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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by ghost on December 26, 2004, at 17:58:44
i had no goals for therapy. there's no one issue (or series of issues) in my life that i need to deal with or get over. i started therapy because my pdoc said it would be good. i'm bipolar. my problems (most of them) are chemical. not psychological.
(or so i thought.)
the T wants me to tell her what my goals are for therapy. but i have none. i make some up, i stretch things a bit. i say i'd like to improve my relationships with people (this is true-- i'm always an acquaintence, never a friend). is this good enough?
it seems like we always come up with something to talk about for an hour, even if the first 20 minutes are spent in uncomfortable chitchat and silence. i hate that silence. the pdoc promised she wasn't a silent sort, but she is. i need someone who talks. (more specifically: asks questions.) she's not bad. i think after breaking out the "sand tray" for me to play with she's learned i'm more hands-on than i am talky out of the blue.
i envy that person who used to walk into therapy with an agenda (who was that?)... i walk in blank. it's like even the problems i had that day are gone, i make it a job, something i have to do, and consequently, i have nothing to really say, even though the more i think about it, the more i know i probably should keep going.
does that make sense? how do you do it?
Posted by Fallen4MyT on December 26, 2004, at 20:40:38
In reply to how did you define your therapy goals?, posted by ghost on December 26, 2004, at 17:58:44
I went into therapy wanting a way to be less isolated by my husband and for a better relationship or to get out....and some sleep no meds. It has grown from there
Posted by annierose on December 26, 2004, at 20:41:29
In reply to how did you define your therapy goals?, posted by ghost on December 26, 2004, at 17:58:44
I think it is Miss Honeychurch who makes an agenda. That previous thread had me in stitches.
Posted by lookdownfish on December 27, 2004, at 5:04:52
In reply to how did you define your therapy goals?, posted by ghost on December 26, 2004, at 17:58:44
To start out with my goal was just to get out of the depression I was in and to get off medication.
I think its important to review goals from time to time. Mine now are improved relationships and greater enjoyment of family life.
I never go into therapy with a specific agenda. My T is the silent type and is quite comfortable with a long silence while I think of something to say. I just gabble about something seemingly pointless and she then tries to help me get to what I really want to talk about.
Posted by badhaircut on December 27, 2004, at 10:26:26
In reply to how did you define your therapy goals?, posted by ghost on December 26, 2004, at 17:58:44
What a great question.
Did your pdoc say what she/he thought therapy "would be good" for? Maybe you could ask her/him. Whatever the pdoc had in mind might be a helpful way to frame your therapy sessions -- at least initially.
Posted by gardenergirl on December 27, 2004, at 15:55:38
In reply to pdoc's goals? » ghost, posted by badhaircut on December 27, 2004, at 10:26:26
That is a good question. I've been going for over a year, and my initial goal was to decrease depression symptoms and to stop sabotauging myself. At this point, I'm not sure how I would describe my goal. I'm not even sure what I would say about how I've progressed. I've got more awareness of how I project onto others, especially authority figures. But I still catch myself doing it, which is really frustrating. I guess my goal now is just increased understanding of myself and perhaps digging out some deeply buried pain.
I always ask my clients in the first few sessions what their goals are, and they often have trouble too. I think it really is a hard question to articulate, especially early on.
gg
Posted by Dinah on December 27, 2004, at 20:03:04
In reply to Re: pdoc's goals?, posted by gardenergirl on December 27, 2004, at 15:55:38
Especially since we lie through our teeth early on. To ourselves as well as to our therapists. :)
Posted by bimini on December 28, 2004, at 10:49:23
In reply to how did you define your therapy goals?, posted by ghost on December 26, 2004, at 17:58:44
My goal was to find my way back to a life that had changed abruptly. I wanted to learn what is happening to me, will it progress, can I do something to prevent deterioration, what are those things I can do, where do I go to find advice, what can I do to improve functioning, what can I do to prevent fading out, how do I deal with pain, anger, frustration, getting lost ?-?-?
Short, I wanted help through the confusion and tips on how to compensate. Over a dozen docs later I have given up searching for professional help. My Neuropsych is nuttier than I and might benefit from a long vacation (smile). I did not get advice nor answers to my questions. A modecum of understanding would have helped, what I got was an apathetic simper and a pill for each complaint.
bimini
Posted by littleone on December 28, 2004, at 15:42:05
In reply to how did you define your therapy goals?, posted by ghost on December 26, 2004, at 17:58:44
I first went to therapy because I just fell apart after witnessing a car accident. So my goal was to get over that.
