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When To Stop Professional Counselling?

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anthony

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This has popped its head a few times for me lately, and I wanted to post my thoughts on this topic, and see what others think.

I believe professional counselling should cease once you have finished dealing with your trauma. This means that when you turnup to counselling / therapist / physician, and you really have nothing more to talk about than what is currently going on within your normal weekly life, then you have reached the point of getting everything out of you. Nothing a counsellor does from this point on is going to continue to help you with your trauma IMHO.

Counsellors are a required part of healing from PTSD, because as much as the support we give you here, a support group you attend could give, etc etc, a counsellor has the professional experience behind them of solution building (well, most do anyway). As much as someone like myself could help you online, without that face to face emotive communication, healing is much more difficult. Besides that, people like myself cannot help everyone, nor a counsellor or physician, as a person only has so much time and scope to cope, then they must also maintain themselves. A good variance and mix of support is what I see the essential tool to faster healing.

So IMHO, I believe counselling can cease at that moment you have discussed and have received all the feedback possible on your trauma.

What tends to happen though, and this is not a bad thing against counsellors or physicians, is that once trauma has been discussed in every aspect, they want you to continue coming back regardless. Now honestly IMO, this gets more to the business side than the support side of things. If you attend community / free counselling, you will often find the therapist or counsellor will cut your sessions once they believe you have spoken about everything, because their duties are not about money, but about treating others who now need the same counselling you have just had.

Private practices though also look at the bottom line, even though this is not their intent, it is still a factual part of their business. This does not make a private counsellor / therapist a bad person, because they have gone through years of tertiary education to get where they are, and generally at considerable cost to themselves, though counselling is not needed forever, nor is the constant financial hardship that goes with it when paying for private practice. This constant extra financial burden often creates more problems for the family, thus you end up talking about finances with the very private therapist your employing and is part of that financial issue. Generally they will never mention you should cut their weekly or fortnightly cost from your budget, but instead give you other solutions. A really good one will do exactly that, or provide you help for free. Though again, this does not make them bad people, because that is their job and they must earn a living also, and have done the work to deserve it.

So the decision time is when "you" feel as though everything has been talked about that can possibly be talked about in regard to your trauma. Once that is done, honestly the rest is up to you. You need to work on implementing the strategies, find free support networks, like this forum, though generally more are required than just one. For example, if your trauma is because of childhood abuse, then your PTSD can be supported here, but you could also get more beneficial information in regard to the abuse at another forum or local support group. The same would go with a person who endured rape. Rape groups exist, online and offline, though they do not specialise with the PTSD aspects. So you would try and get the best from two groups to give you the broadest aspects and wider picture for best recovery.

Me personally, I cut my counselling after I had spoken and recieved all I was going to get from my trauma. I cut my doctors at the same point, and then once I was off medication, the doctors fully gone. I then used what I had learnt and continued my own road to healing. Healing to me is no different from the path we walk getting PTSD, in that the path to healing can only be influenced so much by external factors, then you must do the majority of the work yourself.

I hope that covers my opinions for those who have recently asked, though I would be very interested in knowing others opinions on this matter, or what has / is working for others in regard to leaving counselling and getting on with healing yourself. To me I always kept in the back of my mind, if I fall down, I can always go book another appointment and chat some more. Never had too though.... fingers crossed it remains that way.
 
Anthony, I recently abandoned counselling mainly because of money but also because my Pastor told me that the only one that could help me is me and God. I believe this is probably true. The problem is is that there is no live person to talk to now. I burned out my Pastor too and he doesn't want to see me anymore. Right now this forum represents some hope. I know the problems are mainly mine to solve but I do feel better knowing that my problems are similar to some others. I'm not alone. My pastor said I would have to learn to live with this for the rest of my life. I came away feeling close to hopeless but at the same time I felt "cut free". Now its up t o me to find out the other things out there. I guess thats a good thing. It's just scary right now. I'm glad to be able to use this forum.
 
