 A common theme that comes up in therapy is people holding the belief that rest is a bad thing and that they are somehow bad if they allow themselves to rest. relaxation is often seen as a luxury rather than a necessity. Many people equate being busy with being productive, often neglecting the essential need to rest. Whether it developed from messages passed down in their family, their church, the Puritan work ethic, capitalistic influences on productivity and self-worth, or other cultural influences, the impact is the same- Shame. Shame prohibits people from doing what it is in the very nature to do for their own survival. Rest is not a bad thing. Is this you? Have you shamed yourself for not working enough? Do you prohibit yourself from taking a day off? Do you force your day off of work to perpetually become days of cleaning and project days at home? Where do you think you got that perspective from? Ok, sure, if you spend weeks in bed, that's probably gonna make you feel worse and is likely a sign of depression, but a couple days here or there won't make the world stop. Winter is a great time to give yourself permission to relax and have some downtime. Plants and tree go dormant in the winter. Bears, squirrels, turtles, and even the worker bee hibernates and rests in winter. After a period of rest, the world bursts back to life in the spring. If we allow ourselves permission to rest, we may Still not convinced? Scientific research strongly supports the idea that relaxation is not only beneficial but crucial for overall health and well-being. Psychological Perspective: The Mind Needs Downtime Psychology has long recognized the importance of relaxation in maintaining mental health. Chronic stress and overwork can lead to burnout, anxiety, and depression. Research in cognitive psychology suggests that taking breaks and engaging in restful activities helps improve attention, creativity, and problem-solving abilities. Popular Harvard psychiatrist Daniel Siegel proposed the Healthy Mind Platter (see diagram below) that outlines the various key areas for a healthy mind and body, which include not only time for work and physical activities and sleep, but also time for relaxation, social connection and play. One key neuropsychological theory supporting relaxation is the Default Mode Network (DMN), a set of brain regions active when the mind is at rest. The DMN is crucial for self-reflection, memory consolidation, and emotional regulation. When we relax, our brain shifts into this mode, allowing for better cognitive processing and emotional well-being. Additionally, relaxation plays a critical role in regulating the autonomic nervous system (ANS). The ANS consists of the sympathetic nervous system (responsible for the fight or flight response) and the parasympathetic nervous system (which promotes rest and digestion). Chronic stress keeps the sympathetic nervous system overactive, leading to anxiety, poor sleep, and even depression. Engaging in relaxation techniques such as mindfulness, deep breathing, or even simple leisure activities helps activate the parasympathetic nervous system, restoring balance and reducing stress-related mental health issues. Medical Perspective: How Relaxation Benefits the Body The impact of relaxation on physical health is well-documented in medical research. Chronic stress triggers the release of cortisol, the body's primary stress hormone. While cortisol is essential for survival, prolonged elevation can lead to numerous health issues, including:
Medical research has found that relaxation techniques such as meditation, yoga, progressive muscle relaxation, and deep breathing lower blood pressure, improve heart rate variability, reduce inflammation, and boost immune function. Studies in psychoneuroimmunology (the study of how the mind influences the immune system) show that people who engage in regular relaxation activities have stronger immune defenses and better overall health outcomes. Anthropological Perspective: Rest as a Cultural and Evolutionary Necessity From an anthropological standpoint, relaxation is not just a modern necessity but an ancient practice essential for survival. Human societies throughout history have recognized the importance of rest and leisure. Hunter-gatherer societies, for example, structured their lives around periods of intense activity followed by extended rest. Anthropologists have noted that these populations spend significant portions of their day engaged in socializing, storytelling, and leisure activities. Unlike industrialized societies, where work dominates daily life, traditional cultures incorporate relaxation as an integral part of existence. In many indigenous cultures, rest is tied to communal well-being. Practices such as siestas in Mediterranean societies, tea ceremonies in Japan, and mindfulness in Buddhist traditions highlight the value of structured relaxation. These traditions suggest that relaxation is not merely about physical recovery but also about fostering social bonds and mental clarity. From an evolutionary perspective, downtime is necessary for learning and adaptation. The brain consolidates experiences, integrates new knowledge, and strengthens neural connections during rest periods. This ability to switch off has likely played a role in human survival by enabling problem-solving, creativity, and resilience in the face of challenges. Practical Steps to Incorporate Relaxation Into Daily Life Understanding the necessity of relaxation is the first step; the next is implementing it into daily life. Here are some evidence-based ways to cultivate relaxation: 1. Mindfulness and Meditation -Studies show that mindfulness reduces cortisol levels and enhances emotional regulation. 