Frequently Asked Questions About Therapy

Find out who you are, and you'll know everything you need to know.

- Krishna Das

Below are some commonly asked questions about therapy. If you have a question that I have not answered here or in the information about what to expect in therapy and how therapy helps, please send me an e-mail and I will respond.

Will you give me medication?
Will you diagnose me with a mental disorder?
Will being in therapy mean I'm crazy?

Will you give me medication?

Psychotropic medication (medication taken to effect the mind) is a complex issue and is different for every individual. I believe medication has its place and can be helpful, even necessary, but I also believe it is still a relatively young science and is not well-understood. Human understanding of the brain is always expanding, but there is still so much we don't know. And that limited understanding includes psychotropic medication—how it works exactly and how it impacts our brains short-term and long-term.

I believe, therefore, that medication can be useful and important, but should not be undertaken lightly. Medication masks and numbs symptoms, which brings relief but can also make it more difficult to perceive and understand your symptoms and to find more genuine, long-term relief from them. Medication can also have very frustrating side-effects. Psychotherapy can, by itself, do much to help symptoms, possibly reducing or alleviating the need for medication.

I cannot prescribe medication. I can, however, talk with you about it. If you are interested in or need medication, we can discuss it and I can refer you to someone who can prescribe an appropriate medication. If you are already taking medication, we can discuss how it's working for you.

Will you diagnose me with a mental disorder?

Diagnosis is, like medication, a complex, shifting topic. Much effort and debate goes into determining the many different diagnostic categories that are documented in the official diagnostic manual, called the Diagnostic and Statistical Manual for Mental Disorders (commonly referred to as the DSM). The diagnostic categories change in small and large ways every time a new version of the DSM is released. This work is a sincere, ongoing effort to categorize and describe the various ways that humans experience mental and emotional trouble. It also shows how much is still unknown. Two and three versions ago, the DSM had diagnostic categories that are seen today as entirely wrong. At the time, though, they were used and applied seriously by mental health practitioners. So while a diagnosis can be helpful, it is also an approximation, a very educated guess, based on current but incomplete understanding.

For some therapy clients, it is helpful to have an official diagnosis for what they are experiencing—it gives a name to their experience and makes them feel less alone. On the other hand, a diagnosis can, like any label, be limiting and stigmatizing, making you feel as if you are just that diagnosis or you have a disease.

Because I do not accept insurance, I am not required to diagnose you. I also find limited value in officially diagnosing people. Diagnostic knowledge is an important reference point that I always keep in mind, but I feel it is more valuable for us to explore your individual experience and for you to feel, name, and understand your experience for yourself. Your experience is unique to you.

If a diagnosis is important in your situation, we can discuss that in the course of your therapy. And if I detect potentially urgent aspects to your symptoms or any symptoms outside my scope of practice, I will be attentive to those symptoms and refer you to other providers as necessary.

Will being in therapy mean I'm crazy?

In short, the answer is no and you can read more about the various issues addressed in psychotherapy and my professional philosophy. Seeking counsel for a difficult issue only means you are human like the rest of us and you are seeking help and renewal in a safe place.

Also, I believe that we lose something important when we chalk up issues to brain malfunction or being "crazy." Our brain is central to our experiences, but our experiences also change our brain. So the ways we respond to problems can substantially alter how we experience them. If you are open and curious about an issue and work to bring light to it, new possibilities unfold—you actually create "wiring" (neural pathways) in your brain that expands your capacity for new insights and choices and feelings. If you, instead, repeatedly respond to a problem in the same way or treat it only as a chemical imbalance, it's not just that you lose the opportunity for a new, more meaningful solution—you can actually increase the grip that issue has on you. When you rely on the same old brain wiring, you reinforce it. (The changing of the brain through new experiences is called neuroplasticity.)

So our experiences matter, even the painful ones. In fact, because they challenge our current thoughts and feelings, the difficult times in our lives offer a unique opportunity to change our brain: to expand ourselves and live with a greater sense of possibility, vitality, and meaning.