I’m Not Crazy! Overcoming the Stigma Around Therapy

Therapist Help

“In Hollywood if you don’t have a shrink, people think you’re crazy.” ~ Johnny Carson

Therapist Help

Imagine the following scenario: You go running and roll your ankle. You hear a pop and are in great pain. It turns black and blue and swells quickly. You are concerned it is broken or seriously torn, but you fear going to the doctor for help. What will your neighbors say? Will they gossip about how weak you are for not just “getting through it” or figuring it out on your own? You decide to avoid the doctor, take some Tylenol, hobble around like nothing is wrong, and hope it will just go away on its own.

This example might seem foolish to you…why would you not go to the doctor?! It may seem downright silly to not get help when help is needed!  Likewise, when a person encounters trauma, addiction, abuse, or mental illness, it is of legitimate concern and often necessitates professional help like therapy. In the exact same way a broken or sprained ankle often requires the attention of a doctor, many mental health issues require professional help. And there is nothing wrong with that! 

Recently I had a client look me in the face and say, “I don’t belong here.” She felt she should not be in my office sitting on my couch getting help from a licensed therapist because she was not crazy. She had a fulfilling career, many dear friends, and owned lots of expensive things. She did not believe she fit the image, she had in her head, of someone who needed therapy. In short, she thought therapy was for people that outwardly looked like they did not have their life together and she was not one of them. It hurts my heart to hear the shame she, and other clients have felt for being brave and seeking help. 

When studying roadblocks to receiving therapy, Patrick Corrigan and Andrea Bink (2016) had participants report fear of being stigmatized was the leading factor for avoiding treatment. Participants feared they would be treated differently by their friends and coworkers, that they would encounter rejection or discrimination as a result of seeking out mental health treatment.  Most participants would hide their psychiatric status from coworkers, friends, and even family to avoid being the victim of stigma. Thankfully, in recent years–due in large part to social media attention around the stigma around mental health and therapy–it has become much more socially acceptable to receive mental health care. It is not uncommon to hear about celebrities and prominent figures seeing a therapist; many of them highly recommend it for every- and anyone! I applaud these men and women for using their influence to break the mold and speak up on the many benefits of therapy!

The latest statistics show that the amount of people seeking and receiving mental health support is increasing! In 2018, 47.6 million U.S. adults experienced mental illness…that is 1 in 5 adults! Thankfully, 43.3% of U.S. adults with mental illness received treatment in 2018 and 64.1% of U.S. adults with a serious mental illness received treatment in the same year. 50.6% of U.S. youth aged 6-17 with a mental health disorder received treatment in 2016. Millions of Americans experience mental health challenges each year and millions are receiving help by medical and mental health professionals!

Going to therapy does not mean you are crazy. It means you are smart. Would you sit at home, alone, and let your broken ankle “do its thing” without getting help? No. You would make the proper appointments and follow the advice of the professionals so you could soon be running again. My hope, my plea, my job is to help my clients find lasting healing.  The average delay between onset of mental illness symptoms and treatment is 11 years. Eleven years people will struggle with an emotional “broken ankle” before getting help. Ouch! You do not need to suffer any longer. Make the call–get in to see a therapist today.

I felt sad for the client of mine, and any others who share her sentiments. Just because you receive mental health attention does not mean you are crazy. Just the other day a client, who begrudgingly started therapy at the insistence of their spouse, recently told their new employer that they thought everyone should go to therapy, after they experienced the personal benefits of therapy. While I acknowledge you may believe that going to therapy means you are weak, crazy, limited, hopeless, etc–these stigmatic ideas could not be farther from the truth. I know my clients: THEY ARE BRAVE. They are good people who see their worth. My clients–and those who seek help in other ways–are my heroes and I will always and forever shout that from the rooftops! We need to do away with any and all stigmas that therapy is just for broken, crazy people. It could not be farther from the truth! 

If you have been letting your emotional broken ankle heal on its own because you have felt you do not “belong” in therapy, the time to act is now. Allow a licensed, qualified, experienced therapist, to help you. Emotional health, healing and happiness are possible. Contact me today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville,Texas, personally seeing clients in the North Dallas area.

