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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by ChicagoKat on January 23, 2013, at 9:34:58
I got sick of hearing her tell me what I should be doing to feel better. Telling me to do things I absolutely have no capability of doing. Yesterday it was 'change the channel in my brain' Huh? I felt like screaming, 'you try f*ck*ng doing that after a childhood from hell during which you learned no positive life skills, annd while you are on a Ritalin holiday!' She gets like my Mom sometimes, and that just drives me CRAZY b/c my mom is the main reason I'm so screwed up. No therapist in the world can fix me, I'm just too f*ck*d up. All I want is my Ritalin, and to stop paying good money to be treated the way I was when I was a kid. I talked to my brother yesterday, who went through that hell of a childhood with me, and it occurred to me that he is literally the only person in this world who really understands me. And that he is a FAR better therapist for me than any other I've ever had.
Kat
Posted by Phillipa on January 23, 2013, at 9:57:55
In reply to I fired my therapist yesterday, posted by ChicagoKat on January 23, 2013, at 9:34:58
Kat I'm so glad you found that your Brother also truly relates to you. Unfortunately we can't change our childhood. And it follows us through adulthood all the subliminal messages that were planted in our minds. Same here. Unfortunately no on understands. Now you have someone to share the same experiences with. Phillipa
Posted by Phil on January 23, 2013, at 10:30:07
In reply to I fired my therapist yesterday, posted by ChicagoKat on January 23, 2013, at 9:34:58
That sucks. I've been there several times. I've had two really good therapists and at least four without a clue.
Posted by ChicagoKat on January 23, 2013, at 10:37:11
In reply to Re: I fired my therapist yesterday » ChicagoKat, posted by Phillipa on January 23, 2013, at 9:57:55
> Kat I'm so glad you found that your Brother also truly relates to you. Unfortunately we can't change our childhood. And it follows us through adulthood all the subliminal messages that were planted in our minds. Same here. Unfortunately no on understands. Now you have someone to share the same experiences with. Phillipa
Thanks for understanding Phillipa. It only took me 46 yrs to realize my brother has and always will be there for me, understanding and caring. And acting like a dork, which makes it so much more fun :)
How are you today, my friend?
Kat
Posted by ChicagoKat on January 23, 2013, at 10:39:18
In reply to Re: I fired my therapist yesterday » ChicagoKat, posted by Phil on January 23, 2013, at 10:30:07
> That sucks. I've been there several times. I've had two really good therapists and at least four without a clue.
Thanks for the post, Phil. It's really hard to find a good therapist, isn't it? I want to look for one that has or has had depression his or herself. No more therapists that learn about depression from a book...I'd like to find one that truly understands.
Kat
Posted by Meatwood_Flack on January 23, 2013, at 14:49:25
In reply to I fired my therapist yesterday, posted by ChicagoKat on January 23, 2013, at 9:34:58
Before receiving the gift of melancholic depression, I had earned 15 master's level credit hours in counseling psychology. Much of this sort of curriculum boils down to the following: 1. Learning the DSM and how to use it in a clinical setting 2. An introduction to the various psychological tests that are available for clinical use (example, the MMPI) 3. Learning to research and interpret peer reviewed research 4. Learning the various theoretical models through which counseling may be based (example: Freud, Jung, Erikson, Kohlberg, etc.) 5. Clinical practice (much like the clinical portion of training that nurses undergo and finally (but probably the main focus of graduate school) 6. Writing, writing, writing. The problem with different theoretical models is they don't all agree on what the focal point should be when looking at psychological issues, so most good therapists will borrow from a number of them in a spirit of keeping what's useful and discarding the rest. Studies on the physical structure of the brain is at a minimum and, from what I saw in my program, the role of endocrine-related issues pertaining to psychological disorders isn't even mentioned (but that's what the psychiatrists and psychopharmacologists are for), so therapists aren't trained on the biological side of things and, as such, may not have a clue about neurotransmitters or hpa axis function, etc. A currently popular theoretical model of depression can be attributed to Aaron Beck, who created Cognitive Therapy, and posited that there are three constructs which contribute to depression: thoughts, feelings and behaviors, with all three