Oak City Psychology

Serving the City of Raleigh and Surrounding Areas

Author: Kimberley L. Benton Psy.D. (page 3 of 3)

Attacking the Science of Psychology

On October 2, 2009 a Newsweek article caught my attention that I just can’t stop thinking about. Granted, I am a few weeks behind in my reading so I really just read this about 2 weeks ago, but that’s beside the point. In this particular artical (Ignoring the Evidence) Sharon Begley makes the assertion that therapists do not understand nor use evidence based treatments in their practice. She also asserted that Clinical Psychology programs did not teach students how to be consumers of the literature. In addition, she implies that cognitive and behavioral techniques are the only interventions that can work in therapy. By the time I finished this article, I was incensed. Since that time, I have been ruminating about her article and decided to take some of my own advice and journal (or in this case blog) about it.

I think the main reason this article made me as angry as it did was that it only perpetuates the feelings that are already out there among people considering therapy. They’ve seen every episode of Law and Order where the therapist is sleeping with her clients and killing their spouses. They’ve seen all the news stories that talk about rebirthing “therapy.” All Ms. Begley, who, by the way, does not hold a degree in psychology, did with her article was create yet another stereotype. This is the therapist who despite the science, continues to use treatments that do not and will not work. Along with this stereotype, Begley also seems to be saying that psychology consists mainly of hocus pocus and maybe a little bit of luck.

To me, this was an extremely dangerous article that had the potential to dissuade someone on the fence about therapy from getting the help they need. Of course, as in every profession, there are some therapists who don’t know what they’re doing or who use interventions that harm rather than help their clients. Contrary to what Begley would have us believe, this is not the norm. Here are the facts about therapists and their training in research. Every doctoral level therapist has completed at least two courses in research design and statistics, most have three. They also have to complete a research project in which they either conduct their own original research or use the research of others to propose a new theory. If there therapist graduated from an accredited program, they also learned to consume the research of others and apply it to the work that they do. And what of Begley’s assertion that cognitive and behavioral therapy is the only therapy supported by research. That is blatantly not true. In reality, the bulk of the research shows that the strength of the relationship with your therapist is what really determines outcome, not which technique said therapist uses. Does this mean that if you have a good relationship with your therapist that any technique will work? Absolutely not, and I don’t know a therapist who would make this assertion. Every therapist knows that some techniques work better for some problems than others. For instance, if you are going to therapy in order to conquer your fear of flying and your therapist is analyzing your relationship with your father, you may want to find a new therapist. Sure, any therapist worth their salt will learn something about your family history in the first few sessions. But that therapist will also know that the best way to treat fears is to expose the person to the feared object or situation and help them reduce their anxiety.

It is always important for a profession to take a critical look at its shortcomings. This is especially true in psychology where others put their trust in you at their most vulnerable. However, false allegations only hurt those who truly need the help that therapy can offer when done well. If you are in therapy now and feel that your therapist is practicing below an acceptable level, then you should find a new therapist. You should also express your concerns to whoever oversees the licensing process in your state. It is their job to protect the public and ensure a standard of care. If you ever have questions about what your therapist is asking you to do, voice them. Regardless of how good your therapist is, you will only get out of the therapy what you put into it. Oh, and if your therapist starts talking about rebirthing – run.

Putting the Thanks back in Thanksgiving

According to the popular history of America, the first Thanksgiving was celebrated with the Pilgrims and Native Americans in honor of the collaboration and new friendship between the two groups. It was time to give thanks for not dying during the first hard years in the New World and to honor the Native Americans who taught the newcomers how to live in this new world. Over the years Thanksgiving grew into a national holiday devoted to remembering the blessings of the past year.

Unfortunately, for a lot of Americans it has also become a time of extreme stress. Many people find the tension of a large family gathering difficult because of unhealed wounds. Many people feel pressured to present the “perfect” picture of Norman Rockwell happiness with perfectly carved turkey, homemade sides, and amazing desserts all displayed alongside perfectly manicured children who haven’t destroyed their special clothes for the occasion. This image is exploited by the advertising company in hopes of pressuring a few bucks out of those desperately searching for perfection at the holiday.

Between trying to balance family tensions and the pressure of creating the best meal yet, the true meaning of Thanksgiving can get lost. Now, I’m going to make a kind of extreme statement here, but I think it’s accurate. I think this loss of meaning for a holiday focused on blessings is a symptom of a greater problem in our society right now. For years, the western hemisphere has become obsessed with image and acquiring the newest and best. In this kind of environment, we have forgotten to look at the things we have and to live in the moment. This focus on the future and inability to find contentment in the moment leads to feelings of worthlessness at not being able to keep up with the Joneses, feelings of helplessness when factors out of your control (can anyone say economy) wreak havoc on your finances, worries about how you’re going to maintain the standard you have set for yourself, and a desparate search for something to numb the pain.

