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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 31. This is the beginning of the thread.
Posted by Twinleaf on September 1, 2012, at 22:55:39
I thought I would post on this topic, because there aren't too many discussions about therapy on the board now, and also because I have relied principally on therapy myself in my efforts to recover from a major depression. I do not mean to suggest that I don't have physiological changes in my brain as a result of having developed MDD; I am sure that I do. Although most of the medications I took were not very helpful, tianeptine combined with rTMS made a big difference, not in getting rid of the depression exactly, but in giving me much more of a hopeful feeling that I could overcome it. This did gradually happen in the therapy I had, which was a kind of psychoanalytic therapy in which the relationship between me and my therapist was the primary focus. A vulnerability to depression was undoubtedly always there, because of my mother's hospitalization for post- partum depression just after I was born, and her subsequent difficulties with being a close, supportive mother. I did not develop depression myself after the birth of my son, but did develop it for the first time shortly after my mother died. There were clearly strong emotional reasons in my situation; I know that many people who develop MDD have a much less clear picture of the reasons why. I was very vulnerable to the stress involved in losing someone very important.
The therapy really helped tremendously. It has been a "good match". He seemed to fill the much-needed role of a good mother, who stayed right there through many ruptures and repairs, and through all the intense feelings I had for him, from love to rage. As I began to really know that he was there for me, no matter how I was feeling, the depression gradually lifted; I have not had much at all for the past three years; I feel once again happy and engaged with people, work and activities. Looking back, the quality and intensity of the relationship to him is what mattered, and is what I will always remember. I'm now very gradually seeing him less - we are both very cautious about doing that very slowly! As long as he is practicing, I will probably see him at least once in a while.
I feel very fortunate that this has worked so well for me, but am curious as to whether others who have strong emotional reasons for their depression have found the same thing to be true for them. I think it's pretty hard to find the right person. It certainly was for me, but once I did, things began to get better almost right away. I hope this has also been the case for others.
Posted by Phillipa on September 2, 2012, at 10:14:26
In reply to What psychodynamic therapy can do......., posted by Twinleaf on September 1, 2012, at 22:55:39
Unfortunataly this area are from what other professionals have said always lacked psychologists. Those in practice here at least those left don't do psychodynamic. It's not short term. You were very lucky to have found a great therapist. Phillipa
Posted by Twinleaf on September 2, 2012, at 14:59:56
In reply to What psychodynamic therapy can do......., posted by Twinleaf on September 1, 2012, at 22:55:39
That's very discouraging about your area. Wouldn't there be at least a few social workers and psychologists practicing? I think they are all trained psychodynamically, and a few may have had psychoanalytic training. Psychodynamically- trained social workers or psychologists can do a wonderful job; psychoanalytic training is an added plus, but not a necessity.
Posted by emmanuel98 on September 2, 2012, at 18:46:47
In reply to What psychodynamic therapy can do......., posted by Twinleaf on September 1, 2012, at 22:55:39
I got a lot out of dynamic therapy with a psychiatrist, whom I still see every other week for half an hour. I had lots and lots of issues which contributed to my depression. But ultimately, the depression had its own momentum and I would become severely depressed despite therapy and despite things going well in my life. Medication was only occasionally helpful. My p-doc felt that my best hope was DBT, so I now see him part-time while seeing a DBT therapist weekly. DBT has been invaluable in helping me cope with depression and fight it more effectively.
I have now been better for several months and am cutting the DBT to every other week. I will continue seeing my p-doc every other week, because I am so attached to him and he helped me so much. But eventually I will need to cut that back as well. I have little left to talk about after seven years and the depression finally lifting.
I have to add that one of the factors that has helped the periodical bouts of depression and suicidality is lamictal. I was getting better but still had powerful mood swings when my p-doc suggested lamictal. I've been taking it for five months and haven't had any bad bouts of suicidality since I started.