2. Physical Relaxation Technique -Practices like yoga, progressive muscle relaxation, and deep breathing help reduce stress and promote bodily relaxation. 3. Set Boundaries and say No to things that you do not need to do. 4. Give Yourself Permission- assure yourself you are a good person, doing good things for yourself, and will be able to do more good things for the world when you allow yourself intermittent periods of doing NOTHING. 5. Scheduled Downtime - Setting aside time for non-work-related activities, such as reading, painting, or spending time in nature, improves overall well-being. 6. Social Connection - Engaging in meaningful conversations and social interactions helps reduce stress and fosters a sense of belonging. 7. Quality Sleep - Prioritizing good sleep hygiene (such as limiting screen time before bed and maintaining a regular sleep schedule) allows the brain and body to recover. 8. Nature Exposure - Research shows that spending time in green spaces reduces stress and enhances mental clarity. Relaxation as a Fundamental Human Need. Relaxation is not a sign of laziness, badness, or inefficiency; it is a scientifically supported necessity for both mental and physical well-being. From a psychological perspective, it enhances cognitive function and emotional resilience. Medically, it lowers stress-related health risks and strengthens the immune system. Anthropologically, relaxation is deeply embedded in human culture and survival. By embracing relaxation as a fundamental part of life, individuals can achieve better health, improved productivity, and greater overall happiness. In a world that constantly pushes for more, taking time to slow down is not just beneficial, it is essential. So go ahead, on the next snow or rainy day, listen to your body when it says it wants to stay in bed. Treat yoself! Your body will thank you later. Author Megan Garza, MA, LMFT AI assisted content 
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 It’s February, which means Valentine’s Day is quickly approaching.
Whether this is a meaningless holiday to you, or your favorite holiday…you can’t forget to show a little love to yourself! Small ways to show yourself a little extra love: Treat yourself to a special meal Have an at-home spa day Buy yourself flowers Read a book Make up a bubble bath Practice positive affirmations Make a sweet treat (chocolate dipped strawberries are a holiday favorite!) Valentine’s Day does not have to be about romantic love. Valentine’s Day can also be showing love for family members or friends or your favorite fur baby! So, you can get creative during this holiday of love and show a little more love and gratitude for yourself and all that you are! Author: Anne Marie Mathews, MS, SMFT Anne Marie is Currently Accepting New Clients. If loneliness and feelings of isolation are triggered by this time of year, reach out today.  The word is out. Winter is in!
The fresh white snow. The cozy evenings snuggled inside in the warmth. Fire crackling in the fireplace. Mug of hot cocoa in hand. It all sounds great, doesn’t it? Well for 10-20% of adults in the US, this is not the coziest season of year. But rather, the season of the winter blues or Seasonal Affective Disorder (SAD). But what causes this? 1. Less sunlight • It is not just the physical lack of sun on your skin, but a shift in biological clock that occurs when there is less sunlight. This internal clock is responsible for regulating mood, sleep, and hormones. 2. Brain chemical imbalance • Because sunlight helps regulate serotonin (which contributes to feelings of happiness), a lack of sunlight in the winter can exacerbate feelings of sadness. 3. Melatonin boost • Melatonin is a chemical that affects your sleep patterns and mood. With the lack of sunshine, an overstimulation of melatonin can occur. Symptoms of this include feeling sluggish and sleepy. Ok, the cold dark days are causing my sadness. What can I possibly do about that? Well. While you can’t control the season or weather, here is what you can do… 1. Start or resume therapy. Our therapists at Healing Reflections Therapy are available to help in-person or virtually. 2. Spend time with people who bring you glimmers of joy 3. Spend time outside in the limited window the sun is shining 4. Adding light to your space that mimics the sun’s light 5. Discover a new indoor hobby or rediscover one that you have not done in a while. Need ideas? Maybe baking a new recipe, painting, journaling, make a soup, reading a new book, do a home yoga or meditation video. Reference https://my.clevelandclinic.org/health/diseases/9293-seasonal-depression Author: Anne Marie Mathews, MS, SMFT I am currently accepting therapy clients. Feel free to reach out if you need help.  Over the holiday season people often come together with families, sometimes to celebrate, sometimes to grieve losses that tend to congregate around these times of year. As is often the case when families get together, sometimes things are said or done that are hurtful. Sometimes painful truths of the past are unmasked. People are often forced to reconcile with these new harsh truths and realities and to cope with their hurt feelings or the way they have hurt others, sometimes intentionally, but more often than not inadvertently or unintentionally, yet the hurt remains.
