Therapy - at a loss
 

i have a problem with therapy. i don't know if it's my tdoc's style (behavioral "approach" but not CBT strictly) or what. i have several lamentations on the subject.

• big picture. i say i want to look at a big picture and he wants to take it a bit at a time. i think we've had 8 years to look at many bits and examples to refer to. he says they are different. i say they are examples of a pattern i saw long before. i need help with the pattern, not with getting out of an individual instance. sure, getting out in general can be a good thing to learn, but since i create the pattern. i also need to learn to create different (healthier), not keep repeating the same crap where i need emergency meds and emergency escape routes to escape my own prisons after i make them.
  .
• feelings vs. behaviors. i want to work on how i feel about things rather than how i deal with a situation. for instance, i can "deal" with my teasing coworkers... i figure ignoring them will scoot them along to something more interesting. it took us 3/4 session to get here. i still have NO idea what to do about the FEELINGS that are evoked when these ppl tease. the feelings are about ME not about them, and my behavior towards THEM does control MY feelings. i got teased a lot and never ever learned, internally, to deal with it. INTERNALLY.
  .
• lack of continuity between sessions... to my knowledge docs here don't keep files, not even medical. the pts do. that includes xrays, labs etc, everything. so if you think your doc will need your history you gotta lug it all with you. it has good and bad sides. bad is, the docs can lose sight of critical info very easily. this GP rx'd a macrolide antibio first thing when i got here. i was on carbamazapine AND had informed him. had my pdoc in the US not warned me explicitly, i would have taken his stupid antibio and landed in ER or worse - the morg. Welcome to the Olde Worlde. this is how things are done.

those are the big ones. i've tried to resolve the last one myself but other than a few times i seem to go blank. i used to write things on paper till i became afraid of the papers being lost/found. things never got covered anyway... it wasn't working.

~~~~~~~~~~~~~~~

i've had my T/pdoc (same person) for about 8 years now. i like to think he knows me. he is certainly a good guy. he saw me free for 4 of those years because i was broke. i had some issue with this as a boundary violation (i felt and still feel an obligation to continue with him). i did not tell him that because otherwise at the time i was without T or pdoc.

i am not displeased (nor impressed) in terms of his pharmacological management. he is flexible and listens to me so if i prefer one med to another or prefer to try a lower dose etc. also he prefers to lean on the side of caution in terms of adding meds, he's not huge on cocktails though he'll use them, once shown that a single med fails. again on same page as me.

one thing that never fails to freak me out is when i ask for a med report (list) for bureaucratic purposes he asks me to dictate... or he'll say remind me what you're taking again... :eek: ????

however pdoc helps me if i need tests scripted through my GP (state) and GP is giving me a hard time. if he thinks the tests are reasonable of course. faced with a request from a specialist, the GP cannot refuse. whereas if i am the requester, not only can GP refuse, but he can get all huffy and puffy about it.

the way i see my pdoc now is via private therapy, with the meds folded in. he practices as pdoc-only in 2 clinics near where i lived before having to crawl back to the folks - too far to juggle with work.

SO if i got a new T, i think i'd have to get a new psychiatrist too and lose him completely. :( unless i didn't tell him and saw both - which i CANNOTTTT afford.

i get attached to people (things, too!) so i can't imagine changing ... and possibly ending up with ... well, not better, for sure. then again i don't feel like the therapy is particularly therapeutic.... :o:rolleyes:

~~~~~~~~~~~~
thank you for reading. sorry for the usual longwindedness... when i write these i always think with admiration of Bizi's short 'n' sweet posts.

~ waves ~ confused

Dearest waves, I love reading the in depth stories that you tell. You give us important information and some in-between knowledge as well.
My posts are generally short if I am not running hypo manic or am not caught up in a narcisitic stage because I really am not well versed in information....It is easy to post a hug or a kiss to let some one know that I am thinking of them.
having said all of this....
how do you feel about this?
Do you want to get another therapist or can you "change " your current tdoc/pdoc?
bizi

Waves

I have to say, I would hate it if you didn't post all these nice long threads.
s.

:grouphug:
I learn so much when you do.

I too wait on your thought

Dear Waves,
One option is to find a DBT group that would be an alternative to the current doc. You could find some workbooks and audios.

Can you take a 4 month break from him to try someone else? You agree with him that the forth month is temporary?

Find out if this is true. Can you keep the pharmacological management guy and find someone else (not permanent) for talk therapy about feelings.

I remember reading years ago that finding a good therapist can be harder than finding a good friend. Considering finding a new therapist requires instense dissatisfaction at the status quo., willingness to deal with change, and trust in onself that one can make the right decisions.
You can change when you are ready. Take your time.

