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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Racer on March 28, 2004, at 7:28:57
No, there's no question I need therapy. I do, and I know it. The problem is with this therapist -- who was assigned to me, and who is a nightmare for me. I don't mean a nightmare as in "it's so hard, I feel wrung out after every session" because that can be a sign that you're working through hard issues and getting better. I mean walking out of there more convinced than ever that I have to suppress everything I feel, and stop wanting anything at all. I'm also feeling invisible and inaudible, and starting to regress in terms of things I'd actually conquered pretty effectively in therapy in the past. Not especially helpful.
I'm on a waiting list for another therapist, but I"m afraid that, since I have 'a therapist', I'm in danger of being bumped back on that waiting list if someone else comes along. I'm also afraid of what this is doing to me psychologically. Not only am I really distressed by therapy, but I'm afraid to go to my pdoc, too. She'll say little things about meds and about him, and I get this frisson of fear telling me to run away, because she's sabotaging me with him, too. I can't stand it, and found myself last night thinking that suicide would be a good choice to avoid seeing him again. That can't be good, right?
My two choices from there are hoping that this damned agency lights a fire on assigning me a new therapist, or waiting for our marriage counselor to figure out which of her interns would be the best bet -- complicated by the fact that she won't assign me to anyone until I'm medicated, and that's a problem if I can't get to the pdoc.
This therapist keeps saying that she's here to listen to me, so that I have someone to talk to, and all the rest of those things. Oh, they don't want to leave me high and dry through this, and besides, it's supposed to be therapeutic for me to learn to work with anyone they assign to me -- but I think this is worse than nothing right now. I'm feeling distinctly invalidated, and it gets worse and worse and worse.
Any comments, words of wisdom or advice, noodle-lashings? Thanks!
Posted by Dinah on March 28, 2004, at 10:02:21
In reply to Thinking about quitting therapy, posted by Racer on March 28, 2004, at 7:28:57
My only thought is that your current therapy is obviously not helpful.
Do you see any danger in stopping therapy? Does she act as safety for you in any way?
I'm not sure I believe that any therapist at all is better than no therapist. But there's a tiny part of me that worries. Do you have other components of a support system that can be there in case of emergency?
Posted by DaisyM on March 28, 2004, at 16:50:38
In reply to Thinking about quitting therapy, posted by Racer on March 28, 2004, at 7:28:57
Racer,
I agree with Dinah, no therapy can be better than a bad therapist. I have to go see your PD doc soon. You've undone all your meds so you need to get them started up correctly again.
It really doesn't matter what one professional thinks of another, if he helps you. So call and go in.
I'm also worried about the suicidal thoughts. Can you call the director again? I don't think they will bump you from the list because you've made it clear you want someone else.
I'm sorry you are going down hill instead of up.
Hang in there. I seem to be saying that alot these days.
Posted by lonelygirl on March 28, 2004, at 17:29:51
In reply to Thinking about quitting therapy, posted by Racer on March 28, 2004, at 7:28:57
I can't remember whether you have mentioned this before, but I was wondering if you had talked to your therapist about how bad it is. Maybe she doesn't even realize what's wrong (although I guess she should if she knows that you are trying to get someone else). Mine usually asks, either at the end of the session or at the beginning of the next one, "What did you think of our time today?" so I have a chance to say if anything was wrong.
So, just a question, what is keeping you there? It seems like you have a lot of reasons to quit going to this therapist; what reasons do you have to keep going? You could make a cost-benefit table : )
Posted by pegasus on March 28, 2004, at 23:31:03
In reply to Thinking about quitting therapy, posted by Racer on March 28, 2004, at 7:28:57
Hi Racer,
I don't have much to add to Dinah and Daisy and lonelygirl's advice, but I wanted to chime in and say that what you wrote concerns me. I agree that your current therapy doesn't sound like it's helping you, and I believe it is possible for unhelpful therapy to be worse than none.
I really hope you find some good options for you soon, and good meds, if that's what you need. I hate to think of you contemplating suicide just to get away from a bad therapist! Stay here and tell us how you feel if your T is being invalidating. We'll validate you and support you as much as we can.
