What is your therapy perspective?
Therapy can be looked at by different perspectives, including “mind or body” and “bottom-up or top-down”. Talk therapy is considered a “top-down” experience, where the therapist facilitates the client’s exploration of what is currently going on in the client’s head, which ultimately can bring an increased overall inward feeling of calm. “Bottom-up” therapies, such as somatic work, are more focused on the body’s experience and feelings, which are an incredible source of information about the mind. Using “bottom-up” techniques by calming the body directly, though engaging the parasympathetic nervous system can calm our minds.
I combine both talk therapy and body work, so that the approach works in both directions. I find it to be both more informative about the client’s experience, as well as more efficiently and effectively incorporated into the client’s life.
I struggle with anxiety, how can therapy help me?
Much of what makes us anxious is ‘the story we tell ourselves’ about situations. For example, do you ever see someone you know and they don’t give you a proper hello, and all of a sudden you’re down on yourself? Sometimes we notice this is happening in real time and sometimes we will feel the anxiety later.
The nervous system is incredibly important in understanding anxiety! It’s wonderful that many people today are familiar with anxiety responses and the concept of ‘fight, flight or freeze’. This is part of the ‘mind/body connection’ in helping us understand ourselves, while it is still largely ignored by mainstream medicine.
Therapy can help with anxiety in a number of ways. First, it can address the mystery out of anxiety (“Why am I so anxious?”, “what can help me get through my anxiety?”). In the holistic therapy that I practice, my clients and I collaborate in creating a safe place, where they learn to notice how anxiety comes up in their bodies, and they learn to notice the thoughts that accompany the anxious feelings.
The good news is that we can learn to identify that queasy feeling inside (and to not dismiss last nights’ feelings that brought it on), and we can start noticing the piece of the picture that caused the downward anxious spiral.
The other good news is that we can learn to calm our body so that the anxiety doesn’t take over. When we feel the anxiety arising - we name it, separate it as a thought (rather than as our whole being) and then calm it. With time, we learn to quickly go through these steps, work with the anxiety in such a way that there is no longer a need to for these steps.
I’m intimidated by talking therapy, what solutions are there?
One of the most important ground rules for a positive therapy experience is to cultivate a space in which the client feels safe, to be, to explore and to feel. Vulnerability can be incredibly scary! Carl Rogers, known for creating a strong client-therapist connection, listed three important therapist features for increasing safety:
1. Empathy
2. Unconditional positive regard (for the client)
3. Genuineness
It takes time to build a relationship. Good therapy does not mean ‘unpacking’ your deepest issues in the first few meetings. At the same time, deeper issues that you’d like to address can be named early if that feels helpful, and then it is on the therapist to carefully allow for the client’s exploration at the right pace, and with continuous non-judgemental support and compassion. It is totally up to you, YOU have the agency to decide what you would like to discuss with your therapist.
Most of all, trust your gut! If you have a trial session and you aren’t comfortable, it’s OK to keep looking, or give it another short - sort of like a first date.
What is somatic work?
Somatic work is a type of therapy that works bottom-up. We focus on the body, such as tuning into your heartbeat or a sense of tightness or relaxation in your muscles, organs or other body parts. Here too, we gain information about ourselves through understanding our body’s feelings. We can give the mind a break, while we heal through our body.
Somatic work is used as a therapeutic intervention for trauma (see below for more on trauma), as well as for other emotional challenges.
Simply put, even if it’s hard for us to notice in day-to-day life, our body ‘holds onto stuff’. In our somatic work we can learn to tune into those experiences that we weren’t heard, and to hold them with compassion. Working somatically can help to heal those attachment wounds, so that we feel more whole and relaxed.
What is Polyvagal Theory?
This the brainchild of the Phenomenal Dr. Stephen Porges. So to get a little geeky here, the nervous system is split into teo parts: the sympathetic system (“fight or flight”) and parasympathetic system (“rest and digest”).
A great example for this is an ‘almost accident’. When you have to manage a situation, your nervous system kicks up adrenaline to make sure you’re dealing with the dangers and threats immediately. When the situation is over and you feel safe, your body starts to relax. Sometimes we have a quick, extreme reaction like crying, which is like letting out steam out of a pressure cooker before we begin to relax. Afterwards the parasympathetic nervous system takes over.
With Polyvagal work, we learn to kick up the parasympathetic without the stressful experience of a scary moment. Wouldn’t it be great to ‘rest and digest’ on command? With our practice, we can build our capability of calming down faster and for longer.
For more, Porges, S. W. (2022). Polyvagal theory: a science of safety. Frontiers in integrative neuroscience, 16, 27.: https://www.frontiersin.org/articles/10.3389/fnint.2022.871227/full
Psychophysiology 32 (1995) with the title "Orienting in a defensive world: Mammalian modifications of our evolutionary heritage. A polyvagal theory" (Porges, 1995)
How do I know if I went through a traumatic experience?