So I think depression is partly physical, partly psycological and partly the result of poor coping skills. My p-doc has helped me with all these things.
Posted by Twinleaf on September 2, 2012, at 19:50:03
In reply to Re: What psychodynamic therapy can do......., posted by emmanuel98 on September 2, 2012, at 18:46:47
It's great to hear how much better things are for you. I am very familiar with psychodynamic therapy, in which the relationship to the therapist is the principle factor helping towards recovery, but much less so with DBT. In my minimal knowledge of it, I think it is about training oneself to correct distorted thinking. I have the impression that DBT can help one do this better than other forms of therapy, but I don't know if this is accurate.
I have Lamictal on my list as the next thing I would try if I became suicidal again - it's definitely one of the most well- thought- of medications.
I know from previous posts that your therapist is in his 70's; mine is about to be 69,. It is awfully hard to think that they won't always be available.
Posted by Twinleaf on September 2, 2012, at 23:44:54
In reply to Re: What psychodynamic therapy can do....... » Twinleaf, posted by Phillipa on September 2, 2012, at 10:14:26
Your comment about the lack of psychodynamically- oriented therapists in your area made me curious. I looked up therapists for your city, and found 290 who had LSW, MSW, PsyD or PhD degrees, and who stated that they practiced in a variety of ways, including psychodynamically. I know this is just a basic laundry list of therapists, but, if you were interested, there are sure to be at least a few excellent ones.
Posted by emmanuel98 on September 3, 2012, at 19:20:35
In reply to Re: What psychodynamic therapy can do....... » emmanuel98, posted by Twinleaf on September 2, 2012, at 19:50:03
> It's great to hear how much better things are for you. I am very familiar with psychodynamic therapy, in which the relationship to the therapist is the principle factor helping towards recovery, but much less so with DBT. In my minimal knowledge of it, I think it is about training oneself to correct distorted thinking. I have the impression that DBT can help one do this better than other forms of therapy, but I don't know if this is accurate.
DBT, unlike CBT, isn't just about distorted thinking but focuses on how to sit with emotions and not let them overwhelm you. There's a big emphasis on mindfulness and meditation. It's sort of rooted in Buddhism. I know my DBT therapist is a Buddhist and the person who developed DBT (Marsha Linehan) was greatly influenced by Buddhist practice.
>
> I know from previous posts that your therapist is in his 70's; mine is about to be 69,. It is awfully hard to think that they won't always be available.He's 72 or 73 now. He's in great shape and hasn't had so much as a cold in the years I've been seeing him. He's working only part-time now and says he has no plans to retire, but...things can happen. At least now I feel that if something did happen it wouldn't completely derail me. But there is something very sad about knowing that this person who is so important in your life is not really in your life. I couldn't visit him in the hospital, couldn't probably go to his funeral. It makes me sad to think about this. I just hope he stays healthy long enough for me to end therapy.
Posted by Phillipa on September 3, 2012, at 20:12:13
In reply to Re: What psychodynamic therapy can do....... » Phillipa, posted by Twinleaf on September 2, 2012, at 23:44:54
Do they take medicaire & United Healthcare? Many are pay only. 4 I saw took medicaire had Phd's and didn't give two hoots about the patients. The worse was Nona Patterson? Do you have a link? Thanks Phillipa
Posted by Twinleaf on September 3, 2012, at 20:39:05
In reply to Re: What psychodynamic therapy can do....... » Twinleaf, posted by Phillipa on September 3, 2012, at 20:12:13
The one I found was " "Therapists in Charlotte" ".
Posted by Phillipa on September 3, 2012, at 20:50:53
In reply to Re: What psychodynamic therapy can do....... » Phillipa, posted by Twinleaf on September 3, 2012, at 20:39:05
Thanks will take a look. I saw a new grad once in in ER and unfortunately she worked only for the hospital. She was young but we clicked. Phillipa
Posted by 10derheart on September 3, 2012, at 21:00:24
In reply to Re: What psychodynamic therapy can do....... » Twinleaf, posted by Phillipa on September 3, 2012, at 20:12:13
All say they take Medicaire. A random check shows United also. I love Psychology today's listings because there is so much info. You can see their faces, age, education, experience, emphasis, and more.
