Engaging in the First Session of Psychotherapy Treatment

 September is “Suicide Prevention Awareness Month,” as well as “National Self-Care Awareness Month.” One of the most important aspects of taking care of yourself is to engage in mental health care. Negative attributes and negative connotations have been put forth by family, friends, and others when it comes to mental and emotional health. Far too many of you attribute the term ‘mental’ or ‘emotional’ to one being ‘crazy’ or ‘postal.’ These terms are misconceptions, harsh, stereotypical, and they often hinder those in need of mental and emotional health treatment from seeking treatment. 

 

Mental health disorders are associated with disorders of the mind, cognitive functioning, rationality, and all things related to the brain. Your mental health includes and encompasses your emotional health, your psychological health, your spiritual, and your social health. They are all interconnected and interrelated. Like your physical health, you should also engage in mental health checkups and treatment. Psychotherapy treatment for mental health disorders is for everyday people who have difficulty in dealing with everyday life challenges. Sometimes these challenges affect the quality of one’s mental and emotional state. 

 

Psychotherapy sessions can help with the challenges of mental health disorders once properly diagnosed by a licensed mental health professional. There are times that psychotherapy treatment is not enough. Psychotherapy treatment in conjunction with medication maintenance with a licensed medical professional who can prescribe psychotropic medications might be necessary. This dual level of treatment is very important and effective for persons with severe, chronic, and acute mental health disorders. It is especially crucial in the treatment of suicidal individuals.

 

It is important that when an individual is suicidal, with a plan, that immediate treatment is rendered. Family members and friends are cautioned to not try to diagnose or treat a loved one exhibiting severe or acute mental health disorders. Getting that person to the nearest emergency room is essential for their safety, the safety of others, as well as for their life. Recent events regarding family members and friends calling law officials such as police officers to help with their loved ones having mental health episodes has brought about much mistrust. Sadly, not enough police officers have been trained in handling persons with mental health disorders, often resulting in the death of the person in need of treatment. I commend those law enforcement departments that have trained mental health teams working with them to combat the possibility of a mental health call being mishandled.

 

Prevention and early intervention are always the best approaches for effectively dealing with mental health disorders. Once there are signs of possible mental health disorders, it is in the best interest of the individual to seek or receive help in receiving a mental health diagnosis and mental health treatment. And if necessary and if accepted, it can be helpful for a family member to attend the first psychotherapy session with their loved one. The first psychotherapy session can be filled with concern, anxiety, and uncertainty. Having a family member or close friend can be an act of support.

 

As with any relationship, the way the psychotherapist starts the first session will determine the ebbs and flows of the succeeding sessions.  As a matter of fact, the first psychotherapy session is the platform for building the ensuing sessions if the client returns. 

 

The first psychotherapy session is an engagement between the licensed mental health professional and the client (and possibly his/her, spouse, family member, friend, or significant other). The psychotherapy process begins with the client (or parent if a minor) making the initial telephone call to secure a psychotherapy appointment, either by phone or through a tele-mental health process.  I personally speak with all potential clients to ascertain the reason for the call, the perceived reason for psychotherapy, and to ascertain therapist/client fit. 

 

Once the appointment is scheduled the intake process begins. The client completes the “Confidential Client Intake Form,” as well as a signed “Client Fee Agreement,” prior to entering the treatment room. If the psychotherapy treatment is a tele-mental health session, forms will have been completed and returned to the psychotherapist, prior to the scheduled first psychotherapy appointment.

 

Once in the treatment room or on Zoom with the psychotherapist, the process involves clarification and verification of information included on the “Confidential Client Intake Form,” information gathering, including background information, as well as the reason for the visit, his/her view about psychotherapy, expectations, and how the client sees the ‘problem’ that called for him/her to make the visit. The first psychotherapy session is a time for the psychotherapist to bond with the client to foster trust and openness.

 

The psychotherapist is the expert and should be able to help the new client to get through the first session without fear and without trepidation. He/she is being paid to set the tone and to guide the process of the psychotherapy session for the client. My first psychotherapy session is ninety (90) minutes. I start with conversations regarding ‘how they are doing,’ including their thoughts and feelings. I then ask the question, ‘what’s going on,’ focusing on their nonverbal behaviors, feelings, thoughts, insights, as well as gains and/or losses in the here-and-now. I interweave their thoughts and feelings about pre-therapy experiences into the session. I use open-ended questions, humor, and I also focus on nonverbal communication presented by the client. Their moments of silence are brief and reflective. And if, on those rare occasions their moments of silence extend more than a couple of minutes, I inquire about their silence, focusing on their thoughts and feelings in the here-and-now, as well as the meaning of the silence. 

