Episode Transcript
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Speaker 1 (00:11):
You're listening to a Muma Mia podcast.
Speaker 2 (00:14):
Mamma Maya acknowledges the traditional owners of the land and
waters that this podcast is recorded.
Speaker 3 (00:20):
On my therapist instead of meaning every two weeks, which
is strewmining every week.
Speaker 4 (00:24):
Why is she so obsessed with me? We're like best friends.
I knew she liked me.
Speaker 1 (00:32):
For Mama Maya. I'm your host, Ashani Dante. Welcome to
But are you happy? Because I'm fine? Is the biggest
lie in the group chat?
Speaker 2 (00:41):
And I'm doctor Anastasia Hernus, a clinical psychologist passionate about
mental health and happiness. Have you heard of cognitive behavior
therapy or EMDR or integrative psychotherapy, or animal assisted therapy
or couple's therapy or attachment.
Speaker 1 (00:58):
Therapy, Anastasia, There's a lot of kinds of therapy out there.
Speaker 4 (01:01):
On there's more.
Speaker 2 (01:03):
Well, that's what we're going to be talking about today,
the biggest mistakes that people make in therapy and how
to find the kind of therapy that you really need.
Speaker 1 (01:11):
This is really important. Let's get to it, okay Anaesthasia.
As a clinical psychologist, have you ever found in the
therapy room that you had a client that didn't quite
understand the brief for maybe they just weren't the right
fit all the time.
Speaker 2 (01:31):
It happens all the time, and it's really important to
have that right fit because the research tells us the
therapeutic relationship that a client has with their therapist is
the number one biggest predictor of therapy outcomes. It's the
most important thing beyond the type of therapy that you're doing,
(01:54):
or you know, other features relating to the diagnosis, etc.
The therapeutic relationship between a client and therapist is the
number one biggest predictor of change. So it is so
important that you feel comfortable and secure and like you
can be vulnerable with your therapists. You've got to feel
like you've got that connection. If that's not there, I'd
(02:16):
encourage people to try seek out a different therapist and
see how that fit feels.
Speaker 1 (02:21):
Do you find it sometimes when clients come, is there
like certain things that you don't feel comfortable with?
Speaker 2 (02:28):
Yeah, So different therapists and psychologists will have different areas
of I guess expertise in the field, right, So most
of us can deal with the more common mental health conditions.
So most psychologists would be able to help someone with anxiety, depression, OCD, etc.
But for example, I don't really work much with clients
(02:51):
who have eating disorders. That's quite a specialized area of practice.
It's something where you require a lot of upskilling in
as a clinician to be able to do the appropriate
therapy work. So it's not an area that I sort
of delve into because I haven't done that training. So
we all have kind of different areas that we might
feel like we do more work in or we've upskilled in.
Speaker 4 (03:12):
For me, it's addictions.
Speaker 2 (03:14):
I really love working with clients who present with addiction
related concerns. It's a little bit of a niche area,
and it's an area that I've done sort of extra
research and study into, so I feel quite competent doing
that body of work.
Speaker 1 (03:28):
And it's really interesting you kind of speak into kind
of essentially the criteria that's needed on both ends for
there to be a bit of like a flow. There's
a collaboration, right, And I know that you spoke to
that a few episodes back when we were talking about
therapy talk and how it's a two way street and
there's got to be the similar values and goals to
be aligned.
Speaker 2 (03:48):
Right, Yes, absolutely, And I think that's where it's important
for a person who's thinking about seeking out therapy if
you do go to that first session to have an
idea in mind as to what it is you're wanting
to get out of therapy and treatment. At the same time,
the therapist will be assessing the match, right, They'll be
(04:09):
assessing whether or not they're the best person to help
you with that. So when clients call the clinic, we
do a little bit of what's called an intake, so
we'll actually ask people over the phone, what is it
that you're wanting assistance with? Just very generally speaking, they
don't have to divulge a lot of information, but for example,
if they did say I think I might have some
(04:30):
problems with my eating patterns and body image, maybe an
eating disorder, then we would allocate them to a clinician
that does that work. Some of our clinicians, for example,
don't necessarily work with children and adolescents or parents. That's
another area in which a psychologist or a therapist really
needs to be upskilled. So it's important to get from
the outset as best as we can that match between
(04:53):
what it is someone's wanting help with and the type
of work that therapist does so a question.
Speaker 1 (04:58):
I have which I'm really curious about because I feel
like therapy it feels like it's a bit of this
muscle weaflex in today's world. It's like I go to therapy,
you know, look at me. Do you feel like everyone
should go to therapy?
Speaker 4 (05:11):
Oh, that's a tough one to answer.
Speaker 2 (05:13):
I mean, not everyone needs therapy, right, And I guess
like I want to almost like break down what we're
talking about when we say therapy or when I say therapy.
Not everyone needs to see a psychologist or a clinical psychologist.
