Do I need counseling?

I often get calls from prospective clients asking, “Do I need counseling?” And, “How do I know?” 

Often, I start by asking them how they’ve been feeling, and if they like the way they’ve been feeling. That may relate to a whole range of descriptors: sad, depressed, down, blah, angry, frustrated, bored. . .

I then ask them how they’ve been doing? And do they like how they’ve been doing? Sleeping too much or too little; eating or drinking too much; experiencing too much conflict in relationships; lacking motivation and productivity; forgetting things; making mistakes at work or at home; being absent-minded. Are they worrying? Fearful? 

I then ask them how long they have been feeling and doing this way. Has this been going on for just a matter of days or several weeks? I then want to know if these ways of feeling and doing are tied to a loss -- loss of job or relationship or another aspect of their identity. And then if that loss is a singular event or part of an overall pattern -- one of a series of jobs or relationships lost or identity crises? 

When the feeling or mode of doing and being is tied to an event, the old adage, “time heals all wounds,” speaks a lot of truth. Time may tell whether therapy is truly warranted. Depending on the circumstances, I often prescribe to clients who are in the “wait and see” mode, a good dose of self compassion and self care. 

What do I mean by self compassion? Treat yourself as if you have the flu: get lots of rest, eat healthfully, abstain from alcohol, and suspend self judgment. -- particularly now! When you’re not physically ill, self care can include engaging in a number of activities that are nourishing for the soul, body, and mind: exercising, spending time with the right quantity and quality of friends, indulging in one's hobbies and passions, and rediscovering those lost! 

For those who have no identifiable impetus for their struggles or for those whose bereavement of loss is persistent and complex or part of an overall pattern, I definitely recommend therapy. For many, a few sessions is enough to get a satisfactory assessment of their struggles, some direction, and even some immediate coping skills. It is also typically enough time to determine if ongoing therapy is warranted and would be helpful. 

So, if you are struggling, reach out to a mental health professional. In the meantime, practice self care and self compassion.