If you've tried therapy, was it worth the $$$?

[+ FreshFluff]

How I thought it was going to be:

 

Actual me:

Edited March 7, 2018 by FreshFluff

[Rudynate]

I see a psychiatrist for meds. He’s excellent. But I have had a bit of conversation with him which borderd on psychoanalysis. He’s not good at it. I doubt he’s had proper training in that area.

 

Aren't those guys called psychopharmacologists?

[+ OliverSaks]

Aren't those guys called psychopharmacologists?

I think it is pretty much interchangeable / an older term that is being replaced.

 

“A psychopharmacologist is a psychiatrist who specializes in medication management. It is a self-applied label, as there is no special credential or license for this. All psychiatrists are qualified to prescribe medication.”

[Rudynate]

I think it is pretty much interchangeable / an older term that is being replaced.

 

“A psychopharmacologist is a psychiatrist who specializes in medication management. It is a self-applied label, as there is no special credential or license for this. All psychiatrists are qualified to prescribe medication.”

 

 

But some specialize in it. If I were going to take psychoactive drugs long-term, I think I would want the therapy managed by a specialist.

[+ OliverSaks]

But some specialize in it. If I were going to take psychoactive drugs long-term, I think I would want the therapy managed by a specialist.

Nearly everyone training to be a psychiatrist for the last 20 years is a psychopharmacologist. The field emphasizes medicine to treat psychiatric illness (which I have pretty strong feelings about...)

 

I wouldn’t go to an old-school, east coast psychoanalyst for my medication needs probably, but the majority of psychiatrists you find ARE absolutely specialists in psychopharmacology and capable of prescribing psychoactive drugs long term.

[+ FreshFluff]

I wouldn’t go to an old-school, east coast psychoanalyst for my medication needs probably, but the majority of psychiatrists you find ARE absolutely specialists in psychopharmacology and capable of prescribing psychoactive drugs long term.

 

Yep, almost all psychiatrists are trained to do psychopharmacology and then do additional analysis training

[LivingnLA]

In my jaded life experience, I've found that many fans of psychoanalysis are psychoanalysts because it's a great way to get regular patients on the couch for years on end. While I love discussing the theories, particularly Jung, Fromm, and Horney, in my personal experience and education, I find them not to be very effective at helping without many years of work. They can be powerful for helping someone understand themselves, but that's frequently not why people tend to seek counseling/therapy.

 

As I've said in many posts, I believe in personal responsibility, which is part of why I prefer client (active) versus patient (passive) in these contexts. It also means I prefer the more "active" therapies that have documented efficacy, limited though that research may be. For example, CBT (Cognitive Behavioral Therapy), IPT (Interpersonal Psychotherapy), DBT (Dialectical Behavior Therapy), and ACT (Acceptance and Commitment Therapy) have all been incredibly helpful for many people because they are very focused on the client's cognitive and emotional habits/practices/patterns and effective ways to change them.

Edited March 8, 2018 by LivingnLA

[Golem]

Note that the aforementioned "documented efficacy" -- while real -- is generally only empirically documented in very specific areas: for example, using CBT to treat specific phobias. This is not meant to be a negative thing about any of those therapies, all of which I think are valuable. But you can find just as many people who've been helped by less directive therapies as well, not to mention therapists with eclectic styles. And no approach works for everyone. What matters is finding an approach (and a practitioner) that is a good fit for you and your needs.

 

To that end, I think it is ill-informed, at least, to broadly attack any school of therapy or analysis that has clearly been helpful to some patients. "The primary fans of approach X are its practitioners" could be said about nearly any of them, certainly including CBT, DBT, and the like. But I think it's unfair to accuse any of these approaches of being used by its practitioners so cynically, "just to get patients." This is extra true of classical analysts who see their analysands 4-5 times weekly -- the quantity of appointments often means they have to charge significantly less for their time than comparably credentialed psychotherapists do, if they want a full schedule.

[+ FreshFluff]

 

No one except Walker1 thinks I'm cute when I'm attracted?

[+ FreshFluff]

To that end, I think it is ill-informed, at least, to broadly attack any school of therapy or analysis that has clearly been helpful to some patients. "The primary fans of approach X are its practitioners" could be said about nearly any of them, certainly including CBT, DBT, and the like. But I think it's unfair to accuse any of these approaches of being used by its practitioners so cynically, "just to get patients." This is extra true of classical analysts who see their analysands 4-5 times weekly -- the quantity of appointments often means they have to charge significantly less for their time than comparably credentialed psychotherapists do, if they want a full schedule.

