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So You Think You Need a Psychotherapist

People frequently ask  me about psychotherapists. They think they might need one and want to know if I see one. If so, am I getting results?

Here’s my attempt at an answer.

Mood music:

I currently see a therapist. I like him and usually feel better after spending an hour spilling my guts in his office. He’s my sixth therapist in 10 years.

My first therapist helped me unlock a lot of buried emotions that were tearing me apart. The second therapist was a jackass who was clueless about the mind of an addict. (I didn’t stick with him long.)

The third one was only OK, and I left after a couple of years.

I saw my fourth therapist for five years, and he taught me a ton about how the brain works, how different disorders hamper the mind, and how different medications are designed to treat those problems. He also taught me a lot about mindfulness-based stress reduction — the practice of keeping one’s thoughts in the moment.

When he retired, I got a new therapist who was 45 minutes away. That didn’t last long.

Now I’m on therapist number six, who is right in town and flexible with his schedule.

I’ve gone months between therapists because I felt I didn’t need one anymore. But after a while I always remember that there’s no cure for my OCD and related mental health challenges. It’s all about learning to manage it all, and that’s where a good therapist can make a world of difference.

I can’t answer the question people usually put to me, which is whether I think they should see a therapist. That’s a personal decision and I’m not a doctor. I also can’t tell people what they should look for in a therapist. It helps if the therapist has experience dealing with your particular problem. In my case, that means someone who knows about OCD and addiction. It also helps if you like your therapist

I can tell you what I look for, though. Specifically, I need a therapist who:

  • Doesn’t lecture me and tell me how I should do things. To me, that’s not what a therapist should do.  That’s more the domain of a drill instructor.
  • Asks a lot of questions. Therapists who ask a lot of questions force the patient to scour their feelings and get closer to the truth.
  • Is willing to express their own feelings. This is a slippery slope, because a therapist is supposed to focus squarely on the patient. But when therapists respond to my experiences by sharing their similar experiences, they are showing me that they get it. The current therapist does that, and it’s refreshing. It makes me more willing to be honest. A therapist who shows no empathy makes me less willing to deliver my unvarnished truth.

If you are asking yourself if you need to talk to a professional, chances are you’ve exhausted a lot of other options. You have nothing to lose if you give it a try.

silhouette of psychotherapist with patient lying on the couch

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The Danger of False Memories

Since this blog is part memoir, I worry about misremembering the past when I write about it. I’m obsessed with truth and recall things to the best of my recollection. But I know that for every memory I share, someone out there will remember things differently.

A Daily Beast article reminds me that I’m right to be obsessive about honesty.

Mood music:

http://youtu.be/_FPBi9N9hNc

The article notes how terrifyingly easy it is for therapists and investigators to plant false memories in a person as they lob one question after the next in an ironic attempt to get to the truth. From the article:

In the real world false memories can result from well-meaning investigators asking leading questions, from therapists trying to uncover hidden truths, and yes, from distraught parents engaged in acrimonious divorce proceedings. …

It’s important to point out that a false memory is different from a lie. Liars know what really happened, but claim something different. People with false memories honestly believe what they’re saying—there is no intent to deceive. They’re just wrong about what actually happened, for predictable reasons.

There’s some comfort in knowing that you’re not lying if you misremember. But that’s cold comfort to someone who remembers an event differently and feels you have lied about them.

All I can do is keep recounting things to the best of my ability. And I try to always put a disclaimer in posts saying that I’m writing my memory of something, not necessarily the unvarnished truth.

That said, the article prompted me to think back on my own therapy in search of times when a therapist’s questions may have led me to a false memory.

My therapists have helped me a lot, and their approach has always been to ask me questions but not steer me in one direction or another. They’ve typically asked general questions and let me talk from there. If any false memories have been created, it would have been during follow-up questioning. But none of my therapists have questioned me aggressively.

I’ve also always approached therapy in a somewhat standoffish fashion, skeptical of any suggestion they give me. I’ve approached my appointments that way specifically because I didn’t want to be led wrong by their feedback. Therapists are human, after all, and I do know people whose therapists filled their minds with a bunch of bunk.

Up to this point, I think my strategy has worked. Still, you never know when you might be remembering something differently than how things really went down.

Fortunately, many people who were there have told me they remember events much the same way. But some have recalled a different version of events. Whenever they do, it’s my job to think long and hard about their version versus mine, and, whenever necessary, to correct the record.

Memories

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Therapist Shopping

A few months ago my therapist retired and moved to warmer environs in the south. He said I was managing my OCD well and that I didn’t need therapy until the autumn.

Mood music:

http://youtu.be/Ils9GXqU03c

That last appointment was in the spring, with the season’s increasingly long periods of daylight, the environment I function best in.

