"Do I Have to Tell My Therapist the Details of My Self-Injury?" AKA 117

1. I'm wondering if it's important to go into the details of self injurious acts when discussing it with your therapist. My therapist always wants to know exactly how I self injured (what I used, where, etc) but it makes me super uncomfortable to go into such detail. I know I should probably ask her why, but that makes me uncomfortable as well..
2. Depression often robs us of all joy. Is there an effective way to combat anhedonia? How can we motivate ourselves to do things we used to enjoy, when our brain feels no pleasure from it whatsoever? Do we just force ourselves to do it and go through the motions in hopes that...
3. Should your therapist be similar or have similar values to you? I know that usually patients don’t know much about their therapists and their personal beliefs, and I agree that they shouldn’t. On the other hand, I sometimes wonder if therapy is more beneficial if certain values are the...
4. Sometimes I'm wondering what a 'normal' amount of stress or fear is. Everyone is experiencing stress sometimes. (Asking a colleague something, giving a presentation before a group of people, driving your car to a new location, walking in the dark...) At what point is stress or fear 'too much' for...
5. How do you approach patients that don’t feel anything? My last therapist said I was her most difficult client as I never knew how I was feeling I just knew I didn’t like it. I’m worried about seeing someone new as after a year and a half in therapy we came to a place of no progress and...
6. Can you explain how exposure therapy is supposed to work? I get nervous easily, but still manage to do the stuff that makes me nervous (when I can't avoid it or procrastinate). For example, I get sick to my stomach, heart starts beating faster and find it a little harder to breathe whenever...
7. Why can’t I get myself to share things with my therapist? I am 6 sessions in and I want to start talking about things that matter and that I need help with but I can’t get myself to share. I do like her and trust her but I still can’t seem to do it. I find myself full of anxiety while there to the point where...
8. Can you explain the differences between dissociation and a flashback? Also both happen at the same time? My recent experience was triggered through a topic and I felt really anxious. During this I shivered, my muscles were tense and I couldn't react to the words of another person but still hear her.
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[@anniekate76]

Timestamps! 2:18 1. I'm wondering if it's important to go into the details of self injurious acts when discussing it with your therapist. My therapist always wants to know exactly how I self injured (what I used, where, etc) but it makes me super uncomfortable to go into such detail. I know I should probably ask her why, but that makes me uncomfortable as well.. 26:04 2. Depression often robs us of all joy. Is there an effective way to combat anhedonia? How can we motivate ourselves to do things we used to enjoy, when our brain feels no pleasure from it whatsoever? Do we just force ourselves to do it and go through the motions in hopes that... 42:33 3. Should your therapist be similar or have similar values to you? I know that usually patients don’t know much about their therapists and their personal beliefs, and I agree that they shouldn’t. On the other hand, I sometimes wonder if therapy is more beneficial if certain values are the... 56:45 4. Sometimes I'm wondering what a 'normal' amount of stress or fear is. Everyone is experiencing stress sometimes. (Asking a colleague something, giving a presentation before a group of people, driving your car to a new location, walking in the dark...) At what point is stress or fear 'too much' for... 1:06:05 5. How do you approach patients that don’t feel anything? My last therapist said I was her most difficult client as I never knew how I was feeling I just knew I didn’t like it. I’m worried about seeing someone new as after a year and a half in therapy we came to a place of no progress and... 1:15:29 6. Can you explain how exposure therapy is supposed to work? I get nervous easily, but still manage to do the stuff that makes me nervous (when I can't avoid it or procrastinate). For example, I get sick to my stomach, heart starts beating faster and find it a little harder to breathe whenever... 1:25:28 7. Why can’t I get myself to share things with my therapist? I am 6 sessions in and I want to start talking about things that matter and that I need help with but I can’t get myself to share. I do like her and trust her but I still can’t seem to do it. I find myself full of anxiety while there to the point where... 1:31:02 8. Can you explain the differences between dissociation and a flashback? Also both happen at the same time? My recent experience was triggered through a topic and I felt really anxious. During this I shivered, my muscles were tense and I couldn't react to the words of another person but still hear her.

[@jungocarlier4740]

Thank you for these, this is great!

[@OTDM]

Thank you AnnieKate :)

[@nikkimckay860]

Anniekate76.hello thanks again for doing these time stamps 🙂

[@justanotherfan18]

It's why I got tattoos. Right half sleeve and left full sleeve. Yet sometimes people look close and have asked about the scars.. say it was a long time ago.

[@raywood8187]

One of the standard questions I'm always asked at appointment check-in at my therapist office, along with is my address still the same, is have I been to the emergency room? It's hard to imagine a therapist not wanting that information for standard health assessment purposes.

[@toni2309]

1. 2:17 2. 26:04 3. 42:33 4. 56:45 5. 1:06:06 6. 1:15:28 7. 1:25:28 8. 1:31:02

[@OTDM]

Thank you Toni! :) :)

[@MabelRD08]

The 3rd question about therapy and faith reminded me when a psychiatrist I saw asked me if I was a christian...He said anxiety comes from not being a christian and I felt so invalidated and like he just assumed my anxiety was cause of my "lack of faith" that he also assumed. I felt uncomfortable so I never went back to his therapy sessions. Thanks for the amazing place to discuss so many important topics and for support. Gracias Kati❤❤🌹🌹🇩🇴🇩🇴

[@AmethystWoman]

Yuck. Don't blame you. Glad you were able to see it was his issue not yours. So wrong (unless he clearly identified he was a xtian counselor.) Glad he let you know where he stood right away tho.

