Therapy with Megan Tarshis, LCSW

Megan Tarshis is a Licensed Clinical Social Worker in Atlanta, GA specializing in stress management, anxiety, life transitions, and student mental health. Outside of her private practice, Megan supervises the Emory University Stress Clinic, which supports students in learning stress management skills, and she also offers consultation services to other clinicians seeking to increase their understanding of stress management. She encourages clients of all ages to reach out to improve their ability to cope with stress by increasing emotional capacity and awareness.

We asked Megan more about her work with clients and her guiding philosophies on therapy.

Megan’s background and personal life

How did you decide to become a therapist?

I knew I wanted to become a therapist in 12th grade after reading The Catcher in the Rye, by J.D. Salinger. I was moved by the protagonist’s voice, sense of self, and longing to heal. I had begun learning about active listening in a course, and I knew that I could listen attentively to people tell their stories endlessly. When I became a clinical social worker 10 years later, I could still trace my interest back to that book and to my passion in uncovering the voices and needs of my clients. Each person brings a unique story that we get to examine together.

What was your previous work before going into private practice?

I worked at Ridgeview Institute, a day treatment psychiatric hospital, and the Emory University Student Counseling Center.

What do you enjoy doing in your free time?

I enjoy yoga, swimming, reading, watching movies, spending time with my family and friends, and meditation.

Megan’s specialties and therapy philosophies

What guiding principles inform your work?

The guiding principles that informs my work is that each person has the potential to heal. Whatever the circumstances that led a client to engage in therapy, there is always hope for them to have a more balanced, manageable, and happy life. It takes work to explore and uncover what needs to change, but the healing potential is always there. I find that people know what this change looks like and feels like on an unconscious level; they just need to bring it to the surface, nurture that knowledge, and let it help lead to change.

What clientele do you work with most frequently?

Throughout my training, I have worked most often with college students and young adults. During my graduate work at Smith College School for Social Work, I completed an internship at a day treatment hospital working with young adults with psychiatric disorders. I also trained at Emory University, where I completed a fellowship and went on to work as a staff member at their counseling center, serving undergraduate and graduate students struggling with anxiety, depression, and adjustment issues.

I am drawn to working with college students and young adults because I find that period in a person’s life so interesting. It’s a time when big choices are made, be that academic, career, or in regards to romantic relationships. There is a curiosity and exploration about one’s sense of self and how one is going to make their mark in the world. It is natural for stress and anxiety to surface due to the sheer fact of the enormity of the decisions.

The thread of my work has always been focused on stress management. In graduate school, my thesis focused on coping styles and college adjustment. My work at Emory University narrowed to stress management, when I helped to develop and supervise their stress clinic. I utilize my understanding of early life dynamics I learned in graduate school and pair that with a mind-body approach. Stress can be felt strongly in the body, which is why I use strategies to address the mind, but also help the nervous system become more regulated through body-centered exercises. This combination of support leads to both short and long-term relief.

Can you tell us more about your specialty in stress management?

My specialty area is stress management. I have always been interested in the connection between the mind and the body. I have observed that many clients experience stress physically. They feel tired, tense, queasy, irritable, and may be having problems with productivity, time management, or sleep. I help my clients bring light to the unexplored aspects of their lives that are causing them stress and give techniques that regulate their nervous systems. With guidance, we explore both the reasons behind the stress, and pair this with exercises to address the unease in the body. In fact, eustress, the motivating and manageable form of stress, can help someone move closer to their goals. But when eustress turns into distress, one can become unproductive or even paralyzed.

Common reactions to stress are rooted in evolution. The stress response was designed to be protective, but because the body reacts to, say, a difficult conversation in the same way it reacts to, say, a physical threat, the stress response can be overactive and reactionary. What was once an evolutionarily advantageous response can be disadvantageous now. Learning skills to activate the parasympathetic nervous system, the part of the nervous system that keeps one calm and operates when a threat or danger is not perceived, can be helpful.

Exercises and meditations are personalized and all of my clients have access to my app. In the app, topics can be explored and guided meditations used, which helps to make change more doable. This allows my clients to align with their goals and feel motivated to attend to their own needs. These are often subtle shifts that lead to great change.

Can you tell us more about your specialty in anxiety?

