So, you’ve decided to start counseling and you’re ready to go. Perhaps you’ve never done therapy before or maybe you’re looking to take a new approach. Here are some things you need to know before you start counseling.
1. Finding a therapist that you feel safe with is most important.
You can line up a bunch of great therapists, but if they’re not the best fit for you, you’re not going to do the intense, deep work you’re looking to do. The role of a therapist is to be a guide through your journey, reflect back to you what we see and help you to overcome obstacles towards meeting your goals. If you don’t click with your therapist or don’t feel safe enough to trust them, reaching your goals with them is unlikely. Your therapist should be someone you can relax around and speak freely without fear of being judged. Trust and safety are of paramount importance when you’re looking to do deep work on things like eating disorders, trauma, PTSD, couples’ work or issues specific to the LGBTQIA community.
2. Specialties mean that there’s been special training in a particular issue.
Our training in graduate school and doctoral programs very rarely provides training for specific diagnoses like PTSD, eating disorders or addictions. So when a therapist decides to have a particular specialty, we need to seek out training geared specifically towards these issues. If you notice that a therapist you’re interested in has indicated that we specialize in a particular area, you might want to ask us what sorts of training we’ve done to qualify us as an expert. This will give you a better idea of how equipped we are to help you with your specific struggle.
3. When you hire a therapist, you are paying for a space that is yours, for you.
I’ve heard people say that therapy is like paying someone to be your friend. This is actually not true. When you hire a therapist and you pay money, what you are paying for is a safe, neutral, objective space and time where you can do your work. It is an energy exchange. You are not paying your therapist to care about you, you are paying for an hour in a room that is completely and totally about you and no one else. In friendships, there’s a give and take, there’s a social obligation to ask how they are and be a support to them. In a relationship with your therapist, you are taking time for yourself only and receiving support that is not reciprocated emotionally, only financially. This dynamic can be extremely healing and empowering and for many, it is the only time and space where healing can truly take place.
4. The more consistently you go, the more effective therapy is.
Sometimes, in an attempt to save money or save time, people want to schedule therapy sessions every other week or once per month. While there’s nothing particularly wrong with scheduling like this, you may want to rethink the frequency and consistency of your therapy schedule. You don’t have to be in therapy forever. You can establish and work towards specific measurable goals with your therapist and see regular progress. However, progress is more difficult to measure when you attend therapy inconsistently. You may be having symptoms of PTSD, for example, and when several weeks go by without working on those particular symptoms, it is more difficult to get traction. If you’re struggling with binging and purging and you go every week, you can check in with your therapist about the particular triggers and behaviors that may have lead to your binge and purge. Don’t take my word for it, check it out for yourself. Set a goal with your counselor and try going weekly, write down your progress and notice the differences between your weekly sessions over a period of at least 3 months versus bi-weekly or monthly progress over a 3-month period. You may be surprised with the results.
5. Therapy happens in stages.
Sometimes we think that as soon as we set foot in the door of a therapy office, we will be “cured” immediately or within a few sessions. The reality is that there’s a therapeutic process which happens in stages. The first stage is joining with your therapist or learning to trust them. When we meet a new friend, we don’t usually tell them our deepest darkest right off the bat, it takes time and trust building to get to a place where we know they are a good friend. A similar concept is applied in therapy. Depending on the client, the level and amount of trauma and defenses, this stage can take anywhere from about a month to sometimes a year or even more. Safety, trust and a therapeutic bond, known as a therapeutic alliance, is formed in order for the therapist to really know and understand the client and for the client to feel safe enough to open up and do their work.
The second stage is where the work is done. Since there’s now an underlying foundation established between therapist and client, the second stage is about vulnerability. There is an unpacking, uncovering, examining and exploring the process that happens with the client and their trauma or their history. This stage is where people see their patterns and make shifts and changes in their thoughts, beliefs, and behaviors. The second stage of the therapeutic process is where clients reach their goals.
The third stage may or may not be part of the therapeutic process, dependent upon the client’s preference. This stage is for maintenance. The client continues therapy but perhaps doesn’t come every week any longer. They use their therapist to check in with, get help with issues as they arise and review the goals and behaviors they established during the second stage. Some people choose to forego this step and skip to the fourth stage.