But then I kind of introduced the fact that no one likes me. I guess my goal was I wanted to know why that was and to fix it/me.
Then I got really scared about the cutting (and how addictive it was) and my thoughts about s.
My current T addressed the cutting and s thoughts firstly. But I guess I'm kind of too scr*wed up underneath for him to be able to fix the accident and not liking me stuff. So we'd been sorting out family stuff.
But to be honest, I don't think any of them are his current goal. I think he kind of talks a little about all this stuff, but doesn't go too deep. I think he's trying to get me to attach to him and trust him and open up by talking rather than just by writing. I have a feeling things are all in a kind of holding pattern until I can do that. But I haven't asked him if that's right or not. I've never even come close to opening up and talking to someone *ever* in my life. It just feels impossible. And you can't maintain a holding pattern forever. Eventually you'll run out of fuel.
Posted by ghost on December 28, 2004, at 19:20:20
In reply to Therapy Goals (slight trigger) » ghost, posted by littleone on December 28, 2004, at 15:42:05
Posted by Lonely on December 30, 2004, at 1:24:33
In reply to how did you define your therapy goals?, posted by ghost on December 26, 2004, at 17:58:44
That goal thing just drives me crazy. But, usually it's expressed as "what do you want to work on?" My smart-alec side wants to respond with something like "well, maybe we could start with the floor and then the windows?" (Like out of the movie "Annie" when she goes to Daddy Warbuck's mansion and they ask her what she would like to do first) It would really help if they phrased it more kindly with interest and compassion sort've more like prefacing things with "no doubt you're feeling some pain some where in your life and you'd like some help with it?" At least then I'd feel more like they care. As it is, I just feel like it's sort've by rote.
One therapist, an insecure psychologist, even went so far as to write out a sort of contract which she thought I would be delighted to sign. I not only did not sign it, I took it apart, gleefully, and figuratively speaking shoved it back in her chubby face (resplendent with female pattern baldness).
I guess it's the insensitivity that really bothors me and therapists are rife with it. Has anybody ever really clobbered (totally in the figurative sense) these boar type therapists when they do this?
Posted by ghost on December 30, 2004, at 13:49:24
In reply to Re: how did you define your therapy goals? » ghost, posted by Lonely on December 30, 2004, at 1:24:33
hurrah for you calling them on their boarishness.
however...
--from the chubby-faced ghost.
Posted by Lonely on December 31, 2004, at 17:16:06
In reply to Re: how did you define your therapy goals? » Lonely, posted by ghost on December 30, 2004, at 13:49:24
Chubby faced is good! I too have a chubby (round) face. The way it should be! <grin>
> hurrah for you calling them on their boarishness.
>
> however...
>
> --from the chubby-faced ghost.
Posted by Dinah on December 31, 2004, at 19:53:31
In reply to Re: how did you define your therapy goals? » ghost, posted by Lonely on December 31, 2004, at 17:16:06
I had a face like a basketball.
Posted by ghost on January 1, 2005, at 14:35:50
In reply to Daddy used to say, posted by Dinah on December 31, 2004, at 19:53:31
Posted by thistlethorn on January 1, 2005, at 15:10:53
In reply to Re: how did you define your therapy goals? » ghost, posted by lookdownfish on December 27, 2004, at 5:04:52
lookdownfish, may I ask if your work in therapy succeeded in helping you to get off medication? I would be interested in your answer because I am NOT currently in therapy, but I AM taking a heavy dose of an AD (prescribed by a psychopharmacologist) and have been doing so for quite a long time.
tt
> To start out with my goal was just to get out of the depression I was in and to get off medication.
Posted by gardenergirl on January 1, 2005, at 21:15:39
In reply to Re: how did you define your therapy goals?, posted by bimini on December 28, 2004, at 10:49:23
>A modecum of understanding would have helped, what I got was an apathetic simper and a pill for each complaint.
Yuck. What a horrible image of a "helper". Sorry you didn't have a better experience.
gg
Posted by Lonely on January 2, 2005, at 12:49:35
In reply to Re: how did you define your therapy goals?, posted by bimini on December 28, 2004, at 10:49:23
It sounds like we might be dealing with similar issues whether directly or indirectly. I sent a fax to my hubby's neuropsychologist asking for referral to MS support group (my LMSW therapist suggested it) but never heard a word back. For us, perhaps due to insurance, I don't know, the neuropsychologist is nothing more than a tester who seems to base life-influencing reports mostly on the moment of testing without enough long term multi source evaluation. But, at least this one, so far, in comparison to the first one has been much more pleasant. The first one definitely had a taunting "I'm-gonna-lay-you-open" type of attitude. My hubby was diagnosed with MS on Dec. 28th. I have yet to get any kind of support from a health care provider - even my own LMSW - they don't seem to be really trained in this area.
