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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by fires on June 21, 2004, at 14:34:23
with words of caution for those considering psychotherapy (PT from here forth; T=therapist).
I had my first episode of major depression in 1976. It came from out of the blue. I saw my family MD first and he referred me to a P.(P=psychologist; Pdoc= psychiatrist)
After some PT, it became apparent that all of the talking in the world was not going to help my depression. I had other therapists who combined meds and talk. When that failed I had 9 ECT treatments. No relief. The dep. eventually went away with time alone and some dietary changes (NO milk or wheat products), but I was still rather dysthymic.
I had many more T experiences even after I was convinced that my "mental illness" was really a "brain disorder". Here's what ****I******* learned from my PT experiences and my reasearch about PT. Red Flags that my therapy &/or therapist wasn't/weren't "right" for me, and words of caution re: PT/Ts that I've accumulated from many sources over the years:
• T was anti medication
• T tried to get me to agree with his (his=his/her)pet theories even though I honestly couldn't.
• T blamed me when therapy wasn't working. One said, "I never promised you a rose garden."
• T fell asleep on 2 occasions -- right during my therapy (sleep deprived Residents may not make the best Ts for Dep. people who are withdrawn and not talking much).
• I did have a couple of Ts whom I liked, although their PT didn't help my dep., but did help me somewhat with assertiveness. One of them told me that there were at least 100 distinct types of PT. He then added that each particular type thought that their's was the one true type of PT. (Sound something like religion?)
• By 1983, I saw the shift away from psychobabble PT towards more CBT type therapy WITH meds, of course. In the later 80's though the New Age PT types sprung up. To read about a New Age type person and her fascinating conversion away from it go to:
http://www.csicop.org/si/2004-05/new-age.html
• Be wary of any T/PT that doesn't clearly define a theurapeutic goal and a limited timeline. I was hospiatalized with a relatively young woman with dep., whom was told by her T that her "problems" were so severe that it would take 10+ years for her to regain her former health!!!
• Avoid any T that rewards or encourages you to whine, bitch, blame, behave as an "emotional cripple" and or "drama queen/king". If they even tolerate such behavior say "bye" fast. I learned that from my years of working in special education, and Ts working with that population.
• Be leary of PTs that say that you must feel worse before you feel better! If your'e experiencing suicidal ideation, such "therapy" could very well push you to act on your impulses, especially if you have frontal lobe involvement (impulsivity problems can be due to frontal lobe problems).
• Run from any T who suggests that your dep. is due to pent up anger. (that theory is now defunct).
• Leave any T who you become overly dependent on. A good T should not let you become overly dependent on him.
• Run from any T who suggests that sex with him, or anyone else, will help you. Seems silly to have to state that, but there are groups of therapists around who believe that crap.
I may have forgotten some things learned during my 28 years, but I can add them later. BTW, Parnate and now Effexor can be thanked for making my life tolerable or better yet since 1988.
Thank you for reading this and Good Luck!
Posted by antigua on June 21, 2004, at 14:49:36
In reply to My experiences with therapy, posted by fires on June 21, 2004, at 14:34:23
Wow, it sounds like to me that you have had such bitter experiences. I'm sorry you've never had a loving, nurturing relationship with a therapist who could truly help you. I know I did and I wouldn't trade her help for the world.
I'm really sorry your experiences were so bad. Thank heavens many other people have more positive experiences.
antigua
Posted by Miss Honeychurch on June 21, 2004, at 16:36:17
In reply to My experiences with therapy, posted by fires on June 21, 2004, at 14:34:23
all great advice and insight. Took me several tries with different Ts (experiencing some of your aforementioned red flags) before I found a very professional and ethical one.
Posted by fires on June 21, 2004, at 18:03:34
In reply to Re: My experiences with therapy » fires, posted by antigua on June 21, 2004, at 14:49:36
Sorry, but I never went to a T for a "loving" relationship and never will. I don't believe that that's their job (to provide a loving relationship). I went to help my dep.
I didn't say that all my experiences were bad, they just didn't help my Depression. I learned to be more assertive, but that has never been shown to help Depression (at least major depression). Maybe it helps dysthymia somewhat?
I now believe that talk therapy alone is totally inappropriate for major depression.
Dr. Mark Gold, MD, in "The Good News About Depression", 1986 version, states:
"Unquestionably certain individuals benefit from certain therapies. Still, we do not know the percentage of patients in general who improve. We cannot predict which person will benefit from which type of psychotherapy. Despite the overwhelming commercial success of psychotherapy, we cannot even provide proof that most forms of treatment work."
I can't imagine a person with severe Dep. that would go to talk therapy and endure the suffering while he waits for it to work, knowing that there's not even any proof that most forms of treatment do work (per Dr. Gold above). How long must he wait for talk therapy to work? I think the answer is: no one knows. Meds, on the other hand, take about 4 to 6 weeks. There is proof that antiDs do work, although it may take several attempts.