Dealing with the aftermath, once problems surface, means that healing and reconciliation may be needed. Some may find that their friends or family members are distant, if not not cut off from them until they attempt to acknowledge the hurt or make amends. One of the biggest challenges relationships face is when the offending party refuses really to acknowledge the harm done. A good apology is more than just saying “sorry.” Effective apologies help repair relationships, build trust, and promote healing. Here are the key elements that make an apology meaningful and effective. 1. Acknowledge the Harm What it means: Recognize the specific behavior that caused harm or hurt.
validate the other person’s feelings. 2. Take Responsibility What it means: Own up to your role in the situation without excuses or shifting blame.
Why it matters: Shifting blame undermines trust. Apologies are meaningful when they come with accountability. 3. Express Regret and Empathy What it means: Show genuine remorse for the impact your behavior had on the other person.
wounds. 4. Offer a Plan to Make Amends What it means: Outline steps to fix the mistake or prevent it from happening again.
Why it matters: Offering amends signals that you’re committed to change, not just offering empty words. 5. Be Sincere and Timely What it means: Deliver your apology with sincerity, and don’t wait too long to do so.
Why it matters: A well-timed apology keeps emotions from festering and shows the other person you care about their feelings. 6. Avoid Repeating the Same Mistake What it means: After an apology, work on personal growth to avoid the same behavior in the future.
A good apology does not ask for forgiveness of the one that has been harmed. That only further burdens the victim with guilt and responsibility. Quick Recap:
While apologizing may be hard and requires the strength of being vulnerable and swallowing your pride, when done well, the reward is worth it. Keep in mind though, if you are only apologizing as a tactic to get more of YOUR OWN needs met, the other person may see this as a manipulation tactic and may not be willing to accept it. True apologies and amends come from your own desire to heal the person you hurt, sometimes out of a commitment to faith or justice to do right, and they acknowledge that when you attempt to heal others you also heal yourself. If you are still struggling and need help, our counselors at Healing Reflections Therapy are also available to help mend the broken divides. Check out our Meet Our Therapists page to find a clinician that best fits for you. Author: Megan Garza, MA, LMFT The holidays can be rough! We are here to help. We are offering Discounted sessions for new clients starting services with Anne Marie or Jordan November 21-December 31, 2024. $10 off the first 4 sessions.    For many folks across the US, the globe, and in marginalized communities this was a hard day. At Healing Reflections Therapy, we see you. Your pain is valid. Sadness, anger, betrayal, shock, and frustration are all very real and may feel all the more acute when others are celebrating or otherwise blind or uncaring about what you are experiencing. You are allowed to grieve as you need to grieve. Grief Grief occurs in separate and sometimes simultaneous cycles. It may look like shock, numbness or shutting down. It may look like anger and wanting to rage at those you believe hurt you and to cut ties with family and friends, it may look like sadness and wanting to cry or stay in bed and eat or drink your feelings. It may look like bargaining and wanting to rationalize how you can make sense of it, thinking “if I just do x, maybe it won’t impact me”, it may look like denial and telling yourself it’s not over yet, maybe something may change it, or telling yourself or others to get over it. Next Steps Focus on the now. Your brain may be spinning with sooo many possibilities: future fears of changes, loss of rights, concern for your safety and the safety of your loved ones, fears for the choices by lawmakers and the fate of democracy. Instead of focusing on external events that are much bigger than you and beyond your control, focus on what you can do for right now. Think about what you are able to control. The serenity prayer reminds us to ask, "Grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference." This notion of radical acceptance is hard, but can help move you out of helplessness and hopelessness. "Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference." Self-Care Today is a good day for self-care. What does that mean? It means connect with your support communities, your trusted friends, family members, colleagues, and mental health workers- schedule a meeting, date, appointment, a get together. You could create a group text or join a social media group with like-minded individuals. Please take some time for yourself. That may mean taking a day or two off of work. Give yourself grace for having to pick yourself off the floor or peel yourself out of bed after maybe having a night or two of less than ideal coping choices. It happens. Try not to linger there too long. Focus on adaptive coping. Make choices for self-care that will make you feel proud of yourself later and allow you to feel better instead of worse. If you are someone who is in recovery, try to use positive coping skills rather than allow the current political climate to take your sobriety. Find something that creates meaning in your life. Allow yourself to cry and feel your emotional response at times. You need to get it out. No one can hold in this much pain and live with it alone. Rely on chosen family, friends, and community. Distraction You might need to get out of your head for a little while and away from the media frenzy. Try unplugging and refocusing on other areas of your life, if you can, which we realize may be a privilege. Watch a favorite movie. Watch some stand-up comedians on netflix, watch funny pet videos on tiktok, put in your favorite movie- yes, you can go ahead and watch Twilight for the 100th