Thinking Of Seeing A Therapist For One Symptom Only

[Hashi]

I'm thinking of seeing a new therapist for obsessive compulsive disorder (OCD) only. The person I'm thinking of having an initial discussion with is the only person I've found so far who seems they might be a good fit. I'm not sure he would be a good fit for specific trauma work, but I'm not planning any specific trauma work.

I'm wondering how realistic it is, to see a therapist for one symptom only. Has anyone else done this? Could you keep it to the one symptom, or did all sorts of other things come in that needed to be addressed along with it? I know I will need to tell him that I have a trauma history. Did you find you needed to talk about trauma more than you anticipated?

I'm not planning to see any other therapist alongside him.

My background is that I've done trauma therapy and processed a lot of the trauma, although I still need to do more work on childhood issues, at some point. Generally I'm stable enough, able to work, and have very good coping and safety skills. My remaining symptoms are "only" generalised anxiety and depression - I'm not worried about having flashbacks or other symptoms.

I've been working hard on anxiety and particularly OCD which troubles me very much. I've made a lot of progress with OCD but I'm sick of doing it on my own and would really like guidance and support. I tried this towards the end with my last therapist, but it wasn't successful because she didn't specialise in OCD. The therapist I'm thinking of seeing now does, and he also uses Dialectical Behaviour Therapy (DBT) which I find very helpful, rather than only Cognitive Behaviour Therapy, which I don't like but which most OCD specialists use.

He actually has training and experience in childhood abuse, but if I was looking for a therapist for that I don't think I would pick him out. However, I'll need to mention the abuse and other trauma for context so at least he has some understanding of that area.

Has anyone had experience of therapy for only one symptom? Any thoughts?

 

[GWhizz]

I can't exactly answer your question as I haven't had experience dealing with only one problem. Though I would assume the childhood abuse is going to come into it somewhat if you feel it is anyway related to the OCD? I know my OCD gets particularly worse when I'm trying to work through my childhood issues. And I know it stems from my past. Eg. I grew up in a really messy and unclean environment so cleaning is something I do to relieve stress. I'm a total perfectionist.

I'm really glad you've found someone specialising in this though and it should help that he at least has some knowledge and experience of dealing with childhood abuse.

I hope that when you have your initial meeting with him, he can clarify this for you once you give him a background of your story.

Best of luck with it :-)

 

[intothelight]

Hashi,

Give it a try and see how it goes. I tend to use therapy now on an "as needed" basis, to help work through and gain control over a persistent symptom or just to get through a rough spot.

Deb

 

[blackswan]

It's your choice as to how you want to direct your therapy :) if you want to focus on OCD symptoms, a good therapist might gently challenge around this if they see what they perceive to be a more pressing need, but will support your choices as you're the expert on being you. They're just there to help you work towards the goals you have for yourself.

The cornerstone of OCD therapies is exposure tasks and these involve intentionally inducing mild-moderate levels of anxiety (in controlled conditions). Because of the differences in how people who have experienced trauma typically handle anxiety, do definitely mention this history to your therapist so they are best able to tailor your therapy to you.

I used to be quite anti-CBT but have realised I'm just anti- terrible, unempathic, overly directive, insightless therapists. Just like I used to think I didn't like beer, but then realised that I just didn't like cheap, horrible beer that I kept getting given when I asked for a beer. There are lovely, kind & warm CBT therapists out there, and there's a lot of research that backs how truly effective CBT can be. Especially for OCD.

 

[shimmerz]

@Hashi, yes I have used different therapists for different aspects of both my traumas and my symptomology. I find it best to be straight upfront as to what you would like to focus on. There are times when the trauma will come up but as long as it is in the background when spoken about I feel like the p or P or T is doing their job. OCD in and of itself has a very good outcome when it comes to management and even 'cure' although I use that term loosely.

My p is for my day to day stuff and trauma will come up but we don't focus on it, my T talks specifically about my trauma, my shaman and I speak about soul work as well as we meld on the feelings that come up that throw me off balance and my spiritual healers (trance workers, etc) deal with my spells of fainting and dissociation. It seems that it has worked out well for me and each knows about the other (although some were miffed originally I do try to express to them how important they are in the area for which I have chosen them).

 

[nursenurse]

Within internal medicine, you could see a respirologist, a cardiologist, a hepatologist and more. Why not in the mental health field? We already know that not every therapist is an expert on PTSD, and it stands to reason that others are great at dealing with certain aspects/diagnoses. No one person can know everything about the broad subject. You have found someone to deal with your issues at hand, you said you will tell him about your PTSD, but it does not have to be the focus unless it is agreed that the two are connected during therapy. Go for it, you are the master of your own healing journey, and it sounds like you have an excellent grasp of your own situation.

 

[Hashi]

Thanks, everyone.

I'm so glad I posted. I hadn't made a connection until reading your replies, that I had a bad experience with a psychologist I tried seeing some time ago for DBT. She had agreed to teach me DBT skills and leave trauma work alone for the time being at least, because at that point I was functioning very badly and felt desperately in need of doing skills work. However, she didn't keep to that and kept pressuring me to do CBT exposure therapy for the trauma. I left.

I hadn't forgotten the aspect that I didn't want to do CBT exposure therapy - I'd tried that before and it was absolutely wrong for me, as was general CBT when I tried it previously for depression. (@Bronswan I understand what you say. For me, CBT is too limited and literal. DBT was developed from CBT, and by the time I've added in the kind of compassion, validation, mindfulness and other aspects that I need adding to CBT, I've reached DBT anyway.)