Thank you
Posted by fires on June 21, 2004, at 18:18:36
In reply to Re: My experiences with therapy, posted by Miss Honeychurch on June 21, 2004, at 16:36:17
Thank you for posting that info.. It helps support my contentions. (I'm not alone! I already knew I wasn't. ;))
bye
Posted by Dinah on June 21, 2004, at 18:51:07
In reply to Re: My experiences with therapy, posted by fires on June 21, 2004, at 18:03:34
Just curious. Have you ever posted here under another name?
Posted by fires on June 21, 2004, at 19:05:43
In reply to Re: My experiences with therapy » fires, posted by Dinah on June 21, 2004, at 18:51:07
Quite some time ago I did. I think it was "thunder". Then I got sick and didn't post for a long time, so I came back with new name.
Why do you ask?
Thank you
Posted by Dinah on June 21, 2004, at 19:27:46
In reply to Re: My experiences with therapy, posted by fires on June 21, 2004, at 19:05:43
Your story and style just seemed a bit familiar.
I'm sorry you have had bad experiences with therapy. I've had some miserable experiences with medications, and have had one or two that have helped immensely. I've also had some really amazingly horrid experiences with mental health professionals of all sorts, and am glad I currently have a pdoc and therapist that are helpful to me.
Posted by fires on June 21, 2004, at 19:45:44
In reply to Re: My experiences with therapy » fires, posted by Dinah on June 21, 2004, at 19:27:46
Perhaps I should clarify something. When I said I've posted before, I meant on PB pharmacology. I'm not sure about "here."
bye
Posted by lucy stone on June 21, 2004, at 20:22:38
In reply to My experiences with therapy, posted by fires on June 21, 2004, at 14:34:23
> After some PT, it became apparent that all of the talking in the world was not going to help my depression. I had other therapists who combined meds and talk. When that failed I had 9 ECT treatments. No relief. The dep. eventually went away with time alone and some dietary changes (NO milk or wheat products), but I was still rather dysthymic.
>I think very few reputable Ts would treat a severe depression with only talk therapy.
> I had many more T experiences even after I was convinced that my "mental illness" was really a "brain disorder". Here's what ****I******* learned from my PT experiences and my reasearch about PT. Red Flags that my therapy &/or therapist wasn't/weren't "right" for me, and words of caution re: PT/Ts that I've accumulated from many sources over the years:
>
>
> • T fell asleep on 2 occasions -- right during my therapy (sleep deprived Residents may not make the best Ts for Dep. people who are withdrawn and not talking much).I wouldn't let a resident treat me physical illness and I wouldn't go to a resident for therapy. Some people have no choice for monetary reasons and have to rely on resident but it isn't ideal.
>
> • I did have a couple of Ts whom I liked, although their PT didn't help my dep., but did help me somewhat with assertiveness. One of them told me that there were at least 100 distinct types of PT. He then added that each particular type thought that their's was the one true type of PT. (Sound something like religion?)
>This is her opinion. The vast majority of Ts know that the different types of therapy are good for different problems and/or different patients. There are many different kinds of therapy just like there are many different kinds of medication. It's not one size fits all.
> • Be wary of any T/PT that doesn't clearly define a theurapeutic goal and a limited timeline. I was hospiatalized with a relatively young woman with dep., whom was told by her T that her "problems" were so severe that it would take 10+ years for her to regain her former health!!!
>Why would you be leary of a T who couldn't predict how long therapy would take? How can anyone know this in advance. I am assuming the person who was told that her problems would take years to resolve was a adult. If it took her her entire life to get to where she was, why should she expect to solve her problems in a short period of time. Why shouldn't you expect deep and long lasting changes in the way you think to take a long time? Also, why is long term therapy bad? If it continues to improve the life of the client and if the client has the resources and time it's hard for me to see why this would be a negative.
> • Avoid any T that rewards or encourages you to whine, bitch, blame, behave as an "emotional cripple" and or "drama queen/king". If they even tolerate such behavior say "bye" fast. I learned that from my years of working in special education, and Ts working with that population.
>
My T lets me whine, bitch, or blame if that's what I need to do at the time. Then, we talk about why I need to act that way and what I think it will get me. It's a better way to change behavior that not "tolerating" it. I'm not a special education child and don't expect to be treated like one.> • Be leary of PTs that say that you must feel worse before you feel better! If your'e experiencing suicidal ideation, such "therapy" could very well push you to act on your impulses, especially if you have frontal lobe involvement (impulsivity problems can be due to frontal lobe problems).