The type of work that I might do and my
colleagues might do is quite specialized in that we're looking
(05:35):
to assess, diagnose, and treat mental health disorders. Right, But
that's a percentage of the population, not everyone. Then there's
people who want to better know themselves.
Speaker 4 (05:49):
They want tools and.
Speaker 2 (05:50):
Strategies to feel really solid in their day to day
mental health and build that sense of wellness and well
being within their lives.
Speaker 4 (05:59):
And I think that's great.
Speaker 2 (06:00):
They don't necessarily need to see a psychologist or a
clinical psychologist.
Speaker 4 (06:04):
To do that. There's lots of self help resources.
Speaker 2 (06:06):
They can see, counselors, psychotherapists, you know, there's different options,
So I think depending on what someone's wanting, there'll be
different pathways to go down to get that sort of
intervention or support.
Speaker 1 (06:20):
So I'm thinking about people tuning in because throughout these
episodes across the season, you know, we've talked a lot
about different topics around mental health, and a lot of
the time at the end we talk about seeking professional help.
So I kind of wanted to speak to what would
you want to say to the people that are on
the fence around or do I do therapy?
Speaker 2 (06:39):
I don't know, if you're questioning it, I would encourage
you to maybe first talk to a GP or a doctor. Right,
most of the referrals that we get are actually from doctors.
They do up a mental health care plan and then
a person can see a psychologist with some Medicare rebates often,
(07:00):
but a GP or a doctor can be an excellent
first point of contact to go through and say, look,
I'm struggling with my thoughts.
Speaker 4 (07:08):
I keep thinking and I can't stop thinking.
Speaker 2 (07:10):
You know, it could be as basic as that, or
my mood just feels off. I don't feel good when
I wake up in the morning, and a GP will
know how to do some assessing to ask the right
questions to be able to understand your experience a bit more,
and from that point on, they'll also be able to
give you a recommendation as to whether they think you
might need to see a therapist to work through these difficulties,
(07:33):
whether you might need a blood test to check if
you're low in iron right, you know, it could be
a lot of other things that might have sort of
a physical basis to it as well, or whether maybe
you need to see a psychiatrist and be assessed for
particular types of medications to assist with your mood and
mental health. So there's lots of different options, but a
GP can be a great first point of contact.
Speaker 1 (07:54):
And I think it's really great because I think when
in doubt, it's like, why not just get it checked out?
Speaker 4 (07:59):
You know?
Speaker 1 (08:00):
So I really love that. So I kind of wanted
to talk a little bit more to kind of the
myths that are out there, or just an opportunity to
kind of shine a light on what are the biggest
mistakes in therapy, because I'm sure you've seen a handful
of lots of different kinds of people in the clinic room.
Speaker 2 (08:19):
Yes, mistakes or I guess misconceptions about therapy. Right, I'm
like almost mindful about this word mistake being like a
judgment that someone's doing it wrong, Like you're doing therapy wrong,
you're failing a therapy. It's not that, it's maybe they
come in with sort of misconceptions as to how therapy works,
or misconceptions around what to expect from being in the
(08:40):
therapy room. So one big one that I've seen through
my years of practice is there can be a reluctance
to share. Now, fair enough, Right, I am a strange
person that you've never met before, sitting across from you
(09:00):
in a comfy chair, expecting you to open up and
share your deepest, darkest fears with me. Right, That's that's
not a natural way in which we would communicate.
Speaker 4 (09:10):
In the real world.
Speaker 2 (09:13):
There's a fundamental imbalance in the therapy room that can
feel really uncomfortable for people who've never done therapy before,
and that is the client is expected to share lot
and lots and lots of information about themselves, and the
therapist generally.
Speaker 4 (09:31):
Doesn't share very much at all. Right, it's not about us.
Speaker 2 (09:35):
That dynamic is really unnatural in the real world. If
we're talking to a friend, if we meet an acquaintance,
if we're talking to a colleague, one person shares a
little bit, the other person shares a bit, the next
person shares a bit.
Speaker 4 (09:48):
And we build.
Speaker 2 (09:48):
That's how we build a connection through shared vulnerability. We
don't have shared vulnerability in the therapy room. It's a
different dynamic, and so that can be uncomfortable for people
at first, and I don't blame them for that, but
what it can lead to then is maybe them not
sharing everything that might be important or relevant for the
(10:10):
therapeutic process. So sometimes I'll see clients. They'll come in
the first session and this is not uncommon. We'll get
to like the last five minutes and I'll be like
anything else, and then look, something comes out and it's
usually a big thing.
Speaker 4 (10:24):
Oh okay, maybe we have to unpack that next session.
Speaker 2 (10:26):
So there's this sort of like holding and maybe a
bit of testing the waters as well, just seeing how
I or another psychologist might respond to their disclosures of
personal information. So that's something that I see that can
sometimes stall the therapy process a little bit. But hopefully
it's our job as therapists and clinicians to help people
(10:49):
feel comfortable to set the tone for the therapy room
so that a person can feel like they can share
that personal information with us.
