256. 10 years of therapy in 20 minutes (what i wish i learned sooner!)

May 4

listen to this episode:

wanna know what over a decade of therapy, a psychology degree, and my own podcast have taught me about mental health?! in this solo episode, i’m breaking down the key takeaways that i’ve learned throughout my mental health journey.

in honor of it being mental health awareness month, i’m condensing everything i’ve learned from receiving intensive mental health care and years of dbt therapy as a suicidally depressed teenager– combined with my psychology education at upenn and my experience creating this very podcast– to make your 12-step guide to maintaining your mental health.

by the end of this episode, you’ll know all the mental health tips + tricks i wish i’d known when i was struggling!

i talk about:

why avoidance is impacting your mental health
how to start getting better at recognizing your emotions
my mantra for dealing with conflict more effectively
relationship changes + how to navigate them
the power of secondary emotions
effective ways to reach your goals + stabilize your mental health
a mental health quote that changed my life
an underrated aspect of managing your mental health
whether we can use our mental health to predict our futures
the mindset that was stopping me from building a life worth living
how distraction can actually save lives
what i learned in therapy that changed my self-esteem forever

mentioned:

SHOP GUEST RECOMMENDATIONS: https://a mzn.to/3A69GOC

About She Persisted

She Persisted is THE Gen Z mental health podcast. In each episode, Sadie brings you authentic, accessible, relatable conversations about every aspect of mental wellness. Expect evidence-based, Gen Z-approved resources, coping skills (lots of DBT), insights, and education in each piece of content you consume. She Persisted offers you a safe space to feel validated and understood in your struggle while encouraging you to take ownership of your journey and build your life worth living.

a note: this is an automated transcription so please ignore any accidental misspellings!

[00:00:00] I have put together a list of the most game-changing insights that I've learned in over a decade of therapy

approach the things that make you anxious. have that hard conversation to set that boundary.

this is a reminder that I have to be really honest with myself about,

you can't change a problem that you're not aware of.

I didn't know I was avoiding. I didn't know I was depressed. I didn't know I was anxious.

When we're not attached to our future, we're not motivated to change it.

When I reflect on the decade I spent in therapy, all the things that I changed and improved started with

that awareness. Hello, hello, and welcome back to She Persisted.

I'm going to walk you through the most important mental health insights I've learned in therapy, the ones that will actually change how you think, and show up in your life. These are the reminders I wish I had when I was at my lowest. this is what 10 years of therapy and a year and a half of intensive treatment actually taught me.

I have seen on TikTok people sharing their three years of therapy in thirty seconds or six years of therapy in sixty seconds.

And I just had to hop on this train. But we're a podcast, not a TikTok, so [00:01:00] this will be a lot more in depth and a lot more tips you can take what helps, leave what doesn't, and also get more context, insight, and nuance into these takeaways.

So I have gone through my Notes app from past therapy sessions. I've gone through my favorite podcast episodes that I've recorded that act as like a time capsule of different stages in my therapy journey. I've thought about the mantras that I come back to when I'm having a tough day or a hard conversation or a low moment.

And I have put together a list of the most important, relevant, game-changing insights that I've learned in over a decade of therapy Which you might be like, "Wow, Sadie, you're 23. That's a lot of time to be in therapy for that age." Yes, but that means that I get to share it all with you, and hopefully you find some things in this episode that are helpful and relevant and you can implement in your own life.

And what I also think is really interesting and cool and fun about this list, and also just how I approach mental health, is that you're gonna [00:02:00] see a lot of different, like, perspectives and approaches here. I'm a big DBT girl.

There's a lot of DBT takeaways in here. I also got my college degree in psychology, and I went to a program that had a lot of emphasis on positive psychology, and so you see some learnings and takeaways from the classroom sprinkled in. There's also just a lot of things that I've learned through experience and insights that I've had outside of the classroom and outside of the therapy office, which I think are just as important and just as relevant. So before we dive in, I want you to comment what your number one therapy takeaway, insight, piece of advice is. Put it in the comments. I want it to be a little bit of, like, a community resource of all of your best tips and tricks, so anyone who's struggling can check in and see that they're not alone, but also build on this episode with more tips and tricks and what you found helpful in your journey.

If there is one piece of advice I give anyone who's struggling with anxiety or avoidance or an uncomfortable emotion, it is that avoiding that [00:03:00] thing will make it bigger and worse and more overwhelming. Avoidance amplifies.

And I think this is especially true in college students. I describe being in college as being an environment that's, like, optimized for avoidance. No one's taking attendance. No one's making sure you're at dinner at a certain time. No one's knocking on your door to make sure you're up for the day.