>
Sorry, don't buy this one. Going deeply into your thought processes can make you feel worse, but ultimately can make you feel better. Why should therapy only make you feel better? If you experiencing suicidal ideation your T should know that and and can help you, probabley including sending you to a pdoc for medication.> > • Leave any T who you become overly dependent on. A good T should not let you become overly dependent on him.
>
Define "overly dependent." Being dependent on a person who you care about and trust is very healing. A good T know how to deal with dependence.
>
> I may have forgotten some things learned during my 28 years, but I can add them later. BTW, Parnate and now Effexor can be thanked for making my life tolerable or better yet since 1988.
>I accidentily deleted the name of the book you recommended, but I recall that it was published in the mid 1980s. Psychological thinking has changed a lot in the last 20 years. I wouldn't rely on 20 year old information on physical or psychological health. The current thinking is that a combination of medication and talk therapy is most helpful for depression.
Posted by shadows721 on June 21, 2004, at 20:50:31
In reply to My experiences with therapy, posted by fires on June 21, 2004, at 14:34:23
I really thank you for sharing your story. It sounds like you have been through the mill with theories so to speak.
From my little knowledge base, this is what I feel.
"Run from any T who suggests that your dep. is due to pent up anger."'
When I 1st got on Buspar, my depression started to lift and all this rage started poring out. I literally wanted to hit strangers. My psychiatrist told me that it was the depression supressing the action of the rage. I do have rage about abuse, so this may or may not be true. Don't know. I had to get on additional meds to help the rage."Be leary of PTs that say that you must feel worse before you feel better!" I agree and disagree with this. In my case, this does happen many times. I have flashbacks and go through Hell. Seems like it's an oximoron. I am strong enough to face the past, but it still knocks the wind out of me for a while.
As far as the goal of tx, I understood that it is the client that comes up with the goal and not the t.
This is my theory of therapy = "If I am not in control of the ship, it's not sailing". So, therapy isn't going to be their theories as the ultimate truth. Just as any other person I meet in life, I will listen and way in their beliefs. They are people and they make mistakes too.
I don't look to them as my parents. Personally, that theory gives me the creeps. I had parents and they failed in many ways. That is over. My responsibility is me. My therapist can't do the work for me. It's like I told my mother the other day. Your days of parenting are really done in a way. What you did and didn't do are done. It's up to me to choose what to do with it now, so I said, "Stop telling me to do things you never did and never tried to do with your own life."
Since I have been in therapy for a while, I can't even fool myself with transference or other issues like that. When I am having any intense feeling, I seem to want to know why. Sometimes, I tell my t that I've got one of those client issue problems. Then, I dig for the reason. I think of my t as a support person and a comfort. She gives me ideas that maybe I need to be reminded or something I hadn't thought about. I don't rely on her so to speak. Sometimes, she is just holding up a mirror, so I can see what my problem really is. It's a different relationship. I am glad for it. I feel that I do need it and have benefited from it. I have also understood others around me better. Personally, I think everyone could benefit from therapy in some point in their life-even if it's just a need to have someone really actively listen and respond to them. I think we all have that need deep inside.
Thanks again for sharing and I am glad you are doing well.
Posted by shadows721 on June 21, 2004, at 21:08:32
In reply to Re: My experiences with therapy, posted by shadows721 on June 21, 2004, at 20:50:31
I forgot to mention the other part of the theory. "If I am not in control of the ship, it's not sailing. When this ship can't sail, I may have to use my life boats, which carry my supports (therapist, etc) on board." The winds and the waves gets really rough at times, but I try to keep her steady as she goes...
Seems a bit silly, but it works in many ways for me.
Posted by fires on June 21, 2004, at 21:30:53
In reply to Re: My experiences with therapy, posted by lucy stone on June 21, 2004, at 20:22:38
> I think very few reputable Ts would treat a severe depression with only talk therapy.<
There are still some around. I don't think they are ethical though.
> I wouldn't let a resident treat me physical illness and I wouldn't go to a resident for therapy. Some people have no choice for monetary reasons and have to rely on resident but it isn't ideal.<
My current PDoc is a resident and I pay good money to see her. She's been good and is highly supervised.
> This is her opinion. The vast majority of Ts know that the different types of therapy are good for different problems and/or different patients. There are many different kinds of therapy just like there are many different kinds of medication. It's not one size fits all.<
Actually it was a he. There aren't nearly as many kinds of meds as there are PTs. There are so many PTS that a list, if possible to compile , would stretch from here to ?
> Why would you be leary of a T who couldn't predict how long therapy would take? How can anyone know this in advance. I am assuming the person who was told that her problems would take years to resolve was a adult. If it took her her entire life to get to where she was, why should she expect to solve her problems in a short period of time. Why shouldn't you expect deep and long lasting changes in the way you think to take a long time? Also, why is long term therapy bad? If it continues to improve the life of the client and if the client has the resources and time it's hard for me to see why this would be a negative.<Because relatively short term therapies are the only ones demonstrated to help Dep. Psychoanalysis has never been shown to help any condition, with the exception of the therapists bank account.