Anxiety is interesting. It is similar to stress, but can often linger after a specific stressor ends or has been addressed. I treat anxiety similarly as to how I treat stress, but often also explore the underpinnings of where the anxiety is rooted. My training in both psychodynamic therapy and trauma allows me to help my clients root their anxiety in time.

Traumatic events often feel disconnected from time, which is why flashbacks, intrusive recollections, and prolong distress after exposure are common. However, anxiety is not always linked to trauma. It can sometimes be hereditary or biological in nature. The use of medication can sometimes be helpful. Understanding past events in client’s lives and how their anxiety currently shows up informs the work I do.

Can you tell us about your work with clients navigating major life transitions?

Life transitions can occur at any time and are often marked with newfound questions and introspection. Having a therapist to help explore and understand their origin and impact can be helpful. It is like in Dante’s Inferno, in which he opens with the line, “I found that I was in a gloomy wood, because the path which led aright was lost”, and continues, “We must go deeper into greater pain, for it is not permitted that we stay”.

Dante posits that we need a guide on the journey into and out of pain, his being the ancient poet Virgil, someone who can hold space and see our journey clearly. Although life transitions do not always involve pain, they do always involve change. Navigating change can be manageable with the help of the therapist and this is why I hold space and help clients see their change clearly.

What do you find most rewarding about your work?

What I find most rewarding about my work is watching people learn about themselves and using this understanding to better their lives. Social work, in general, has a social lens. People are a function of their circumstances; their families, their communities, their minority identities. No person lives in isolation from the realities that shaped their lives - therapists need to understand this. Part of the reason I became a social worker is because I wanted this idea, that people are a function of their environment, to be central to the work I do and to let this inform me in how I help others change.

Therapy sessions with Megan

What will our first session together be like? What happens in ongoing sessions?

During a first session, clients discuss why they are interested in therapy at this time and what their hopes and goals for working with me would be. Ongoing sessions help focus their needs and we work to address them over time. For stress management, I have a list of helpful topics to cover, and I make sure we discuss each topic that pertains to that client.

How long do clients typically see you for?

Sessions typically range from 4 to 8, but can be longer based on clients needs. Many clients start to feel better quickly due to the mind-body approach I use.

Are there any books you often recommend to clients?

I recently became aware of the book Permission to Feel by Marc Brackett. The author, a founding member of the Yale Center for Emotional Intelligence, opens with a description of himself as a teenager, misunderstood and in deep pain. His uncle asked him how he was doing and created space for him to explore the difficulties in his life.

I always think a therapist’s early life experiences shape how they help their clients. In fact, in graduate school, I took a course that charted Sigmund Freud, Melanie Klein, and Donald Winnicott‘s lives, and how their lives informed their understanding of human nature. Because Dr. Brackett had early life experiences, of both pain and of which helped him heal, he understands the importance of connecting the dots of lived experiences, and the processing of that lived experience, in making change.

Do you assign “homework” between sessions?

All of my clients have access to my app, which has personalized exercises and meditations for them. If a client would like to try out an exercise about something that they learned during a session or practice something such as deep breathing, it’s up to them. They can also use the app after ending therapy, as a transitional tool. The app has information regarding topics and grounding meditations.

Each client chooses how they want to spend their time between sessions, from no time to brief exercises. Clients seeking support for stress management often feel stressed, so adding to their stress with more work can be counterproductive. Anything done outside that therapy hour is completely optional.

How do you help ensure I'm making progress in therapy?

I chart progress in therapy in two ways. First, after each session, my clients can complete an optional session survey. This evaluates the work we do together. Additionally, I check in with my clients regularly, to mark how they feel the process of therapy is going and if we are meeting and moving towards their goals.

How can I prepare for our first session?

In order to prepare for their first session, clients will complete a brief questionnaire, asking about their history and what they hope to learn and gain from therapy. The questionnaire will be the starting point for our first session. Nothing else beyond that is necessary or required.

How will I know it’s time to end my time in therapy with you or reduce session frequency?

Deciding on an ending point to therapy is a decision that is made by my clients. I help my clients assess their progress towards goals, as well as mark typical growth points. We discuss if they have met their goals and how they would know if they need additional support in the future.

Visit Megan’s profile to read more about her practice and schedule an initial phone consultation!