Psycho-Babble Psychology Thread 1048199

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Re: do you think of therapy as having a goal?

Posted by alexandra_k on August 3, 2013, at 15:22:58

In reply to Re: do you think of therapy as having a goal?, posted by alexandra_k on August 3, 2013, at 14:58:41

Which is of course what is potentially magic about private practice and private funding.

Along with the other obvious aspect.

Privacy.

The need for which... I have learned... Most people are incapable of understanding. Because most people would love to be seen by the world.

 

Re: do you think of therapy as having a goal? » Dr. Bob

Posted by Twinleaf on August 3, 2013, at 19:46:35

In reply to Re: do you think of therapy as having a goal?, posted by Dr. Bob on August 3, 2013, at 0:00:32

I think it' impossible for the therapist and the client to engage in therapy without having hoped-for goals. For the client, relief from anxiety snd depression are probably foremost, but both participants also probably hope for well- being and self-fulfillment. I can't imagine what a goal-free therapy would be like, but I don't think I would like it or stick with it!

 

Re: do you think of therapy as having a goal?

Posted by baseball55 on August 3, 2013, at 20:46:26

In reply to Re: do you think of therapy as having a goal? » Dr. Bob, posted by Twinleaf on August 3, 2013, at 19:46:35

When I started therapy, I didn't really have a goal except to feel better. As I continued, my goals kept changing and getting more specific. My therapist is very big on setting goals and asks periodically what my goals are and where I see this going. At this point, I have no real goals but still feel emotionally needy for him. I guess my goal is to keep cutting back on the frequency of our sessions until I can imagine life without him.

 

Re: do you think of therapy as having a goal?

Posted by alexandra_k on August 4, 2013, at 0:36:08

In reply to Re: do you think of therapy as having a goal?, posted by Dr. Bob on August 3, 2013, at 0:00:32

if i won the lottery...

i think i would be inclined to look for a therapist.

if i were located where i was before... i would be inclined to hunt out my old therapist, actually. which is saying rather a lot, i guess.

he wasn't perfect... but he was good enough. indeed.

or i'd pay bob a sh*t ton of money to be my therapist :-)

i have a feeling he might be cool with the whole internet therapy thing :-)

i would like...

to be able to talk to someone. to say some of the things that i'm ashamed of, or struggling with.

someone to help me see things differently sometimes. or to feel things differently sometimes.

i would like... to be more productive. one day... when i'm on my death bed... i want to be able to look back on my life... and feel like i gave it a good and honest effort. to understand things. to make things better for people. to contribute.

i would like someone to help me feel like a worthwhile human being. and some of it is about acceptance. and some of it is about change. and some of it... i need a little bit of help sometimes. i'm not sure why. but i do.

i get scared sometimes. so scared. such a fine line for me of being homeless and dressed in rags and totally unemployable... not able to function in this world at all... so scared.

 

Re: do you think of therapy as having a goal?

Posted by Willful on August 4, 2013, at 11:02:41

In reply to Re: do you think of therapy as having a goal?, posted by baseball55 on August 3, 2013, at 20:46:26

Therapy has a goal, but the more diffuse it is-- like becoming less anxious or less depressed, the harder it is to identify a method, or even a concrete way of working toward that-- unless you're in CBT or DBT or something. But in terms of talk therapy, it seems that there's some sort of vague sense that if you talk about things, they get better.

But beyond feeling better to be talking about them--which seems to be an intermediate step toward changing them-- or becoming more aware of things you do, so you can sometimes stop yourself from doing them- (or not)-- the finding of goals seems to be hampered by this lack of any clear method. Even if you say-- which is questionable-- that you understand why you do things-- or, less questionable, have a clearer awareness of what you do that's problematic-- the looming issue always seems to be-- how to not-need to do them.

The question of how to stop needing something seems to be as unanswerable as the question of how to fall asleep when you're wide awake and know you need to get to sleep in order to function the next day. There is no answer-- the best you can do is keep trying, as you also try to find a way of mitigating the terrible sense of hopelessness that creeps in when the condition persists.


 

Re: do you think of therapy as having a goal?

