A Relationships with Good Therapist and Bad Therapist


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justme27 is offline justme27 Post #1  December 17,2009, 7:24am
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There isn't mental health section on here, so I thought I'd post this in the relationship section because therapy is a relationship. The point here is to help people seek therapy, especially those who grew up in a generation where there was a stigma attached to it. However having seen various therapists over the course of my life, I have had good therapists and bad therapists--mostly good but one in particular was bad. I'll share my own story but please do not share to hesitate yours. The point ultimately, is that if you do decide to seek therapy you maximize your experience by identifying qualities of what make a therapist a good therapist. This is just my opinion from experience and I'm not an expert but again I encourage everyone to share there own.

1. Is aware of the limitations of therapy and works with psychiatrists: I would be wary of a therapist who is reluctant to refer to a psychiatrist or believes that there therapy alone will see immediate results. Reality is, it may take months to years for coping strategies to sink in. Consequently, a therapist should make psychiatry an option at the outset. While medication alone is not the solution there is no need to suffer until you can finally pull through a situation. Also, it could be the case that what is going on is actually biochemical and if that is the case therapy will only be able to help you manage it and medication should be the priority. A good therapist will distinguish between the two and guide you appropriately.

While there are many more things to look for in a therapist, I'll leave it at that to see if this thread generates interest and to see if anyone else can share their experience.

Hope this helps!
 
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Sassafras54 is offline Sassafras54 — Advice Official Moderator Post #2  December 17,2009, 7:27am
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Justme, how did you know the one therapist you were seeing was bad? I think that can be very hard for people to spot while they're wrapped up in the process.
 
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Nanette is offline Nanette Post #3  December 17,2009, 7:35am
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wrote :
Also, it could be the case that what is going on is actually biochemical and if that is the case therapy will only be able to help you manage it and medication should be the priority.
i'm not an expert nor have i ever been on any medication (except antibiotics) but shouldnt medication be the last resort?

doesnt it change your brain biochemically, as in mess it up to a certain extent? i think medicating people is taken far too lightly these days and it seems like its done at the drop of a hat. somethings not right with that
 
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justme27 is offline justme27 Post #4  December 17,2009, 7:47am
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That's a good question. The one therapist was bad for several reasons:
1. He he had too many reservations regarding psychiatry. I was clearly suffering from depression but instead of referring me to a psychiatrist he expected me to come in and see him every week and try to do it without the medication. Subsequent therapists, indicated that psychiatry should have been the first option while I was still learning to grasp coping skills.

2. He was more interested in listening then he was in guiding. I do believe the misconception regarding therapy is that you sit on a couch and talk and all the person does is listen. Not the case, everything you state should be met with feedback, or a challenge, or a strategy. Reason being is because you are not perceiving correctly while by definition his or her perception should be clear. So while he or she should listen, what is more important is that they are identifying where your perception is distorted.

3. He took my side way too often. A good therapist will generally give your friends and loved ones the benefit of the doubt and find out where you are distorting the relationship. The only situation is when there is outright abuse. However, the beauty of therapy is that you come to realize that the majority of the world is not abusive by nature.

4. We did not share similar values. In retrospect while I am moderate, he was too liberal for my needs. Consequently, there was a little bit of imposition of values that I did not appreciate. Like all relationships it is important that values are in line.

5. He did not practice a form of therapy that I found was beneficial for me. What has worked for me is Cognitive Behavioral Therapy. There are different forms of therapy and CBT is inline with my values because it is a very scientific and analytical process. He was more of an emotion based therapy and while I may need that at some point in the future, that is not what I need then.


Does this help or is there some more clarity necessary? There are more reasons but these are the top five I can think of at the moment.
 
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justme27 is offline justme27 Post #5  December 17,2009, 8:21am
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Nanette wrote :
i'm not an expert nor have i ever been on any medication (except antibiotics) but shouldnt medication be the last resort?

doesnt it change your brain biochemically, as in mess it up to a certain extent? i think medicating people is taken far too lightly these days and it seems like its done at the drop of a hat. somethings not right with that
Nanette thanks for posting in this thread. I think in general when people refer to over medication, they are referring to the instance of children and learning disabilities. I was never medicated as a child, I sought therapy as an adult, so I'm not certain how I feel about the argument.