 

The feelings of my clients are always worth discussing, especially during the first session. They are personal and are not often provided a true, uninterrupted, and honest opportunity to discuss their feelings without shame, guilt, or fear of a loss of confidentiality. Conversations about their children, grandchildren, as well as vacations, trips, and leisure activities are always great topics for discussion during the first and ensuing psychotherapy sessions…they are personal.

 

Clients should be allowed to ask the therapist about external and general topics that might be of common knowledge about the psychotherapist (school, work, favorite foods, favorite TV/radio shows), as opposed to asking personal, internal, and private topics (marital, sexual, family, financial). Topics that can cause either transference or counter transference are not great discussion topics between a therapist and his/her client. It is important that the psychotherapist set the tone, while setting boundaries with their clients for discussing his/her life. It is important that the psychotherapist shows humanness, a sense of humor, as well as compassion and positive regard for the client.

 

 By the end of the ninety (90) minute first psychotherapy session and after completing a “Mental Status Exam” worksheet, the experienced psychotherapist should be able to develop a diagnosis based on the DSM-V (Diagnostic Criteria Manual). However, nothing is etched in stone. The psychotherapist is responsible for developing an effective treatment plan with the client for follow-up sessions as directed by the client’s diagnosis, and to make necessary referrals if warranted.

 

If you or a loved one need mental health treatment, please contact either of the following:

 

1.    Mental Health Hotline--988

2.    NAMI--800-950-6264

3.    SAMHSA—800-662-4357

 

 

 

©2023; J. Morley Productions, Inc.; P.O. Box 1745; Decatur, GA 30031; 770-808-6570; www.doctorjoyce.com

 

Signs It's Time to Cut Ties with Toxic Friends

True friends are very hard to find, especially in this fast paced society of ‘what can you do for me?’ It is important that you recognize, everyone you meet is not your friend. Some are couriers, with the intent of only delivering something to you (information, direction, etc.). Others are short-term parkers, there to get you through a temporary situation, and then move on. Still, there are the monthly parkers who are those people you meet who play various roles in your life, but not on a regular basis, just when you need them. Finally, there are the lifetime parkers, who are those true and genuine friends in your life for the long haul. This friendship is like a marriage that is only consummated through a commitment to and with each other by acts of loyalty, respect, and trust. This friend sits at your personal board of director’s table. This friendship is a ride or die, got your back, call you out, hold you up, no matter what friendship.

 

When you are in a true friendship and there are signs that things are going awry, there are somethings I suggest you consider before ending the friendship, such as the level of the friendship, including the links that hold the friendship together, the longevity of the friendship, the love within the friendship, the landmarks that have solidified the friendship, as well as the lights that keep the friendship alive.

 

However, there are some friendships that have occurrences that become deal breakers. If you won’t drink from the bottle under your sink with the skull and crossbones due to the level of toxicity, why should you remain in a toxic friendship? Here are just a few of those toxic occurrences that can be friendship deal breakers that indicate this friendship is over!

 

1.     When you begin to realize your so-called friend has become a liability, rather than an asset A true friend should not only have your back, but he/she should also stand with you, side by side, through thick and thin, and through the good and the bad. A true friend should not only add value to you and the relationship, but he/she should also enhance who you are as an individual. When a friend is no longer supportive and you begin to doubt the relationship, you no longer trust his/her intentions, or you have to look over your shoulders because of the unpredictability of your friend, it’s time for you to begin to assess the value of the relationship. You must decide if you are in a true friendship of respect and love for each other or are you in a situation of convenience for selfish reasons being put forth by either of you. A true friendship comprises a relationship for the long haul, where a convenient situation is only for the short haul. If the friendship is not genuine, growth producing for you, as well as your friend, and the relationship itself, it’s time for you to cut all ties with your friend. 

