I am thinking about starting psychotherapy. I’m going to start by phoning a few therapists. How can I tell if the therapist I start with will be right for me?

Sincerely,

S. C.

Dear S. C.:

Thanks for your question. I agree with you that it is a good idea to speak with prospective therapists by phone as a first step. A prospective therapist or counselor should be willing to give you 10 or 15 minutes of their time to speak with you by phone. If they are unwilling to give you this time to make sure that there is a good fit between what you need and what they can offer, then I would suggest that you cross them off your list and call someone else.

All successful psychotherapy depends on a good relationship between the patient and the therapist and on your participation with the therapy. In order for the therapy to be successful is important that you have a feeling that the therapist understands and respects you, that the therapist approach makes sense to you, and that the therapist is going to work on the goals that you bring with you. Here are a few things to consider with regards to finding a therapist who is right for you:

1. If you don’t like your therapist, find another one. Don’t be shy about this. No therapist can be right for everyone who might need help. If you get a bad feeling or vibe from your therapist, trust your gut and go see someone else.
2. If you think that your therapist doesn’t like you, understand you, or appreciate your point of view, then find another therapist. It is very important that you believe that your therapist is on your side. They do not have to agree with you all the time, but it is important that you feel that they have your best interests at heart. If you have a problem with your therapist, discuss it with him or her and watch their reactions. If they do not appreciate your point of view and show a willingness to change how they deal with things, then you should get a different therapist.
3. If you do not agree with the goals of the therapist, or if you do not think the goals that the therapist is working towards are right for you, then find another therapist. It is very important that the therapist agrees with your goals and that the sessions are designed to help you meet your goals.
4. If you do not agree with the opinions or suggestions that your therapist makes, or if you are asking for something and not getting it in the sessions, and your feedback about these things to the therapist doesn’t change her or his approach, then find another therapist. Your therapist might suggest an approach that you hadn’t considered and, after discussing it, you may be willing to give it a try. However if you do not want to use the approach that the therapist has suggested, and they are not willing or able to change the approach to something that seems more relevant to your needs, and a better fit for you, then you should find a new therapist.
5. If you think that your therapist sees your problem or situation as hopeless or unchangeable, or as something that would take years to change, then find a new therapist. You do not need a pessimistic therapist. Find someone who can understand your problems and who can offer an approach that can help you start to change things.
6. If nothing positive starts to happen within the first 3 to 6 therapy sessions, talk to your therapist. If after talking things over there is still no progress, then find another therapist. If change is going to happen in therapy it usually starts relatively quickly. This doesn’t mean that everything will be “cured” within six sessions, but you should be able to notice some change or improvement that can let you know that you are on the right track. If there are no signs of such improvement in the first six sessions it is very unlikely that additional sessions will make a useful difference. If there is no progress in the first six sessions, then find another therapist.

These tips are based on 40 years of research about how to make psychotherapy effective. This list is adapted from the work of Barry Duncan. If you’d like more information about the tips have a look at his self-help book, What’s Right With You.

F.V.

Dear F.V.

Thanks for you question. I have heard this kind of question before. I am sure that you could be comfortable in our MBCT groups. Over the years I have had a number of Christian ministers, priests and other religious workers take part in the mindfulness groups that I offer. None of them ever had a problem with my approach and some clergy who do pastoral counselling have referred members of their congregations to my mindfulness groups.

The mindfulness training that we offer is based on psychological principles and techniques. Our programs do not involve any religious beliefs or rituals. A few weeks ago a man who came to my office also asked if the MBCT groups had “anything that would be a problem for a Christian.” As a joke I warned him that “we do ring a bell” to start and stop the meditation training session. He smiled and reminded me that Christians have also been using bells for rather a long time. If you have any more specific questions about mindfulness and religion, please feel free to call our clinic at any time.

Hope this helps,

Dr. Kelly

• People who are more mindful are less likely to experience psychological distress, including depression and anxiety. They are less neurotic, more extroverted and report greater well-being and life satisfaction.
• People who are more mindful have greater awareness, understanding and acceptance of their emotions, and recover from bad moods more quickly.
• People who are more mindful have less frequent negative thoughts and are more able to let them go when they arise.
• People who are more mindful have higher, more stable self-esteem that is less dependent on external factors.
• People who are more mindful enjoy more satisfying relationships, are better at communicating and are less troubled by relationship conflict, as well as less likely to think negatively of their partners as a result of conflict.
• Mindfulness is correlated with emotional intelligence, which itself has been associated with good social skills, ability to cooperate and ability to see another person’s perspective.
• People who are mindful are also less likely to react defensively or aggressively when they feel threatened. Mindfulness seems to increase self-awareness, and is associated with greater vitality.
• Being more mindful is linked with higher success in reaching academic and personal goals.
• Practising meditation has repeatedly been shown to improve people’s attention, as well as improve job performance, productivity and satisfaction, and to enable better relationships with colleagues, resulting in a reduction of work-related stress.
• People who are mindful feel more in control of their behaviour and are more able to override or change internal thoughts and feelings and resist acting on impulse.