References:

Emotional Support Animals At a Glance

Emotional Support Animals - Cluff Counseling - Lewisville Therapist

Emotional Support Animals - Cluff Counseling - Lewisville TherapistEmotional Support Animals (ESA) are no ordinary pets! They serve to stabilize and/or maintain the emotional or mental health of their owner and their role is vital! I am a proponent for emotional support animals when they can truly fill an individual’s needs. Read on to learn more!

It is estimated that 68% of U.S. households (or 85 million families) own a pet. There are some instances, however, where the animal is more than just a “pet.” In these cases, the individuals rely heavily on their animal for mental and/or emotional support. Their animals are called Emotional Support Animals, and they play an important role in the very livelihood and stability of their owner(s). This post will be all about Emotional Support Animals and hopefully will answer your basic questions about Emotional Support Animals.

What exactly is an Emotional Support Animal (ESA)?

An emotional support animal (ESA) is a companion animal that a medical professional has determined provides benefit for an individual with a disability or mental illness. The goal is for the ESA to help with or improve at least one characteristic of the disability.

Who can have an ESA?

In order to be prescribed an Emotional Support Animal, the person must have a) A verifiable disability, and b) A note from a physician or other medical professional (stating that the person has that disability and that the emotional support animal provides a benefit for the individual with the disability). ESA are typically used when the owner struggles with depression, mental health issues, autism, aspergers, psychotic disorders, or is a veteran/military individual dealing with PTSD.

When applying for housing with an ESA, the U.S. Department of Housing and Urban Development (HUD) asks two questions:

  1. Does the person seeking to use and live with the animal have a disability — i.e., a physical or mental impairment that substantially limits one or more major life activities?
  2. Does the person making the request have a disability-related need for an assistance animal? In other words, does the animal work, provide assistance, perform tasks or services for the benefit of a person with a disability, or provide emotional support that alleviates one or more of the identified symptoms or effects of a person’s existing disability?

Answering “no” to either of these questions means that a housing provider is not obligated to make a reasonable accommodation according to HUD. This may mean that the person does not meet the definition of disability or that the assistance animal does not help with symptoms of the disability. If the answer is “yes” to both, then HUD states the FHA requires an exception to a ‘no pets’ rule.

How does an animal become an ESA?

An animal does not need specific training to become an emotional support animal. There are several websites online where you can go to register your animal. Some organizations will send you a card, a bib for the animal, and/or packets of information (depending on how much you pay). Many of these organizations are not monitored by the government, however, so I recommend choosing one carefully so as to not get scammed.

Are Emotional Support Animals ONLY dogs?

While dogs are the most common type of assistance animal, other animals can also be used for this purpose. Sometimes cats or other animals may be used by people with a range of physical, psychiatric, or intellectual disabilities. There was a case in 2012 where a guinea pig was used as an ESA, and another in 2015 where a miniature horse was filed as an ESA. All that matters is that the animal needs to alleviate the burdens that come from physical, emotional or mental illness. Obviously, any animal that poses a direct threat to the health and safety of others would be questionable (a wild or exotic animal that poses a greater risk of attack or disease to other residents could be denied based on this reason). The key indicator is whether or not the animal alleviates some part of the disability or mental illness.

Is there a difference between an Emotional Support Animal and a Service Dog?

Emotional Support Animals are animals that provide therapeutic benefits to their owner through affection and companionship, where a Service Dog is specially trained to perform a task to help someone with a disability. For example, a blind individual will likely have a seeing eye dog–a Service Dog with training and a very specific function. Other examples include pulling a wheelchair or responding to seizures. Emotional Support Animals, however, do not need specialized training to handle a task. Further, Emotional Support Animals come in different breeds and animal types and are not just limited to dogs, while Service Animals are either dogs or horses.

Can I have more than one ESA?

Although I have not seen any cases dealing with the issue of multiple emotional support animals, the basic requirements for this reasonable accommodation would be the same. If a person were to claim the need for multiple emotional support animals, he/she would need documentation supporting this need from his or her physician or medical professional. The practitioner would need to provide documentation that each support animal alleviated some symptom of the disability.