It is easy to see the descriptions of depression, anxiety, substance abuse, and eating disorders in the previous paragraph. New research also shows some interesting connections between thankfulness and decreased depression and anxiety. One study found that participants who wrote down three things they were thankful for each day for three weeks saw an improvement in depressive symptoms for SIX months. Something as simple as being thankful decreased depression to a significant level.

So in honor of Thanksgiving, here are some ideas about bringing some of the true nature of the holiday into your holiday. In short, putting the Thanks back into Thanksgiving and getting rid of some of the stress, pressure, and family drama out.

1) Prior to the chaos of preparing the meal, tkae time to think about what you truly want people to feel while enjoying the products of your work. If you are honest with yourself, you probably want to impart a feeling of love and caring in your family as they enjoy each other’s company.

2) While preparing your meal, remember times from the past that were happy or made the holiday so special for you. Whether you’re cooking the traditional meal or bringing home Boston Market, focusing on you true purposes behind these preparations will help take some of the pressure off creating the perfect meal.

3) For that matter, get everyone involved in making the meal together. Rather than making the entire meal on your own, invite your family into the kitchen with you to share in the process of creating a meal together. Or, just have everyone bring a side dish. It will give you more time to relax before the family descends and leave you with a lot less clean up.

4) Whether or not your family prays prior to the meal, you may want to try to incorporate a way to share what you are thankful for just before the meal. It is nice to stand in a circle, hold hands with your loved ones, and give thanks for your blessings.

5) After the meal participate in something that has the family interact. If you all love football, by all means watch the game together. But, if that’s not your thing break out the board games, go for a walk, or simply sit by the fire (hopefully it’s cold enough for that).

These are just a few ideas to get you thinking about what this special time of year should really be about. I have a feeling that there may be a move back to the roots of Thanksgiving, simply because the financial hardships many are facing make it impossible to create the extravagant feasts that may have been a part of the past. Even in these tough times, the people who survive and even prosper are not necessarily the richest. Our lives are not about the things that we accumulate but about the times we spend with those who lift us up and bring us peace. I hope that you and yours are able to reconnect with the true thanks giving that this holiday is all about. Happy Thanksgiving.

Simple vs. Easy

I had a client say to me recently, “Just because it’s simple doesn’t mean that it’s easy.” This hit me as such a profound statement. I think it’s probably something we are all aware of on some level, but never actually verbalize. Some of you reading this might be thinking, “Wait a second, I learned about synonyms in elementary school and simple and easy definitely have the same meaning. So I got a little curious and looked up the definitions of each word.

Let’s start with simple. Dictionary.com provides 29 definitions for this seemingly simple word. For our purposes the two best definitions are “not complicated” and “easy to understand, deal with, use.” To me this implies something that has minimal steps and can be explained in about 3 words. Comparatively, easy had much fewer definitions, with a grand total of 17. Again, two stand out as the best for psychological purposes, 1)not hard or difficult, requiring no great labor or effort and 2)free from pain, discomfort, worry, or care. So, while we may have learned that simple and easy were synonyms in elementary school, when we really look at the meanings, simple seems to refer to the plan or the steps involved in a process while easy applies more to the effort required to carry out the plan.

OK, so now that we’ve had our grammar lesson for the day, what could this possibly have to do with psychology? It comes back to my client’s observation that while something may be simple, it most certainly will not be easy. This seems to be an innate understanding that anyone who has ever had therapy has. Anyone who has sat with their therapist discussing their depression will at some point express shame or guilt about not being able to follow through on the steps they know are necessary to feel better. And for the most part they are not difficult steps. The steps tend to be along the lines of get out of bed every morning, take a shower, eat breakfast, and participate in one activity that you enjoy. Simple? Yes. Ease? No. Being depressed is similar to having the worst flu you’ve ever experienced except no one seems to believe that you’re really sick. Can you imagine having the flu and getting the message from loved ones that you are weak because you became sick?

The same thing occurs for almost every psychological concern. Friends and loved ones become frustrated with the person who is depressed or anxious or addicted because they can’t seem to follow the simple steps to recovery. It is similar to people who blame battered women for staying in abusive relationships. While the steps are simply – pack your bags, grab your kids, and run like hell – they are far from easy. Wouldn’t it be more useful to help the person discover what keeps them from taking the steps, rather than to blame them for not making it look easy? Sometimes it is necessary to understand the system that keeps the simple steps from being easy. Nothing in life is easy; anyone who has walked out their door recognizes that. However, when it comes to psychological issues, the shame and guilt attached to messages that recovery should be easy keep people stuck.

