Should I see my partner's therapist for our couple therapy?
Though ending your child's therapy may be easy compared to making the decision to introduce it to her, it has as much significance as the beginning.
The short answer is no. The longer answer is that it sometimes works out well enough that it's worth the risks involved.
The full answer is so complex that it's probaby better to look at it in parts. This part will address some ways a therapist can faciliate the shift from individual to couple therapy, if you've decided to give this a try.
There's no denying that opening up someone's private and personal space to a "co-patient" involves invading a boundary. Such a change is fraught with the potential for misunderstandings and hurt feelings.
So you should know that in order for your therapist to help you make this shift she has to have a healthy respect for the ramifications of expanding the boundaries that protect the current therapy.
She must also have the ability to help you work through and overcome the problems that will inevitably arise as a result of stretching them to include another.
It isn't so much that there's a conflict of interest---after all, isn't it in everyone's best interests to have a healthy relationship?
But a therapist who is conflicted or confused about what she's doing will cause her patient---possibly by now the couple---to feel conflicted, confused, or unsafe.
It's counter-intuitive, perhaps, but you'll know whether making this transition with your therapist is a good idea by how well she describes all the ways it's a bad idea!
Can it be done? Can she hold two people, one she knows very well, in her mind at the same time, without showing preference?
Although in some ways doing so is similar to a parent's ability to convey her care and concern for two of her children, there are challenges that make this accomplishment seem simple by comparison!
In fact it does take a certain way of thinking to faciliate the transition, one that involves maintaining a clear separation in her mind between her patient as an individual client and the new configuration, in which the relationship is the patient.
While she makes this internal shift for herself, she's also helping her patient feel safe opening up the boundaries that usually protect his therapy. One door closes, another opens.
If you think about it, even if the process doesn't result in a new form of therapy, there's much to be learned by going through it: about feelings regarding therapy, what comprises boundaries, why they're helpful, and when to let them down.
Most of all, your therapist must help you feel confident she can keep these experiences separate, giving both you and your partner the sense of security you need. This means she can also keep everyone's feelings about the shift in her mind, and address them right away, if possible.
The person whose individual therapy is being opened up may initially be convinced that he has no problem sharing his therapist with another, but over time he may develop reservations about doing so. During this process it may turn out that the idea of sharing his therapy, even with someone he loves, is uncomfortable or even too painful to bear.
It takes an intuitive and aware professional to stay on top of this, continuing to evaluate the wisdom of making a transition to couple therapy until her patient comes to a decision, ideally with as little ambivalence as possible.
It's important that the therapist listens carefully. She should understand that inviting her patient's partner in is not her decision to make, even if she thinks it would enhance the overall therapy outcome to do so. The patient has the last word.
If her patient does decide to invite his partner into his therapy the therapist should now begin to consider the feelings of her new patient, and be aware that the person who is coming in has a lot of trepidation about being the unknown quantity in the equation, as well as fears that he or she she can't possibly "catch up."
An individual session sometimes establishes a sense of balance and certainly provides an opportiunity for him or her get to know the therapist and to assess the viability of the enterprise through discussion with her.
Most people who are thinking about participating in therapy with their partner's therapist fear that the entire experience will be weighted unfairly in favor of their partner---that the therapist will be on the other side, as it were.
They come by their feelings of competition with their partner's therapeutic relationship honestly, but they have yet to realize that it's their partner who is in a far more vulnerable position, with much more to lose.
To the new patient, the idea that a therapist now views the whole equation as a balanced one is possibly unimaginable until demonstrated.
In summary, in order for a therapist to help her patient transform his therapy into couple therapy her mind must be able to hold two seemingly conflicting experiences as separate entities----putting one on the back burner---and communicate her capacity to embrace the new configuration without bias.
Secondly, she must develop and communicate her understanding of each patient's feelings about the transition and the process itself.
Finally, the therapist must be willing to let go of the idea of couple therapy (if it's hers), as well as put a stop to the process if it seems untenable.
Next: how your therapist continues to prepare you for the switch.
