Jump to content

How to find a good therapist?


justokre

Recommended Posts

1 hour ago, wyattstorch said:

Bad Therapy, Good Therapy (And How to Tell the Difference by Michael J. Hurd
https://www.amazon.com/dp/B005EJATDU/ref=dp-kindle-redirect?_encoding=UTF8&btkr=1

A 1 star ('bad') review from 'Amuhzone':

"I'm a professor of psychology and picked up this book to consider for my incoming PhD students. Don't waste your money... [...]"

Can't help but be doubly intrigued now!

Thanks for that,

Barnsley

p.s. (good to see you back, both of 'youz')

Link to comment
Share on other sites

  • 1 month later...

I'm confused about my therapist. I am doing essentially regular talk therapy, where the therapist just asks you questions and helps you talk about whatever comes to mind at the time you're there. I've been doing it for about 3 months now and although I seem to have improved psychologically in many ways, I find it hard to determine what effect the therapy itself has actually had.

Many times I leave the session disappointed because I had many things on my mind which were bothering me, and I went there and we ended up talking about something completely off topic for the entire hour (for example my interest in linguistics in relation to history). Other times I feel like I'm just telling the therapist things which I've known and told myself over and over again over the years, and all she does is say "yeah that makes sense". She has never told me to perform any specific exercises or tasks outside of therapy. However I have started doing some things voluntarily and begun taking them more seriously. I have begun using a meditation and mindfullness program called HeadSpace, which has had surprising results on my ability to be in touch with my emotions and be able to have more freedom to choose my response rather than resorting the knee-jerk reactions. I have quit many compulsive behaviours such as mindlessly browsing social media, watching youtube videos, overeating, drinking, pornography etc. I have stepped up my dieting and exercising routines and found ways to integrate them into my life, and I'm going out and trying new things which push me to step out of my comfort zone.

So this is still early days for me yet, and I have far to go but it does seem that the practice of going there is having an effect, even if it hard to recognise how exactly. Also I am paying for it myself rather than relying on public insurance that we have here (which is a bureaucratic nightmare). It's possible that this is also driving my to want to get my moneys worth.

I hope this helps maybe know what to expect in a way or what not to expect, and I wonder if anyone had a different experience.

Link to comment
Share on other sites

Hi @sharp

Welcome to the board!

I know you didn't mean to make a contradictory statement, would you agree with me if that perhaps what you meant was: 'not enough & /, not in the way I feel/think it should be'?

2 hours ago, sharp said:

(overall)

I find it hard to determine what effect the therapy itself has actually had. 

With

2 hours ago, sharp said:

3 months now and although I seem to have improved psychologically in many ways

 +

2 hours ago, sharp said:

(11 examples) !!! 

have started doing some things voluntarily and begun taking them more seriously. I have begun using a (1)meditation and mindfullness program called HeadSpace, which has had surprising results on my ability to be in touch with my emotions and be able to have more freedom to choose my response rather than resorting the knee-jerk reactions. I have quit many compulsive behaviours such as mindlessly(2) browsing social media, (3)watching youtube videos, (4)overeating, (5)drinking, (6)pornography (7)etc. I have stepped up my(8) dieting and (9)exercising routines and found ways to integrate them into my life, and I'm(10) going out and (11)trying new things which push me to step out of my comfort zone. 

Erm... :unsure:

Um... :whistling:

11 areas of improvement,

11 aspects of your life (!!!)

according to your description. Highly contradictory self-discription in your intro, if only a few were true but I suppose they're all true.

Maybe it's just me, but that was my impression of it.

btw. I had experienced 9 of those improving for me also, more recently I've been working on the remaining 2 plus a few more... yes, awareness counts.

2 hours ago, sharp said:

Many times I leave the session disappointed because I had many things on my mind which were bothering me, and I went there and we ended up talking about something completely off topic for the entire hour

Three months is a long time (relatively). Not asking you for specifics, I'm estimating ->

that's ~24 occasions in total, ->

~24 hours; is a full day and night (1440 minutes).

If I told you that me reading out loud your post took me ~4 minutes, and that has the ratio comparatively with the time you had spent in therapy :

1   :   360

What thoughts come up for you as a result?

(yeah, I read it slowly with proper intonation and word-stress 'n all... not that:turned:)

2 hours ago, sharp said:

Also I am paying for it myself rather than relying on public insurance that we have here (which is a bureaucratic nightmare). It's possible that this is also driving my to want to get my moneys worth. 

