define 'fine' therapy/ psychiatry

[write]

I've only skimmed the other thread but I do think getting the right therapist/ psychiatrist is so important. It's an individual thing. That can mean trying several and learning loads about the subjects yourself and feeling able to choose.

It also depends on the access: in Britain on the NHS for example you'd wait months and most likely get one or two appointments with a psychiatrist or psychologist, then counselling from a psychiatric nurse. Here in US the facilities are much more available but at a price- nh's costs $170 45 mins; out of many price ranges.

I regularly refer to the REBT site now I can only afford irregular therapy sessions, especially those times I slip back into a negative frame of mind about everything which happened.

[Anonymous]

Write,
Good idea on starting a new thread. The old one became a bit of a shambles. Sorry if I contributed to that.
mudpuppy

[Anonymous]

In my experience all therapists are disappointing. I generally have a negative transference to them and don't go through the "idealizing" stage as many people do. With that said, I'm going to stay in therapy as long as my insurance holds out. I need to be in therapy and I'm going to see a therapist. I also need meds. What I ask for is someone who knows about object relations and anti-depressants. And they need to tolerate a negative transference.

bunny

[mum]

I have had good and bad therapists.  Bad for me was one who immediately told me, verbatim, what my husband told her about the demise of our marriage ("she left me out, I just had to have affairs").  I fired her on the spot, after telling her "my side"....her jaw was open when I left.

What I have noticed about "traditional" phsycotherapist I have had, even my latest, most beloved, is that they do allow a lot of negativity to pour forth (I had a lot) but when it came to real coping, there was never enough time to talk about strategies.  This might be because every week was a long update, BECAUSE I was in crisis and there were new attacks and developments all the time.  I don't fault her, she is great, but the focus was always on how BAD things are.  I would leave her relieved and understood, but no better at handling pain than before, so when it came back up again (sometimes within minutes) I was right back at square one ("MY LIFE SUCKS" etc).  She was great at validating that I was in an unjust situation....but hey, anybody who knows my story knows that.

I started working with someone else who definately ACKNOWLEDGES how bad things are, but chooses to focus on moving through that to embrace possibility, not limitations.  It has been FAR more work, internally, but I am actually changing inside.  I have learned that stepping OUT of my story and life situation has enabled me to CHOOSE how I feel, rather than leaving it up to (horrible) circumstances.

So now, today, I am actively practicing...ex just dumped another doozy on me.  But now that I am different, his negative energy is heading back to him....boy is he in for it!!!

[Anonymous]

My idea of a good therapist is:

Someone who listens intently, acknowledges thoughts and feelings well, is able to empathize and summarize, who validates and encourages, who helps me to see my choices.....but who doesn't make those choices for me, or insert thier own personal feelings into my situation.

I've been badly taumatized by one therapist, stood up gallantly to one who was wayyyyy out of line, (who like yours...ended up looking like one of those clown faces at an amusement park, with a hole for the mouth  ...you know...the hole you have to try to throw the bean bag through??), and I was blessed to find a couple of others, who were really excellent, having the skills listed above and the patience to use them.

If you ask me, they can be immensely helpful, or they can make matters much worse.

GFN

[Anonymous]

I generally have a negative transference to them and don't go through the "idealizing" stage as many people do.

Bunny, do you mind me asking....what is negative transference?  Does it mean you tend to take on their emotions?

Also....what happens in the "idealizing" stage?  I have no idea what that is.

Thanks for explaining, if you feel like it.

GFN

[Anonymous]

what is negative transference?  Does it mean you tend to take on their emotions?

Also....what happens in the "idealizing" stage?  I have no idea what that is.

Negative transference is a fancy term for feeling negatively toward the therapist due to my early interactions -- the therapist is in reality benevolent and not doing anything so terrible. But I find reasons to devalue him, criticize him, and feel disappointed. I tell him all the things I dislike about him. I think he understands this as a negative transference, and the hope is that he understands what my childhood was like, and what my internal harsh parents are like.

Some therapy patients at first idealize their therapist and think the therapist can do no wrong, is incredibly wise, perceptive, the kindest person, the most empathic, etc. This stage inevitably results in disappointment. I just skip right to the disappointment.

bunny

[October]

in Britain on the NHS for example you'd wait months and most likely get one or two appointments with a psychiatrist or psychologist, then counselling from a psychiatric nurse.

At present I have a psychiatrist on the NHS who is mainly there to prescribe stuff, and because I am not interested in taking the stuff he prescribes, he is not too bothered whether he sees me or not.    

