How to find a good therapist

[Cookson]

Can see why In the last elections Scotland was wanting independence.

 

Doesn't sound as if the national health service isn't national enough!

 

I think in answer to the original question posed ultimately their is a combination,

 

The genuinely good psychologists, The ones who push you on drugs in a chance to fill their wallets. And the ones who are lazy, or lack the time or effort giving a simple prescription and a pill hoping it will quickly resolve the patients problems.  

[Cookson]

I am actually getting some cbt with a physiologist one to one in the next few weeks. 

[mammaP]

Hi Cookson, I had my 3rd session a few days ago and it's still positive. We are starrting to use CBT next week

because there are some things I need to work on, mainly confidence and assertive techniques. She's been a great help already 

and I'm glad I went. It could have gone the other way though and been a disaster but I went in with an open mind and prepared to

walk away if it didn't feel right.  Hope your sessions go well for you. 

[dekiru]

Hi CS,

 

Oh dear, Sorry to who hear that!

 

In the UK ssri drugs are regarded as a last option.

 

Perhaps because your health institutions are privatised they are under more aggressive influence by the drug companies to sell their product!  

 

You do read about them being wined and dined by these drug companies :/

 

In my experience ssris are not regarded as a last option. I was prescribed sertraline to help me while I waited for CBT....then just left on it.....

[kaza31]

hi

 

I do believe there are some good psychologists out there, however my own experience of my psychologist we just never connected at all.. It is very hard to get appointments to see a psychologist in my area, the mental health hospital is just bursting at the seams with patients going to cbt, outpatient classes, counselling etc that they cant keep up with demands.. Plus to go privately is very expensive..

 

I was sent to a six week course with a psychologist, her  attempts were to delve in my childhood talking about things that happened me etc... This was not the reason I was in the state I was, it was medication withdrawal, but she had no idea about protracted withdrawal from meds.. She just stared at me blankly when I described how I was feeling especially the depersonalisation..

  What I believe I needed was coping strategies to help me through my terrible time and proper advice which I never received.. All the psychologist did was to insist that I went back on to the 150mg of my  medication..

 

 

However one area of expertise in mental health I will praise is a thing called "home crisis team" in our local area..im not sure of everywhere has this service though.. Basically when I contacted my gp on the morning I was really ill and I was having severe panic attacks... i told her i was very scared as i kept getting thoughts in my head of hurting myself which were frightening me obviously brought on by abrupt medication withdrawal.. I was on  my own in the house and i think she thought i was going to harm myself.. Within 30  minutes she was at my door... She in the meantime had contacted the "home crisis team"

 

the way the home crisis team works is , when someone is very low, they have contacted gp and there are concerns for their mental health, but the doctor doesn't think there is big enough risk of suicide or that they need to go into a mental institute.. the home crisis team are called, they are made up of nurses who know all about mental health issues etc....  They came to my house to give me an assessment,, i described what had been happening to me. they believed it was medication withdrawal and anxiety brought on by that.. They stayed with me for two hours till my family came home... I was giving their number to phone at any time if i needed to talk or was in distress...

For the next week i had a visit each day from a nurse to talk about how i was coping, gave  me relaxation tapes, coping strategies etc.. then the following week they wanted me to come see them in their offices, i think it was a way of getting me up and about and out of the house to go to them..

 

In that time i could still phone them whenever i needed and if i was in distress they would be out with you within the hour..

 

All in all the home crisis team, is trying to  basically stop people having to go into a mental institute, if they have family at home they feel it is the best option to stay there, and for the next week which is a very crucial time they will be there for you day or night if there needed.. only when someone openly admits they want to commit suicide then of course they will have to be sent into a hospital..

 

i swear i never met nicer men and women than those who worked on that crisis team, they were warm, caring and sympathetic and understood everything i was saying.. i just wish i could have seen them for longer rather than having to go see my psychologist as they helped me more than anyone...

 

When i got better i went back into see the ladies, i brought them a card and flowers to thank them for all they did, and how they made me feel so safe in a time that i felt so scared and alone...

 

i couldn't believe that these men and women could tell me about med withdrawal symptoms, depersonalisation etc and what i was feeling was normal.. yet when i went for my appointment a few weeks later with my psychologist she looked at my like i was mad...

[areyouthere]

I have never had a BAD experience seeing a psychologist. As I've gotten older I've come to look at them as more of a sounding board than anything else. Sometimes it's just good to process out loud and hear myself talk as I am somewhat of an introvert and tend to mull things over.

 

My most significant moments of growth have happened when I am asked a question about what I mean or why I say something... you know a thought provoking question that I'd never considered  before... making me look at things from a different angle. I do the thinking... and the "work" the psychologist just gives me a new way look at or think about things.

 

Good luck and cripe.... you were on a WAITING list for that long? YEARS?!