Therapy, the Termination Process, Your Child's Sense of Self
In fact the termination of her therapy may have more importance to you than you think, because though in theory you may know that your role as parent is sacrosanct, for the first time you may feel like an outsider to events in your child's life.
So the things over which you do have control, like its ending---and also her attendance at sessions, and your questions to her about them (try to abstain!)---take on tremendous personal significance to you as a parent.
Its ending is actually a critical part of therapy---it provides a book-end, as it were, propping up the whole experience for review, and giving it a "place." However, parents frequently interpret this part of the treatment as separate from the rest, and their territory, so to speak, lumped among their other scheduling duties.
Of course taking your child out of therapy is only a matter of a phone call---sometimes not even that. But the un-scheduling of psychotherapy has its own context. Allowing your child to also have her own experience of closure allows her to acknowledge that it had value to her.
If something is worthwhile we don't simply leave it behind. To do so is a way of saying it didn't matter that much, and your child knows this. Parents sometimes unwittingly undo the good intentions they had in sending a child to therapy by giving this unconscious message at the very end.
In fairness, much of the time parents are only victims of the overscheduled-child and overtaxed-parent syndromes: keeping track of appointments and activities becomes a tedious extra job. Many times all they want is to prevent their children from experiencing the pain of separation---hence, ripping off the band-aid, as it were.
Sometimes family conflict, separation, or divorce causes confusion that makes it harder to stay on top of things, resulting in decreased communication between parents, and ultimately the accountability of children.
For a few, more anxious parents it is in fact a way of denying the existence a relationship their child has had with an "outside" person.
But for whatever reason a child might miss out on the termination process, the result is that she is unintentionally deprived of an opportunity to express how much she valued the experience she has had.
Why does this matter?
In many ways it matters a whole lot, in large part to the development of healthy (versus unhealthy) narcissism in your child.
Because the amount of value she attributes to her experiences correlates to a healthy and realistic valuation of herself.
Of course you don't want your child to value everything in order to feel good about herself. But not encouraging her to value too many experiences (to devalue too many things) can artiificially inflate her valuation of herself. She becomes, in a sense, too important for events such as endings---a budding narcissist?
Since we live with societal attitudes that appear to reinforce what is merely ephemeral, in turn reinforcing an idealization of the ephemeral, narcissistic personality, your child needs all the support you can give her to be a person of substance.
Developing the ability to integrate all of her experiences instead of discarding some of them at will helps her to have a cohesive sense of self instead of a increasingly empty, devalued and "unfinished" one.
When you teach your child to integrate endings into her life rather than to treat them as though they aren't part of the "real" thing, you help her develop this cohesive sense of self, a self with a beginning, a middle, and an end---like every experience she has.
Giving your child the opportunity to explore herself through the therapy process is a gift, but it's one that really isn't complete without the ribbon you put on it---the last meeting.
The Death of a Parent
No matter what your age, the death of a parent can stir up an amazing number of conflicting emotions. For as complex as relationships with the living are, this is how complicated facing the death of a loved one can be.
There is a myth that unless you somehow reach a state of connection usually vaguely referred to as "closure" with a difficult parent, all peace of mind will be lost to you, post-mortem. But the truth is that if such a balanced state could be reached at all, there would be no negative issues to address: the cure to the problem, as in so many human conditions, is the problem itself.
I urge my patients to do only the best they can to address these frequently difficult and disappointing relationships while their parents are living. This is sometimes difficult, because particularly in early stages of psychotherapy the curtain to your childhood can be pulled aside in such a way that the inadequacies of your parents can be painfully exposed. The myriad ways your parent might have seemed to be adequate, but in truth fell far short of meeting your psychological needs, are suddenly clear.
The impulse in the beginning of therapy is often to confront the parent and force them to face their evil ways. In truth, it is the rare parent who willfully deprives their child of what she needs. Emotional intelligence is learned, and it's at their own parents' knees that your mother or father first learned how to feel emotions, as well as to guage the feelings and the needs of others. This is part of the tragedy of the human condition, and must be confronted by almost everyone.
