5 Tips for Teletherapy or Online Counseling

Many therapists in the United States and probably across the globe have switched to some or all virtual sessions. It all shifted so quickly that I’m amazed the Internet didn’t collapse! Between everyone streaming movies, shows, games, and exercise classes, I’ve been pleasantly surprised at how well my online sessions with clients have gone and how well my clients adapted to this new medium.

I’ve been doing online therapy, or teletherapy, with a few clients for about a year, so I’m familiar with the platform.  A lot of free training is available to help therapists  get online and feel more comfortable, but I haven’t seen much to help our clients feel more at ease with this “new normal.”

Sitting in the client’s seat

I experienced the discomfort first-hand as I got ready to meet my therapist online for the first time this week. I’ve been advocating for the switch with my clients, but when it was my turn, I found I wasn’t as enthusiastic at all! Some of the thoughts that went through my head were:

• “Maybe I don’t need a session this week.”

• “It can’t possibly be as meaningful as in person.”

• “I wish I’d just cancelled my session.”

I like going to my therapist’s office, and I was a little frustrated that I had to do this “new thing at home.” We talked and I laughed about my own discomfort as we met through our screens. Guess what? My session went really well! I got so much out of the session.

Experiencing virtual therapy myself gave me a lot of perspective and I felt so much compassion for my clients who have to do this “new thing.”

So, I thought it might be helpful to share some things that might help you if you’re going through a something similar, or if you’re considering therapy for the first time and your sessions will be online.

Here are a few tips for client of online therapy:

1.    You’re probably going to feel a little nervous about seeing your therapist online if you’ve never done it that way before. Your therapist will probably be nervous, too, especially if it’s new for them too.

Meeting a therapist in a new space in a new way feels different, and that can make us feels uncomfortable and anxious. That’s totally normal! Talking to your therapist about your feelings can help you feel comfortable as you get more familiar this new platform.

2.     If possible, find a place in your home where you feel at ease and have a comfy place to sit.  As a therapist, I go to great lengths to make my office feel like a sanctuary. A place you come to and say, “Ahhhh…”

We will talk about difficult issues in session and we want you to feel supported even in your discomfort. So, do your best to find a place where you can relax when meeting virtually with your therapist.

3.     Privacy is very important. When you go to your therapist’s office, there’s good chance you’ve come across a white noise machine. That’s because we want our conversation in the therapy room to be private. Now, you don’t necessarily need a white noise machine, but you do want to find a place in your home where you can talk freely.

If you have to monitor your voice level or are worried about someone listening to your conversation, address this with your therapist.  Maybe you can find an alternative solution, like calling or meeting virtually in your car, or another private place.

Using headphones or earbuds can help, too. That way, you are the only one hearing your therapist’s voice.

4.     There will be glitches! Technology is rarely seamless. Screens will freeze, voices will sound disjointed of clipped, or you might not be able to connect at all online. Those issues can be very frustrating. The amazing thing is that, most of the time, it works really well. So, try not to get too discouraged if a video session isn’t perfect.

I’ve opted to call clients by phone when the online technology is working against us. Your therapist might not be able to provide this option if your insurance won’t allow phone calls, but your therapist might be able to suggest other options.

5.     If you’ve always met your therapist in their office, know that we are in this new space together. You will get used to it. The discomfort will fade, and therapy will continue to be a source of support, learning, comfort, acceptance and growth.

As we move forward in this new world where entire countries can be affected by health concerns, I’m grateful for the virtual spaces where we can feel connected to our families, friends, colleagues and our therapists!

---

If you enjoyed this blog post and would like more insights into living with anxiety, tune into the Woman Worriers podcast. In each weekly 30-minute episode, host Elizabeth Cush, LCPC, and her guests explore living with anxiety, relationships, parenting, surviving trauma and other topics and offer insights into mindfulness, meditation and other helpful resources.

