- 22 minutes ago
ASMR Roleplay - Your First Therapy Session (help for stress, anxiety, intrusive thoughts)
Category
🦄
CreativityTranscript
00:01Hello. Welcome in. I'm Miss Lavender. Can I just double check your first and last name?
00:16Perfect. And your date of birth.
00:22Alright, we are good to go there. Go ahead and make yourself comfortable. Perfect. Did you see our tea bar
00:32in the lobby?
00:34I actually have some peppermint tea. Peppermint tea here myself. It's my favorite during the winter. So, first things first.
00:59How are you feeling?
01:04Okay, a little anxious. That is completely, completely normal. Do you want to work together to try to make you
01:12feel a little calmer and then we can do, you know, some questionnaire type things?
01:19Perfect. Okay, well, first of all, just go ahead and relax your shoulders. Good. Okay, I can see your face
01:31is kind of tense. Maybe you could close your eyes if you want.
01:35Good. And then loosen your jaw. Loosen your brow. Just make sure you're kind of melting into the sofa there.
01:49Perfect. Okay. Let's take a deep breath in together.
01:58Okay. Let's take a deep breath in together. Okay, one more time.
02:04Okay. Now we're going to do that again, but you're going to hold your breath after you inhale, okay? No
02:15need to do a big inhale. You're just going to hold it for a few seconds.
02:20And then really exhale, okay? Let's do it together. Exhale. Good. Okay, keep doing that. I'm going to light a
02:39candle, add to the ambiance a little bit.
02:45Okay. This is lavender mint and ling-ling. I'll be honest with you, I don't know what ling-ling is,
03:03but it smells great. Do you want to smell?
03:13So good, right? So good, right? So let's light this.
03:29It's a little bit loud. It's a woodwick, woodwick, woodwick, woodwick candle.
03:36It's a little bit loud. Okay, another deep breath.
03:47I take it that maybe this is your first meeting with a counselor.
03:58Okay. No, that's absolutely fine.
04:04So, do you know the difference?
04:06Here, let me pull this up.
04:12Do you know the difference between a therapist or counselor and a psychiatrist?
04:20Exactly. So, psychiatrists tend to deal with diagnosis and medical treatment via medication.
04:29And the therapists and counselors, it's more of an interactive, verbal exchange, if that makes sense,
04:38where it's the classic talking it out.
04:41So, I'm still a professional.
04:43We're just not going to be addressing the medication side of things, okay?
04:49Perfect.
04:50A big part of this is making sure that we are a good fit.
04:55So, if you feel like we are not a good fit by the end of this session,
04:59I will not be offended in the slightest.
05:02If you want to, try a few others until you find somebody you feel really comfortable with.
05:12Yes. So, if you decide to stick with me, we would be meeting in this office, my office,
05:19one or two times a week.
05:24I normally recommend with new clients twice a week.
05:29Though I know that's not completely possible for a large majority of working people.
05:37So, one a week is pretty normal to.
05:42Perfect. Okay.
05:44Well, let me just input a few things into my system for my own records,
05:49and then I can get started getting to know you.
05:54Okay.
05:58All right.
05:59So, your insurance is all set up.
06:04Excellent.
06:05That means every visit will be completely free.
06:12All right.
06:14Let's see.
06:15Your contact information is all filled out.
06:18Wonderful.
06:23Really quickly, your family mental health history.
06:29Can you tell me a little bit about that?
06:30If you know.
06:33Okay.
06:34Your mom.
06:36Okay.
06:38Okay.
06:49And your father.
06:52Okay.
06:53Okay.
06:56So, your uncle.
06:58Okay.
07:01Okay.
07:08All right.
07:09Anything else you'd like to tell me?
07:11Have you ever spoken with a, your primary care physician about any mental health things you wanted to address or
07:19anything like that?
07:21No?
07:21Okay.
07:23Okay.
07:25Surprisingly, your primary care physician can be a really good resource when it comes to mental health as well as
07:33physical health.
07:35Yeah.
07:36And they are capable of prescribing you medication if you wanted to go down that route.