 

RU

 

ps... and as far as going into the past... I totally understand that and if you are feeling that way it is probably a good idea. Just tell him/her that and that you are looking FORWARD now that your tapering has given you a new outlook... and that you look forward to new ways of thinking?

[Cookson]

Hi mammaP,

 

Please keep us updated and thank you.

 

Hi dekiru,

 

Sorry to hear that, Are you still going to be receiving cbt as of yet?

[dekiru]

Hi Cookson,

I had CBT and it didn't help at all! Every session I had I came out feeling worse because the therapist always telling me off for not being able to name my emotions and always fidgeting (I fidget when I'm nervous). The CBT just made me feel like my thinking was bad and wrong, and didn't address any of the issues that had caused panic attacks and depression to start. I hated it. Things only improved for me when I saw a psychiatrist who diagnosed Aspergers Syndrome and then made it very clear that I could talk about whatever I wanted to in sessions with him, and show any emotions at all, and it was ok. Then I started making progress. I can name my emotions now and the issues that caused the panic attacks and depression have been spoken about. Now my only problem is the withdrawal symptoms and wondering if I'll ever be well enough to do what I want to do in life.

[Cookson]

That therapist doesn't understanding at all, And quite outspoken and arrogant at that!

 

Sounds like they have a bad case of 'oppositional defiance' disorder and should receive psychiatric treatment immediately!

 

No but on a more serious note, Good that you feel your getting the right treatment now.

 

I'm not expecting to much, Just going to walk in with an open mind.

 

And yeah, Tell me about it pal.

[alexjuice]

John Breeding comes into the office of the healer who I started working with this year on nutrition and parasites. What a coincidence! This is a very very small office and I have no idea why John is loitering in there. Maybe they are sharing an office but like I said it is a tiny tiny office. Feels like a huge coincidence. I am going to ask about this next time which is Monday.

[Altostrata]

Let's start this topic up again for more discussion. How would someone with withdrawal syndrome find a good therapist?

 

From what I've seen, folks have a difficult time finding therapists who are not indoctrinated regarding drugs. Still, it's a lot easier to find a therapist than a physician who hasn't drunk the Kool-Aid.

 

Here are my ideas on the subject:

Finding a therapist who is emotionally supportive is crucial. Ideally, the therapist should understand withdrawal syndrome, but given that few are educated about withdrawal symptoms, the therapist should be open to learning with the patient.

This is a conundrum, because patients need to educate themselves about withdrawal syndrome, and many are so upset by the symptoms they can't do the problem-solving. Still, one must start somewhere. Let's assume people understand withdrawal syndrome to the extent they recognize their own withdrawal symptoms.

In situations where the patient is recently off drugs, the more prevalent symptoms are the ones catalogued in the medical literature: Dizziness, insomnia, depersonalization, parasthesias, etc. (Joseph Glenmullen's book is a good one to explain these to therapists and patients.)

But -- there's no literature other than what we have generated about prolonged withdrawal syndrome (I'm calling it post-discontinuation syndrome these days for greater acceptance among physicians, to align with Post-Acute Withdrawal Syndrome in addiction medicine). The significant symptom patterns in post-discontinuation syndrome are different and, while generated by a dysregulated nervous system, are more subtle and can be mistaken for entirely psychological.

I recently talked with a young Harvard-trained psychiatrist in San Francisco, Girish Subramanyan, who has a subspecialty in "treatment-resistant depression" (an execrable term). He had begun to suspect much of what he was seeing was iatrogenic, possibly withdrawal syndrome. He asked me about the most significant prolonged withdrawal syndrome symptoms.

I mentioned emotional anesthesia, the lack of a sense of reward, and the lack of emotional associations with everyday experiences, such as the change of seasons. This flatness of inner emotional life is very frightening to people which, of course, generates more distressing symptomology.

Dr. Subramanyan recognized this in some of his patients. Understanding it was post-discontinuation syndrome gave him insight into more psychological  approaches. I suggested that many SA members embraced meditative techniques and benefited from them.

Some of the more habitually anxious find CBT helpful.

Other common symptoms are iatrogenically induced hypersensitivity to drugs, supplements, even foods (which, of course, makes drug treatment of "treatment-resistant depression" endlessly recursive) and sleep problems.

There's also akathisia, or a low-level sense of unease or anxiety. Some people experience this in waves. Dr. Subramanyan noted that it was in these periods of overstimulation that his patients were most likely to be suicidal.

A therapist might have to give practical guidance to cope with these.

At any rate, understanding that learning to cope with symptoms and allowing the nervous system to heal over time is reassuring to many people (after their initial horrible realization that they have been damaged by psychiatric treatment). It's hard work, though. Stuart Shipko called coping with withdrawal syndrome "the ultimate behavioral therapy" -- the individual has no choice but to learn how to care for  his or her self. A therapist should be able to work with that.

 

How have you found a therapist to work with? What have you had to teach this person? What has the therapist taught you?