So how do you address your own very real disappointment with your parent while still maintaining a relationship? Much of the time, inherent in the disappointment is a failure to have accomplished an adequate emotional separation from her. Human beings have an interesting way of hanging on to even negative relationships---well, perhaps especially negative relationships!
What you may find during the process of psychotherapy is that an internal separation occurs that is healthy----far healthier than a real estrangement---and in this separation a sense of realistic expectations can emerge as well as an awareness of the limitations of your parents, and how to implement your own responsibility in changing your life.
5 Clues Your Therapist Might Be Behaving Unprofessionally
Patients bring their most fragile, vulnerable selves to psychotherapy, whether they are aware of it or not. And well-trained therapists know that gratifying themselves through their patients is not just unprofessional, but a perversion of the therapeutic relationship.
Most people come to psychotherapy looking for an experience of "mirroring" that they either didn't have at all, or had too little of. A therapist who steals minutes or even moments of the 45 or 50 minutes during which a patient can expect this kind of undivided attention is not only cheating her patient but may be unwittingly adding to the deprivation she has come to therapy to address.
It's one thing for a therapist to provide a comfortable space for people to feel relaxed and safe, to be approachable, and to be good at engaging a patient's ability to be open. It's quite another to continually allow the dialogue to become personal or extra-therapeutic.
The operative word is continually. It helps if your therapist acknowledges that such a departure from the therapeutic "frame," or expected boundaries, may in fact be wounding, even if slightly. Even---or especially--- if it's out of the patient's awareness, it's our job to notice what might be happening in her unconscious. And you should also be aware that every therapist departs from the frame on occasion, sometimes purposely.
Usually it's not a therapist's training that falls short when she strays from the straight and narrow, but the instinctive pull of excessive narcissism, or in a more normally narcissistic therapist, fatigue with the constant deprivation involved in containing her own needs day in and day out.
This is one of the most difficult aspects of being a psychotherapist, and why vacations and some form of ongoing supervision, not to mention a satisfying life, are essential to the healthy practitioner. So what are the clues? They are:
Your therapist seems too often to explain something to you based on her own experience rather than on what she knows about you, or psychological theory.
She asks you personal questions about your belongings or endeavors, seeming to reflect her own curiosity rather than her interest in furthering her real understanding of you, or your growth .
She answers her telephone or otherwise disrupts your session without exploring what this is like for you
She continually mentions the experience of other patients
She suggests any kind of meeting outside of the therapeutic environment
The other day I received a request from a documentary film maker for the submission of a couple currently in the aftermath of an extramarital affair. This was for consideration, along with their therapist, as "stars" of a proposed television show about the subject.
The film maker was interested in furthering her project, of course, but I was a little surprised at what was to me the somewhat cavalier assumption that therapists would be willing to offer up their patients in such a way.
In the service of the good name of therapy and therapists everywhere, I explained my perspective, which was that to make such a request of a couple would be a distraction and a devaluation of their work, as well as easily interpreted as self—aggrandizing on my part. I guess the director was appreciative, but she undoubtedly also secretly hoped not all therapists shared my point of view.
Should you receive such a request from your therapist, you might consider it to be the sixth clue that your therapy may be as much about her as it is about you.
Will your therapist understand you better if she shares your gender?
It depends on how well she understands herself.
Seeing a therapist who shares anything at all in common with you is important only to the extent that the therapist is conscious, well-trained, and a student of the issues you present, whether they appear to be related to your gender, marital state, or place in the developmental cycle.When I was is training I had a lovely, brilliant, and perceptive clinical supervosor. She was also an incredible straight-shooter. When one of her patients asked if she, too was a parent, she replied, "I might or might not be. But what if I were, and I was not a very good parent? How would that help you?
Simply having something in common with you isn't a guarantee that your therapist will be better able to understand you.
I learned to think of therapy not as issue-driven, but as self-driven. In other words, though you might come to therapy because of something is particular that's troubling you or is related to some aspect of your life, an event, or a particular relationship, the best therapy will address the issue, but do so in the larger context of helping you understand yourself.
