Is this normal during clinical therapy?

Greetings and felicitations! This thread is simple. It’s a bit of an embarrassing topic for me, so I’ll cut to the chase. Best to just come out and be honest. So without further stalling to diffuse the awkwardness of this topic…let’s talk a little bit about psychological and/or psychiatric therapy.

I have discussed it more than once on ATS, but what I am seeking today is some useful advice from those who have experience with ongoing clinical therapy.

I am going to cut right through the mustard: while I am generally very bubbly and optimistic, I never paid close attention to what was fermenting underneath, a mess of self-doubt, anxiety, and depression. I also became more aware of my juggling act between mania and depression. I never once before thought of myself as being bipolar, unstable, or even depressed in any sense of the word. I always just blamed my grumpy mood on my environmental circumstances.

Having said all that I decided to try clinical therapy with a psychologist. The difference of course between psychologist and psychiatrist is the methodology, namely, use of prescribed medications. I have been truly happy and content before, which leads me to believe I am not facing a chemical imbalance; this is why I chose a psychologist.

Okay so here’s the twist, I actually seem to be a bit worse off after a few months of therapy. I feel even lower now than before. My question to others with more experience, is this normal?

I am determined to stick with this doctor, as I am mostly comfortable with him and do like his approach. On the other hand, I sometimes feel he isn't quite listening and absorbing what I have to say. I don't fully agree with a lot of his statements and interpretations. And once or twice I sensed some genuine frustration on his part, which wasn't very encouraging to me. I just feel even worse coming out of his office. I have started to dread going in there. I am more tentative opening up to him now. What should I do? I don’t think turning away from clinical therapy is the right thing to do right now.

Are my feelings of trepidation and discomfort because I’m starting to examine things about myself I previously ignored and suppressed?

I am taking a break right now from our sessions, and I actually feel quite a bit better these few weeks knowing I don’t have any appointments for a while. I feel better! I am at ease and feel happier, more optimistic, and refreshed.

So what gives? Again, is this normal during the first few months? Is this a sign I should drop out? Maybe find a new doctor? I’m not quite sure what to make of this. All I know is I feel better right now, and am not looking forward to my next appointments.

Thanks in advance for your help and suggestions.

a reply to: NarcolepticBuddha

Im not professionally qualified to assess...but Ill just say what you express feeling during and on break from....is normal. Good luck to health to you! MS

originally posted by: mysterioustranger
a reply to: NarcolepticBuddha

Im not professionally qualified to assess

I'm not asking for medical advice. And I'm capable of making my own decisions--not asking anyone to decide for me. I'm just asking for others to share their experience so I can gauge my own feelings about it.

Thanks for your reply

I have studied some psychology and attended various courses etc on it at a place of work, also years of experience working in the housing sector including mental health housing. I have attended many CPN and psychiatrist meetings as part of my previous job.

It is my own opinion that whilst much psychology and psychiatry can have a good effect in such that it resolves issues, there have been those that it adversely affected as they were reliving things from the past that they had dealt with, in their own way, they were effectively re experiencing the traumatic emotions of those experiences which affected them negatively.

Perhaps you should mention how you are feeling about it during your next session.

originally posted by: theabsolutetruth
Perhaps you should mention how you are feeling about it during your next session.

I did. I'm not sure if that's why he called for the break or not..or if he had a planned vacation already. It wasn't clear why he called for the break.

I studied psychology as my minor study, and tend to agree it seems like a lot of hot air at times. Thanks for your input. Luckily my sessions aren't costing anything, so I have a little room to give it some more faithful effort.

I think you were accurate thinking that your apprehension is due to disliking the thought that the problems might be internal, rather than environmental... dont wish to fully accept it...

I noticed most patients want to be reassured in their beliefs rather than told the truth, many are looking for legitimization of their feelings rather than actual advice... it might just be this apprehension. But I dont know your exact situation.

You revealed you dont think he is quite listening so it is either the doctor, or your perception of him, that is the problem. Not the method. Im biased though as a firm believer in clinical psychology. If you have the opportunity try another psychologist, and dont be afraid to message us on ATS!

a reply to: NarcolepticBuddha

Yes, unfortunately - I do think it could be your doctor. As I've mentioned in a few past threads I've seen various counsellors, psychologists, psychiatrists. Their job is to LISTEN to you and to make you feel safe. It's also their job to guide you to healing and a healthy future.

