Author: Regis Butler

Therapy can be rejuvenating. Therapy can be cathartic. Therapy can also be exhausting. Each session is different; some will require focus, honesty, and raw emotions, while others can be filled with humor or casual discussions. Not all sessions will produce an emotional breakthrough. The work can be a slow process, and some sessions are about creating a strong relationship between therapist and client.

The sessions that tend to be exhausting are the ones where we have to recount painful memories or process difficult emotions. Though it might just be talking, it can take a lot of energy to bring up and feel intense emotion. We often equate physical energy expenditure with pride while we avoid emotional energy expenditure at all costs. As a society, we are much more comfortable sweating after a run than crying after a therapy session. That being said, both are the result of hard work.

Whatever the trigger for exhaustion may be, it is important to keep a clear line of communication with your therapist. If you are feeling overwhelmed or flooded with emotion, share that information with your therapist. Together you can decide if you are ready to continue talking about the subject or need a break from it. Remember that you are working in collaboration with your therapist. You can speak up and say that a topic is causing you emotional exhaustion. In the end, this will benefit your work because it will give your therapist more insight into your emotional state. One of the goals of therapy is to increase wellbeing, and being upfront with your therapist is a good way to do so.

Another way to combat therapy exhaustion is to reassess your goals for therapy. New goals can be set at any time. It can be useful to assess the progress you have made towards your goals.Setting goals can give you something to work towards each week in therapy. When you see progress towards these goals, it can stave off feelings of self-doubt and exhaustion. This is a conversation that is useful to have with your therapist to make sure you are on the same page.

Written by Jessy Pucker, LMSW

Photo Cred: Canva

There is no script for how to talk about sex with your partner. Communication about sex is not often taught, so it requires practice. The safer a relationship feels, the easier it can be to talk about sexual preferences. Exploration with your partner can be fun, but it requires trust. Below are a few tips to communicate your sexual interests with your partner:

1. Be honest with yourself about your needs. It is important that you accept your own preferences without self-judgment before you discuss them with your partner.
2. Approach the conversation with emotional honesty. For example, you could say, ‘this is something I would like to explore with you, but I am worried that you will think it is strange’. Being upfront about your feelings can reduce miscommunication once the conversation begins.
3. Focus on personal statements. Instead of bringing up things your partner doesn’t do to satisfy you, talk about the things they can do to enhance your sexual experience.
4. Ask your partner what they want! It takes courage to ask for what you want. If you are able to do it yourself, encourage your partner to do the same.
5. Try to have fun with the conversation. Explore the ways this could improve your sexual experiences and build off of one another’s interests. This is a collaborative effort where both partners want to enjoy themselves and have the other feel the same.

It is important to note that communication about sex can be even more complicated with LGBTQIA relationships. This stems from the lack of basic education surrounding non-heterosexual sex in schools. When kids learn about sex, they are taught about safety, sexual health, and the mechanics of normative, heterosexual sex. Being taught through the lens of heteronormative relationships can put LGBTQIA people at a disadvantage when developing understanding and communication skills about sex.

The more we speak about our sexual preferences, the more comfortable we become in them. As partners, we should all work on being accepting of various sexual preferences. Creating a comfortable sexual environment will increase intimacy with your partner and allow a freedom in expressing your sexual interests.

Written by Jessy Pucker LMSW

Photo Cred: Canva

Overthinking. We all do it; some more frequently than others. We fixate on an awkward interaction or an upcoming event. It can be uncomfortable to feel the tornado of thoughts that swirl in your head when you are overthinking. This type of thinking can breed anxiety, which leads to further fixations. This is a cycle we can break by recognizing the signs of overthinking and actively managing them before they become overwhelming.

Here are a few of the telltale signs that you are overthinking:

1. Being unable to stop thinking about a certain event or subject
2. Developing irrational thoughts and fears surrounding the event or subject
3. Replaying moments and interactions in your head surrounding the event
4. Being stuck on thoughts about the things you cannot change or control about the subject
5. Thoughts about the subject are impacting sleep and daily functioning

A few tips to manage overthinking:

1. Ask yourself how this overthinking serves you. Is it changing the situation, or is it just upsetting you further?
2. Create a helpful phrase that you can repeat to reset yourself. An example of this could be, “I am here” or “keep calm”.
3. Do grounding exercises, like mental math, rubbing palms together, or putting hands under water.
4. Try Box Breathing (https://www.webmd.com/balance/what-is-box-breathing):

• a. Step 1: Breathe in counting to four slowly. Feel the air enter your lungs.
• b. Step 2: Hold your breath for 4 seconds. Try to avoid inhaling or exhaling for 4 seconds.
• c. Step 3: Slowly exhale through your mouth for 4 seconds.
• d. Step 4: Repeat steps 1 to 3 until you feel re-centered.