Posted by Phillipa on August 4, 2013, at 18:56:34

In reply to Re: do you think of therapy as having a goal?, posted by Willful on August 4, 2013, at 11:02:41

When one repeatedly talks of something that is troubling or other it tends to dissipate. First time it's talked about emotions very strong, as you continue to discuss it it becomes less & less. This is used a lot with PTSD. Phillipa

 

Re: do you think of therapy as having a goal?

Posted by rjlockhart37 on August 5, 2013, at 23:42:14

In reply to Re: do you think of therapy as having a goal?, posted by SLS on August 3, 2013, at 7:04:48

my opinion: think there's 2 types of theapy, talk theapy that you just can vent emotions, and learn more about yourself in general, then others are more goal directed like CBT which more of self imrovement, psychodynamic is good theapy....i did when i was 17 with the most best therpist that i will never forget, he listned to everything i said, and was compassionate....i felt so free to tell my feelings, but then when i had to rehab 4 years later....they used congnitive behavioral therapy....and it was systematic therapy for the people in the room that they where doing teachings....not individuel counseling, they use the term "us" or "we" and tend to refer to "out disease" or "our pain" and that gets on my nerves because i am not a part of the others, and they don't about me....

my own view is to plan out your life, write down the emotions and the things that cause intense pain, and then come up with a self made improvement plan, no money, no therpist, but i do have to have support other than myself, babble....and talking deep inside the heart....

 

Re: do you think of therapy as having a goal?

Posted by rjlockhart37 on August 5, 2013, at 23:55:45

In reply to Re: do you think of therapy as having a goal?, posted by rjlockhart37 on August 5, 2013, at 23:42:14

this is another thing i found on CBT on study of its effency with older adults....

Cognitive Behavioral Therapy with older adults[edit source | editbeta]
CBT is used to help people of all ages, but the therapy should be adjusted based on the age of the patient with whom the therapist is dealing. Older individuals in particular have certain characteristics that need to be acknowledged and the therapy altered to account for these differences thanks to age.[55] Some of the challenges to CBT because of age include the following:
The Cohort Effect
The times that each generation lives through partially shape its thought processes as well as values, so a 70-year-old may react to the therapy very differently from a 30-year-old, because of the different culture in which they were brought up. A tie-in to this effect is that each generation has to interact with one another, and the differing values clashing with one another may make the therapy more difficult.[55]
Established Role
By the time one reaches old age, the person has a definitive idea of her or his role in life and is invested in that role. This social role can dominate who the person thinks he or she is and may make it difficult to adapt to the changes required in CBT.[55]
Mentality toward Aging
If the older individual sees aging itself as a negative and this can exacerbate whatever malady the therapy is trying to help (depression and anxiety for example).[55] Negative stereotypes and prejudice against the elderly cause depression as the stereotypes become self-relevant.[52]
Processing Speed Decreases
As we age, we take longer to learn new information, and as a result may take more time to learn and retain the cognitive therapy. Therefore, therapists should slow down the pacing of the therapy and use any tools both written and verbal that will improve the retention of the cognitive behavioral therapy.[55]

Wikipedia

_______________________________

so talk therpy i guess can be a good thing because it focuses on the pain, and what causes it, and not stress the pain to change.....cuzz it could be worse if it stays

thats all.....i don't like CBT, the rehabs did it, and if i didnt follow along they always gave me these looks like I was a moron, my personal therpist after group sessions always had a whiteboard and wrote it like a teacher, wrote the goals, it wasnt really a sympathy therpy.... more motivational speaking

 

Re: do you think of therapy as having a goal?

Posted by alexandra_k on August 6, 2013, at 3:38:58

In reply to Re: do you think of therapy as having a goal?, posted by alexandra_k on August 4, 2013, at 0:36:08

I think of CBT quite often as 'a little bit of knowledge can be a dangerous thing'. Clinical Psychologists (in this country at least) can be like that about it. Thinking that it is the wonderful magical cure for everything (they consider legitimate) it is the most scientifically effective treatment (there is lies, damned lies, then there is statistics) it is a knowledge base that they have (based on very outdated theory of emotions and the relationship between reason and emotions) and they alone have this knowledge base in virtue of being selected to study a fairly competitive program: Clinical Psychology. This form of therapy distinguishes them from the counsellors (they are reimbursed at a higher rate, I believe) and they get to feel superior to the p-docs who (they believe) are the ones suffering from outdated psychological theory.