I'd sort of forgotten that she agreed to work on one thing and then didn't keep to the arrangement. I didn't agree with her then, and I don't now, that it would have been better to push through trauma work than to work on skills. It seems obvious now that the experience makes me doubtful of a therapist really being willing to work on one thing/skills only. Interesting that I wasn't thinking about that... :oops::confused:

But I suppose the point is that I don't doubt my feelings about what's right to do. I'm grateful that you guys have given me a reality check about that, or at least that it's worth a try. The problem is that I doubt a therapist being willing to work with me in that way.

How can I tell whether this new therapist really would be willing to work me on OCD only? After all, the past psychologist agreed to work with me on DBT only, before we started. She knew about the trauma, and knew I didn't want to work directly on it.

The differences I can think of in the situations are:

Past: I was still quite symptomatic with PTSD.
Now: I am not.

Past: I hadn't done so much trauma processing at that point.
Now: I have.

Past: She was a clinical psychologist, and as such her training was rooted in methodology and directing the therapy, with exposure therapy as the dominant approach to trauma.
Now: He is (or whatever therapist I do find would be) an integrative psychotherapist who's trained in a number of different therapies in order to work with the client in the way that best suits them at the time.

Is that enough? Because what I keep thinking is - she agreed then didn't keep to it. How can I possibly avoid that happening a second time? Ask him if he's willing to focus on one thing only, then if he says yes, ask him if he is really willing to focus one thing only? :eek:

It's a very big deal for me financially to see a therapist, even for one or two sessions. Basically, I can't afford it but I'll find a way if I really need the help, which I do. I hate thinking I might pay him for several sessions then he would change his mind like she did.

So, now I want to ask him:
Is he willing to focus on one thing only? then
Is he really willing to focus one thing only? and
If he later breaks his word will he give me my money back?
:eek::eek::eek:

Which obviously I can't ask...

...Help?

 

[blackswan]

You can definitely ask that!

Clinical psychologists are supposed to follow treatment plans based on client goals, like all psychologists. Pushing someone to do trauma exposure when they're not ready... I have no words for how unprofessional that is.

I would encourage you to be very honest about what you want and why, as well as your difficulties with your previous therapist, with your next therapist. Interview him in the first session. Find out if he's willing to commit to transparency in his processes. If he's happy to talk openly about these things, that suggests to me that he might be worth taking a chance on. But if he's a dick about it, then you have your answer!

Wishing you luck :)

 

[shimmerz]

@Hashi, I looked up treatment protocols for OCD. I notice first line involves the prescription of SSRI's and CBT. I don't see many who use DBT. CBT, from my experience and understanding is not so good for people with C-PTSD (if that is what you have). After google searching on 'ocd treatment guidelines' I noticed quite a few resources and am wondering if you could put together what feels good for you, researching DBTand OCD and present that to prospective therapist?

 

[Candleflames]

Seeing someone specifically for a particular issue is an excellent idea. I did just that and it worked really well. For me it was CBT for Trichotillomania and I had no idea what to even ask for. I guess I am lucky it worked. DBT to treat OCD sound like an interesting and useful approach depending on how someone's OCD presents. I know it is particularly useful for people who experience emotional extremes. I've thought about using it myself.

I think you have a really good sense of what it is you want from therapy, which is a huge plus over where I was at. Any therapist should honor that, granted some won't. You can and should ask all the questions you want. You've presented everything very well here. Use this thread to make some notes if it helps you, but like Bronswan said, interview the T in that initial session. You are hiring him. When you've gotten what you need from this approach and/or have your symptoms under control you can choose what to do next then. He might have some suggestions but you do make the final call.

 

[Sarah2732]

Been following and thinking about this thread, I think my only contribution would be to say that I think it's impossible to see a therapist for "only one specific issue"- because our issues are so interwoven with our story- but I definitely think it's possible and a sign of health to see the therapist who is best equipped to treat your currently most distressing symptom!

I have switched therapists to start seeing someone who could better help me with what felt like the next layer of my recovery was. I felt like to move forward I needed to know if a safe relationship with a male was possible and therapy with a male T was the only place I'd even consider maybe attempting a tiny bit of vulnerability/trust.

 

[shimmerz]

I think as we progress through our trauma, we are much more capable of being able to compartmentalize the trauma's into specific 'areas' that we are, through our inner voice, driven to conquer (or at least address). Originally when I saw my T I was so invested in the trauma that he would have to stop me often as I would default back into the trauma of 50 years ago. I now have processed that information and need to be able to address individual facets of my mannerisms NOW that are behaviours of my self protection mechanisms. The trauma doesn't come up so much as what is happening to me here and now. Bringing me back into the trauma aspect does me no good right now and although I feel like at times the certain trauma pieces need to come up (to reference but not be invested in - which many T's tend to gravitate to) they can be referenced rather than focused on. From what I see in this posting by @Hashi, she is ready to move onto the here and now - focus on a problem area and move forward.

I think it can be done but there needs to have been some pretty significant healing done prior to this stage and the dissociative behaviours (most) need to have been addressed through strategies and tools so that there is more awareness on the part of the patient to be by and large under control if dissociation happens. I feel like once dissociation is broken or at least manageable, we can start focusing on more current issues like @Hashi's OCD behaviours.