Written by Jessy Pucker, LMSW

Photo Cred: Canva

Write out your to-do list. How does it feel to see it? Is it long? Does it feel overwhelming?

Between in-person and online tasks, we all have a lot going on. Our lives are expansive because of sheer access to information, connection, and communication. Maybe you have kids. Maybe you are caring for a loved one. Maybe you are trying to balance personal, social, and professional life. No matter what your circumstances, it is ok to feel overwhelmed. It is not uncommon for us to overextend ourselves for the purpose of pleasing others.

Saying ‘no’ can be challenging, but it is an important skill to develop. It takes confidence to know and assert your needs. The first step in developing this sense of confidence is to know your limits. It is not weak to say you are unable to do something. If we overextend ourselves for other people, what do we have left for ourselves?

It can take time to figure out your limits. Occasionally it takes pushing those limits to recognize that they exist. Practice saying, “I won’t be able to help with that because I have a lot on my plate right now”. Saying ‘no’ can be as simple as that sentence. There is no need to apologize for knowing yourself or provide further information.

Try to think of your life as a pie chart. How much space is work taking up? Social life? Alone time? Check in with yourself. Ask yourself what the ideal chart is and what you will need to do to achieve it. Block off time in your schedule to take a walk or do something that will de-stress you. These are essential activities that can be seen as ‘frivolous’ in our productivity-focused world. Though you’ve seen this written again and again in various mental health blogs, you cannot help others until you help yourself. Sometimes cliches exist for a reason. Honor your limits and watch yourself find a new sense of balance.

Written by Jessy Pucker, LMSW

Photo Cred: Canva

Each of us experiences mental health in a different way. For some, it is a constant struggle to balance. For others, it is an afterthought. It is hard to put ourselves in the shoes of those around us; even those we love. Mental Health Awareness month can be about so much more than recognizing the signs of illness or discussing stigmas. That work is important, but there is more. It can be a time to celebrate the hard work of taking care of your mental health, or supporting others in their efforts. To be aware of mental health is not just to be aware of its dangers and downsides. It is also to shed light on the powers of thinking differently, or to celebrate human strength and resilience.

The world around us is changing fast. Between a global pandemic, political dividedness, extreme weather, and all the rest, no one has been left unaffected by the last few years. The list of global traumas keeps building, and it would be easy for each of us to crumble under the weight of it all. Yet, here you are, reading a mental health blog. Or maybe you are searching for a therapist at Refresh. Maybe you are unsure of what you are looking for but found yourself here. No matter the reason, you’ve taken an active step in promoting mental health awareness, whether for yourself or others.

As therapists, we at Refresh have dedicated our time, education, and focus towards the study and practice of mental health. We recognize that asking for help is not easy, and feel privileged to do the work we do. May is Mental Health Awareness Month, so we want to spend the time celebrating and applauding those of you who reach out for help, information, and support. Whether it is signing up for a therapeutic group, one-on-one sessions, or coming to the website to seek information about mental health, you are making a difference.

Written by Jessy Pucker, LMSW

Photo Cred: Canva

Being honest about mental health issues can be challenging for anyone. Even with the people closest in our lives, being vulnerable takes courage. Though the cultural conversation surrounding mental health has opened many up to subject, these thoughts and feelings can be intensely personal and hard to communicate. Creating a vocabulary surrounding mental health is important for all of us. When we normalize talking about our emotions and mental health challenges, we invite others to do the same.

When a friend or family member comes to you with their personal mental health challenges, it can be hard to know the ‘right’ thing to say. The reality is that each person will respond differently to different support. This is why it is important to ask them how you can best be supportive. Some people won’t know the answer, but it can be empowering for the person to be asked what they need.

Mental health issues can feel overwhelming for those experiencing them. Try not to belittle the experience by minimizing or trying to ignore the issue. Work on using validating statements like, “that sounds really challenging” or “I hear you and am here for you”. If you don’t understand the issue at hand, educate yourself on the symptoms that the person is experiencing. This little bit of research can go a long way when supporting a friend in need.