07:42All right.
07:43Are you feeling a little better now, by the way?
07:48Okay.
07:49Okay.
07:50Perfect.
07:51We'll do a little bit more talking and then we can try an EFT session if you'd like.
07:58It's one of my favorite, favorite, favorite methods of calming down.
08:06Perfect.
08:07Okay.
08:13Is there any substance abuse history in your family or with yourself?
08:19If you feel comfortable talking about that right now?
08:23Okay.
08:29Are you on any medications or anything else?
08:38And is that information with your doctor?
08:43Okay.
08:43Do you know the dosage off the top of your rear head?
08:48Oh, you do?
08:49Okay.
08:49Excellent.
08:51Okay.
08:52And that's once a day.
08:55Okay.
08:58That medication can sometimes have some behavioral or mental side effects.
09:06How long have you been taking that?
09:10Okay.
09:12Well, that's a good segue into the reason you're here with me today.
09:18Is it for a particular reason that you would like to address?
09:26Because a lot of people do come in here just for somebody professional and capable to help them sort through
09:33their feelings.
09:34I think everybody should have a therapist.
09:37I have a therapist.
09:39And my therapist has a therapist.
09:40I have a therapist.
09:42Okay.
09:43So it is a specific issue, though.
09:45Okay.
09:48When would you say that first started manifesting strongly enough?
09:55You wanted to...
09:57You started noticing it.
10:00Okay.
10:14So you would define this as the primary reason that you're seeking counseling.
10:27So this anxiety...
10:29Do you feel like it manifests physically or in ways that surprised you or that you want to talk about?
10:40Of course, we're going to go into a lot more detail.
10:43This is kind of just my intake form.
10:47Okay.
10:51Any suicidal ideation?
10:54Anything like that?
10:56Okay.
11:00Do you find that you suffer from anxiety attacks or panic attacks?
11:07Yeah, they're really hard.
11:09Okay, let me make a note of that.
11:12I'm sorry to hear you going through that.
11:14About how many times?
11:16A month?
11:19Okay.
11:26Of course, like I keep saying, we're going to get more into this here in a second.
11:31But are there any life transitions or life events that could have triggered this?
11:41Okay.
11:43I understand.
11:46All right, let me just make a note of that.
11:54Okay.
11:56And you've noted that this is your first time or your first true experience with behavioral health treatment.
12:07Okay.
12:09Okay.
12:09Well, pleasure.
12:14Okay.
12:15Last question.
12:18What would you say your goal is for your behavioral health treatment?
12:25Okay.
12:28Now, that's wonderful.
12:29That's wonderful.
12:30Let me add that.
12:32It sounds like you've put some thought into this, which...
12:37You're a pretty introspective person, would you say so?
12:41Okay.
12:53There we go.
12:55Thank you so much for your patience for that section.
12:59I know questionnaires are never that fun.
13:04We're switching over to me just taking notes in my notebook, if that's okay with you.
13:14I will be paying complete attention to whatever you're talking about.
13:19I just really love organizing what I learn about you and what you want to tell me.
13:28Having it written down just really helps me stay on top of it and just figure out the best treatment
13:37plan for you.
13:40I will admit, though, I do have a few other patients, and I've embarrassingly enough gotten some names mixed up
13:50for people important in one person's life.
13:53And so, let's avoid that.
14:05Isn't this a cute little journal?
14:09Let me check in again.
14:11How are you feeling if you could place your anxiety or...
14:16That's what you said, anxiety right now, right?
14:20Okay, it's better.
14:22How would you place it on a scale of 1 to 10?
14:29A 4.
14:30Okay.
14:31We can work with that.
14:33Of course, we can do that UFT tapping technique, if you'd like.
14:37Or we can do that at the end of the session.
14:44Yeah, of course.
14:45Another thing I like to do is evaluate, using this 1 to 10 scale, how you feel at the beginning
14:53of our session.
14:55After talking about it, then how do you feel?
14:59Some people find it.
15:01Talking agitates them more, and some people find...