The fourth stage of counseling is a closure process. After attaining goals in the second stage, and maintaining new behaviors and thought processes in the fourth stage, this last and final stage is a review of accomplishments, work together and closure of the therapeutic relationship. If the client chooses to end counseling, this practice of review and closure can be especially healing for those who have experienced traumatic grief or loss. Saying goodbye in a healthy way, honoring the relationship without suddenly cutting it off is a beneficial process to learn about emotional maturity and sophistication.
I hope these tips have been helpful. Please feel free to comment below with any other tips or feedback you have on this topic. If you’d like to speak further about starting counseling or have any other questions about some of the things I’ve mentioned, please contact me at TiffanySpilove@yahoo.com or call 610-314-8402. I wish you luck in your endeavors and look forward to hearing from you soon!!
Lucky us! Scott Giacomucci, MSS, LSW, CTTS, CET III, trauma specialist, psychodramatist and all around amazing therapist has shared his insights and explained that complicated title: Eye-Movement Desensitization and Reprocessing, also known as EMDR. The following is a handout Scott put together for his clients to help explain what EMDR is and how it's done:
EMDR: Eye-Movement Desensitization and Reprocessing
Often, when something traumatic happens, it seems to get locked in the nervous system with the original picture, sounds, thoughts, feelings, etc. Since the experience is locked there, it continues to be triggered whenever a reminder comes up. It can be the basis for a lot of discomfort and sometimes a lot of negative emotions, such as fear and helplessness that we can’t seem to control. These are really the emotions connected with the old experience that are being triggered.
What is EMDR?
Eye Movement Desensitization and Reprocessing, is a late-stage, trauma resolution method. Developed in the late 1980's, EMDR currently has more scientific research as a treatment for trauma than any other non-pharmaceutical intervention. Based on empirical evidence as well as thousands of client and clinician testimonials, EMDR has proven an efficacious and rapid method of reprocessing traumatic material.
EMDR appears to assist in processing of traumatic information, resulting in enhanced integration - and a more adaptive perspective of the traumatic material. The utilization of EMDR has been shown to be effective with a variety of conditions including generalized and specific anxieties, panic attacks, PTSD symptoms (such as intrusive thoughts, nightmares, and flashbacks), dissociative disorders, mood disorders and other traumatic experiences. Theoretically, EMDR is about integration - bilateral hemispheric (right/left brain) integration; triune brain (brain stem, limbic system and cerebral cortex) integration; and mind/body integration, but practically, it’s about convincing the mind and body that the traumatic event is, indeed over. EMDR helps to put the past in the past, where it belongs, instead of staying stuck in it (feeling like it is happened all over again in the present-with the same thoughts, emotions and body sensations- that accompanied the event in the past).
The eye movements (or other bilateral stimulation) we use in EMDR seem to unlock the nervous system and allow your brain to process the experience. That may be what is happening in REM, or dream, sleep: The eye movements may be involved in processing the unconscious material. The important thing to remember is that it is your own brain that will be doing the healing and you are the one in charge.
How is EMDR Done? (Parnell, 2006)
- Establishment of Safety and Resources - Safety within the therapeutic relationship and safety within each individual EMDR session. During each EMDR session, your therapist will begin by activating your own internal resources. (S)he will guide you in an imaginal, multisensory imagery exercise designed to activate images, emotions and body sensations of safety, protection, nurture and comfort. Once these images have been activated, the actual trauma reprocessing will begin.
- Activating the Traumatic Memory Network - The therapist will ask a series of questions regarding the traumatic memory. The purpose of these questions (or script) is to activate the entire traumatic memory network.
- Adding Alternating Bilateral Stimulation - Once the entire traumatic memory is activated, the therapist will add alternating bilateral stimulation using:
a) buzzing in your hands by turning on the Theratapper
b) alternating auditory tones via headphones or ear buds
c) moving his/her hands back and forth, so you may visually track the movement
- Reestablishment of Safety - regardless of whether the traumatic material was completely processed or not, the session will end at a pre-set time. Before you leave, you will be stable, embodied, oriented and calm. Depending on you and your therapist’s preferences, this may be accomplished in a variety of ways including, but not limited to re-activating your own internal resources, breathing exercises, prolonged muscle relaxation, etc.