So,the next time you’re tempted to tell your friend how easy it would be for her to just dump her scummy boyfriend or to tell you dad that if he would just leave the house he wouldn’t feel so depressed, think about the message you’re really sending. You’re probably confusing something that is simple with something that will never be easy. Maybe a better way to show your love, caring, and support would be to sit with your friend or your dad and listen, cry, or just hold her/his hand. What could be easier?

Much Ado about Happiness

This may be the most often made statement in therapy – “I just want to be happy.” It’s amazing to me how often the person making this statement cannot answer the logical follow up question – “Well, what do you think would make you happy?” Don’t get me wrong, I don’t think they necessarily have to have a full, complete, detailed plan, but some idea of what happiness would look like would be helpful. What started me thinking about this common issue was an article from the October 5, 2009 issue of Newsweek. In that issue, Julia Baird wrote an article entitled “Positively Downbeat: Sometimes happiness isn’t everything.” The basic gist of the article was that we spend so much time trying to reach this goal of “being happy” that we forget to enjoy the process. I think she has a point.

I’m sure that you, just like me, have received the relentless message from your parents, your friends, your siblings, even exes that “we just want you to be happy.” And for the most part, we find this message comforting. It expresses unconditional love, in that no matter what you are doing as long as you’re happy I’ll be supportive. However, it can also be used as a weapon when someone disagrees with your actions, i.e. “The only reason I’m telling you that your boyfriend/girlfriend/best friend is a terrible, horrible, no good, very bad person is because I want you to be happy.” or “The only reason I’m discouraging you from pursuing your dream of being a chef/artist/psychologist/fill in the blank is because I want you to be happy.” Am I discrediting the intent behind these words – absolutely not. Am I questioning the impact they have on the people who receive them – you bet I am. Humans are innately social creatures. We make determinations about our lives based on the reactions that we receive from other people. If you are surrounded by healthy people, who are completely unselfish in their intents, and will always think of your well being first, that’s a great way to be. However, if even one person that you trust and depend on employs the “I just want you to be happy” excuse to stamp on your desires and dreams, then you have a problem. Done over a repeated amount of time, in many different situations, the message becomes “You will not be happy until you agree with me.” Which in turn leaves you unable to decide what happy is for you.

In addition to these messages that most of us have gotten since birth, we are also living in a society where positive thinking has become the gold standard. Books, talk show hosts, even morning DJs encourage people to think positive in situations that in truth deserve, if not outrage, at least frustration. We are encouraged to ignore the unfair, unjust events that happen in our lives, in the pursuit of happiness. Friends try to convince us that “everything happens for a reason” and “it will all turn out for the best.” In all honesty, I’ve probably said these things myself when at a complete loss for words in the face of a loved one’s pain. Now, I’m not endorsing that you dwell on every negative event that has ever happened in your life. I am, however, endorsing that you allow yourself to experience the emotions that come along with these hard events. When we attempt to block our emotions, we usually end up blocking anger, sadness, guilt, and shame. Unfortunately, we usually end up blocking happiness, joy, peace, and contentment too.

So, the next time someone tells you “I just want you to be happy,” remember that your happiness may not match their picture of happiness. Use the tragedies of your life to learn about your strengths. I’m not saying that happiness does not exist, just that the paths we are currently taking to get there may actually lead to depression related to not understanding ourselves, anxiety over our abilities to be happy, or guilt about our inability to be happy. On our way to happiness, we may be missing laughter, joy, hilarity, and moments of grace. Many of us would be able to agree that the Dali Lama is a model for happiness – the secret to his happiness and probably to ours, is an open heart and mind to what is happening in the moment. Rather than a continuous focus on some vague happiness in the future, become mindful of the happiness that is occurring now.

How do you become a therapist anyway?

After “Do you think I’m crazy?” this may be the most asked question I get. Since starting my training to become a Psychologist, I have come to learn that people have no idea what it takes to get the required training to be licensed as a Psychologist. I’ve also learned that this is partially because every state requires something a little bit different, but there are commonalities. So if you want to be a therapist, or are just curious about how your therapist got to where they are these are the typical steps.

1) Get a college degree. Seems pretty obvious right. I think most people believe that you have to have majored in psychology as an undergrad in order to become a psychologist. For most graduate schools (yes, I said more school), this isn’t a requirement although it might be recommended and is definitely the easiest path. But, if you didn’t major in psychology that does not mean that you can’t attain your dream of being the therapist of the century. It just means you’ll have to take a few extra classes to meet the requirements of whichever graduate program you choose. Which brings us to my next point.