In line with feeling overwhelming, mental health issues can make small tasks seem disproportionately daunting. An easy way to support a friend is to offer to help them with the small tasks. Whether it be helping cook a meal or helping the person find a therapist, doing these small tasks can alleviate stress for your loved one.

If you are worried that the person might harm themselves or others, you can provide them with local mental health services like the ones below for New York City. In the event of an emergency, call 911.

24/7 NYC Well Hotline
1-888-NYC-WELL or Text “Well” to 65173
https://nycwell.cityofnewyork.us/en/

Written by Jessy Pucker, LMSW

Photo Cred: Canva

Do you ever find yourself asking the question, “Should I continue doing therapy?” Sometimes we hit a point in therapy where it seems less fruitful than it once was; or worse, maybe we even start to feel distressed at the idea of preparing for our weekly sessions. I get it! I have been there, and trust me…it absolutely can be cyclical.

I have been in therapy for over four years. I have had sessions biweekly, once a week, and for a while even twice a week. I know from experience how taxing being in therapy can be on us. Nevertheless, in moments when I am frustrated by, or even tired of, therapy I think about what it means to not have this outlet. I think about what it would be like to lose connection with my therapist after dedicating and investing so much time into developing my rapport with him. It is not easy for me–as I imagine it is not easy for you–to just create new relationships. Relationships are hard work…like really hard work! Wouldn’t you agree? If you do agree, then maybe this is a good blog post for you.

What to do when I am tired of therapy!

If your mind, or support system, is telling you to just suck it up or find someone else, it may be right. It may also be wrong. I always think it is best to challenge ourselves before we make any decisions in our lives. Personally, I ask myself a simple, yet daring, question. Can I live with this decision? If you feel like you no longer need or want therapy and you can navigate life well, and without symptoms, by all means end therapy. However, if there is a part of you that is concerned about if you can manage your symptoms or stressors without therapy, ending may not be the answer. I argue that what you are experiencing is treatment fatigue. What is meant by treatment fatigue? Treatment fatigue is the process in which we become burnout, or depleted, by constant treatment. This is particularly impactful when we feel like our symptoms are worsening or never changing. In physical health you find this often in patients who are fighting long-term conditions cancer, failing kidneys, HIV, among others.

Think of it like this. Remembering to take a pill everyday can become overwhelming, right? Well so can talking about your stressors and symptoms. Telling your therapist every week about your work anxiety or your sadness around dating prospects or even toxic relationship with a roommate/friend can be tedious and frustrating. For me, it was the drama and monotonous of dating as a professional Millennial. Like many of you, I was tainted by the wilds of the New York City dating scene. Thinking about this for 45 minutes straight every week and then getting homework to work on over the week about it can be…well let’s just say intense to say the least.

If you are currently thinking, “Well Andre, what is the resolution to treatment fatigue?” Here are three resolutions that I have used throughout my tenure as a person receiving long-term treatment in therapy.

1. Take a break! Simple, yet effective. Talk to your therapist about taking a few weeks off, especially if you have not had a significant break and it has been over a year of treatment. This break should be exactly that, a break. This should not be a stepping stone for termination. I would recommend 2-4 weeks off. If you are taking longer than a week off you may lose your time slot with your therapist and reentering treatment is its own beast as I am sure you are aware from when you first started therapy. If you would like to terminate, then it is better to have that honest conversation with your provider.
2. Spice things up! It is my true belief that sometimes we all forget that therapy is a relationship. It is a very specific kind of relationship, but a relationship nonetheless and should be treated as such. I remember once when I was feeling treatment fatigue I asked my therapist if we could try a different approach. For the next two weeks, we ran therapy differently. This will look different among all the different types of therapy out there, but for me it was as simple as us having sessions in a new location. A change of scenery really helped me feel less repetitive. For a brief moment in life, I finally got relief from the feeling of “here we go again.”
3. Make sessions active! Ask your therapist to add some light movement to your sessions. It is even a great idea for you to come to sessions with some ideas. Many of you may have done some breathing exercises within your sessions. Those are great exercises to start with, but you can potentially add more. I have started some of my sessions with patients by standing and doing some breathing exercises. I have even added some light stretching for centering the self. One fun thing that I like to do, particularly after deep sessions is a shake. I stand with people and shake it out. All over, just be silly and loose with it, break up the tension we hold within our bodies.