As an adult, my humble opinion, is that medication should not be the last nor the only option. Meaning a good therapist will determine whether what you are feeling is situational or biochemical. This determination has to be made withing a reasonable amount of time to minimize needless suffering and needless medication. If the situation is biochemical such as hereditary anxiety, depression, bipolar...etc then medication should play the primary role in treatment (do you know why?). If the circumstances are situational, then it depends on the gravity of the situation. Loss of loved one, unemployment...etc. are all things that can cause a depression. Depending on how severely an individual is handling it, the psychologist should make a determination again whether medication is necessary within a reasonable amount of time. People are different and some people were raised with better coping skills then others. So for some people, medication may not be necessary. However, the psychologist should evaluate coping skills as soon as possible to determine whether medication is necessary.

Finally, medication should not be the only option. Meaning that you go to your general practitioner and tell him you are feeling down and he automatically prescribes medication without a referral to a psychologist or a psychiatrist.

Does this make sense? Is there anything that is unclear? Again this is just my experience and hopefully others will share there own.
 
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Sassafras54 is offline Sassafras54 — Advice Official Moderator Post #6  December 17,2009, 8:21am
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Those are all good reasons ... I'm wondering if you became aware of them while you were working with him, and quit, or did you quit for whatever reason, and in retrospect you realized he hadn't worked well with you?

I think people have a lot of hope about therapy, and they get attached to their therapist, and they're in uncharted territory, and so it can be difficult to see, while they're working with someone, that it's not going well or there are problems needing to be brought up.

Your point about his approach being the wrong one for you is particularly good ... there are lots of types of therapy (and therapists) and some pairings work better than others. You could have a therapist who's great with some clients; just not with you.
 
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Sassafras54 is offline Sassafras54 — Advice Official Moderator Post #7  December 17,2009, 8:31am
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I worked with 3 different therapists on and off over about 20 years. The first was a husband-wife team, and I worked with both individually and together. At the time I thought they were great. In hindsight, and with later therapy experiences, I realized that while I did learn some useful things from them, I basically just delayed doing actual therapy by spending time with them. They did some really wrong things.

While I worked with them, there were times when I felt really bad about how it was going, but (with their encouragement) I felt responsible for that, that it was my problems that were causing the difficulties. Later, when no longer involved with them, I realized they screwed up in a lot of big ways.

The 2nd & 3rd therapists were excellent experiences, in different ways, but not perfect. At the time, and afterwards, I realized they each had some limitations -- because they were human. That was an education in accepting people as they are, and in staying true to myself. It did not limit working with them.
 
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justme27 is offline justme27 Post #8  December 17,2009, 8:56am
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Sassafras54 wrote :
Those are all good reasons ... I'm wondering if you became aware of them while you were working with him, and quit, or did you quit for whatever reason, and in retrospect you realized he hadn't worked well with you?

I think people have a lot of hope about therapy, and they get attached to their therapist, and they're in uncharted territory, and so it can be difficult to see, while they're working with someone, that it's not going well or there are problems needing to be brought up.

Your point about his approach being the wrong one for you is particularly good ... there are lots of types of therapy (and therapists) and some pairings work better than others. You could have a therapist who's great with some clients; just not with you.
Thanks Sassafras for posting. To answer your first question, in my case I lucked out and had a real good first therapist. The only problem was that he was elderly and in retirement and began to develop health complications. Consequently, we were not able to finish our work together. I stopped seeing him and later on began seeing the second therapist, who based on the first I could perceive was not as beneficial. I believe I saw him for about a year before I moved on. Neither the first nor the second did I properly screen. I just lucked out with the first therapist and struck out with the second. However, I had developed a strong relationship with my psychiatrist and came back to him and asked him to refer me to the best in the field at whatever price--in the second therapist I was looking for the inexpensive answer. My psychiatrist is out of the Ivy League and so had connections to the best in the area. The third therapist I worked with had amazing credentials! With him I was able to nearly complete my goals. CBT practitioners make it a point to set goals and only see you for a short duration of time--it's one of the tenants of CBT, that there is an end to therapy. So we ended therapy until other issues resurface. I currently see a very inexpensive and inexperienced therapist but mostly just to go over minor issues. When bigger issues resurface, then I will return to the third therapist. However, both my psychiatrist and my CBT therapist are working aggressively with this new young therapist to help her guide me through the therapeutic process. Great investments!

Finally, you are right I should clarify. The bad therapist was bad for me and not malicious nor fraudulent. Consequently, he may be better for some people but just not me.

Also Sassafras, since you are reading this has the financial group been any help to you? I plan to upload an investment video as well as some news as well as some podcasts. Sorry, I'm not trying to plug the group but since you are here I just wanted to know if has been beneficial so far.