Also, I have a therapist (but not for much longer   ) who is a clinical psychologist, and who is using cognitive behavioural therapy.  But this is rare.  In my area in terms of mental health provision there is level one, which is crisis care, and level two, which is short term (6 or 12 weeks max) care, but no provision at level three, which is long term care, apart from for eating disorders.  I don't have an eating disorder but I have a therapist 'borrowed' from that area to provide for me.  As far as I know this is a one off situation.  I have had I think about six months therapy, and it is now closing, way before I am ready   .  God knows what other people get.

Other counsellors I have had, either on the NHS or privately (before my money ran out!!) have been a very mixed bag, and not much use, on the whole.

One counsellor - not NHS, but church based - confused the relationship and ended up using me as his counsellor.  My story resonated with his, to the point where he told me of his childhood abuse, in great detail.  Very bad experience.  Did me a lot of harm.

One rather better (NHS again) counsellor took what he called a humanist approach, and that was useful in validating who I was, and how I approached life and its problems.  Perhaps on the whole that was the most useful of all, to be honest.  The CBT is challenging, and if it carries on long enough has the potential to achieve the most long term real change.  Trouble is, it probably won't, and a short term course is not enough.

Another approach I have come across is systems theory, and that was terrible.  Pushed me towards a nervous breakdown, and did me a lot of harm.  Terrible.  Never want anything like that again.

Very mixed experiences.  In summary, my experience is that if something goes wrong, there is only me to realise it, because the t often won't know what is happening until way after the damage is done.  Bad t does a lot of harm.  Better no t at all than the bad kind.

[October]

I just skip right to the disappointment.

I don't know if you are like me, Bunny, but I keep my expectations right down there on the floor, to save being let down or disappointed.

And then they still manage to let me down and leave me disappointed.  

[Anonymous]

Thanks Bunny:

I guess I did the opposite, in a way.  I finally learned to keep my expectations high (once I realized it's ok for me to do that), and when a therapist did not behave professionally, or if I felt like there was some  harm happening, I skipped being disappointed and high-tailed it outta there!  Or at least...I finally did that, after the first couple of really unsatisfactory therapists.

Therapists are people too and I know I have to understand that they are only human but.......and it's a big but......they are acting in a professional position....they are obligated to act professionally.....they are being paid to do that.....and they are in a great position of power over their clients...so they best do their job reasonably well.....or I'm a gonner!

Because as October says:  

Better no t at all than the bad kind.

GFN

[Anonymous]

GFN,

I don't think you understood what I was saying. A negative transference is about me, not the therapist.

bunny

[Anonymous]

Hi Bunny:

I think I understand about the transference.  It was this:

Some therapy patients at first idealize their therapist and think the therapist can do no wrong, is incredibly wise, perceptive, the kindest person, the most empathic, etc. This stage inevitably results in disappointment. I just skip right to the disappointment.

re idealization, that I think I was actually thinking about.

Either way....I give you very much praise for continuing to go....regardless of your disappointment.  I'm not sure I could do that.  I'm too demanding.  I require their empathy and their perception, wisdom, etc.  I don't expect them to be perfect but I do expect them to be professional and I guess I've just had a couple of poor experiences (but the good ones made up for it!!!).

Gotta go get dinner ready now.  Thanks again for the info.

GFN

[serena]

I am unbelievably lucky in that my GP (in the UK) recommended me as a 'charity' case to a psychotherapist.  His normal charges would have been £80.00 per hour and he took me on at £5.00..... this went on for nine years and three times a year.  He was my angel...  I don't know if such a system exists in the US?

[Anonymous]

I am unbelievably lucky in that my GP (in the UK) recommended me as a 'charity' case to a psychotherapist.  His normal charges would have been £80.00 per hour and he took me on at £5.00..... this went on for nine years and three times a year.  He was my angel...  I don't know if such a system exists in the US?

Should've been three times a week!

[Anonymous]

Either way....I give you very much praise for continuing to go....regardless of your disappointment.  I'm not sure I could do that.  I'm too demanding.  I require their empathy and their perception, wisdom, etc.  I don't expect them to be perfect but I do expect them to be professional and I guess I've just had a couple of poor experiences (but the good ones made up for it!!!).

I still don't think you understand. My disappointment pre-dates ever meeting the therapist. I am projecting onto the therapist. That's a transference. You may think I'm literally talking about the therapist's actual behavior. I'm not.

anyway, have a nice dinner.

bunny