God cannot help you, only you can help yourself. God is a presence, not an entity that actually circumvents life. God sets rules and boundaries, we choose to believe in them (believe in god) or not (not believe in god). I believe in rules and boundaries and that my choices impact the direction of my life, and / or afterlife.
 
A different spin to what he said and my opinion on going through God for help. God gave you free will. He does not get involved directly with choices you make. Personally I think it is bad advice for him to tell you only God can help you. You can help you and so can doctors or therapists, and it is up to you with your free will to seek the help needed to get though this. I am a strong believer and faith goes a long way at keeping yourself together. I think there must be a reason for this than always sitting around thinking poor pitiful me; well, I do that sometimes still... But for the most part he has a reason for this in the big picture even if I do not get it yet.

I think waiting for God to fix you and make you heal is along the lines of testing him and that is a no no. Would you sit in the water if your boat sank waiting for God to rescue you, or would you get in the boat of someone passing by who can help you and perhaps a has a better grasp on how to navigate those waters you sank in?
 
How I view my therapy... Training wheels. I am not confident enough to take them off yet. I know I need it still to a degree. I think he is trying to prepare me to start cutting the strings a bit as he is directing me to more self help materials along the lines of what he tries to teach me. He sees me at a reduced rate because of my finacial position though as he saw I desperatly needed help where I was. He does not do reduced and sliding scale.

I have leared the ropes of my head a bit though depression seems to still be a hard one to knock. I know what I should be doing and it is a lot of work and bravery to do it. I am getting there. Everytime I wean my medication more it is harder, but I am getting where my days can and are getting better.

I also had to come to terms with the fact right now I do need the anti-depressants to get my head above water and enable me to learn instead of being in a bed all day and in pain and not going forward. So an anti-depressant may be around a while but the xanax is on the way out, and will be kept in the back ground as a back up if I relapse with the panic disorder aspect of this. I think it is better to take in an emergency rather than end up in ER again when I know exactly what is happening now. I would also know to haul my self back to my doc ASAP to get my bearings.

For me I am getting close to getting my training wheels off and see if I can take this ride...

ETA - He and my shrink think the anti-depressants help me learn these tecniques, as in such a deep state of depression I was heading I could not snap out of it enough to learn and retain what I needed to do. Once I get where I need to be then they will start to wean the anti-depressant and I will try to keep up the coping skills. So I guess I have a few sets of training wheels to get off!
 
seeklife, I know where you're coming from, and i know your pastor means well, but sometimes God allows us to go through something, its just a part of being a human on this earth. (it rains on the just and the unjust) I KNOW that God can and will help you, but you must help yourself, too. and there is no reason you can't have help of anyone else that can help. it doesn't say anywhere that God has to be the only help. Sometimes, He is a comfort more than help, and that is His plan. This site is a wonderful help, and a good counselor can be a wonderful help. mine is great, trained for trauma, and experienced, and a christian by coincidence? Hang in there, and try to find a good counselor.
 
I think you're right about ending counseling at a point, anthony. My therapist told me very early that we would get things settled and see each other less and less, and i could check in once a yr, if i wanted, or just know that if something kicks up, i can call her. not the point to keep you coming. i think that makes sense.
 
I think you have a good counsellor cookie, and this just reaffirms that there are many good one's out there, who's moral grounds go both ways, therapy and not stringing therapy along once it is complete, turning patients into customers once they heal. Some do it, some do not. Doctors are the worst one's IMHO for these acts, where they literally run "x" number of people per hour, and they just prescribe nonsense regardless whether it works or not, hence come back and book another appointment if this guess doesn't work.
 
I think this thread says it all about how far we have to go as a profession. The first thing we were taught in school was that we are working to put ourselves out of work! Our goal is to get people to the point that they don't need us. I truly believe in this. Although we all have bills to pay, using a client as a money pot is just unethical. Period.