15:06It helps.
15:07I think it depends on the situation, you know?
15:18Alright, so...
15:20Go ahead and keep trying to make yourself as comfortable as possible.
15:36Okay.
15:39So let's get started.
15:43Can you tell me about you?
15:47I know that's a little overwhelming, but...
15:51Let's start with...
15:54What's your job?
15:56Who are the important people in your life right now?
15:59Okay.
16:06What was her name?
16:08Okay.
16:13Okay.
16:24Now that's your sister.
16:27Okay.
16:30Perfect.
16:31Tell me a little bit about the person that's been on your mind the most lately.
16:37Good or bad.
16:41Okay, so that's...
16:46Great.
16:49How is work or...
16:52School?
16:52Work.
16:53How is work going?
16:55Do you like it?
16:59Okay.
17:02Fair enough.
17:04I do like my job, though.
17:05I genuinely do.
17:07It's pretty rare, though.
17:09Okay.
17:23Where did you grow up?
17:25Did you grow up here?
17:29Okay.
17:30And you moved around a lot.
17:34Okay.
17:38Your parents, are they still together?
17:44Okay.
17:46Any remarriages?
17:47Do you have any...
17:48Step-parents?
17:56Do you get along with them?
18:00Okay.
18:01Okay.
18:04Now you said there was no major life event that you feel like could be triggering...
18:10These feelings of anxiety.
18:13Okay.
18:14Okay.
18:17Okay.
18:18So you struggle with what you think are intrusive thoughts.
18:22Tell me about that.
18:28Okay.
18:31These thoughts, do they scare you?
18:35Can you tell me...
18:37I know it's really hard to talk about them.
18:39Intrusive thoughts generally are scary.
18:44They're generally upsetting.
18:46It almost feels like your brain is working against you.
18:50Trying to make you feel powerless.
18:53Trying to shock you.
18:56Okay.
18:59No, they're absolutely not any kind of indication of a moral failing on your part.
19:05It's truly your brain trying to mess with you.
19:09So, we'll get into it.
19:12So, can you describe?
19:20Okay.
19:22Does this happen many times in a day?
19:26All right.
19:29Yeah, that's really...
19:32That's scary.
19:35But I will tell you...
19:37I've heard many stories exactly like this.
19:41You are not...
19:42You are not abnormal.
19:45Okay.
19:46I know it might feel like that when your brain is...
19:50Working against you.
19:52You consider your brain to be working against you, but...
19:56It's scary, but it's normal.
19:58And we're gonna work on...
20:00Helping.
20:01I have some techniques.
20:05Okay.
20:10All right.
20:13And again, how long has this been going on?
20:19Okay.
20:24Okay, okay, okay.
20:26So, you perform...
20:29Little checks.
20:33That sounds a lot like OCD to me, if I'm being honest with you.
20:39So, you get an intrusive thought, and you have to do something to make the thought leave your head.
20:47I know it doesn't sound like classic OCD, but I think we're already learning quite a bit right now.
21:01I know it doesn't look like what many people think of OCD as, where you have to wash your hands
21:08this number of times, or you have to flick the lights on a certain number of times, or check the
21:17oven, things like that.
21:18However, it's just as valid, a type of OCD.
21:24Some therapists like to call it pure O.
21:28I don't really agree with that term, because it separates itself from OCD, calling it pure O.
21:35Pure obsession.
21:37Because you are still performing a compulsion, even if it's mental.
21:44So, it's still obsessive-compulsive disorder.
21:48I'm not trying to get ahead of myself here.
21:50I think we can just explore this avenue a little bit.
21:55But, um, go ahead and keep telling me anything.
22:01Okay, so...
22:05You do perform a physical compulsion.
22:10Okay, yeah.
22:12Tell me more about that.
22:16Do you believe that this compulsion will...
22:23Okay, all right.
22:28Let me...
22:30I have a OCD questionnaire that I just want to talk about some points with you.
22:40All right.
22:42This isn't stressing you out, right?
22:44I feel like we're making some really good progress.
