Let's Talk Therapy - with Danielle Sethi
My Story + An indepth Q&A with an experienced therapist
I have toyed with this topic for a really long time. I think this is one blog post I’ve gone back and forth on posting ever since the blog was launched in 2020. Not because it’s a charged topic (it is); but because my real life conversations on this topic end up being so nuanced and deep and wide-ranging, that I feared I wouldn’t be able to do it any real justice by writing an article about it. Being nuanced and wide-ranging is not a bad thing. As a matter of fact, it is so deep that a series might be necessary. So I guess I’m done stalling. Now let’s talk therapy!
Now, to help kick things off, I thought I would do two things. The first is to share a bit about my experience with therapy. Yes I was the cliche. I used to think therapy was for people who were damaged and needed help. And while I have now seen and learnt that that mindset was damaging at worst and ignorant at best, I encountered therapy from hard experience. The first time I KNEW I needed something different from my usual coping strategies was in response to grief. I had experienced 3 devastating losses (2 family bereavements and one miscarriage) in very quick succession and for some reason, thought I could go on with life, just coping. After a bunch of issues including insomnia, migraines and behavior changes that I felt might have had to do with me working super hard to act like I was okay, I eventually got to speak to a professional who diagnosed me with clinical depression.
At this time I had no idea about the effects of PCOS on mood, anxiety and depression, even though I had received my PCOS diagnosis at the time. And neither did I know what to expect from a therapist or how to approach the conversation. I also had no clue how talking to a random stranger could help me automatically get cured of this ‘ailment’. One more thing I didn’t know? That the right therapist makes all the difference. So after a few false starts and one bad experience, I have somehow found myself with the right system and structure around me. I have found a therapist that ‘works’ and I have embraced this as a very much ongoing adventure - one where I know what I know and I know that there is a ton I don’t know. And one more thing I know? It’s that you shouldn’t have to navigate this space blindly.
“Your mind is a delicate and powerful thing that must be handled with care. It’s integral to who you are and who you are becoming.”
So this brings me to the second thing I chose to do, to make this blog post resonate with you. Well, I thought I’d pull in someone who is way more qualified than I am to talk about this. Enter our first guest feature of 2024 - introducing Danielle Sethi!!! Danielle and I met in a facebook group, believe it or not. Then I spent a lot of time trawling through her blog and her content hit me right where I needed it to. So as usual, I thought, hey why not share this with my people? So here we are. I interviewed Danielle and I’ll just let the conversation speak for itself.
Danielle is an experienced therapist, focused on marriage and family therapy. She decided to pursue this path based on her desire to work with people. I haven’t known her for a long time but she is earnest, authentic and just feels like a safe place.
Before we dive into the specifics of my interview with Danielle, I think you should take a minute to think about therapy in the context of YOU. What you need, what your preconceptions are, and what you’re hoping to benefit from the conversation. That way, if you don’t get that, you can let me know and I’ll try to cover it in our next series.
Danielle Sethi, Therapist
Getting to know Danielle
M: Can you tell us a bit about yourself and how you got into this line of work?
D: I am a marriage and family therapist (accruing hours for licensure in Florida). I used to work in finance, but always was interested in pivoting to a more people-focused role. After some professional reflection and my own experience in individual and couples therapy, I decided to pursue a degree and practice of my own.
M: Can you briefly share your approach to therapy and how you typically work with clients?
D: Most times, people seek therapy because there is something they want to change in their life. I believe that people change through a combination of gaining insights in self-understanding (i.e.- how did we get here?) and having a safe environment to create new experiences that can rewire defense mechanisms encoded into our brains. A lot of times the reasons we get stuck in situations is because we unconsciously apply the same thought patterns or self-protecting behaviors we learned early in life in scenarios in our adulthood, where they don’t work as well.
In working with clients, I help people transform the aspects of life they are unhappy with into goals that we can work toward. From there, I work with people to evaluate their relationship patterns, process emotions, and take actions aligned with their values.
I often start with a deep dive into a client’s childhood and relationship history to unpack how they have learned to stay safe in their world and connected to others in relationships, and where they may have been hurt in the past. We evaluate where our early relationship patterns are showing up in current relationships, and whether they are helpful.
We also work on exploring emotions, how a client experiences emotions in their body, and how they can learn to get in touch with their own needs that lie underneath them. We use grounding and mindful exercises to build skills in processing emotions to reduce unhelpful reactions to them.
I also work with clients on clarifying their values - the aspects of life that are most important to them and give their life meaning. How they wish to live. We evaluate whether the decisions and actions they are taking are moving them closer to or further from their values, and how we can adjust if needed.
All About Therapy
M: How varied are the kinds of issues or challenges people often bring to therapy?
D: I tend to see variation in higher level context - meaning, people have a variety of different types of fights, experiences, or that lead to pain and a decision to seek therapy. Underneath all of that, there is a pattern to emotions underneath those experiences that lead them to be so impactful.