Before we go any further, if you believe you’ve experienced trauma, I’m sending loads of compassion and kindness your way.
Now, to the answer:
‘Trauma’ is a term that shows up ubiquitously. Some practitioners differentiate between ‘Big T’ and ‘Little T’ traumas, though others struggle with this because only the individual can really categorize the level of their own trauma. In fact, a whole range of distressing events can lead to emotional scarring, from a “mismatch” in attunement between children and their parents to natural disasters to personal or communal experiences of violence.
In terms of therapy for someone who believes they may have experienced trauma, I believe it is more important to ask yourself whether the traumatic episode is resolved for you. In the holistic view that I practice, we try to avoid pathologizing or ‘naming illnesses’. However, certain guidelines, or symptoms, are helpful in seeking care where it is needed. Are you having flashbacks, nightmares, trouble sleeping? Are you finding yourself thinking about the traumatic event too much (what we call rumination)? More importantly, do you think it’ll be helpful to you to reach out for help in sorting out what happened to you? A consultation call with a therapist can help you decide if seeking professional help is right for you.
How do I convince my partner to try couples’ therapy?
Great question! Like Dr. Terry Real says, it’s simple physics: people, like things, naturally take the path of least resistance. So if one partner is happy and the other isn’t, the happy partner will just continue on the their merry way and may not be interested in couples’ therapy.
The first place I would start is with asking politely, for your partner to join you in counseling because you are struggling with some things, and you think it will help the relationship. For some people, asking once or a few times will not get their partner into therapy. You may want to consider bringing it - front and center. ‘I love you and at the same time I very upset about A, when can we go to therapy?’
A big thing we do in couples’ work is not trying to ‘convince’ our partners to do anything! Convincing can be felt as a type of control, and as I’m sure you know, control never works. Our partners may comply, but there is a good chance that your relationship will have to pay the price, perhaps in the form of resentment. If you feel you need help setting up a couples’ session, reach out and we can have a chat!
For more, ‘How to Get More out of Your Relationship’, Dr. Terry Real: https://terryreal.com/articles/how-to-get-more-of-what-you-want/
What is EMDR and how do I know if it’s right for me?
EMDR, or Eye Movement Desensitization and Reprocessing is an evidence-based intervention that helps people ‘change their story’ around distressing events of the past. It’s known as a trauma intervention, and it can help with all sort of memories as well as pre-concieved notions we have about ourselves.
I love EMDR because it’s evidence-based as well as strength based. And some of the protocols are actually fun! Francine Shapiro, the psychologist behind EMDR explained:
“[We] use EMDR therapy to help identify the earlier memories that cause maladaptive defenses and intra-psychic conflicts, and it helps people process those memories and experiences. It’s the same with those who practice cognitive behavioral therapy. EMDR therapy is used to process the memories that are causing dysfunctional behavior and irrational cognitions.
It’s a remarkably efficient treatment. There are three studies that have indicated that for single trauma victims there’s an 84 to 100% remission of PTSD within about five hours of treatment.”
To read more about EMDR: https://www.emdr.com/what-is-emdr/
What is EMDR and how do I know if it’s right for me?
EMDR, or Eye Movement Desensitization and Reprocessing is an evidence-based intervention that helps people ‘change their story’ around distressing events of the past. It’s known as a trauma intervention, and it can help with all sort of memories as well as pre-concieved notions we have about ourselves.
I love EMDR because it’s evidence-based as well as strength based. And some of the protocols are actually fun! Francine Shapiro, the psychologist behind EMDR explained:
“[We] use EMDR therapy to help identify the earlier memories that cause maladaptive defenses and intra-psychic conflicts, and it helps people process those memories and experiences. It’s the same with those who practice cognitive behavioral therapy. EMDR therapy is used to process the memories that are causing dysfunctional behavior and irrational cognitions.
It’s a remarkably efficient treatment. There are three studies that have indicated that for single trauma victims there’s an 84 to 100% remission of PTSD within about five hours of treatment.”
To read more about EMDR: https://www.emdr.com/what-is-emdr/
My depression is really bad, I don’t know if I can commit to therapy. What’s the point in trying therapy if I don't if I'll last?
The first step is making the first phone call! People often report that they feel a bit lighter from the moment they reach out for therapy. It can be comforting and helpful to know that there is a caring homan being with professional training and experience who will share with you the carrying of your burden while you work together towards healing. However, I would want you to hold on to the understanding that major changes don’t happen in one day and that perfection is the enemy of the good enough.
I invite you to choose the therapist that seems most compassionate and understanding, that seems to fit YOUR needs. Together you can figure out how you can get the most out of therapy.
I invite you to reach out to me for a consultation: https://www.psychologytoday.com/us/therapists/sima-sharon-menora-boston-ma/868832
If you want to learn more about what to expect in a therapy session, you can read: https://www.choosingtherapy.com/expect-at-first-therapy-session/