22:47But if we want to slow down, take it back a step,
22:52we can just focus on calming you down and continue the get-to-know-you section.
22:59No?
23:00You feel like we're onto something?
23:01Okay, perfect.
23:06Let me just find my checklist.
23:08There are basically three...
23:11One, two, three screening questions.
23:15Okay.
23:21Here we go.
23:24So, let's relax again.
23:29I'm going to ask you the first question.
23:35Do you experience unwanted thoughts, images, or impulses that repeatedly enter your mind
23:42despite trying to get rid of them?
23:45For example, worries about dirt, germs, or thoughts of bad things happening.
23:55Okay, so these are the obsessions.
23:58So, you already said you struggle.
24:00Intrusive thoughts and obsessions are...
24:06They're...
24:07They're super similar.
24:14So, that really resonates with you.
24:19The next question.
24:21Do you feel driven?
24:23Do you ever feel driven to repeat certain acts over and over?
24:27For example, repeatedly washing your hands, cleaning, checking doors, or having to repeat thoughts
24:37in order for your mind to feel better?
24:42Okay, I thought so.
24:44Let me just write something down.
24:55And you said there was a slight physical aspect to this.
24:59Okay.
25:01Okay.
25:17How many times a day?
25:19Right?
25:20Right, right.
25:22Do you find that this...
25:23This is off the questionnaire, but do you find that these intrusive thoughts and your reaction
25:30to them are amplified when you're feeling anxious or stressed?
25:35Okay.
25:35Okay.
25:36That's common.
25:38The third and final question is...
25:43Does this waste significant time or cause problems in your life?
25:50For example, interfering with school, work, or seeing friends.
25:55So, this helps determine the severity.
25:59I think that's really the difference between deciding if something is a disorder is does it upset you?
26:08Does it affect your life negatively?
26:12Because our brains are very weird.
26:16Everybody's brain does weird things.
26:19It's really how much of a problem to you does this create.
26:34Like I keep saying, I think we've narrowed in on a potential treatment plan just by identifying what you could
26:44potentially be dealing with.
26:47Of course, after a few more sessions, we could be going down, you know, the wrong path and we could
26:55be led somewhere else.
26:58However, if the treatment plan that I provide to you and maybe some exercises that I provide today, if they
27:06resonate with you and if they help you, we can work on this moving forward.
27:13So, the very first thing I want to talk to you about is one of my favorite pieces of literature
27:25regarding OCD.
27:31If you're having trouble identifying with the OCD label, I'm definitely not trying to force a label on you that
27:41you don't feel comfortable with.
27:44But, I just want to really emphasize that a lot of people's perception of conditions and disorders and mental health
27:54can be completely different than the reality.
27:59And they're actually quite a bit more nuanced than you'd expect.
28:03And, um, so yeah.
28:07You don't have to identify with any disorder.
28:12It just sometimes help with accessing and finding resources.
28:18Like the book that I'm going to show you.
28:24So, let's see here.
28:33This is called the Mindfulness Workbook for OCD.
28:38The Mindfulness Workbook for OCD.
28:52This is my favorite workbook.
28:57It is a guide to overcoming obsessions and compulsions using Mindfulness and Cognitive Behavioral Therapy, also known as CBT.
29:13Now, this is just our initial one-hour consultation, so we can't really dive into what CBT is.
29:26And you're going to learn, if you have more sessions with me, that I am a big advocate for mindfulness
29:32and how powerful mindfulness can be.
29:38If you're anything like me, which it sounds like you are a little, you would also enjoy having it be
29:46in a workbook style.
29:55So, some people really thrive with this style.
30:03So, it has questions, prompts that you can write in.
30:09And I can let you take this home for this week.
30:12This is my office copy.
30:16And you can write your answers in a notebook.
30:18And you can bruise the book, see if it resonates with you.
30:23If it does, I can get you your own copy.
30:33Let me read you the book.
30:35Don't let your obsessions and compulsions consume your life.
30:41If you have OCD, you might suffer from overwhelming fears and fixations that keep you from truly enjoying your life.