You can narrow down further by focus on your issues on the left side, like OCD, Anxiety, etc.
I hope you pursue this. I really think talking to someone regularly would help a lot - probably more than any med.
Posted by Twinleaf on September 3, 2012, at 21:34:25
In reply to Re: What psychodynamic therapy can do....... » Twinleaf, posted by Phillipa on September 3, 2012, at 20:50:53
I know you have made attempts to find a therapist before which haven't worked out.. I agree with Tender that talking regularly to someone who is a good fit will do much more than any medication can do, and you do have quite a few major interpersonal stresses, both past and present, which therapy can help resolve. You do need to have sufficient motivation and interest to go through a number of trial interviews; there really isn't another way to find someone who is right for you. I hope you consider it seriously!
Posted by Willful on September 4, 2012, at 11:17:35
In reply to Re: What psychodynamic therapy can do......., posted by Twinleaf on September 3, 2012, at 21:34:25
I can't agree more with Twinleaf and Tender, Phillipa.
Don't count out MSWs though-- even if their training isn't as intellectual as that for psychologists, they can be wonderful and helpful individuals. It isn't so much the amount of reading that someone does, or even the ability to write a research paper-- it's more a personal fit, and an ability to reach out and awaken someone's own capacities for growth and resilience.
It may take seeing quite a few people before you find the right person, but you shouldn't let that discourage you, or take it as a sign that there's no one out there for you. You may be a very particular person, and be looking for a very special response. I know I was!
but you just need to persevere, if you're that kind of person. It took me forever and many wrong starts and years to find the right person- but I didn't know that fit was so important. It's only my own experience and some of the more recent writing in the field that's begun to show this.
So you're ahead of the game. And don't count yourself out because of age! 60 is only a number- my bf's mother is 87 and has more energy and is more involved in the community and in activities than I am. She's on volunteer boards, and plays mahjong (not my cup of tea, but so what?) with friends and even goes to tournaments! So it's not too late.... while you're alive it's never too late.
So please-- the time ahead is the time that counts-- so we all, no matter how old one is, have to try to make what's to be lived the best that it can be.
Which takes effort and sometimes working against our usual patterns of response, but it all we've got--
Willful
Posted by Phillipa on September 4, 2012, at 18:54:38
In reply to Re: What psychodynamic therapy can do....... » Phillipa, posted by 10derheart on September 3, 2012, at 21:00:24
I'm sure you are right. Let me see who is listed. Thanks Phillipa
Posted by Phillipa on September 4, 2012, at 18:58:28
In reply to Re: What psychodynamic therapy can do....... » Phillipa, posted by 10derheart on September 3, 2012, at 21:00:24
10der not medicaid medicare and united health care. The medicaid docs and therapists are the bottom of totem pole. Phillipa
Posted by Phillipa on September 4, 2012, at 19:06:58
In reply to Re: What psychodynamic therapy can do......., posted by Willful on September 4, 2012, at 11:17:35
Agree no the the person's degree don't give a darn about it's the fit. Like I said that young girl in the hospital ER was a great fit. Too bad don't remember her name as could have own practice now. Will do a search. No meds are not the answer for me. Phillipa
Posted by SLS on September 4, 2012, at 23:57:12
In reply to Re: What psychodynamic therapy can do....... » emmanuel98, posted by Twinleaf on September 2, 2012, at 19:50:03
Please excuse the interruption...
Nice thread, Twinleaf. I am happy to see this forum utilized in this fashion.
> I have Lamictal on my list as the next thing I would try if I became suicidal again - it's definitely one of the most well- thought- of medications.