Speaker 1 (10:59):
I like that you've kind of named the unnaturalness of it,
because I think I know from friends who have gone
to therapy they do speak a bit about that. They
kind of just say, oh, but I want to know
more about their person life, like I don't really know
anything about them. And it is true, it is very
one way, but it sounds like it's intentional.
Speaker 2 (11:17):
Yes, yes, And I think the reason one of the
reasons that that's important is because A it's not about
us as a therapist, but b it's also not about
our experience.
Speaker 4 (11:28):
Right.
Speaker 2 (11:28):
So, as a psychologist, I've studied the science behind how
the mind and the brain works and how that influences
certain emotions and.
Speaker 4 (11:37):
Behaviors, et cetera.
Speaker 2 (11:38):
My work as a therapist should not be based on
what my life experiences have been and whether I've had
similar life experiences to my client or not. It should
be based on the science and the psychological frameworks that
I've studied that I know can help a person with
the challenges they're facing.
Speaker 1 (11:58):
Okay, so what are some of the other misconceptions out there?
Speaker 2 (12:01):
Okay, so the kind of holding back information avoiding that vulnerability.
I think another misconception could be thinking that all the
therapy happens in the therapy room. So sometimes we see
people come to therapy, they do their fifty sixty minute session,
We talk through all the stuff, we give them some
(12:22):
tools and strategies, and then they leave the room and
they come back next week. But not much happens in
the in between. And when I say not much happens,
what I really actually mean is not much changes. The
therapy room is going to be one hour of your week.
But in reality, what we want to try and do
(12:42):
is help people build the skills and the tools to
be able to make changes in their day to day
life outside.
Speaker 4 (12:50):
Of the therapy room.
Speaker 2 (12:51):
And so what this often comes with is some degree
of homework. I have mixed feelings about the word homework,
and I remind me of school. But it's like there
are some tasks, some activities, some practices for people to
do in their day to day life.
Speaker 4 (13:07):
We could do all the.
Speaker 2 (13:08):
Best talking in the therapy room. That's possible, but if
nothing changes, nothing changes.
Speaker 1 (13:15):
And it's important because I can imagine that the real
work happens outside of the therapy room, like the integration
the real life, you're in life as well, So I
can get how that's really important.
Speaker 2 (13:26):
It's one thing for us to talk about how to
manage a panic attack in the therapy room when a
person's not having a panic attack, but it's another thing
for them to go out and then apply those skills when.
Speaker 4 (13:37):
They're in the thick of it.
Speaker 1 (13:39):
Yeah, So what else?
Speaker 2 (13:41):
Another one is clients may be feeling like they can't
share their thoughts about how the therapy process is going. Now,
this goes two ways, right, I think it's really on
the therapist to be able to create a space and
ask questions that invite feedback. So I want to know
(14:04):
if my clients feel like the therapy is working for them, right,
I want to know if they feel comfortable. I want
I don't know if they feel like they're making progress.
And so we as therapists have a responsibility to be
asking those questions and actively checking in with our clients.
But if there is something that someone feels like isn't
working for them, voice that share that.
Speaker 4 (14:24):
With your therapist.
Speaker 2 (14:25):
We need the feedback so that we can provide strategies
and treatments that work for you. I could have the
best strategy or solution that I think is going to
be great for someone, but if they turn around and say,
I'm never going to do that.
Speaker 4 (14:41):
Then let's try something else.
Speaker 2 (14:43):
It's like when we talked about in episode one with anxiety,
like the ice cold showers. Right, I could be like,
I have the best tip for you, and if someone's like,
you got buckleys of me getting in a cold shower,
I'd be like, right, let's try another strategy. So we've
got to work collaboratively. As you said before, collaboration is
key when it comes to therapy.
Speaker 1 (14:59):
Mmm. I love that. I think so often when we
look at therapy in pop culture, you know, it's the
classic when you're watching a movie, someone's laying on the
couch sharing everything. But I'm curious to know what is
therapy actually, like, what does it look like?
Speaker 2 (15:15):
Well, I can tell you that I don't have a
couch that you lie down on, damn it. I've got
some comfy couches that you can sit in, like the armchairs.
Speaker 4 (15:24):
Yeah, but not a lie down couch.
Speaker 2 (15:27):
I'm afraid there's lots of different types of therapy, and
I agree that there's a bit of a misconception maybe
as to what therapy actually looks like in the therapy room.
Maybe I can give you a bit of a therapy
one oh one on maybe like the four different common
types of therapies we've seen, but also how therapies evolved
(15:48):
over time, so that people can understand maybe what the
best therapy approach might be for them. And look, that's
what a psychologist is there to do, to assess and
also provide a recommendation as to what type of therapy
might suit you best. But I'll give a couple of
brief explainers of some common types of therapies.
Speaker 1 (16:04):
How's that. I love that we're ready for therapy one
on one?