Perhaps it's different in different parts of the country or maybe just differences between neuropsychs. We're in the SW US.
I'm intrigued that you also have apparently asked for concrete or objective info and finding it hard to get. I noticed the same thing. The first one was really squirrely. Still waiting on the report from the current neuropsych. There are so many layers in all this - the "old" stuff (behavioral & relationship issues) the emotional impact, the need for info that's not drug-company tainted, and the need for tangible resources peratining to "what do I do when he thinks he's Napoleon?" or "what do I do when he starts threatening me?" or "what do I do when he forgets to fasten his pants, puts his shirt on backwards, leaves a pan of grease on the stove with the burner on?" etc. And, like you, I could use a ton of compassion.
This must be some sort of a gift - just haven't figured out how to use it - would have preferred great artistic talent or something!
> My goal was to find my way back to a life that had changed abruptly. I wanted to learn what is happening to me, will it progress, can I do something to prevent deterioration, what are those things I can do, where do I go to find advice, what can I do to improve functioning, what can I do to prevent fading out, how do I deal with pain, anger, frustration, getting lost ?-?-?
>
> Short, I wanted help through the confusion and tips on how to compensate. Over a dozen docs later I have given up searching for professional help. My Neuropsych is nuttier than I and might benefit from a long vacation (smile). I did not get advice nor answers to my questions. A modecum of understanding would have helped, what I got was an apathetic simper and a pill for each complaint.
>
> bimini
Posted by gardenergirl on January 2, 2005, at 13:29:21
In reply to Re: how did you define your therapy goals?, posted by Lonely on January 2, 2005, at 12:49:35
Hi,
You are right that real life practical advice is valuable. You might want to look into occupational therapy for your husband if he starts to lose his ability to do basic daily living activities. Even more complex ones. Ask your doc for a referral.Also, I'm sure there are support groups out there. They have them for all kinds of things these days. You can probably find one at http://www.nmss.org/
And there is a message board at http://groups.msn.com/AHomeawayfromHomeaMSSupportBoard/_homepage.msnw?pgmarket=en-us
Finally, you might check out the book "Where is the Mango Princess?" This is the story of a family dealing with a traumatic brain injury and subsequent recovery. There is practical stuff, heartwarming stuff, tearjerking stuff, and negotiating health care systems stuff. I enjoyed reading it for a neuropsychology class. It's an easy read.
Good luck. MS is tough. I feel for you and your family.
gg
Posted by Lonely on January 2, 2005, at 13:56:28
In reply to Re: how did you define your therapy goals?, posted by gardenergirl on January 2, 2005, at 13:29:21
Posted by fallsfall on January 2, 2005, at 21:36:06
In reply to how did you define your therapy goals?, posted by ghost on December 26, 2004, at 17:58:44
Everyone is different. Only you can know what you need from therapy.
My goals today (to get back to work) are very different from when I started (to stop driving my best friend crazy with my dependency).
I used to go in with an agenda (though I think the previous poster was right - it was Miss Honeychurch, and KK? who did the great threads on agendas). But neither of my therapists thought my agendas were helpful. Because my agendas meant that I had already role played the whole session, and I already had expectations about what was going to happen. So I try not to plan too much. I usually figure out how to get started (i.e. brief chronological update since last session or jump into the issue from last session or introduce new topic) so I don't sit there with my mouth open for 5 minutes at the beginning. But if nothing strikes me before hand as something important, I try to go in without an agenda. And I tell him what I'm thinking about. Some of our most valuable sessions have been the times when I haven't had anything in particular to talk about.
But agendas and goals aren't really the same thing.
I guess to figure out what your goals are you might try completing these sentances:
I would be happier if ...
I wish that I could ...
Most people can ..., I wonder why I can't?
I get really uncomfortable/unhappy when ...
I think that I'm different from everyone else because I ...I guess the bottom line is to try to figure out what kinds of changes you would like to make that would make your life better. Those can be your therapy goals.
Posted by ..::ghOsT::.. on January 2, 2005, at 21:45:31
In reply to Re: how did you define your therapy goals? » ghost, posted by fallsfall on January 2, 2005, at 21:36:06
thanks so much. this helped a lot.
hugs to the ice cream queen,
ghost
Posted by Lonely on January 2, 2005, at 22:21:34
In reply to Re: how did you define your therapy goals? » ghost, posted by fallsfall on January 2, 2005, at 21:36:06
I agree that these are good points and good ways to get started. Oh, and thank you for putting them out there! I might very well try tackling them a bit with my T.
