The Enigma of Mental Health?

Therapy is a space where people seek understanding, change, and clarity for diverse challenges. Often, these challenges come in the form of symptoms, both self-reported and observable—manifesting as anxiety, phobias, trauma, depression, obsessions and compulsions, or significant life events. Every symptom has a story to tell, and within those stories lie the connections between symptoms and diagnosable mental health conditions.

Diagnosis vs. Symptoms

Unpacking Common Symptoms

Anxiety

Anxiety is like a storm hovering in your mind. It brings waves of constant worry that crash throughout the day, accompanied by endless ruminating thoughts—those negative or catastrophic loops that seem impossible to escape. It’s not just in your head; your body feels the weight too. Dizziness, trembling, a racing heart, nausea, and even shortness of breath can almost make reality feel distorted—as if you’re a step removed from the world around you.

Phobias

Phobias are like shadows that loom large over specific situations or objects—a bridge that suddenly feels uncrossable, the thought of needles bringing a cold sweat, or the sight of snakes igniting unbearable dread. These fears trigger intense anxiety and physical sensations like trembling, dizziness, and heart palpitations, making the world feel like it’s spinning.

Trauma

Trauma is an invisible wound, carrying the weight of past experiences that leave deep emotional scars. Whether it’s a single life-altering event or a collection of moments over time, trauma lingers in ways that reshape your everyday reality. You might find yourself reliving those moments—emotionally or visually—as if they’re just as real today as the day they occurred. Nightmares, intrusive thoughts, hypervigilance, and sleep disturbances become constant companions, while sadness, anger, or avoidance trap you in a loop you long to escape.

OBSESSIONS AND COMPULSIONS

Imagine a thought you can’t escape, one that circles obsessively through your mind. Now, pair it with compulsions—rituals or actions that feel impossible to ignore. These might take forms like excessive cleaning, checking, organizing, or seeking reassurance. Often tied to a need for certainty, obsessions can center around fears of contamination, symmetry, perfectionism, or even imagined harm. It’s a relentless quest for control in the uncertainty of life.

Depression

Depression feels like a heavy fog that dims the light on everything you once enjoyed. It can bring feelings of hopelessness, fatigue, guilt, and worthlessness that weigh on your every thought. The smallest tasks become monumental, motivation vanishes, and even sleep becomes elusive or excessive. At its most challenging, depression may involve thoughts of self-harm, underscoring the need for connection and help.

Significant Life Events

Navigating major life events—whether the birth of a child, a challenging relationship, losing a loved one, or even moving to a new city—can feel like walking a tightrope. These pivotal moments often create a mix of excitement and overwhelm, compelling many to seek therapy as a space to process emotions openly with someone educated and objective.

From Symptoms to Diagnosis

While everyone experiences emotional turbulence at times, symptoms become diagnosable when they meet specific clinical criteria and disrupt daily life. Many well-documented conditions are cataloged in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), providing a roadmap for understanding and treatment.

Common DSM-5 Diagnoses:

Major Depressive Disorder

Symptoms include persistent sadness, diminished interest in enjoyable activities, fatigue, changes in sleep and appetite, and sometimes suicidal ideation. These symptoms go beyond “low moods”—they alter the very fabric of day-to-day life.

Generalized Anxiety Disorder

Chronic worry dominates daily life, paired with physical symptoms like trembling, a racing heart, nausea, and difficulty concentrating.

Obsessive-Compulsive Disorder (OCD)

Individuals experience relentless, distressing obsessions alongside compulsive behaviors designed to alleviate their anxiety. These cycles often feel unbreakable without intervention.

Post-Traumatic Stress Disorder (PTSD)

Beyond experiencing trauma, PTSD involves intrusive memories, heightened reactivity, and emotional disturbances, making it difficult to move forward.

Specific Phobia

Intense fear is triggered by an object or situation, causing an immediate anxiety response that can feel physically paralyzing.

Social Anxiety Disorder

Social situations become overwhelming, leading to avoidance behavior and intense fear of judgment or scrutiny.

Panic Disorder

Characterized by sudden, intense panic attacks that come with heart-pounding fear, shortness of breath, and a dread of losing control—or worse, that the attacks will return.

Change Through Evidence-Based Approaches

Regardless of whether symptoms are diagnosable or simply causing personal distress, therapeutic approaches aim to understand, manage, and alleviate these challenges. Through skill-based frameworks and compassion-driven practices, therapy provides a structured yet flexible space for growth.

What are Skills-based approaches?

I emphasize a skills-based approach when addressing disorders and symptoms. This method empowers individuals by helping them build confidence and a sense of control, which are essential for navigating their internal experiences.

How Skills-Based Approaches Build Confidence

A common challenge for trauma survivors is the overwhelming feeling of powerlessness. Many report significant improvement when they develop the tools to manage their emotions and feel they have choices in responding to uncontrollable emotional reactions. I am passionate about supporting individuals in cultivating the skills they need to regain this sense of agency and resilience.

Dialectical Behavioral Therapy (DBT)

DBT offers powerful strategies to help individuals regain control over their emotions, relationships, and thought patterns.

• Mindfulness teaches staying present, and fully engaging with the moment while letting go of judgment.

• Distress tolerance helps reduce emotional overwhelm by building resilience to negative emotions.

• Emotion regulation strengthens skills to steady intense emotional responses.

• Interpersonal effectiveness shows how to communicate assertively and maintain strong, respectful relationships.

Mindfulness Practices

Mindfulness is an anchor in the storm of emotions. Whether it’s a 30-second grounding exercise or a 30-minute meditation, mindfulness helps you observe thoughts and feelings without attachment or judgment, creating space for calm and acceptance.

