Exercising for Mental Health

By: Garry Cooper, LCSW

Reprinted with permission from Psychotherapy Networker magazine. Copyright, Psychotherapy Networker, Inc.

 

Therapist Jane Cibel really makes her clients sweat. After a brief check-in, during which they report how their lives and therapy homework have gone in the past week, they get on her treadmill for five to eight minutes, and then hit the weight machines in her office for a full workout. Throughout their workout, she’ll ask them the kinds of questions about their thoughts, feelings, and memories that other therapists ask clients.

For years, Cibel, who’s certified as both a social worker and personal trainer, had been thinking about integrating exercise and therapy. Then four years ago, as the research continued to accumulate showing that exercise is as effective as therapy or meds for certain conditions, Cibel finally made the break with tradition. She set up her Washington, D.C., office with exercise equipment and told her clients to wear workout clothes to sessions. As word of her unique practice spread, her caseload shifted toward clients who are unhappy with their bodies, although she doesn’t specifically treat body-dysmorphic or eating disorders. Underlying her clients’ dissatisfaction with their bodies, she says, is usually depression, anxiety, or other mood disorders, and those are the issues her distinctive approach primarily addresses.

Cibel believes that much of the benefit of exercise comes both from making an initial commitment to taking action and from an increasing sense of accomplishment. While her clients work on their bodies, she reinforces their courage to change, their strength, their endurance, and their balance. “I’m not just commenting on their physical effort but using metaphors for how resilient they are,” she says.

Cibel also uses homework exercises to build psychological strength. She’ll tell depressed or isolated clients to call a friend or check the newspaper for community activities. She’ll instruct clients trembling at the brink of career transitions to bring in a draft of their resume or schedule a few job interviews. She also advises them to do at least two workouts between weekly sessions. The sense of mastery they gain from their workouts and from her positive feedback, she says, stays with them during the week and encourages completion of the homework assignments.

Cibel carefully monitors her clients to make sure the exercise doesn’t harm them. She warns that therapists who start their clients on exercise regimens without appropriate training might be exposing themselves to liability. But, she says, therapists who want to use exercise to bulk up clients’ emotional confidence and strength can always suggest that they head for the nearest gym and sign on with a personal trainer.