In this way you'll develop an awareness of how you function that can be something from which you generalize. You learn how you respond, and why. Then you know what to expect and can adjust yourself accordingly, as similar circumstances arise
Be A Gourmet About Your Friends
I wish I remembered to whom I should attribute this sensible suggestion. I say it often, though I never take credit for the good advice. Frequently in the course of my practice someone with whom I'm working suggests that engaging in this kind of evaluation process is being "judgmental," and something clearly to be avoided. I call that being a little judgmental.
When we consider creating a friendship with someone we're presented with an opportunity to add something to our lives. And we're allowed to make an evaluatiion of the componants of that something.
If you follow, you can see how it's almost impossible not to be evaluative. Life is about making one judgment after another. From mundane decisions about what we eat and wear, to how we spend our money or our leisure time, and what parts of the newspaper or which websites we read, we make judgments all day long.
I think I understand where the confusion lies. To evaluate someone else is not the same as thing as criticizing them. We don't have to share our evaluation with them (or with anyone else---that might be gossip), but we should think critically about all aspects of the life we're creating for ourselves, and this includes the individual characteristics of each individual to whom we become close.
What should detemine a woman's decison to have a child on her own?
Having a child is an enormous responsibility, whether done in the context of a committed relationship or on one's own. Unfortunately, it's uncommon for those considering parenthood to attend classes to help them understand this responsibility in depth. Many couples naturally feel that having children is simply a natural "next step" to marriage.
When I first started to facilitate my seminar for single women considering motherhood I received a thoughtful but somewhat outraged letter from a woman whose young relative was pregnant through donor insemination. The writer of the letter found my guidance of such women unconscionable, and asked me for a rationale.
I explained that many women I've spoken to said that the high divorce rate has made them wonder if marriage is any guarantee that they'll wind up raising a child with a partner in the long term, even if they do marry. The apparent pervasiveness of single motherhood may therefore have as much to do with the state of marriage as an institution as it does with individual choice.
I explained that some women who have wanted to be in a committed relationship but not found a partner---and are nearing the age when pregnancy is no longer a viable option---felt that being single was an indication of not having been "chosen" by someone who loves them. Being put in the position of having to set aside the desire to have a child because of this made them feel as though yet another choice was out of their hands.
I described what I'd also learned from women about this "double loss" and said that the fact that women came to such a seminar was evidence of the care they were taking to make the right decision for themselves, and especially for a child. It was gratifying when this kind woman was able to hear what a dilemma some women are in and how much care they take to resolve it.
Of course, children potentially benefit most from having two parents. Having a father teaches boys about masculinity and teaches girls about what it feels like to be cared for by a loving man. Having two parents gives parents the opportunity to "spell" one another, allows for different points of view, and provides a wider range of family experiences.
But the same things that are required to be a good parent as part of a couple apply to single women: emotional and financial stability, a good support system (even couples need an extended family---remember, "it takes a village"), and an understanding of the needs of a child.
In the case of single women (or men) considering parenthood, the last requirement also involves understanding exactly what, if anything, will be missing from the life of a child who has only one parent, as well as what feelings their child is likely to have about such a loss.
When should you give up on your relationship?
Many couples fear going to couple therapy because they've heard stories of how it can be the death-knell of a relationship. I find this is rarely the case. More often, it's when one person is growing through her own therapy and her partner is stuck in one place that the relationship can begin to appear to be unbalanced.
No one should avoid seeking help with a partner when the going is rough. With a good counseler, relationships can make great progress, old hurts can be healed, and a new path forged.
However, having given couple therapy an honest try----this means more than 3 or 4 sessions---sometimes it becomes clear that two people simply do not have the same capacity to use the tools that are being provided. In this case, it still isn't time to give up hope. Individual therapy can assist the partner who seems to be overburdened with "old baggage." Frequently it isn't the past events in the partnership that make it seem at a standstill, rather what one or both people have brought to the connection from their individual pasts.
