DO I NEED THERAPY?

and that your therapist may actually be able to help you

i know what an MSW is, but what is an MFCC?

Motherfucking Cranium Changer

how many sessions should one allow before deciding to continue on with the same therapist? i mean, obviously there are situations where you know for sure that the person is helping you break through stuff etc..
but in the past, i have not been sure if a) i'm not working hard enough on the process or b) the therapist is just not a good match.

my college therapist wasn't a student, i'm guessing that she was in her late 30s/early 40s. i don't know whether she was a *bad* therapist, or if it was just a matter of me not finding her method of psychotherapy very useful. it was a bunch of students sitting around in a room talking about whatever it was that was bothering us at the moment. and the therapist didn't really give us any advice -- she would just let us go on and on and on ... That's why it seemed pointless at the time. But that may have been her style/school of therapy.

yeah, the therapy that has worked for me has been A) one-on-one and B) lots of feedback & questioning from the therapist

btw pre-revive this reads like an Ask A Drunk thread

I was just thinking about this...the clinic I was going to wanted me to have an annual appointment with their psychiatrist. The psychiatrist was a middle-aged dude and he was listening to Michael Savage in his office during our meeting, which I thought was maybe not appropriate. Anyway, I said, "My dad listens to Michael Savage," prompting him to ask if my dad knew X trivia item about Michael Savage. I had no idea. He said, "Call your dad." I said, "It's long distance, are you sure?" He said, yes, so we put my dad on speakerphone. He grilled my dad about minor points of Michael Savage trivia, and my dad knew none of them. "Looks like you don't really appreciate Michael Savage," the psychiatrist said to my dad before we ended the call.

that does not strike me as professional behavior

lol

Yeah, it was like the second least professional therapy experience I ever had.

It was so funny & weird that I didn't want to stop it, though...I was thinking, 'how far can this go?' It can go as far as a self-entitled stranger insulting my dad over speakerphone.

Looks like you don't really appreciate Michael Savage.

Abbott, you mistook what the clinic meant about the annual appointment -- the middle-aged guy was the patient.

you were billed for that??!

assuming not this guy btw

# Michael Savage (musician), singer of American rock band Pigmy Love Circus

Tracer Hand, I didn't pay a cent at this place. I guess you get what you pay for.

yeesh, physician heal thyself indeed!

Yeah, it was like the second least professional therapy experience I ever had.

...what was the first?

"I'm on a tight schedule, do you mind if I whip up dinner for my kids while we do this?"

^ i've heard this from dusky voiced beauties on sexlines tbh

what are all your experiences of therapy like?

i have been considering it lately, due to a combination of factors. i'm not feeling majorly down, in fact a little better than usual, but i think in a weird way it feels a good time to go as a result of that, in that i feel i can rationally see some problems and it'd be better to do something before life creates situations that makes them harder to deal with.

i guess it's a combination of lack of trust in myself, or not knowing when i am doing the right thing or the wrong thing, or whether i should be more self confident or less, or how to change or whether i need to. along with this i have a lot of trouble trusting people and feel a lot more introverted than at other times in my life, not that this would appear obvious to those around me, but the disconnect there is prob another problem.

further to all the above i never really talked through my chronic illness properly with anyone and i feel i should at some stage.

i guess underlining all the above is just an essential unhappiness which has become resignation to some extent.

i know everyone is prob reading thinking if the above means i need therapy then everyone should be signed up, but can i benefit from it does anyone think?

i feel like if it could help me to regain the impetus i had in my teens and early 20s, even a little bit, or some kind of impetus and self assuredness, then it'd be worth it.

and also just...erratic behaviour, one day over the moon the next disgusted, etc etc...no pattern to any of my moods.

go to therapy, but look for a "hard" therapist and not just one who waits for you to talk yourself out. you can always call around and interview them on the phone – ask them what their approach is – and look for one that fits with your goals. I think cognitive - behavioral therapists are better at giving homework, asking you to do real work on yourself, etc., as opposed to the old model of 'let's enable your narcissistic rambling for an hour every week'

Ugh. I've started seeing several over the years but never kept it up because each one I've seen (maybe 4 or 5 in total) was of the "one who waits for you to talk yourself out" variety. I know what my issues are and think about them ALL the time. I don't want to just talk about it. In fact I'm tired of talking about it. I want someone to give me feedback and help prompt change. The last one I saw told me that she didn't think CBT would work for me because I was too smart. I have no idea WTF that meant but it sounded like BS and I never went back.

