Below two seasoned psychologists debunk common myths about psychotherapy and offer pointers on making the most out of therapy.

Misconceptions and Concerns About Psychotherapy

According to Ryan Howes, Ph.D, psychologist, writer and professor in Pasadena, California, “Some clients expect their therapists to give them direct advice, telling them who to date and what to study and when to break up.” It’s easy to think this way considering that TV therapists dole out advice without hesitation. “But most therapists resist giving advice because they believe it’s better for the client to learn to solve their own problems,” he says.

Clients also worry about what others will think. They wonder what’ll happen if their co-workers or friends find out they’re going to therapy. They might automatically assume others will think they’re “weak, flawed [or] crazy,” comments Chicago psychologist and life coach John Duffy, Ph.D. In reality, though, “More often than not, people tend to be very supportive,” he says. Plus, it’s up to you who you tell about your therapy, and confidentiality laws protect your privacy.

The therapy process itself can get confusing. According to Duffy, people might have questions like: “Is it brainwashing? Will it change my personality? What if focusing on my problems will make them worse, not better?”

These myths and concerns stem from various sources, including therapists themselves. Howes says: “…no two therapies/therapists are alike, the media does a lousy job of portraying realistic therapy, many people are still too ashamed to talk about it and therapists don’t always do a good job of teaching clients the best ways to get the most from their therapy.”

How to Make the Most of Therapy

1. Do your homework.

Be a discerning consumer by doing your research. Therapists “have different approaches, and come from different schools of thought,” Duffy says. For instance, you might learn the differences between treatment approaches, such as cognitive-behavioral therapy and psychodynamic therapy, he says.

2. Ask for referrals.

“It is difficult to determine on paper or via a website who will work for you,” Duffy says, “So ask around.”

3. Consider expertise.

“If you are seeking a therapist for a teenager, for instance, you probably want to avoid the therapist who focuses on couples work,” Duffy explains. Similarly, if you know your diagnosis, see someone who specializes in that disorder.

4. Be open to change and the process.

Change is hard. And it’s a pivotal part of therapy. As Duffy says, “By definition, therapy is a change process, and it will and should foster a bit of discomfort. This is not a bad thing.”

Engaging fully in therapy increases the chances of its effectiveness, he says. Think of it this way: “In order to get a different result, you’ll probably need to try a different approach,” Howes says.

So trust the process. “Some of the techniques therapists use — like the empty chair, reflective listening and thought stopping — can seem corny at first, but many people find them effective.” And keep in mind that some issues will require bigger changes than you initially thought, he adds.

5. Limit the process.

Another way to foster change is to remember that the therapeutic process doesn’t go on forever. “That is, if we think therapy has no end, we may put off the changes we want and need to make. If we know we’re working together for about 6, or 12 or even 20 weeks, that timing provides a context for us to think about and enact change,” Duffy says.

6. Make therapy part of your life.

Many people expect change to happen from an hour a week at the therapist’s office, Duffy points out. But “…in order for the process to foster real change, a great deal of the work has to take place outside of the therapy room.”

This “might range from a simple meditation to a significant change in work habits to ending a dysfunctional relationship.”

In other words, “Therapy is one of those ‘you get out of it what you put into it’ activities,” Howes says. He suggests “Keep a journal, show up to appointments on time, read books about your issue, do your homework and dive in.”

The key, Duffy says, is to hold yourself accountable for this outside work.

7. Be brutally honest.

For instance, whether you have positive or negative feelings about your therapist, don’t be afraid to bring them up, Howes says. In fact, “…this sort of discussion can provide some of the best results therapy has to offer.”

Consequently, he says, “Whether you’re talking about yourself, your past, your ‘craziest’ thoughts or the relationship with the therapist, brutal honesty is the quickest route to results.”

8. Realize that “things can get worse before they get better,” Howes says.

“After a few sessions of poking around in a person’s psyche, we’ve opened several cans of worms and it can feel overwhelming,” he says. It’s not uncommon that “…people come in to work on one problem and soon realize they have four.”

