Demystifying Therapy | Spectrumly Speaking ep. 118
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IN THIS EPISODE:
(AUDIO – 30 mins) In this episode, hosts Haley Moss and Dr. Lori Butts go guest-less to discuss therapy — what it is, how it helps, why people need it, and how to get started.
Spectrumly Speaking is the podcast dedicated to women on the autism spectrum, produced by Different Brains®. Every other week, join our hosts Haley Moss (an autism self-advocate, attorney, artist, and author) and Dr. Lori Butts (a licensed clinical and forensic psychologist, and licensed attorney) as they discuss topics and news stories, share personal stories, and interview some of the most fascinating voices from the autism community.
For more about Haley, check out her website: haleymoss.net And look for her on Twitter: twitter.com/haleymossart For more about Dr. Butts, check out her website: cfiexperts.com
Have a question or story for us? E-mail us at SpectrumlySpeaking@gmail.com
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EPISODE TRANSCRIPTION:
HALEY MOSS (HM):
Hello, and welcome to Spectrumly Speaking. I’m Haley Moss, an attorney, author, advocate, and I’m autistic. Today I am joined here by my one and only co host…
DR LORI BUTTS (LB):
Hi, I’m Dr. Lori Butts. I’m an attorney and a psychologist.
HM:
How are you?
LB:
Good. How are you?
HM:
Tired. I think that goes for a lot of us, though. I think with somehow I know a lot of folks have been going back to school. I know there’s been some transition going on and think everybody’s just tired and also just being home.
LB:
Yeah, yeah. It’s a lot of new routines, a lot of new things, a lot of different demands. And it’s a lot of changes.
HM:
I think so too. I think some of us are feeling very chill, and others are feeling very heavy. Like a little bit of everything going on in their heads.
LB:
Yeah, I mean, a lot of people that I talked to are just completely overwhelmed. To be quite honest. I don’t I don’t talk too many people over saying, Yeah, everything’s working great.
HM:
Exactly, I think a lot of us are thinking we’re burned out, we’re just overwhelmed or just tired emotionally in some way, shape or form. Which is actually a really great way to kind of kick off our discussion for this week.
LB:
I think so too. I think our, our listeners and the general public are ready for it.
HM:
I’m ready for it, too. So this week, we are going guest-less. And we are discussing therapy. So, we know that mental health is something that’s been at the forefront for not just the autistic community, but for everybody, especially during the pandemic. And we really want to make sure that if getting help is something that you need, or that you’re interested in exploring, or just maybe, for whatever the reason it is we want to help you figure out more about that. So I know you are a psychologist, so I think you have a lot more information on this topic than I do.
LB:
And a lot of things I take for granted too. And, and I have some some opinions about this, that might not be very mainstream, so I have to be careful about what I say. So…
HM:
I think opinions are always a good thing to have. And I think people appreciate honesty. So I think kind of understand where we’re coming from on this topic, why should somebody seek therapy? Or is there like a sign that somebody should be thinking about this or are definitely going versus if they don’t, or is it mostly just a very personal decision.
LB:
So that’s on like, a broad spectrum, right. So there are certainly people that are in crisis, that have psychiatric conditions and are in crisis and need, you know, a lot of intensive help. And then all the way down to somebody who is functioning really well, but needs kind of an objective person in their life to be able to bounce off and problem solve. So, um, and everything in between, you know, so it’s, it’s complicated, and it’s individualized, and in that complications and individualization, there’s also understanding the right fit the right person that can assist with the needs, so and in a different points in someone’s life, the needs are going to change, and they can be from, you know, more intense and more, you know, crises type of things, to I just need, you know, somebody that I can talk to, you know, once a week, once every two weeks to keep me focused on, you know, taking care of myself or, you know, small little goals that you have. So that’s not like a great answer. But it’s a pretty broad question. And it changes and it depends on what a person is going through.
HM:
So it’s almost like the level of need is different. But Can anybody pretty much benefit? So I feel like I’m hearing that anybody can benefit from having someone else to talk to that maybe might be non judgmental, or working through a problem. So I’m kind of hearing as this is something that could benefit you, no matter who you are. Right?