From here, very far, only seeing a tiny slice of what might be the reality, in my honest opinion, you seem to be getting what you paid+negotiated for.

Am I greatly mistaken?

2 hours ago, sharp said:

I hope this helps maybe know what to expect in a way or what not to expect, and I wonder if anyone had a different experience. 

Having bad experience works magic in seeing value... I have had some wasted trips, pretend professionals who I quickly switched from, avoided.

Link to comment
Share on other sites

Hi barn,

Thanks for the very detailed and thoughtful reply!

My original point about not being sure how it is affecting me is that I don't know how much of the improvement could be considered as a result of the therapy vs how much could be simply me choosing to voluntarily engage in other activities which have improved my wellbeing. Many (even most?) of the changes I mentioned are things that I haven't even had a chance to discuss with my therapist yet.

The main difference seems to be that I'm taking these things more seriously than I did before. I have tried all of them at some point in the past but haven't managed to pull them together at the same time or be as persistent.

I realise that if I spend a lot of time thinking I will inevitably have thoughts that are never discussed in therapy because there simply isn't time (I'm even only doing one hour per week, rather than two as you guessed). But I find it strange that I will go in with a list of things that I think are important to discuss and end up not bringing up any of them and instead talking about something which doesn't even seem to have a link to psychological health. The interesting thing though I seem to become more sure about my own answers to some of those questions and find ways of working towards solving them without even bringing it up. 

I guess this is a kind of correlation vs causation question. I spent many years considering therapy without taking action. Now I took action it is possible that the other actions are also consequences of the same change in internal dialogue that led to finally pursuing therapy. Maybe it doesn't matter? Maybe the therapy has a symbiotic relationship with everything else I'm doing?

Link to comment
Share on other sites

25 minutes ago, sharp said:

Thanks for the very detailed and thoughtful reply!

You're welcome, you did write a proper ask in my opinion.

25 minutes ago, sharp said:

I don't know how much of the improvement could be considered as a result of the therapy vs how much could be simply me choosing to voluntarily engage in other activities which have improved my wellbeing. 

The therapy suppose to make you do more with what you have, enabling your greater potential... there are many different approaches and people are very colourful too.

Would you say that if the only thing that the therapy has achieved for you is to be more pro-active regarding your needs, would you consider that a success?

Or ,

Still a success since you started taking your needs more seriously? as in:

25 minutes ago, sharp said:

The main difference seems to be that I'm taking these things more seriously than I did before.

 

25 minutes ago, sharp said:

I realise that if I spend a lot of time thinking I will inevitably have thoughts that are never discussed in therapy because there simply isn't time

Given that you haven't tried focusing on them, (trying to say) taking the initial idea through... You can't know what would it look like, right?

25 minutes ago, sharp said:

The interesting thing though I seem to become more sure about my own answers to some of those questions and find ways of working towards solving them without even bringing it up.  

In general, that's a bit perilous since there's a chance for cognitive bias when our ideas aren't exposed to different perspectives.

i. e.

' Is this true? I dunno, looks like... It must be true then. Yeah! It's true! I was right! I am right!

...

Wha?! Why it's not working? I don't understand, but I am right... '

As long as you are looking for true ways to see things and not 'just answers', the likelihood of you improving on your 'vision' is higher. BUT that requires curiosity, being open to having sometimes inconvenient observations. It's a system, it's an ark, not a destination or a single answer... does what I'm saying (with my abstractions) make relatable sense to you?

25 minutes ago, sharp said:

I guess this is a kind of correlation vs causation question. I spent many years considering therapy without taking action. Now I took action it is possible that the other actions are also consequences of the same change in internal dialogue that led to finally pursuing therapy. Maybe it doesn't matter? Maybe the therapy has a symbiotic relationship with everything else I'm doing? 

When I say:

You set out to be in therapy, the way you wanted. You started therapy, but you haven't arrived there yet, you 'aren't in therapy' yet.

... what comes up for you?

p. s.

Edited by barn
p. s. - Sorry, 12 hours not 24 as I had mistakenly assumed. Though the ratio is still 1 :180
Link to comment
Share on other sites

Alternatively:

Say someone had to make calls to a dozen companies requesting raw materials, resources for a project. As this person approached the office, another person disconnected the outgoing phone-lines in a way that the people trying to make calls would always hear the 'occupied' tone after dialing.

What would you call the action of this individual who has disconnected the outgoing calls unbeknownst to others?