 

2.     When your friend has become too costly emotionally, psychologically, spiritually, socially, and sometimes physically, it is time to let him/her go When the burdens of your friend become too much for you to bear because he/she piles personal and other burdens on you without considering your emotional, psychological, spiritual, and physical strength, it might be time for you to let that friend go. Friends are supposed to stand for and with each other. However, when your friend constantly, carelessly, and selfishly pulls you into mess, causing unbearable stress, and strain, when you have asked for relief to no avail, it’s time for you to make a decision about the value and the worth of having this person in your life. When your friend decides that you should be miserable due their misery and keeps getting involved in craziness that can cause you to lose your mind, your spirit, your religion, your relationships, your job, your home, your freedom, and anything else that can cause you to lose yourself, let him/her go! He/she is NOT your friend!!

 

3.     When the relationship becomes one of convenience and has no benefit to you If your friend is constantly taking and not giving, at your expense, it is time to let him/her go. He/she is always borrowing something from you, including your clothes, money, your mate, your car, your time, etc., while giving nothing in return, it’s time for you to consider the value of your friendship. When you are being misused, instead of used, it’s time for the so-called friend to hit the door, Is it a real and true friendship, and is it worth being with this person or not??? A friendship should be a reciprocated process and each of you in the relationship should yield a return, with consistent acts of give and take. When your friend takes more from the friendship than he/she gives to the friendship, as far as time, effort, and energy, making more withdrawals than investments, it’s time to call it quits.

 

4.      When your existence as a worthy individual is being threatened When your integrity, standing in your community/career field, your brand, your image, and your credibility are being threatened because of rumors and lies being spewed and spread by your friend or because of your friend, it is time to cut the relationship. When your friend becomes the spoiled apple in the barrel while in the barrel with you, it’s time to walk away from what is no longer a friendship. As a matter of fact, because of these actions, the friendship is no longer a relationship; it’s a situation! It no longer has any merit or longevity. Any situation that causes you to no longer be you is most certainly not the best for you! You can always get another friend, but it’s difficult as hell to get your good name back!

 

5.     When your friend is involved in a toxic situation with his/her mate and constantly complains or cries to you about it, without a willingness to seek help or take action When your enabling and constantly complaining friend tries to pull you into his/her enabling cycles of toxicity and/or abuse and misuse, it is time for you to take a break, stand back and decide if things will get better or are getting better or worse. When your friend constantly complains to you about their toxic situation, but they make no effort to help themselves, as they usurp your time, your energy, and your spirit, talking about the situation on a daily basis, it’s time for you to observe and no longer participate. And when your life could be in danger because of his/her dangerous situation, it’s time to move on. If your friend won’t quit, you must quit!

 

6.     When your friend is bold enough and disrespectful enough to sleep with your mate It’s past time to let this so-called friend go when he/she crosses very personal boundaries and violates all levels of trust and loyalty of the friendship. It’s time for you to cut all ties with your backstabbing friend who has become a foe. If your friend betrays you once, he/she will betray you again. And if the betrayal is not against you, it will be against someone else either close to you or someone you know. This so-called friend is a liability and not an asset, who has been and is jealous and envious of you. If he/she sleeps with your mate, what else will he/she try to take…your life? Get out of that situation with both of them, your friend, and your mate! They are both betrayers with no care and no respect for you, the friendship, or the relationships. Once a cheater, it is difficult to not cheat again. You might eventually forgive, but you will never forget. You deserve better. As a matter of fact, you ARE better!!!

 

7.     When your friend finds an intimate partner and begins to treat you like a discarded toy When your close friend finds that girl or that guy and begins to ‘kick you to the curb,’ to pick up and use you when convenient, it’s time for you to assess your friendship status. Females are more likely to kick their best girlfriend to the curb when they find that person thought to be a keeper, compared to males. When you become a light switch to be switched off and on or a doorknob to be turned whenever entry is desired, based on the whims of your best friend, because of their intimate relationship, it’s time for you to find the friendship exit door yourself. When the phone calls and levels of effective communication become weeks and months apart and their memory of the friendship becomes an ‘I forgot,’ it’s probably time for you to forget your friend. He/she seems to have forgotten you. True friendships can still exist when one or both friends find an intimate partner. Clearly, there won’t be as much time spent together in the friendship as occurred prior to the new intimate relationship, but true friendships can be maintained with boundaries. The reality is that your new intimate relationship might become a situation much sooner than expected, while your true friend has been there for the long haul. If you are willing to diss your friend for someone new, you weren’t in a friendship from the onset.

