how to fight a lengthy battle with a condition that won’t go quietly, could cause the presumption to surface that entering therapy, an option periodically considered but not as yet acted upon, may indeed be unnecessary after all. Should the know-how within reach to meet the challenge at hand no longer suffice, the recent upturn, hard-won though still fragile, will shift downward, sometimes, as when the Sisyphean nature of the climb back is too demoralizing, sharply and steeply. In a chain reaction that pulls a promising sequence in the opposite direction from which it was heading, collapsing behavior and defeatist thought recurrently potentiate each other. When the savvy and stamina aren’t present to underpin the longer game that must often be played, progress stalls, dropping one toward the level of functioning that formerly existed, and perhaps to previously unexperienced depths, as the confidence destroyed by the contraction of heartening action impedes mounting an effort to reclaim the lost ground. As this unmerry process runs its course, faith in oneself is eroded and the earlier resilience comes to the halt.

          It can be important to acknowledge that unhelpful patterns are too firmly in place, or that the resources are missing to grapple with pressing circumstances, or that life is moving harmfully off course. The time may have come to let go of the belief that whatever is bringing grief can be managed single-handedly. Having to entertain such thoughts may be unnerving because they threaten the image of oneself it would be pleasing to maintain. And given everything that is already challenging, a person might not want to adopt a perspective that adds to the weight of the existing load. Keeping unwelcome realities at bay could provide temporary comfort, though it would prevent acting in response to them with the aim of introducing change. Repeatedly opting for the short-term dividend can exact a toll over time. A psychological condition may deteriorate when we put off learning to handle external demands or insufficiency within. Attending to issues that have been neglected too long will necessitate a tougher climb upward, which would need to begin from a weaker position, thereby reducing the pace of progress, and possibly lowering the chances of a fuller success. A willingness to accept personal limits, and to back away from a stance of utter self-reliance, opens the door to making a decision that would constitute, even before the initial therapy session occurs, a pivotal step in taking charge of one’s life.     

          Someone who is ambivalent about starting counseling could also have worries about whether the therapist will play a helpful role. Concerns may be present about entrusting one’s mental fate to a stranger. The fear that help won’t arrive after one extends oneself to receive it, and that speaking with a counselor might lead to disappointment, could make deciding to give therapy a try all the harder. In addition, unfamiliarity with the characteristics of the therapeutic dialogue, and the ways in which it can be beneficial, could deter someone from attempting what feels like a voyage into the unknown. In mustering the courage to step toward therapy even when the outcome of the venture cannot be known in advance may allow one to feel brave for being prepared to take the risk. Many people who harbor doubts about counseling will experience a pleasant surprise when they discover the positive aspects of talking with a therapist. And it is worth keeping in mind that nobody needs to continue a therapy that for whatever reason just doesn’t seem right.

          One of my goals as a counselor is to create an atmosphere that makes it easier to talk about difficult subjects. I am flexible in my approach, open to discussing thoughts, feelings, and relationship or behavioral issues, depending upon what is most relevant at a given moment. I might gently draw someone out who is having trouble knowing where to begin, or who finds it hard to put inner experience into words because things inside feel blocked or jumbled. Remarks of mine that accurately characterize, or add substance to, the disclosures of the other person could facilitate the journey inward. Should a participant in therapy be unsure about the next turn the conversation ought to take, and be comfortable with sitting in silence, I will provide room for contemplation, so that a direction in which the discussion could proceed might eventually emerge. When the story is flowing freely, I stand back and absorb its details and implications, and then respond to the material presented, offering observations, and possibly guidance, or inquiring further in order to learn more. With the questions I pose, and through seeking to name the ideas and sentiments beneath the words already spoken, I hope to put a person in touch with elements of experience that are deserving of focus but not immediately within view. A sense of relief may accompany the gain in awareness when subsurface currents are captured in language. Feeling understood can quiet the apprehension about not being understood and encourage further sharing. Greater calmness may allow recessed content within the mind to rise to the surface, and a growing confidence in the therapist could leave one inclined to take chances regarding the topics to be talked about. Thoughts may be raised for exploration even though they are only partially formed, or when it is unclear along which lines their introduction would send the exchange. Concerns or emotions that are uncomfortable to face, because they expose vulnerability or place one in an unflattering light, might be more readily expressed aloud. The reward for overcoming a reticence toward openness, or for seeing previously unrecognized features of one’s make-up, conduct or relationships is an expanded sense of freedom.