All of these pieces of the puzzle can seem contradictory. Here I'm saying that individual therapy can make or break a relationship. This is true, but the alternative is to do nothing, in which case no one wins, neither party, nor the relationship.
The true test of whether to give up or not may lie in a simple balance-sheet. If what you stand to gain from staying in it outweighs the benefits of being on your own, and this is based on your history together as well as your own personal life goals, it would seem to be a shame to give up prematurely.
Sometimes a relationship that has a history of success runs into overwhelming stressors that cause a temporary, though seemingly insurmountable rift. Recalling the good you've had in the past can shore you up for dealing with the challenges of the present.
However, it's not uncommon to find out that what you settled for in an intimate connection years ago has actually been inadequate all along, and you were perhaps afraid to desire more for yourself, or had an iincomplete idea of what you wanted from life, or another person.
If you haven't made a list of what your own priorities---or even a "dealbreaker" list of qualities you'd like in a partner---now might be the time to do so.
First on this list might be the expectation that your intimate partner be invested in helping you be the best you can be, and vice versa.
Is there anything to help relieve constant anxiety?
This is one of those questions that is very hard to generalize about, but deserves some response, especially since anxiety is something that is more and more prevalent. The following information is just an introduction to how your therapist might help you. You may even benefit from some of the suggestions on your own.
Of course our ancestors were programmed with a "fight or flight" respnse that was activated when danger was near. We're wired with that capacity---to run away or face down something threatening us---to keep us safe. But feeling like you're constantly on edge is a very uncomfortable way to live, and this can be treated successfully through gaining some insight into your on psychology, behavior modification and cognitive re-structuring, and if necessary, through medication.
First it's important to rule out a specifically medical cause for feeling nervous. Some physical conditions related to your heart, thyroid, or metabolic system, as well as overuse of stimulants can make you feel "wired." It may even be that you're genetically programmed with an extra bit of the "fight or flight" response and should address it from this perspective.
After these are ruled out, it's a good idea to be specific. "Free-floating anxiety" is different from panic disorder, stage fright, or social anxiety.
If what you feel is like the term suggests---a free-floating feeling of unease that seems to underly all your activities, no matter what occupies you, some psychological digging will probably uncover the reason or reasons for feeling this constant state of dread. In this case, a combination of insight into beliefs you may have developed about your safety and some cognitive-behavioral tools will help.
Should you be overwhelmed by a debilitating feeling that starts with a sense of dread, involves palpitations of your heart, difficulty breathing, and a sense of impending doom, often about dying, you may be having panic attacks.
There are very clear methods of dealing with this. The first thing you can do for yourself is to tell yourself that what you're experiencing has a name: it is anxiety, not a heart attack (please be certain all medical problems have been ruled out, first) and that it will end. Taking regular, even breaths will help bring your physiological state back to normal and allow you to think more clearly. You might think of what's occurring as if it were a wave of psychological (and physical, certainly) experience you're riding that will recede just as it welled up, and certainly not end in death.
A combination of insight therapy and cognitive-behavioral work will also help you address stage fright, fear of public speaking, and social anxiety. These all involve very uncomfortable symptoms, certainly, but are much easier to address than you might think.
What is "in-depth" therapy?
This term is generally used to descibe therapy that emphasizes the role of your unconscious in your behavior, in what motivates you, and in how you feel about almost everything, especially yourself.
Freud likened our conscious behavior to the tip of an iceberg, believing that our (frequently forgotten or repressed) past experiences result in beliefs about how the world works and what to expect out of life and from other people. These experiences affect our sense of our own worth as human beings and the goals we set for ourselves, as well as influence the way we act in relationships.
Taken together, they form a map, template, or inner guide that may be distorted by our immaturity at the time they happened to us, the lack of awareness or understanding of those responsible for our care, or other external stimuli or circumstances.
The result is that, metaphorically, we're not actually driving the car, so to speak---rather we're on "automatic pilot," taking routes and finding ourselves at destinations that frequently surprise us.