9. Talk about challenges regarding therapy.

Therapy requires resources, namely time and money, which as Howes says, “are increasingly hard to come by.” Also, some people might not have access to community resources or a good support system. Then there are also what Howes refers to as “backseat drivers,” “well-meaning loved ones who try to tell [clients] what to talk about in therapy, ask a million questions about it or even poke fun at them for being in therapy.”

Many clients don’t bring up these issues to their therapists. Instead, they might suddenly stop therapy or keep getting stressed out. Howes emphasizes the importance of talking to your therapist about these concerns, because together you can brainstorm solutions.

In general, therapy offers many benefits, whether you’re struggling with mental illness, a difficult life transition or other concerns. According to Howes, therapy is an opportunity “to try new things. It’s a place for thinkers to try feeling, busy people to practice slowing down, non-confrontational people to be assertive, people pleasers to practice thinking only about themselves, and cut-and-run people to learn the art of a healthy goodbye.”

He concludes, “It’s like taking a college course where you are the topic. Make the most of it!”

Photo by Code Pink, available under a Creative Commons attribution license.

Whether it’s studying for an exam, writing a paper, working on a project or doing things around the house, everyone has at some point in his or her life procrastinated on a project. Procrastination is universal. Usually, people procrastinate because accomplishing the task is hard or makes them uncomfortable in some way. So it’s not surprising that we’d also like to avoid any difficulty or discomfort when trying to curb procrastination. Consequently, quick fixes for procrastination abound. But many of them are Band-Aids that don’t really get to the root of the problem.

In End Procrastination Now! by psychologist William Knaus, Ed.D, you won’t find quick-and-dirty anti-procrastination pointers. Instead, what you will find is a thorough step-by-step system that tackles procrastination from all sides — including getting to the causes and core.

Knaus is known as an authority on procrastination. He has authored over 20 books and is one of the original directors of post-doctoral training in rational emotive behavioral therapy (REBT).

To conquer procrastination, Knaus presents a three-pronged plan: cognitive (understanding what procrastination is and changing inaccurate thinking); emotive (being able to deal with discomfort); and behavioral (taking action and following through). Accordingly, the book’s three parts discuss the prongs in greater detail.

In Part One, which contains chapters 1 and 2, Knaus provides an explanation of procrastination and the various styles. Ending procrastination starts with self-awareness and requires readers to become self-observant. To do this, Knaus suggests keeping a procrastination log, which documents your thoughts, feelings and actions as you’re procrastinating. He also outlines the five phases of change to progress from procrastination to productivity.

Chapter 2 focuses on overcoming procrastination thinking. Readers learn how their thoughts can promote procrastination and how to challenge and change this type of thinking with the ABCDE method, created by REBT’s founder Albert Ellis. The various types of procrastination thinking (“I’ll need to let the idea simmer longer”) will no doubt resonate with readers.

Part of ending procrastination is resisting the temptation of short-term gains and keeping your eye on the prize with long-term goals. When a task makes us anxious or triggers other unpleasant emotions, we’re more likely to avoid it. This is known as emotional procrastination, covered in Part Two, chapters 3 and 4.

In chapter 3, Knaus teaches readers how to strengthen their “emotional muscle.” He describes the various ways our emotions affect procrastination and how readers can conduct a “procrastination analysis” to explore their goals. According to Knaus, “procrastination is normally an impulsive response to avoid discomfort.” So readers learn how to pause and tolerate tension.

Stress, anxiety and self-doubt boost procrastination. In chapter 4, Knaus gives readers tools to overcome stress-related procrastination. For instance, many people don’t think they have the resources to meet a challenge, which in turn increases their insecurity and tendency to procrastinate. Knaus shows readers how to change our language to welcome a challenge by outlining concrete and actionable steps to take.

In Part Three — chapters 5 through 7 — Knaus teaches readers to follow through by developing their decision-making skills and avoiding behavioral diversions (e.g., reading blogs instead of writing a book review). These steps include typical tips like creating a to-do list and lesser-known ones like backward planning and a cognitive-behavioral correction exercise.