Speaker 2 (16:07):
All right, so we go, so back into the ages.
The most well established therapeutic approach that we have is
something called cognitive behavioral therapy c BT for short, and
cognitive behavior therapy looks at our thoughts, our feelings, and
(16:29):
our behaviors and how the three of these are connected.
Speaker 4 (16:33):
Right. Hence, cognitive and.
Speaker 2 (16:35):
Behavioral CBT has a lot of evidence to support its
use for things like anxiety, depression, OCD, even eating disorders.
Lots of evidence behind CBT. However, CBT focuses very heavily
on change, right, how can you change your thinking? How
(16:57):
can you change your emotional state? And how can you
change your behaviors? Now, that is very helpful for some people. However,
if you come to the therapy room and you've experienced trauma,
if you've experienced chronic patterns of invalidation, if you are
(17:20):
someone who's been given a terminal or life changing diagnosis,
walking into the therapy room and having a therapist say
to you how can you change your thinking about that
is going to be a highly invalidating experience. If I
come in and tell you I've had this traumatic experience
and you tell someone to change their thinking, that does
(17:41):
not land well, that's highly invalidating.
Speaker 4 (17:44):
So the reason I say.
Speaker 2 (17:46):
This is because there's a newer wave of therapies that
have emerged that focus on change as well as acceptance,
and we're always looking at how we can balance these two.
So we have therapies like acceptance and commitment therapy, which
is ACT for SUT that really focuses on how can
(18:09):
we work with sort of mindfulness based strategies to accept
our thoughts, our feelings, and our behaviors. Now I'm going
to jump in I'm going to get I'm going to
get on my acceptance kind of ramble here and say,
acceptance is not approval, right, Acceptance does not mean that
I approve or I like the experience. It just means
(18:32):
that I can sit with it and go it is
what it is. I'm having this emotional experience right now.
I'm not going to try and change it. I'm just
going to accept it for what it is and it
will make it pass easier. So we've got our acceptance
and commitment therapy. Then we have DBT dialectical behavior therapy
(18:53):
that again focuses on that balance between acceptance and change.
And this specific type of therapy is quite useful for
people who have conditions like complex trauma, borderline personality disorder,
addiction concerns, some eating disorder, and sort of chronic experiences
(19:13):
of emotions that feel out of control, emotion dysregulation. And
then one more I'll touch on is EMDR. This is
a newer type of therapy. It's quite popular at the
moment for the right people. I Movement Desensitization and reprocessing EMDR.
It's a bit of a mouthful, it is, but this
has been really developed to help people who are trying
(19:36):
to recover from traumatic experiences that they've had through utilizing
sort of eye movements to reprocess traumatic memories.
Speaker 1 (19:45):
There really is a lot of different kinds of therapy,
isn't there?
Speaker 2 (19:48):
And there's more, but these are anight.
Speaker 1 (19:51):
Now and those are the most with like the most
evidence as well.
Speaker 4 (19:55):
Yes, there's some other therapies.
Speaker 2 (19:57):
There's scheme of therapy for example, there's other therapies that
do have evidence behind them. And again, I think there
can be some benefit in trying to do a bit
of homework and research around these different type of therapies
if you think one might be benefit issue for you.
But ultimately it's a conversation to have with your psychologist
or with your therapist, because based on an assessment, they
(20:19):
will be able to determine what they think is the
best fit for you.
Speaker 1 (20:23):
So what about couple's therapy, Like, what are the common
misconceptions that can happen there?
Speaker 2 (20:30):
Well, probably one of the most common things I see
is that one person in the relationship will come to
a psychologist like myself wanting help with the relationship. So
they'll come into the room, they'll tell me about the
struggles that they're having in the relationship and they want
some advice or guidance or tools and strategies as to
(20:52):
how to make things better. Now, we can do that
to a degree, but ultimately that's a situation where couple's
therapy is going to be more beneficial. And I often
say that to the person. I'll say, look, we can
work one on one to help upskill you with the
strategies until that might be helpful for you. However, one,
(21:13):
it may have limited effect because the other person in
your relationship is not here. And second, it might end
up feeling like the onus is all on you to
then try and fix the problems in the relationship because
you're the only one here in the therapy room getting
the tools and the strategies and the guidance around it.
(21:33):
So you might end up feeling like you're carrying the
load of trying to repair or improve the relationship, and
that's not going to feel particularly fair on you. So
I think that's a misconception that I see where people
come in wanting to fix a relationship, but they're not there.
Speaker 4 (21:50):
With their partner.
Speaker 1 (21:53):
I wanted to quickly out on that because I've definitely
had experiences with friends where they want to get couple's therapy,
but one is keen and the other isn't. So what
do you say about that? Like when the partner's just
resistant to wanting to get therapy.
Speaker 4 (22:07):
It's really hard.