WARNING

Unfortunately, people sometimes take advantage of the Emotional Support Animal system… using their “ESA” to get out of paying pet deposits, getting into certain housing where animals typically are not allowed, or even trying to fly for free with them. In an article, from The New Yorker, the author takes a turtle, a snake, a turkey, an alpaca, and a pig (separately!) all over New York and was allowed access to all things “non-pet” because she claimed (and showed fake letters from her “therapist”–an online reference who sent a letter over after she paid $140 to be evaluated) that these were here Emotional Support Animals. I want to be clear–while there are benefits of having an Emotional Support Animal, those should not be the driving force behind having an ESA. The intended use for these animals is to alleviate discomfort and provide meaningful companionship to those who truly need it. I do not condone cheating the system, but I fully support the idea behind and purpose of having an Emotional Support Animal.

It is possible that you or someone you care about could find an Emotional Support Animal extremely helpful in dealing with mental illness or disability. I urge you to contact me with questions or schedule an appointment today and we can discuss whether or not an ESA could meet your needs. I have seen Emotional Support Animals do great work and provide much needed comfort and stability to those grasping at straws for relief. Animals are smart and intuitive, and having an ESA can add much needed comfort and stability in the lives of those who so desperately need it.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

Strength in Numbers: Support Groups

“Regardless of the road we follow, we all head for the same destination, recovery of the [alcoholic] person. Together, we can do what none of us could accomplish alone. We can serve as a source of personal experience and be an ongoing support system for recovering alcoholics.”            -Alcoholics Anonymous

I posted an article mid-February about disclosing mental illness–when, how, where, to whom, etc. It may seem easier to deal with mental illness alone, but great strength can be found in numbers. The same is true with addiction; more often than not, disclosing addiction to trustworthy individuals can empower and motivate you to overcome your addiction. There is great power found letting other people in so they can can comfort you, support you, and keep you accountable. Your family and friends will have an important role in your recovery and healing, but this post is about the kinship and healing you can find beyond your immediate circle of support and in support groups.

You have likely heard of Alcoholics Anonymous or “A.A.” This is an international fellowship where those looking to overcome alcoholism will be encouraged and supported towards sobriety. People all across the spectrum of alcoholism take part in these A.A. meetings, and participants become friends and a support system.  Alcoholics Anonymous is one of the most well-known examples of a support group, but support groups are certainly not limited to overcoming alcoholism. In short, a support group is a gathering of people who share a common health concern/condition, an interest or a specific situation–such as breast cancer, diabetes, heart disease, addiction, or long-term caregiving.  

The general purpose of support groups is to help identify healthy and effective coping strategies, as well as skills often geared to mitigating feelings of angst, fear, pain, and loss. The groups also provide a great support network—in support groups you can find other members in similar circumstances with similar feelings with whom you can share in an open and unedited fashion. The group allows you to be where you are and validates and normalizes what you are feeling. Imagine the benefits of being surrounded by people who not only support you, but understand what you are feeling and going through!

Support groups are available worldwide. If you are in search of a particular support group, ask your doctor, or mental health provider for recommendations, or search the internet, contact local centers (community centers, libraries, churches, etc.), or ask someone you know in a similar situation for their suggestions. In addition, there are many options online including chat rooms, email lists, newsgroups, FaceBook groups, blogs, or social networking sites. Help is out there!

On the other hand, group therapy is a more formal type of mental health treatment that brings together several people with similar conditions under the guidance of a trained mental health provider. Its focus is more educational, therapeutic, and process-oriented. It provides a forum for change and growth, and there is often a theme presented for the entire group, with specific outcomes anticipated.  Support groups are less structured, with no set curriculum, and the facilitator can be a lay person or anyone who has an interest in the subject (instead, many themes may enter a discussion by a fluid group of members, and the facilitator guiding from the side). The following are a few of the key differences between support groups and group therapy:

  • Openness. Oftentimes, support groups are very open, meaning individuals can come and go as they please. If participants are unable to make it, the group carries on as normal. With a therapy group, participant’s attendance is crucial to the benefit of the whole.
  • Size.  Therapy groups range from four or six to ten individuals. Support groups can be communal, allowing more participants.
  • Facilitator’s role. Therapy groups function because of the therapist at the helm, directly leading and educating the group. In support groups, however, the facilitator, who is typically a selected participant, guides from the side, allowing participants to make comments and build off of one another. In both cases, facilitators objective is to create a safe learning space for all participants.