^^^ i thank you for typing that out for me. having the same exact problem, only minus the trying.

i need someone who will be really "hard" i guess because i am EXTREMELY stubborn and not likely to enjoy this at all.

anyway ronan, i don't think this is a bad idea. have been considering it myself but haven't taken the next step. the last year has been pretty tough and i would like to know what to make of it.

The last one I saw told me that she didn't think CBT would work for me because I was too smart.

this is indeed straight-up bullshit, btw.

I KNOW

That's why we had to break up.

Have done CBT before and it was somewhat helpful btw.

CBT is really great if you have identifiable problems and behaviors you want to work on and change (which is why its great for anxiety-related issues), but (ime, and judging by the experience of friends) is a lot less helpful for... "working through issues" or what have you.

i mean its all related, ppl should do what works best for them, but given the way ronan is describing what he's looking for i think oldish-school "narcissistic rambling" therapy could be just as helpful. sometimes the best thing is to just talk to someone who is unconnected to your life for an hour every couple weeks!

...the clinic I was going to wanted me to have an annual appointment with their psychiatrist. The psychiatrist was a middle-aged dude and he was listening to Michael Savage in his office during our meeting, which I thought was maybe not appropriate.

LOL!!..

CBT is really great if you have identifiable problems and behaviors you want to work on and change (which is why its great for anxiety-related issues), but (ime, and judging by the experience of friends) is a lot less helpful for... "working through issues" or what have you.

Yes, this makes sense to me. Also my anxiety was pretty under control at the time so perhaps that was part of what she was getting at and just didn't phrase it correctly. We weren't a good fit in general mainly because of what I mentioned earlier. She would just look at me and nod the whole time and I found it really unhelpful. I think M is right though and that for some people the opportunity to talk to someone unconnected can be what some people find most helpful, it just hasn't been for me.

One of the major problems with going to therapy, for me at least, is when I feel low enough to make the appointment, suddenly the mere possibility of actually meeting this person is enough to make me remember OH YEAH I feel just FINE.

i find it hard to say which type would be good with no experience, apart from the cost being £0, that'd help me a lot i know for sure!

i think i prob have a pretty clear idea of what i want to change and what goals i'd have from it all (despite my rambling above), which sort of is my main reason for thinking it'd help me. like if you know some of the things you want to work on then i guess like going to the doctor you can be specific and hopefully get some help.

identify with a lot of yr post ronan.

If you find somethin PM me dogg

oh sure ronan, i didnt mean to say that you didnt know what was "wrong" with you. i just wanted to stick up for the "narcissistic rambling" model of therapy, which can be very useful to people! i think pragmatism is key, dont spend time with therapy that doesnt work for you, regardless of yr... ideological (or what have you) feelings

once you don't tell anyone else in ireland darragh

x-post to max yeah i wasn't on the defensive on that, yeah it could actually be that that's just as good, i guess it's hard to tell until you go, and prob depends on the person.

yep

sry mn just facebooked you 'lol u nuts lol'

once you don't tell anyone else in ireland darragh

lol

he went mad over the want of the pint of harp

'it's 'me time' back home'

my narcissistic rambling comment isn't, obv, directed at everybody who does talk therapy, and especialy not at introspective types or people considering therapy who haven't been before. there is a definite 'type' of professional therapy-seekers, though, who pay somebody to indulge their blah-blahing, and use the time to entrench themselves more deeply in their (often wacky) opinions. there are a TON TON TON of bad therapists who really value and believe in letting people wallow in their own shitty mire as part of a therapeutic practice, when learning to move past / effectively deal with bad situations is a much loftier, and harder, goal.

yeah no definitely...and like i think it can be hard in a way for anyone not to have a little voice that tells them it is just narcissism. but i suppose at a point you think "would i benefit from this", "do i have goals from this" and "will i be happier after", i sort of think there is potential at least for the answer to be yes to all of these. i don't actually talk to anyone about how i feel about anything, hardly ever really...

and of course i know you're making a general point btw...rather than anything specific to this thread

sorry guys, CBT means something very different in my "community"

haha

dr morbius' cbt would probably not be very helpful to ronan

it could be really good – i benefitted from visiting a talk therapist at one point, and when i came to the realization that i no longer needed to see him it was a goood 'oh, i'm okay with this situation and my psychic baggage moment'

This isn't to discourage Ronan from going but I really identify with what Remy is saying. It's so frustrating!