Elizabeth Cush, LCPC is a therapist, blogger,  creator and host of the Woman Worriers podcast, and the owner of Progression Counseling in Annapolis, Md and she’s been featured in these major publications. Elizabeth helps busy, overwhelmed men and women manage their anxiety and stress so they can live their lives with more ease, contentment and purpose. If you'd like to know more about how individual, online and group therapy can help ease anxiety and stress, contact me!

Be Kind To Yourself

Everyone makes mistakes, but some of us continue to think about what we could have done better after the event. We beat ourselves up about small things. If you find that you are your own worst critic—harder on yourself than others—maybe it’s time to show a little self-compassion.

What Is Self-Compassion And Why Is It So Hard?

Why is self-compassion so hard?

We seem to be able to offer others, even strangers, compassion when times are tough. Why is it so hard to be kind to ourselves when we are struggling? Some people think, “If I am not hard on myself, I will never get things done.” Others might say, “Self-compassion is self-indulgence, or selfishness.”

Many people think self-compassion means we give ourselves a pass for everything we do. That’s not it. Self-compassion means that we offer ourselves the same message of comfort and understanding that we might offer a friend who was going through the same thing.

Dr. Kristin Neff has done a lot of research and writing about self-compassion. She identified that self-compassion has three components: self-kindness, common humanity and mindfulness. You can read more about her findings here.

The Argument For Self-Compassion

I’d argue that if we don’t take care of our own emotional well-being, we’ll have a hard time helping others when things get tough. If we are struggling emotionally, frustrated with ourselves, or constantly self-critical, it is very hard to give balanced support to someone else. If we can’t accept and love ourselves, faults and all, how can we offer that compassion to others?

Self-Kindness

Believe and be kind to yourself

Self-kindness means that if we are feeling fearful, or sad, or we are questioning our behavior, we offer ourselves words of kindness, instead of criticism. When we imagine what we might say to a good friend who was suffering and then offer those same words to ourselves, we can acknowledge our discomfort and recognize that no one is perfect. This can help challenge our inner-critic, which can cause us to feel bad about ourselves, create anxiety, and keep us from taking chances or trying out new things.

Common Humanity

When times are tough—maybe you’re feeling anxious, depressed, or just having a bad day—if you can remind yourself that everyone has bad days, that everyone struggles, it can ease the intensity in that moment. When we ease the intensity, we can reduce the feelings of anxiety and depression. Here’s a guided meditation to help you.

Mindfulness

Dr. Neff writes that “Mindfulness is a non-judgmental, receptive mind state in which one observes thoughts and feelings as they are, without trying to suppress or deny them.”

When rethinking a mistake, we can get stuck in the “what ifs,” or if onlys.” Learning to come back to the present moment, through mindful breathing and grounding techniques, we begin to understand that thoughts, feelings and behaviors all come and go. Instead of the constant worry about the past or future, we become accustomed to allowing what is. This can help reduce negative thinking, ruminating, self-blame and shame, because we learn not to over-identify with our feelings or thoughts.

How To Move Forward With Self-Compassion

Through self-compassion practice, we can begin to accept our imperfections, and to feel more connected with those around us, because we are all human, and humans struggle from time-to-time. We learn to accept the ups and downs in life as a part of our experience, instead of a reflection of who we are. We learn that the anxious inner critical voice is just one part of us, and with compassionit can be quieted.

Trying anything new takes practice. At first, it might be hard to offer yourself kind, compassionate understanding but keep at it. The more often you can see yourself with love and kindness the easier it becomes.

If you want to bring more self-compassion into your daily life, check out my blog Spring: A Time To Cultivate And Grow Self-Compassion, or contact me, 410-340-8469.

---

Elizabeth Cush, LCPC is a therapist and the owner of Progression Counseling in Annapolis, Md. She helps busy, overwhelmed men and women manage their anxiety and stress so they can live their lives with more ease, contentment and purpose.

Photos courtesy of Yoann Boyer and Seth Doyle for Unsplash

Do Anxious Parents Raise Anxious Kids?