I would mention that Lamictal can take 4 weeks to arrive at an effective dosage so as to avoid the precipitation of the rash-reaction. If you are in a suicidal state that is so acute that you do not feel safe, Zyprexa is probably the fastest-acting anti-suicide drug available. It can be used as a temporary bridge until the Lamictal takes effect. Klonopin would be another drug to consider to fill this role. Perhaps low-dose lithium would help prevent an acute relapse into depression.
That's all I have to say about that.
:-)
- Scott
Posted by 10derheart on September 5, 2012, at 10:28:18
In reply to Re: What psychodynamic therapy can do....... » 10derheart, posted by Phillipa on September 4, 2012, at 18:58:28
> 10der not medicaid medicare and united health care.
I don't think I mentioned Medicaid :-) Isn't United the same as United Healthcare?
Posted by zazenducke on September 5, 2012, at 13:36:49
In reply to Re: What psychodynamic therapy can do....... » Phillipa, posted by 10derheart on September 3, 2012, at 21:00:24
Ms derHeart
The link you left goes to Medicaid therapists.
Posted by 10derheart on September 5, 2012, at 13:59:10
In reply to Re: What psychodynamic therapy can do....... » 10derheart, posted by Phillipa on September 4, 2012, at 18:58:28
Oops, sorry, thanks to Zzd I see what I did. I clicked the wrong word on the left as they are next to each other.Here you go.
Only 34 (or 33 since we know you won't be calling Dr. Patterson!) but that's still an awful lot. Maybe ask their offices if they will do a phone session/interview or anything like that to see if the most basic things are a fit....schedule, insurance, philosophy, etc.I hope something works out.
Posted by 10derheart on September 5, 2012, at 14:01:04
In reply to Re: What psychodynamic therapy can do....... » 10derheart, posted by zazenducke on September 5, 2012, at 13:36:49
Oops, you are totally correct. I posted the correct one to Phillipa. Glad someone is on top of things :)
Posted by jane d on September 5, 2012, at 16:53:36
In reply to Re: What psychodynamic therapy can do....... » 10derheart, posted by Phillipa on September 4, 2012, at 18:58:28
> 10der not medicaid medicare and united health care. The medicaid docs and therapists are the bottom of totem pole. Phillipa
Phillipa,
I think you are saying that you have medicare as your primary insurance and united health care as a "medigap" type secondary coverage. Is that correct?
You really need to check the terms of your own policy. If the written material is unclear call united up and ask them who you can see under YOUR plan and how much, if anything, they will pay. It may need to be a medicare provider if it's medigap coverage.
Posted by Phillipa on September 5, 2012, at 19:17:11
In reply to Re: medicare and insurance coverage » Phillipa, posted by jane d on September 5, 2012, at 16:53:36
Jane of course it is. I know this. The ones I have seen here are Patterson, Jane Marcus, a wasted year with her as she couldn't remember what the previous session had been about. Phillipa
Posted by Twinleaf on September 5, 2012, at 20:32:28
In reply to Re: What psychodynamic therapy can do....... » Twinleaf, posted by SLS on September 4, 2012, at 23:57:12
Thanks Scott! I hope I don't have to, but it's great advice.
Posted by Twinleaf on September 7, 2012, at 22:27:33
In reply to Re: What psychodynamic therapy can do....... » Willful, posted by Phillipa on September 4, 2012, at 19:06:58
The interpersonal trauma and stresses that you have mentioned, beginning with your mother, are a strong indication that therapy will help much more than medications can. That's not to say that the medications don't have an important function; they do, but not to the extent that they would if you had schizophrenia or bipolar. I think you have chosen your medications wisely, and don't need to continue searching for a hypothetical "perfect" med -I don't think such a thing exists for you. From what you have posted, you haven't yet explored what really good therapy can do.
I'm so glad to see that you are interested in doing something about that. Will you let us know what the results of your search for a therapist are?
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