Link to comment
Share on other sites

Ok I just typed an entire response to this and then I wanted to copy/paste the name of  the original poster and I misclicked and the page changed and the whole reply was lost.... hopefully I can remember / improve upon what I wrote... but it will be harder since I am frustrated now.

21 minutes ago, barn said:

Would you say that if the only thing that the therapy has achieved for you is to be more pro-active regarding your needs, would you consider that a success?

Or ,

Still a success since you started taking your needs more seriously?

The point is that I'm not sure whether any of that is due to therapy or due to my own initiative.

22 minutes ago, barn said:

In general, that's a bit perilous since there's a chance for cognitive bias when our ideas aren't exposed to different perspectives.

i. e.

' Is this true? I dunno, looks like... It must be true then. Yeah! It's true! I was right! I am right!

...

Wha?! Why it's not working? I don't understand, but I am right... '

As long as you are looking for true ways to see things and not 'just answers', the likelihood of you improving on your 'vision' is higher. BUT that requires curiosity, being open to having sometimes inconvenient observations. It's a system, it's an ark, not a destination or a single answer... does what I'm saying (with my abstractions) make relatable sense to you?

My problem seems to be that although I am capable of seeing things from many perspectives, and reconsidering possible weaknesses and seeking out new information, I have trouble acting on it since it comes from a place of self-doubt. Ideally one would improve their knowledge inductively, in other words, have a theory, act based on the theory, and then reflect on the result and see if it matches what would be predicted. This is what I have trouble with and instead tend to spend more time reconsidering the theory using third hand knowledge. Which leads to your final point:

26 minutes ago, barn said:

You set out to be in therapy, the way you wanted. You started therapy, but you haven't arrived there yet, you 'aren't in therapy' yet.

... what comes up for you?

Perhaps this is why I am questioning the effectiveness of the therapy. My original intention is that it would force me to confront and talk about topics which I had been avoiding bringing up with friends and family, or simply acting out and reflecting on the out come as I mentioned above. However the type of therapy seems to be more self directed, so it would seem that this would put the ball in my court for directing the conversation and bringing up topics that I think are more important.

The question would then become, is there something wrong here? Perhaps this is the wrong type of therapy for me, or the wrong therapist? Or is this just a chance for me to get frustrated with continual avoidance of those topics and actually begin to teach myself how to bring them up in a safe environment?

While I was typing you also replied this:

14 minutes ago, barn said:

Alternatively:

Say someone had to make calls to a dozen companies requesting raw materials, resources for a project. As this person approached the office, another person disconnected the outgoing phone-lines in a way that the people trying to make calls would always hear the 'occupied' tone after dialing.

What would you call the action of this individual who has disconnected the outgoing calls unbeknownst to others?

He would be sabotaging the operation?

Link to comment
Share on other sites

22 minutes ago, sharp said:

Ok I just typed an entire response to this and then I wanted to copy/paste the name of  the original poster and I misclicked and the page changed and the whole reply was lost.... hopefully I can remember / improve upon what I wrote... but it will be harder since I am frustrated now. 

Yes, that is frustrating and when it happens... same here, though many times I can improve upon it even so.

Nice honesty crumb, appreciated it.

22 minutes ago, sharp said:

The point is that I'm not sure whether any of that is due to therapy or due to my own initiative. 

Why do you think it matters?

What if both?

What if either but having needed the other as an induction?

Have you considered the opposite scenario, what would have happened if you had decided not to follow up on your idea for improvement?

(Sorry for the multiplicity of questions, they are all intended at different angles.)

22 minutes ago, sharp said:

My problem seems to be that although I am capable of seeing things from many perspectives, and reconsidering possible weaknesses and seeking out new information, I have trouble acting on it since it comes from a place of self-doubt. Ideally one would improve their knowledge inductively, in other words, have a theory, act based on the theory, and then reflect on the result and see if it matches what would be predicted. This is what I have trouble with and instead tend to spend more time reconsidering the theory using third hand knowledge. Which leads to your final point: 

Am I accurately defining it as repetitive procrastination? (my 'before this' post is about this btw)

22 minutes ago, sharp said:

" force me to confront and talk about topics which I had been avoiding bringing up with friends and family, or simply acting out and reflecting on the out come "

" therapy seems to be more self directed "

" this would put the ball in my court for directing the conversation and bringing up topics that I think are more important "

"  just a chance for me to get frustrated with continual avoidance of those topics and actually begin to teach myself how to bring them up in a safe environment? " 

You have the answers laid out for you.