time, throw yourself into some true crime, re-read your favorite YA book, spend time in nature, go thrift store shopping, go to a museum, create some art or play music. Self-soothing Self-soothing may look like connecting with your body and 5 senses to bring you peace. It may mean snuggling your fur babies and enjoying the texture of their soft fur, or hearing the relaxing sound of their purr or breathing, it may mean taking a hot bath or cold shower, it may mean making yourself some hot cocoa, putting on your favorite smelling lotion or cooking something that transports you to a childhood memory, cleaning your closet, walking around barefoot in the grass, buying yourself some fresh flowers to smell and look at, making a playlist of songs that bring your inspiration or peace or help channel your rage, enjoying some pumpkin spice whatever fall stuff has to offer, or maybe you put up your Christmas decorations early to surround yourself with things that bring you joy and calm your nervous system. Safety Planning Are you a member of a marginalized group like LGBTQIA+ people or immigrants that is being targeted? Although some may try to minimize your concerns, you know what your experience has been and what you have endured, your fears are valid. Does making a plan for safety give you a sense of control? For some folks, there may be talks with your loves ones about where in or outside the US you feel most safe and protected. Yes, I know lots of folks talk about leaving the country around elections, which just is not a real feasible for most. So there may be more practical solutions to consider. Are there legal documents that you need to arrange to protect the status of your relationship and/or your loved one? DO you want to work on getting your name change or gender-affirming surgery while that is still definitely possible? Do you have a list of community spaces where you feel safe and people who you can trust? Don't allow people who do not see your pain or the situation accurately to deter you from doing what you need to do to be as safe and comfortable as possible. Re-focusing your energy on Advocacy For some people the best way to deal with this immense sense of lack of control is to look for ways to feel in control. This may look like volunteering for a cause or group that is important to you. It may mean joining your local political group and focusing on the next local election. It may mean spending time supporting local marginalized communities. Hope It is never wrong to hope. Do not be ashamed or mad at yourself for allowing yourself to hope. Sometimes that is all we have. If you are familiar with the Greek myth of "Pandora’s Box," then you know that when Pandora, the first woman on earth, was given a gift by Zeus, she was told not to open it. When Pandora gave in to her curiosity and opened the box, it was said she unleashed all the evils, sickness, disease, evil and horrors unto the world, but at the bottom of the box was HOPE. I often think about Red’s line in Shawshank Redemption “Hope is a good thing. Maybe the best of things.” As crisis counselors we know that people die when they lose hope. For those in power, we know that hope can be a threat to their power. Remember, all the previous fighting to legalize abortion and lift abortion bans was successful. Oberfel and Hodges has managed to be the law of the land for 9 years. In Hunger Games President Snow tried to stamp out hope in the districts, because he recognized hope could be dangerous. From research on Learned helplessness, we know that it happens when we lose hope, people & animals give up opportunities for freedom from terrible situations even when presented to them...I won't tell you the story about the experiment because it will depress you even more (you can google Seligman's story if you really need to know more). Never be ashamed of having hope and choosing to believe in a better tomorrow. Remember, this is a marathon relay, not a sprint. You are not alone. He won't be the thing that breaks you. Getting to the other side of this likely will mean a lot of pain and discomfort along the way. You may not look the same or feel the same when you come out of it. You may learn hard lessons along the way. You may be a different person on the other side of it all. The losses you suffer may not be fair or just. At times you may fall back and need someone else to tap in while you step back and allow yourself to rest for a while. Don't be afraid to ask for what you need and pause when you have to. You have been though hard things before. You can do hard things. Throughout the world and history people have gone through enormous suffering, but humanity has endured...and generally moved toward progress. Have faith. Have hope. Have Courage. Have Endurance. Be Persistent. Have Heart. We are here to pass you back the baton when you are ready. “Hope is a good thing. Maybe the best of things.” -Red (Stephen King's Shawshank Redemption)  Authors: The Healing Reflections Therapy Team
 We spoke in an earlier post about the important elements for success in therapy, one of which was finding a therapist that was a good fit. With the rise of mental health platforms run by tech corporations that have a wide social media presence, there has been a new vogue of treating your therapist like online dating, the minute something is uncomfortable you should get out, swipe left, keep shopping, there’s always another one ready to pop up and take their place. Wait! Hold on just a minute. There may be some valid reasons to terminate your relationship with your therapist, but there may also be some good reasons to stay that you may not have considered. When to go As therapists, we frequently hear horror stories of past therapists- be it unethical practices, unorthodox practices, or interventions that did more harm than good. A therapist that crosses boundaries to have sex with a client, or exploits the therapeutic relationship for their own gain, or abuses their power are all serious causes for concern. If a therapist is displaying overtly