Each type of group offers a unique dynamic and the key is finding a group that meets your specific needs and association. Not everyone will find it helpful to participate in the more intense, focused, therapy-based experience of group therapy; however, nearly everyone can benefit from a support group. Support groups are readily available and are often free. Benefits from participating in both a support group as well as group therapy include feeling less lonely, isolated or judged; gaining a sense of empowerment and control; improving coping skills; talking openly and honestly about your feelings; reducing distress, depression, anxiety or fatigue; developing a clearer understanding of what to expect with your situation; getting practical advice or information about treatment options; and comparing notes about resources, such as doctors and alternative options.

Support groups and group therapy have an important place in healing and recovery–be it from addiction or from mental illness. Depending on the situation, it may be beneficial to see a therapist one-on-one, in addition to attending groups. In some cases, medication is also necessary. If you would like more information, please contact me today. I am more than happy to schedule a session with you or your loved one and help create a plan for healing. When looking for resources to address addiction or mental health issues, do not forget about the strength of numbers you can find by participating in support groups and/or group therapy!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

Finding Happiness After Hurt

Finding Happiness After Pain - Cluff Counseling, Denton Therapist

Finding Happiness After Pain - Cluff Counseling, Denton TherapistLife isn’t fair: people are unkind, injustices happen, and life sometimes seems to have dealt us a pretty hard hand. Here are practical tips to overcome emotional pain and find happiness.

Every day I see clients who are hurting. Some are suffering from childhood trauma, others from addiction, chronic illness, or the unexpected ending of a key relationship in their life. One of the things I have learned firsthand as a counselor is that there is a lot of hurt out there. You and I are literally fighting a world of hurt. But the main reason I absolutely love my job is that I have the chance to help my clients fight through their hurt and find happiness.

We have all experienced something unjust or painful in our own lives. Sometimes it is easy to shake those feelings and other times we just cannot seem to let them go.  Prolonged anger and feelings of injustice—directed toward a particular person, circumstance, or yourself—have a steep price tag: they can rob you of happiness in the moment and have negative impacts on your overall health. But there are steps we can take to overcome the inevitable feelings of hurt, pain, and resentment to find happiness. In addition to seeing a therapist, there are several simple ways you can start today:

  1. Fill your own cup. Sometimes, when we feel empty, we hope for and expect others to fill our cups for us…which is incredibly dangerous. More often than not, we let people in who are not healthy or worthy, and they do more harm than good. Stop that. Fill your own cup. Sandra Bienkowski writes for Mind Body Green, “You have to fill your own cup. Whatever you didn’t get and need, you have to give to yourself. If you didn’t get praise, give yourself praise. If you didn’t get love, show yourself some love and compassion with kind thoughts and doing things that make you feel good about yourself. If your home didn’t feel safe, create a safe and secure home as an adult.” Happiness begins when you are at peace with yourself.
  2. Stop looking for external validation. Be comfortable in your own skin.  Do not look to Instagram/Facebook/Twitter, your friends/family, or anywhere else for validation. Look in the mirror. Use your internal gauges to measure how you are doing and how you could improve. That is what they are there for!
  3. When people show you who they are, believe them. We sometimes make the mistake of hoping or expecting others to be who we want them to be. Let your friends, family members and acquaintances be who they are. Accepting their limitations and allowing them to be imperfect will help you avoid feeling disappointed when they do not measure up to your high expectations of them.
  4. Set boundaries. You are the only one who can set limits of where you end and others begin. Do not let other people’s issues/history/negativity hurt you. Your boundaries set the bar on how you expect to be treated or set the limits of what you accept and what you do not. Knowing how to protect yourself is really just you protecting your happiness.
  5. Have patience and compassion for yourself. Recognize that you are dealing with something hard. Cut yourself some slack, give yourself time to make changes, and focus on what you are doing well!
  6. Decide it is not worth it. Feeling angry, frustrated or wrong only harms you. Decide that is it not worth it, get help, and move on. Do not dwell on the negative!
  7. Separate facts from emotions. Yes, you got laid off–fact. Yes, that will impact your finances–fact. But these facts do not mean you are entitled to feel angry, frustrated, and wronged for years to come. Reconcile the facts (what you are NOT always in control of) with your emotions (what you are ALWAYS in control of), and you will be a lot happier.
  8. Seek treatments that help resolve feelings of anger and injustice. Effective modalities include Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Mindfulness Based Stress Reduction (MBSR), Loving Kindness Meditation, and Compassion Meditation. Contact me today if you are seeking one of these treatments to increase your happiness.
  9. Use relaxation as the antidote for anger. Have a plan or strategy to calm yourself down in the face of anger or frustration…because you are sure to need that plan at some point.
  10. Use imagery. Imagine yourself letting go of the negative emotions you are feeling and holding on to. Then envision yourself finding and clinging to happiness. As cheesy as it sounds, it may be remarkably helpful for you visual learners out there!
  11. Talk it out. For some of us, talking to a therapist or someone we trust can be extremely liberating. Getting a fresh perspective, as well as, suggestions for how to move on is invaluable. Use your words to extricate your feelings, work through them, and let them go. It is remarkable how liberating talking it out can be.