M.

Waves

I believe that Mari has some very good ideas.

I would like you to see about these options.

I really do believe it about finding a good therapist before a good friend
at times.

But honestly what would I know I don't have either right now.

Sometimes I wish I had both.


I have a hard time making friends. Its from my childhood, and I can totally
understand that. Its so different here, making friends.

They don't just go find a new one and leave old ones to the side.

Donna:grouphug:

i agree donna, it is hard making friends. the last new friend I made was when I took an art class and we were sitting next to each other and we started talking....we sometimes get together and always enjoy her company, we used to chat on face book but then she stopped coming on line at night when I was on line.
Putting yourself in a new situation is a great way to meet new people...it is hard putting yourself out there.
bizi

Thanks Bizi.
i don't think i can "change" anything more than minimal aspects, but when i have tried to address the 3 "big" areas i brought up in my first post i have not succeeded - and it's been a long time trying.

i've often put to myself, if it hadn't been for the money thing, would i have left already? of course conscience and sense of debt prevents me from even entertaining that notion for too long.

LOL :hug: thank you, Donna! You're such a sweetie. :)

i'm looking but not finding. aside from finding groups that are not near me, most are inpatient or require a Borderline Personality dx. I would like someone i could just have as a therapist, who could teach me to improve, say, stress tolerance, for starters - one of the basic elements used in DBT. THAT ONE THING would help me a lot.

i wonder if i can find someone specializing in DBT who ALSO takes other patients... so i could benefit from some of the DBT aspects without doing the full-blown thing. There just doesn't seem to be much DBT here. It kinda surprises me. It's not that new at this point. Maybe i'm not looking in the right places. Or maybe it is still very much in the private sector and i don't have visibility ... you have to know someone who knows someone...

i've taken a break before. but it was like 5 weeks. a sudden 4 month break - and TELL him i am therapist-shopping??? :(:( i don't think i could do that, no. it would be mega-WEIRD. i could try something like saying i only want to do 1ce a month, and then see a different one once a month... until i figure out what's what... then maybe by the time i'm 90 i'll find someone??? :p:eek::cool::D

problem is the only person i can ask is my pdoc. this reveals that i am wishing to leave/unhappy with therapy. perhaps that would be a good thing to reveal. but not the part about looking around... :o:eek:

i guess i fail a prereq's huh. and then there's the letting go bit which is a personal prereq that i fail with flying colors. but assuming i passed all prereqs with flying colors, i don't know how to go about looking.
I may never be ready, just like i never would have been ready to start working again. furthermore i found previous writings similar to this post .... one dates back to 2005 - i am certainly taking my time... i daresay too much of it.

sometimes they take a trip across the ocean they don't want to take, thinking they're coming back. and then the world turns around and says, sorry, not today, not tomorrow. and then the friends drift away... move from phone to e-contact to nothing at all. and i think in our age bracket it is hard to make new friends. i am so grateful i have you guys. :grouphug:

thank you all so much for your replies. :) So much food for thought. i am thinking how i can do part of this or a little of that... i am thinking. thank you. and any more innovative ideas welcome.

:grouphug:

~ waves ~

Waves,

You are right in thinking that DBT likely exists near you.
You have not yet found how to ask the right questions of the right people.

I don't think that my tdoc was formally trained in DBT. But she does a lot with mindfulness. If someone asked her if she does DBT, would probably say "no." If you asked her to do the following that you list, she could do most of i.

ONe thought I have is that your doc is not exactly doing CBT. Maybe you can look for a CBT person.
Here is a link for CBT:
http://www.rcpsych.ac.uk/mentalhealt...ments/cbt.aspx

Most of what you describe in your last two posts are exactly what Cognitive Behavioral Therapy does.

M

Dear Mari,

yes i will have to be more specific perhaps in the way i pose questions to ppl i interview. if i manage to do this it will be shots in the dark beyond what i can et through the phone.

i just realized a typo in one of those parts that you highlighted, thought i better correct it - i'm missing a 'not' - inserted in red.

"i still have NO idea what to do about the FEELINGS that are evoked when these ppl tease. the feelings are about ME not about them, and my behavior towards THEM does NOT control MY feelings."

in the uncorrected form it may have misled to think that i believe my behavior towards others then feeds back into how i feel. that is not what i meant to say. i meant to say, while on the one hand i can perhaps handle the social (external) aspects in a useful way, that is not true of the feelings (internal).

