Counseling Intervention

Q & A with Veteran Counselor on Combating Anxiety, Grief, Depression

March 3, 2009

By Mimi Ko Cruz

Susan Leavy, a licensed counselor and coordinator for the Women's Center's Prevention of Crimes Against Women program, has helped hundreds of clients overcome great anxiety, depression and grief over the years.

She said her specialty is in counseling those who have been sexually abused and raped, but the advice for overcoming the mental and emotional anguish her clients suffer often is universal.

Leavy earned her bachelor’s degree in psychology in 1974 and her master’s degree in counseling in 1981 from Cal State Fullerton. She became a licensed marriage and family counselor in 1983 and has been practicing at her alma mater since 2003.

Q. What are some ways people can cope with pain, such as anguish and grief?

People often use survival skills to get through tough times. Survival skills include methods such as drug and alcohol abuse, eating disorders, self mutilation, harm to others, and anger mismanagement, to name a few. That is not healthy. Healthy coping skills include exercise, good nutrition, good sleeping habits, connection to others, counseling and interaction with others who have been through, and survived, a similar sorrow.

Q. Who should seek counseling for such pain?

Most of us will experience pain in our lives at some point. How the experience is processed varies.

Some are more resilient than others. They pick themselves up, dust themselves off and go on with life. Others are less able to integrate the loss. Those are my clients.

They experience pain as a life-changing event that alters their worldview for a time, and need outside assistance to recover.

Resilient people are not better people. They just seem to have a built-in strength that allows them to continue forward with less angst. It is rare to be a person who has no stress, anxiety or loss.

Counseling is not for crazy people. Counseling can help people feel more centered and in control. Connections are very important. Attempt to meet people who you can relate to and who can relate to you.

Q. What tips do you offer people suffering from post-traumatic stress syndrome and similar problems?

Rape and military action are two experiences that often precede post-traumatic stress syndrome. Since my expertise and current position is primarily with sexual assault, I am quite familiar with the diagnosis.

Symptoms include nightmares and flashbacks that repeat the event again and again. They also manifest as a startle response that interferes with daily living. Clients might generalize the fear associated with the attack to benign daily experiences.

My primary theoretical orientation is existential, phenomenological and humanistic counseling. That just means I let the client tell me how he or she best recovers. I also use cognitive and behavioral techniques to help clients change how they think about the attack and replace the running commentary in their ruminations to a more empowered position.

It is important to remove generalizations from the client’s thinking. For example, the blame must be placed squarely with the perpetrator and not on the cologne the perpetrator was wearing.

Q. What do you advise for those suffering with grief over the loss of loved ones?

Don’t expect to feel whole for a while. Experts in grief therapy suggests that for the first year after the death of a loved one there are a succession of losses, the first Christmas, first birthday, first Valentine’s Day, etc., without the loved one. The first anniversary of the loss is often a dreaded date, but then, the real healing can begin.

Q. What do you advise to those suffering from depression?

Exercise, exercise, exercise. Studies indicate that exercise is a better antidepressant than pharmacology. That alone might not be enough, so counseling to aid in understanding the origins of depression is important (heritability, loss, anxiety, domestic violence, childhood trauma, etc.). Antidepressant medication might be indicated for those who are deeply entrenched in their depression.

Q. What do you advise to those suffering from anxiety?

Anxiety can be debilitating. It ranges from mild nervousness to full-blown panic attacks and everything in between.

College students are rife with anxiety. My advice is to write everything down to provide a visual.

Often, we lump all of our obligations into one big ball. In reality, we can only do one thing at a time. Keeping those demands separated gives us a better picture of how to manage our time.

When anxiety becomes immobilizing, I recommend talking to a professional, some are referred for pharmacological intervention.

Q. Besides counseling, do you know of other ways people can address their problems?

There is Eye Movement Desensitization and Reprocessing, which is a somewhat controversial therapeutic method. The technique requires formal training and experience. It changes brain patterns and neural pathways, and thoughts about the traumatic event can change.

Other methods are hypnotherapy, biofeedback and systematic desensitization.