> My T lets me whine, bitch, or blame if that's what I need to do at the time. Then, we talk about why I need to act that way and what I think it will get me. It's a better way to change behavior that not "tolerating" it. I'm not a special education child and don't expect to be treated like one.>I suppose that's OK as long as you restrict that behavior to his office. I've noticed a lot of such behavior demonstrated on the web, and the people say they are in therapy. If one can't take the lessons learned in therapy and apply them to one's daily life, what good are they?
> Sorry, don't buy this one. Going deeply into your thought processes can make you feel worse, but ultimately can make you feel better. Why should therapy only make you feel better? If you experiencing suicidal ideation your T should know that and and can help you, probabley including sending you to a pdoc for medication.>Why would going deeply into one's thought processes make you feel worse? CBT teaches that you are what you chose to believe about yourself. A given thought only carries the emotion that you wish to apply to it. Example: If someone puts me down I can get angry at him, or I can chose to think that the guy must be disturbed if he has to put me down; therefore I would feel sorry for him.
> Define "overly dependent." Being dependent on a person who you care about and trust is very healing. A good T know how to deal with dependence.>
Like making frequent phone calls between visits, or stretching therapy out when you really don't need any more. Or having to consult your T before making even minor life decisions, etc...
> I accidentily deleted the name of the book you recommended, but I recall that it was published in the mid 1980s. Psychological thinking has changed a lot in the last 20 years. I wouldn't rely on 20 year old information on physical or psychological health. The current thinking is that a combination of medication and talk therapy is most helpful for depression.
>
It was first published in 1986. It still has info. that is accurate to this day. In many ways PT has actually gotten worse since then: examples such as rebirthing therapy, Recovered memory therapy, and MPD (dissociative disorder) therapy have become quite the "in style" therapies, but they are HIGHLY questionable, if not outright frauds, as my links have demonstrated.Many of "us" foresaw this happening and it will probably continue as more of the biology of mental illness is understood, i.e., psychologists just won't disappear , they will find new disorders to treat. Oh, I left out hypnosis (regression type)/past lives therapy, and Jungian stuff that still surfaces every so often, etc...
Thank you
Posted by antigua on June 21, 2004, at 21:59:43
In reply to Re: My experiences with therapy, posted by fires on June 21, 2004, at 18:03:34
"I can't imagine a person with severe Dep. that would go to talk therapy and endure the suffering while he waits for it to work"
If you were referring to me, and I assume you were since the post was addressed to me, please know that I don't "endure the suffering." I'm sorry that you didn't approach therapy with an idea toward developing a "loving" relationship. "Loving" has many meanings to me, including trusting, and since it appears that you never developed a relationship that extended into transference, I understand why you are at such a loss to understand what so many of us are talking about.
antigua
Posted by lucy stone on June 21, 2004, at 23:05:27
In reply to Re: My experiences with therapy, posted by fires on June 21, 2004, at 21:30:53
I started to answer this post again with a point-by-point argument complete with links to pro-psychoanalysis sites but I stopped myself. I find myself examining my thoughts and trying to figue out why I would do this. I have explored these issues many times with my analyst, my need to be right, my need to be smarted and know more than other people, my need to dominate and control, even the pleasure I get out of being angry and hurting other people. I realize that the argument I am getting into with you is just a repeat of old patterns and is not helpful to me. My treatment is helping me with my life and I realize that my desire to debate this issue is not healthy. This is my analysis in action and it has helped me a great deal. Perhaps you could try a bit of analysis with your own thoughts. Why do you feel it necessary to challenge people on their treatments? What exactly is this doing for you? I suspect that you will say that you are trying to be helpful, but I wonder if the posters you are challenging find your comments helpful. I suspect that the challenging has more to do with your own needs that with the needs of the posters. I'll play amateur T and speculate that it has something to do with anger at the Ts that did not help you in the past and let you suffer much longer than you needed to. My wish for you is that you find a good T, and there are good ones out there, that can help you with your issues.
Posted by antigua on June 22, 2004, at 9:55:49
In reply to Re: My experiences with therapy, posted by lucy stone on June 21, 2004, at 23:05:27
Thank you for helping me clarify why I would let myself be drawn into being challenged/wanting to justify my treatment choices. It is a repeat of a pattern for me as well and as much as I'd like to win, it probably isn't worth it on this occasion.
(now, if I could understand why I feel compelled to be right or "win"--actually, I think I do. So little control as a child. But I'm not a child anymore and I have choices now)
best,
antigua
Posted by pegasus on June 22, 2004, at 11:01:55
In reply to Re: My experiences with therapy, posted by lucy stone on June 21, 2004, at 23:05:27
This is the end of the thread.
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