 

 

©2023; J. Morley Productions, Inc.; P.O. Box 1745; Decatur, GA 30031; (770) 808-6570; www.doctorjoyce.com

Loving With Boundaries

 

The month of February is the month of love. However, every month should be a month of love. As a matter of fact, it would be awesome if love was in the air daily! With more than seventy-five mass shootings, hundreds of school shootings, earthquakes, and other national and global tragedies and disasters that have occurred and are occurring, many are crying out for love. Unfortunately, many don’t know how to define love, how to give love, and just as many don’t know how to accept love.

 

 There are many of you who believe that Valentine’s Day will create a fix if you can at least have love for one day. The reality is, because you are, you were endowed with love on the inside from birth. Unfortunately, many of you are so busy looking for love on the outside, in your efforts to fix or fulfill the seeming lack of love on the inside, that you become desperate. When you are desperate for love, it is easy to fall for the wrong person, falter in the choices you make, or you will fail by getting with and giving your love to the wrong person.

 

For you to be successful with an external love, you must first be successful with your internal love, by loving yourself. You will not be able to be with someone else until you learn how to be with you. It is imperative for you to remember that love can be a noun or a verb. If you have self-love, it is easier for you to show the love you have for yourself. Your active self-love allows others to see how you treat yourself, what you will and will not accept, and that you will only stand for what’s best for you. Your self-love will show that you are not willing to just stand for anything, accepting anybody. You have clear expectations and standards regarding what you are looking for, what you expect, and what you will accept in a potential partner. When you have self-love, you are not desperate to be with somebody, allowing yourself to get with anybody, who turns out to be nobody.

 

Self-love, the noun, allows love for self. The action verb of love emanates from you to the world. That love will show in your walk, in your talk, in your dress, and the fact that you will not settle for mess. You won’t fall for the first person who comes along, and you won’t keep wasting your time and your life, searching for love in all the wrong places, with all the wrong people. With your self-love, you will also not wait until February to try to fill the loneliness you feel, because you recognize that although you might feel lonely, you are never alone. You recognize that God is with you first and always, and you are with you forever and a lifetime.

 

If you are looking on the outside to fill that seeming void you feel on the inside, you will be searching for quite some time. Your efforts to be with someone else and love someone else must come from within your love for yourself. It cannot be predicated on if, and when someone else loves you. You should expect love in return if you give love, but you must not let whether love is reciprocated to you or not, serve as a condition for you to love others. However, you must be careful, cautious, and have boundaries as to whom you decide to let into your heart, let into your life, and with whom you share your love.

 

The problem isn’t so much that you love someone, as it is you finding yourself in love with someone who doesn’t love you back. The Bible calls for loving your neighbor, but it does not call for you to be in love with your neighbor. Here is where the boundaries come into play. You can love everyone without boundaries but cannot throw yourself into situations of being in love with others, without boundaries. You also must have clear and consistent boundaries as to whom you give permission to enter your love realm. Just because he/she says, ‘I love you,’ what is he/she doing to show you that this love is true? Further, don’t be so desperate to be loved, that you become boundaryless, allowing words to become your guide, with no evidence or action.

 

It is important for you to remember, that you not only have a choice and a say as to who you love, but also as to with whom you allow yourself to fall in love. You also have a choice as to whom you allow to take up space in your heart and in your head, especially when he/she is not paying rent. Take your time, be patient, and don’t just allow others to choose you, but have a say and a choice as who you allow into your life and to who you love, especially with whom you fall in love. Desperation can land you at the wrong destination. You don’t have to look for love, it’s already right inside of you. It’s time for you to give love and accept love with boundaries, giving way for balance between your head and your heart, opening doors for a life filled with happiness and wholeness.

 

Remember, your soul is already connected to and with Gpd. Everyone you meet is not your soulmate. Some people serve as couriers in your life, some as short-term parkers, some are long-term parkers, and then there are the life-time parkers. When you have self-love, you will be able to decern and decide, who fits where, and recognize, everyone has a soul, but he/she is not necessarily your soulmate. Love with boundaries, three hundred and sixty-five days a year!

 

 

 

©2023; J. Morley Productions, Inc.; P.O. Box 1745; Decatur, GA 30031; (770) 808-6570; www.doctorjoyce.com