I haven't gone in a couple years because I got so tired of only encountering the types of therapists R is describing. It really sucks because I'd really love to find something who I work well with that could help me learn to "to move past / effectively deal with bad situations" because essentially that's what I can't figure out on my own. The whole process of finding someone new and going to enough sessions to get a feel for them is kind of a pain in the ass not to mention time consuming and costly. The thought of going through that whole process again is really daunting even though I know it would be worth it if I finally found someone good for me.

BTW when I said I've tried 4-5 that's over 10 years. I'll go through the process and get discouraged and it always takes me a while to get around to it again. I just didn't want it to seem like I was tearing through these peeps without giving them a real shot or that I was just being difficult and writing off one after another.

sorry guys, CBT means something very different in my "community"

I was all, "what could that possibly... OH DO NOT WANT"

I can't figure it out.

I think I've got the C and B parts down but not sure about the T. :(

maria said that this therapist would basically repeat back everything that maria said to her only in a longer way. which took up more then half of her time there! didn't sound ideal.

I dont think it’s great that dudes can just set up their own practice and rake in $$$ while providing no useful service whatsoever besides a listening board. No accountability, no on-the-job training or whatever when new developments arise, no collaboration with other therapists, just a total shit sandwich.

My last ex and I talked about couples counseling before it ended (we didn't end up going), but I was shocked at how expensive it was... I spoke with one woman who was quite nice, almost ready to book an appointment - she said it was $275 for a 50 minute session, but the first session should be double-length to really get to know each other so that would be $550! I almost had a heart attack

many people I have talked to who went to therapy thought it was no use and this is very disappointing. Maybe there should be some kind of other certification or Yelp or something. I mean who is measuring the outcomes of these therapists? If peopel think it is no good they just stop going

Don't you have to have some kind of training or certification? Or you can just call yourself a therapist?

of course you need some kind of training or certification. a quick google search will clear that up for you. i'm sure it's different everywhere/regionally/nationally but obviously there is some standard of training.

it's like accreditation for higher ed aiui -- there are accredited schools (good) and unaccredited schools (bad) and sadly it's on the customer/student/client/patient to determine if a care provider is sufficiently accredited.

Psychologist here. It's a pretty confounding landscape. There are absolutely certifications needed in order to use certain terminology, but as LL says, there are wide variations from state to state in the US and surely from country to country as well. Profession names like "psychologist" tend to be well regulated. "Therapist" is tricky because there are all sorts of therapists - physical, respiratory, etc., but generally people can't use that word if they aren't accredited in some way, in some profession. "Counselor" is even more slippery. "Coach" aiui is totally unregulated, which is why you see lots of people who fancy themselves therapists hanging out their "life coach" shingle without any training or accountability whatsoever. And some of them are great! But if you're making an investment, nice to maximize the chances that you'll get someone who actually has some expertise to offer you.

Andy the Grasshopper - not sure where you're located but that is exorbitant. Not so much the hourly rate (although I totally get how much of a nonstarter it is for most people), but asking for double length. I am assuming that is an out-of-pocket quote from a therapist who doesn't take insurance. When you bill insurance, there are higher reimbursement rates for initial sessions to help offset the fact that they may be longer, but it is not double, and ime private pay folks may charge like 150% of their usual for an intake, but not double. Whether or not the average therapist takes insurance is another thing that varies widely by region - in wealthy urban areas people tend to get away with being private pay only, whereas elsewhere it can be hard to fill a caseload that way. But even when someone doesn't take insurance, good therapists who have their shit together should be offering to support you with submitting reimbursement paperwork so that you can get at least a portion of their oppressive rates back.