I got along wonderfully with a woman psychologist for some time and then, like you, I started to feel that I was just repeating myself and not growing anymore. And I quit her. I did find wonderful help some time later with someone who listened to me, didn't judge me, asked questions, asked me to express myself, etc, etc. And gave me tools to continue to help myself.

Just two years ago I found myself dealing with an enormous depression related to my job and all the new psychiatrist could go on and on about was the loss of income due to my job changes. He wasn't helping me, he was just floored over the change in my financial circumstances. It was funny as I found HIM dwelling on something that should have troubled me but I had already moved on from that particular issue. I realized I was paying (or let me say that my insurance) was paying for some moron to gripe about something that wasn't going to change and that I had already moved on from. And that he wasn't helping me in any other way other than to continue to write prescriptions. So I decided not to see him again.

This is my scenario and not meant for what I advise you to do. But having said that in the end the reason you are there is for help and you sound like you're willing and ready to do that but you need the right person. To answer your question: yes.

Keep up the good work.

Is there another person in the practice you could try? I know you said you want to stick with this person. I'm wondering if maybe its not what is being said but how its being said. Another person in that office would be vaguely familiar with your case and may tell you what this person is trying to convey to you on different words that will reach you.

Also, do you get "homework "? If you're working on something is it only in that office or do you follow through at home?

a reply to: NarcolepticBuddha

My advice, never stop growing and thriving.

We dont arrive untill the next journey.

Dont be hard on yourself.

Sometimes its not counselling, breath and remember.

Hope it helps, its helps me .

Cheers to you, and everything you hold deer.:cheers

What form of psychology? For depression or bipolar, Cognitive Behavioral Therapy has studies showing effectiveness...

Link
Link

Not all therapies work for all people, as others have mentioned.

Another GREAT tool is EFT - Emotional Freedom Technique - for moving through emotions and working things out efficiently. "Tapping" is a great tool for this and I highly recommend looking into it and seeing if it works for you.

Mostly, I would ask if you are stirring up a lot of "emotional junk" with this therapy that is just "hanging around" and not "resolving" or being worked out... If so, that could be a problem and be making you feel worse. Also, its easy in "talk therapy" to just talk and talk and talk and not really get anywhere, but feel like you are "doing something" about your issues because you go to therapy and share stuff. Does that make sense?

So, if its not helping, and you are paying for it, then evaluate if 1) its the right kind of therapy, 2) its process is to move you through your "stuff" with solid guidance and techniques to manage your emotions and thought processes as they come up.

Sorry - I'm totally sleep deprived and trying to be helpful with a low-functioning brain right now! Forgive me if I am not being helpful.

I wish you peace on your journey!

- AB

a reply to: Iamthatbish
a reply to: AboveBoard

I think I can address both of your posts in one stone's throw.

First, there hasn't been any official diagnosis from him. He has never said the word 'depression' or 'anxiety' or 'bipolar' etc. So, I'm not really sure what he is looking at, and trying to plan for in our sessions.

Yes, I would say there's a lot of 'homework' on my part, unofficially. He's basically telling me to go home and get my act together because he can't do it for me. I'm not getting a lot of guidance from him, it feels more like inspirational cheerleading.

Most of our sessions involve him trying to get me to talk, and I just clam up as the hour goes forward--I am getting tired of having the same conversational arguments with him, and I think he is getting fatigued as well. Maybe we hit an impasse rather quickly?

I'm willing to accept part of the blame. I'm not fully open and trusting either. I'm very careful of what I say and don't say. There are some major hurdles I can't seem to get myself over, and that's making his job more difficult as well.

I'm mostly just trying to figure out if my feelings about our appointments are due to resistance on my part, if it's a natural part of the clinical therapy process, or if I'm dealing with a Dr. Landy type here

Thanks for both of your replies.

a reply to: NarcolepticBuddha

On the other hand, I sometimes feel he isn't quite listening and absorbing what I have to say. I don't fully agree with a lot of his statements and interpretations.

The fact that you are even there means your own opinions and interpretations are not working out for. Why not try trusting your doctor and make an attempt to live on the basis of their interpretation. That comes down to trust, quite a bit. But if you think their intentions are positive, perhaps a little trust will go a long way.