unethical or illegal behavior, then the relationship needs to end. Ruptures in rapport: A Forgivable Offense? Most complaints about a prior therapists usually arise not because the therapist is inherently bad, but because of differing perspectives/worldviews, cultures, generational differences that lead to feeling, hurt, invalidated and misunderstood. For example, a client not liking the words chosen or boundaries set, or feeling uncomfortable with being held accountable in session, the therapist breaching trust by fulfilling their legal obligation to make a hotline report, or recommending medication or hospitalization; or a therapist making a human error in scheduling, missing an email or call, looking sleepy, forgetting something client previously said, being distracted, conflict over a billing error, snacking during session, seeming too casual or not casual enough, or perceiving the therapist as not on their side enough. These slights, however unintentional can hurt, but whether or not it is worth ending the therapeutic relationship over may be complicated. Ruptures in rapport are common, especially as the relationship deepens and therapy reaches newer levels of trust and patterns of earlier relationships begin to play out in the therapeutic relationship. While most licensed therapists are well meaning and do their best to serve their clients with the tools they have, they are also human and have their flaws. Some are wounded healers who are still in the middle of their own journeys, others come from a place of privilege or have not sufficiently done their deconstruction and decolonizing work. Both may inadvertently harm the client. Ideally, therapists should spend some time in their own therapy as well as supervision and consultation doing self-of-therapist work prior to seeing clients, if not on an ongoing basis. Ruptures as Opportunities for Corrective Emotional Experience Therapy is a microcosm of the rest of the world, meaning that problems that play out in the external world often find a way to play themselves out in the therapy room as well. Challenges in the therapeutic relationship are opportunities for a corrective emotional experience that one may not otherwise have had with others in their life. For example, if you are upset with you therapist for something they said or how they handled a situation, your ability to confront them can be the first time you may feel able to use your voice and challenge someone who has hurt you, but in a safe way (hopefully). In this way, addressing conflict and dissatisfaction with your therapist is both courageous and encouraged, and can be an empowering and healing, and deeply transformative process with breaking patterns in the clients’ life. Political Betrayal by Your Therapist There are times when a therapeutic relationship just isn’t the right fit, for example there is a recent discussion about folks leaving their therapist after learning their therapist voted in a way that went against their rights. Essentially, the therapist has violated the clients' trust with their betrayal and failure to protect their rights. Traditionally, therapists are trained to be neutral and not bring their stuff into the room and not share much about themselves personally- but arguably anyone who works with marginalized populations and sexual or religious trauma survivors needs to NOT be neutral about protecting the folks they serve. They have a fiduciary responsibility to care about their clients not just in the therapy room, but who they are as people. In this way, the political is very personal, so sometimes a political/cultural/gender/racial/religious match may be necessary for building trust and eliminating harmful bias. When To Pause before a break-up-When Attachment Wounds Run the Show The "swipe left" method for choosing/leaving a therapist is particularly problematic if the client has concerns with attachment. What do we mean by that? Healthy attachment develops from our early caregivers. When we feel safe and our needs lovingly cared for, we develop a secure attachment, which enables us to have healthy, secure trusting relationships in adulthood. When our needs are not met, or we grow up in unsafe/traumatic, unpredictable, or chaotic environments we may develop anxious, avoidant, disorganized or insecure attachment styles that hinder our brain development and adult relationships. In children, they may be given a diagnosis known as RAD, Reactive Attachment Disorder, commonly seen among foster and adopted kids where there is a disruption to the early attachment relationships. This article talks more in-depth about the disastrous consequences of early attachment wounds and the impact it has on one's ability to attach to future care-givers. https://www.theatlantic.com/magazine/archive/2020/07/can-an-unloved-child-learn-to-love/612253/ . Mary Ainsworth, Margaret Mahler, Harry Harlow, and John Bowlby were among the early pioneers of attachment theory and more modern books by Dr. Bruce Perry have talked about this concept. At the end of this article there are some videos that talk about these foundational attachment studies and why early attachment relationships are so fundamental to development. Carl Rogers, famous for developing the Humanistic client-centered psychotherapy treatment method commonly seen as the foundation of most clinical practices wrote about his theory of change in “On Becoming a Person” where he compared the role of the therapist to that of a healthy soil for a tree to grow. In order for someone to grow and flourish, there needs to be a healthy, nurturing soil. Although the home/family environment might not have been provided enough sustenance for early growth, healing/growth in the therapeutic realm can be made through a secure attachment with the therapist by way of empathy, genuineness, and unconditional positive regard. So while for some people the task may be to find the “right fit” with the therapist, for others their challenge is deeper- to work through their attachment wound and allow themself to connect/share