Now it’s late October, with shorter days, and the seasonal issues are starting to kick in. Sunday I started getting chest pains and Monday I was breaking out in a sweat for no good reason. I’m familiar with these symptoms. It usually starts as heartburn and then my OCD runs wild with thoughts that I might be having a heart attack. When that worry increases, the sweat appears.

It’s a classic anxiety attack.

I used to get them all the time, but in recent years they’re few and far between. When I get one, it usually means I’m experiencing some big stress in my life.

I thought about what might be causing it. All in all, life is good. My wife and children are healthy. I love my job. Most things are status quo, except that we’re still helping the kids adjust to life in a new school. But that’s been an ongoing processes and hasn’t kept me up at night. So what’s the deal?

Of course, that’s what therapists are for: helping you yank out the underlying issues you can’t see on the surface.

I’ve been shopping for a new therapist for a couple months now. It hasn’t been easy. I’ve called several that I researched online. Most haven’t called back. The rest weren’t the right fit.

Fortunately, I have great friends looking out for me. One friend, herself a mental health specialist, is working her contacts and getting me names. From that list, I may have found the therapist I’m looking for.

Wish me luck.

patient therapist

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Teething Trouble

I’ve just started the new job and am happy as hell to be here. I’m finding I’ll fit right in. But when a person is a couple days into a new job, there’s usually an unsettled feeling. In my case, the challenge is not to be an asshole about it.

Mood music:

I’m not sure I’m having much success there, particularly at home, where I’m told I’ve been cranky and snippy and in OCD overdrive. I know the latter is true, because I know my trigger behavior when it surfaces. I get anxious to set up the new laptop, get work email on the phone and get access to all my various online portals. Most of that went fine &emdash; until I tried to access the dashboard for this blog. My username and password wouldn’t work. When I got home, I became obsessed with fixing the problem.

Erin and I tried all kinds of things to get me in and I dug in deeper every time we failed. It turns out I was simply using the wrong admin link. How stupid do I feel right now? Pretty stupid.

It’s been a long season of feeling unsettled as I went through the process of getting the new gig. I stayed a month at the old job before starting here so I could finish my various projects instead of dumping them on someone else’s lap. The result was that I pushed myself hard to the bitter end, leaving myself no time to detach and enjoy being a lame duck. Friends said I should have taken a vacation before starting the new job, and they’re probably right. But what’s done is done.

I have to right myself and pull it together, which means:

  • Being more disciplined about meditation. I’ve been doing it, but I can’t seem to sustain the balanced feeling for more than a few minutes after doing the exercise.
  • Getting a new therapist. Though my last therapist told me I didn’t need it anymore, I’m realizing that I still do. I don’t need weekly sessions or even bi-weekly. Once a month might do it (or not). But I need an objective voice to keep sounding the siren when I go barking up the wrong tree.
  • Making the kids pull their weight. My kids have chores they’re supposed to do. But I have no patience right now, so if they don’t move fast enough I do it for them. Being children, they’re happy to let me do that, but in trying to do everything on the chore side I become a scattered mess. I need to pull back.
  • Praying. Checking in with the man upstairs is always helpful to me — when I remember to do it.

I know I’ll get through this, and the truth is that there are nothing but good things happening in my life right now. I’ll keep you all posted.

Cracked Glass
Photo Credit: W J (Bill) Harrison via Compfight cc
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‘Dude, You Are Pathetic’

I don’t always respond to readers who call me names in the comments section, but sometimes it’s necessary.

Mood music:

[spotify:track:0xfaolnQFiBRZLff8vvkUK]

When I wrote a post the other day about being released from mental therapy, a guy named Jerry had this to say:

Dude you are pathetic. Be a man, work out your issues outside, or in the gym. Talk to your friends and family. You don’t NEED anything, you just tell yourself you do.

Now, I don’t care that he called me pathetic. After 20 years as a journalist, I have pretty thick skin. I also don’t feel the need to repeatedly justify why I write about these things.

But I see his comment as an insult to anyone who struggles to overcome the demons that hold them back.

So I’ll just say this to you, Jerry:

I agree that people need to talk over their challenges with friends and family. If not for that outlet, I wouldn’t be here. I also agree on the value of the outdoors and the gym as both a physical and mental strengthener.

But mental disorders often require the intervention of a medical professional. In this case, a therapist. If a person’s brain chemistry is off and signals don’t move back and forth properly, venting to a friend or demolishing a punching bag in the gym will help. But it won’t fix the brain chemistry problem, and the person will continue to suffer.

Pathetic? Hardly. It takes courage for someone to admit they need help and then go get it.

If that concept is hard for you to accept, leave this blog behind. I’m sure there are plenty of more manly blogs out there for you to enjoy.

weight-lifting-brain

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My Therapist Fired Me

For the first time in many years, I have no therapist. No shrink to call my own. The guy who worked me through five years of challenges officially fired me Friday.