Oh one more thing to add -- in many states and disciplines you have to accrue supervised hours after getting a degree but before you can sit for a licensing/certification exam. So there are also lots of unlicensed folks operating out there under someone else's supervision. That should all be disclosed at the outset, and is more likely to be in a larger institution like a big group practice or a community mental health center. But people can pay someone to supervise them when working independently too in some circumstances. Paradoxically, while those folks are generally very green, it can be a perk that you sometimes also get the benefit of their supervisor's wisdom filtering back into the work, and at the very least there's some accountability there that can disappear once they are able to strike out on their own. But there's no question that results vary wildly in all of these cases. Ultimately psychotherapy is such an inexact and individualized science that there's bound to be a lot of trial and error involved to find someone who is both actually good/knowledgeable, and a good fit for a particular client. Which sucks because it can be so hard to find a therapist that the idea of shopping around and trying a few, which is highly recommended, is often a pipe dream.

I am happy to use this thread as an "ask a therapist" space anytime. I'm in Massachusetts btw

thanks for the offer!

Andy the Grasshopper - not sure where you're located but that is exorbitant

This was in the Silicon Valley, where everything is expensive. She did not accept insurance, as far as I recall... and I'm with an HMO that has their own team of therapists ('pick from one of seven'), but I highly doubt that includes couples counselors

Lavator Shemmelpennick my concern is over time, years after getting a degree, are therapists keeping up with current research?

I am interested in the TEAM version of CBT - https://feelinggoodinstitute.com/what-is-team-cbt-therapy

One thing that seems good about it is there is an element of testing the therapy sessions to see if the patient is actually getting anything out of them

I agree psychology tends to cover such a nebulous terrain of human life - very complex problem with complex solutions. And the blurry line between what is medicine and what is philosophy

It's likely they have to do periodic continuing medical education courses to keep up with the latest stuff. That's been the case with the doctors I've worked with over the years. They weren't psych docs but I bet it's similar.

I'm almost done with my course of CAT and while it's been interesting I don't think it's helped as much as I'd have liked and now I'm at a loss for what to do next.

Never heard of CAT before. SOunds like its meant to be kind of a quick treatment. I like bibliotherapy and I've been enjoying this

https://www.newharbinger.com/9781886230354/feeling-better-getting-better-staying-better/

Any pharmacist up in here? Seems like an awful job

Why

I am happy to use this thread as an "ask a therapist" space anytime. I'm in Massachusetts btw

― Lavator Shemmelpennick, Thursday, 10 October 2024 15:59 (four days ago) bookmarkflaglink

Likewise, I’m in training if you want to, uh, “Ask an inexperienced therapist”

x-post - Pharmacists have to take A LOT of shit from people.

They do! My local chemist is responsible for the area’s methadone patients’ scripts and it’s both exasperating and heartbreaking for them as practitioners.

So, I had a session with my therapist today and I noticed a guitar case in her room. She’s maybe 40, very sweet and kinda soft spoken. We click really well. So at the end of the meeting we’re wrapping things up and small talking, and I ask her about the guitar.

She tells me that someone gave her the guitar and a guy across the hall from her office teaches guitar so she started taking lessons, going on about a year.

I asked her what she likes to play the most, and she pauses for a second and says “Do you know GG Allin?”

“What?!? Yes…”

“I like to play his songs. He’s kinda crude and... you know, I have to be really polite and proper here. I can let something out when I play that.”

The next session might be my last because I’ve been feeling a lot better for a while and i’m bummed that I don’t get to see her anymore. I imagine people don’t usually become buddies with their therapists, but she’s the coolest person in this town.

Ok, she rules

Now that’s a different kind of interaction. Very nice

haha that is not what i was expecting yikes

"well I'm something of a murder junkie"

would you say she's been a good *Mentor* to you? (hi-hat splash)

She’s seen some shit

I have a bass. She and I need to start a band.

From therapy sessions... to JAM SESSIONS

"kinda crude"

some of The Jabbers stuff is downright catchy

Therapy -- as written like this in the papers -- really sounds like a remarkable thing.

https://www.theguardian.com/lifeandstyle/2025/mar/29/my-patient-was-happy-with-her-partner-of-25-years-then-started-a-torrid-affair-a-psychotherapist-on-why-people