intimately in a therapeutic relationship, to not run away as the relationship deepens as a form of self-sabotage (i.e., I will leave them before then can leave me, So I won’t be hurt again), and to be able to appropriately address and work through conflict in order to make repairs to be able to have enduring relationships. This process of challenging patterns helps build new neural networks in the brain, to make repairs from earlier setbacks. Trust and Attachment Takes Time For some folks, the real work in therapy may not begin for 6 months to a year until they have worked with the therapist long enough to “test them” to ensure the therapist will not reject or abandon them, only then do they start to show their therapist their deeper wounds, pain, insecurities and problematic behaviors. Not surprisingly, this same pattern can emerge in romantic relationships, where the partnership seems like bliss, so they rush to marry or move-in together quickly. Once the partner has them on the hook, suddenly their personality and behavior shift. One begins to see an entirely different side of the person than they did before, and in some cases it may seem like a Dr. Jekyll/Mr. Hyde situation. The other partner often feels confused and betrayed. A Note About The Impact of Sexual Trauma on Attachment Wounds One common scenario where attachment wounds play out with women in romantic relationships is when there is a history of sexual trauma. In the wake of the trauma she may experience distorted beliefs in which she believes it is her fault, is damages, unloveable, unwanted, or not good enough. This leaves her feeling hurt, sad, lonely, and isolated. As a result she may end up hooking up with various people in a serial fashion combo of trauma re-enactment, maladaptive coping, attempts to reclaim power, and self-fulfilling prophecy. Eventually she ends up with a hook-up that turns into a situationship that turns into a relationship. It starts out hot, but once the relationship gets to a point of stability and safety, the sex life turns cold and avoidant. The couple starts fighting more as he is frustrated and hurt from the rejection and she is feeling pressured and coersed into unwanted and painful sexual activity which cause her to further lose interest and avoid any attempts at intimacy, for fear it will lead to demands/pressure for sex. This pressure is a trauma trigger that feeds back into her original negative beliefs about herself that she is damaged/unloveable/only good for sex. The antidote is recognizing those patterns, and encouraging the partner to create a safer space while the she works to challenge her distorted beliefs and anxiety about triggers. If the couple can work through this together, they can have a deeply satisfying, intimate relationship. If they cannot address it together, there is the risk that the pattern will be repeated with the next partner, and the next. The same can be said about the therapist, if conflicts in therapy room are not addressed, there is a risk that pattern will present with the next therapist and so on. So, before you fire off that email to break-up with your therapist, really sit and be curious. Ask yourself: Is this about them, or is this about Me? Is this similar to a pattern in your life with other providers, family members, friends, or romantic partners? Am I leaving to avoid conflict? Am I leaving to avoid connection? Have I done the work to give them the opportunity to change or demystify their process or apologize? Are they safe? Do they respect my dignity and autonomy? Is this therapeutic relationship doing more harm than good? Were they having an off day when something happened that hurt your feelings or do you feel hurt more often than not when meeting with them? Am I expecting perfection? Did they tell me something I did not want to hear, but maybe needed to hear? If I don’t trust them, do I feel I can trust anyone? Am I ready to make changes to myself and the patterns I am in? Barriers to Change, Lack of Readiness and Low Motivation While we are talking about reasons people stop therapy, sometimes it's because of the therapist, sometimes it's because of client attachment concerns, but sometimes it's lack of readiness or willingness to change. When people are at the pre-contemplative or contemplative stages of change, the might throw up all kinds of barriers to attending services, like needing things to be "perfect", requiring just the right time slot, location, proximity or services; or just the right therapist demographics of race, gender, religion, level of experience/certification/degree, or lived experience; minimal cost, and just the right modality. While all these things certainly can help as previously discussed, when folks are creating barriers that sometimes set it up to where no one can fulfill their needs, and they thus get to avoid the therapy process by escaping it but claiming no responsibility. They may also create further barriers to change by not thinking about their therapy after/between sessions, not doing homework, etc. We find that when people are really desperate and motivated for change, most those barriers fall away and all people are really left with is “Can you help me?” And “How Soon can I get in?” Research is clear that the number one predictor of positive outcomes in therapy is not the therapeutic modality, it is the alliance with the therapist. Attachment matters. Readiness to change matters. Attachment to your therapist matters. Take time to see if they are trustworthy. Decide if you are really ready. If they are trustworthy, and you are ready for change, take time to consider before you leave. Author: Megan Garza, MA, LMFT  A common misunderstanding in the therapy realm has to do with all those confusing alphabet soup of letters after the providers name- LMFT, PsyD, PhD, MS, MSW, MD, NP, MFT, LPC, PLPC, LCSW... and so on. Even as someone who went through years of school, multiple graduations, and career highlights, admittedly my family still mislabel my title and don't understand the work I do.
