Alexandria Counseling Center

10/26/2025

The first two questions I ask prospective new patients address both why they are seeking treatment and what they are hoping to accomplish in therapy. As per the national statistics, symptoms of anxiety are the primary cause of pursuing mental health treatment, followed by symptoms of depression.
We could say that addressing these questions are the easiest and hardest parts of therapy. Making the decision that you have a problem that you haven’t been able to solve by yourself is a big first step. Thinking about what you hope psychotherapy might offer is an important second step towards getting the kind of treatment you want.

The harder part comes later. It’s important to reflect on what has worked for you, and what hasn’t worked, when trying to feel better. The next question is, are you willing to try substituting new behaviors and thoughts for those that have not worked for you in the past?

In my own practice, working with those who serve the U.S. government, families, young adults, and seniors, the most common diagnosis that my patients receive is an Adjustment Disorder with Anxiety and/or Depression. What you are feeling may not be permanent, may not be habitual, and may just be a result of changes in your environment. Are you adjusting to a new job, a new boss, illness or loss? Are you trying to help a family member who is not doing well?

In many ways therapy, while challenging, is usually not complicated. It is about assessing a problem, exploring what solutions have worked and have not worked in the past, and brainstorming about a plan for the future. The hard work comes with practicing new ways of thinking and behaving. The world is full of things that we cannot change. But, each day we can continue to grow by doing the best we can, by not looking backwards, and by trying to have a plan for moving forward.

The two links below might help you to examine whether you are thinking about difficult situations in a healthy way. The thought-record worksheet encourages you to record thoughts in order to make them more realistic and solution-focused. The video link below is both a funny and honest view of therapy. Don’t let the title, “Four Years of Therapy in One Minute “ scare you; 4 years of therapy are not required to come to healthier conclusions! One minute? Might take a little bit longer…

Rebecca Hecht-Lewis, PhD Clinical Psychologist

https://www.getselfhelp.co.uk/media/djbmtdfj/thoughtrecordsheet.pdf

https://youtube.com/shorts/QdJrrKm6ZH4?si=HoW_zCDtmct5DSGm

09/15/2025

We all need a good night’s sleep. Sleeping approximately 7-9 hours each night is essential for both our mental and physical health. If you’re having difficulty getting enough sleep, resulting in low energy and decreased clarity during the day, you are not alone. In the United States, between 50 to 70 million adults experience some form of sleep deprivation. Women tend to have more sleep problems than men, and those who have experienced stressful events also tend to have increased incidences of sleep disorders. Sometimes lack of sleep can be a short term issue, but it can also be chronic, lasting weeks, months, and even years.

Poor sleep affects mental health by increasing cortisol production, which increases anxiety, irritability and depression. It’s noteworthy that 70% of individuals with mental health disorders report difficulty sleeping and nearly all individuals with suicidal thoughts also have sleep problems. Sleep serves many important functions in the body, allowing the cells to repair themselves, helping us organize our memories efficiently and storing energy that can be used during the daytime. It’s hard to have energy and to think clearly when you are tired.

Causes of sleep disorders are complex. While long-term stress can create sleep problems, sleep problems can also cause stress. Sleep disorders can lead to medical conditions, and medical conditions can also create sleep disorders. It’s important to discuss sleep concerns with your physician. This helps to rule out medical problems that may be impacting sleep such as sleep apnea, low vitamin D, and hormonal imbalances that impact melatonin production.

While various medications can be helpful for sleep, cognitive behavioral therapy and sleep hygiene education are clinically effective treatments without the risk of many pharmacological options. Therapy and sleep-training focus on setting you up for success when you head to bed. Things that tend to promote quality sleep include having a regular sleep/wake cycle, avoiding caffeine and alcohol, getting exercise in the sunlight between 7 and 9 AM, diminishing light in the evening, and practicing self soothing before laying in bed. Self-calming techniques include anything from taking a hot bath, listening to soothing sounds, music or a guided sleep meditation, practicing relaxing breathing, or using progressive relaxation to systematically tense and then relax muscles.

If you wake up, don’t lay in bed worrying about not sleeping. Talk to yourself logically and positively. Remind yourself that eventually, you will likely fall back to sleep, just as you have many times before. If you are still fretting, get up, repeat some self-calming techniques and then go back to bed. Retraining yourself to develop sleep-promoting habits may take time, with or without medication. But, improved sleep can happen. Sweet dreams…

Rebecca Hecht-Lewis PhD
Clinical Psychologist

Better sleep can be yours! Consider sleep tips for the weary.

07/31/2025

The notion that those who are closest to us share our beliefs and values begins in childhood. Infants cry, hoping that their caregivers will know whether they are hungry, tired, wet, or bored. Although believing that others think the way we do can be reassuring and bonding, it also can be frustrating. Studies of couples and families around the world have found that assuming loved ones share the same values and beliefs can lead to misunderstandings. Although your partner may know you well, they may not know exactly what you mean when you talk about your feelings. To avoid the conflict that can come from misperceptions, it’s useful to check-in with your partner about their statements. Simply repeating back a statement to clarify the meaning is a good first step, ie, ”So you said…, right?”
“Tell me more,“ or “help me to understand that better“ can also be helpful and affirms your interest. When sharing something very important to you, let your partner know that it’s a core belief or goal. Speak non-judgmentally from your own perspective, such as, “For me, it’s really important that…” Understand that other perspectives exist and avoid words like “should.”

Don’t make assumptions about your partners values, because it may get in the way of actually learning what’s really important to them. You don’t have to be a good mind reader to have a good relationship. But, it’s important to have the tools to try to understand where your partner is coming from. Couples don’t need to agree in order to have great relationships, but they do need to both try to understand each other and to avoid devolving into arguments when their perceptions differ.

Rebecca Hecht-Lewis, PhD
Clinical Psychologist