Dear Tony,
I would like to expand a little more on the last point I made in the last letter.
Therapists are not supposed to grow angry at their clients, but it does happen. My advice - and this is just me - is, if it only happens occasionally and you still feel safe and comfortable there, don't worry about it. Therapy is a very emotionally charged environment, therapists often need to make quick decisions about how to respond, and people - both the therapist and the client - sometimes do not process their feelings appropriately. Also, I think that sometimes therapists can unintentionally appear to be angry when they are really not.
I would suggest that it is more important to ask yourself: Am I comfortable telling this therapist what is going on? Does the therapist listen to me and respect my judgment? Am I making progress in the areas I would like to? If the answer to both questions is yes, then I would probably recommend staying with that therapist.
On the other hand, there is no excuse for rage. If your therapist grows uncontrollably angry, or angry for an extended period of time, you should try to find a new therapist. If you are afraid of telling your therapist something because s/he will be angry or will take it the wrong way, then you are not receiving the help you need. And - to repeat what I said in the last letter - if your therapist grows enraged because you did something without first asking his/her permission, there are serious control issues. You need to find another therapist quickly.
Saturday, July 20, 2013
Thursday, July 11, 2013
Choosing a Therapist
Dear Tony,
As you know, I am a mental health researcher. One of the issues I sometimes research is what factors produce a good therapeutic relationship. Those factors are complicated and difficult to determine. But based on some of what I have observed and personally experienced, I wanted to give some advice about choosing a therapist.
I realize you might not always have a choice of therapist. Geographic and insurance (among other) factors may limit who you are able to see. But you might have a choice between a few people or be able to request a transfer. Everyone's situation is different, which means I cannot give general advice. You need to figure out yourself what your options are.
With that caveat, here are some suggestions about choosing a therapist:
The absolute primary factor is: You must be comfortable with that person. If you are not comfortable, you are not going to be open and honest, which means you are not going to be able to address the complexities of your own situation. You might be more comfortable with a certain gender or a certain age group. If so, try to request it or look for it. Do not try to be fair to the therapist. Health does not play fair. Your needs have to come first.
This ideally works both ways. The therapist might say s/he is not comfortable treating you. This is very painful to hear (I have had that happen). In the long run it is most likely for the best. But you can be left feeling like a mutant. There is not much advice I can give about that situation, except to be aware that it might happen.
I have a few warning signs that you need to find a new therapist:
1. If you cannot discuss something which you feel you need to discuss. Therapists do make mistakes, and they may cut off an important point during a session. But if you bring up this point several times over different sessions and are never able to talk about it, then you are not receiving the help you need.
2. If you disagree with your therapist and are not comfortable saying so. Or if you do tell the therapist you disagree and are repeatedly ignored.
2.a. On a similar note - if the therapist tells you things about yourself that appear wildly speculative or just wrong, and you are not able to disagree (or it is too much effort to do so).
3. Very important - if your therapist becomes enraged if you do something without his/her approval. Therapists are not supposed to become angry in session, but it does happen. But if they grow enraged if you do something without his/her permission, they are insisting on having control over your life. That is wrong - the goal of therapy should be to help you lead the life you want, not to be dependent on the therapist. The therapist should be a guide, not a caretaker.
That is all for now. I will add more suggestions as I think of them later.
As you know, I am a mental health researcher. One of the issues I sometimes research is what factors produce a good therapeutic relationship. Those factors are complicated and difficult to determine. But based on some of what I have observed and personally experienced, I wanted to give some advice about choosing a therapist.
I realize you might not always have a choice of therapist. Geographic and insurance (among other) factors may limit who you are able to see. But you might have a choice between a few people or be able to request a transfer. Everyone's situation is different, which means I cannot give general advice. You need to figure out yourself what your options are.
With that caveat, here are some suggestions about choosing a therapist:
The absolute primary factor is: You must be comfortable with that person. If you are not comfortable, you are not going to be open and honest, which means you are not going to be able to address the complexities of your own situation. You might be more comfortable with a certain gender or a certain age group. If so, try to request it or look for it. Do not try to be fair to the therapist. Health does not play fair. Your needs have to come first.
This ideally works both ways. The therapist might say s/he is not comfortable treating you. This is very painful to hear (I have had that happen). In the long run it is most likely for the best. But you can be left feeling like a mutant. There is not much advice I can give about that situation, except to be aware that it might happen.
I have a few warning signs that you need to find a new therapist:
1. If you cannot discuss something which you feel you need to discuss. Therapists do make mistakes, and they may cut off an important point during a session. But if you bring up this point several times over different sessions and are never able to talk about it, then you are not receiving the help you need.
2. If you disagree with your therapist and are not comfortable saying so. Or if you do tell the therapist you disagree and are repeatedly ignored.