LB:
I’m a little biased, right? So I mean, I’m a psychologist. So yeah, I think everybody can benefit from some type of therapeutic relationship. Now does that mean that everybody as mentally ill or any, no, that’s not what I’m saying. But, certainly everyone can benefit from having, you know, a set time to have their person to just talk about themselves and work through whatever it is that we all have, you know, struggles or challenges and any varying degree. And certainly having somebody who’s a professional to be able to walk you through that, and give you the skills, that doesn’t mean you need it for the rest of your life. But what happens is, is you gain skills that you can then implement into the next problem. So, you know, 2, 3, 5 years down the road, you have a different problem. But you can use the skills that you gain by working with somebody to work through that problem on your own.
HM:
I think a lot of our listeners are probably thinking this sounds really great, just like I am. And then I think a lot of folks also get very apprehensive about therapy for reasons that are related to access. So maybe it’s finding a provider who’s understanding maybe it’s cost, what does my health care plan cover? What does my employee benefits cover? So I know that’s something that’s been an obstacle in people’s lives that I know is that I’m afraid my insurance won’t take it, or what options are available to me. Because I think finances is something that comes up a lot when we talk about therapy as well.
LB:
Of course and herein lies. My problem is that right now, in the pandemic, there’s all these kind of online therapy sites that are popping up everywhere, and it’s, you know, great because access to care, and, and you can do it from your phone and things like that. But then the problem is, is that what are the qualifications of the person on the other line? It’s, um, it’s one thing, that if you are functioning really well, you just need a few pointers. And it’s another thing if you have some really complex issues, that the person that you’re dealing with is not well trained, and, and, and potentially could do more harm than good. And so that’s where my caution comes up in that area, where there, you know, and some of our listeners tend to be pretty vulnerable. And that sometimes impressionable, or suggestible. And heaven forbid, you get, you get attached to a mental health professional that even with with all good intentions, kind of rewards a sick behavior, and then that that sick behavior or that sick thought process continues. And that’s, that’s where my area of concern is, if that makes sense.
HM:
Oh, I think it does. I know that some services are a lot better at vetting people that are providers that are listed than others. So I know that some of them make it very clear that they have expertise to say adolescence where they have to be licensed in this, this and this before they even recommend a provider to you. I’ve never used those services. So I can’t really say but that’s been what I’ve heard.
LB:
Right but even even a license doesn’t mean that the person is…
HM:
So I think especially for our listeners who are neurodivergent I think there’s also this kind of frustration is sometimes you might have to be explaining why you are who you are. So how do we find someone who might be versed in neurodiversity or autism? And also is understanding that it’s not that we’re wasting all this time, kind of explaining or feeling frustrated that we’re like a lab object.
LB:
I think you’ve got to do your homework. I mean, you you look at somebody’s CV, their resume, you you look at, you know, what their experience and their credentials are, you talk to other people to see what their experiences it are, you know, personal referrals. And I know that that’s, that’s opening yourself up to some vulnerability by you know, telling somebody I want to seek help, but personal referrals to me are the best. The second best is looking at somebody’s resume, their CV, their training their experience. And then the third is, you know, getting somebody’s resume training experience and then giving it to somebody who, who can look at it for you. I do that, you know, I do it all the time for people where they asked me: do you think this is an appropriate person for me, this is a good fit? And I look at their credentials, and I say, you know, probably not let’s, you know, let’s go in another direction or Oh, yeah, that person has great experience and training and can really be the right fit for you. So and that’s, that’s that that part of the process is often skipped. And understandably so. But, but I do think that that’s an important piece of the process, and it shouldn’t be a barrier to access. Um, but it should be, you know, you have to be an educated consumer. You wouldn’t go to a podiatrist for brain surgery, you know.
HM:
It makes a lot of sense. Are you allowed to have like a consultation before you keep going? I know that sometimes it’s like to see if you have like, kind of that rapport even that you feel safer, you’re like, this person seems trustworthy.
LB:
Of course, of course. And that’s something you know, if you feel good about advocating for yourself, that’s something that you should be able to do like this is, you know, this is something that you’re interviewing that person as much as their, you know, to see. If that’s somebody that you you fit with unfortunate. And then here’s my little Asterix and caveat. There are a lot of times where I see people who go shopping for a mental health professional, because everybody is telling them that they need to change a certain piece, and they don’t want to change that piece. So then they find somebody who will yes them to death, and then that’s counterproductive as well, right? So it’s so tricky, and I’m making it probably more complicated.
