How Tools Learned In Therapy Can Improve Migraine
Ctrl M Health: For anyone considering therapy, especially for the first time, there are a lot of unknowns. The big question is often, “How do I know if the therapist I find is the right therapist?”
Dr. Caryn Seebach: When people ask this question they’re really asking, first and foremost, “Will I like them?” And, “Will they be able to help me with my problem beyond what I can do for me?” And people are right to be skeptical, you want to know you’re in good hands. My guiding light here is: a good therapist is going to be able to tell you whether they can help you with your problems. It’s really on the therapist to explain how they’re going to help you. Your job is to decide whether that person is a good fit.
How do you decide if they’re a good fit? Trust your instincts. This is a relationship like any other. I would say it takes three to four sessions to truly feel somebody out. In that time, ask yourself if this is someone you feel comfortable sharing with. Do they ask insightful questions that make you feel like they “get it?” Or do you feel hurt by them, misunderstood? Or maybe you can’t quite put your finger on why it works or doesn’t––that’s okay too.
Similar to dating, you’re using your instincts, sensing your way forward, and at the end of the day, you’re going with your gut. I think peoples’ fear is that they don’t trust their instincts. But your instincts won’t fail you. Trust yourself. In a worst-case scenario, you can start again with someone new. It may take a few tries, and it’s hard to keep opening yourself up again and again, but it’s worth it when you’re looking to find a therapist that can address your needs.
Reaching out to your medical providers for referrals can be a great place to start — this could be a primary care physician or a specialist. Ideally, it’s someone you trust and have a good rapport with. If you prefer to go through insurance, get a list from your carrier and then cross-reference it with a site like Psychology Today or Good Therapy, where therapists list profiles with important details like their education, specialties, and style of therapy. These profiles often link to the therapist’s own website, where you can often find more specific information like fees and steps to get started. It’s not a perfect science, but having more than a name can go a long way towards narrowing down your search.
Another question people ask is “Once I find a therapist, how do I begin talking about myself? I don’t even know where to start with my story.”
This is a commonly asked question. But it masks the real issue, which is: “I don’t want to have to tell my story.” And that’s a fair concern, one that’s entirely rational. Telling your story is a very vulnerable place to be. Feel compassion for yourself, and know that it’s all to help you progress and build your mental toolkit.
Truthfully, where you start doesn’t really matter. This process is really about that vulnerability. So start wherever feels like a natural beginning. It’s up to the therapist to help you figure out where you need to go from there.
How long should therapy last?
It depends on a couple of factors. First, it depends on what you’re hoping to get out of the therapy. And again, it’s up to the therapist to help you identify your goals because that’s going to put a time stamp on it. If it’s, “I need tips and tricks to help me with my migraine and put me on track,” that’s one set of goals versus, “Everything is overwhelming and I don’t even know how to get through the day”––that’s a whole other set of goals with a longer time frame. So once you’ve agreed upon your goals, it’s helpful to keep an open mind that your therapist is going to steer you in the right direction in terms of the time it will take to achieve those goals.
Unfortunately, the reality is that therapy is expensive, and that’s a real barrier. So be practical when looking for how to find a therapist. If you can only commit to eight sessions because of time or finances or energy, be upfront. And it’s on the therapist to convey, “I’ve heard you say these are your goals, I think we can achieve a couple of them in our time together.”
Why does therapy take as long as it does?
If you’re looking for someone to size you up and tell you what to do, that can be pretty quick. But in my mind, that’s not therapy. Meaningful therapy is helping you figure it out for yourself, helping to plant some seeds that will continue to grow. That means the therapist is getting to know you well enough––your aspirations, your talents, your blockers, where you’re criticizing, where you’re avoiding––all these nuanced things to help you get there for yourself. And as much as we’d like for that to be fast, by necessity it takes time. And that tends to scare people off because it can feel overwhelming. Ideally, this is an ongoing dialogue between you and your therapist. Also, while insights do happen in the therapy session, the real progress largely happens outside of the session, so doing the “psychological work” by practicing what you learn in therapy can really drive the timeline.
How does someone know when they’re done with therapy? And how do they bring it to a close?
A directive therapist will say “Guess what? You came in a couple of months ago wanting to do this, and you’ve met your goal. Do you feel you’re at a good ending point?” But also, if you as a client start coming in thinking, “I’m not sure what I’m going to talk about today,” assess yourself honestly and ask, “Did I meet my goals? Did I get out of it what I needed?” versus “I’m avoiding talking about the tough stuff.” And then discuss it with the therapist. When in doubt, ask. “I think I may have met my goals, what do you think?” Ideally, there are ongoing discussions about progress throughout the therapy course, so it won’t feel so blurry.
It’s important to assert yourself in this process. Think of therapy as a microcosm of life. You start to practice the things in therapy that you want to do outside of therapy. You can practice being vulnerable. You can practice exerting control. And you can practice being assertive. All this practice leads to building confidence and empowerment: “If I can do it in here, I can do it out there,” in the wider world.