acting on each other. This can be a helpful perspective in therapy, as long as the client is able to concentrate well enough to congnitively grasp the concept, has the motivation to explore the concept as applied to their own experience and has the energy to work on homework assignments designed to get thoughts, feelings and behaviors into a healthy working order. The drawbacks are not in the theories, themselves, but in the fact that they are interpreted by humans. While training also stresses the importance of establishing a relationship with clients based on empathy and unconditional positive regard (nonjudgmental), empathy not based on personal experience usually has a brief shelf life and, regardless, is not as effective as empathy that is based on personal experience. Many counselors and therapists have experienced psychological issues, which is a major reason they chose to go into the profession (hoping to figure themselves out along the way.) But, from a purely academic standpoint, earning a masters degree in counseling is also a lot easier than earning a master's in business administration, a master's in one of the hard sciences or mathematics. So, just as we've all had experiences with bankers or insurance agents or even doctors who don't seem to know what they're doing, there are also therapists whose capabilities are limited (for a variety of possible reasons.) Unfortunately, what this means is, just as many of us must endure the trial and error nature of finding an effective medication, we're also stuck with trial and error in choosing a therapist who is helpful. Oh, I actually left out the area of counseling instruction that actually gets the most airtime: ethics. Does having a therapist who has experienced a profound depression give them a leg up in being able to help? It's possible, but if that's all they bring to the table, it's probably not enough.
Posted by Phil on January 23, 2013, at 14:58:16
In reply to Re: I fired my therapist yesterday » Phil, posted by ChicagoKat on January 23, 2013, at 10:39:18
Kat I had a great therapist that was a recovering alcoholic. They get it. Maybe call some offices and see if they have any ex boozers there. :)
I've also had great social workers that had their office at the psych ward I vacationed at.
They were good.
If you have NAMI meetings in your area go to one. Great peer support and they will know of good therapists. Ant MI support groups not just NAMI.
Posted by Phil on January 23, 2013, at 15:07:27
In reply to Re: I fired my therapist yesterday » Phil, posted by ChicagoKat on January 23, 2013, at 10:39:18
I just signed up for a 10 week peer to peer deal at Austin State Hospital that starts the 31st. I got one thing going for me, I never give up. :)
Posted by ChicagoKat on January 23, 2013, at 16:24:16
In reply to Re: I fired my therapist yesterday, posted by Meatwood_Flack on January 23, 2013, at 14:49:25
Meatwood, would you be my therapist? :)
Not only are you obviously quite intelligent, you understand what it really feels like. Thanks for explaining all that to me, it helps me to understand much better.
By the way, for some reason, I get an F in CBT. My mind is too stuck in its mire of misery.
Thanks again, and I'm truly sorry to see such a mind afflicted with depression.
Kat
Posted by ChicagoKat on January 23, 2013, at 16:26:10
In reply to Re: I fired my therapist yesterday » ChicagoKat, posted by Phil on January 23, 2013, at 14:58:16
> Kat I had a great therapist that was a recovering alcoholic. They get it. Maybe call some offices and see if they have any ex boozers there. :)
> I've also had great social workers that had their office at the psych ward I vacationed at.
> They were good.
> If you have NAMI meetings in your area go to one. Great peer support and they will know of good therapists. Ant MI support groups not just NAMI.Thanks for the advice Phil. I have heard absolutely nothing but good things about NAMI, and they do have meetings in my area. I have to find the will to get myself to one.
Kat
Posted by ChicagoKat on January 23, 2013, at 16:30:15
In reply to Re: I fired my therapist yesterday » ChicagoKat, posted by Phil on January 23, 2013, at 15:07:27
> I just signed up for a 10 week peer to peer deal at Austin State Hospital that starts the 31st. I got one thing going for me, I never give up. :)
Dear Phil,
That's a good thing to have going for you. I have it too. Despite today being literally one of the worst days I've ever experienced while depressed (I found myself not long ago throwing up and actually screaming in agony from my mental pain...I'm surprised the neighbors did not call the police), I too seem to not give up. I have too much to live for, if I could just get better, dammit.Anyways, what's a peer to peer deal? You've got me quite curious. Take care, and don't give up!