You don't even have to make friends. You don't have to interact with a single person throughout your day if you don't make that intentional choice. It is an environment that allows you to very easily avoid emotions and people and challenges and things. You've lost that external structure that high school and middle school and work later on can provide.

But if there's one thing that we know about anxiety, it's that when we avoid something that makes us anxious, the next time we are confronted With that thing, we only become more anxious.

So the best thing that you can do in life when you feel that urge to avoid or that urge to run away and go in the opposite direction or that feeling of anxiety in [00:04:00] your gut, it is to go towards that thing. Obviously, different caveats and barriers here. Don't put yourself in unsafe situations. Make sure that you're being supported.

But generally, approach the things that make you anxious. Send that email. Stay after class to talk to that professor. Introduce yourself to that new friend. Post that video.

Interview for that internship. Have that hard conversation to set that boundary. If nothing else, you are building that muscle of exposing yourself to the thing that makes you anxious and getting better and better at overcoming and sitting with these challenging emotions.

Similarly, a little bit related to avoidance, name it to tame it to change it. It is really hard to grapple with an experience that you can't name or explain.

Like when you just have this abstract, unknown, unclear emotion or fear or urge that you don't have the vocabulary to describe, and you don't have the experience to understand how it will pan out, it feels even more overwhelming because there's so much [00:05:00] unknown. And as humans, we associate the unknown with threat, so we're scared of it.

We're more overwhelmed. We want to avoid it even more.

And even more than that, you can't change a problem that you're not aware of. You can't work to shift an emotion if you're not in touch with what that experience is.

It's really hard to work through a feeling if you haven't identified it. So the next time you're feeling an uncomfortable experience,

the first step you should take is naming that experience, and research shows that we put names to our emotions. When we put labels on our experience, our stress levels go down. We feel less overwhelmed. We feel less distressed, and whenever we're less distressed and overwhelmed, we're more easily able to navigate a situation.

Also, when I reflect on the decade I spent in therapy, all the things that I changed and improved started with that awareness. I didn't even realize that those were the problems that I had when I began therapy. I didn't know I was avoiding. I didn't know I was depressed. I didn't know I was anxious.

It was only once I had the vocabulary and the ability to name those [00:06:00] experiences that I was able to tame the emotion and work through it, and then change the way I was approaching it. So whenever you're feeling something big, feeling something overwhelming, feeling uncertain, work on sitting with that emotion.

Be mindful of that experience, name it, which tames it, and then you can work to change it.

Next is one of my favorite questions that I try and ask myself daily whenever I'm in an interpersonal situation and I find myself feeling stronger emotions, and that is, do I want to be right or do I want to be effective? In most situations in life, you can't have both. You can't absolutely hold on to your truth and your perspective and your opinion while also being effective in the relationship and allowing the other person to feel seen and heard and validated and supported.

And understanding that you can't have both and being forced to choose what you want to prioritize in that interaction is extremely effective. For me, it's almost like an emergency parking brake of like, do I wanna be right or effective? I'm like stopped in the [00:07:00] middle of the intera-re- interaction. I have to decide, do I care about the relationship? Do I care about the outcome? And then I decide which way I'm turning. Am I going to work on validating the other person and making sure they feel heard, and trying to come up with a solution that works for both people Or do I only care about being right?

And also through therapy, I've learned that I like being right. It's really hard for me to let go of that sometimes, especially when I think I am right and people are wrong,

but I cannot be right and also be effective in the interaction. And so forcing myself to choose, and most of the time choosing to be effective, allows me to change my approach and soften how I'm communicating and make sure that I am showing up as my best, most effective self in that interaction.

People are in your life for a reason, a season, or a lifetime. This is not something I heard in therapy. It was actually from someone that I met through podcasting, and it's a mantra that I continuously come back to when I feel relationships shifting and changing, and it's that reminder that you don't [00:08:00] have to keep every single relationship in your life with white-knuckle control.

People are not gonna stick around forever. They might be there for a reason and serve a purpose, like being a teacher for a semester or being a study partner in a class. They might be there for a season, like high school or college or postgrad, or they might be there for a lifetime. And so the ways that you show up in their life and the ways that they show up in yours can be really dependent on that level of involvement and engagement.

And that also means that it's okay to let people go when they no longer fit in your life and you no longer fit in theirs.

Secondary emotions. One of the most important things I learned in therapy is that we don't just experience emotions, we experience emotions in response to our emotions.

So if you are working on a group project and someone is not pulling their weight, they're not doing their assignments, they're not showing up to the meetings you've set, they're missing the deadlines, the response to that is probably anger, and it's right to be angry. Anger protects something that's important to us.