Of course there are a plethora of ways to replace hurt with happiness. I could spend hours talking about the power of hobbies, a balanced diet, regular exercise, quality sleep, religious outlets, and several other physical and emotional-reducing strategies. The 11 suggestions I have mentioned above are simple things you can do now with no added time, props, or money. In fact, most of the 11 suggestions I have shared begin with you deciding to be happy. At the end of the day, you are the one who decides to hold on to feelings of anger, guilt, resentment, frustration and injustice. While there are many tools available, your will is the most important. So if you are looking to stop the hurt in your life, decide now. Do it. Use the above methods and contact me if you need additional assistance. I find immense joy witnessing the personal transformations of my clients as they prepare to move on to the next phase of their life–as healthier and happier people. Stop the hurt in your life and welcome the happiness that is waiting for you.

Resources:
Cluff Counseling: “Choosing the Right Therapist for You”
Cluff Counseling: “Welcome”
Mind Body Green: “The 4 Best Lessons I Learned From Seeing A Therapist In My 20s”
Psychology Today: “7 Practical Strategies to Overcome Emotional Pain”
Psychology Today: “9 Tips to Stop Anger and Injustice from Hurting You”
Psychology Today: “Acceptance and Commitment Therapy”
Psychology Today: “Cognitive Behavioral Therapy”
Psychology Today: “Happiness”
Psychology Today: “Meditation”
Psychology Today: “Mindfulness”
Psychology Today: “Stress”

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Seven Questions Your Therapist Doesn’t Want You to Ask

7 Questions Your Therapist Doesn’t Want You to Ask

...but that the well-informed client will want to know7 Questions Your Therapist Doesn’t Want You to Ask

Have you ever been asked an awkward question that you are unsure how to answer? Well, therapists get those all the time! So often, in fact, that I have spent time to compile my typical responses for when people are brave enough to ask.  I completely understand where you are coming from–you are anxious, coming into therapy trusting me with something vulnerable. So when you ask difficult questions, such as the ones below,  I am impressed–it shows me that you are invested in your therapy and the progress in our sessions. Because I know these questions can take courage to ask, I am devoting my blog today to answering them all at once.

Q:  How can you help me if you have not been married/don’t have children/are not an addict, etc?

A: Fantastic question! This is one I understandably get a lot, as I’m not yet married or may not have experienced exactly what you’re going through. Here’s an analogy I love to use: A doctor does not need to have had a broken leg to know how to fix it.  In last week’s post, I talked about my extensive education, research, certifications, and training I have received in order to be an experienced therapist. I have been in the middle of hundreds of marriages totalling thousands of hours of counseling; I know what works! My job is not to share personal biases or experiences from my own life (like what I have done to achieve the perfect marriage), but to be an unbiased, third party observer and use my education, research, experiences, and skills gained through counseling others to help you reach your goals.