Looking to continue EMDR therapy?
-You might begin by asking your IOP/PHP counselor for a recommended outpatient counselor who is skilled in EMDR.
-At the EMDR International Association website (EMDRIA.org) you can navigate to the “Find a Therapist” tab and search for a certified EMDR therapist in your community.
The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post traumatic stress. EMDR was also found effective by the U.S. Department of Veterans Affairs and Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies.
(Giacomucci 2017)(References: EMDRIA; Linda Curran; Laurel Parnell)
Scott Giacomucci, MSS, LSW, CTTS, CET III is a certified trauma treatment specialist and licensed social worker in Pennsylvania. He is a graduate of Bryn Mawr College where he received his Masters in Social Service (MSS) with a concentration in clinical social work. He facilitates trauma treatment services at Mirmont Treatment Center serving a variety of populations including young adults and emergency responders (veterans, police, fire, etc..) in both individual therapy and group sessions. Scott has a gentle, non-judgmental treatment approach that honors the inherent worth of each individual. He utilizes a blend of treatment modalities including both traditional talk therapy and experiential therapy which have been research-proven as the treatment of choice for treating trauma.
To learn more about Scott Giacomucci and the work he does, you can visit his website at: http://sgiacomucci.com/
Any comments or questions? We'd love to hear from you! Please comment below. For confidential questions, email TiffanySpilove@yahoo.com. If you need help finding an EMDR therapist, please call 610-314-8402, I'd be happy to help.
Post-traumatic stress disorder, also known as PTSD, is an indication from your body that it needs support in sorting some things out. Traumatic memories are stored in a different part of your brain than the rest of your memories. When therapy is completed successfully, brain scans show that the trauma memory has been moved to a different area of the brain. This alternate area of the brain doesn’t trigger your mind to get confused, your adrenaline to rush, and your body to be on alert.
Here are some of the symptoms of Post Traumatic Stress Disorder from the Diagnostic and Statistical Manual (DSM-V):
A stressor such as actual or threatened serious injury, threatened death or witnessing of death or actual or threatened sexual violence.
Intrusion symptoms such as
- intrusive memories
- traumatic nightmares
- dissociative reactions such as flashbacks
- prolonged or intense distress after being exposed to a trigger
Avoidance symptoms such as persistent efforts to avoid anything that triggers traumatic memories.
Alterations to thoughts and mood symptoms such as
- not being able to remember important parts of the traumatic event
- believing bad things about yourself and/or the world
- blaming yourself for the traumatic event
- overwhelming emotions such as horror, shame or anger related to the trauma that continue to happen even long after the event
- losing interest in things that you used to enjoy
- not being able to feel positive emotions such as joy
Reactive symptoms such as
- exaggerated startle response
- difficulty concentrating
- sleep difficulties
- aggressive or irritable behavior
- reckless or self-destructive behavior
If you are ready to listen your body signals and get some support to untangle the memories and put them in their proper place, I can help. My name is Tiffany Spilove and I LOVE working with people to heal their past. I want to make sure that you find peace inside your body and your mind. I have specialized training and experience helping people who have gone through sexual abuse, physical trauma and emotional pain.
Call me today for your free 15-minute phone consultation at 610-314-8402 and find out if therapy is a good option for you
West Chester, Pennsylvania is just south of The Main Line – an area rich with resources, beautiful settings, history and academic prestige. With all this knowledge about … well, everything - in our town, why is it so difficult to fully grasp what eating disorder therapy actually is? What does it do? How does it work?
And the most important question of all – WILL – IT – MAKE – ME – FAT?
You may have found counselors in West Chester that were kind enough and surely helpful. Understandably, you’ve got lots of questions.
It is so normal to be scared.
It is completely understandable if you’re wanting help – wanting support, but you can’t quite get yourself to take the plunge – and for MANY reasons (including the fear of getting fat). There are other reasons you’re probably scared:
you know there’s a bunch of things in your past, or perhaps your family, that may have contributed to your anorexia, but you don’t want to blame them.