These are just three tools you can use when you are starting to feel treatment fatigue. There are many others so please feel free to Google some and see what fits your style and needs if these are unhelpful. The greatest message to receive from this is locus of control. You are in control of your therapy sessions. You have the right to self-determination and if you are feeling fatigued or even bored with the work you are doing in therapy feel free expressing that by asking for a change in your treatment process. Termination is not always the answer, especially if you still believe there is work to be done.

Written by Andre Thomas, LMSW

Photo Cred: Canva

We all have grown up hearing the saying, “Communication is key”. It couldn’t be more true, especially when we are talking about the communication between you and your partner(s) in the bedroom. This is a topic, in society, still viewed as taboo. Schools still struggle to navigate conversations around sexual education and forget about freely talking about your likes and dislikes over some coffee.

We have been raised with very little free space to freely talk about intimacy, so it makes sense why it is such a difficult topic to feel comfortable discussing with your intimate partner(s). No one wants to tell someone they like or love that they are, “doing it wrong”. While this is empathetic, what then is the end result from holding back our true likes and dislikes when it comes to intimacy? What happens when we repress our needs and wants for someone else’s happiness or comfort? Clients tell me all the time, “I am nervous to rock the boat”. This is such a valid hesitation, however, the boat is already rocking if you aren’t being fulfilled. Picture this, you are in the middle of the Atlantic on this boat with said partner(s), and you need to work together to find your way to land for more food and water because you are running low. In order to do this, you need to communicate effectively to ensure everyone is getting what they need to be successful in the relationship. Long story short, the boat is rocking and will sink if you don’t start effectively communicating to get to those needed reservations, aka intimacy that is leaving you both feeling happy and fulfilled. When we partake in intimacy that is not leaving us fulfilled we can begin to make an association with intimacy as a place of stress, anxiousness and sometimes even frustration and resentment. Orgasms should never be associated with any of those.

So how do you talk to your partner(s) about your likes and dislikes if they aren’t being met?

1. TIMING – Make sure you pick an appropriate time to talk. Letting your partner know that you have something you would like to discuss and asking when would be a good time you can both/all sit down to discuss this.
2. TALK ABOUT THE GOOD BEFORE THE BAD – Starting a conversation off with all your complaints or displeasures will surely leave your partner(s) guarded and shut down. You want to ensure your partner(s) is listening with open arms. Praise them on the things you do like, the things you are happy about. Letting them know you acknowledge the positives in your relationship and recognize their efforts.
3. BRING UP HOW YOU FEEL and WHY – Let them know how you feel. This is a straightforward approach, no beating around the bush. If you are feeling disconnected, tell them. If you are feeling lonely, tell them. If you are feeling rejected, tell them. If you are feeling frustrated, you know what to do, tell them. Once you have told them how you feel, provide insight on why. Giving context to your feelings is very important for your partner(s) to hear you. This means, give the contexts/ situations that have left you feeling this way.
4. TELLING THEM WHAT YOU NEED – So you have told them the problem, given them the context on why you feeling what you feel, now it is time to provide them what you need instead. No one is a mind reader (I wish we all were) so it is important for your partner(s) to know what is needed to feel happy. Rule of thumb, if it is in your mind and hasn’t been said, it needs to be advertised so no unrealistic expectations are placed on your partner(s) to know what you need without saying.
5. COLLABORATE – Collaborating with your partner(s) allows you to hear what they need as well and how to achieve both needs for each other. Sometimes a need may not be negotiable, but how you get there with your partner can be negotiated. Give a visual, a road map of how you and your partner(s) can possibly achieve this.

Intimacy is supposed to be a protective factor, not a place to stress or become anxious. Conflict is not the big bad evil experience that the media and society paints. Without conflict it is impossible to grow. It is how you partake in conflict that determines if it is positive or negative. I leave you with this, how will you approach your conflict to get the results you deserve?

Written by Leann Borneman, LMSW

Photo Cred: Canva

Cleaning your personal space can often feel like a positive, proactive measure to clear your mind. Michelle Newman, the director of the Laboratory for Anxiety and Depression Research at Penn State University said, ‘if you can exert some control over your inbox or your office space, these are small things you can attend to and feel good about’. This type of behavior can improve self-esteem and feelings of accomplishment. It can be empowering to feel like you are accomplishing goals and taking items off of your to-do list.