Kat
Posted by Meatwood_Flack on January 23, 2013, at 17:39:23
In reply to Re: I fired my therapist yesterday » Meatwood_Flack, posted by ChicagoKat on January 23, 2013, at 16:24:16
If I were in remission, degreed and licensed, I'd be happy to be your therapist. I'm still 45 semester hours shy of the degree, so there's still a lot I don't know. In defense of therapists, though, it's easy for me to sit on my couch and offer advice on the internets. Most therapists have 30+ clients per week, each with different personalities, different problems and different levels of commitment to working to solve those problems. That's a lot of pressure (especially when even the best therapists are unable to help everyone) and explains why burnout is so pervalent in the profession. I am friends with a therapist of over 10 years experience and, as much compassion as she has, she's been jaded by her experiences. A lot of clients in therapy are too dependent on the therapist to do their own work, a lot of clients don't really even want to be in therapy so they offer as little involvement as they can get by with. Earnest and well-meaning clients who do want to work to get better shouldn't pay for the sins of their less motivated counterparts, but -- human nature being what it is -- sometimes do. You sometimes see the same thing with policemen who have been on the job for a long time who have come to regard most people as untrustworthy because they've dealt with criminals for so long. Another hurdle therapists face is maintaining sufficient empathy while also keeping appropriate distance to allow them to leave work at work and not toss and turn in bed at night over the problems their clients are going through. Add to this the less than perfect batting average of even the best, and the frustration at not being able to help can be overwhelming. Over time, I imagine it's tempting to become emotionally vacant just to stay sane. But then, when things get to that point, a career change might seem to be in order, but that's a lot easier said than done, especially when you're talking about walking away from a degree for which you may be paying off student loans for the rest of your life. We inherited an imperfect world. Unfortunately, when you add depression or any other disability to the mix, it becomes even less perfect. It's truly a shame that any of us must bear the weight of these types of illnesses. And thank you for the compliment. Keep searching and you'll find a therapist you mesh with. Finding an effective med will make that process a lot easier. Meds can't do it all alone, and neither can talk therapy. Each one compliments the other.
Posted by jono_in_adelaide on January 23, 2013, at 18:31:16
In reply to Re: I fired my therapist yesterday » ChicagoKat, posted by Meatwood_Flack on January 23, 2013, at 17:39:23
I didnt find therapy helpfull either kat, platitudes like "you dont need to feel bad about feeling bad" werent very helpful when what I wanted was to feel better.
I likent it to having a broken leg - they could either give me therapy to help me deal with the pain of a broken leg, or they could put the leg in plaster and give me some painkillers - i wanted the latter
Posted by baseball55 on January 23, 2013, at 19:14:03
In reply to Re: I fired my therapist yesterday » Phil, posted by ChicagoKat on January 23, 2013, at 10:39:18
> Thanks for the post, Phil. It's really hard to find a good therapist, isn't it? I want to look for one that has or has had depression his or herself. No more therapists that learn about depression from a book...I'd like to find one that truly understands.
> Kat
Sorry about your therapist. But I don't think a therapist needs to have suffered mental illness to be a good therapist. Empathy and years of clinical experience are important. In fact, I find it hard to deal with people who are depressed when I'm depressed. In fact, the last thing I want when I'm depressed is to be around other depressed people (or to be around people at all, for that matter).Therapy is all a matter of fit. Some people click together, others don't. Before I started seeing my p-doc (who has never been depressed), I interviewed three others. After talking to others, I realized he felt right to me.
So if you ever want to go back to therapy, you should probably check out three or four people before making a decision.
>
Posted by baseball55 on January 23, 2013, at 19:26:58
In reply to Re: I fired my therapist yesterday » ChicagoKat, posted by Meatwood_Flack on January 23, 2013, at 17:39:23
Meatwood - Thanks for a very interesting post. I saw a p-doc for therapy for six years (I still check in once a month) and now see a DBT therapist for going on two years. They are really good but both have said they like working with me because I work hard.
I understand this from teaching college. The students who are engaged and interested and work hard keep me engaged and interested and working hard. The ones who skip class and don't put in the effort are a pain to deal with. If I was dealing with too many students like that, I would burn out.