You're almost there, finally getting it... at least it looks like to me.

I'll add something later, depending on what you are going to answer to...

22 minutes ago, sharp said:

He would be sabotaging the operation?  (<-interrogation)

Please, you tell me why yes/no but just one possible answer.

(hopefully I'm not being perceived difficult but I want to see your input and not put words into your mouth...)

Link to comment
Share on other sites

27 minutes ago, barn said:

Why do you think it matters?

What if both?

What if either but having needed the other as an induction?

Have you considered the opposite scenario, what would have happened if you had decided not to follow up on your idea for improvement?

I think it matters because I now want to know if I've chosen the right therapist or not. If I could've had the same results without going, I could've saved money, or perhaps had even better results with a different therapist. But as I said it could be the case that it is a combination of both. All of the new changes could be reinforcing eachother and causing a general improvement. It's hard to imagine how it would be if I hadn't started therapy. At the very least I'd still be thinking about starting it and wondering what would happen if I did.

27 minutes ago, barn said:

Am I accurately defining it as repetitive procrastination? (my 'before this' post is about this btw)

Yes but mainly with regards to challenges that require confronting anxieties and fears. The problem is that just talking about those anxieties and fears is one of the things that invokes anxiety and fear, so I have gone many years without talking about it to anyone. I hoped therapy would force me to talk about them but instead I find myself in the same situation of having to confront it just to be able to even make use of the therapy at all.

Part of the issue is that I'm a very creative person so I am good at finding creative ways to distract myself or others who are trying to help me. To paint the picture to myself or others that everything is going fine. Perhaps this is what you meant by your sabotage story earlier? If not then I'm not totally sure how to respond to it.

Link to comment
Share on other sites

8 minutes ago, sharp said:

I think it matters because I now want to know if I've chosen the right therapist or not. If I could've had the same results without going, I could've saved money, or perhaps had even better results with a different therapist. But as I said it could be the case that it is a combination of both. All of the new changes could be reinforcing eachother and causing a general improvement. It's hard to imagine how it would be if I hadn't started therapy. At the very least I'd still be thinking about starting it and wondering what would happen if I did. 

Yes. I understand it much better now, thank you.

Would you choose a similar or different therapist if you were in that position?

9 minutes ago, sharp said:

Yes but mainly with regards to challenges that require confronting anxieties and fears. The problem is that just talking about those anxieties and fears is one of the things that invokes anxiety and fear, so I have gone many years without talking about it to anyone. I hoped therapy would force me to talk about them but instead I find myself in the same situation of having to confront it just to be able to even make use of the therapy at all. 

Gotcha. (as in: I understand)

I wanted to say this earlier... Force... Force is aggression, aggression creates resentment. For example, in this convo with you I can only be curious and reasonable, putting forward arguments constructively... but if I tried to use force, threat, manipulation... I'm guessing it wouldn't have gone past the first reply. I think it is counterproductive to make yourself do something that you have NOT accepted its reasoning. Understanding is NOT accepting. When you DO concede, you simply do it or don't (depending on the thing). I think by putting yourself in a situation where you are inconvenienced in order to circumvent having to argue yourself into it is rather manipulative and on the 'dark side' of things. Am I going in the right direction here?

17 minutes ago, sharp said:

Part of the issue is that I'm a very creative person so I am good at finding creative ways to distract myself or others who are trying to help me. To paint the picture to myself or others that everything is going fine. Perhaps this is what you meant by your sabotage story earlier? If not them I'm not totally sure how to respond to it. 

Ok. So I'm 90% sure that you are seeing the correlation but hesitating to 'say it out loud' (based on previous and this message extending on the same answer I was seeing present).

Do you think you are self-sabotaging?

Link to comment
Share on other sites

6 minutes ago, barn said:

Would you choose a similar or different therapist if you were in that position?

I originally wanted to try CBT because it supposedly has more consistent results. I was told in a short meeting with a staff member before starting therapy that this would be the most likely form of therapy that I would have there. I had a first "advisory appointment" with the therapist, where these kind of topics should have been determined, but in the end the whole hour was taken up by giving an overview of the problem. At the end she simply asked "so do you want to start therapy then?". And I said yes, and I was with her. It took until receiving the invoice in the mail to even see what type of therapy it was. Of course I could also have just asked.