2.a. On a similar note - if the therapist tells you things about yourself that appear wildly speculative or just wrong, and you are not able to disagree (or it is too much effort to do so).
3. Very important - if your therapist becomes enraged if you do something without his/her approval. Therapists are not supposed to become angry in session, but it does happen. But if they grow enraged if you do something without his/her permission, they are insisting on having control over your life. That is wrong - the goal of therapy should be to help you lead the life you want, not to be dependent on the therapist. The therapist should be a guide, not a caretaker.
That is all for now. I will add more suggestions as I think of them later.
Tuesday, July 2, 2013
Outside Resources
Dear Tony,
You probably have some clear, tangible needs which my blog cannot help with. Maybe you would like to connect with other people who are living with mental illness. There are clubhouses designed for people with mental illness to socialize and support each other. Maybe you would benefit from face-to-face support.
That support can be difficult to find. I would like to give some suggestions. Every region is different, and what works in one area might not work in another. This is especially true for readers outside the United States. But I hope some suggestions will help.
Often these centers are familiar with each other: If you can find one, you can find help from others. The difficulty is finding that first one.
Large mental health organizations such as the United States Psychiatric Rehabilitation Association (www.uspra.org), the Depression and Bipolar Support Alliance (www.dbsalliance.org) and the National Alliance on Mental Illness (www.nami.org) have chapters in each of the fifty U.S. states (and some locations outside the United States). If you check their websites you might find a branch near you. If not, I would suggest you e-mail a contact person from the nearest geographical area in your state for suggestions.
Many states have 2-1-1 organizations which try to connect people with resources they need. These sites vary widely by state - some states don't have them and others have extensive lifts of resources. I suggest you check your state government website to see if they have lists of resources. You might need to spend some time looking at different links, but I would strongly suggest it. If that does not work, try typing "211 + the name of your state" into a search engine.
That tactic can work for a lot of needs. If you are having difficulty, you might want to try simply typing "clubhouses + your city" or "mental health resources + your city" into a search engine. Make sure what you find is really geared towards your needs. But that can work.
Also, you might want to try looking on www.meetup.com. Meetup is a place where many different groups search for new members and advertise events. A lot of groups promote themselves there. Depending on your region, you might find groups dedicated to supporting people with mental illness.
Finally, you might want to searching www.craigslist.org. Craigslist is an all-purpose site. Make sure your search is on "Community" and then try typing in "mental health" "mental illness" "depression" "schizophrenia" etc.
Be aware it might take a while to locate these resources. Nothing works for everyone and every region. But hopefully it will be enough for you to start finding what you need. If you can, check out the site's individual pages and try to determine what you need. You often cannot tell in advance, but it is still a good idea to look first.
Good luck!
You probably have some clear, tangible needs which my blog cannot help with. Maybe you would like to connect with other people who are living with mental illness. There are clubhouses designed for people with mental illness to socialize and support each other. Maybe you would benefit from face-to-face support.
That support can be difficult to find. I would like to give some suggestions. Every region is different, and what works in one area might not work in another. This is especially true for readers outside the United States. But I hope some suggestions will help.
Often these centers are familiar with each other: If you can find one, you can find help from others. The difficulty is finding that first one.
Large mental health organizations such as the United States Psychiatric Rehabilitation Association (www.uspra.org), the Depression and Bipolar Support Alliance (www.dbsalliance.org) and the National Alliance on Mental Illness (www.nami.org) have chapters in each of the fifty U.S. states (and some locations outside the United States). If you check their websites you might find a branch near you. If not, I would suggest you e-mail a contact person from the nearest geographical area in your state for suggestions.
Many states have 2-1-1 organizations which try to connect people with resources they need. These sites vary widely by state - some states don't have them and others have extensive lifts of resources. I suggest you check your state government website to see if they have lists of resources. You might need to spend some time looking at different links, but I would strongly suggest it. If that does not work, try typing "211 + the name of your state" into a search engine.
That tactic can work for a lot of needs. If you are having difficulty, you might want to try simply typing "clubhouses + your city" or "mental health resources + your city" into a search engine. Make sure what you find is really geared towards your needs. But that can work.
Also, you might want to try looking on www.meetup.com. Meetup is a place where many different groups search for new members and advertise events. A lot of groups promote themselves there. Depending on your region, you might find groups dedicated to supporting people with mental illness.
Finally, you might want to searching www.craigslist.org. Craigslist is an all-purpose site. Make sure your search is on "Community" and then try typing in "mental health" "mental illness" "depression" "schizophrenia" etc.
Be aware it might take a while to locate these resources. Nothing works for everyone and every region. But hopefully it will be enough for you to start finding what you need. If you can, check out the site's individual pages and try to determine what you need. You often cannot tell in advance, but it is still a good idea to look first.
Good luck!
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