Anxiety is sneaky — so sneaky that we often don’t realize we have it until it’s a part of our daily lives. I didn’t recognize that I was experiencing anxiety until I was over 40 years old. I just thought I was irritable, stressed, introverted. When I began to recognize that my anxiety caused these things, I took a look back at my life and began to understand how often it showed up. After I saw the impact anxiety had on me, I worried about how much my anxiety had affected my kids.

The thing about anxiety is that you can pass it down to your kids without even trying or knowing that it’s happening.

Anxious Parents = Anxious Kids

Studies have shown that anxious parents can lead to anxious children. And it’s not genetics; the kids aren’t born that way. One of the ways children learn is by modeling the behaviors of others, then imitating them and internalizing them. Anxiety is one of those behaviors. If your child sees you getting stressed out or irritated before taking them to school, he picks up on your anxious feelings about going to school. If this occurs regularly, , your child might then develop her own anxieties about going to school. Your children can pick up on your anxieties in other areas, too, like social situations, making phone calls, phobias, when things are out of your control — you get it.

My children have manifested anxiety in their own ways: a fear of bugs (me too), anxiety attacks (I’ve had them) and social anxiety (I get it). This is not the legacy I wanted to pass down to my kids.

Learning To Manage Anxiety

The good news is that other studies have shown that parents who learn to model healthy ways of managing their anxiety have children who are less likely to develop anxiety themselves. When kids see their parents managing their anxiety in healthy ways, they learn how to manage their own anxious feelings. When I realized that I’d been anxious a long time, I discussed it with my kids and shared the ways I was learning to manage it.

My previous post gives some awesome tips from a colleague on how to help you manage your children’s anxiety. Below are a few suggestions for healthy ways to manage anxiety that you can model for your children:

• Practice calming techniques together when you’re not stressed out. Creating space to calm yourself when you’re feeling at peace helps you access that calm place when you’re stressed.  Involving your children will help them access it too. Meditation, breath awareness, yoga, mindful drawing and sitting quietly are all good ways to practice.

• Pause before reacting. Anxiety can make you very irritable and short-tempered. If you’re stressed or feeling uncomfortable, you might lash out at those you care about in ways you’ll regret later. Take the time to pause and take a deep cleansing breath, acknowledge your anxious feelings, think about what you want to say and how you want to say it. For example, maybe you’re driving in heavy traffic and your kids are singing or talking loudly in the car. Because you’re anxious about the traffic, you might find yourself yelling at the kids to be quiet. Instead, take a deep breath, recognize that you’re anxious and think about what you need from your kids to help ease your anxiety. You might then be able to say something like, “It’s super busy on the roads right now and it’s stressing me out. It would really help me if you guys can keep it down so I can pay attention to all the cars on the road.”

• Be kind to yourself. Anxiety often gets activated when we make mistakes or forget things. Beating yourself up only increases your stress. Try offering yourself words of comfort and support: “Oh no! I dropped the eggs! But that’s OK, everyone makes mistakes,” or “I missed my dentist appointment! That happened because I have a lot on my mind. But it’s OK because I’m human and sometimes I forget things.” Saying these phrases aloud shows your children that no one is perfect, and being imperfect is a part of life.

Therapy Can Help You Manage Anxiety

If you’re having trouble managing your anxiety and stress, counseling can help. It helps you understand what your triggers are and how they developed. Therapy provides support and a safe place to share your thoughts and feelings. A therapist can also help you figure out what strategies work best for you to help you manage more effectively. If you’d like to find out if therapy might help you, please call or email me.

---

Elizabeth Cush, MA, LGPC is a therapist and the owner of Progression Counseling in Annapolis, Md. She helps busy, overwhelmed men and women manage their anxiety and stress so they can live their lives with more ease, contentment and purpose.

Photos courtesy of Caleb Jones and London Scout for Unsplash.com.

10 Signs That You Might Be Under Stress

She’s Got It All, Doesn’t She?

Maria might seem familiar to you. Maybe she’s a friend, relative, co-worker…. Maybe she’s even you. I know her well, because she’s like many women I see in my Annapolis counseling practice who are affected by stress.