CBT is basically behaviorist theory applied to humans, channelling through the thought process. it holds that feelings are the result of thoughts. i think this can be true in some cases (and CBT is useful applied to those) but not all.

i think sometimes feelings are produced in other ways, emerge spontaneously. sometimes the problem is not the quality of feeling, but the intensity. managing feelings in real time is something i need to learn. i believe this skill is distinct from analysis of feelings, and necessary regardless of their "cause" if any.

thank you for helping me to think these things through.

~ waves ~

i believe in being thin skinned
love
bobby

Oh Bobby you crack me up!!! :D:D:D

love

~ waves ~

trying to find the path....
 

Oh, waves, you are digging deep and asking hard questions. Lots of levels (& valleys) to this stuff.

Behaviour-based therapy I know, that's what I studied decades ago & I didn't much like it then. Pavlov never saw a big picture. Some of those guys had a handle on patterns tho. I used to work with a Jungian therapist & think it worked for me. There are Jungian groups around that study various aspects & when I was able to work both with one of those & my therapist, I think I made more progress than with therapy alone. I'm one of those people who ran out of school long before I ran out of questions :confused:; so when I find someone like that, we pursue some common interest. It sounds as if you might have worked with some such groups.

Do you know Jung's work? It focuses on a person's inner world. Dream work figures in, & of course feelings. The big picture. Goals.

One of the things you said that hit me hardest was that you didn't think your therapy was particularly therapeutic. Maybe the therapy has become a social occasion? If it's not therapeutic, sounds like you need to get therapy. If you want to continue with your tdoc, fine, just don't call it therapy. Is that too harsh or outright mean? I hope not. From what you said, it seems logical.

Mari has good ideas. I'm curious what you think of those.

As for stress tolerance, my "I'll go to work for 30 mins" trick I learned from a behaviourist I studied with for a while. I was able to tolerate a few minutes of a very narrow narrow range of people/events/activities but did learn slowly to expand those into a longer period that allowed me to have more "normal" experiences. I have to make the right choices for it to work. I have to be able to. Meds & general health figure big there.:rolleyes:

God it's complicated. :eek:

I still work with the group but the doc left the area. Can't afford the other Jungians. Tried several nonJ tdocs but couldn't say they helped at all. Need help.

Keep the faith ~waves~ -- faith in the journey, faith in finally asking the right question...which is inevitable if you just keep asking! :D :hug:

therapists...friends...blessings
 

My psych prof used to say that she got her degree so as to latch onto a best friend who would make ever needing a therapist unnecessary. Sounds a little crazy for a psychologist maybe. I've had TWO grand friends in this life! :D Don't guess there's much better. Hmm... Only one grand therapist. :(:(
One of the friend's still here!
& I've found y'all :grouphug:

Dear Waves,


I understand you here . . . . .Despite all the zillion coping skills and ways of dealing with the problem of the teasing (for example), your feelings are evoked and you want these feelings worked out in therapy.

In 2011, most therapists can deal with the feelings issue whether or not they are CBT or DBT. Many therapists can use mixed orientations / frames.


My first psychologist in the late 80s was a CBT guy, but he was only months out of school when I met him. By the end of our first or second year together, his method had morphed and continued to morph as we worked with each other and as he grew as a therapist.

M.

Dear JudeLauren,

That is one creepy psych prof :eek: Yuck.

The Jung stuff could be very helpful to deal with feelings. I wish I had a chance to do something like that.
I had a friend who was a social worker. She liked a Gestalt therapist she had. At that particular time in her life, she liked the Gestalt stuff.

M.

I really miss having what I would call real friends. Someone to do something
with.

I hate to admit it. But the only real friends I have are people I work with,
or my family. So when I lose them by they quit working with me.
Or they aren't part of my family anymore. Then I'm at a lose.

I have always had this problem. So its so hard for me.

Thats one reason I enjoy this place so much, and sometimes wish we
were closer together. To get together once in a while.

But then maybe I still wouldn't have friends. its always been this way it
seems.

Donna

Having friends takes time, & so much of your time has been spent dealing with kids, hasn't it, Donna? That's what I've heard from moms, that they miss adult friends. I think maybe that's why so many work, to "have it all." I'm not sure we can.
Maybe friends have to be a priority, chosen over something else.
So how to get friends...
I'm impossibly shy. I am sometimes able to see shyness in another & try to connect with that. Maybe there is someone in your neighborhood you have something in common with?
Life is so hard.:hug::hug:
This is a great place, huh?--wish you could drop by for a virtual bar-b-que!
Ive got 1 good friend, a few good acquaintances. They help. :hug:
You're a really good woman.