Posted by Wittgensteinz on February 21, 2008, at 3:33:40
In reply to Therapy - Bang for the Buck?, posted by Hermitian on February 17, 2008, at 14:42:08
Firstly,
I feel delighted to read the success of your own therapy and how a short course of therapy had such a positive effect on your life.
When I turned to therapy I was in a difficult place. I needed help urgently. Before deciding on a form of therapy I researched the different approaches carefully - including the research. It should be said that the effects of certain types of therapy are more 'researchable' than others. There's no easy way of comparing therapy types due to the types of issues different clients present. There is no lab test to say "you're cured" and many people present with a number of issues, rather than a 'simple' phobia. Of course positive research results supporting short-term cost-effective therapy is very convenient for the managed care industry (health insurance companies), and perhaps we should question the motivation for such research when there are such obvious short-comings in comparative studies of therapy.
With any 'service' there is the potential for abuse. I'm sure there are some bad therapists out there - not just bad analysts but bad CBT therapists too, just as there are bad builders and sneaky salesmen - that's life and something we have to look out for. I have the feeling, however, that the people who post here are well-informed and intelligent adults capable of assessing their own therapists. This forum provides a good way of voicing our concerns (if they arise) and getting feedback from others.
I'm very glad there are several different types of therapy and that I could make an informed choice as to what suited me. Personally, a short-term CBT therapy did not appeal to me. I think it would have helped somewhat with my symptoms of social phobia but not with my trauma and abuse issues. I worked through some CBT techniques myself to help ease the social phobia and this quickly helped me with simple but important things like walking to the shops without having an attack.
What I felt I needed was a longer term therapy where I would be engaged and supported. I wanted to go on a journey through my past, to look back and face all that happened and understand it. It's not a simple matter of telling a story, and I imagine you know that really. If one's basic attachments - basic care-givers abused you, you carry that template onto future relationships - you get off on the wrong foot and it doesn't just stay in the past 'where it belongs'. I wanted an indepth look at my past - so for me psychoanalysis was my choice. I've seen my analyst for 10 months, twice weekly. The relationship itself is the key factor in the therapy. I'm learning to trust and in a setting where I can voice my fears and have them responded to. I can't really envisage another way of achieving this than indepth longer term therapy. I didn't want to be pressured or to have the therapist lead me through strict exercises or tell me "you have to be done by this date". I need to work at my own pace, these things can't be forced. Trust is not something that can be timetabled - some people take longer than others and that's fine - there are very good reasons why.
So, I can understand why you are suspicious of longer-term open-ended therapy but I think you should give those who have opted for this therapy the benefit of the doubt (I am suspicious of the long-term benefits of short-term therapy and would be unhappy if that was the only option available to me). My therapist is not doing his work for the money. He's retired as a professor and continues to see patients. Incidentally, he insisted on offering me a lower rate (I didn't ask for it and he didn't know much of my financial situation at the time). He continues to work because it gives his life meaning - he loves his work and he will work until he is unable to due to age - I think for a lot of long-term therapists, their work is not just work but a vocation. Their patients are important parts of their lives, just as to us, our therapists are very important in our lives. There's nothing pathetic or stupid about it.
It's interesting the number of people here who themselves want to become therapists. My therapist first was a patient and the dynamics of the therapy interested him so much that it inspired him to study and become a therapist himself.
So, I will conclude that, it's great you shared the success of your therapy - and I am pleased to share the value of mine - but I feel no need to convince you that 'my way' is the best way (I believe it is the best for me - and it sounds like you had what was just right for you) - it's too simplistic to assume that one size fits all and it's threatening when another person advocates their choice of therapy to the exclusion of all others.
Witti
poster:Wittgensteinz
thread:813285
URL: http://www.dr-bob.org/babble/psycho/20080210/msgs/813869.html