2) Get a graduate degree in psychology, either Clinical or Counseling Psychology will be your best bets. Now, you do not have to obtain a Doctorate (Ph.D. or Psy.D.) to do therapy but in order to call yourself a Psychologist in 5-10 years (yes, I said 5-10 years) you will need either a Ph.D. or Psy.D. and most likely from an APA accredited program. Most of these programs are full time, in residence programs, meaning that you have to attend class just like in undergrad and actually live within driving distance of your program. Most of these programs will take anywhere from 5 – 10 years depending on their requirements and how long it takes you to write your dissertation or its equivalent. It is always an option to stop with your master’s in psychology but that will limit your options for a career later.

3) COMPS!!! During grad school you will have to complete several steps before your program will let you go on internship (yes, there are more things after classes are over). One of the more difficult steps is passing your program’s comprehensive evaulation, better known as comps. Depending on your program, this ordeal can range from four days of written exams on every topic known to psychology to a case presentation and defense. Regardless, if you don’t pass you will not be allowed to apply to internship programs and in some cases may have to wait an entire year before you are able to retry.

4) Get an internship. Now, assuming you have passed comps and achieved an acceptable GPA, the Director of Training (DOT) at your program will approve you to apply for internship. Basically, the process goes something like this – you choose about 20 sites that you think you would like to apply to; your DOT approves your list; you complete essays, cover letters, and supplemental materials for each site; you mail your applications prior to the deadline; the sites review your application and decide whether or not they will offer you an interview; after interviews are offered you decide which interviews to go on (all that are offered most likely) and book plane tickets, hotels, etc for the trips; you buy a nice suit that doesn’t look too flashy but stands out to just the level; you interview at 10 of your sites in a 2 week time span; and finally after all of your interviews are completed you rank the sites where you interviewed. Now, this is where it get complicated (yes, that laundry list above was the easy part). As you were doing all of those stesp just listed, each site was doing basically the same process and also submitting a ranking list. This means that the way you get an internship is determined by how you ranked each site and how you were ranked by each site. Hopefully it all works out and you’re “matched” the first time around, but sometimes it doesn’t and you have to take another year and go through the process again. Sometimes that’s just how it works – that’s life.

5) Defend your dissertation. So finally all of that is done, you’ve passed comps you’re either on your way to internship or somewhere along in that process. It’s time to get that dissertation or your program’s equivalent taken care of. Depending on your program, this will be a document somewhere between 30 and 200 pages in which you either review someone else’s research or complete your own unique study. After you create the document, you will do about a hundred revisions before finally being able to “defend,” which is a fancy way of saying presnt your research to a group of people. No matter how your graduate program does this requirement, you have to finish this before you can get your degree. And, if you don’t finish it before you leave internship and start working, you’ll be working as a master’s level clinician with the commisserate pay scale plus paying tuition to your school in order to stay enrolled and complete the dissertation. Point being – finish this step BEFORE you finish your internship! I promise you, you will not want to miss the chance to walk across that stage at graduation.

6) Graduate!!! Congrats Dr., you made it. This is a day to celebrate your accomplishments, take loads of pictures, and tell everyone (yes, including your mom) that they must call you Dr. from now on. Cherish this moment, you will have enough to worry about when you start to try to get licensed.

As you can see, becoming a therapist takes a lot of time, committment and sacrifice. Each of these 6 steps could have been a full blog unto themselves. Unfortunately, just because you graduate and get your degree does not mean that you will be considered a “Licensed Psychologist” in most states. In order to do that you will have to complete another 1500-2500 hours of supervised experience, pass one incredibly hard nattional exam (the EPPP), and in most states pass at least one more state exam. In the process, you will meet people who make comments about how your job can’t be that difficult, all you have to do is listen. You will also meet amazing people whose lives will change because they know you and work with you. As with everything in life, you take the good with the bad, the sour with the sweet. Then if you, yourself have become a therapist, you realize that you are blessed with one of the greatest jobs. Everyday people give you the gift of their trust and believe that you have something to offer them. To me, that’s more good than all the bad it takes to get through 6 steps.

Welcome!

Welcome to my blog. The purpose of this blog is to share information on the field of psychology, new research, advice, and my own thoughts about the world around us. When people find out that I am a therapist, they always want to know what the job entails, what kind of training I have, and why they should pay someone to listen to them. In the coming weeks I plan to answer those questions and many more. If you have a question you would like to have answered or a topic you would like more information on feel free to email me at kim@kimbentonpsyd.com. I plan to post weekly, but will make every attempt to answer your email the same week as it is received. Also, check out my website www.kimbentonpsyd.com. There you will learn a little about my thoughts on therapy and my style as a therapist. If you or someone you know is looking for a therapist, give me a call. If we are unable to work together, I will make a referral for you.

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