30:50Sometimes, you may even feel like a prisoner, trapped with your intrusive thoughts and ruminations.
30:57If you've tried different treatment options with little success, don't lose hope.
31:02You might benefit from a mindfulness-based approach.
31:11So, here you go.
31:17Okay, so, just trekking back in with you.
31:20How are you feeling now?
31:22Where would you put your anxiety on a scale of 0 to 10?
31:29Okay, a 3.
31:30So, a little better.
31:33Okay, we can definitely talk about your anxiety for a second.
31:40You'd like that? Okay.
31:42Okay, so, go ahead and tell me about your symptoms there.
31:54Okay.
31:57So, you do get physical.
32:02You get hives.
32:04Okay.
32:06Have you brought this up with your doctor?
32:09Okay.
32:12Take a look.
32:13Take a look.
32:15Take a look.
32:17Take a look.
32:20Well, let's take this chance to kind of see, using mindfulness, what your anxiety feels like in your body.
32:29So, if you could just close your eyes for me.
32:34Okay.
32:35So, you said that your anxiety was a 3 out of 10.
32:41Where in your body do you feel this anxiety?
32:47Okay.
32:49Can you give me some adjectives describing it?
32:56It is difficult, but any adjectives that you like.
33:01Anything that feels right.
33:03Maybe it's gray.
33:07And it makes you feel like your brain is in a fog.
33:11It's foggy.
33:13Or static-y, like electricity.
33:17Okay.
33:21Okay.
33:22A couple more adjectives for me.
33:27Perfect.
33:29Okay.
33:32Now, go ahead and open your eyes.
33:36Do you find that sitting with it and identifying it helps at all?
33:45Okay.
33:46So, I'm going to send you some of my favorite guided meditations along this concept.
33:53Can I get your email?
33:57How do you spell that?
34:00Oh.
34:02Okay.
34:05Okay.
34:08So, I'm going to shoot you an email with some of my favorite anti-anxiety mindfulness guided meditations.
34:16Something I like to do in my office is, if you come in, starting a session, feeling really overstimulated, really
34:25anxious, we can start off with the meditation.
34:30Of course, of course.
34:33Okay.
34:35Of course, if you're interested, I think we have maybe like 10 or 15 more minutes, so.
34:45A little less.
34:46Okay, okay.
34:53So, have you found that your anxiety has been higher previously in your life, or do you feel like you
35:00are at a peak right now?
35:06Okay.
35:09Okay.
35:13Okay, I understand.
35:15Okay.
35:18Perfect.
35:25Of course, let me explain the EFT tapping technique.
35:30Have you heard of it?
35:34So, this is another exercise I do like doing with my patients, my clients.
35:43What's cool about this is that you can do it on your own, and you can even do it in
35:50public.
35:50It looks a little strange, but it can help, especially if you're feeling really anxious in public.
35:57So, what you're going to want to do is, once again, try to relax as best as you can, and
36:04then you're going to come up with a statement that goes along the lines of,
36:09Even though I feel, even though I completely and wholly accept myself, even though I feel ashamed of this, I
36:22completely and wholly accept myself.
36:26Even though I feel anxious, even though I feel like I'm being dramatic, I completely and wholly accept myself.
36:36So, create a statement like that, that resonates with you, and then you're going to take your hand.
36:42You can choose the fingertips, or you can choose this part of your hand.
36:52Or your fingertips.
36:53I did cut my finger earlier, it's fine.
36:59Make it a little strong, firm, and then you're going to touch certain points on your head.
37:07I'll send you a link with more information about this, about why they think that tapping a little forcefully on
37:14these points of your body can calm you down.
37:17But just trust me for now.
37:19You're going to tap the top of your head, and then you're going to tap above the eyebrow, side of
37:31eye, under eye, above your lip, your chin, your collarbone, and then your armpit.
37:47So you're following a pattern, top of head, eyebrow, around the eyebrow, around the eye, lip, chin, collarbone, armpit.
38:06And each time you move on to a new section, you repeat this phrase that you learned.