For example, you might have a strong desire to be in a relationship, but have difficullty finding one; find one, but become disappointed; want success but are constantly thwarted; try your best to communicate, but seem to be frequently misunderstood.
The goal of in-depth therapy is to uncover these experiences and relate them to your life today. In this way you learn how what happened to you led to the creation of beliefs, fantasies, conflicts or fears that still drive your behavior, even though they're outmoded. With new awareness, you can re-define yourself and plan your own journey, this time in a conscious way.
You can drive the car.
This exploration of the past and the insight you gain is best attained working with someone trained to help you understand its meaning and how it shaped your views, and importantly, your behavior.
Such a therapist can really open your eyes, by combining her knowledge of human psychological development with what she learns about your history. In the best outcome, she can effectively help you change your life, so that what happens to you coincides more with what you consciously desire.
What makes a good therapist?
Aside from comprehensive training in theories of human development and research related to human behavior, the thing that is most important is the same thing it takes to be a good parent:
This is being able to separate her "stuff" from her patient.
A therapist is only human, and will have reactions to the person she is seeing that are based on her own experience, just as a parent may sometimes feel the stirrings of her own needs competing with those of her child. But there is sometimes a temptation to give advice, teach a moral lesson, or give an opinion, and often this can be confusing to a patient.
Unlike a parent, a therapist isn't meant to teach in this way, except under certain circumstances, such as when communicating techniques to change behavior, or when actually dealing with a child.
The "stuff" that both parent and therapist would do well to separate from the work she's doing to help someone else relates more than anything to her own psychological needs, wounds or limitations, particularly her own need to be gratified.
This is why being as conscious as possible about one's psychological weak areas is vital to being a good practitioneer. The best way to do this is to have successfully completed enough psycholtherapy of her own.
You may have a feeling that your therapist is taking too much of an interest in a particular part of your life, or she may be revealing more than you're comfortable hearing about her personal life. She may seem to be expressing emotioons that don't seem appropriate under the circumstances.
If there's any way you feel that your therapist does not seem to be able to separate her own issues from yours---at least for the fifty minutes you are together---you may want to begin a dialogue with her about it. It could initiate a helpful burst of energy and growth in your work together.
Why do things not seem that different between my ex and me, though we're divorced?
This question has come up twice this past week, in the Women and Divorce Group and in session with an indiviual patient. It's the source of a great deal of frustration for many men and women whose marriages have ended.
Of course even endings take a certain amount of time, and most human beings find it pretty hard to make a clean and surgcal break instantaneously! But here we're talking about relationships that may have ended several years (at least two) ago, and still seem to be the surce of pain, or at least proviocation.
The issue of establishing strong boundaries between you and your ex can be a persistent problem whether you have children or not, though parenting kids together makes a total separaton almost impossible.
The most important thing to know is that you separated for a reason. The second thing to understand is that you can't have it both ways: you're in or you're out. If you and your ex are friendly and have completely separate lives, clearly there's not a problem. But if you find that the degree to which your former mate is involved in your life is preventing you from feeling as though you are truly going ahead with a new life of your own, then there may be something to address.
There is a third, and very important issue: this is that fighting can be an extremely efficient way of staying un-divorced. If you cannot seem to stop bickering or worse, it's possible that there is somethig you'd benefit from addressing in your own readiness to really take the leap, and go forward alone.
Will therapy help if you aren't able to come to sessions every week?
Sometimes this question comes up when finances are an issue, or if travel makes consistency difficult. If you've been seeing your therapist for a while and this is a temporary and unavoidable situation, you and she can talk about how to make the most of the time you're able to devote to your therapy sessions.
If you're thinking about beginning therapy but are concerned about the cost, then it might be a good idea to investigate the possibility of using insurance, if you have it, to help defray the expense. Otherwise, there are excellent lower-fee counseling centers in most areas. Two in Los Angeles are the Wright Institute and San Fernando Valley Counseling Center.
However, a good way to think of this is to consider the physical therapy model. Just as you would think that it's essential to have regular treatment for a part of your body you're trying to strengthen, the same holds true for your psychological state. Going to physical therapy every other week would very likely create a situation where it'd be hard to make consistent progress by waiting so long between sessions.