          A person in psychological trouble may feel stumped when it comes to finding a means to remedy the distress. Should someone be unable to figure out how to tackle a problem, I will offer for consideration suggestions for becoming unstuck. Based on my appraisal of the strengths and the gaps in a person's thinking and behavior, and drawing on my sense of the resources needed to handle the demands of the circumstances, I will propose ways of looking at matters and courses of action designed to narrow the divide between the capacities available and the competencies required.

          It is hard to use one's faculties effectively after the nervous system becomes highly aroused. Poise and rationality suffer when autonomic reactivity spikes or is chronically above optimal levels, making it tougher to think clearly, to keep emotionality in check, or to behave ably. Painful recollection, fruitless preoccupation, endless self-denigration, or fearful anticipation can each disrupt composure. Learning to dampen visceral intensity through self-calming techniques, which promote a shift in attention to thoughts or images that are emotionally neutral, could be restorative. The tensions inside will ease when the body is not riled up by what is going on in the mind. A quieter state may give rise to a heightened feeling of self-possession, granting a person a better shot at assuming control. Useful ideas might arise about how to orient or comport oneself, and access to behavior that over-arousal had disabled may be regained.

IMPULSIVITY

Urges or cravings can intrude upon consciousness, occupying a sizable portion of the psychic terrain and placing a person in jeopardy of losing agency. An unhealthy impulse emerges as behavior if resistance to its expression is insufficient or absent, leaving one worse off for not having mustered the capability to act otherwise. The drama in psychological life revolves around whether someone in danger of falling prey to an unruly internal force will rally, correcting the course of the episode in progress before it reaches an unfortunate end. Inserting into the flow of thought a different set of considerations can alter the balance of power within the mind. The revised perspective could break the momentum of a surfacing threat while laying a foundation for behavior that allows a person to sidestep being ensnared. Gorging on food, drinking too much, shopping compulsively, or smoking day and night are among the forms of excess to which people become subject. These habits take hold because they succeed, during the interval before their impact subsides, in ridding the system of unpleasant emotion by flooding the body with pleasurable sensation. This tactic, which is useful in alleviating tension when the means aren’t available to meet the moment in a better manner, often begets ambivalence about continuing to employ it. However acceptable, or at least tolerable, such conduct may be initially, when attention is primarily fixed on the relief it can deliver, along the way a shift may occur in how the reaction is appraised. Misgivings arise once the physical or financial costs of routinely yielding to temptation reveal themselves, or after the realization dawns that heading down the road being traveled is making it difficult to reverse direction. Over time someone gets caught between opposing currents, wanting to embrace the habit because of the bad feeling it can relieve, and wanting to stop the repetition because of the bad feeling it can engender. How the impulse is experienced is related to where in its cycle a person stands. As it swells somatically, or completes the leap between inner and outer worlds, it may seem compelling and alluring. But self-dissatisfaction often spikes in the aftermath of a reflexive act. The behavior that, in advance of its appearance, is seen as a vehicle for easing discomfort, comes to be viewed, after the opportunity to exert self-control has been lost, as an indication of weakness. And each addition to the accumulating number of lapses is likely to spur anew the unhappy recognition that one again couldn’t keep from happening what one wishes in retrospect had not occurred.