- p
Posted by antigua on March 30, 2004, at 16:19:20
In reply to Re: Thinking about quitting therapy, posted by pegasus on March 28, 2004, at 23:31:03
I'm a big believer in going with your gut feeling. It doesn't sound like you're running away--perhaps this T just isn't a good fit for you. Take it from me, you don't need T damage added on to what you are already dealing with. Not every patient-T relationship provides a healing or "learning" opportunity.
You know yourself better than anyone.
good luck,
antigua
Posted by platinumbride on March 30, 2004, at 23:03:36
In reply to Re: Thinking about quitting therapy, posted by antigua on March 30, 2004, at 16:19:20
I will try to make this brief and concise, though it is really far from that.
I was referred to my current pdoc, who also does pshychotherapy(heretofore to be called 'shrink') about 7 years ago. He is a very kind, well-intentioned man who has bent over backwards for me over the years.
My therapy with him was not a consistent thing until a few years ago, after a stint in the psych ward of a city far from him. I had made a suicide attempt. I was stuck in that ward for at least 2 weeks according to the laws of my state. I wanted out asap. The doc at the hospital advocated for me to get out of there with several stipulations. One was that I have intensive therapy, three times per week. So I moved back to that area where my shrink practices (also where my dad lived) and did everything I had agreed to do.
I had no insurance. This MD charged me fifty bucks a session. His sessions always run over an hour. We have things in common. ( I was an opera singer before I flipped out, he was a pianist before med school).
The problem is that the therapy never really "goes" anywhere. I feel like an ingrate because he has been so flexible and good about so many things. But the sessions are so "willy nilly". there is no structure to them, and there is no continuity from session to session. In many cases I have told him the same story more than twice! He deems significant things that are really obvious and trivial. OK, I am NOT where I was 3 years ago when I came to him fresh from the hospital, but all of the things that are better are situational. No fundamental changes have really taken place in me. We play games with meds, but that is such a crap shoot anyway, as anyone who is on meds will attest to.
In reality, I am just using him for his prescription pad and becoming more and more annoyed when I have sessions with him either on the phone (I have since moved again) or in his office. I have been a chronic canceller of appointments for over a year now, and he doesnt' GET IT!!!!!!
I have tried being subtle about leaving him (yes, it does feel like leaving a lover) but he rarely bites......then when he does, I cower and miss my opportunity to say "thanks, but I need to move on".
part of the thing is that I owe him thousands of dollars, which he has never ONCE asked for or made an issue of. Another part is that he always has returned phone calls when I have been in distress and stayed on with me for an hour in some cases!
But I am not moving along in this. And I feel deep inside of me that I need to stop wasting my time and his and get either a new therapist to talk to or just screw talk therapy altogether for the time being (I am, in general, very resistant to it.....maybe it is because I think his suggestions are inane.......THERE I SAID IT!!!)
But when you owe someone so much.......it makes it tough.
I jsut cancelled another appt. I know that I need to give him a speech about not wanting to do talk therapy now (but will ya still write me scripts???). In an ideal situation I would not be such a chicken and just look him in the eye and say "dude, this is sooooo not working", but I am a chicken.....
Can I end this with a phone call? I mean the guy is an hour from me....and getting there is extrememly complicated. Do I owe him a look in the eye? Am I making a mistake?
Any input would really help, I think....
My stomach is getting upset just thinking about it.Thanks,
Diane
Posted by platinumbride on March 30, 2004, at 23:24:05
In reply to can i jump in here for support too?, posted by platinumbride on March 30, 2004, at 23:03:36
I am Bipolar II, and cycle pretty rapidly, so I am never really sure if it is a voice of reason or a voice of rationalization talking.
OK, another thing:I am not sure that he will go for just prescribing me meds without doing therapy with me as well. And I am not really "all set" with a cocktail here. I may still need to make changes. Furthermore, there are 2 meds that I really don't want to stop at this point, and one of them is klonopin, which some docs won't want to prescribe because they believe it is addictive. (there is a lot of debate about this)
And now that I DO have insurance, I find that there is only ONE psychiatrist on my plan within a 30 mile radius! 30 miles from here there is ONE other one!
I just don't know what to do...and so I have been doing nothing. But I just don't know if I can sit through another inane session with the man - I really dont'.
Posted by platinumbride on April 1, 2004, at 17:42:33
In reply to can i jump in here for support too?, posted by platinumbride on March 30, 2004, at 23:03:36
or was it inappropriate for this board in some way?
