Tag: mental health

5 Lessons from Five Years of Therapy

Marlena Sauceda

This month marks five years since I had my first conversation and began meeting with a therapist on a regular basis. I have written about my experience somewhat in reflecting on my anxiety, and I have publicly advocated for therapy and mental healthcare online for years, but I have not yet shared in very great detail about my journey. Therapy has become more normalized recently; I could not believe my ears last summer when I heard the so-called POTUS on the radio, saying that mental health is just as important as physical health. But awareness and access are two different things, and for many people a lack of knowledge about the process may be the biggest thing standing in their way of seeking therapy.

To mark this anniversary, I thought I’d share five lessons that I’ve learned over the past five years of accessing therapy and working on my mental health. I hope this helps you feel validated in your own therapy experience, or provides the insights you’re seeking if you’re just starting to wonder if therapy might be for you.

1. There’s nothing “wrong” with you

I hope you know this, but in case you don’t, let’s start here. Therapy is not just for when people experience very serious mental health episodes, and it’s not just for people actively going through a difficult or traumatic time. While many people may find their way to therapy after a devastating loss, or a hard break-up, or some other traumatic incident, you don’t have to actively be going through something in order to seek therapy, and accessing therapy does not mean there’s anything “wrong” with you.

When I started therapy I was recently engaged, had just purchased a home, and was on my way to a promotion at work. It was one of the best times of my life. It had been several months since I first recognized that I may have anxiety, and my upcoming marriage made me feel a sudden sense of urgency to access the mental health care I needed to live my best life. I had considered therapy once before, as a teenager, but was deterred by the stigma around it and believed I was fine. Five years ago I was relieved, even excited, when I made my first therapy appointment and proudly shared about it on social media. I was met with some reactions that made me feel like I was sharing that I had some kind of terminal disease, and it made me realize that some people still believe therapy is only for when you are in dire straits.

2. Be selective

After getting over the stigma and finally accepting that I could benefit from therapy, came the enormous task of finding a therapist. My first thought was my then-employer’s Employee Assistance Program (EAP), which many companies and organizations offer. These programs provide employees with (usually) free access to sessions with licensed counselors or therapists, and may be a great option. There are also affordable options for virtual therapists offered through many services, some of which allow you to set certain criteria or specialties. I knew that I wanted to find a therapist who shared some aspects of my cultural identity, so that I would not have to spend time during sessions explaining things, and who specialized in some of the specific issues that I was dealing with.

I found my first therapist using PsychologyToday.com, which has a directory that allows you to be very specific with the criteria you set, including certain identities, specialties, ages, therapy types, and languages. It also shows you pricing options, so you can find something within your budget if therapy is not included in your healthcare plan. You can get even more specific with directories like LatinxTherapy.com, or TherapyforBlackGirls.com. Therapy is an investment, and being selective in finding a therapist will help ensure that you’re getting the most out of it.

3. Set clear goals

Okay, so you’ve found a therapist you can afford, specializing in what you need, who is accepting new clients; congratulations! Now what? Most likely you’ll start with a consultation, your therapist may send you some forms to complete an assessment, or you may have a brief meeting to discuss your concerns. In your first “official” meeting, whether it’s in-person or virtual, your therapist should discuss your goals with you. What are you hoping to get out of therapy? How do you want your life to be different 6 months to a year from now?

Having clear goals allows you and your therapist to have clarity in your treatment plan, and provides a benchmark for you to measure progress against. I remember being so surprised after my first year of therapy, when my therapist asked me to review the goals I had set in our first session together. It felt as if I had manifested all of these things that were now true or almost true, but in fact I had spent hours upon hours in therapy sessions and in every day life steadily progressing toward those goals. It’s important to continuously review and reset your goals to ensure that you continue to get what you need out of your investment in therapy, and to enable your therapist to adjust your treatment and incorporate new or different techniques.

4. Check your expectations

It’s important to be realistic with your expectations. In my experience, a therapy session often leaves me feeling less anxious – it can also leave me feeling emotionally exhausted, or angry, and on one occasion even more anxious. Attending therapy is not a one-stop shop solution to your mental wellness; it requires practice, after care, and lifestyle changes. You wouldn’t expect that a single visit to the doctor is enough to heal your physical ailments. You might also have to go pick up a prescription or OTC meds and take them, or need a cast or brace, or additional testing, or physical therapy, etc. So you shouldn’t expect that simply meeting with a therapist is going to solve all of your mental health issues. You will also need to implement healthy coping mechanisms, adopt habits that support your mental wellness and shed habits that don’t, and possibly even take medication or supplements.