Case in point: my therapist does not have a sliding fee scale. She created one just for me because I couldn't afford it. I owe half what I should. Although free would be nice, it's just not realistic.

I could never work for myself. I'd go broke giving everyone deals ! LOL

Bec
 
Absolutely bec... both sides have a story, but unfortunately we the sufferer must generally make the call most of the times, because not all therapists are out for the good of the patient. It is nice to hear the positive stories though that some do still exist, and are out to help the patient by reducing costs.

I guess I am that now.... DOH! All free, no payment... lucky my income streams are already established.
 
i think this is a difficult issue that is different for everyone. I've been dealing with my PTSD for the last 9 years and have seen just about every kind of therapist there is. Some were totally unhelpful, some didnt understand PTSD, some were too heavily meds-based. Sometimes the "fault" wasnt the therapist but me, getting disgusted with the whole thing and ditching it again. Sometimes i frankly was happy to not dwell on what happened but talk about coping strategies, yet there was still a need to deal with what happened that i would leave at home. Sometimes it seems like i've dealt with it but unfortunately in my case there are still alot of buried memories, feelings that i dont want to resurrect. There were hundreds of rapes at gunpoint over many months; i simply shut down and did what i was told. I blanked it out. So i stop when it gets too painful. Its not a case of "getting it all done and over with". Its a case of learning to live with the stops/starts/ups/downs. Even when i have gotten as much as i could out there, it dosnt make it go away. It will never go away. So its been a stop/start thing for me, and i've accepted that it always will be.

Sometimes the counselor says to me that they think i'm ready to stop, and then i get angry and dont go back. Its like a rejection. Sometimes they say they dont have the ability to deal with serious dissociation issues like i have and want me to see someone more "professional". Sometimes we just end up talking about larger social issues and i leave feeling like i've just given a sociology lecture. Sometimes they dont understand that there are several people here in me, several dissociated personalities, i've been told that they dont understand my "contradictions" and different aspects. How can i be a masochist and a feminist? Even that i seem like someone different every time, even look different. Sometimes they havent even read the basic books on mental health and are totally ignorant. I'm an academic and i come to sessions with photocopies of the latest research. i guess i'm the nightmare patient, i tend to cover my own personal pain with theories and philosophy. People need a mix of dealing with their own personal stuff and seeing the larger social picture, daily coping strategies as well as connecting to larger community networks. Maybe i havent found the right therapist, maybe its as simple as that, even after 9 years of trying. I've pretty much given up. No one can really help you in the end; its up to you. As for religion, I'm a pantheist, so i dont believe that there is a personal "god" who can help you, but that we are all part of something that is divine in its entirety. Even the pain is necessary. We just have to be attached to the Whole, and not be driven back into ourselves.....even our pain has meaning, has dignity, and must be accepted. Therefore therapy with a goal to "healing" completely, is pointless (and a particularly western concept i might add). Its about acceptance, perspective, and tactics......
 
Cat, you proved a point. Everything is different to everyone. Back when this was originally posted I was trying to accept I had to be on antidepressants. Boy did that back fire in my face big time. I ended up worse later in my treatment and got really bad when I went back off. Thankfully I am in a much better place now. Not much on the forum about it except after that... I end up suicidial. Was not a fun trip. But again I am a lot better for it and really opened my ears up around here after that and really tried to buckle down. That was too close for me.

Also, I think "healing" completely is how you look at it. We all know here PTSD will not leave us. But we are learning to go back through our traumas and reprocess them and "heal", but it is more acceptance like you say that is healing. You accept the trauma at face value for what it is. Not false feelings of false guilt and "I should haves". Grieving and reliving it but with an attempt to put a different spin than you have in the past.

I think you just have not found the right doc yet. Finding one you can click with is very hard to do. It is really hard to find someone willing to pull their head out of their butt long enough to treat you properly.
 
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