All right, I'm going to be away for a couple of hours studying currencies. So I will get back to your next post later on in the afternoon.
 
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peg099 is offline peg099 Post #9  December 17,2009, 9:21am
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justme27 wrote :
1. Is aware of the limitations of therapy and works with psychiatrists: I would be wary of a therapist who is reluctant to refer to a psychiatrist or believes that there therapy alone will see immediate results.
I would actually expand this. Yes, a good therapist is aware of the limitations of therapy as well as their own personal limitations. However, they need to be willing to work with or refer to a wide variety of health professionals - not just psychiatrists. Alternative health therapies, lifestyle, and social support can have as much or more impact on mental health and well being than medications. A good therapist should be willing to help you explore whatever resources would be the best fit for you as an individual.
 
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peg099 is offline peg099 Post #10  December 17,2009, 9:56am
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justme27 wrote :
Nanette thanks for posting in this thread. I think in general when people refer to over medication, they are referring to the instance of children and learning disabilities. I was never medicated as a child, I sought therapy as an adult, so I'm not certain how I feel about the argument.

As an adult, my humble opinion, is that medication should not be the last nor the only option. Meaning a good therapist will determine whether what you are feeling is situational or biochemical.
While this is the ideal, the reality in this day and age is that many people are put on meds simply because it's quicker, cheaper, and easier than prolonged therapy. Granted, it's often of their own choosing because they want the quick fix. But bottom line is that Nanette has a very valid point - psychotropic meds are handed out far too quickly, and this applies as much or more to adults as it does to kids. If anything, there's more reluctance to put kids on meds because of the concerns around how it will affect their developing brains.

Yes, for many people depression and other mental illnesses are at least partly organic. But that doesn't mean that drugs are the best approach. Much of depression is related to low serotonin levels. Now, you can't just give someone serotonin. But there are several vitamins and an amino acid that the body needs to produce serotonin, and a really high percentage of people with depression aren't getting enough of those in their diet. B vitamins and tryptophan are particularly important. But instead of encouraging patients to eat better or to take vitamin supplements, psyciatrists will dole out the latest anti-depressant, which does nothing to actually increase one's serotonin levels - it just changes the way your brain reacts to the serotonin in the first place to try and make it go further. Not only does it fail to get at the root of the problem, but it also causes all kinds of side effects that you wouldn't get simply by increasing your vitamin intake. What's even woorse is that many anti-depressants actually deplete the body of those B vitamins (and CoQ10). So they are compounding the initial problem.

Another example is magnesium, a natural relaxant. Docs prescribe various (highly addictive) benzodiazepines when magnesium could help with the problem. Low magnesium levels play a huge role in depression, and many depressed people compound the problem by not eating properly (often because they are too drained to do so). But if you want to give them a pill to pop, why not make it something that will help them improve and reduce the need for meds rather than something that will perpetuate dependence on the drug? (Magnesium supplementation also helps with ADD/ADHD. In fact, many symptoms of ADHD are similar to symptoms of magnesium deficiency).

Another really important one is fish oils - and that one is gaining some acceptance in psychiatric circles. Several studies have found fish oil to be more beneficial than many anti-depressants. It has also been found to be beneficial in treating bi-polar disorder and schizophrenia. Which really isn't all that surprising, considering that many antidepressant such as Prozac aren't much more effective than placebo.

Granted, natural remedies are often not enough for people with severe depression, but incorporating those into a treatment plan would reduce the amount of drugs that a person would need. And yet you'd be hard-pressed to find a psychiatrist who would suggest those remedies as a line of first defense unless they're part of an integrative health practice.

wrote :
This determination has to be made withing a reasonable amount of time to minimize needless suffering and needless medication. If the situation is biochemical such as hereditary anxiety, depression, bipolar...etc then medication should play the primary role in treatment (do you know why?). If the circumstances are situational, then it depends on the gravity of the situation. Loss of loved one, unemployment...etc. are all things that can cause a depression. Depending on how severely an individual is handling it, the psychologist should make a determination again whether medication is necessary within a reasonable amount of time. People are different and some people were raised with better coping skills then others. So for some people, medication may not be necessary. However, the psychologist should evaluate coping skills as soon as possible to determine whether medication is necessary.

Finally, medication should not be the only option. Meaning that you go to your general practitioner and tell him you are feeling down and he automatically prescribes medication without a referral to a psychologist or a psychiatrist.

Does this make sense? Is there anything that is unclear? Again this is just my experience and hopefully others will share there own.
That I pretty much agree with.I just think that the assessment needs to look at more than therapy and drugs.
 
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