Chapter 7 addresses a common concern: curbing at-work procrastination. Like the other parts of the book, Knaus doesn’t just give quick tips to push past procrastination. Instead, he helps readers dig deeper. He lays out a five-step process for analyzing the when, where, why and how of your procrastination and finally becoming productive.

Throughout the book, Knaus provides readers with practical exercises they can do to work on each prong. Typically, several tips are outlined in the chapter and some are presented in table form.

Overall, Knaus does a nice job of simplifying a broad and complex topic. The book is straightforward, easy to read and relatable. At some points, though, it’s fairly dry and could’ve benefited from more anecdotes and livelier discussion, especially because the reader is introduced to so many new terms and concepts. This isn’t a book to read in one or two sittings. Instead, it’s more like a workbook that you put down and pick up throughout the weeks, letting the information sink in and giving yourself plenty of time to do the exercises.

End Procrastination Now! gives readers a comprehensive system to make lasting changes. It helps you better understand why you procrastinate, how to weather the distress that may initially come from taking action and to finally undertake the project at hand. Again, the reader has a fair amount of work to do in curbing procrastination (which can get tedious). This system is a process that takes time, thought and much effort. It requires thoughtful self-analysis and action. If you’re willing to put in the work, this book can be a huge help.

End Procrastination Now!
By William Knaus, Ed.D
McGraw-Hill: March 2010
Paperback, 256 pages
$16.95

When Ellis presented his theory in the mid-1950′s (Ellis, 1962), the role of cognition in emotional disturbance had not been fully addressed by the field of psychology. Ellis developed REB theory and therapy in reaction to what he saw as the inadequate techniques of psychoanalysis and behaviorism. He attributed the deficiency in the two camps’ techniques to their conceptualization of personality and emotional disturbance. Ellis felt that by ignoring the role thinking played in emotional disturbance both psychoanalytic and behavior theory failed to explain how humans originally became disturbed and how they remained disturbed.

The word “belief” means a conviction in the truth, actuality, or validity of something. So a belief is a thought with an emotional component (conviction) and a factual component (truth, actuality or validity). Beliefs can be either positive or negative. Having a negative belief is not necessarily a bad thing; however, when one believes in something that is false, a negative belief tends to become what Ellis called an “irrational” belief. Irrational beliefs are not friendly to happiness and contentment and are definitely unhelpful for getting one’s basic desires for love and approval, comfort and achievement or success met.

Core Irrational Beliefs

• Demandingness or Absolutism – inflexible, dogmatic, extreme beliefs signaled by words such as should, must, have to, and need to (e.g., “I should not be in pain” or “I should be able to do what I used to do”). This is not the kind of should as in “I should go to the store and get some milk,” but rather a should with a capital “S”, a demand.

• Demand for Love and Approval from nearly everyone one finds important
• Demand for Success or Achievement in things one finds important
• Demand for Comfort or nearly no frustration or discomfort.

When someone holds one of these irrational beliefs, they also tend to hold one or a combination of the following irrational beliefs.

• Awfulization – refers to 100% disasterizing beliefs signaled by such words as disaster, horrible or awful, and catastrophe.

• Low Frustration Tolerance – beliefs signaled by words such as intolerable, can’t stand it, and too hard.
• Global-Rating – beliefs in which you condemn or blame your entire selfhood or someone else’s basic value in some important way. Global rating is signaled by such words as loser, worthless, useless, idiot, stupid.

ABCDE Model of Emotional Disturbance

Albert Ellis thought people developed irrational beliefs in response to preferential goals being blocked. He set this up in an ABCDE model (Ellis and Dryden, 1987). “A” stands for Activating Event or Adversity. This is any event. It is just a fact. “B” refers to one’s Irrational Belief about the event at “A.” That belief then leads to “C,” the emotional and behavioral Consequences. “D” stands for disputes or arguments against irrational beliefs. E stands for New Effect or the new, more effective emotions and behaviors that result from more reasonable thinking about the original event.

Disputing Irrational Beliefs

It is important to use vigor or energy when disputing irrational beliefs. Disputing is not just a rational or cognitive method but also an emotional method of changing irrational beliefs into rational ones.