So what do all these letters mean and why does it matter to you as a person seeking mental health services? Many people frequently get confused about whether they were seeing a psychologist or a psychiatrist, which can lead to a lot of frustration and disappointment when they are expecting an hour long psychotherapy session, but instead get a doctor's appointment that lasts 5 minutes and are given a prescription for antidepressants, or vice vera. Well, for starters these letters are basically indicators of their years of education, specific degree, specialization. They may even tell you about the philosophy and values of that profession. Your Medication Prescribers MD- Your psychiatrist is usually and MD. They went to medical school and specialized in studying the brain and its impact on mental health. Visits with a Psychiatrist are usually 5-15 minutes once a month or every few months for adjusting medications based on symptoms. Occasionally you will find old school psychiatrists (think Fraser Crane, Dr. Freud, or the dad in Growing Pains) that still do psychotherapy on top of prescribing meds, but that is far less common these days. GP -or general practitioner also has an MD and also frequently prescribes basic medications for anxiety for depression or anxiety in cases that are less complicated. NP - Your nurse practitioner is a nurse (RN) with specialized clinical training that can often prescribe meds for mental health and usually works in conjunction with an MD. Your Testers, Forensic Evaluators, High level Administrators, Psychotherapists PhD- This is where you typically find Psychologists. These individuals have doctoral degrees usually in clinical psychology, Marriage and Family Therapy, Education, Social Work or a related field. They have typically 10+ years in academia after high school completing their education with scientific research components, teaching, and writing/publication. Clinical Psychologists may provide psychotherapy, but often you find them doing a host of other jobs. They are highly trained in diagnosis, testing, and various forms of evaluation. There also other Cognitive Psychologists and Industrial/Organizational Psychologists who specialize in other areas of psychology, but do not usually provide therapy. PsyD or EdD- These individuals also have a doctorate in either psychology or education, or counseling usually, but their programs were more clinical and less research focused. They have 10+ years in education, but their training was highly specialized to working with clients or students in the field rather than the research lab. Your Master's level Therapists/Psychotherapists/Counselors These folks make up the bulk of who is providing therapy today MA means they have a Master of Arts degree MS means they have a Master of Science degree MSW- These folks have a Master's degree in Social Work- They have a 4 yr Bachelor's degree + 2-3 year Master's degree with a strong social justice component. LCSW- These folks are Licensed Clinical Social Workers- They have a 4 yr Bachelor's degree + 2-3 year master's degree with a strong social justice component but they also have added clinical training and experience to work with clients and have passed their licensing exam. They usually are opposed to diagnosis, but in practice diagnosis is often required to billing purposes. LMFT ( or MFT of FT in some states)- These folks are Licensed Marriage and Family Therapists. They have a a 4 yr Bachelor's degree + a 3 year Master's degree in therapy interventions with a specialization in relational and family system therapies. They have specialized clinical training and passed their licensing exam. PLMFT- These folks are provisionally Licensed Marriage and Family Therapists. They have a 4 yr Bachelor's degree + a 3 year Master's degree with a specialization in relational and family system therapies. They have passed their licensing exam, but have not yet completed their required 2+ years of clinical training prior to being fully licensed. They work under the license of a supervisor. SMFT- These folks are working toward their provisional License as a Marriage and Family Therapist. They have a 4 yr Bachelor's degree +a 3 year Master's degree with a specialization in relational and family system therapies. They have not taken/passed their licensing exam yet, and have yet to complete their required 2+ years of clinical training prior to being fully licensed. They work under the license of a supervisor. LPC- These individuals are Licensed Professional Counselors with a 4 yr Bachelor's degree + 2-3 year Master's degrees in Counseling or a related field. They have very similar education requirements to MFTs, but they tend to focus more on the individual, so they don't usually have the additional specialized training for working with kids/couples and families unless they sought that out separately. PLPC- is a Provisionally Licensed Professional counselor who has completed their Master's degree and have passed their licensing exam, but are working on completing their 2+ years of post-degree clinical experience. Bachelor Level support workers BA Bachelor of Arts- 4 year degree BS Bachelor of Science- 4 year degree Your Case Worker or Support worker or Tech usually