Not always, of course. But the above is my experience with Clinical Psychology (and CBT). But... My experience was with the publicly funded versions and I'm fairly sure they were expected to write a page full of notes after each session clearly stating the goal and how we had made progress towards it in order to justify seeing me. Wow. Poor them. That is what it looked like when I got hold of my notes... And poor me. Who can't actually talk to them very much at all for fear of what they might say and how that might be 'understood' by random wandering shift workers... I think our note system has moved to online. Now it is easily accessed. I think the good old days were better where whole files might be 'lost' or 'hard to locate' or just never really ended up getting sent on... They are expressing frustration at how hard it is to get my notes from Aussie, anyway. Yay Australia rah rah! A little bit of privacy... Is a wonderful thing.


 

Re: do you think of therapy as having a goal?

Posted by Dr. Bob on August 6, 2013, at 4:19:58

In reply to Re: do you think of therapy as having a goal?, posted by rjlockhart37 on August 5, 2013, at 23:42:14

> I don't think it is very easy to predict the ultimate destination where achieving a set of goals will bring someone
>
> - Scott

> At this point, I have no real goals but still feel emotionally needy for him. I guess my goal is to keep cutting back on the frequency of our sessions until I can imagine life without him.
>
> baseball55

> Even if you say-- which is questionable-- that you understand why you do things-- or, less questionable, have a clearer awareness of what you do that's problematic-- the looming issue always seems to be-- how to not-need to do them.
>
> Willful

> my opinion: think there's 2 types of theapy, talk theapy that you just can vent emotions, and learn more about yourself in general, then others are more goal directed like CBT which more of self imrovement
>
> rjlockhart37

I like the distinctions that Scott and RJ made. If the idea were to vent or to learn about oneself, it's not clear when one would terminate. OTOH, if one had a more specific goal, one might consider terminating after reaching it. And setting goals, as opposed to an ultimate destination, could have a couple advantages:

1. it would be one step at a time, so it might feel more doable

2. acceptance of the actual ultimate destination might be more likely

Would you consider the following goals or ultimate destinations?

a. not feeling emotionally needy
b. being able to imagine life without someone
c. not needing to do certain things

> most people would love to be seen by the world.
>
> alexandra_k

Some do. Others feel terrified by the prospect.

Bob

 

Re: do you think of therapy as having a goal?

Posted by SLS on August 6, 2013, at 5:08:33

In reply to Re: do you think of therapy as having a goal?, posted by alexandra_k on August 6, 2013, at 3:38:58

I don't see CBT as being an answer so much as it is an interventional technique.

In my experience, CBT can be very useful to deal with negative thoughts and associations quickly as they occur near the surface. If practiced with guidance, I think that counterproductive core beliefs can be challenged with reality testing, but this does not occur instantaneously. It is a top-down, trickle-down approach. I don't think that CBT is a replacement for interpersonal or psychodynamic psychotherapies, but it can act as a supplement to them.

I have heard it said by others that CBT can do more harm than good. I don't understand why.


- Scott

 

Re: do you think of therapy as having a goal? » Dr. Bob

Posted by Partlycloudy on August 6, 2013, at 12:00:45

In reply to Re: do you think of therapy as having a goal?, posted by Dr. Bob on August 3, 2013, at 0:00:32


> I'm starting a new thread because the above got me wondering: How many of you think of therapy as having a goal?
>
> Bob

My therapist and I started talking about termination last year. We decided that when I had a solid 6 to 12 months of stability that we would probably taper off and leave it to making appointments just for crisis situations.

Life, as it turns out, has not cooperated. The most problematic component has been my PTSD, and learning tools to deal with triggers. I have encompassed new techniques for me to deal with it.

I don't worry about termination or the length of time I remain in therapy. I have a chronic health condition. As many appointments as it takes to keep my progress steady, or to get me back up to speed on development. It is what it is. I would be a fool to deny myself the correct care.