[@name-ni3jc]

I know this is late but Id like to add that I'm a Christian and if I had a therapist ask me that, i probably would've gotten up and left right there. Anxiety isn't invalid because of lack of faith or something similar.

[@toni2309]

I really just wish I knew what to do when having to calm yourself is a trigger. Like, a lot of the time when I put out a comment or question the answer is "find ways to calm yourself" and honestly just when I hear this I'm feeling anxious and angry :/.

[@nikkimckay860]

Toni. I can understand and definitely relate to everything you wrote 😢

[@Becca-lh7mr]

That kind of phrase/advice used to make me feel more upset as well. While the intention behind that kind of answer is to be helpful, it can feel invalidating and just make feeling calm seem unattainable. What has helped me with this, I think, is connection with others. They may not understand right away, but good friends and safe people will keep trying, and you communicating what's going on for you can help them to better help you, too. So for example, one thing a lot of people tell me to do to help calm is to breathe. However, this is a direct trigger from my trauma plus failed attempts to gain control of my breathing, and almost always used to make me start hyperventilating. I think that through communicating this additional upset with others who are in a position to help, I have learned to break it down into really tiny steps that I can practice and eventually feel okay with talking about breathing (a bit, sometimes) and generally learning to calm myself by responding to myself in a similar way to the way I respond to small children and others who are upset, and observing how others can calm and trying some things that might be a bit helpful.

[@nicholelasater4881]

Does it help if you replace ‘calm’ with soothe? I hate the advice to ‘relax’ or ‘calm down’ because if I could manage to relax, don’t you think I would be? It helped me to think of it as soothing. Just trying something that’s somewhat comforting without needing a full solution really helped. (For me, it’s stuff like a soft blanket, sitting under the shower, sitting outside, green tea, etc) sometimes it doesn’t really help and I end up having a crisis anyway, but sometimes it prevents it until I’m ready to deal.

[@toni2309]

​@@nicholelasater4881 I guess it would if my mother tongue would let me do it. Unfortunately, in German there is no second word and the word is "beruhigen" and "Ruhe" also means quiet, which is exactly my problem, I feel like it's done to quiet me down. Words like "besänftigen" that are used when an animal is sedated don't help either. It helps to be thinking about making myself feel better as opposed to looking more professional for others. It is kind of hard in the situations I actually need it in though, because I tend to already be thinking about how people would be judging me, so the leap is not very far.

[@JenniferMeinel]

Re: Alexithymia....so I have it and it's actually very common in people with autism and also many people who have it come from a trauma background. I also have the added bonus of having major introspection issues, so I don't know what my body is feeling 90% of the time either. 😂 My therapist just had to learn to pay very close attention to my body and muscles during each session. I'll have absolutely no clue that I'm tensing my muscles and physically doing things until they point it out. I say all of this to recommend that when you start with a therapist, let them know. Mine knew from Day 1 and we're in a very good groove now where they know before I do that I'm having some kind of feeling and will guide me in figuring out what feeling it is. And yes...we use a laminated feelings wheel as a starting point. 🙄 I still can't do it on my own, but it's practice and I've been getting better. It's all about practicing and learning your own self/body and how to take different clues/patterns to figure out a feeling even if you aren't consciously aware that you're having one. Finding the right therapist is going to be extremely helpful.

[@GiraffesEatStuff]

I'll say that personally for phobias regarding sexual stuff, genitals and maybe intimacy in general, I found that welcoming communities and just the ability to express discomforts and receiving kindness has helped soothe or explore a lot, so I'd maybe recommend trying to make online communities and such feel less daunting and stressful to seek out if anything. Though maybe it's not straightforward depending on the phobia and where you're at in expressing/such, and it's kind of exposure already. And like personally I still stay up for 2+ nights from really mundane random stuff and it's still super inconsistent, but general avoidance and the responses themselves are unrecognizably different and more tame now because of them and especially one person, and because of the ability to express or vent even rarely too. I feel like isolation and such makes it ramp up a lot a lot especially if you've to act like it's not there.

[@bryannaumann4127]

You made a great point around the fifteen minute mark about addiction, alcoholism, and self injury relapses. If someone goes ten years without doing those things but then have a relaspse, I don't think all that time clean was wasted, like they have to start from zero again. They already got clean once, maybe for a very long time. So I think they should be able to do it again.

[@smoupnhoize]

Agree 100%. I think a lot of people that really lean on how many days/weeks/months/years they've been "clean" (even the language of saying "clean" as if the coping mechanism makes one "dirty") leads to starting over at zero when a relapse happens. I know for some people this is helpful as they don't want to have to "start over" and want to keep the streak going, but it can really make things worse when/if a relapse happens. If a person hasn't engaged in harmful coping mechanisms for a period of time, SOMETHING during that time was helpful. You have that much more time/resources/self knowledge. It's not starting over in recovery. It's starting over in days, sure, but you are SO MUCH further ahead of where you started.

