Is This All Therapy Is?

[angel2write]

I have a couple questions. Had my 3rd appointment today with my fifth therapist in 20 years. Some were helpful, some weren't. This one seems nice, and is supposed to be knowledgable in the area of PTSD and childhood sexual abuse trauma. (She's worked with the local military base.) I don't have a particular problem with her or what's happening. I'm just wondering... is this all therapy is?

Why can't I do this at home with my husband and on the forum? I have learned SO MUCH from reading Anthony's articles and the book I bought. Doing the diary work has been tremendously powerful. I'm remembering more and more, and beginning to experience the emotions that go with the memories. I've had some bad days, but the support from people has been wonderful. I love getting on here and seeing how kind and caring and encouraging people are. I've never had the positive reinforcement I've gotten here from anyone- not my family, not my friends, and certainly not from any therapist.

Bear has learned a lot, too, and it's creating a new openness between us about the past, about feelings, about how we cope with the problems that come up... It's tough, but it's also been good. I feel like I'm making progress. (It feels like fewmets at times, but it also feels like progress.)

So what is the therapy for? She asks questions, but doesn't take notes. Every time I see her, I have to explain what we talked about last time again. If I tell her about something, she basically doesn't react. She hasn't given me any information at all. She tells me I'm good at breathing and that I'm "doing good work" remembering. I keep wondering when we're going to start working on some of my symptoms.

I've asked her about getting an official diagnosis of PTSD, but she says she really isn't "into" diagnoses. I'm not sure how to take that. I told her about the forum today and she says it's great- it's a great way to process memories. If all I'm supposed to be doing with her is processing memories, why can't I do that here and with Bear for free? Why am I paying her $150 an hour to listen to stuff I could (and do) tell my husband?

My husband hugs me, makes me feel safe, holds me while I'm experiencing strong emotions or flashbacks, helps me brainstorm about ways to deal with or evade triggers, comforts me when I'm sad, and enjoys me when I'm happy. I can see where having someone to talk to could be a big deal to someone who's dealing with this alone, but I'm not.

Am I missing something here? Is there some secret element to therapy that will appear later? She's going on maternity leave in about six weeks. If something else doesn't happen between now and then, I'm really considering fading into the woodwork. Is this an ok idea? It's a lot of money for us, and I don't want to waste it.

 

[Abrasky]

It depends on what therapy you are doing. I've been to therapists a bit like this that do talking therapy and I haven't improved at all from it and it has been a waste of money. I have also been to therapists that do a bit more deep therapy. And this is where I made a lot of gains in my PTSD. If you do deeper therapy you know it, you usually end up linking something up, crying a lot and either going a bit backwards or forwards at the end.
Being that it's your third appointment, It is still early. Maybe try another one and find another therapist is what I would do, but that is my personal opinion.

 

[Abstract]

I actually think that part of the benefit of therapy is working out the differences one has in that environment. It is apressure cooker of an environment and being face to face with someone is very different to not being. We are partly hidden on the web. I can discuss things online that are impossible facing a living breathing human being.

The right therapist is a must though in my experience.

What type of therapist is she?
Has she specialist knowledge of trauma?
What approach does she practice? CBT, psychodynamic, person centre?
What are your expectations from t? Are you expecting someone to "fix" and tell you what to think and do to get "better"?

A therapist does not normally take notes and they are also not there to support you in the way a fellow sufferer would.
You are the one that does the work and the t is there as a support for you while you do so.

Saying tht though, she may just not be the right t for you and also may not have a suitable approach!

 

[ronin47]

Well, in all fairness I think the 3rd session is a bit early to know for sure if she's a good match, but it's getting pretty close. Some of the things she's doing make sense, like asking you what you both worked on last time. I do that when I'm tutoring to help "warm up" the student and refresh their memory. It's also a good way to make sure the student really absorbed what we talked about. I also don't think I've ever been with a therapist that took notes except maybe during intake sessions. That's something I've only seen my psychiatrist do.

Though, on the flip side, she kind of sounds like a nurse I worked with a few years ago. Really all she did was just sit there and I would do most of the talking. She offered very little in the way of insight and was very narrow in her approach. I wholeheartedly regret letting my mother spend that much money for me to see her as long as I did. After that, I would tell all my therapists in our initial sessions that I did not just need someone to talk to. I have a very melencholy friend from Maryland who could serve that purpose quite nicely. I'm now working with a female therapist, the first since I stopped working with that nurse, and I admittedly will get even a little confrontational whenever I feel she is not giving me enough feedback or tools for practically addressing a problem.

It sounds to me that you're not really "clicking" with this woman. Her approach does not mesh with what you are looking for.

Whenever someone tells me they feel like they're not really getting anywhere in therapy I suggest that they write down a numbered list of their personal goals and share it with their therapist. Perhaps you could try that with this lady you're seeing and if it's still more of the same then I would suggest you proceed to look for another therapist. Concrete goals and a rough plan is, I have discovered, a very good way to get past some of the frustration one experiences in initial therapy. Also, may I ask if this woman is a psychologist? Certainly there are good MFTs, counselors, social workers, etc out there, but in my experiene psychologists are a far safer bet.

 

[anthony]

Why can't I do this at home with my husband and on the forum? I have learned SO MUCH from reading Anthony's articles and the book I bought. Doing the diary work has been tremendously powerful. I'm remembering more and more, and beginning to experience the emotions that go with the memories.

You can... absolutely. A therapist is a feedback loop... that is what they do. Many people can't find their own rational solution, or they can't read over their own writing and identify faulty thinking, behaviours, positive attributes, etc. That is all a therapist does for the most part, they listen, then respond enforcing your positives and helping you change your negative thinking patterns and behaviours.

Some can do this, some need lots of help.