• Meditation practices more generally have been shown to increase blood flow, reduce blood pressure and protect people at risk of developing hypertension; they have also been shown to reduce the risk of developing and dying from cardiovascular disease, and to reduce the severity of cardiovascular disease when it does arise.
• People who meditate have fewer hospital admissions for heart disease, cancer and infectious diseases, and visit their doctor half as often as people who don’t meditate.
• Mindfulness can reduce addictive behaviour, and meditation practices generally have been found to help reduce use of illegal drugs, prescribed medication, alcohol and caffeine.

Mental Health Foundation (2010) Mindfulness Report, London.
Executive summary available from Be Mindful UK.

I have OCD. Sometimes I am late for work because I have to keep rechecking my front door to make sure it is locked. Once I was halfway to work and I had to go back to check the door. Part of me knew better but I was too tense to just leave it. I could give you a million other examples, of having to check the stove, the lights, the bank card in my wallet… I have had this problem for years. It gets worse when I am stressed. Can mindfulness help for my problem? I have been taking medication but it has not fixed my problem.

-Concerned about OCD

Dear Concerned,

A few years ago someone saw me for a consultation. His problem was very similar to yours. I used a psychometric test to confirm his diagnosis and then I reviewed his problem with him and gave him some advice. I recommended that he read Brain Lock, a book by Dr. Jeffrey Schwartz. The book explains a 4 step approach to using mindfulness to get obsessive thoughts and compulsions under control. He thanked me for the advice and said that he would call if he wanted another appointment. I did not hear from him for 2 months. When he came in for the second meeting he said “I have a family problem I want to talk over. I don’t need any more advice about OCD–my symptoms are 80% better. I read Brain Lock and I have been using the 4 steps every day. It was hard at first but now my symptoms are pretty easy to control. Thanks for recommending the book.”

If you would like to read a short article about the 4 step approach, have a look at this website. To watch Dr. Schwartz explain the 4 steps, have a look at this video.

I was very pleased that my patient had been able to make so much progress after reading the book. At The Mindfulness Clinic we always try to help people improve quickly. I suggest that you purchase Brain Lock and give the approach a try if the information in Dr. Schwartz’s video makes sense to you. I have recommended Brain Lock to dozens of people with OCD symptoms and most of them have found it to be very useful. If you find that it is hard to apply the 4 steps, it may be worthwhile for you to find a mindful psychotherapist who understands the method so you can get some coaching and guidance. It is not easy to overcome OCD but the 4-step method will give you a very helpful tool for taking care of yourself.

Regards,

Dr. Kelly

Here in Toronto there is a vibrant community of health professionals, called Mindfulness Toronto, which meets each month to share information and practice together. Check their website for information about how to join. The community welcomes new members.

Here at The Mindfulness Clinic we also support health professionals and students who want to practice mindfulness meditation.

On the third Saturday of each month we host a meditation retreat day for them so they can deepen their meditation practice and share in discussions about how to use mindfulness to take care of themselves and help their patients.

We have been joined in our downtown Toronto office by psychologists, physicians, social workers, psychotherapists, massage therapists, chiropractors, pharmacists and others. Find out more about our retreat days here, and come along if you’d like to experience one yourself.

I have realized over the past few years that I have ADD.  I am in my 40s now.  I used to think that my attention problems were caused by depression.  Now I know that there is more to it than depression because I have had treatment and my depression is much better.  I want to cope better with my ADD symptoms and I do not want to take medication.  Would mindfulness meditation training be helpful for me?

-T. R.

Dear T.R.,

Thanks for your question.  It is fairly common that  people not to realize that they have Attention Deficit Disorder (ADD) until they are adults.  The good news is that you can learn to control how you pay attention.  Training for this can help you to stay focused better and help you overcome some of the limitations caused by ADD.  There is a lot that you can learn to do that will be helpful without taking medication.  Mindfulness meditation training could help you to improve your attention skills.  This book will be published soon and it can give you some useful advice:  The Mindfulness Prescription for Adult ADHD: An 8-Step Program for Strengthening Attention, Managing Emotions, and Achieving Your Goals by Lidia Zylowska.

Mindfulness training can be challenging for people with ADD but the training would help you feel more in control and  be more productive.

I’ve been living with chronic fatigue and fibromyalgia for a number of years. Recently my doctor suggested that I should start meditating. How can meditation help me? Do you have any advice on how I should get started?

Thank you,

C.F.

Dear C.F.,

I have helped many people who have been living with chronic fatigue syndrome and fibromyalgia.  Your doctor has made a good suggestion for you.  Training in mindfulness and meditation can certainly help you to better deal with these problems.  If you would like to learn how and why meditation can be helpful, have a look at this video Lessons from Mindfulness Meditation & FM/CFS Research. More resources for fibromyalgia can be found here (MSN article) and here (PDF article from Psychotherapy & Psychosomatics). For chronic fatigue and mindfulness, take a look at this journal article.

Information in the links explain what mindfulness is and how it can help people who have fatigue and pain problems.  You are also welcome to contact me if you would like a consultation about how mindfulness training might add to what you are doing now to take care of yourself.

If you would like to get a taste for mindfulness meditation, try one of the free meditation instructions on our website.  The 30 minute guided meditation might be a good one to try.

I know that your problem can be frustrating.  You can trust that it is possible for you to learn and use meditation to help you suffer less and begin to do more day to day.

All the best,

Dr. Kelly