[00:09:00] And in that situation, what's important to you is probably your performance, the grade you'll get, the project you're working on, what the teacher thinks of you.

But that anger that's protecting that resource that is valuable to you is the secondary emotion in response to fear. The fear of getting a bad grade, getting bad feedback, being viewed as a slacker, or not pulling your weight, or not doing the assignment, feeling misunderstood and misrepresented.

And anger especially is almost always covering another emotion, whether it's shame, guilt, fear, sadness. Whenever I feel angry, I try and take a step back and figure out what the base emotion is, what is happening beneath that

And in addition to anger, we experience a lot of secondary emotions, and this is something that came up on a daily basis when I first started therapy, where I would experience an emotion like sadness or fear or guilt, and then I would have a second emotion in response to that.

I don't deserve to feel guilty. I'm ashamed that I'm having this reaction because no one else feels this way. [00:10:00] I'm guilty for struggling with my mental health because everyone else seems to be fine. I'm angry that I'm sad because there's nothing that I should be sad about. Everything's going fine. I'm guilty that I'm putting this burden on other people because I'm struggling with this anxiety.

Understanding that these emotions don't just happen because of external factors, but that they can also be a response to initial emotions that are happening internally was really helpful for me to understand, again, where these things were coming from, why I was responding in the way that I was, and take away that, like, black box mystery that was my emotional experience that I just wanted to avoid.

So being able to understand and reflect on which emotions are primary emotions and your actual instinctual initial response to an experience and which ones are secondary, which ones are responses to your response, because we can work to change those secondary emotions. We can work to lead with validation and acceptance and [00:11:00] understanding rather than guilt or shame or anger.

The next one is a bit boring, but it's something that I talk about all the time on the podcast, because while there's a lot of these emotional breakthroughs that come from intense therapy sessions, most of the work, especially in the phase of maintaining your mental health, comes in the mundane day-to-day.

And the big takeaway there, is that you don't rise to the level of your goals, you fall to the level of your systems. And this is the Atomic Habits philosophy, if you've read that book. But as I've come to learn through years of psychology classes and a lot of time spent in the world of psychology research, we don't reach our goals through willpower.

Willpower and self-control are important. They're a part of our mental health, but that can't be what we're relying on. And you are not going to improve your mental health, you're not gonna maintain your mental health through goals and willpower. It is going to be through your daily habits and the systems you set in place and the external accountability that you have to keep you [00:12:00] on the right track

Motivation is incredibly unreliable.

So I want you to think about your daily commitments, the job you go to, the school you attend, the people you see, the appointments you make, your sleep routine,

the workout classes you sign up for or the sports teams you're on or the clubs you join, the classes you take, the people you call every weekend. All of those things that you do on a rinse and repeat basis are a direct roadmap of what your mental health will look like. And what I try to do, because I know that even if I have the goals of I'm going to wake up at 6 a.m.

and do a workout and journal and read that nonfiction book and have that conversation with that friend I haven't talked to in a year so we can catch up and reconnect. Even if I aspire to do that, even if I want to do that, even if I feel motivated, that is not going to be happening in a regular recurring way that will have a meaningful impact on my mental health.

Instead, I set my baseline weekly habits, In a way that will help me maintain my mental health [00:13:00] and end the week better than I started. And that is my sleep. That is movement. That is the people I talk to.

That is my workday. That is my hobbies. That is my goals for the future. All of those things work. To refill my cup and improve my mental bandwidth. So instead of trying to approach your mental health goals through willpower and self-control and motivation, I want you to approach it through habits and systems and accountability.

I promise you will get much better and more consistent results.

Life is impermanent and that impermanence will be on your side. This is actually a quote that comes from the podcast where I talk about this interview alarmingly frequently, It hits so close to home, and it's something that I continuously go back to, and it's a conversation that I had with Dr.

Blaise Aguirre on the podcast. He was one of the psychiatrists I worked with at residential when I spent fourteen weeks at Three East McLean Hospital, and he came on the podcast and said that quote, which is that life is impermanent, and that impermanence will be on your side. No emotion, no [00:14:00] urge, no relationship, no thought, no challenge, no experience lasts forever.

Just the way the world is designed, these things ebb and flow. They come and go like a wave. And while that can be sad when it comes to the good things in life, it also is incredibly reassuring and relieving when we are struggling and when we are in crisis, because this can't last forever, and it won't.

And when you're able to really sit with an emotion or a thought or an urge and do the DBT skill of riding the wave and noticing when it's more intense and less intense and watching it come and go as time passes, that reminder in every moment of life is incredibly encouraging when you're struggling.