The person who can no longer stand being driven by impulse, and has reached the point of needing to gain leverage over it, begins the contest at a disadvantage. While the problem starts life as an outgrowth with, for each individual, a particular set of roots, its very expression, on occasion after occasion, causes it to become, for just about everyone, a contributing factor to its own persistence. The predicament facing the would-be master of runaway habit is that the impulsiveness which sparks a sense of urgency to reduce its occurrence, or to quash it permanently, also detracts from the ability to put an initiative at self-change into effect. Faith in one’s powers is not acquired through engaging in behavior that instills doubt about one’s capacity. Past deficiency undermines the conviction that success is attainable. It decreases the odds that someone, when facing a comparable test subsequently, will undertake an effort or persevere should the demands tax the resources on hand. To move from being unwilling to run the risk of not succeeding to daring to attempt what seems tough to accomplish requires establishing the belief that it is possible to perform the challenging action. Positioning oneself to exercise restraint in the presence of a rising hunger, after a string of defeats has lowered morale, begins with observing the behavioral record from an alternate angle. The purpose of this maneuver is to highlight previous demonstrations of strength. By focusing intently on instances, however infrequent, when a craving was subdued or evaded, a person stands a chance to withdraw attention from deflating setbacks, and to turn dormant potential into an active force. In recalling choice points where recalcitrant habit was bested, one reconnects with the know-how and fighting spirit at the heart of these deeds. As a consequence, an action typically thought to be out of range may be newly conceived as doable. The reminder I-did-it-before-so-I-can-do-it-again could permit the commendable side of one’s history, despite being a lesser feature of the overall story, to act as prologue. Even a single strand of competence might be used to lift oneself toward a further uptick in efficacy. In the absence of evidence that bouts of excess can be prevented from running their course, a person will have trouble limbering up for combat cognitively, and is vulnerable to standing idly by the next time the wayward tendency starts to assert itself.   

          For those without triumphs to relive when feeling the pull toward indulgence once again, there are other avenues to a mind-set that could underpin resolve. Someone who is ready to approach a debilitating habit with a new seriousness can aid the effort to preserve control by viewing the consequences of jumping on board the impulse, or of not being at one with it, through a broader lens. When the entrenched pattern is about to play out unthinkingly, a quick escape from an unwanted condition is the anticipated outcome that propels a person to act with abandon. Moreover, the thought of not doing the urge's bidding is unsettling because it gives rise to the prospect of having to withstand a hard-to-bear state for longer than seems manageable. During the mental feat that keeps one’s first inclination from becoming the last word, a change occurs in the relative prominence of the competing priorities, akin to a reversal between figure and ground. The justifications abetting impulsivity are discredited as a source of influence, and a reconfigured outlook, focused on the logic for imposing behavior that cuts against the grain of established habit, is elevated to a position of authority. In the realignment which tips the scales in a favorable fashion, emphasis is shifted from the equilibrium to be restored by heeding the call of impulse to the price to be paid for taking the path of least resistance to a steadier state. And in the corresponding segment of this interior pivot, the emphasis shifts from the frustration to be endured by delaying the release of an intensifying need to the psychic capital to be earned from remaining steadfast while in harm’s way. Clinging tightly to this modified framework, especially if previously ascendant ideas threaten to reclaim their former dominance, makes it possible to move from being on the verge of an action that seems irresistible to achieving a victory in an uphill struggle.     

          By projecting the mind forward in time, a person gains a shot at derailing a craving whose overt expression is imminent. Bringing images into the present of the hazardous shape the future will take creates an opportunity to prevent the envisioned developments from materializing. While looking back at examples of success can furnish a needed assist, foreseeing the ill effects of succumbing to impulse may produce a galvanizing scare. A risky situation could be retrieved by turning one’s focus from the good feeling to be enjoyed immediately, as the stimulation or numbing being sought arrives, to the adversity that lies ahead, when less pleasing realities displace the recently amplified inner state. Concentrating on the repercussions of bowing to an enticing but detrimental urge can swing the pendulum from what one just a bit earlier did want to do, to what on second thought one does not want to do. The reworked perspective will supply reasons to stifle an awakening instinct that could be pitted against any arguments in support of its unfettered advance. Should a person throw sufficient psychological weight behind sustaining the reign of the newly operative ideas, the nascent impulse can be blocked from crossing the threshold into behavior.