will fall into this category. They don't have a license or any specialized clinical training beyond education and work experience. These are the "trench workers" who usually work very hard, for little pay, and see high volumes of clients. Certificate holders A Lifecoach is a person that helps direct a person to make important decisions in their life. They have no specialized education/degree requirements, no exams, nor is their a governing regulatory body that gives that a license or oversees them to guarantee ethical practice. They typically receive a certificate as a life coach and often train under another life coach. This area is over controversial because the lack of oversight and lack of public knowledge their is a concern that people may be taken advantage of individuals that label themselves lifecoaches, but may in fact be doing their clients harm. Conversely, many licensed therapists also double over as lifecoaches and offer coaching as a separate part of their practice. Some people who find mental health stigmatizing may shy away from "therapists" but may proudly seek out a "lifecoach." Lifecoaches should avoid diagnosis and attempting to provide therapy. Their work is usually skills and decision based and should not involve diagnosis, or attempts at therapy. Hopefully after reading this you have a better sense of the kind of provider you are seeking or seeing (and maybe what label you should actually call your family member). Sidenote, though it may seem like these words are interchangeable, it's actually illegal/unethical for these professionals to call themselves by a title that does not belong to them so as not to misrepresent themself. A psychologist cannot call themself a psychiatrist and a lifecoach cannot call themselves a therapist unless they have a Master's degree and clinical license. As you become a savvier consumer, the more likely you will ensure you have the satisfactory treatment experience you are expecting. by Megan Garza, MA, LMFT  We want to welcome aboard a new clinician to our practice. Anne Marie Mathews, SMFT recently joined us at Healing Reflections Therapy: Diversity, Trauma, and Wellness Services as our newest Marriage and Family Therapist Supervisee. She graduated from St. Louis University for undergrad and recently graduated from Nova Southeastern University in FL for with her Master's degree in Marriage & Family Therapy. She is specially trained in relational therapy and play therapy, including sand tray work. She is available for working with individuals, couples, and families of all age ranges. She has flexible scheduling and hybrid in-person and in-office therapy service options. Please welcome her as she settles back into the St. Louis community and keep her in mind for any referrals. [email protected] www.hopehealreflect.com  Considering therapy or meeting with a therapist for the first time? You may wonder if there’s a ‘right way’ to participate. While there isn’t a secret formula, there are strategies to maximize its benefits. Many people approach therapy expecting immediate success or a guaranteed timeline, but it’s important to remember that therapy is a personalized journey, and progress varies for each individual.
1. Find the right therapist Therapy is a personalized process, and finding the right therapist is crucial. A good therapeutic relationship fosters vulnerability and open communication. Rather than particular techniques, the far greater predictors of positive outcomes are therapeutic relationships, or counselor qualities in therapeutic relationships that capitalize on clients’ internal strengths. Cochran and Cochran, 2015, p. 7 NOTE: for some individuals, it may be difficult to overcome anxious, insecure, or avoidant attachment tendencies. In these cases, and cases of trauma and those who struggle with trust, it takes a little more time to develop good rapport. It's important to maintain a consistent therapeutic relationship through the initial adjustment period which could take up to twelve sessions, rather than seeking out new therapists. 2. Collaborate with your therapist Openly addressing concerns about the therapeutic process helps build trust and collaboration. Successful therapy requires active participation, including advocating for your needs and providing feedback. 3. Get ready for doing Confronting difficult emotions and developing coping skills is a key component of therapy. These skills are cultivated through consistent effort and practice, both during sessions and independently. 4. Show up for yourself Going into sessions can feel overwhelming. Some things that can help you feel more present and prepared include:
Therapy is truly a different experience for each person. People seek out therapy for a variety of reasons and have different end goals in mind. These tips may not suit everyone, but they are a great stepping stone to fostering an individualized and comfortable session. Author: McKayla Robinson, MS, SMFT |
AuthorSMegan Garza, MA, LMFT is a certified Specialist in Treating Trauma at a Supervisory level and is Licensed as a Marriage and Family Therapist. She specializes in work with sexual abuse survivors. Archives
February 2025
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