(It is nice to be back. Very different feel, and it is nice to see you engaged with the members.)

PC

 

Re: do you think of therapy as having a goal? » SLS

Posted by Dinah on August 6, 2013, at 13:55:08

In reply to Re: do you think of therapy as having a goal?, posted by SLS on August 6, 2013, at 5:08:33

It might have to do with the differences in personalities. The advantages of different types of therapy is that different types help different people.

CBT was of limited help to me. The only thing I would have found harmful about it was if my therapist was determined that it *should* be the answer for me - something I have noticed among various adjunct therapists I've seen. They seem to be quite put out if I don't respond the way they think I should.

I have always suspected that my therapist slipped a bit more CBT into our therapy than he admitted, tho he had the sense not to make it sound like CBT, but more like wisdom. It *always* puts me off to have homework and fill out worksheets and answer questions that, in my opinion, haven't got the easy answers they "should" have.

When confronted with textbook CBT - questionnaires and standard verbiage - I tend to feel even worse than I already do, as well as mulish and obstinate.

I might prefer DBT. I always suspected I would, given its better balance of acceptance of where one is while admitting that change could be beneficial. But in reality if I were confronted with the associated groupspeak, I suspect I'd quickly tune out.

As far as having a goal, I tend to agree with pc. My goals in therapy may shift over time, but what is wrong with having ongoing treatment for an ongoing condition?

That being said, I suspect the end of therapy will be when I've internalized my therapist enough to not see any real benefit in consulting him in times of stress. Or, as what sometimes happens with children and parents, when I strongly suspect he's no more capable than I am of dealing with something and see no real added value in his assistance. (Which is not to say that I will feel capable, merely that I won't think he's capable either.)

 

Re: do you think of therapy as having a goal? » Partlycloudy

Posted by SLS on August 6, 2013, at 18:23:36

In reply to Re: do you think of therapy as having a goal? » Dr. Bob, posted by Partlycloudy on August 6, 2013, at 12:00:45

> Life, as it turns out, has not cooperated. The most problematic component has been my PTSD,

Prazosin?

Pharmacotherapy isn't always helpful, but I have seen prazosin work well to treat both depression and anxiety in situations where there has been a history of trauma, neglect, and abuse.


- Scott

 

Re: do you think of therapy as having a goal? » SLS

Posted by Partlycloudy on August 6, 2013, at 18:33:51

In reply to Re: do you think of therapy as having a goal? » Partlycloudy, posted by SLS on August 6, 2013, at 18:23:36

> > Life, as it turns out, has not cooperated. The most problematic component has been my PTSD,
>
> Prazosin?
>
> Pharmacotherapy isn't always helpful, but I have seen prazosin work well to treat both depression and anxiety in situations where there has been a history of trauma, neglect, and abuse.
>
>
> - Scott

I'll ask about it. I may be changing pdocs (the trauma is ongoing) and would prefer not to do any more tweaking; but it would be silly not to suggest something that might help.
Thanks!
PC

 

Re: do you think of therapy as having a goal?

Posted by baseball55 on August 6, 2013, at 21:49:45

In reply to Re: do you think of therapy as having a goal? » SLS, posted by Partlycloudy on August 6, 2013, at 18:33:51

When I started therapy, I had a trauma history which I had completely buried and had built all these defenses against people which isolated me and began to depress me. I saw a p-doc in psychodynamic therapy, which helped me a lot But we had a really good relationship and I trusted him totally.

When I got depressed and suicidal a couple of years later, he wanted me to find a DBT therapist. I had done CBT in groups and didn't find it helpful. I was not depressed because of distorted thinking. I was hopeless and in despair and could not control thoughts of suicide. DBT therapy has been great. It's not at all the same as CBT. It's all about getting control, learning to live with strong emotions, learning to be mindful, etc.

I hear so much negativity on this board about psychiatrists and therapists. My experience is that they have helped me immeasurably.

 

Re: do you think of therapy as having a goal? » baseball55

Posted by SLS on August 7, 2013, at 6:10:54

In reply to Re: do you think of therapy as having a goal?, posted by baseball55 on August 6, 2013, at 21:49:45

What are the most important differences between CBT and DBT?

Thanks.