Speaker 2 (22:08):
I think they're the situations where at at least one
person going and getting support is better than no people
going and getting support. But ultimately, if both can be
open to just giving it a try and seeing what happens,
that would be ideal.
Speaker 1 (22:26):
After this shortbreak, doctor Anastasia is going to give you
some clear guidance on how to find the right therapist
for you and how to make sure you're getting the
most out of therapy. Atasasia, we've established that knowing that
you might benefit from therapy is a great first step,
but how do we make sure that we get the
right therapist and how do we make the most of it.
Speaker 2 (22:48):
So first step is finding the psychologist, the therapist, the
person that's the right fit for you. So, if you're
considering getting some professional help but you're not sure where
to start, as I said, first off, try the GP.
The GP might be able to actually recommend some specific
psychologists or therapists in your local area that could be helpful.
(23:10):
But if you're wanting to look beyond that. There's a
website called Psychology Today where lots and lots and lots
of psychologists and counselors and therapists have their profiles listed,
and it can be a great resource to put in
your postcode and seek out some therapists that might be
local to where you live or where you work.
Speaker 4 (23:28):
If you're wanting to check out.
Speaker 2 (23:30):
A bit of the therapist and sort of the work
that they do, what types of therapies they use, what
types of clients.
Speaker 4 (23:36):
They typically see. You can get a bit of.
Speaker 2 (23:37):
A sense of who they are and the work that
they do from their profiles on Psychology Today. Next step
would be actually contacting maybe a few different psychologists right
and sharing what it is you're wanting help with. As
I said, if you feel like you're struggling with anxiety,
if you struggle with eating concerns, if you're struggling with
(23:59):
an addiction, whatever, it might be calling up that clinic
or that therapist and sharing this is what I'm wanting
help with. Who would be the best psychologist at your
clinic to see me? Just like gps have different areas
of specialty, right, some gps specialize in women's health, others don't.
Some specialize in skin, skin tags and skin removal of conditions, right,
(24:22):
others don't. So you want to find a therapist who
has knowledge in what you're wanting assistance with, and the
clinic that you call should be able to give you
some guidance around that.
Speaker 1 (24:32):
It's kind of like we're essentially shopping for the best
psychologist in a way, you know, like who's going to
be the right fit, the.
Speaker 4 (24:38):
Right fit exactly.
Speaker 2 (24:39):
Then I would say, once you have that initial appointment,
you're in the therapy room, maybe before you even walk in,
write down a couple of dot points for yourself as
to what it is you're hoping to get.
Speaker 4 (24:53):
Out of therapy.
Speaker 2 (24:54):
Now, I say this with care because you're not expected
to know all the answers, right, You're not expected to
know what you're experiencing and where it is you'd like
to get with certainty. But if you have some idea
as to the trajectory you want to head in or
the goal as you'd like to achieve for yourself, that
can be useful information for the therapist to be able
(25:15):
to say, oh, look, maybe that sounds unrealistic or absolutely
that's something we can help with or yes, we can
do that, but it might take a bit of time.
Speaker 1 (25:25):
Okay, So we've established now that therapy is very beneficial.
So how do we make sure we find the right therapist?
And when we do find the right therapist, how do
we make the most out of it.
Speaker 2 (25:37):
Yes, as therapists, we work according to the mantra of
unrelenting positive regard. Right, my job as a therapist is
to have unrelenting, without limits positive regard for my clients.
(26:00):
That means that I'm non judgmental, that I'm not sitting
here with my clipboard judging what you say, but that
I'm open and curious to understand your life and your experience.
Speaker 4 (26:13):
If I can't do that, if I can't.
Speaker 2 (26:15):
Sit in the room with my client and be open
and non judgmental, I'm not the right therapist for this client,
and I'm best to refer them to someone else who
can sit with them and not have that bias and
that judgment.
Speaker 4 (26:27):
So I would say, if a person has fears.
Speaker 2 (26:31):
Around opening up and sharing vulnerably, our job as therapists
is to be non judgmental and to welcome that vulnerability
into the room. I also want to say we've heard
and seen most things.
Speaker 4 (26:46):
Right, It's a.
Speaker 2 (26:47):
Rare day these days that someone says something that shocks me.
And I say that to give comfort to people who
might think that they're going to walk into the therapy
room and say something that is so terrible or so
shameful or so devastating that I.
Speaker 4 (27:03):
Would judge them for it.
Speaker 2 (27:05):
We've heard a lot, and so I say, bring it
all in, Lay it out on the table. You know,
tell us about your sex life, tell us about the
times you've done things that you're really not proud of
yourself for. Tell us about the mistakes you've made. We
understand that you're human and it's our job.
Speaker 4 (27:22):
We're here to help.
Speaker 1 (27:23):
So it's just laying out all the mess. Just lay
it all out, no shame, just go for it.
Speaker 4 (27:29):
And will help you sort through it.
Speaker 1 (27:31):
So is there anything that you do as a therapist
to make sure that the client feels really comfortable?