Q: Will you respect my values and/or spiritual beliefs when they are different from your own?

A: Yes, absolutely. As a religious woman, this is something I feel very strongly about. When you come into my office, I leave my beliefs at the door and adopt your values. For example, based on personal values, I have chosen not to smoke. But if you choose to smoke marijuana on a daily basis, I am not going to tell you that’s a bad decision or that you are a terrible person! My job will be to point out if your choices are steering you away from what you are ultimately wanting. If smoking marijuana is affecting you from keeping your job, for example, then I may point out that the drug is interfering with your ability to think clearly.  While I will never expect you to live according to my beliefs and quit smoking, I may advise that you be smart about when you smoke (ie. during the weekend or other times that will not interfere with your work performance). My job is to help you make the most of your life.  I’m not going to project my values on you; instead, I am going to meet you where you are and we will work together to get where you want to be!

Q: Have you seen a therapist for your own issues?

A: I see a lot of therapists as clients, and many of them ask if i have “done my own work.” Without going into details about what specifically I have had to work through, yes, I have certainly invested time in self-betterment. In many of the trainings I have been through, it was required that all attendees bring a piece of personal work to process during the training. If I felt like I did not completely work through that piece by the end of the training, I sought additional resources to help me fully resolve it. In order to be the best therapist I can be, I have to do my own work. I’ve been on the other side of the couch and I can honestly say that I understand where you are coming from.

Q: Do you practice what you preach?

A: You bet I do! Well, I try. I give my clients homework–things like practicing mindfulness or self-care, watching their diet and sleeping patterns, reaching out to their social network for connection, processing/identifying their emotions, etc. And yes, I do all the same things I ask my clients to do. I am not perfect…some days I fail miserably!  But I will redouble my efforts the next day–which is what I will expect of you when you fall short.

Q: Why do I feel worse than I did before I started therapy?

A: Although this is actually quite common, I can see why it would be frustrating for a new client to feel this way. In therapy, I’m going to help you work through issues you have ignored or numbed to protect yourself. Reliving difficult experiences or using coping mechanisms instead of resorting to an addiction can be uncomfortable and/or overwhelming at first. But this is good! It means there is movement where you used to be stuck. It’s a positive thing. I don’t expect it to last forever. A good analogy for this is the first time you took a new medication–did you feel some side effects before it kicked in and did its job? As you continued to take the pill, you likely began to feel more of the positive and less of the negative side effects.  Therapy can be hard, but these painful “side effects” will only be temporary; the “medication” (aka the work you have put into therapy) will kick in and you will experience the satisfaction that comes from your hard work.

Q: Will you let me know when I’m done with therapy or will you prolong my sessions so I keep paying you?

A: I am sure you can think of a million things to spend your money on other than therapy, so I admire you for even considering to come see me.  I always tell clients that my job is to work myself out of the job. As I said in this post, I experience such joy seeing clients progress, get healthier, and move closer towards their goals. (It is important to note that the amount of sessions required for each person and/or situation varies. There is no set time frame, but we will go at your pace until we both feel that you have fully worked through your issue.) So no, I absolutely will not “hold on” to you for monetary gain. I want you to move onto the next stage of life healthier, happier, and independently. Plus, as you “graduate” and leave counseling, that makes room for someone new. (Not to mention that I would probably get bored if I saw you forever…haha!)

Q: Why did you specialize in sex addiction and why do you like being a therapist?

A: Such a valid question. Let me just preface by explaining how I got interested in it: I was working at an agency where I saw numerous clients with signs of sex addictions. I did not have the needed skills to appropriately address or assess this piece of their treatment. I was led to seek additional training in sex addiction, and to working at an inpatient treatment center to further my knowledge, before moving into the private practice sector. I continue to see many sex addicts, male and female, in my office. Why? Because I have found that these dear people have the most tender hearts! And I find deep satisfaction helping them find their worth–they make mistakes (don’t we all?), but that does not make them bad people. I love reminding them of that!

On a more general note, I chose to be a therapist and work with couples and families because I deeply value those relationships. I absolutely love that my life’s work is helping others improve relationships I esteem so highly.

Do you have a question you would like me to answer? Click here to contact me today!