- Scott

 

Hello, Dinah! (nm) » Dinah

Posted by Partlycloudy on August 7, 2013, at 11:52:52

In reply to Re: do you think of therapy as having a goal? » SLS, posted by Dinah on August 6, 2013, at 13:55:08

 

Hi! Welcome back! » Partlycloudy

Posted by Dinah on August 7, 2013, at 18:11:17

In reply to Hello, Dinah! (nm) » Dinah, posted by Partlycloudy on August 7, 2013, at 11:52:52

It's good to see you.

 

Re: do you think of therapy as having a goal?

Posted by baseball55 on August 7, 2013, at 19:35:43

In reply to Re: do you think of therapy as having a goal? » baseball55, posted by SLS on August 7, 2013, at 6:10:54

> What are the most important differences between CBT and DBT?
>
> Thanks.
>
>
> - Scott

CBT is all about distorted thinking - nobody likes me, I f*ck*d up at work, my husband looked at me funny -- and therefore I am depressed or anxious or whatever. DBT is all about emotional regulation. There is very little focus on exacerbating thoughts (and I didn't have any of those thoughts. I was pretty realistic about my life and relationships.) The focus is on regulating emotions. If you feel depressed, how can you use mindfulness techniques to prevent a downward spiral. How can you learn to recognize emotions as they occur and just sit with them. DBT is very steeped in mindfulness practice and meditation. It was developed for people with out-of-control suicidality and self-harm. I had out-of-control suicidality.

At first I didn't take it seriously enough. But after a month in a hospital, my p-doc and DBT therapist met together with me and basically said, you do this and work hard at this or you are not going to make it. Over the last two years, I have worked extra hard at this. I meditate every day. I sit with painful emotions and watch them ebb and flow. If they don't ebb, I call my therapist and she suggests things I might do to distract myself and get control. She's the best.

I have to say though that I called nearly 50 people before I found her. People who specialize in DBT are rare.

 

Re: Hi! Welcome back! » Dinah

Posted by Partlycloudy on August 7, 2013, at 20:01:36

In reply to Hi! Welcome back! » Partlycloudy, posted by Dinah on August 7, 2013, at 18:11:17

> It's good to see you.

Sorry I have been such a $hit. Turns out, this place is a trigger for my PTSD. I am trying to be careful.
I am really sorry for anything unkind I might have said about you. Babble can bring out the worst in me. I am trying to learn better to walk away. And stay the heck away from Admin.
PC

 

Re: Hi! Welcome back! » Partlycloudy

Posted by Dinah on August 9, 2013, at 12:07:36

In reply to Re: Hi! Welcome back! » Dinah, posted by Partlycloudy on August 7, 2013, at 20:01:36

Whew! You scared me. I had to go read a few threads on Admin. :) I haven't been keeping up. I don't know about Admin, but Bob's behavior sure is triggering me right now. I keep having flashbacks of middle school.

I appreciate the apology. What's past is past and the future has always been of more interest to me than the past. I hope that we can build on the positives in the past and leave the baggage behind us. I also hope that you can forgive anything I have done to hurt you. I often later regret things I have said and done.

 

Welcome back PC!!!!!!!!!!!!!!!!!!! (nm) » Partlycloudy

Posted by HomelyCygnet on August 9, 2013, at 13:13:12

In reply to Hello, Dinah! (nm) » Dinah, posted by Partlycloudy on August 7, 2013, at 11:52:52

 

Re: Welcome back PC!!!!!!!!!!!!!!!!!!! » HomelyCygnet

Posted by Partlycloudy on August 9, 2013, at 14:22:59

In reply to Welcome back PC!!!!!!!!!!!!!!!!!!! (nm) » Partlycloudy, posted by HomelyCygnet on August 9, 2013, at 13:13:12

Thanks! I take it I should know you...?

 

Re: Welcome back PC!!!!!!!!!!!!!!!!!!!

Posted by Phillipa on August 9, 2013, at 20:31:47

In reply to Re: Welcome back PC!!!!!!!!!!!!!!!!!!! » HomelyCygnet, posted by Partlycloudy on August 9, 2013, at 14:22:59

Are you the Duck?


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