Go walk into a rape group, and you can find women who have been attending them for 15 years, still stuck, still angry, still at the same point, even with a group of like minded people. Some people struggle to get themselves out of trauma, some don't want to and are happy being miserable, some want out but don't know how to get past the initial pain and suffering. Each to their own really.

Therapy is proven to be as effective via the web as it is in therapy, if done right. Use forums for a sounding board basically, target your questions specifically as a thread title, short, sharp, to the point, to elicit a specific range of responses, which you take and put together that work for you, toss the rest away, OR, try one, fails, move to the next on the list, until you find the solution that works for you / combination off.

The main aspect of trauma therapy, is actually learning about each specific aspect. With the knowledge, you then adapt it to your life and situation, put it into action. It is that simple... that is how I have done it... very little therapy at the beginning, learnt more from others, then began reading every book I could get my hands on, then putting things into action in my own life.

 

[angel2write]

After that, I would tell all my therapists in our initial sessions that I did not just need someone to talk to. I have a very melencholy friend from Maryland who could serve that purpose quite nicely.

(laughing)

Whenever someone tells me they feel like they're not really getting anywhere in therapy I suggest that they write down a numbered list of their personal goals and share it with their therapist. Perhaps you could try that with this lady you're seeing

I did this last week. She took the list and copied it, but didn't really say anything. Yesterday I gave her a time line I wrote with significant events on it. We talked through a few of them. I did a year and a half with someone who did "reflective listening." It's really not what I'm looking for. I like having answers. I'd like a definite diagnosis. I like to know what to expect. I want to know what's happening to me, and what kinds of things I can try to try and improve my life and my responses. I don't want to be "fixed," but I also don't just want to be listened to. Like you said, I have a couple people in my life I can just vent to. I need someone more knowledgable than I am to point me to things I wouldn't think of on my own.

and if it's still more of the same then I would suggest you proceed to look for another therapist. Concrete goals and a rough plan is, I have discovered, a very good way to get past some of the frustration one experiences in initial therapy. Also, may I ask if this woman is a psychologist? Certainly there are good MFTs, counselors, social workers, etc out there, but in my experiene psychologists are a far safer bet.

She's a LSW- a licensed social worker. In the past I've seen an intern psychologist, a psychologist specializing in anger issues (who kind of freaked when the sexual abuse stuff started coming out), and a woman who was some sort of counselor- I don't remember any more. Maybe you're right and I should try someone else. This is a small town, and there's not a lot of services out there. Mostly like divorce care & stuff. But I could try again. The thought is really tiring. It was a lot of mental energy and anguish to find this lady. Argh.

 

[angel2write]

The main aspect of trauma therapy, is actually learning about each specific aspect. With the knowledge, you then adapt it to your life and situation, put it into action. It is that simple... that is how I have done it... very little therapy at the beginning, learnt more from others, then began reading every book I could get my hands on, then putting things into action in my own life.

The thought of this is really appealing. It's certainly how I would prefer to do it... I just don't want to make a stupid decision that will end up hurting my family. I've seen what happens when someone decides they're just going to "handle it" on their own. Come to think of it, that's a good part of how I ended up the way I am! My life would have been very different if my dad had gotten help.

Don't want to make that mistake for my kids. But I get frustrated with paying people to help when they don't really help!

 

[ronin47]

She's a LSW- a licensed social worker. In the past I've seen an intern psychologist, a psychologist specializing in anger issues (who kind of freaked when the sexual abuse stuff started coming out), and a woman who was some sort of counselor- I don't remember any more. Maybe you're right and I should try someone else. This is a small town, and there's not a lot of services out there. Mostly like divorce care & stuff. But I could try again. The thought is really tiring. It was a lot of mental energy and anguish to find this lady.

It is difficult, I know. Finding adequate medical care of any sort can be a challenge in a smaller community. That was part of my problem before I left for college. Have you tried searching online? You may be able to find someone in a neighboring community. Don't give up! I'm on my tenth counselor in six years; if you count all the ones I've seen more than three times and ones I saw similtaneously. Though that hasn't just been because they've all been incompetent. My last three therapists have been interns so they were only around for one year each, but they've all had the same supervisor.

But yes, I think you should look for a psychologist who, if not a specialist in the area, at least has some experience with sexual abuse. That could make a big difference.

 

[Reclusive]

I'm kinda facing the same situation with my therapist. I'm low income, though, so I know it's this guy or no one since there's such a shortage in my town. He works really good for my fiance, but he just keeps telling me things I already know, so I don't know if I'm getting anywhere. I actually took notes during out last session and I don't see anything helpful in them. At the very least, maybe you could tell her that you would appreciate a more active/interactive approach?

 

[OKRADLAK]

The trauma care that I feel I cannot do alone is that kind that teaches me- like DBT and others.

The fact is, even with the others, I am not that motivated 24/7 to just do it. I like having someone that I am accountable to and helps me to keep going.

I cannot afford it, to be sure, and had to go without any therapy when I moved to a place and NOT ONE SINGLE T took my insurance and I had to go about 1 year without anything and it was a slow decline at first and after about 3 months, WHOOSH, downhill so fast.......suicidal, awful!!!!!!

Too much came back. I felt like such a failure to not be able to do it on my own when I needed to. :(

Back in T I did much better. So maybe I need help for a long time. That is OK, just like someone with a heart problem.

 

[angel2write]

Well, I talked to her that week & she loosened up and told me a lot of things, like the fact that I am PTSD (I hadn't had more than a self-diagnosis before) as well as having some kind of anxiety disorder- she wasn't sure yet.

Things have been better since, and we've had a couple good sessions. I guess I'm sticking with her. I'm actually starting to look forward to talking to her.

 

[OKRADLAK]

It's good when you look forward to seeing them! Yay! :-)