The idea of organization looks different for everyone. Some people feel most comfortable in ‘organized chaos’ where their spaces appear messy, but they know where everything is. Some people require complete tidiness in order to feel comfortable in their space. It is important to first define what organization means to you, and how to maintain that organization in the future. Below are a few daily habits to practice to increase your organization.

Think about the objects you use most in your house
Make sure you can see these objects or have a good understanding of where they are. Start to take stock of your daily activities and what you need to complete them.

Place tools for daily use near their spaces
Example: put your books near your reading chair or your pens near your desk. This can help stave off any frustrations about losing objects and time spent looking for them.

Create physical boundaries for different spaces
Designate which areas you will do daily activities, which include eating, sleeping, working, etc. If you are working at your desk, make sure to only do work related activities there. Since the Covid19 pandemic has pushed many people to work remotely, it is important to create spaces for work that you can clearly leave when you are not working.

Being organized doesn’t always mean buying the newest organizational tools or having your whole house color-coded. It is about knowing your space and having access to the spaces and objects you need most. These tools can help to de-stress your home environment, which will lead to less stress in daily life.

Written by Jessy Pucker LMSW

Photo Cred: Canva

Hypnosis used in therapy can have wonderous effects in healing and achieving a sense of wholeness and feeling aligned within oneself. Hypnosis allows clients to enter a trance like state to conduct a deep dive into the unconscious to bring awareness to what needs to be healed, released, processed and validated. Ultimately hypnosis allows clients to deeply understand underlying thoughts and behaviors and emotions that need to be processed in order for them to remove blocks or feel a sense of wellness mentally, physically and emotionally.

A breakdown of what to expect in a hypnotherapy procedure begins with the hypnotist serving as a guide for clients to enter the hypnotic trancelike state through different induction methods. Induction methods may include guided meditations for calmness and relaxation or tapping the client while offering them relaxing or calming suggestions to focus on. Some people may respond well to these suggestions or guided relaxation scripts and some may not and that could be dependent upon fears, concerns or limited ideas about hypnosis from common misconceptions the person may have heard. Some common misconceptions may include the client’s belief that they will lose control of their behaviors and mind when under hypnosis, they could become brainwashed, they can get stuck in hypnosis, hypnosis can trigger harmful results from what is uncovered and so on. It can be very helpful for a client to ask a hypnotherapist and clarify what the procedure entails and what they can expect before trying it to ensure they are fully prepared for the experience.

Once the client has been successfully relaxed and induced into the hypnotic state, the hypnotist then uses visualization to guide the client to different levels or parts of their mind to explore repressed memories, their motivation, their truest desires, unprocessed memories, the source or root reason for a emotional wound, or a phobia or whatever could have triggered a disconnect they experience in their conscious reality. Whatever comes up can ignite a cathartic experience with the client just becoming aware and “knowing” what has triggered their disconnects in the first place, but the client can also discuss and process next steps to heal with the clinician after the session has ended, if needed. If a client isn’t exactly searching for any answers or information through hypnosis they may just be looking to strengthen self esteem, positive behaviors and habits or feeling a sense of calm and safety in their everyday reality, with the clinician offering them positive suggestions for the clients best interests.

Through my work in using hypnotherapy I have been able to help clients achieve various results. For some clients, it’s reconnecting with repressed or forgotten memories, hidden deep into their unconscious, it could be reconnecting with positive emotional experiences or pleasant memories. Some clients may utilize hypnosis to reconnect with negative experiences of the past, such as traumatic events to allow the client to process these experiences in a safe and controlled way to ultimately feel healed and able to live in the present without being impacted by past traumas or distress on a unconscious level, that can impact how they think, feel or behave.

If you have ever felt stuck with consciously exploring your past and what impacts your mental health wellness, exploring the unconscious through hypnosis could be a next helpful route to achieving your mental health goals. Those who are just curious and open-minded to experiencing the endless benefits of hypnosis are also invited to give it a try. Hypnosis can be a very therapeutic modality to use for achieving mental wellness and an overall sense of wholeness by using it to deepen your state of calm and relaxation to deal with life’s worries and everyday stressors.

Written by Aneela Choudhary, LMSW

Photo Cred: Canva