It’s also important to recognize that a therapist is not a life coach…or a friend. A therapist is not meant to tell you what to do or not do when you face a difficult decision or situation, and they’re not meant to always agree with you. This is why the previous tip is so important – if you have clear goals then your therapist can continuously hold you accountable to them, then your sessions will focus on how you can better manage your mental health and move toward your goals no matter the situation. It’s also important to spend time on your mental health outside of therapy. I have found that exercising, eating a healthy diet, spending quality time with loved ones, and limiting screen time are all also essential for me to feel mentally healthy, and I continue my learning outside of therapy by reading books relevant to my experience.

5. Don’t be afraid to start over

One of the best pieces of advice I received after starting therapy, was to not be afraid to change therapists. The thought was, at first, inconceivable, that I would enter into such a vulnerable relationship with someone and then, one day, end it. I felt happy enough with my first therapist, until I didn’t. My first therapist specialized in Cognitive Behavioral Therapy (CBT), which focuses on mindsets, beliefs, and attitude, otherwise known as “talk therapy.” This was incredibly helpful at first, and provided plenty of space for me to talk through my experiences and gain greater insight into my anxiety. After a while, however, I felt like I wasn’t making much progress. Therapy began feeling like a chore, and I even found myself dreading my appointments. I took that as a definite sign it was time to move on and search for a new therapist.

I took a short break before starting again, and my experience with my second therapist has been that much better due to being informed by my experience with my first therapist. I realized that I need more than CBT, and sought someone who incorporated somatic therapy practices that focus on the mind-body connection and releasing pent-up emotions. I feel like I’ve made more progress in the last two years with my current therapist than I made in my first three years, even while meeting less frequently. As scary as it was to start the whole process over again, it was one of the most essential things I’ve done for my mental health.

I hope this helps you on your own mental health journey. I truly believe that everyone can benefit from some amount of therapy, and that the world would be a much better place if more people had access to mental healthcare.

Lost/Free

Marlena Sauceda

I’m stuck in this
side hustle
make content
meal prep
romanticize your life
hamster wheel,
and I wonder
why I keep getting
tension headaches.

I try to drown it out
with NPR and
podcasts and
nonfiction audiobooks,
but sometimes
the truth
is too heavy.

What is it like?
To not be
in fight or flight?
To be able to rest
in the quiet of your mind?
To feel safe,
safe enough to digest.
I wonder,
have I ever
really slept?

I was so close
to finding myself,
to meeting the version
of me
who would exist
in an alternate universe 
where capitalism did not,
where humanity
was truly free.
The glimpse alone
is enough to make me know,
I can’t let that version of me
go.

I’m trying to interpret
the angel numbers,
trying to read
the universe’s signs,
but I’ve forgotten how
to look for them
without too much
screen time.

So what do I do?
Do I say
fuck it all,
leave the city,
quit my job?
Live like a monk
so I can be
what I want?

Or do I girl boss,
get a raise,
buy some stock,
start a business,
and hope that
by the end of it all
I still have it in me
to be
what I want?

//

I hope one day
these years
are remembered
as a dark time
where we lost ourselves.
I hope one day
we relearn to live
in the light,
to cherish the earth.
I hope one day
our children
might be free –
free enough
to be.

Me and my anxiety

Marlena Sauceda

It’s difficult to explain to those who do not have anxiety what it’s truly like for those of us who do. Most folks know what it’s like to feel anxious. Butterflies in your stomach, your heart racing, maybe your palms get sweaty – a general feeling of anticipation that makes you feel unsettled in the moment.

Generalized anxiety disorder is different. For me, it is an undercurrent of that anxious feeling paired with an incessant narrative in a voice that is my own and isn’t – one which is quick to think of the worst case scenario for any occurrence, which tells me that the things I know and feel in my heart are to be questioned. My anxiety is very pronounced when I am in the car and someone else is driving; I feel a sense of impending doom with every merge, every uncontrolled left turn. The narrative in my mind tells me that at any second, another vehicle or a slip of the driver’s attention will bring an end to everything I know and love. When I travel to the land currently known as California, the place of my birth and where I spent most of my life, I am constantly on edge waiting for “the big one” to hit – the giant earthquake that I spent my childhood hearing about and preparing for with earthquake drills. I will be standing on a hilltop looking down & around at a beautiful vista, and in my mind’s eye I see the earth around me undulating, the trees swaying, buildings crumbling. All while at the same time, feeling gratitude and love for the beauty of the world around me.