For example, a sense of betrayal in relationships is a common reason for seeking therapy. It’s common for this sense of betrayal to lead to a reduction in trust and healthy communication patterns. However, there may be different contexts that lead people to feeling betrayed. Maybe for me, I feel betrayed when my partner is late coming home from work because I don’t feel prioritized, and they haven’t kept their commitment. But for you, lateness doesn’t bother you, and you experience betrayal in a different context. I am treating the impact or meaning of the event (i.e. the betrayal), not the event itself (i.e. the lateness). When looking at issues that way, it’s a lot easier to see patterns that are more commonly shared and a part of humanity.
M: A lot of people struggle to open up, especially to a stranger. Some of us use humor as a coping mechanism to brush past hard topics. So I know first hand how challenging it is to start this journey. So as a therapist, if you met someone who had some skepticism or resistance about starting therapy, how would you approach that?
D: This is completely normal. Starting anything new can feel sticky, especially something as foreign as talking about our feelings with a stranger. A lot of times, resistance is actually fear, and your brain’s attempt at trying to protect you from something unknown- our brains are just naturally scared of change.
I would ask yourself - what do you have to gain from starting? What are the reasons you are interested in therapy? Has anything that you’ve tried outside therapy helped you heal or fix problems in the long term? Likewise, what do you have to lose from starting? What’s the worst thing that could happen if you set up a session?
Therapy has so much to offer, especially living in the grind of the modern world where most people are in reactive modes all the time. I actually wrote a blog post about some of the pros and cons of therapy so you can consider if it’s right for you, and some steps on finding a therapist.
I also like to remind clients that most of us never learned about emotional regulation or healthy communication as part of our upbringing or education. Most people would benefit from some sort of therapy at some point in their lives.
Why Therapy?
M: Getting to the root of issues has definitely been a big one for me. It’s so funny how only as adults do we begin to ask ourselves a lot of the whys, only for these answers to take us back to the beginning. And most times it’s about things that have happened TO us vs things we’ve thought were just WHO we are. What are some common reasons people seek therapy? Do you often find that what people seek in therapy and what they actually need are not the same? If yes, how do you handle that?
D: I’m trained in systemic therapy, which means that usually people who reach out to me are looking for help in a relationship issue - whether it is impacts of their relationships with their family, their partner, or some other significant person in their life. Having healthy relationships with other people is a core need of being human. When important relationships feel broken or disconnected, it’s only human to feel distraught, upset, depressed, anxious, or otherwise dysregulated.
It’s also only natural that people tend to look outside themselves. So sometimes, they come to therapy thinking that their partner is the “problem.” If only we could convince the partner to stop doing X, things would be fine. However, my belief is that in relationships, people are constantly influencing each other, and that everyone part of the dynamic contributes to it. In the beginning of therapy, there is often a shift of people looking outward to looking inward and seeing the ways they may contribute to where they are (and are empowered to change them!) and places they may need to heal on an individual level.
M: I have found in my experience that I need therapy at different pivotal moments in my life, or maybe because of those moments - career changes, high-stress situations, grief, relocations, having a new baby etc, and these have had to be adjusted as my life and circumstances evolved. And I find that most times it’s hard to determine when exactly it’s time for this kind of help; more so what exact type of help or therapy one needs. So, how can someone determine if their concerns are suitable for therapy?
D: It’s important to understand if your issues are suitable for therapy, and for the specific therapist and type of therapy they offer. One size does not fit all when it comes to therapist and client matches. For example, as I am a relationship-based therapist, I tend to see clients who are experiencing symptoms of anxiety or depression as a result of relationship dynamics or life transitions- whether that’s a partnership, family, work, or another significant relationship. If a client told me they were experiencing symptoms like hallucinations or delusions, I would refer them to a clinician who specializes in that type of work.
Finding the right therapist can be daunting. I know personally I have put off therapy at different times in my life because the idea of finding the right fit was overwhelming.
I always recommend that before looking for a therapist, people get clear about what their challenges are, and what they want to work on. From there, look at a few provider’s websites, and see if you can find one that lists the type of issues that match what you are looking for.
Most therapists offer free introductory calls as part of their intake process, which I think are incredibly important. This is a chance to tell the therapist what you are going through, what you want out of therapy, and determine whether your area of concern is within their scope of competence and practice. I always recommend asking the therapist what sessions will be like and whether they have worked with other clients on similar issues.
What are Therapy Sessions Like?
M: What can someone expect from their first therapy session?
D: The first session is typically a broad brushstroke of the client’s background. The therapist needs to gather key information about the client (e.g. physical health history, cultural background, occupation, spirituality, family background, trauma) to get an idea of all the factors at play in the client’s life. Typically, the therapist will gather a lot of this information on an intake form before the first session and guide the conversation from there. The first session will also cover the client’s goals and what they can expect from therapy moving forward.