Maria sees herself as a woman who can handle a lot. She’s very busy most of the time, and when she’s got free time she finds things to fill her schedule. She juggles a career, children, laundry, cooking, cleaning, volunteering, and helping out friends in need. In fact, Maria loves to help others, but she finds asking for help much more difficult.

In the past, her friends often wondered how she managed to keep everything under control, but lately they worry that she’s struggling. Maria hasn’t said anything, but she’s missed a few plans with friends, she’s forgotten about parent meetings at the middle school, and she seems very distracted, as if her mind were a million miles away.

Life Changes Can Add Stress

Until recently, Maria had always seen herself as independent and motivated. More important, she always felt in control. Then she was promoted at work. In her new position, she has to manage employees and learn new responsibilities. She was so excited and proud to be promoted, but the added work has created stress. Maria believes that she should be able handle her new job without a mistake. She’s sure the employees are judging her and will no longer respect her if she doesn’t get it right.

10 Signs That You Might Be Under Stress

1. Worrying all the time.
2. Feeling as if our mind is always in the “on” position.
3. Being short-tempered towards family and friends.
4. Wanting to avoid people and places for fear that others are judging you.
5. Anxiety attacks that seem to come from nowhere.
6. Experiencing frequent headaches or stomachaches.
7. Feeling tightness in the chest, or shortness of breath.
8. Difficulty focusing on daily tasks.
9. Trouble sleeping most nights because your mind won’t turn off.
10. Feeling overwhelmed at work and at home.

Perfection: A Realistic Goal?

Maria thought she had to be a perfect parent, a perfect employee, a perfect wife, a perfect friend — but suddenly all of the pieces of her life that she’d kept organized and balanced suddenly felt overwhelming. She was irritable with her family, she avoided friends because she was sure they were judging her, she was constantly worrying, and she was stressed out. Maria thought that asking for help made her weak. When her husband and best friend suggested she see a counselor to help her manage her stress, Maria felt like a failure, but she knew she needed the outside support. 

With counseling perhaps Maria can learn to let go of the need to control everything and everyone, to reach out for help and support and to accept herself for who she is — a human with built-in imperfections.

Counseling Can Help You Manage Stress By:

• Giving you a safe, non-judgmental place to talk about what’s on your mind.
• Providing space to tell your story from your perspective.
• Allowing you to gain an understanding of your body’s stress response, and how it impacts your mental and physical health.
• Teaching you stress-reduction strategies and techniques.
• Helping you learn to accept yourself as you are, so that you can embrace your imperfections.

Sometimes our carefully controlled lives can feel out of control, like Maria’s did after her promotion. Counseling can help you bring balance to your life and reduce the feelings of being overwhelmed and stressed.

If you would like help managing your stress please call me for a free 15-minute phone consultation. You can also check out my blog for more posts on stress, mindfulness and how counseling might help you.

---

Elizabeth Cush, LCPC is a therapist, blogger,  creator and host of the Woman Worriers podcast, and the owner of Progression Counseling in Annapolis, Md. She helps busy, overwhelmed men and women manage their anxiety and stress so they can live their lives with more ease, contentment and purpose. If you'd like to know more about how individual and group therapy can help ease anxiety and stress call me 410-339-1979. 

Signs Of And Strategies For Dealing With Worry

Worrying is normal; it’s how we assess for potentially dangerous situations. But sometimes worry can take over your life, and leave you feeling overwhelmed. When that happens, you might need some strategies to let go of the worry.

Always Worrying

You might see yourself in this story because this could be many of my clients that I’ve worked with in my Annapolis counseling practice who have struggled with worry, stress and feeling overwhelmed.

Worrying can leave you exhausted and feeling overwhelmed.

Francie was always busy. She took care of her home and her family, she worked part time, she volunteered at her kid’s school, and she was always the first one to offer to help out her friends. From the outside Francie appeared to have it all together, but what most people didn’t know was that Francie worried all the time.