Posted by spoc on April 3, 2004, at 22:42:54
In reply to was my messge too long?, posted by platinumbride on April 1, 2004, at 17:42:33
> or was it inappropriate for this board in some way?
Hi Platinumbride,
I'm pretty new so I'm sure I can't think of anything about this place you don't already know, so excuse me in advance! But your title grabbed me so I just wanted to say I know that feeling. I've slipped into some long ones myself (and even not-so-long ones) where later I ended up wondering if I just sounded self-absorbed or something. I feel embarrassed if in my mind I was opening up and being vulnerable. But I think maybe I don't express myself from the gut/hip enough for it to even show that I am actually "reaching out."
Maybe in these situations it's just that there can be no rotating shift where someone is always watching to make sure each post gets at least a brief acknowledgement! And I guess the nature of this place is that we shouldn't expect one. Ironically, in some ways we have to be tough/strong around here, even though that may be the last thing many of us are. Given so much going on around here, things of certain natures may jump out at different people, and they assume the rest will be jumping out at and being addressed by others.
I'd like to figure out the "protocol" too. Maybe sometimes it's better to start a new thread, like in this case one about considering leaving therapy -- or about *you* considering leaving therapy? Maybe people have a sense of waiting for the initiating poster to respond back before the thread gets active and takes other turns? I don't know, I'm only guessing, and I probably shouldn't! And as a newcomer maybe I should be staying more on the sidelines for awhile anyway.
Now, uh, what was your question again?? Ok, you said any input would help! Mine would be that other than the obvious choices (stay with current "shrink" or drop him and switch); you really only have going ahead and asking him if you can see him only for meds; or, overlapping him for a few sessions with the new doc until you see if that is working out. Even at the low rate your current pdoc charges you, I'd hesitate myself to keep running up the total if you are really going nowhere. The other doc sounds closer too?
But you did say that you are "supposed" to be seeing someone quite frequently and I haven't been answering from that perspective, so this is incomplete. But if it were me I'd try a switch. Your current doc sounds amiable enough to even welcome you back someday. Maybe you could just call it a break if you could get that out more comfortably. Knowing as you do that you back off whenever quitting comes up, maybe you could first leave him a voice mail message noting that "I absolutely need some time to think, but know I can never stand my ground. So please bear in mind when you call me back that if I again defer, it is only from discomfort, not from genuinely changing my mind..." Maybe then he'll be more amenable when you finally talk to him about (wink, wink) "taking a break."
Good luck whatever you do! : )
Posted by fallsfall on April 4, 2004, at 10:03:13
In reply to can i jump in here for support too?, posted by platinumbride on March 30, 2004, at 23:03:36
Hi Platnum bride,
I didn't answer earlier because your question is pretty complicated and I had too much stuff in my brain as it was. I guess I didn't have the mental energy to delve into your question and give you a reasonable answer.
(As a matter of protocol, you probably should have started a new thread since, while the topic is the same you have a lot of details etc. But DON"T feel badly about that! We really are a very forgiving bunch, and I assure you that it won't be held against you (in fact it is already not held against you!). I mention this only because you asked.)
Now, to your question.
Do you know what kind of therapy your shrink is doing? Often MD Psychiatrists would tend towards Psychoanalysis instead of Psychotherapy. And, from your description, it sort of sounds like that: 3 times a week (though I am in 3 times a week therapy...), no structure, no continuity from one session to the next. Does he ask you to "free associate"? This is where you say everything that you are thinking whether or not it makes sense to you and whether or not you think it is important. It gets you into a mode where you aren't censoring what you are saying, so you tend to reveal more of your unconscious thoughts this way.
There are other kinds of therapy, and you might discuss with your shrink if one of those might not be more appropriate for you at this time.
CBT is very structured. You define problems in your current life that you would like to work on. The therapist helps you to see if there are any ways that you are seeing things that aren't quite consistent with reality (i.e. if your spouse never does the dishes, but you never ask them to, then you might be "fortune telling" - where you don't bother to ask because you already "know" what the answer will be). Then they would help you to recognize that and come up with a strategy to deal with it (i.e. try asking your spouse and tell them why it is important to you that they do the dishes - you could be really surprised with their response!). That's a pretty simplistic example, but the point is that you evaluate current problems, come up with strategies to solve the problems, try the strategies out, evaluate whether they worked etc. Often with CBT the therapist will even give you homework (like "tell your spouse this week that you want them to do the dishes", or make a list of all the times that you don't say something because you think you already know the answer).