You know you’ve got some difficult memories stored away, but that’s just the point – they’re STORED neatly away and the thought of walking into a counseling office and TALKING about them seems like the worst idea ever! Also, the commitment!
The binging and purging takes up ALL OF YOUR TIME –
every last ounce of energy you have to get to the grocery store, buy your binge foods, bring them home, make sure no one’s around and then the binge. Eating and purging and eating and counting and cleaning and being COMPLETELY EXHAUSTED! Who has time for therapy, let alone has the ability to commit to a specific time every week to show up?
But you’re so tired!
Tired of this dance you are doing with a gorilla – he won’t let go and you just keep spinning and you’re out of control and you want help, but it all just seems too overwhelming.
I hear you – it’s a dark way to live
You don’t have to feel like this anymore
Here are some debunked myths about eating disorder therapy:
1. Will my therapist try to make me fat?
No. We are not here to make you fat, contrary to popular belief. Geneen Roth says that recovery is about finding balance in food, weight and life; it's not about gaining weight. Recovery from anorexia, bulimia and binge eating disorder is NOT about making you fat. My focus, when I work with clients struggling with ED, is to help them break free from the obsession with food and body. To help them learn to love their bodies and live inside of them. To find peace around food and this is NOT done through binging! This is done by UNdoing the diet mentality. Diets make people with eating disorders either fat or nutty or both.
The goal for someone trying to find recovery from anorexia, bulimia or binge eating disorder is to eat when you are hungry, to eat enough food, that you enjoy, to SATISFY you and to stop eating when you are SATISFIED.
If you practice this way of normal or intuitive eating, your body will follow suit. If you are not restricting all day, every day and then binging and purging up your food, your body will do what it was born to do naturally – it will process the food and use the calories to give you energy and help your hair shine and your skin retain moisture. It will also alleviate the depression and anxiety you are experiencing from malnutrition.
2. If I go to therapy, will I spend all my time digging up the past and talking about my mother?
No. As a therapist, I believe your history is one important component of what makes you - YOU. I usually spend some time exploring things that happened in the past, but only as I find it helpful for the present – or if my client wants to explore or use EMDR to process an upsetting memory, then, of course we go there. But this is not the focus. As a therapist, my job is to help you identify YOUR GOALS and I am the guide that helps you reach them.
Another thing to consider is coaching. One of the differences between a therapy and a coaching is that coaching is usually much more directive and there’s virtually no history that comes into play. Coaching can be very useful especially for help with navigating things like grocery stores, restaurants or meal times. I incorporate coaching techniques when my clients are in need of this sort of direction. Whatever it takes to reach your goals and so you don’t need to be in therapy for the rest of your life.
3. Won’t I just be put on another diet?
No. Not when working with this type of eating disorder recovery, anyway. Some clinicians believe the way to heal an eating disorder is through rigid meal plans and restriction of certain food groups. Perhaps this works for some people, but don’t you want freedom? REAL freedom? As Jenni Schaeffer said, “How free do you want to be?” YOU CAN FULLY HEAL FROM YOUR EATING DISORDER. You CAN find freedom from all sorts of restriction. The beginning stages of recovery may involve a meal plan from a registered dietitian who specializes in eating disorders. We usually work on the exchange system. Rather than counting calories or measuring amounts of foods, we use exchanges to help you get away from the diet mentality.
And we meet you where you are at.
If you are not ready to eat 3 meals a day, that is okay. It is our job to help you mediate your anxiety around food; not to overwhelm you. Middle and late stages of recovery often move away from meal plans and move more towards intuitive and normal eating. (whatever that is right?) But honestly, the goal is to help you find freedom to enjoy meals with friends and family – to put food in its place in your life instead of allowing it to dominate and terrorize you. Dieting is not part of eating disorder recovery.
I hope this helps debunk some of the myths about eating disorder therapy, and hopefully, it will help you in your search for the right eating disorder therapist in West Chester Pennsylvania. If you are still feeling stuck, please don’t hesitate to call me at 610.314.8402 for a free 15-minute phone consultation. I’m happy to hear about what is happening and help direct you to the right person. If you are looking for help with eating disorders, you can read more about how I can help here.