How to get better

I’m a research psychologist, not a therapist, but I get a lot of requests for how to find the right person to work with on mental health issues. For people just starting the process, here’s my take on how to approach getting better.  

First of all, congrats for deciding to do better for yourself! I may or may not know you personally, but for damn sure I know you don’t deserve to feel shitty all the time.

There are three main things that help people: 1) having a good, deep, quality relationship with a person giving you care 2) gaining a better story about what’s going on with you that helps you cope with the demands in front of you; and 3) learning to relax and feel what’s happening in your mind and body, so that you can respond better in the present moment. 

Finding a modality (that is, your therapist’s theory about what’s wrong and best practices for how to fix it)

Here’s the tricky part. I don’t know what’s wrong with you, and chances are, your therapist doesn’t exactly know either, though they may be able to make a variety of educated guesses. In this day and age, with so many choices, you are going to have to consider yourself not a patient to be healed by an expert, but a partner in making your life better.

So what modality should you look for?

Most people seeking help have symptoms of anxiety and/or depression. Any therapist in any modality can potentially help you with these. However, they are often part of a larger picture, involving unresolved trauma, addiction, brain disorders, or other factors, and working directly on those conditions is often useful.

If you have trouble with dissociation and freezing, or anxiety and hyper-vigilance, or you generally can’t put your finger on what’s wrong, somatic therapy, EMDR, or trauma therapy can work wonders.

If you find yourself making bad choices, cognitive behavioral therapy will help you learn how to think things through for better outcomes.

If you need help tackling a present-time problem – for example, you need to get better habits in your life, or need some specific strategies for addressing a leadership, health or wellness issue – try coaching. A coach should help you move toward your goals by setting up some structures for you, acting as a mirror so you can see your blind spots, holding your feet to the fire about results, and being present to give you a pep talk/strategy session when things don’t go the way you planned. What they won’t do is dig too deep into root causes – say, your emotions or childhood problems. That’s therapy.

For anxiety and ingrained habits, hypnosis can be pretty great. It can help you learn to calm down and feel safe, which is super important to recovery from all kinds of things. Mindfulness, embodiment, self-compassion, and meditation can all help with those too. 

For addiction and alcohol: This one’s tough. Everyone thinks of AA first, but honestly it does not have as great track record of helping people recover as you would expect. There are all kinds of alternatives, like Smart Recovery, which, instead of focusing on abstinence, focus on reducing the harm that comes from drinking while you work out the problems that drive you to drink too much. Addiction, like a lot of mental health problems, seems to be related to feeling disconnected from other people. Whatever path you choose, heal your relationships, don’t isolate, and get involved in helping other people, if you can, even in some small way. It seems to help.

If you think you may have ADD/ADHD you may want to try meds. For this you’ll need a psychiatrist - as they are medical doctors, they are the only ones who can prescribe pills. Few psychiatrists still do therapy, and I would strongly encourage anyone who wants to try any of the wide variety of ADD meds to also work with a therapist for a much better and long-lasting outcome.

 Finding the right person

I can’t legally tell you that the degree doesn’t matter.  Only therapists licensed in California may perform therapy, i.e. helping you deal with clinical-level mental health issues and solve the problems of the past.  A licensed person has had years of training, testing, and supervision to make sure they are behaving ethically, not straying too far from the evidence base, and are not doing harm – something your average shamanic healer or life coach cannot attest too.

That said, research has shown that it’s the quality of your relationship with the therapist that contributes the most to a positive outcome, and no diploma can promise that.

The right therapist is some who “gets” you, but doesn’t buy into your bullshit.

The wrong therapist is anyone who:

  • Triggers you by reminding you of an old relationship (even if it’s through no fault of their own, like their appearance or tone of voice)

  • Believes they have all the answers to your problems right away

  • Puts more pressure/challenge on you than feel is just or doable

  • Has a story about what’s going on with you that doesn’t ring true for you

What about the, um, off-label stuff? NLP, sound baths, vitamin deficiencies, etc. 

As I said before, there are three main things that help people: 1) having a good, deep, quality relationship with the person giving you care 2) gaining a better story about what’s going on with you that helps you cope with the demands in front of you; and 3) learning to relax and be more aware of what’s happening in your body and mind, so that you can respond better in the present moment.

Those things are not merely the province of licensed professionals; regular ol’ humans have been helping each other since the dawn of time, and today’s outré method often contains seeds of tomorrow’s wonder modality.

I want you to remember that you are in charge of your own healing, and chances are, even if the diagnosis is clear, the remedy is not. It’s going to take some experimentation and learning to find something that really works for you. To the extent your resources will allow, try different things, and record what you learn. Mix it up.

That said, not all modalities are equal, and probability is meaningful. I’m not saying don’t try reiki for, say, bipolar. If 1000 people are diagnosed with bipolar, it’s likely that one of them got better by receiving a shit-ton of reiki, and that 600 of them got better with a round of meds and a regular therapist. Sure, meds and therapy are not 100% effective either. But are you planning to be that one outlier? Do you feel lucky, punk? Don’t play dice with your recovery – your time on earth is too precious for that. Try lots of stuff, keep trying stuff, pay attention to what works and do more of that.

But what about the placebo effect?

The placebo effect is real. And if something is working for you – and it’s not causing anyone else harm or draining your bank account – then really, who cares if it’s the thing doing the work, or your belief in the thing?

As a person who has spent years pursuing self-healing, I have run into plenty of practices that were super helpful toward improving your life, but which tended to promote a theory for explaining human behavior that was just ridiculously, laughably wrong.  In the course of pursuing my Ph.D., I’ve also run into plenty of theories of human behavior that are inarguably accurate, and yet totally useless for helping you change your behavior or feel one jot better.

Don’t be that guy who confuses the two, shouting from the rooftops how the modality or theory that helped them is the only one true way. Take what works and leave the rest.

So, even though you are at the beginning of the journey, congratulations. You have chosen to get better, which not everyone in pain manages to do. No one knows how much better you’ll get – maybe you’ll become the superhuman you hope to be, maybe you’ll be able to do a few things you couldn’t before, maybe you will just remove a little suffering from the equation. No matter what, I do know that actively seeking help is superior to pretending everything’s fine. If you work with your reality, it will get better. I believe in you.

Sliding scale counseling centers in Southern California

If you have health insurance that covers mental health, start there and find a therapist the way you’d find any other doctor. If you don’t have mental health coverage, you may be interested in this list of centers that offer low cost therapy with a counseling intern. (Don’t be fooled by the term “intern”: they all have at least a master’s degree and will get a lot of support and supervision). I am told fees start at $20 per session.

To use these services, call the number to make an appointment. All of these centers will do a beginning “intake” session (usually with a fee) that will go into some depth about what’s going on with you, so that they can make a good therapist match for you. You should know that you will have to sit with other humans in the waiting room, so if strict privacy is a concern for you, you should try a private therapist and not a counseling center. This list is not exhaustive. If you know of a center I should include - particularly on the East Side - let me know!

Southern California Counseling Center, MidCity-ish, (323) 937-1344

Phillips Graduate Institute Counseling Center, Chatsworth, (818) 907-9980

Antioch Counseling Center, Culver City, (310) 574-2813, ext. 366

Maple Counseling Center, Beverly Hills, (310) 271-9999

Airport Marina Counseling Center, (310) 670-1410

Sunrise Community Counseling Center, (213) 207-2770

Kim Perkins