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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Emily Elizabeth on October 9, 2004, at 22:53:08
Hi all,
I have been in therapy for 3+ yrs and on meds for 2+ yrs. An assortment of bad stuff has happened in my life during this time as well. However, I just don't seem to be getting better. I mean, I have had ups and downs, but I have never really gotten to the point where I am okay for more than a few weeks. I keep switching meds, but that hasn't done enough.
Recently, someone I respect told me that I should have a consultation on my therapy to help figure out why I'm not getting better. It would be a sort of 2nd opinon. I really like my therapist and feel like she has been helpful, but maybe this is something I should consider? Has anyone out there done this? how did it go? how could I possibly bring this up w/ my T w/o sounding like I'm accusing her of doing a bad job?
Anyone have any advice? (If it matters, my diagnosis is GAD, MDD, and dysthymia.)
Thanks!
EE
Posted by Dinah on October 10, 2004, at 1:29:42
In reply to Ever hear of a consultation on therapy?, posted by Emily Elizabeth on October 9, 2004, at 22:53:08
I sometimes even think it should be mandatory for long term therapy relationships to have them on a regular basis. What happens in the therapy room is so private and unexamined that it's easy to get lost and wound up in what's going on in there, and lose the big picture.
If you feel like you're stuck or plateaud in therapy, a consultation can be a fresh viewpoint as to why that might be. If they come into it new with no preconceptions from either party, and if your therapist cooperates, I think it could be a huge learning experience. Depending on the consultant I suppose. I guess sometimes you could get one that doesn't grasp things quickly and is unable to offer useful input based on one or two meetings. That's a rare and valuable skill. I can't tell you how many mental health professionals can listen for an hour and get things completely and totally wrong.
In fact, I think it would be a wonderful thing for the mental health community (not to mention a good marketing tool) to offer special certification in consultation, with special emphasis on collecting and collating information quickly and accurately.
As to how to do it, is it possible to just tell the truth as nonjudgementally as possible, and be ready to respond to any defensiveness on your therapist's part? The truth is usually so much easier in the long run.
Posted by Annierose on October 10, 2004, at 7:42:27
In reply to Consultations are wondrous things. :), posted by Dinah on October 10, 2004, at 1:29:42
Yes, I have had a consultation (really a 2nd opinion a few times). I went through a period of wanting to quit. On my own, I got a 2nd opinion.
2nd T told me to flee.
Afterwards I discussed this with my T. My T is psychodynamic and the 2nd T was clearly NOT. My T was a little surprised, but controlled in her reaction. She explained I was comparing apples to oranges. She then referred me to another T. This guy was right out of a 19th century Freud clinic. How could anyone feel comfortable with him as a T? My T is way cooler and hipper. Anyway, he of course explained why I was feeling the need to flee, and encouraged me to stick it out in a very complicated, detailed conversation.
Did these opinions help? Ultimately I am not sure. I think it may have lit a fire. Have my T examine why I was so unhappy with my therapy and progress. A year later I did quit, after another 2nd, and 3rd opinion. However 15 years later, I am back with her, and we are both more grown up and mature. I am getting much more out of the experience than before. And I think she is a much better T. When I brought up my reason for quitting years ago, clearly she was a little uncomfortable. Both of us are really working hard. And I am so happy to be working with her again. I had no therapy in those between years.
I am not sure my little saga has helped answer your question. It's an useful exercise, but it did confuse me. In the end, trust your heart.
If you have any questions, please ask. Annie
Posted by Aphrodite on October 10, 2004, at 7:58:53
In reply to Ever hear of a consultation on therapy?, posted by Emily Elizabeth on October 9, 2004, at 22:53:08
Good timing on your post! This just happened to me. I have been with my T for a year, and though I think he is very competent and caring, I am much, much worse. I have nothing to compare him to considering I have never had therapy before. While my T was on vacation, I went to another for a second opinion. I think in general it is very looked down on in the profession, but the consulting T was very ameanable and said it was "refreshing" to see patients seek other opinions to take care of themselves. I think I had reached a point that I feared that I stayed with my T out of loyalty and because he's nice. I didn't want to hurt his feelings.
Without divulging much about my therapy, I explained my situation to the new T. Not only did he give me the exact same diagnosis as my current T, but his style/approach was exactly the same. He even did a great job explaining why I am worse a year later and said I would be the same way if I had been with him for a year. So, the second opinion was extremely validating. I had something to compare my current therapy to. I liked the second T, so I also felt better knowing that there was another competent T out there if mine moves or a piano drops on him.
I do have to say that the second T asked several probing questions about my therapy that exposed a weakness in my relationship with my current T. It gave me a lot to think about.
So, when my T returned, I confessed after a couple of visits. He was great about it, very reassuring, and he said that my only loyalty should be to my own well-being. In a check-in call later, he said that he was glad the other T talked about our weakness (which is emergency procedures and my continued reluctance to call my T when I need him) and said he was glad this gave us an excuse to shore up that part of our relationship.
The one thing I would do differently was to have been up front with my T about it. Even though he said he wasn't offended, he is human and I can't imagine it stung just a little. So, I asked him what he would have done if I had asked him, and he said he had a couple of psychologists he would have happily referred me to if I wanted. It wasn't as big of a deal or betrayal as I thought.
I think you should not sneak around as I did! The consultation will either reassure you or give you food for thought. Good luck.
Posted by Dinah on October 10, 2004, at 8:33:17
In reply to I cheated on my T and confessed ;) » Emily Elizabeth, posted by Aphrodite on October 10, 2004, at 7:58:53
Aphrodite, I'm so happy that your consultation gave you information that helped you improve your therapeutic relationship.
I must confess that I while I really do believe that periodic consultations in long term therapy would be beneficial to both therapist and client, in practice I would be scared to do it because I'd be afraid of losing some of the things I like best in a relationship that works well. But I feel the same way about my therapist's continuing education, so I know it's not a rational fear on my part.
So if the licensing boards ever take my recommendation and make it mandatory (smile), I'm going to have to have my therapist promise that any changes will have to be mutually agreed upon.
P.S. I did have a quasi-consultation once. It was more a pdoc consultation than a therapist one. But the pdoc also approved my then shaky relationship with my therapist and sent me back to him. And I've had several adjunct therapies or email consultations that *weren't* about my therapy relationship, but where the other therapist made positive comments about my relationship with my therapist. And one (biofeedback guy) where negative comments were made. I consider those "check ins" to make sure that I'm on the right path as well. Including the negative comment by biofeedback guy. If he thought it wasn't good, I consider that proof that it's good.
This is the end of the thread.
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