Speaker 2 (27:38):
The thing I focus on for myself and in terms
of how I show up in the room is authenticity.
While I don't necessarily reveal a lot about myself and
my life to my clients, you know, they wouldn't know
about my personal relationships and things like that. I always
(28:00):
always aim to show up emotionally in a way that's authentic.
So I don't have a different persona when I walk
into the therapy room. I'm me, not at a stage
of the psychologist. I'm still just Anastasia, the same way
I'm talking on this podcast with you, in the same
way I am in the workplace, pretty much the same
I am with friends, family, etc. Those parts of my
(28:20):
personality are still there, and I think that's not going
to work for everyone, right, People gel with others in
different ways, So my personality and who I am as
a person might not be the right fit for everyone,
and that's okay. But I always aim to show up
authentically because that's what I'm asking my clients to do.
Speaker 4 (28:39):
I'm asking people to come in here and be vulnerable and.
Speaker 2 (28:42):
Be authentic, so I need to show them the same
respect in return.
Speaker 1 (28:46):
So what you're trying to tell us is that we've
been in the therapy with you this whole season because
you've been the same person.
Speaker 4 (28:52):
Right, It's like being in the therapy.
Speaker 1 (28:55):
Anastasia without you, guys knowing. Surprise. Okay, So where does
tellyhealth come into all of this? Because a lot of
people are using it more right.
Speaker 4 (29:06):
Absolutely since COVID.
Speaker 2 (29:08):
I mean it was one of the beneficial things that
came out of COVID is that we realized, hey, online
therapy really can work. And actually there's been a lot
of research done into this. Whether in person or online
therapy is more effective and really the results are pretty similar.
Online telehealth sessions can be just as effective as in person.
(29:29):
Now some people prefer in person they feel more connected
to their therapist, but online can be really really useful.
And the other thing about online that I really like
is it's convenient and it's accessible.
Speaker 4 (29:42):
You know, if you live.
Speaker 2 (29:44):
In a rural or remote or regional area, or if
you have a busy work schedule, you can schedule and
appointments in your lunch break or just after you finish work.
You don't have to worry about the commutes to go
and see the therapists. So people can fit it into
their schedules more easily nowadays as well with online therapy,
and I think that breaks down one of the barriers
(30:05):
to actually being able to access it.
Speaker 1 (30:07):
So with telehealth, like, is it cheaper than seeing someone
face to face?
Speaker 2 (30:13):
It can be, but it might not be depends on
the therapist, the service that you're going through, and the
sort of fees that they charge. I do know that
there are some clinicians who do only telehealth, and sometimes
they're in a position where they can offer reduced fee
sessions because they don't have the overheads of needing a
physical space. They do the therapy from their home, so
(30:35):
their kind of costs of running their practice are lower
than what someone else's might be. So there definitely can
be some telehealth options that can be cheaper than in person,
but also cost is a barrier, right, and so I
want to really highlight that because it can mean that
people who need to see someone feel like they're not
(30:57):
able to because of how expensive it can be. There
are some fantastic self help online resources these days so
too that I'm going to give a little bit of
a shout out to. There's a pro program or online
service called this Way up Right, evidence based programs that
are specific for different mental health conditions. So there's like
(31:18):
one for OCD, one for anxiety. You work through them
at your own pace, and they're very accessible. Sometimes you
can get them for free, sometimes it's a very low cost.
But there's also a clinic called mind spot right. This
is run out of McClary University actually, and what it
is it's again online evidence based programs that you work
(31:38):
through and you can get either phone or email support
from a therapist as you work through it.
Speaker 4 (31:44):
So these kind of fall into.
Speaker 2 (31:46):
The category of what I would refer to as like
early intervention self help type programs that can be assisted
by a therapist. They may not be the right treatment
approach for someone who's experiencing very severe mental health concerns,
but for someone who wants to do something to help
themselves but doesn't feel like seeing a therapist online or
(32:08):
in person is the right step.
Speaker 4 (32:10):
Right now, there are these.
Speaker 2 (32:11):
Kinds of evidence based options, often run via universities that
can be great resources.
Speaker 1 (32:17):
So what do you do for someone that feels like
they might have a severe issue and they don't think
the self pace is going to work and just having
a bit of support here and there isn't going to work. So, like,
what should we do for people that have a very
severe condition and still need that one on one, hands
on support and they might not have the money for it.
Speaker 4 (32:38):
Through your local health services.
Speaker 2 (32:40):
At least in Australia, we're lucky here we have access
to some free options. You are able to see mental
health professional psychologists, psychiatrists. The issue is that there's often
a weight, So it's not that you're unable to access
free or very low cost mental health services in Australia.
It might just be that you are waiting to get
(33:03):
in to see someone. I guess this is also the
point where I want to say we've talked a lot
about how to find a therapist and get into the
groove of therapy for people who really have the luxury
of being able to seek out and see a therapist.
And that's not everyone, right, and not everyone can wait.