She had twin girls and entering middle school, and she worried about them out in the world. She worried about her husband driving to Baltimore County on the beltway each day. She worried about her parents, who might be getting divorced. She worried about her sister, who seemed to like to have a little too much fun. She worried when her house wasn’t clean, or the laundry didn’t get done. She worried when everyone in her family wasn’t happy, and worried when she couldn’t make everything better. She worried that maybe she wasn’t a good enough mother, wife and friend. She worried about worrying too much.

We all worry. It’s part of being human, and worry can serve us well because we are ready for danger when and if it comes. But for some people, like Francie, worrying can take over their thoughts, leave them feeling overwhelmed, and they lose the joy and ease in their lives.

5 Ways To Recognize That Worrying Could Be Ruling Your Life

1. Worrying keeps you from falling asleep or staying asleep most nights.

2. It feels like your mind is always “on.”

3. You rehash conversations, your actions or behaviors over and over again, wondering how you might have done things differently.

4. When things don’t go as planned you get frustrated, angry or scared.

5. You’re irritable a lot of the time.

All the worrying made it hard for Francie to sleep well. Some nights she fell asleep at 3 a.m., only to wake again at 6 a.m. Her friends and family didn’t know that she worried so much, that she often had trouble concentrating at work, and felt unfocused much of the time. She got frequent headaches and stomachaches. Sometimes she couldn’t swallow food because of the tightness in her throat.

Recently, Francie had an anxiety attack while working at her daughters’ school. She was light headed. Her chest felt constricted, and she could only take shallow breaths. She began to sweat, she saw stars, and she thought she was going to faint. This was the first time her friends knew she was struggling. She was mortified that they had witnessed her in such a vulnerable state. The feeling of losing control prompted Francie to seek therapy.

Counseling For Anxiety

Through counseling, Francie began to understand that her need for control stemmed from her learning at a young age that being in control kept the peace, and it also kept her safe. Over time, Francie revealed that her father had been an alcoholic. Francie had to take care of her younger siblings when her mother was at work. If Francie didn’t keep them under control, her father would yell at her and then at her mom when she got home. This made her mom really sad, and Francie felt she was to blame. When she was able to keep her siblings under control, things were less stressful, and she felt safer.

Counseling also helped Francie understand that her constant worrying was anxiety, and staying busy was her way of controlling it. If she was always doing something, she had little time to think about her worries, and so she filled her days with work, activities and chores.

We discussed the impact that all her worrying was having on her mental and physical health. We talked about why being in control was so important to her, and how hard it was to control everything in life.  Together we came up with some strategies to help her more easily accept the natural ups and downs of life, which allowed her to let go of her need to control everything.

5 Strategies To Help You Let Go

Practicing mindfulness can help ease worry

1. Practice daily mindfulness. Mindfulness means paying closer attention to what is happening right now, with openness and compassion. It keeps you attuned to the here-and-now instead of worrying about past and future events. You can read more about practicing mindfulness and self-compassion.

2. Exercise regularly. Exercise releases the body’s natural “happiness” chemicals and hormones. It can also help you sleep better.

3. Practice healthy sleep habits. A good night’s sleep can take the edge off, make you less irritable and activate your body’s immune system.  Here are some tips for a good night’s sleep.

4. Do yoga, get acupuncture or meditate. These alternative practices can help you relax your body and calm your mind.

5. Get support. Talk to friends, family or a counselor. People often feel alone in their struggles. Sharing your experience can help you feel more connected and supported.

Achieving Emotional Balance

Through counseling and some lifestyle changes, Francie has been able to live a more emotionally balanced life. If you would like to live your life with more balance please call or email Progression Counseling for a free 15-minute consultation.

---

Elizabeth Cush, LCPC is a therapist and the owner of Progression Counseling in Annapolis, Md. She helps busy, overwhelmed men and women manage their anxiety and stress so they can live their lives with more ease, contentment and purpose. If you'd like to know more about how individual and group therapy can help ease anxiety and stress call me 410-340-8469.