M: How do you tailor your approach to meet the unique needs of each client? I personally have tried a couple and now know that it’s not a one-size-fits-all approach that works.
D: This is such an important point that is not always explained to clients (the idea that not one-size-fits-all). The way I approach this as a therapist is I get really clear on what the client is looking for and what their issues are today. If those issues are ones that can be addressed with the model of therapy I use, I will take them on as a client. If they are looking for something I do not or cannot help with, I’ll refer them to another provider who specializes in that area. Ethically, this is the approach therapists are trained to take.
Sometimes, clients need a few layers of support. I’ve been in situations where I take on a client as more of their “general” provider, and refer them to other shorter-term, specific providers as a supplement. For example, I might refer a client to a grief group or substance abuse group for another layer of support. It’s also common to work with clients as a couple, where one or both members also has an individual provider for more individual support. In these cases, I love to have a team of coordinated providers that can work together to support the couple unit (if the client is okay with that). There are many ways that it can look, but it is the ethical responsibility of the therapist to provide services in line with the scope of their training.
M: I remember in the first session with my current therapist, she clearly reminded me that I needed to be comfortable, and if I found she was not a good fit, I could very easily change therapists. I found that so counterintuitive yet fascinating, as most providers want to keep their clients. And of everything she said in that intro session, that was the one thing that made me instantly comfortable and open with her. So in your experience, How important is the therapist-client relationship, and how do you work on establishing a strong connection?
D: Research shows that the therapist-client relationship is the most important part of therapy, meaning, the factor that most strongly predicts successful outcomes of therapy. Having a strong connection with a therapist can take a bit of time as trust is built, but many therapists are trained in non-judgmental frameworks that promote empathy and help strengthen the rapport.
It is my personal belief that humans change when they have someone they trust, who does not judge them, and sees the humanity in them, and when this security can lead to new understandings and experiences. So the strength of the relationship between the therapist and client is crucial.
M: What is the typical frequency and duration of therapy sessions?
D: I typically meet with my clients weekly for the first 5-8 weeks for 50 minutes at a time. After that, we reassess where they are in terms of meeting their goals. Some clients prefer to stay at a weekly cadence, while others prefer to have continued support over the long-term meeting biweekly or monthly. The frequency can be flexible but an upfront commitment is usually required so that you can build momentum.
Practical Considerations for Getting Therapy
M: How do you work with individuals who have busy schedules or financial constraints?
D: My practice is fully telehealth, which helps a ton with the barrier of a busy schedule or time. Without commuting, waiting in an office, and walking in and out of the building, therapy goes from a 2-3 hour commitment to a 50 minute commitment. I often see people during their workday who just trade out their lunch hour once a week for therapy.
Regarding financial constraints, I price my sessions to be accessible to my clients while allowing me to keep the lights on in my business. I maintain a small number of sliding scale spots as well (currently full) for clients who cannot pay the full fee. I also work with many individuals who have out-of-network funds through their insurance that I am able to accept as payment for sessions. Therapy has a much larger ROI than a lot of the things people spend money on without even thinking about it (going out to eat, shopping, etc.) and making the decision to spend the money on bettering themselves sends a strong message.
M: Are there situations where therapy might not be the best option, and what alternatives could be considered? How do you work with such clients to determine next steps in this scenario?
D: I do not personally work with clients who are not willing and committed to the therapy process, because I do not think that state is the condition for change and I do not want to waste their money or time. I also don’t work with couples clients who have any domestic violence in their relationship. For the type of work I do, physical and emotional safety are a prerequisite. For clients not yet ready for therapy, I will be clear with them about my requirements for onboarding and encourage them to get back in touch with me when they are ready. I also may recommend other services, such as a support group, in the meantime.
M: What specific services do you offer, and how can people contact you if they need to reach out?
D: I offer individual therapy, couples therapy, and family therapy for adults located in the state of Florida. My therapy focuses on healing from relationship dynamics and significant life transitions, and on building secure attachments (individually and in relationships). I work most predominantly with individuals and couples in their mid 20s - mid 40s. The best way to get in touch with me is through my website.
I hope we have given you a lot to think about, or at least reinforced some healthy habits you have developed. if you still have questions, you can start with Danielle’s post - Is Therapy worth it?
Even if, like me, you don’t live in Florida and can’t book therapy sessions with her, her blog also covers multiple topics around Anxiety, Life Transitions, Relationships etc. I have found them very helpful so far, and I think you will too!
In Canada, most employer-funded extended health care benefit plans include funding for psychologists, social workers, counsellors, psychotherapists and online cognitive behavioural therapy. Typical cover is from a minimum 60% to the full amount. Some employers are removing the annual caps on such services as well. Check your benefits package to see if your therapeutic needs might be covered.
Please share this post with your network, and let’s jointly promote healthy minds and beneficial habits across the board.
To find a therapist in your area, check out the directory on psychologytoday.com and you can find registered therapists in your city.