(33:23):
So for people out there who may be struggling, who
may be having an acute episode of mental health distress,
or who might just need quite urgent assistance, I would
encourage you to consider going to the emergency department, calling
Triple zero, calling Lifeline, or calling the mental health line.
(33:44):
So in New South Wales where we're based, we have
the Acute Care Team and a mental health line where
you can call for yourself or for someone else to
make a referral for someone who's needing some acute care,
and different states have their own hotline for this, so
you can look that up online, but there is definitely
immediate help available when you need it.
Speaker 1 (34:06):
After this shotbreak, we hear from someone who wants to
break up with her therapist, but she doesn't know how
stay with us.
Speaker 4 (34:15):
Erb Barb Bibby.
Speaker 2 (34:17):
I'm having a serious crisis, Berb having a crisis.
Speaker 1 (34:22):
Okay, we've reached that time in our episode where we
answer a question or dilemma from one of you, our listeners,
And this one's a really special one because it's the
last one for the season. And yeah, I'm very excited
about this one. You're about to hear from Ariana.
Speaker 3 (34:40):
I've been seeing my therapist for like two years and
she's really helped me a lot, But honestly, I feel
like I don't really need therapy right now. The problem
is I have no idea how to actually break up
with her. We're not friends or anything, so it feels
weird to just stop going without saying anything. Do I
have to tell her I'm done? Should I email, call
or bring it up next session. I don't want to
(35:01):
be rude or make it awkward, but I don't want
to keep going if it's not helping me anymore. So, like,
what's the best way to handle this.
Speaker 2 (35:10):
Ah, therapy goodbyes, the therapy breakup.
Speaker 4 (35:15):
This happens all the time.
Speaker 2 (35:17):
No, you know what, first thing I have to say
is don't worry about it too much. Right there's no
perfect way to do this, but it's important that you
communicate to your therapist if you feel like you're.
Speaker 4 (35:30):
In a good place, because hooray, that's.
Speaker 2 (35:32):
Great, that's what we want, right We don't want you
to be in therapy forever. Therapy should be for a
period of time until you feel like you're at a
good place where you can go out into the world
on your own and the door is always open where
here if you ever want to come back and re
engage any point in the future.
Speaker 4 (35:50):
But if you're wondering how.
Speaker 2 (35:52):
To do the actual goodbye, there could be a couple
of different ways. You could send an email to say
thanks for your help. I actually feel like I'm in
a really good place right now. I feel confident to
be able to here's the skills and strategies you've taught me,
and I'm not struggling with the things that I was
struggling with two years ago.
Speaker 4 (36:10):
So I think I'd like to pause things.
Speaker 2 (36:13):
For now, and if I need anything in the future,
I'll email you again, and you know what.
Speaker 4 (36:17):
That's always a It's a.
Speaker 2 (36:19):
Bitter sweet email to reply, right Like, I have a
fondness for my clients, and of course I'm going to
be a little bit sad if i don't get to
see them anymore.
Speaker 4 (36:28):
But when I end.
Speaker 2 (36:30):
A therapeutic journey with a client, I'll say to them
in a joking way.
Speaker 4 (36:35):
I mean this in the nicest way possible, but I
hope I never see you again, because that's a good
sign for you. It's not that I don't want to
see you again. I like you, but.
Speaker 2 (36:45):
I hope that you feel like you can go through
life without needing my help.
Speaker 1 (36:51):
So there is an end point to therapy.
Speaker 4 (36:55):
There should be. Yeah, look, not for everyone.
Speaker 2 (36:57):
There are people who will be in and out of
therapy throughout their life, depending on what their diagnosis might be.
But for many of us, there should be an end
point to therapy.
Speaker 1 (37:08):
So they determine the endpoint or do you like, how
does that happen?
Speaker 4 (37:14):
This is actually a really good question.
Speaker 2 (37:16):
I'll have a conversation with my clients at a certain
point where I think they don't really need me anymore,
because ethically, I have a professional duty to let someone know, Hey,
you know that anxiety you came in with a year ago, Well, it.
Speaker 4 (37:32):
Looks like it's not there anymore. Good on you.
Speaker 2 (37:35):
So I'll have a conversation with someone where I say
something like, based on the reasons you originally came in,
it seems like you've made leaps and bounds in your progress,
and I'm wondering if you even need to keep continuing
with sessions. That's not to say I'm kicking you out
the door and you can't come back. You can, of
(37:56):
course keep coming for sessions if you want, but I
want to let you know that, from my opinion, you're doing.
Speaker 4 (38:03):
Heaps better now.
Speaker 2 (38:05):
That for me is letting the client know you don't
need to come from a kind of professional clinical diagnosis perspective.
We've ticked the box and you're doing heaps better. Right,
So that's my professional duty to let someone know that.