I think that part of what bothors me is that there is no immediate solution to the things I would like to be doing such as working in my profession. Several things have happened that have hampered it ranging from financial to advocates dying or moving away to slow market, to hubby who has brain damage and is not dependable, etc. Probably the only thing I could "work on" in relationship to all this is my sense of value and in 5 years of therapy that just went down hill. Also, I find therapists tend to project their own professional issues and perceptions on to me. ie... a client is one person who comes to them. For me a client is a large organization, usually a corporation, and I'm not dealing with their personal issues but rather their professional issues. But, the word "client" seems to trigger something in an LMSW's mind and one therapist sniffed, and rather arrogantly told me to ignore the phone calls and not let them make demands on me. Yeah, sure. Therapists can pull that bologna but in a very highly competitive corporate environment I can NOT. Also, I'm shy and self conscious - those are classics no doubt for people going into therapy and there must be a myriad of treatments for it but I've never found one that helped per therapy. Just a real world advocate and practice in non threatening situations is the best thing. But an LMSW with a Mary Miller background is sure it's getting into one's childhood. Bull.
But, again, I think you did a good service to all of us by putting those items out there; I guess it's less threatening to me and I feel more comfortable carrying it in to my T. Best to you!
> Everyone is different. Only you can know what you need from therapy.
>
> My goals today (to get back to work) are very different from when I started (to stop driving my best friend crazy with my dependency).
>
> I used to go in with an agenda (though I think the previous poster was right - it was Miss Honeychurch, and KK? who did the great threads on agendas). But neither of my therapists thought my agendas were helpful. Because my agendas meant that I had already role played the whole session, and I already had expectations about what was going to happen. So I try not to plan too much. I usually figure out how to get started (i.e. brief chronological update since last session or jump into the issue from last session or introduce new topic) so I don't sit there with my mouth open for 5 minutes at the beginning. But if nothing strikes me before hand as something important, I try to go in without an agenda. And I tell him what I'm thinking about. Some of our most valuable sessions have been the times when I haven't had anything in particular to talk about.
>
> But agendas and goals aren't really the same thing.
>
> I guess to figure out what your goals are you might try completing these sentances:
>
> I would be happier if ...
> I wish that I could ...
> Most people can ..., I wonder why I can't?
> I get really uncomfortable/unhappy when ...
> I think that I'm different from everyone else because I ...
>
> I guess the bottom line is to try to figure out what kinds of changes you would like to make that would make your life better. Those can be your therapy goals.
Posted by bimini on January 4, 2005, at 11:04:18
In reply to Re: how did you define your therapy goals?, posted by Lonely on January 2, 2005, at 12:49:35
> It sounds like we might be dealing with similar issues whether directly or indirectly. the neuropsychologist is nothing more than a tester who seems to base life-influencing reports mostly on the moment of testing without enough long term multi source evaluation.
Maybe the objective was to be as objective as possible, evaluating the results uninfluenced.
> Perhaps it's different in different parts of the country or maybe just differences between neuropsychs. We're in the SW US.
I had thought of that too. After I was bounced around like a hot potato I searched for a Neurologist who specializes in trauma. Had to display a tempest to get the referral. I could go on and on here...
> I'm intrigued that you also have apparently asked for concrete or objective info and finding it hard to get. I noticed the same thing. The first one was really squirrely.
After two years of asking the same questions I did get some answers. Not the answers I had wanted, but calming and confirming what I knew in my heart. Also, I prefer a Doc who admits he doesn't know to one who belittles or ridicules my concerns. I remember in the beginning I was overwhelmed with all the changes and confused enough that if I were given M and M's to take three times a day I would have believed in its magical powers.
> for tangible resources peratining to "what do I do when he forgets to fasten his pants, puts his shirt on backwards, leaves a pan of grease on the stove with the burner on?" etc.
A handbook would have been a good idea for me too.
"How do I stand without falling over? How do I dial a phone number? Where did words go? Where did everything go? How did my toe get purple? Why don't I know what a shovel looks like?" Warnings about cooking, candles, climbing on ladders and forgetting it isn't the ground. Driving? Working?I speculated the reason, for the lack of practical help I received, was circumstance of injury, litigation, insurance policies and ignorance.
It disturbs me to hear this problem to be wider spread.bimini
This is the end of the thread.
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