HM:
I don’t feel like you’re making it more complicated, I think that you’re actually really explaining things because I do think like you were saying, a lot of folks who might be seeking help for the first time earn as an especially vulnerable place, or they’re vulnerable people because of neuro divergence, or they might not have the same social skills and awareness that a neurotypical person who might just be experiencing a lot of stresses. So I think it’s really helpful that you’re giving these extra caveats, because I think it’s especially mindful of who our listeners often are.
LB:
Right. And, and, and if, and so you have to balance out like that first consultation with, do I feel good with this person because they’re telling me what I want to hear? Or do I feel good with this person, because they might push me beyond? You know, and I need some pushing, and I need some direction. So that’s, again, that’s a complex process for, for the person that’s, that’s seeking therapy.
HM:
I’m assuming there’s also a trust component there. Because even if it’s someone, if it’s someone who’s pushing you, or that you think can push you, they can only push you as far as you’re probably willing to share. So you have to feel comfortable sharing with this person.
LB:
And that’s the most and then that’s another like, very integral piece, right? Because I tell professional psychologists, we’re not psychics.
HM:
Wait, we’re not? We can’t do mind reading and like mind melding type stuff? Sorry y’all.
LB:
Right, we’re often asked to, to perform such functions, and we are not. And so, you know, if you’re hiding things, or not divulging things, we’re embarrassed to talk about things that’s counter-therapeutic, because it’s probably the most important thing that the person needs to know about. And so yeah, that trust is really, really essential, and being able to, to be honest with your vulnerabilities so that the person on the, you know, the professional can actually help you, because they can’t guess what’s going on with you. And certainly, I’ve had clients many, many times that they keep having a problem, and they keep repeating this problem, and I can’t figure out what’s going on. And then lo and behold, there’s this whole other thing that’s happened, and, you know, that I hadn’t been privy to that makes it all, you know, make sense, but it’s a lot of time down the road that could have been, you know, the intervention could have been tailored to what it needed to be.
HM:
Mm hmm. But it’s also hard when you have people who might communicate differently or might not realize what they need to be sharing.
LB:
Right. And that goes back to the skill base of the professional their knowledge base or experience. And you know, the the communication which, you know, when right now mental health professionals are very strapped for time a lot of people are enrolling and treatment which is great, which is great. But also you can see that if you’re kind of going along quickly. Just like any other human kind of doing their job you might be missing. That, that piece. So it’s important for the professional to slow down. And and, and foster good communication and understanding with the neurodivergent client as well as the client, being a self advocate and saying, wait, I don’t understand this, or I need to, I need this explain better or those kinds of communication skills.
HM:
I love it. And I think something else is say you’ve never been before. And I know this is something that scares people is they’re like, I don’t know what it’s going to be like, maybe there’s going to like scrutinize me they’re gonna judge me or something shameful? Like, what’s it actually like when we’re in a session like this? Because I know there’s plenty of people who’ve never been like, what does that process kind of look like? Are you just having a conversation? Are you lying down? Back up on a couch? Like, what image that some of us have thought of since childhood? Like what are we really looking at?
LB:
Well, it depends on the orientation of the therapist, it depends on their education, and background. But typically, you’ll fill out forms ahead of time, and you fill out a bunch of history forms and things like that. And then, and then your first session will be more of an information gathering where you’re going to be asked a lot of questions about those forums and your history so that the professional can figure out, you know, what’s going on what needs to be addressed? And then you’ll do like a treatment plan. You know, what are your goals? What, what, what, what is, what is this going to look like? And so you’re collaborating with that person to talk about what what are priorities for you, and maybe in the professional can say, well, these are, these are things that I think would be priorities as well. And this is how I think we can get there. So it’s information. The first few sessions are more information gathering and, and goal setting and treatment planning settings. So it’s a collaboration, it’s not it’s a collaboration between the person and the and the professional just call, you know, the client and the professional. It’s a it’s a collaborative experience about what what needs to be prioritized, what makes sense and how we’re going to get there.
HM:
So expecting instant results is pretty unrealistic, right?