Emotional vulnerability is so underrated. It might not be why you're struggling, but it is absolutely making things worse. If you are hungry, if you're tired, if you had a hard conversation the day before, if you are emotionally strung out, if you didn't take your meds, if you're already anxious, [00:15:00] all of these things can impact how you show up in any situation.

We don't struggle for no reason, and if we look at things like emotional vulnerability, it makes sense why we're struggling.

So getting those things in place is so important before you try and make other big changes because that's your foundation, and if you don't have a strong foundation in place, everything else will fall apart

And the best part about those, like, habits and behaviors is that they're relatively easy to fix. You're not trying to undo 10 years of lived experience, core beliefs. You're just changing what time you go to bed or trying to be more consistent about taking a medication in the morning or walking to school instead of taking the bus.

These are small shifts, and they can have really big impacts.

You cannot predict your future based on your worst day. And I know you're not gonna believe me when I say that because I did not believe anyone that told me that when I was struggling. But we know from so much research that we are notoriously terrible at predicting our futures, for better or for [00:16:00] worse.

We change a lot when it comes to our interests and the intensity that we experience our emotions at and our relationships.

Where we live, who we spend time with, what kind of music we listen to, all of these things change in a huge way, and we also are really, really bad at predicting that change. and rather than trying to motivate yourself to get to this future that you're not even predicting correctly, I found it so much more effective to just focus on getting through the moment and getting through the day and the week and the month.

Those changes will come in time, especially if you put those systems in place rather than the goals and motivation and willpower. The relationships will change and evolve because they're there for a reason, a season, or a lifetime. The emotions will change and evolve because life is impermanent, and that impermanence will be on your side.

So if you can just focus on the moment and the day and the week and the month, the future will come.

You can't build a life worth living if you don't plan to live it. I did DBT four or five [00:17:00] times before I felt like it worked, before I actually saw a shift in my emotions, in my relationships, in my habits, in my behaviors. And it's not because I didn't know the skills or because I didn't have support systems in place.

it was really that I didn't have this commitment or drive to build my life worth living because I didn't plan to stick around to see how it panned out. Why would you work on something that you have no vested interest in? Why would you be engaged in solving a problem that you don't care what the outcome is?

Our mental health is the exact same way And so if you are really struggling with your mental health, if you're struggling with suicidal ideations, and you are trying to work towards this future, but you constantly have this back burner escape hatch, as I used to call it, of suicidal ideation, of if this gets so bad, there's this option.

If this is too unbearable, there's always an out. If you're always giving yourself the option to not live your life worth living,

it's no surprise that you're not committed and engaged [00:18:00] and motivated to build that life worth living.

When we're not attached to our future, we're not motivated to change it. And I found that I made a huge shift when it came to my mental health when in therapy I realized that I had been living with this back burner option and this mental escape hatch.

When I stopped giving myself that mental out and instead committed to being here,

then I was able to build and live my life worth living.

Distraction can save lives. Distraction is not a long-term fix. Again, avoidance amplifies. We can't avoid things forever, but when you are in crisis, when you are really struggling, if you need to get through the hour, the night, that wave of emotion, whatever it is, distract. Watch a show, talk to a friend, listen to music really loudly, do a workout, take a hot shower, take a cold shower.

You don't have to process and work through the experience in that moment. If you are in crisis, just survive that crisis. Get to tomorrow.

And you're not weak for distracting through a crisis. We [00:19:00] have crisis survival skills for a reason, and you deserve to use them. As long as you loop back later on and process through the emotion rather than avoiding it indefinitely, distraction is an incredible tool to have in your toolkit.

Learning in therapy that all people deserve love was really an eye-opening moment for me.

I operated through years of my life not thinking that I deserved love from my family, from my friends, from myself. My view of myself was so low

and so self-deprecating that I didn't think I was deserving of this basic human need that is love and support and validation. And to realize and understand and accept that regardless of how we feel or how we act or what we've done or the choices we've made, that we as humans deserve love just for being really changed my view of myself, my view of the world

And my self-worth as a whole. So if you are really struggling with how you view yourself and how you see yourself in the context of a larger world, I want to remind you that you deserve [00:20:00] love. You don't need to earn it. You don't need to be good enough to get validation and support and affection just for who you are, regardless of what you do or say or how you act, you are deserving of love, and you are loved.

So those are some of my top therapy takeaways that have really meaningfully changed my mental health and my life as a whole. I would love to know what your number one therapy insight learning takeaway is. Let me know in the comments.

And like I said, save this episode for the next time you're struggling. Come back to it. Remember these tips. Use them as a reminder. And with that, I'll see you next week.

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