Do process-driven approaches help?

Imagine mental chaos as a tangled ball of string—knotted, overwhelming, impossible to unravel all at once. Process-driven approaches like EMDR, ERP, and DBR are tools that help untangle that chaos, one thread at a time. 

Exposure Response Prevention (ERP):

This targeted therapy for OCD involves gradually facing fears (exposure) while resisting compulsive behaviors (response prevention). Over time, individuals build resilience to anxiety, regaining a sense of control.

Deep Brain Reorienting (DBR) 

DBR addresses the effects of trauma by targeting the brain’s deep emotional processing systems. Developed by Dr. Frank Corrigan, DBR focuses on how the brain and body react to traumatic events, particularly the initial moments of a traumatic experience when survival instincts are triggered.

Eye Movement Desensitization and Reprocessing (EMDR):

Through the use of bilateral stimulation (such as eye movements or tapping), EMDR helps reprocess traumatic memories, reducing their emotional charge and fostering healing.

If you’re navigating your mental health storm, consider asking your therapist about the methods they use. Research them. Being informed allows you have reasonable expectations for your change, to lean into the discomfort with purpose. And perhaps, bit by bit, you’ll find your way toward steadier ground.

Therapy Norms

Therapy is not just about easing symptoms—it’s about reclaiming a sense of balance and equipping yourself with tools to build a fulfilling life. Evidence-based techniques like DBT, mindfulness, EMDR, and ERP offer pathways for healing, tailored to each individual’s needs.

If you’re experiencing symptoms that feel overwhelming, whether diagnosable or not, therapy can help guide you toward clarity and peace. Every step toward understanding yourself is a step toward healing, and you don’t have to take it alone.

Here are some frequently asked questions about therapy and how the process works:

What are reasonable therapeutic expectations?

Most of us start therapy unsure of how long it will take to change the patterns woven into our lives. Changing how we respond to symptoms isn’t simple—it’s shaped by time and circumstance. How long have these behaviors been part of the story? Are they tangled with other habits or struggles? Anxiety, for example, is often tied to things like alcohol use, trigger avoidance, or coping mechanisms that offer short-term relief but tighten the cycle—like endless research or seeking reassurance.

When clients come to me, it’s often because they’ve hit a wall they can’t climb alone. If they could, they wouldn’t be here. These barriers, though frustrating, are often ancient defenses, built long ago to protect. They may no longer serve us, but they once had a purpose in our journey. My role is to approach these barriers with patience and compassion, helping to unravel them without judgment. Avoidance, though tempting, only adds to the burden. Instead, we gently lean in, peeling back the layers to create space for growth and healing.

How long does therapy last?

Therapy is much like setting out on a journey, one where the path unfolds with time and intention. It’s important to have an open conversation with your therapist about the timeline of this process—what feels reasonable, what feels possible. For many I’ve worked with, those navigating the weight of a diagnosable disorder or symptoms that ripple through their daily lives, therapy often becomes a steady companion for at least a year, sometimes two, sometimes 5 years. Change, after all, doesn’t rush; it moves at the pace of understanding, one step at a time.

Do you have behaviors that may stand in the way of your goal?

Sometimes, there are patterns in our lives that act like silent barriers, making the therapeutic path harder to navigate. These behaviors often show up as:

• Struggling to practice skills between sessions
• Missing appointments often, like skipping stones across a pond
• Arriving late, as if time itself feels like a weight too heavy to carry
• Only seeking help when the storm clouds gather and the rain feels unbearable

Change is like a seed—it needs tending between sessions to take root. When I notice someone struggling to practice their skills, I pause to understand the barrier. Is it fear? Overwhelm? Together, we work to adjust the course, breaking the journey into smaller, more manageable steps. When we tend to these barriers, we create space for growth, like clearing weeds so sunlight can reach the soil.

Skills learned during calm seasons prepare us to weather life’s storms. They are tools forged in peace, ready to serve in chaos. But if you aren’t showing up for the sessions, we lose the chance to unearth those tools together. Change requires both presence and practice—a gentle but steady rhythm of effort and understanding.

Therapy is Really About Learning

Therapy isn’t just about talking and listening, though these are at its core. It’s the starting point—a doorway to change. Like planting a seed, the conversation nurtures growth, but what emerges can go far beyond where it began.

Therapists come in many forms, each with their own approach, like coaches. Finding one who fits your needs is essential. If, after months, change hasn't occurred, it’s okay to pause, reflect, and consider a new therapist. Talk openly with your therapist—share your doubts and thoughts. Sometimes, a fresh perspective with a new therapist is what leads to progress.

When I work with clients, I’m always open to the possibility that they might need help elsewhere. If someone isn’t improving, I welcome that conversation. Referring a client to another therapist isn’t a failure—it’s about ensuring they get the best tools for their healing.

Therapy is goal-driven, but those goals can shift as you grow. My role is to help you understand your challenges and build resilience. Whether that growth happens with me or someone else, the goal is to help you live better and hold space for yourself.

If you have questions, don’t hesitate to reach out to me or your therapist. Therapy is a 50/50 relationship, and honesty is essential. If you’re unsure or uncomfortable, discuss it with your therapist. You may need a different approach or simply more time to connect. Therapists aren’t mind readers, so letting us know how you feel helps us support you better.

Information empowers our choices

At KDH, we see therapy as a process—one where knowledge acts as a guiding light, illuminating the path toward growth. We hope to provide information that empowers you, so you feel informed as you navigate therapy. Like steady hands on the wheel of a ship in uncertain seas, understanding gives you direction, helping you move toward better outcomes. Therapy is a space of intention, a place where we lean into the process with care, and with every step, knowledge becomes a tool of change for you and our therapists.