As a way to look at doing psychotherapy in the long run, at least once a week is how it works best. Many therapists who work more deeply believe that twice weekly is the best way to do it.
How much secrecy from you should your adolescent have about her life?
Two things are true: First, keeping more things to herself is a vital part of growing up and separating from her parents and individuating as a person in her own right . And second, an open, consistent line of communication to their parent(s) is the hallmark of teens with the fewest issues related to substance abuse.
How to walk this fine line between allowing privacy and encouraging openness is the real question. If you started early letting your teen know that especially when something troubled her or confused her, she could always talk to you---no matter what the topic---you're ahead of the game. With this foundation, your teen will feel it's less awkward to share things of a personal or highly charged nature.
If for some reason this communication becomes interrupted (this can happen for all sorts of reasons, including in the event of a divorce, when attention is diverted somewhat from this open line) it's always possible to re-open it. You can make sure she understands that though she's clearly growing up and needs privacy, you're always available as a sounding board to help her think through her "stuff."
There are cases when you're concerned and feel that something might be so wrong that intruding on her privacy seems important, and in some situations the only choice. This is why some parents check the web history of their teen, or insist that a family computer is used or that the door to her room be left open.
The truth is that what most parents see of their teen's life is like the tip of an iceberg. It isn't wrong to communicate your awareness of this to her, and that you trust that she knows when sharing her life with you is the right thing to do.
What should you say to someone who's depressed?
It can be uncomfortable being around someone who's feeling blue. And if you've been lucky enough in your life to have had little or no exposure to negative feelings, you may feel especially out of your element when a friend tells you she feels bad.
If this is the case, your first impulse may be to try to make her feel better, perhaps by enumerating all of the good things about her life that seem so clear to you, but that she seems unable to see. Though this undoubtedly comes from a compassionate place, it's helpful to ask yourself whether it's really your discomfort you're most aware of, and trying to address.
Parenting is a model that seems to fit almost all relationships. There are many aspects of being a good friend that are essentially the things a "good-enough" mother would do. One of these is called mirroring, when a mother validates her child's feelings in order to let her know first, what the feeling is, second, that she has a right to have it, and third, that she is not expected to replace it with another one in order to make someone else more comfortable.
So the answer to the question really is some version of "Gee, you do sound sad. It must be really awful for you right now." This will help someone who's depressed far more than reminding them of what they have to be happy about. You aren't really expected to find a solution to whatever it is that seems to be at the bottom of the sadness. The cause is frequently a mystery, anyway.
However, if there's someone in your life who's feeling so hopeless that life doesn't seem worth living to her, it can be frightening. Telling her that she has something to live for probably feels like just the right thing to do. Please see the links section for resources, in that case, if your friend does not have a professional to talk to.
What if you haven't spoken to your mother in years? Who needs her, right?
The short answer is that although you may not need her as an adult, you once did, very much. From the moment you were born and during the time you were developing your ideas about your own worth---and how the world works---her effects on you were profound. Your relationship with her formed a sort of template for succeeding ones.
If you've become estranged you should be able to draw on the strength and flexibility of your early connection to repair your relationship, now. When a hurt is so unbearable that it feels as though the only option is to cut one another from one's lives, it's possible that this bond wasn't strong, or what you learned about relationships did not foster the resilience needed to deal with conflict. Perhaps you can relate to the experience of feeling that there is only room for one opinion, or one person's feelings in a relationship.
It may be that what happened between the two of you is (or was) unforgiveable. Today's the day we set aside for paying homage to the moms who are devoted to their children. If you were not fortunate enough to have a mom you could count on, you may have just given up on her. The effects of a conflictual or at worst, abusive parental relationship can be deep and longstanding.
Unfortunately, out of sight is not out of mind, because whether or not you currently interact with a parent you've fought with, been disappointed by, or has abandoned you in some way, you've internalized what you learned from her about how to deal with strife. Whether you have a connection with your parent or not, there's a good chance the pattern of relating has been been replicated many times over in other relationships. In other words, this lack of flexibility may be interfering with your ability to withstand the "slings and arrows" most of us must endure in being close to others.