The penalties for rushing headlong toward gratification too regularly are an upsurge of discontent and a decline in personal power. Capitulation in the face of an onslaught of desire can spawn self-disappointment for having forfeited the chance to react effectively at a critical moment. As the instances of impulsivity multiply over time, and the growing, though not easily recoverable, loss of volition becomes painfully apparent, one may feel shamed, even sickened, by the warping turn fate has taken. Were the uncontrollable actions to harden into a refractory pattern, and be experienced as having a life of their own, the verdict reached internally could be sweeping and severe. Rather than viewing flare-ups as ill advised conduct that begs for repair, they might be interpreted, particularly if inadequacy is evident in several domains simultaneously or there exists a proneness to channel vehemence inward, as an incontrovertible sign of one's utter lack of value as a person. An inability to deter a consuming urge from appearing as behavior can influence whether it will be possible to exercise restraint at a later point. Since it is difficult to gain sustenance from observing an absence of competence, and because winning the fight against the formidable opponent within often entails drawing on reserves acquired through prior resourcefulness, each stumble contributes to the higher likelihood of another fall when the same battle is joined on the next front. An alternate route to uncoupling from a craving, which relies on fear rather than pride and mettle as a catalyst, is to be guided by the imperative to avoid becoming trapped within the problem more deeply. Vividly picturing, at a moment of vulnerability, the sour feeling in store and the weaker future being cemented were rashness to prevail, could unlock the motivation to parry its thrust, so that further depletion is averted and a stepping stone toward additional progress is put in place.

A boost in self-respect and an infusion of new resolve are the benefits that may derive from halting an impulse from seizing control of the helm of the mind. A method for skirting trouble involves treating an invasive urge not as a command to be obeyed lest intolerable tension persist, but as a call to brave the pressure in need of release until an experience of mastery solidifies. There are modes of thinking that can temper the disquiet within, and facilitate a reversal in the relative intensity of the conflicting inclinations. A person in the throes of a developing impulse might profit from realizing the situation offers a choice between seeking comfort and fostering strength. Remaining aware that the easy satisfaction to be reaped from making a beeline toward relief is usually fleeting, leaving enervation in its wake, could lessen its appeal as an option. Psychological muscle is built by resisting the push of an unwholesome inner force, or by pushing past an inner resistance to engaging in advantageous though demanding action. A keenly felt sense that a dedicated effort to counter being overtaken by desire will enhance mental toughness can provide the incentive for someone to gather the energy to embark upon it. Another consequence of standing firm while being driven toward excess, which could serve as an impetus for acting resolutely, is the effect of the initiative on the depth of one's self-regard. Recognizing at an urgent moment that a choice exists between feeling good after dosing the body with sensation, and feeling good about oneself as a person for suppressing a harmful urge, can be a prelude, for anyone who aches to escape the grip of the habitual, to selecting the truly nourishing alternative. The delight in evincing discipline at junctures where one had been victimized by appetite may prove to be an ample substitute for the mindless pleasures being left behind.

An awareness of the measures that could stave off falling under the spell of impulse is not synonymous with having the ability to put a protective response into effect. The pull toward acting precipitously may be stronger than the force that can be applied to pushing back against it. A craving might swamp the mind with its hungry presence, wrenching one’s attention solely toward the purpose of pursuing its fulfillment. When a fierce inclination is traveling through the system at a high rate of speed, the likelihood plummets that an alternate base of power, from which an attempt could be launched to keep an impulse on the move from completing its takeover, will be established. An encounter between these contrary wants, at its most asymmetrical, would resemble a boxing match in which one fighter knocks out the other in the opening moments of the first round; the face-off is over without a counterpunch being thrown. Each instance of dominance by an impulse adds to its future might, which accrues at the expense of one’s wherewithal to thwart an incursion emanating from within. To avoid having to contend with a strengthened urge from a weakened position it is necessary to fortify oneself in advance. The aim would be to build the capacity to disarm the impulse before it gains the momentum to make resistance futile. Constructive ideas or behaviors that fail to arise naturally won’t play a role in how the story unfolds unless they can be introduced deliberately. Not anticipating the arrival of a recurring temptation before it actually emerges will have one entering a zone of susceptibility unsuspectingly, at risk of being blindsided by the unforeseen. Surviving the danger requires looking ahead to the fork down the road where the next choice between submission and restraint must be made, and then bringing to bear, before onrushing desire begins to cripple inner control, previously readied deterring thoughts or evasive actions. Learning one’s psychological lines can imbue the redeeming steps with the power to preclude a potentially uncontainable urge from reaching the point of inception. An alertness to the conditions under which an impulse might strike, honed through reviewing the times, settings and emotional states that were associated with prior incidents, could prime one for managing prospective upsurges in a variety of contexts. By remembering to recall what it is essential to not forget, a person raises the odds of neutralizing a threat while it remains on the horizon. Hindsight and forethought can help transform a looming reversal into an occasion for success.