For example:

It's kind of like if you saw someone who is violent and you told them they are violent and that people do not like it. If it's a part of their culture they won't understand you, believe your interpretation of their actions, or take your advice. But if they are willing to see themselves or judge themselves through someone else's interpretation, they may become less violent.

(Not suggesting you are violent just using it as an example)

PS:

I thought the thread was going to be like, "So then my doctor undressed me and said 'does this make you feel awkward?' "

originally posted by: boncho
The fact that you are even there means your own opinions and interpretations are not working out for.

I admit I have some issues, that's why I'm there and still attending appointments. It just seems counterintuitive to feel worse before an appointment, during an appointment, and afterward. I think it's a valid question about the process of therapy--one I've never seen discussed or addressed.

Is it a clue that it's not working? Or is it a clue that it is?

a reply to: NarcolepticBuddha

Homework I have gotten is like this...

1. Pay attention to the words you use internally, you need to count how many times they are negative.
2. Next step (another visit) is try to change that to a positive thought 50 % of the time.

So, that puts all my therapy on me. The more effort I put into it, the better I'll feel. That's one of the reasons I always remind people that words have power.

You don't have to be specific but, do you do this type of homework? Because I can't see how you can resist this. To me it was I don't want to be sad and the answer I got was, lets try this.

a reply to: Iamthatbish

Okay then yes about homework. Last session he asked me to pay attention to how cynical and pessimistic I am with everything I say. Maybe that's what I'm supposed to be doing right now on this break?

He said I manage to find pessimism in everything, but that I don't notice it. He asked me to start noticing this.

So, this is probably a good sign of his involvement and commitment eh? Doling out homework.

a reply to: NarcolepticBuddha
excellent example of cynicism right there in your edit.

originally posted by: NarcolepticBuddha

originally posted by: boncho
The fact that you are even there means your own opinions and interpretations are not working out for.

I admit I have some issues, that's why I'm there and still attending appointments. It just seems counterintuitive to feel worse before an appointment, during an appointment, and afterward. I think it's a valid question about the process of therapy--one I've never seen discussed or addressed.

Is it a clue that it's not working? Or is it a clue that it is?

Well, considering the therapy is meant to take you out of your comfort zone (comfort zone being depression or whatever other condition you are battling) I think it's to be expected.

I don't know why we as human beings jump into our conditions like depression or neurotic behaviour with open arms, from an outside perspective it makes no sense. But in reality, we use these things like a comfort blanket. Probably because we are afraid to deal with the alternative?

Easy to be depressed, sure. You just sit around and sulk. Don't have to be outgoing, don't have to talk to people, don't have to be happy, force a smile, gets rid of all those awkward moments where we have to be cheerful and open to failure right? I think it's one of those things probably to counteract anxiety or other fears we have like trust issues, relationship building, etc.

I have dealt with all my past demons but I know a lot of people struggle. The thing that helped me was stepping back and taking a clinical-like look at my life and actions, eventually incorporating new behaviours into it.

It may seem awkward and dodgy at first, "Im supposed to smile, Im supposed to like this, Im supposed to say ___" but eventually it becomes second nature and suddenly you can be a much better person.

a reply to: NarcolepticBuddha

So the first step is just to notice when you're doing it. You can't change it if you don't know you're doing it. Also with this I got examples of words that brought negative thoughts and feelings as opposed to words that brought positive thoughts and feelings.

If you personally don't associate a word with a negative thought that may be where the frustration comes in.

I grew up hearing and saying that I'm not helpless, it helps me suck it up. But, the word helpless isn't a positive word. So this self afformation wouldn't be one suggested for others to use.

Does that make sense?

ETA: words control thoughts, thoughts control feelings... WORDS HAVE POWER!

originally posted by: PLAYERONE01
a reply to: NarcolepticBuddha
excellent example of cynicism right there in your edit.

Actually I edited to give him a little more deserved credit. Perhaps my word choice was more passive than it ought to be though. And yes, that's just it, small things like conscious or unconscious word choice may be revealing in a way I can't see objectively.

originally posted by: boncho
Well, considering the therapy is meant to take you out of your comfort zone (comfort zone being depression or whatever other condition you are battling) I think it's to be expected.

Said perfectly! That makes perfect sense to me, and it's a great explanation for what I'm feeling. A new perspective can often be startling and uncomfortable.