CBT is great for a lot of people. It is a really good way to learn coping skills, so life doesn't *feel* so hard. Insurance companies like it because it is often time-limited (often CBT will only talk about a particular problem - the one you talk about when you start - and won't end up going off on tangents of other problems that might show up along the way. This is not always true, though).
I'm in Psychodynamic therapy. This is more like analysis in that we talk about my childhood a lot and *why* I feel and behave as I do. The basis of this therapy is pretty much Freud's theories. But, unlike analysis, you tend to have fewer sessions (2/week, or 1/week, or even every other week). And the sessions are more like conversations. There are analysts who talk a lot and Psychodyanmic therapists who don't, I sort of see them on a continuum (for instance, my therapist also does analysis, so I may actually get a mixture of the two). Psychodynamic therapists are less likely to ask for free association. The conversations have more give and take between you and the therapist (where with true free association, it is almost like the patient talks for 42 minutes, and then the analyst interprets for 3 minutes - well, that is an exaggeration...).
So, I think that it would be worthwhile having a conversation with your shrink. Ask what his therapy orientation is (it will probably be analysis, psychodynamic, humanistic, CBT (Cognitive Behavioral), eclectic (which means they use whatever they think will work best with each individual patient)). You can ask him to explain how that orientation works.
Tell him what you find frustrating about your sessions. Sometimes frustration is because you are in a type of therapy that doesn't fit what you need right now, sometimes frustration is because you are bumping into issues that you really aren't sure you want to talk about. So sometimes frustation means that you need to change therapists or therapies and sometimes it means that you have to work harder where you are.
It would be perfectly fine to tell him that you are frustrated with the way things are going, and that you want to learn more about therapy in general so that you make good choices for yourself. They are trained to be objective, and not be personally insulted if you don't like their style. I have found that most therapists really would rather have you see someone else, if that would help you. You really need to find the right "fit" (just like you do for a job or a spouse) with a therapist. Different therapists (and therapies) work better for different patients - or even for the same patient at a different time.
The money thing is not a particularly good situation. By the nature of therapy, the therapist has a lot of power in the relationship. Money is one of the few things that the patient has that balances things out. A therapist who has allowed you to go deep into debt without talking about it can put you in the kind of bind that you are in now. I would suggest that as part of this "evaluation" of your therapy that you address the debt. Try to find some kind of plan where the debt will be repaid (whether you stay or not). You don't say much about your financial situation, but it really isn't good for the therapy relationship for there to be long term, increasing debt.
Yes, I think you owe him a face to face discussion. As painful (and often embarassing) as these are, they are also frequently incredible learning experiences. Go talk to him. Tell him how you are feeling. Ask what your choices are. Ask what he recommends. Then follow your gut.
Let us know!
Good luck!
Posted by platinumbride on April 4, 2004, at 14:03:30
In reply to Re: was my messge too long? » platinumbride, posted by spoc on April 3, 2004, at 22:42:54
Thank you both so much for your supportive responses. I still keep waffling on this...called him to make a "phone appt" purely out of guilt! Maybe I will try to get down to his office instead of blabbering away on the phone and becoming frustrated and pissed at what seems to be a more "psychodynamic" approach, as fallsfall put it.
I once had cognitive therapy when I was younger, and it was good at the time. I'm not totally sure that that is the route for me though. What really occurs to me is that there is no type of therapy that can work unless one WANTS it to work. (Of course my doc's take on this is that one has to figure out WHY said person doesn't want it to work...and the answer always is "I don't know) And I am so disillusioned and disenchanted thatI have given up. I can't deal with the ups and downs anymore. A frontal lobotmy might be nice, because meds don't seem to be making a significant dent..... ha ha ha. Maybe meds can't make a significant dent unless you want them to either...I don't know.
But I thank you both for your posts and I will be reading them over and over again.
I feel better having read them.Diane
Posted by gardenergirl on April 4, 2004, at 14:05:35
In reply to Re: can i jump in here for support too? » platinumbride, posted by fallsfall on April 4, 2004, at 10:03:13
Fallsfall had excellent suggestions. I don't really have anything to add, but I wanted to offer support. It sounds like quite a dilemma. And don't worry about being new and not understanding protocol. I think everyone is pretty forgiving. I've been here for a few months now, and probably do the same thing as you did more than not. I have to remind myself: "start a new thread! start a new thread!"