Even were it not possible to keep a craving from starting to surface, one may intervene to prevent it from climaxing as behavior. Time is of the essence if an advancing impulse if to be tamed before it dictates the course of events. Given how rapidly the internal culprit can take hold, the risk is real it will shoot the gap into action without its interior flight registering in consciousness at all. Much depends on whether an urge is detected prior to the point when its propulsion becomes unstoppable, and while there is still a chance to undo its claim on the mind. The trick is to spot a craving soon after it originates inside. Although accomplishing the early part of the work doesn’t guarantee that other cognitions related to changing direction will invariably fall into place, blunting an urge cannot happen without this act of identification occurring first. Stepping outside the impulse to observe its growing presence creates a fleeting pause during which someone can assume an adversarial stance, paving the way for further extricating thoughts to be brought into play. The room gained to maneuver may be used to gauge the trajectory of the process underway as well as enlist one’s healthier ambitions. By recognizing where the sequence in motion is headed, and connecting with the desire for the episode to not conclude badly, a person becomes better equipped to refrain from just going along for the ride. Adding to the mental mix an awareness of the ravages of surrender, and the psychic dividends to be earned from eluding capture, could promote reflection about the drop or rise in wellness that follows making a poorer or smarter choice. Such calculations could provide the reasons needed to stop an impulse that was beginning to dominate from continuing to rule. Any of these ideas, either individually or in concert with kindred notions, can stretch the partial detachment initially obtained into a full parting of ways. As the tide shifts internally, power is transferred from the body to the mind. Sensible behavior is likelier if one has planned for the moment when self-restraint is about to disappear, or if recent performances in similar situations have supplied evidence of an upswing in discipline. Should liberating perspectives fail to appear spontaneously, it would be crucial, if the first urging isn’t to determine the outcome in store, to remind oneself, within the limited span of time available, of the watchwords that could spearhead the inner move to safer ground.

          A person may be pulled in opposing directions at times by a desire for indulgence and a preference for restraint that are roughly equal in strength. The mind travels back and forth as each tendency makes a stab at seizing the reins. Both wishes are robust enough to vie for dominance, and to block the competing alternative from determining what happens, but neither is sufficiently powerful to become the driving force. When the side of oneself that can impede an impulse is unable to escape being constrained by it, the conflict between the contrary voices will remain unresolved. The impasse increases the tension already present in the system. A route toward exiting the limbo of not knowing what ought to happen next—to step on the accelerator or put a foot on the brake—is to give up the belief that either inclination could prevail absolutely. Seeking a compromise between the antithetical choices can allow each interest to be represented in the behavior expressed in line with its comparative heft. Such a response, because it is congruent with one’s divergent leanings, could feel just right. It would allow a pleasure to be enjoyed that cannot be denied while its unbridled release is tempered by the yearning to exhibit discipline. For example, a person in the grip of a craving for ice cream might imagine that eating a gallon of it would be necessary for the pressure to be relieved. However, an aim may arise, fueled by an aspiration to stay steady in the face of oncoming trouble, and deriving from the thought that another romp with impulse would not be a sound idea, to abstain from having any ice cream at all. A bargain could be struck by raising the question about what is the minimum amount that, if ingested, would suffice to assuage the desire; the answer might be one cup, or two cups, or anything short of total immersion. A quick appraisal of the mixture of need and capability existing at the moment can uncover the proper ratio between plunging forward and holding back. Acting in accord with the balance chosen may leave someone feeling good without feeling gross. Even limited resistance could make a difference by keeping an urge from emerging in maximal form. After an impulse is duly satisfied, and one moves beyond the immediacy of being under its gun, a concern might surface about whether the pushback attempted should have been greater. If a person concentrates, once a compromise is enforced, on the headway made—I brought myself to eat less ice cream than I at first wanted to consume—and doesn’t bemoan the absence of the capacity to accomplish more, the success can be banked internally, and undergird a further, and perhaps stronger, effort when confronted in the future with a similar challenge.