Mood music:

[spotify:track:28clONjZmul6FjfO6tZQDE]

Maybe it was all the times I walked into his office with a huge cup of Starbucks bold. He was always on me about quitting coffee because it’s “just another drug.” Bringing coffee to my appointments was my way of telling him to fuck off.

Maybe it was that I constantly forgot appointments. He’d call five minutes after an appointment was scheduled to start and I’d always be like “Uh, that was today?” He never charged for missed appointments, so clearly I was starting to cost him real money in lost co-pays.

The truth is far less dramatic than all that: He’s retiring and moving to a sunny place in the South. I expected him to talk about therapists in the practice I could see next, but instead he told me sternly, “You have no business being here.”

He didn’t mean forever. When autumn hits and the seasonal depression starts tapping me on the shoulder, I’ll probably need to resume therapy.

But for now, and for the next several months, I’m done.

That doesn’t make me cured of OCD or the unpleasant byproducts. I still have my off days. But I now have the coping tools I need to manage it all, and his verdict is that I’m using the tools well for the most part.

I want to thank my therapist for the last five years. He taught me a ton about how the brain works, what OCD and other disorders look like with pictures of brain scans and illustrations showing little nodes that don’t fire commands to other nodes properly. He made it concrete. I was no longer a freak for having OCD. I had a medical condition that affected my thought processes. A treatable condition at that.

He showed me how different medications work for specific disorders and helped me adjust my own meds.

I’m in a much better place today, thanks to him. And now he has told me to stop therapy — if only for a few months.

I would have celebrated with a drink, but I no longer drink.

Instead, Erin and I went to the Newburyport Literary Festival Saturday afternoon and attended talks by authors Matthew Quick, Evan Roskos and David Yoo.

Those authors write about their own struggles to manage depression, to overcome all the fears and insecurities of youth and to find acceptance. They do it differently than I do. They use fictional characters who mirror themselves and people in their lives. I take the direct, nonfictional approach. Both types have their place, and listening to them talk made me feel like I was listening in on their own therapy sessions.

We had our afternoon date planned before Friday, but it turned out to be an appropriate way to celebrate.

There are still enough people out there who have been where I’ve been and are willing to share what they’ve learned. Therapy or not, my support system continues to thrive.

Dr Bird's Advice for Sad Poets

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Maybe It’s Time for a New Therapist

Lately I hate going to my therapy appointments. I dread getting in the car to go, and once I leave his office my head goes from slight ache to migraine in the course of an hour. It’s not the therapist’s fault as much as it’s a change brewing within me.

Mood music:

[spotify:track:7rvD6aTf1Aa2OMwzAQbQwO]

I’ve written about my therapist before. He’s taught me a lot about how the brain works, what happens when a mental disorder takes hold and how specific drugs go to work on specific defects. In that regard, he’s been a godsend. I’ve never agreed with everything he tells me to do, especially the bit about not drinking caffeine. To protest that suggestion, I usually show up for an appointment with a Venti Starbucks bold in my hand. But that’s never taken away from what he’s helped me with. In fact, his good humor under my needling has only made me like him more.

But lately I keep feeling like we’ve hit a wall, that he can’t take me any further on this journey.

I’ve been here before with other therapists. They help me move forward up to a certain point, then we start going in circles, covering the same ground over and over again — sometimes simply for the sake of using up the 60 minutes that I pay for.

To some extent you have to retread the same ground in therapy, because the patient is usually dealing with the same old issues. Retracing the old steps is how a therapist checks to see how well you’re managing and using the tools you’ve developed.

But lately, I’ve had less and less patience for covering the ground I know all too well.

It could simply be that I need a fresh face to dump on every few years, and there’s nothing wrong with that. I used to hate having to change therapists because in my mind it meant I would have to tell someone the whole back story all over again. What I’ve learned, however, is that I can tell the backstory through a fresher mindset, one that works differently now that I’ve significantly improved my ability to manage the demon.

I’m not the anxious, fear-filled introvert who first walked into a therapist’s office in 2004 when I first realized I had big issues that were making my life unbearable. Today I’m a lot more outgoing, sure of myself and at ease with who I am. But I’ll always need therapy to ensure that I’m still using all my coping tools the way I’m supposed to. Besides, life is always changing, throwing new curve balls my way. Through the normal challenges of life, I need help keeping my balance.

Maybe that’s part of my current dilemma: I’ve gotten better to the point where I’ve become too comfortable with this particular therapist. In life, we’re always searching for the comfort zone, but sometimes being in the comfort zone makes you forget what really needs to be discussed in that 60-minute block.

I could be imagining all this right now. It could be that I’m looking for excuses to stop talking about things I actually need to talk about. Taking the necessary medicine is often unpleasant.

But for now I have that feeling in my gut, telling me that something isn’t working like it used to when I first step into that office.

Time for a change? We’ll see.