What do I do with my life?
It's clear you have a lot going on. It can feel so empty to go through life without feeling that you are successful or even comfortable with yourself or the path you are on. I'm so glad you came to BetterHelp; once you are matched with a therapist you will be able to work together to figure out ways you can (1) improve your current progress and (2) make sure that the choices you are making will truly make *you* happy (not just your family). It can be very scary to think that you might be disappointing others, but this is your life and there are many, many potential paths to happiness. Sometimes we need to take a step back and reconsider what is truly most important.
I wanted to set some expectations for you so you know what therapy will be like. Depending on your subscription you will likely have one live session a week with your therapist (by video, phone, or live texting). In addition, you and your therapist can text back and forth through the week, you can attend unlimited free “Groupinars” about behavioral health topics, and you can use the journaling feature.
It’s good to shop around for the right therapist based on their specialties. When you are matched with a therapist, make it clear what you are looking for. It will not hurt our feelings for you to try out several of us until you find the correct fit (there are literally 20,000 on this platform, so you have choices!). We just want what’s best for you. Think of it like remodeling a home. You may just want help painting and changing some fixtures or going after walls with a sledge hammer. You would certainly want different kinds of professionals for these tasks, and you would also want to learn their specialties before getting to work. For example, I specialize in anxiety disorders, grief, sleep improvement, and sexual functioning. I also have been successful with many other areas. However, if a client comes to me asking for help understanding their dreams, I would (kindly) suggest they pick another therapist since that is not my area of expertise.
Here are considerations as you look into therapy and shop around.
1. CONSIDER WHAT YOU NEED HELP WITH. As I mentioned above, there are lots of styles of therapy, and many different practice specialties. Here are some of the main areas that people usually want help with (but there are many more, of course. You may want to Google, “types of therapy.”)
- Empathy (unconditional positive regard). Sometimes we just need someone to listen to us without judging. You may come from a family or friend group where this is hard to find, and a therapist can listen to you kindly and empathically.
- Reality testing (helping you separate the logic from emotions). Sometimes we have difficulty understanding whether a situation warrants the kind of reaction we feel. For example, you may become enraged at poor customer service. A therapist can help you understand why you feel this way and how to deal with such situations.
- Learning new patterns for thoughts (cognitions). Sometimes we fall into logical fallacies or thought distortions such as-or-nothing thinking and catastrophizing. These lead to increased feelings of depression and anxiety. Your therapist can help you understand these distortions and what to do about them.
- Understanding anxiety triggers. We are creatures of habit, and we tend to be afraid of consistent things. Unfortunately, the more we avoid a fear, the stronger that fear gets (avoidance is like fuel for fear). As such, it is important to start learning about the common themes of what makes you anxious. Is it a fear of being judged? A fear of failure? A fear of not being loved or admired? Everyone is different. The best way to do this is to start keeping a log of the times you experienced the fight or flight response. Jot down in a journal or in an app like Google Keep these times, including:
-- What was the triggering event?
-- How long did it take to calm down?
Over time, your therapist will likely recommend that you also track “what was the automatic thought,” or the instant thought that just popped in to your mind that might have made you feel even worse (such as “everyone here is going to hate me.” Or “They all think I’m stupid.”) Your therapist can help you identify themes and come up with alternative cognitions or thoughts to battle these automatic thoughts.
- Disrupt intense fear or the fight or flight response with deep breathing. Learning deep belly breathing (or “diaphragmatic breathing) is a great tool to add to effective stress management. Taking time to breathe deeply for a few minutes is a free and easy to learn method to take you out of the fight or flight zone and into a zone where you can think more clearly and not experience those side effects. You can Google “deep breathing” or “diaphragmatic breathing” to start learning a technique that really helps most people. You can find mobile apps to help (for example the Breathe2Relax or the Virtual Hope Box app – both are free and evidence-based) or watch videos online that can walk you through it. These are skills that not only help you now, but can assist you throughout your entire life (for example, dealing with road rage, poor customer service, annoying family). You can also disrupt the fight or flight response in the moment with just a minute or two of intense exercise (for example, push-ups, jumping jacks or walking up and down a flight of stairs). This helps use some of the adrenalin and glucose that are released into your blood stream when you have encountered a stressor and leaves you thinking a bit more clearly.
- Accountability partner. Your therapist can help you set achievable and realistic goals and help keep you accountable for making progress. This can prevent you from making goals that are too large and unrealistic. Your therapist can also congratulate you on the small achievements that you may not want to share with others (for example, “Yay! You were able to go through the day only reading the news twice!”).
- Helping you understand how your early life affects you now. In our early childhood we learn many things and have many experiences that lead to our behaviors as adults. Some therapists (especially those with psychodynamic backgrounds) can help you understand these effects.
- Coping with grief, mourning and break-ups. Therapists can help you grieve and mourn losses such as deaths, break-ups, and other ways that you have lost people close to you.
- Processing and working through trauma. Therapists can help you understand the symptoms of posttraumatic stress and help you learn ways to reduce these symptoms.
- Learning ways to improve sleep, chronic pain, sexual functioning, and other quality-of-life factors. There are many evidence-based techniques that therapists can help you learn to improve your daily functioning in these areas.
- Improving communication skills with partners, family, children, friends, or co-workers. As the saying goes, “love is never enough.” To help maintain healthy relationships, your therapist can help you learn effective and clear communication skills.
2. CONSIDER YOUR “STAGE OF CHANGE.” Sometimes we may have the need to change but not yet the motivation (like reducing substance use, quitting smoking, or other healthy behavior change). Depending on your stage of change, it may not be the right time for therapy. Here are the major stages of change. Consider where you are:
- Precontemplation: This is the stage during which you may not even be aware of the issue.
- Contemplation: This is when you are just starting to think about making change.
- Preparation: This is when you get ready to change. This is when a therapist is MOST helpful.
- Action: This is when we actually start making the change. Therapists are also very helpful here.
- Maintenance: Maintaining the change can be difficult, and therapists are very helpful at this stage as well.
I’m sending you hopes for quick healing and lifelong growth. Thank you so much for reaching out!
Note: If you are in crisis and feeling like hurting yourself, please call 911, go to your closest emergency department, or call the suicide hotline (the National Suicide Prevention Lifeline) immediately at 800-273-8255. You could also go to their website to chat at https://suicidepreventionlifeline.org/.