LB:
Yeah.
HM:
I think I because I’ve met people who will go to one or two sessions and be like, well, I still feel like I don’t feel like anything’s changed. And I think that’s also unrealistic. So what kind of realistic expectations should we have?
LB:
Well, it depends on the issues right so um, so some, some things can get resolved within 4, 6, 12 sessions. You know, you don’t have to be in therapy for the rest of your life. If you go in and you have specific kind of goals or needs, and you get in there and you do the hard work, then you you get, you get the skills and you move on and you’re you move on with your life. You don’t have to, if you if your issue is, you know, problem solving, organizing, prioritizing, you certainly don’t have to talk about you know, what happened when you were two years old, to be able to, to work with somebody to take a you know, to get organized and to problem solve and things like that, certainly, if you’ve experienced life, you know, a whole history of trauma that might that’s a different type of scenario. But even still, you know, evidence based trauma work isn’t necessarily the rest of your life as well as focused and there’s treatment protocols that you would engage in and and and help you work through it and and move on it’s not meant to be you know, something that you have to be in treatment forever and, and it should be in a supportive, trusting environment right now, a lot of things are over zoom. So I think people are kind of comfortable in their own houses more so than coming into a new place like you’re saying, imagining what the room would look like it things like that. So I think the accessibility of of over the internet not having to drive the car and park and all all of those who’s going to be in the waiting room and all those things, barriers have gone by the wayside. But some people miss that and they want the you know, it’s up to the individual but it’s certainly I think right now less threatening for most people to do it on the on the internet because it’s it’s let you have less of those like experiences that are scary and unknown.
HM:
And I think even if you’re really that afraid of the unknown, do you think something like an in like a group therapy session or if it’s a relationship, maybe going with your partner and working through those issues, So basically that you’re not just one on one, do you think that could be helpful for some folks?
LB:
Sure, absolutely. Depends on the person. So, you know, groups are great, especially for people who are having difficulty socializing. And people with social skills deficits and people feeling like, they’re the only person struggling with whatever x, y and z is, then groups show you that there’s other people that are struggling with the same thing. And there’s, as human beings, we, we feel validated and supported by knowing that you’re not the only person that’s going through something, whatever that something is. And so group therapy can be a great avenue to do that. And of course, couples or family therapy, you feel supported going with, with a loved one with a partner. And that can totally break the ice and, and help you manage and deal with what the issues are that you want to address.
HM:
That’s exciting. Yeah, I love that. Cuz I always think of group kind of like the movies where you see it when people are doing inpatient stays. And I don’t think that’s always realistic, either. So I kind of wanted to demystify some of the stuff that like someone who might have never had an experience or thinking about because I’m thinking, the first thing I think of when I think of group is I think of like inpatient, when that’s part of your schedule.
LB:
Oh, interesting. Cuz I always think people, I always think people are grief groups, like AA groups or something like,
HM:
Well, I think of grief groups. When I think of things like, when I think of therapy in that setting, I think of a grief group, or I think, or I think of when people are impatient, and that’s part of their treatment plan. So things like, or I’ll think of things with, like support groups, like if you’ve seen The Fault in Our Stars, and they’ll have the cancer support group or write different things with grief groups, and they show that and they have the relationships with grief group.
LB:
Yeah, I think I think that grief group probably is probably the closest thing like, I think that that would probably be a good kind of representation of what it would be like.
HM:
Okay, I just wasn’t sure. So I was like, cuz I know that some of us are ideas of everything comes from pop culture, because we if we don’t have a concept of it from personal experience, or someone who has lived experience, especially because I think for a lot of younger people, mental health is something that’s seen. It’s not taboo for younger folks, but for our family members. And like people, like our parents, or grandparents, it might be a little bit more taboo, because they’re not used to talking about it the way that younger folks usually are more willing to write. So I guess it’s trying to figure out what things look like, because we might not have had that experience of like, our parents, or some other older relative or loved one saying, Oh, yeah, this is what we’ve been through. But their frame of mind is also probably what they saw in the movies.
LB:
Good point.
HM:
So that, so I think I’m trying to just get some clarity on the things that people will jump to is their script or something if they haven’t had any background?