38:14Even though I'm having scary, intrusive thoughts, I completely and utterly accept myself.
38:23Even though, and so on and so forth.
38:28So that is one of my favorite techniques.
38:31Another one is doing that, but just hitting your hands like this.
38:40Now this is probably more recommended if you're in like a classroom or work setting, and you don't want to
38:46stand out.
38:47So you can kind of close your eyes and do that affirmation statement, hitting the meat, the meat of your
38:57hand here with your other hand.
39:03So, again, I'll be sending you an email with all this explained a little more thoroughly.
39:10And with every session, we're going to practice what you feel like doing in the moment and maybe what I
39:16recommend.
39:17Sound good?
39:29Well, we are wrapping up.
39:32I have one last thing I want to tell you.
39:36So I mentioned that I'm very invested in the mindfulness approach to counseling and therapy.
39:43Along with the compassion route, which is holding compassion for yourself.
39:50It's something I don't think anyone does enough of.
39:55So we're going to be exercising a lot of compassion, and we're going to be practicing mindfulness together.
40:02I have a fun exercise I like to do, sometimes with children, but also sometimes with people who consider themselves
40:10on the artsier side.
40:13Or people who like working with their hands.
40:18The next time I see you, I think we should make a mindfulness object.
40:35Now what this is, is a heavy object that you hold in your hands to focus on while you practice
40:43meditating or practice mindfulness.
40:49Some people like to focus on a sensation their body's feeling, such as a heavy weight.
41:03So, we can go ahead and make one of these together.
41:06Watch this.
41:28So, we can go ahead and create one of these jars.
41:35I have a ton of different colors of glitter.
41:40And you can take it home with you.
41:42And even if you don't use it religiously in your meditation practice, having it on your desk can be a
41:50good reminder to even just take a moment and practice mindfulness.
42:11Okay.
42:13Okay.
42:14If this is my final check-in, just so I can get a gauge and get to know you better,
42:19where would you say your anxiety is at this point?
42:23You can close your eyes and try to feel it to get a better idea.
42:32A two.
42:33Okay.
42:34I'll take it.
42:34Perfect.
42:36Some people never become truly comfortable in a therapy setting, or maybe it takes years and years and years.
42:44However, work is still being done.
42:48So, I just want to promise you that, okay?
42:52Okay.
42:54Well, it was great speaking to you.
42:57It was great getting to know you.
42:59I'll be in contact.
43:01You can go ahead and stop by my secretary's desk on the way out if you would like to ask
43:07her any questions about scheduling or payment or things like that.
43:13And, though, you have your insurance set up, so that should all go through them.
43:17So, never mind on that front, but she's an excellent, yeah, Susie, she's an excellent point of contact as well.
43:28Yeah, so when I send you the email, you'll have my email, and that's where you can cancel along with
43:36Susie.
43:37Okay.
43:40Well, your only homework for this session is to peruse that OCD workbook, maybe do some research online to see
43:49if it resonates with you.
43:52You could even Google pure O, though, like I said, I have a bit of a problem with how they
43:58phrase that, but I think it can provide some interesting insight.
44:04What else?
44:05Your homework, because there will be a little bit, just a little bit of homework every session, is generally things
44:14like practicing mindfulness,
44:18trying to, various exercises to learn to identify what emotion you're feeling, techniques for calming down,
44:27articles, if you're interested in things like that, setting goals, if that's something you're interested in.
44:36Like I said, we're going to build a treatment plan together.
44:39This was just the initial assessment.
44:44Okay.
44:46Well, again, thank you so much for stopping by.
44:49How did you hear about me, by the way?
44:55Psychology Today.
44:56Ah, excellent.
44:57I think that's a really understated resource.
45:00Yeah, use the find a therapist near me.
45:04Perfect.
45:06Okay, well, it was great meeting you and talking to you, and I'm really excited to see what we can
45:14work on.
45:17Okay.
45:18Take care.
45:21Bye.
45:23Bye.
45:35Bye.
45:36Bye.
45:37Bye.
45:38Bye.
Comments