[@smoupnhoize]

Re: #5 - I've always been very difficult for people to read emotionally as I'm rather numb. I had a therapist tell me I could be having my worth day ever or my best day and she'd never know the difference because my face doesn't change. Can I pretend? Yes, but it's exhausting If I'm asked what I'm feeling, I usually base it on physical sensations and my thoughts. There's some great pages from the DBT skills training handouts and worksheets by Marsha Linehan that break down emotions and the kind of situations that usually lead to them, the kind of thoughts, physical sensations, action urges, etc.

[@natashapieterse7717]

I just discovered your channel and all I can say is THANK YOU

[@LessThanThree76]

YAY! Always looking forward to your podcast episodes. Like a soothing friend to listen to before the Quetiapine kicks in and I can fall asleep. Thanks, Kati. ❤️

[@toni2309]

Thank you so much for uploading this episode early! I was really interested in the answers, but there were other things I was considering doing this evenig. Thanks.

[@nancyliawoods]

Appreciate your videos and the nice folks in the comment sections, thanks for sharing your knowledge and insights ❤

[@nikkimckay860]

Good afternoon Kati ☀️ good to see you again so glad it's Thursday because AKA podcast is always part of my day and always need it iv had a bad week of feeling stressed out and anxious plus not getting enough sleep or too much sleep 💜

[@kaseyactis7848]

Is it inappropriate as a therapist for them to ask to see your scars? It was my very first session and that was the first question she asked and it made me super uncomfortable

[@ababy6074]

I think what you do is great, that you are a very devoted therapist, you dedicate your life to therapy and research, your podcast to help answer our questions, and your book writing, all for the benefit of helping people.

[@raywood8187]

This just showed up in my feed but it's still not in my notifications for some reason.

[@annejordan-baker5990]

Thanks!

[@allan8364]

Looking forward to your tour, Kati.

[@yb4691]

Thank you Kati for the podcast! And for answering my question about a healthy amount of stress or fear. That was helpfull! And yes, it is more difficult to express yourself in another language. I have rewritten my question multiple times before posting it. In Dutch it would take me a few seconds with the same question 😆

[@raywood8187]

I've lived in Anhedonia for so long that I wonder why it doesn't have it's own zip code.

[@mollypawlaczyk3488]

Hey Katie, thank you for makeing these great videos!! You've said in previous videos that you have only made around $35 an hour in the past. I know that some clinical therapists make less than that and some make way more. Why is it that some therapists that are less experienced, make $100 an hour sometimes? Doesn't this make it hard for low income clients. Is it true that often times lower income clients have had more trauma?

[@janetslater129]

It makes it hard, or damn impossible for any low income client, regardless on how much trauma they have. I’m not sure how all of the expenses are divided our, but I think a lot of those fees are paid for upfront if a therapist is considered an independent contractor, and they have to pay for things like leasing an office/room, phone, gas/electric, internet, their own health insurance, various town/city taxes for the building property, etc. That may be why their take home pay may be much less.

[@lalacameron170]

What about the scratching thing on question 7??

[@sarahbrennan1342]

If you have a feeling someone is doing this … how do you approach them … and should you approach them …

[@lakennedy569]

Why does my therapist ask where I self-harm? She doesn't look at it

[@shannonnichols3415]

38:27 I get the dancers hesitation! Dancing, especially in your original style, seems impossible when one’s body has changed so much from how it was! So-not only is it physically more difficult (which can be worked out), but it’s the idea that I know what my body looks like now! So much more weight! Disgusting

[@Me-yr1ix]

I want you as my Counselor, Kati 😔.

[@AmethystWoman]

I can't even apologize for feeling I need to be questioning my therapist right off the bat. My T doesn't answer personal questions but I have to know, for example, if the are a conspiracy theory person. Do they think Jan 6th was a good thing? What are their gov (USA tho probably the same for anywhere) values. Also, do they look down on people who aren't wealthy. If they are seeing me for less money, do I feel that from them. (That would just be a.bad therapist and shouldn't offer sliding scale or work at a low cost clinic.) The religion part is important to me and probably that goes both ways - both ways totally valid. Whatever we feel, is valid. We don't have to justify our feelings when it comes to therapy. Trust your gut. 🧡👍🏽

[@shannonnichols3415]

3:21 ok, here’s me being me! I know it’s weird but this is me. Hi everyone! 😊 You should maybe rethink doing the OCD talk when you’re in an empty corner with no artwork or anything! I haven’t ever been dx with ocd, but that’s what I call it. I am spending every ounce of brain power to keep from fixating on visually measuring if you are evenly spaced on both sides of the wall from the corners!😂

[@shannonnichols3415]

You don’t believe that stuff? What stuff? 46:10

[@nikkimckay860]

Good afternoon everyone happy Thursday to you all how are people doing what mental health problems do you suffer from what are your struggles I'm here as always to offer care and support and spread love I always want to offer advice and I'm a good listener take care everyone ❤️