LB:
Right, right. And I mean, you know, that the expectation is that that the first the first time in person will not be particularly comfortable, but the environment should be welcoming, and comforting. And after you kind of like rip the band aid off of that first kind of meeting, and whatever it should feel comfortable, but it doesn’t have to, you know, it’s not always going to be super comfortable, right? Because you’re working to change and change is difficult.
HM:
So we should get comfortable with the idea that we might be changing and we might feel uncomfortable during this process.
LB:
Right.
HM:
But that’s the thing that’s comforting is that you are going to grow you are going to change, right? It might not always be easy, like get comfortable with that idea. Right? Right. Right.
LB:
Right. Because it and that’s, that’s okay, that’s growth that’s, you know, healing, you know, um, and even, you know, a lot of times we get stuck in, in negative spirals that are comfortable, even though they’re negative, right? They’re comfortable. And so hopefully you get involved with a professional that kind of nudges you and pushes you out of that comfort zone so that you can experience more positive things, you know, trying to be general about it, but experience.
HM:
I like that we’re getting cast those kind of images that a lot of us think of of like the movies or those types of groups in those settings, or even things like just someone crying on a couch that they’re laying down tape like. I’m glad that we’re kind of getting past some of that imagery. I I’m glad that you’re helping us. understand what’s going on, or what someone might be expecting.
LB:
If anybody watched The Sopranos, the therapy sessions from the sopranos are pretty good. I mean, she had a beautiful office. That was very, you know, high end gorgeous furniture and all of that, but…
HM:
I’m actually really glad you mentioned that because I know a lot of folks are, especially with HBO Max, rediscovering The Sopranos. I think that’s a really great frame of reference is when we’re thinking of what it looks like, in practice having something to kind of go back to and go, Oh, yeah, it’s kind of like the sopranos that makes a lot of sense. And hopefully, all our offices are that pretty far in person safely. Because that might not be your comfort level right now, either. So I kind of just, you know, trying to be accommodating to everybody as well. Is there anything else super important that we should know? Because I think this is a lot of information. And we don’t want to have everybody feel like they’re drinking water out of a firehose. Is there a resource or something that maybe we should point folks to,
LB:
um, there are lots of resources. So like, each, each state has a psychological association, and they have their members like, on that, where you can find people locally in your area, the American Psychological Association has like a find a psychologist, button. You know, local, I’m trying to think if our, who are who our listeners are most linked to, and maybe physicians, you know, physicians tend to, to be able to refer people to local psychologists, psychiatrists in their area, they tend to know, no people. And again, I kind of, I have a bias against this kind of mass marketing of these online. And maybe that’s not fair to them. But you really, you just strongly, I strongly encourage everybody to look up the person their name their credentials. And, and if the credentials don’t mean anything to you, as somebody in your life that may know. If your LinkedIn to some, you know, to different advocacy groups online, talk to them, network and do your homework, because it’s important for you to find somebody that has that has good education training, and can help you.
HM:
That is so helpful. And I’m really glad that you spoke to us more about this. And I’m glad that I got to ask a lot of questions that might have been questions that others have or that we’re thinking about if this is new to us, or maybe not so new to us. So thank you again for having such a wonderful discussion with me. I truly appreciate it and I know our listeners do as well. I think we have a really great note to wrap up and a lot of information to take in. So if this was a lot of information or you’re struggling feel free to reach out the be able to do what you have to do, it’s okay to need help and as we go in therapy can be beneficial to anybody. So, to get more information about all of us, be sure to check out differentbrains.org and check out their Twitter and Instagram @DiffBrains. And don’t forget to look for them on Facebook. If you’re looking for me, I can be found at Haleymoss.com or I can be found on all major social media. Feel free to say hello.
LB:
I can be found at CFIexperts.com. Please be sure to subscribe and rate us on iTunes. And don’t hesitate to send questions to spectrumlyspeaking@gmail.com. Let’s keep the conversation going.
Spectrumly Speaking is the podcast dedicated to women on the autism spectrum, produced by Different Brains®. Every other week, join our hosts Haley Moss (an autism self-advocate, attorney, artist, and author) and Dr. Lori Butts (a licensed clinical and forensic psychologist, and licensed attorney) as they discuss topics and news stories, share personal stories, and interview some of the most fascinating voices from the autism community.