Take care!
gg
Posted by spoc on April 4, 2004, at 15:01:59
In reply to Re: was my messge too long?, posted by platinumbride on April 4, 2004, at 14:03:30
> ...Maybe I will try to get down to his office instead of blabbering away on the phone and becoming frustrated and pissed at what seems to be a more "psychodynamic" approach, as fallsfall put it. >
--------
Hi again,I agree that discussing methodology is imperative. When I recently made an attempt to start therapy, I didn't ask about the doc's beliefs and practices. In the end it turned out to have been classic analysis, which was (especially given his particular application) the polar opposite of what I had wanted.
I felt a lot of upset at how things were going before he finally stopped deflecting my attempts to sort it out, and came close to admitting that his method wasn't at all what I had said I was looking for. While I hadn't asked him at our first meeting if he practiced what I was interested in, I had made myself 110% clear by sending an inquiry letter in advance, to which he responded with a call saying "Yes, I can help with all those things." And I repeated all those things when I went in, and proceeded throughout as one who obviously had been expecting those things. I take responsibility for not being a more assertive consumer, but he really should have told me he didn't carry the product I was shopping for! There were at least three things I specified were key to me, and his methods concerning all three of those things turned out to be the opposite... several thousands of dollars and attempts at clarification later.
So yes, discussing methodology is *key.* At least your feelings about the treatment you've been getting are along the lines of "inane;" I wish mine were that benign. I hadn't tried many things, so wanted to start with something that would absolutely identify the negative but focus on the positive, and on baby-step actions, which I was coming up with myself to no response. But with no warning, what I was receiving ranged from a total void to hunting only for the negative. It made me feel nauseous assuming for months that that must be all there was to see in me, despite a previous history of good self esteem in some of those areas -- which I couldn't afford to lose as well. He wouldn't clue me in even when he could see how much this simple failure to clarify his methods vs. those I had asked for was devastating me.
SORRY! You are way beyond needing to sort things out on that level with your current doc. This bitterness just has a way of still seeping out of me, even though in my heart I think I have put it in perspective that it was just a bad fit and he is only one of thousands/millions out there. I truly do not mean to knock all therapists or even analysts whatseover. (EEEK! Maybe I should have started a new thread!) : )
Posted by platinumbride on April 4, 2004, at 15:33:35
In reply to Re: discussing methodology » platinumbride, posted by spoc on April 4, 2004, at 15:01:59
But with no warning, what I was receiving ranged from a total void to hunting only for the negative. It made me feel nauseous assuming for months that that must be all there was to see in me, despite a previous history of good self esteem in some of those areas -- which I couldn't afford to lose as well. He wouldn't clue me in even when he could see how much this simple failure to clarify his methods vs. those I had asked for was devastating me.
I am so sorry that you had to go through that. One would think that therapists would possess a certain degree of intuition with regard to patients. I mean, would it have killed him to notice that his methods were not what you needed? I don't know....maybe they are so trained to NOT take things personally that they stop paying attention to what is right in front of their eyes...
Then there are the ones who seem to just be evil and controlling. Sometimes one has to remember that Hannibal Lechter was a shrink! Damn, that is scary!
I guess there is a part in everyone that would like to be able to help, and some of us will jump through a thousand hoops before we realize that we are simply not capable of doing so for a particular individual. I also believe that a lot of therapists kind of use their patients as methods to deal with their own personal garbage. I had one who was like that, but again, she was so well-intentioned in so many other ways that it was hard to admit that. In the end, she referred me to the guy I am having qualms about now! I think she did the right thing for both of us, because I really didn't need to hear things like "I could crush you if I wanted to". (Not kidding) Hmmmmmm judges have to recuse themselves if there is a conflict, but therapists don't.
I really hope that your next experience is more positive. It probably will be, seeing as you are more savvy, several thousands of dollars later...
D
Posted by spoc on April 4, 2004, at 15:39:23
In reply to Re: discussing methodology » spoc, posted by platinumbride on April 4, 2004, at 15:33:35
This is the end of the thread.
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