We really do learn what to expect from intimacy very early on. If you were lucky enough to have a mom who made it easy to be close to her, you may have very little problem becoming close to others. We also learn how to feel about ourselves from the earliest love experience we have. If we were criticized or disparaged, expected to always do better no matter how well we behaved, asked to deny our own feelings in order to make room for the feelings of a parent, our sense of self can be wobbly.
This doesn't mean that if one of these situations has caused an estrangement you have to confront your parent now. But it does mean that spending some time contemplating how you learned to form relationships can lead to a lot of growth.
How long should you expect to be in therapy?
This is one of the practical issues that needs to be addressed before you can be sure that you're ready to take part in this process. Unfortunately, there isn't a one-size-fits-all answer, but your therapist should be able to give you some idea of the length of time it will take to address the situation you confront.
When you're in crisis, this question is often most pressing: how long you have to wait until your life seems "back to normal" is all you want to know. Actually, the answer to this question can correlate directly with the level of normalcy you previously had: if you have a good support system, strong internal defenses, and a stable life-style before the events that brought you for help, it's likely that the time it takes to return to the life you were leading before will be shorter.
But if you're in a serious and complicated crisis, and this is only the most recent way your life has manifested chaos, it may take some time to first resolve the issues at hand, and then to learn the new ways of dealing with life that will protect you from disarray in the future.
Otherwise, you should feel some relief from the psychological issues you confront right away. Here I'm referring to the relief of sharing your burden, not to symptom relief. However, if you don't feel some change in how you're feeling within about three months of beginning therapy, you should discuss it with your practitioner.
Perhaps the addition of medication, more frequent sessions, or a re-examination of the treatment plan will introduce some progress.
Sometimes people ask this question because they worry about the stories they hear of people being in therapy for years---in some cases not even seeming to make progress. You should know that you can leave therapy at any time, have every right to know approximately how long your therapist feels your treatment will take, and, importantly, that frequently people who seem not to be changing because of their long-term therapy are actually making gains that aren't always that apparent, but are deeper and more internal.
What do you do if your relationship is in trouble, but your partner won't agree to couple therapy?
You obviously don't have the power force someone into therapy, though some of my patients have reported that communicating to their partner that their continuing to be in the relationship depended attending an agreed-upon number of sessions was sufficient. (You can bring a horse to water, but remember . . .)
But you can make incredible progress resolving conflict with your partner by going to individual therapy. Just you. Because the good news is that when you begin to change a little in therapy, the people with whom you have intimate relationships behave differently, too. They have no choice but to change, sometimes a little bit, and sometimes quite a lot.
This is because when one component in a system is altered, the other parts of the system are also transformed---just like in something that contains mechanical parts. All of us, in a close relationship, develop patterns of behavior that become ingrained over time. The relationship "machine" learns to function this way. It works the way it does because its parts behave the way they do. To switch metaphors, it only takes one person to " go off script" for things to change.
Sometimes I ask someone who is having relationship problems what they say to their partners when in conflict. They sometimes sort of paraphrase or sum up the a conversation that has been the source of a fight. I ask them to tell me exactly, not approximately what it said (and this isn't usually too hard to do---it's often literally the same conversation. You know what I'm talking about.)
I stop them after they have repeated a few words, to ask them if they think their partner knows how the rest of the sentence is going to end. Enough said.
The changes someone has to make internally to stand up for themselves in abusive relationships, admit they are not in love any more, or even come out to their partner are very large ones. If your you're dealing with these kinds of issues in your relationship, it will take a bit of work to become the kind of person who is ready to change the system.
But I believe it's possible, and life-changing---sometimes even life-saving.
Disclaimer: These observations are meant to be general and Dr. Gable holds no liability for their application. They do not represent prescriptions for behavior or treatment that should be applied without professional consultation. Ask your physician or psychotherapist what may be safely applied to your situation.