Dear Alice...

All year I have been wondering about my stress level and what I perceive as unusually heavy mood swings. I'm sure I'm not the only first-year on campus who has noticed new changes in her or his psyche as of "the first year at college." I had a hard time doing it, but I finally decided to see a therapist about my psychological condition, the development of which continues to this moment. I am experiencing some amount of sexual frustration, and I have managed to find my way into plenty of stressful situations all year.

Alice, I'm disappointed. My "health services" therapist is not listening to me (i.e. remembering things that we have discussed in past sessions), and I am feeling only worse. I feel lost. I'm an actor, and I have been in theatre since seventh grade. My mind is always in the theatre, and I feel as though my acting pervades my life. I have lost myself in a sea of specifically self-engineered "parts" which I "play" in differing situations which call out for differing personae. I feel as though hardly anyone really knows me, and I feel like an idiot for identifying with this pseudo-artistic complaint.

I want to make films, but first I have some major issues to work out, and health services is not helping me. I feel intimidated by my therapist, and I feel unable to change therapists within the Columbia system. I want a therapist that I feel will see through the guise that I think I put up automatically. I'm sorry to be cliché, but I need some help finding myself. Meanwhile, my stress level and periodic depression is keeping me from being alert in class (I'm perpetually tired) and pulling me behind in my studies. I have lost the will to work, and I want to find it again. Sorry that it's so long.

Loose ends

Dear Loose ends,

First, kudos to you for seeking help at Health Services and for taking the initiative to look more closely at the quality of your therapy. It can be frustrating to feel like you're not making the progress you'd like to make with your therapist. A couple things could be going on. You can decide which of the following scenarios resonate with you and move forward to find a solution.

One thing that could be happening is that these uncomfortable interactions with your therapist could be just what you need! This might sound really odd, but ask yourself this really tough question: what persona(e) are you playing in therapy sessions? What could these sessions be like if you were to be totally upfront, all cards on the table, completely yourself?

It seems that by holding back your negative feelings about the therapist in session, you may actually be playing some sort of role. There you are, sitting in therapy sessions and not having satisfying interpersonal interactions. By recognizing this and putting it out there in session, you might have a breakthrough from your typical "act." IF this is what you think is going on, you could have a frank discussion with your therapist to disclose the things you expressed here. Seriously, the therapist will be able to handle it, and s/he could probably use the feedback. It would be a courageous and honest move on your part to help yourself step out of your actor role. Once you begin to act authentically, you might be better able to get to work on your depression and stress management in sessions instead of juggling personae and roles.

Now, if after reading that, you still think there's no hope for you to make progress with this therapist, or if you actually try a "full disclosure" session and don't have a breakthrough, here's another possibility: maybe it's just not a good match between you and your therapist. If this is the case, it won't be the end of the world, and you'll still have learned a great deal about yourself and your preferences in therapy. It's not unusual for people to have a hard time finding a therapist who is a good match. People say that finding a therapist is like shopping for clothes; the first, second, or even third outfit doesn't always fit quite right.

If it gets to that point, you'll have some choices to make. First, it'd be a good idea to be assertive: let your therapist know that this isn't working for you, and that you're interested in seeing someone else. You can give her/him your reasons, but it's your choice. Discuss with her/him whether you might see someone else in Health Services or whether s/he would be willing to refer you to someone off-campus with whom you could do longer term work. You have a right to see a different counselor at any time. And, if you want additional help negotiating the Counseling and Psychological Services system, you can always ask to speak to the Director to hear you out and connect you with a good match.

If your counselor refers you to an off-campus provider or you find one on your own, your student health insurance may cover part of the costs (up to 75 percent). If you don't have student health insurance, you'll need to make more decisions. If money's tight, you can peruse the related Q&As to read about ways to find low-cost counseling in the city. If money's not a big issue right now and you can pay out-of-pocket, you'll have more options. In any case, you can choose to interview your potential counselor, asking her/him questions that are important to you. You have the right to a therapist you like, someone who'll do the most constructive work with you. You might even find someone who specializes in working with actors — this is NYC, after all.

It sure can be challenging to look at ourselves in the mirror and admit we need help from a mental health professional. It's great that you want to take an active role in getting the care you want. Through this, you'll definitely learn more about who you really are while recovering from your depression and learning new ways to manage and prevent stress. Before you know it, you'll be getting your work done at school and tackling some of your film-related ambitions!


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