8 minutes ago, barn said:

I wanted to say this earlier... Force... Force is aggression, aggression creates resentment. For example, in this convo with you I can only be curious and reasonable, putting forward arguments constructively... but if I tried to use force, threat, manipulation... I'm guessing it wouldn't have gone past the first reply. I think it is counterproductive to make yourself do something that you have NOT accepted its reasoning. Understanding is NOT accepting. When you DO concede, you simply do it or don't (depending on the thing). I think by putting yourself in a situation where you are inconvenienced in order to circumvent having to argue yourself into it is rather manipulative and on the 'dark side' of things. Am I going in the right direction here?

Well by force I basically meant to push. If find it much easier to do something if I am simply asked, even if the actual task is something which I find difficult. For example I have trouble with public speaking, but yesterday I went to a toastmasters event, and was called out on the spot to give a talk, so I went up and did it even though I was nervous. The initiative on my part was just going there and not finding an excuse to avoid it. But in future I would want to have the initiative to also volunteer to give a talk rather than being called on. There is still an element of "pushing" in this, because once you say "I will do it" when everyone expects you to do it and it becomes harder to back out than just to continue. In that case it was still voluntary because I specifically went there with the intention of being pushed (like asking to be pushed out of an aircraft when doing skydiving).

14 minutes ago, barn said:

Ok. So I'm 90% sure that you are seeing the correlation but hesitating to 'say it out loud' (based on previous and this message extending on the same answer I was seeing present).

Do you think you are self-sabotaging?

Yes. I guess I am still clinging to the idea of not being allowed to succeed and feeling guilt at any accomplishments I have made. This is the kind of thing I wanted to discuss in therapy.

Link to comment
Share on other sites

22 minutes ago, sharp said:
45 minutes ago, barn said:

Would you choose a similar or different therapist if you were in that position?

I originally wanted to try CBT because it supposedly has more consistent results. I was told in a short meeting with a staff member before starting therapy that this would be the most likely form of therapy that I would have there. I had a first "advisory appointment" with the therapist, where these kind of topics should have been determined, but in the end the whole hour was taken up by giving an overview of the problem. At the end she simply asked "so do you want to start therapy then?". And I said yes, and I was with her. It took until receiving the invoice in the mail to even see what type of therapy it was. Of course I could also have just asked. 

Um... Sharp?!

That's not what I asked.

(nevertheless, very interesting 'segway')

22 minutes ago, sharp said:

Well by force I basically meant to push. If find it much easier to do something if I am simply asked, even if the actual task is something which I find difficult. For example I have trouble with public speaking, but yesterday I went to a toastmasters event, and was called out on the spot to give a talk, so I went up and did it even though I was nervous. The initiative on my part was just going there and not finding an excuse to avoid it. But in future I would want to have the initiative to also volunteer to give a talk rather than being called on. There is still an element of "pushing" in this, because once you say "I will do it" when everyone expects you to do it and it becomes harder to back out than just to continue. In that case it was still voluntary because I specifically went there with the intention of being pushed (like asking to be pushed out of an aircraft when doing skydiving). 

Force, push, made to do something... basically the same. Bad.

(This is going to sound very straightforward, maybe a bit strong)

What's worse, that you are not just putting yourself into situations with which you disagree with (no agreement, avoidance prior) but you pile a big heap of anxiety on top of it and call it "it was still voluntary".

Those situations described = zero understanding (with reason&evidence ) and resentment inducing.

Basically what you did was, rationalised a form of self-abuse, inflicted by others and summarised it as 'I needed that to do what I wanted'.

... not good.

Oh, dear.

22 minutes ago, sharp said:

Yes. I guess I am still clinging to the idea of not being allowed to succeed and feeling guilt at any accomplishments I have made. This is the kind of thing I wanted to discuss in therapy.

Interestingly, I'm not getting the sense from your answer that you realise it's you (a part) who is doing the sabotaging to you.

Who would benefit from you not getting more confident, in your inner circles?

Link to comment
Share on other sites

 

Let me rephrase this

1 hour ago, barn said:

Would you choose a similar or different therapist if you were in that position? 

Knowing what you know now, would you choose a similar or a different therapist?

(and this, extended)

27 minutes ago, barn said:

Interestingly, I'm not getting the sense from your answer that you realise it's you (a part) who is doing the sabotaging to you.

Who would benefit from you not getting more confident, in your inner circles? 

Why do you think you have learnt to self-sabotage in the first place?

Edited by barn
typo
Link to comment
Share on other sites

×
×
  • Create New...

Important Information

By using this site, you agree to our Terms of Use.