Anxiety is not an invited feeling. It arrives even when you feel peace, happiness, safety. Yes, anxiety can be triggered by certain unwelcome events, but it also shows up when nothing has specifically triggered it. Those of us with anxiety can feel it when we’re on vacation, when we’re enjoying a birthday celebration, when we’re at a family gathering. It is often unrelated to our physical environment. The thing that those with anxiety have to learn to navigate, and those without anxiety have to learn to accept, is that anxiety is not a reflection of reality. The inner dialogue doesn’t care if you are physically safe, if you are surrounded by loved ones, if you are in a beautiful place. It can be kept at bay by self affirmations and supportive words from your loved ones, but when it’s really bad it can make it difficult to believe yourself and others about what is reality. It often doesn’t make any sense, and that’s what makes it difficult for those who don’t have anxiety to understand and empathize with those of us who do.

One of the best and only examples that I have seen of anxiety in media is on Issa Rae’s Insecure. I’m not sure if it’s intentional, but it feels as though it must be. There are multiple ways that the show depicts characters’ anxiety and anxious thoughts & feelings. One way is with flash forwards – scenes that seem real to start, then become very exaggerated versions of reality before flashing back to Issa’s character in the present, who was imagining the worst case scenario in a conversation she is anticipating or an action she is considering. This is a great example of what it’s like, to imagine a reality completely different from the one we know, where all of our worst fears come to fruition.

A frame from the TV show Insecure, showing the main character, Issa, from the shoulders up, off-center against a plain background.
A frame of Issa Rae’s character in Insecure

Another way is through cinematography – they frame a shot of a character so that the center of the frame is not their face, but instead a blank space that is meant to represent all of their unstated thoughts. This technique depicts why those of us with anxiety can seem to lack presence when we are around others, because so much of our mental capacity is spent on the inner dialogue of things we are too afraid to say out loud.

My anxiety is very different from my otherwise very logical and process-oriented brain. I will hear an odd sound in the night and my anxiety will convince me that it’s an intruder come to destroy everything I know and love, before I realize that it’s just the deep snores of my dog, or the ceiling fan, or the wind. What is often said and written about anxiety is that your brain and your body don’t know the difference between a real and a perceived threat. I have found that to be very much true. In those moments where I am convinced that a strange sound is death knocking at my door, my heart is racing, my jaw is clenched, my entire body is stiff waiting for the next sound that will confirm that the threat is real. Even after realizing that there is no threat, it can take several more minutes for my heart to stop racing, and for my mind and muscles to relax enough to let sleep take over.

I’ve seen recent posts on social media that claim that anxiety is beneficial, a survival instinct that we have refined over millennia, which can keep the anxious one safe or sound the alarm when something feels “off.” My anxiety has certainly helped me in some ways. It made me a great student and test taker, as I would cope with my anxiety by reading incessantly and consuming every piece of learning material accessible to me, so that by the time I sat down for a test I felt confident in my knowledge. My anxiety makes me a great employee – I am constantly thinking that I’ve missed something or forgotten something, so my organizational systems are robust and effective. I am good at thinking ahead to all of the possibilities for a given project, pilot, or organizational change, and trying to understand how other people might be affected. My anxiety makes me detail-oriented, thorough, and direct – traits which are for the most part rewarded in U.S. workplaces.

Beneficial, though? I would give up my anxiety in a second if I could. My anxiety disturbs my peace and impacts my relationships. It makes it difficult for me to build new relationships, to be present, to be confident. I am constantly working on being better at these things and confronting my anxiety, because it tells me that I am not worthy or deserving of others’ time and attention.

My anxiety is the main reason why I started therapy a couple of years ago. I finally recognized and labeled my anxiety, and began cognitive behavioral therapy, a common treatment for anxiety. I talk with my therapist about my anxiety, how it’s affecting my life, and I learn ways to manage and work with it. I try to maintain a meditation practice, and though I’m not very good at it, I at least have that in my toolbox to turn to in moments when I am feeling overwhelmed by my anxiety. I am getting better at recognizing my anxiety, interrupting the narrative, and letting go of the fear. I know that there are medications that I can take to treat my anxiety, but I prefer to learn how to manage it on my own, and I am grateful that my anxiety is very rarely debilitating. Writing is another way that I manage my anxiety. When I write I come back to myself, I tap into the voice in my head that is my own.

After recognizing and accepting my anxiety, then learning ways to work with and through it, I am feeling ready to move onto exploring the root causes of my anxiety. Understanding where my generalized anxiety disorder came from, and doing the work to heal my inner child, is the next great adventure on my mental health journey. I know that there isn’t a cure for my anxiety, and have accepted that this is a part of who I am. But I am determined to live my life joyfully and fearlessly, and to stop letting my anxiety control my actions, my time, and the way I see myself.