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The Most Common Issues People Discussed In Therapy In 2018


WELLNESS--It’s safe to say that this past year has felt extremely brutal for many people. Nothing reflects that more than some of the subjects they discussed in therapy.

Many people sought mental health help in 2018 to work through an array of issues (and that’s a good thing!). While everyone’s specific discussions are confidential and unique to them, there were some subjects that therapists kept hearing about over and over again. Multiple topics are perennial issues that affect people year after year; others became more prevalent this year thanks to current events.

HuffPost chatted with some mental health professionals to get their takes on the most common things their clients brought up in sessions in 2018. The experts also shared their advice on how you can tackle these common problems if you have the same concerns. Take a look below:


 “I have seen an increase in individuals experiencing anxiety, which is characterized by excessive concerns about future events, emotional and physical tension, and patterns of avoiding people, responsibilities or situations,” said Patti Johnson, a psychologist based in Los Angeles.

A study published this year by the American Psychological Association found that anxiety is extremely prevalent among young adults. The most common stressors include work, money and ― shocker ― current events and politics.

Johnson said there are ways to manage these emotions the moment they occur. The first step is to recognize that there will always be unpredictable or uncontrollable events. Accepting this will make it easier to cope with surprises. Next, Johnson said, she advises her clients to stay present. When people can exist more fully in the present moment, they often find less cause for concern.

Finally, Johnson said to remind yourself that you have three choices when anxiety strikes: You can accept what is occurring and leave it alone; you can do something right then and there; or you can plan how to manage a situation or set some specific goals to work toward.

Work/Life Balance

According to Lauren M. Gross, a psychologist at Elev8 MD Wellness Center in Charlotte, North Carolina, people’s concerns over balancing work and their personal lives often stem from the unrealistic viewpoint that they can “do it all.”

This mentality can come at the expense of oneself, and “often leads to stress, depression, anxiety and can cause relationships issues,” Gross said.

Gross suggested carving out time for daily self-care through exercise, spending time outside, talking to a friend on a phone, taking a bath ― whatever helps you relax and focus on yourself. You should also try to come up with a list of five things that went right each day, she said.

And if your routine feels too overwhelming, Gross said you should talk with a professional. You don’t have to hit rock bottom to seek help.

Political Woes

 “Many people found their anxiety symptoms harder to manage this year due to political stress,” said Anna Poss, a therapist and owner of Anna Poss Counseling & Psychotherapy in Chicago. (Approximately 69 percent of people said the nation’s future causes them significant stress, according to the APA’s study.)

Poss said many of her clients found themselves checking the news more frequently or increasing their activity on social media, thus making it difficult to relax and manage anxiety in a healthy way.

“One of the best things you can do for your mental health is limit your screen time. Give yourself a break from the news and social media to focus instead on self-care,” Poss said.

Sexual Assault

In response to news events like Brett Kavanaugh’s confirmation to the Supreme Court after he was accused of sexual misconduct in the 1980s, more people are having conversations about sexual assault ― including with their therapists.

Kelifern Pomeranz, a clinical psychologist and certified sex therapist in Menlo Park, California, said that many of her clients have been sharing their #MeToo moments in sessions. Some other clients are also talking about the movement by reflecting on whether they have been perpetrators, questioning how they can be allies and wondering how to navigate interactions with coworkers, she added.

Pomeranz encourages her clients to use their social support systems to help get through their trauma. She says people shouldn’t be afraid to have an open discussion with their friends about how they can best support them. And, most importantly, if you’ve been sexually abused or assaulted, seek professional help if you’re struggling to deal in the aftermath, she said.

Social Media And Technology Use

 “A common issue I’ve run into is people struggling to figure out their relationship to social media ― and even ... Netflix and YouTube ― and whether or not they are addicted,” said Darin Bergen, a psychologist in Portland, Oregon.

It’s absolutely possible to spend too much time on your devices, A recent study found that about 30 minutes of social media use per day is about as much as people can spend on the platforms without it hurting their well-being.

“I encourage my clients to evaluate how much time or energy they are putting into these things, what the return is, and how it relates to their overall goals in life,” Bergen said. “When they do this, some find that there’s nothing wrong with their engagement in social media or Netflix, while others find that it is holding them back from the goals they want to accomplish.”

There is a difference between enjoying Netflix in your downtime and mindlessly watching hours of “Friends” to avoid doing what you need to get done, Bergen added.

Comparing Themselves To Others

Brie Shelly, a licensed mental health counselor and coach with Boston’s Activate Wellness Solutions, said platforms like Facebook and Instagram have triggered body image concerns, depression and anxiety in many of her clients.

“Clients constantly describe pressure to look or travel a certain way based on what they see others doing on their feed,” she said.

To overcome this, Shelly said it’s worth unfollowing people who make you feel bad about yourself. You should also notice which apps make you feel worse and try allotting yourself only a certain number of minutes to spend on them a day. Chances are, you’ll see an improvement when you reduce your time. You can also try deleting the apps from your phone or do another activity instead, like meditation or reading, Shelly added.

Relationship Issues

Fighting with a significant other was a recurring complaint that Fran Walfish, a child, couple and family psychologist in Beverly Hills, saw in her practice in 2018. She stressed the importance of proper communication, especially when navigating a conflict.

Walfish recommended owning up to your part of the problem as a first step and taking the space to cool off if you need to. Next, she said, you should listen carefully without interrupting so you can understand what doesn’t feel good to your partner. If you have a complaint or criticism, present it couched between two positive statements so he or she will be more receptive and less defensive.

Additionally, make sure you stick to the topic. Don’t bring in a laundry list of complaints about things that happened 10 years ago. Finally, Walfish said, you might want to use humor if you’re up for it. Laughing can defuse the intensity of an argument, help you keep perspective and lighten up the moment.


“This year I have worked with a lot of clients who have lost children and other family members,” said Janika Joyner, a therapist with Elevation Counseling Services in Chesapeake, Virginia. She added that the loss of a loved one (expected or not) can be difficult.

To feel close to a family member or friend who is no longer around, she suggested wearing a piece of their clothing or jewelry, creating a space in the house to pay tribute to them (like displaying their photo and a few favorite things) or joining a support group to connect with others going through the same process of loss.

Fear Of Mass Shootings

 “Clients are bringing up the topic of mass shootings more and more because the news coverage has increased at an exponential rate,” said Ginger Poag, a trauma therapist with Brentwood Wellness Counseling in Brentwood, Tennessee.

Poag said the fact that these shootings have occurred in public spaces (like bars and synagogues, just to name a few from this year) has challenged people’s feelings of safety.

She suggested turning off the news and limiting social media exposure to avoid continual exposure to a shooting’s aftermath and a feeling of isolation from friends who share different viewpoints on issues like gun control. It’s also important to do your best to go about your life and not live in fear; since avoiding certain locations may only increase anxiety.

(Nicole Pajer writes for HuffPost  … where this piece was first posted.)


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