But I'm leaving the option up to them if they
want to keep coming and talking through things that are
going on in their life, for things that might be
(38:27):
challenges for them and stressing them out. We can absolutely
do that, but I don't want people to feel like
they need to keep coming, and so once I reach
that point with a client, I'll often finish sessions by
saying something like, what would you like to do for
the next one? What do you think we should do?
When does it feel like it would be a good
time for you to come back and have another session.
(38:48):
If someone is not needing to follow a strict treatment
plan to overcome a clinical diagnosis, we can be much
more flexible in the way that we do therapy, and so.
Speaker 4 (38:57):
I always want to leave the door.
Speaker 2 (39:00):
Open for a client to feel like they have autonomy
in making that decision.
Speaker 4 (39:05):
Can you tell us.
Speaker 1 (39:05):
Some of your breakup stories? I'm really keen to hear
more about your breakup story the collection. Yes, let's get
out the archives.
Speaker 4 (39:15):
Look.
Speaker 2 (39:15):
I guess this example has been kind of a nice
neat one where someone's done therapy, they've got better, it's
been two years, they're ending, right, there's a nice close.
Sometimes we get the no reply, like we're like, hey,
would you like another session? We've been, you know, doing
some work in therapy. Would you like to come back?
And sometimes people will you know, ghost us, you got ghosted,
(39:36):
been ghosted not a couple of times, but you know
what I in any of these situations, I try to
tell myself, like, don't take it personally, Like I'm leaving
the door open. If there's some feedback a client wants
to give me of like, hey, you wanted to take
me down this path, but I didn't want to go
down that path, you know, I like to think that.
I'm open to hearing that. So I'm open to the
(39:58):
feedback and also understand that it's not the right fit
for everyone.
Speaker 4 (40:03):
I'm not going to be the.
Speaker 2 (40:03):
Best psychologist for every person who walks through the door.
Speaker 4 (40:07):
I know that.
Speaker 2 (40:08):
And so if we have a couple of session and
someone's like, oh, that Anastasia girls, she's too casual for me. Like,
I'm pretty casual in my therapy sessions. Other psychologists are
way more sort of like therapists behind the clipboard, more reserved.
Speaker 4 (40:21):
Than I am.
Speaker 2 (40:22):
That's fine, but I know I'm not going to be
the right therapist for everyone, and so I take that
on board when clients may be say, you know what,
I'm gonna try someone else, And in that case, I
might help them find some some other therapists or give
them some recommendations for what they're after.
Speaker 1 (40:43):
At Assia, I'm so happy that we had this discussion
because therapy can feel so overwhelming and intimidating at times,
So I'm really glad you got to step everything out.
Can you reiterate to us some of the main takeaways
from today's episode.
Speaker 4 (40:58):
One hundred percent?
Speaker 2 (40:59):
First up, the process of going to therapy can feel
overwhelming and a bit scary for those who've never done
it before. Second, sometimes people have some inaccurate expectations about
therapy and what it will do for you. People might
think that they can get immediate results or think the
therapists can fix all their problems. Therapy, in fact, often
(41:22):
requires you to do some work outside of the therapy room. Next,
try to be as open and honest as you can
be with your therapist. The more we know, the better
we can help you. Nothing is off limits. And finally,
ensure that you feel you have a solid therapeutic relationship
(41:42):
with your therapist. The relationship is the biggest predictor of change,
so if that doesn't feel right, always consider trying another therapist.
Speaker 1 (41:50):
Anthysia, I can't believe it. This is our last episode
for this season.
Speaker 2 (41:55):
Oh, it makes me a bit emotional. What an incredible
nine weeks it's been.
Speaker 4 (42:00):
Hey, we've covered.
Speaker 2 (42:01):
So much ground, from boundaries to narcissism, to inner critics
to dating guys.
Speaker 1 (42:08):
If you have loved this show as much as we've
loved making it for you, please do leave us a
rating and a review Wherever you're listening to us, follow
us on Instagram and TikTok at But Are You Happy Pod,
and stay in touch. It really does make a massive difference.
Speaker 2 (42:25):
And if you're not already following this podcast, make sure
you hit that follow button to hear updates from us
soon about when we will be back in your ears
with the next season of But Are You Happy?
Speaker 1 (42:38):
Until then, be kind to yourselves out there.
Speaker 2 (42:41):
The executive producer of But Are You Happy is Niama Brown.
Speaker 1 (42:45):
Tarlie Blackman is our senior producer.
Speaker 4 (42:48):
Sound design and editing by Jacob Brown.
Speaker 1 (42:51):
I'm a Shany Dante and.
Speaker 2 (42:53):
I'm doctor Anastasia Hornus. The names and stories of clients
discussed have been changed for the purposes of maintaining anonymity.
If this conversation brought up any difficult feelings for you,
we have links for more resources in the show notes
around the topics we discussed today. You can also reach
out to organizations like Beyond Blue or Lifeline if you're
(43:14):
wanting more immediate support.
Speaker 1 (43:17):
Thanks for listening, and we'll see you next time.