 

Does anyone today see an analyst 4-5 times a week?? BTW, I haven't done a survey, but my feeling is that a lot of therapists use a hodgepodge of techniques--some psychotherapy here, some CBT there.

 

The most disturbing aspect of old-school therapy is idea that the therapist has to be tabula rasa. The problem is that, like everyone else, therapist end up giving away more about themselves than they intend to. Those revaluations take on more significance than they should just because no other information is available.

[+ Kman]

Funny this thread popped up again, I was just thinking about going back to see someone...my last guy retired so I may go to him if he has any recommendations. As far as I remember I don't think I ever saw an actual psychiatrist, only psychologists. Would it be helpful to see a psychiatrist even if I have never taken anything psychopharmacological?

[+ FreshFluff]

Funny this thread popped up again, I was just thinking about going back to see someone...my last guy retired so I may go to him if he has any recommendations. As far as I remember I don't think I ever saw an actual psychiatrist, only psychologists. Would it be helpful to see a psychiatrist even if I have never taken anything psychopharmacological?

 

The most important factor is the therapist's skill and how well you work with him. The degree is less important, especially if you don't need meds. Also, keep in mind that MDs are more expensive.

[LivingnLA]

What matters is finding an approach (and a practitioner) that is a good fit for you and your needs.

 

Very true and well said.

[rvwnsd]

How I thought it was going to be:

 

Actual me:

You thought you would turn into a man?

[Golem]

Does anyone today see an analyst 4-5 times a week??

Not many people, but it does happen. It's a big time commitment. On the other hand, spending 50 minutes each week talking about the, give or take, 6720 minutes you are awake that week, building up your understanding, therapeutic relationship, etc... it's not that much. Some time for thoughts to percolate between sessions is one thing, but there is zero question to me that the standard one-session-a-week model is the result of other influences (like the generally busy character of American culture, and insurance companies) rather than any concept of best practices. Two sessions are IMO a better standard.

 

BTW, I haven't done a survey, but my feeling is that a lot of therapists use a hodgepodge of techniques--some psychotherapy here, some CBT there.

Yeah. It's overwhelmingly what psychotherapists state, when asked what their theoretical orientation is.

 

The most disturbing aspect of old-school therapy is idea that the therapist has to be tabula rasa. The problem is that, like everyone else, therapist end up giving away more about themselves than they intend to. Those revaluations take on more significance than they should just because no other information is available.

I agree, though I would call it frustrating more than disturbing. The therapeutic relationship is pretty central for me. But there are people it works for. And there are analysts who take their classical training and apply it to relational psychotherapy.

[mentalkink]

I disagree with everyone who says it's not worth the money. When I was in my mid 20s I had major depression and combination of cognitive therapy and antidepressants helped me get to the other side. Without the cognitive therapy I would never understood why I had that inner voice telling me how worthless I was and what was causing it. The therapy helped me face my demons. Now days your primary care physician will put you antidepressants without even a psyc consult. I think that is why we see so many suicides of people on antidepressants because they are not getting the therapy. The two go hand in hand in depression treatment.

[+ FreshFluff]

I agree, though I would call it frustrating more than disturbing. The therapeutic relationship is pretty central for me. But there are people it works for. And there are analysts who take their classical training and apply it to relational psychotherapy.

 

Yes, "frustrating" is a better word. When you talk about the therapeutic relationship, it sounds like you're talking about something that involves more two-way communication than traditional analysis.

Edited March 8, 2018 by FreshFluff

[gallahadesquire]

The nice thing about CBT is that it leaves you with tools to deal with further setbacks in life.

[+ FreshFluff]

BTW, when I talk about revealing things about themselves, I'm thinking of something like this. Let's say this occurs after the client was away for a while and had to reschedule an appt.

 

Client: I have a bit of a Groucho Marx complex when it comes to interacting with people.

Therapist: Does that apply to me?

Client: ???

Therapist: [Apparently realizes how insecure he sounds and tries to rephrase it.] I mean, do you tend to reject, uh, institutions that are willing to have you?

Edited March 8, 2018 by FreshFluff

[LADoug1]

Aren't those guys called psychopharmacologists?

 

If he only did meds I’d say yes but he also sees clients for psychoanalysis so that’s why I refer to him a psychiatrist.

[LADoug1]

The nice thing about CBT is that it leaves you with tools to deal with further setbacks in life.

 

 

+1,000

[samhexum]

[samhexum]

 

[+ Gar1eth]

Just quit a counselor that employed CBT (and I don’t mean cock-ball-torture). It just wasn’t for me. And come to think of it, neither is cock-ball-torture.

 

Gman

[samhexum]