I think therapy is the same way. If you have patients who are engaged and want to change and willing to try, it's very exciting. Of course I know, when I got severely depressed for nearly three years, that I was not easy to work with. My p-doc sat through it, but it couldn't have been easy on him. And at least he can busy himself by playing with meds. What must it be like for a non-MD therapist to deal with intractable depression. I can't even imagine.
Posted by ChicagoKat on January 24, 2013, at 10:42:07
In reply to Re: I fired my therapist yesterday, posted by jono_in_adelaide on January 23, 2013, at 18:31:16
Thanks for the post Jono. It was the ' you need to change the channel in your brain' statement that really got me. My mind is filled with a black cloud right now and there is NO way to change the channel to anything else.
To my therapist's credit, she did text back and said she was sorry, and that maybe we could talk and work out what I want from therapy. I told her I want understanding, compaassion, and yes, even sympathy, though I know you're not supposed to ask for that. And that I did NOT want to be told what I should do to feel better. That makes me think of my Mom, which is not a good thing. I told her no therapist in the world can fix me, and I will always need meds, despite her claim early on in our therapy that eventually I wouldn't need meds. That is an impossibility.
So we're gonna meet today on a trial basis and see if she can treat me the way that will help me. I do really need to see someone. Ritalin has completely given up on me and I'm tired of leaning on my family. We'll see.
Kat
Posted by ChicagoKat on January 24, 2013, at 10:45:06
In reply to Re: I fired my therapist yesterday, posted by baseball55 on January 23, 2013, at 19:14:03
I agree with a lot of what you had to say baseball. There's no doubt that I simply love my pdoc, and he's never suffered from mental illness. But he is filled to the brim with compassion. And lots of experience. And he is the only person who can actually make me laugh when I am in my darkest place.
So I am going to try to see my therapist again after talking with her about what I expect from therapy, on a trial basis. We'll see how it goes.
Kat
Posted by sleepygirl2 on January 24, 2013, at 12:07:35
In reply to Re: I fired my therapist yesterday, posted by Meatwood_Flack on January 23, 2013, at 14:49:25
Nice post.
I have to say though, that I found my first degree, in the realm of biological sciences, "easier", because it was very structured, factually focused, left a lot less in the area of gray, was logical, about cause and effect.
Because there are many approaches within counseling/therapy there can be many approaches to solving any particular problem. I think we can benefit from a basic understanding of a therapist's particular approach.
Posted by Meatwood_Flack on January 24, 2013, at 13:00:40
In reply to Re: I fired my therapist yesterday » Meatwood_Flack, posted by sleepygirl2 on January 24, 2013, at 12:07:35
Thanks for the compliment.
I agree we could benefit from a basic understanding of our therapist's approach. I imagine most are somewhat eclectic, but it would be helpful if the therapist at least gave a brief overview of the perspective he/she would be working through. Most people don't understand the basics of cognitive behavioral therapy, dialectical behavior therapy or any of the many other available approaches. Having a basic understanding as the client and therapist work on a treatment plan would help make future sessions, homework assignments, etc. easier to understand.
Posted by jono_in_adelaide on January 24, 2013, at 17:14:35
In reply to I rehired my therapist on a trial basis » jono_in_adelaide, posted by ChicagoKat on January 24, 2013, at 10:42:07
"It was the ' you need to change the channel in your brain' statement that really got me."
Same here Kat, i would have felt the same - you dont need to pay somebody $200 per hour just to be insulted. I never felt therapy would help me, as I didnt feel that i had any "issues" I wanted to talk about, no baggage at all. When i eventualy saw a psychiatrist he agreeed with me, that my case was almost certainly biochemical, and that what i needed was the right cocktail of drugs, not talk therapy
Posted by baseball55 on January 24, 2013, at 19:02:46
In reply to Re: I fired my therapist yesterday » baseball55, posted by ChicagoKat on January 24, 2013, at 10:45:06
> So I am going to try to see my therapist again after talking with her about what I expect from therapy, on a trial basis. We'll see how it goes.
> Kat
That's good if you like her. I think empathy and compassion are the basic qualities in a therapist. When you feel they aren't giving you that, therapy becomes very hard. Depression is hard on them too, I think. I once asked my p-doc what it was like to be in his position and he said, it's intense - it's intense on both ends.
This is the end of the thread.
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