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Q: I have been depressed and anxious for some time and things just don't feel like they're getting better. I know I probably need professional help. But how can talking about my problems really make things better?

When you are in emotional distress, you often end up revisiting the same disturbing thoughts and feelings over and over again. You don't feel better because there is no new information, and no different perspective. By working with a trained psychologist, you have the benefit of hearing a new and probably far more accurate assessment of what is causing your difficulties. Your distortions can be corrected, and your emotions, no matter how confusing they may seem to you, become more understandable.

Q: But couldn't talking to good friends work just as well?

Friends are essential to all of us, especially when we need support. But there are limits to the help that your friends can provide. For one thing, the complexity of the problems that you would bring to a psychologist often would not be obvious to someone who is not professionally trained. In addition, no matter how close your friends may be to you, they can't be entirely objective. A psychologist is much better equipped to take the concerned, but neutral stance that is often required. You need to be able to think about and say anything in the therapy hour, without concern about how you sound, who might disapprove, or what effect it might have on your relationship. This allows you to be as honest as possible, knowing that everything you say will be held in confidence, and that the counsel you receive is really about you, not the other person's issues.

Q: What about medication?

There are times when anti-depressant or anti-anxiety medication can be very helpful. As a psychologist, I do not prescribe, but part of my evaluation involves making an assessment of whether medication should be considered. If I do conclude it would help, and if you are comfortable with this recommendation, I will refer you to one of several psychiatrists whose work I know well. Together, we can then determine which medication would be most appropriate.

I cannot emphasize enough, however, that usually medication is not the primary treatment for emotional difficulties, relationship problems, or addictions. In cases where medication appears necessary, it generally serves to assist the process of working through problems in psychotherapy. Medications are not magic pills; they alter brain chemistry in complex ways that can make it possible to think more clearly, or alleviate the oppressiveness of a disabling depression. But then issues and problems must still be faced in a careful and thoughtful way if there is to be lasting change.

Q: I know people who have been in therapy for years. Is that typical?

The length of time an individual spends in psychotherapy can vary from a few months to several years. Several factors determine how long the treatment will take. For a relatively focused problem, such as grief counseling or dealing with a life transition, brief treatment is often possible and highly effective. But many issues are more complex. Depression, anxiety, and addictions are rarely simple issues, and they tend to connect up with many aspects or a person's history and personality structure. Consequently, treatment for these problems is generally more complicated, requires more thorough examination, and therefore takes longer. But I always emphasize to my clients that this is a collaborative process. As a client, you can always inquire about what we're doing, how far along we are in the treatment, and if there is some way to make more rapid progress.

Q: If I am having marital problems, should I see a marriage counselor or a psychologist?

As a clinical psychologist, I have been trained in the study of human nature, rather than a set of techniques to treat a specific problem. So unlike marriage counselors, who often are trained exclusively in couples or family therapy, I bring a broader set of skills to this process. This matters, because every couple has both interpersonal issues as well as problems that are unique to each of the individuals in the couple. To really be of assistance, you must understand each person's complexities, not just the problems they have with each other.

Q: I know I'm drinking too much. Is that something you can help me with?

Alcohol and other drug abuse is one of the areas in which I specialize. I have worked extensively in the addictions field, both in my private practice, and previously as a consultant in substance abuse to government agencies and area hospitals. What I have learned in over twenty-five years of treating addictions is that to be effective, you need to understand both the nature of addictive disorders and the particular personality, needs, and issues of the individual who has the problem. I always keep in mind that I'm not treating a disease, I'm treating a person.
Contact Dr. Permut today to schedule a private, confidential consultation.