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For this week’s interview, I get to interrogate a woman who asks other people questions all day. Score! I love interviewing therapists. Because most of them are so complex and intriguing that they went into the field of psychology to learn about themselves. Right?
Therapy Doc, a woman from Chicago with lots of degrees and 30 years of experience in the mental-health profession, writes a fascinating blog called “Everyone Needs Therapy.” Even before I read any of her posts, I knew I was going to like it based on that name.
Her mission statement:
This social work blog reflects my multi-disciplinary scholarship, academic degrees, and all kinds of letters after my name that make me feel big. Patients wanted more feedback, but it’s morphed, so you get how I cope, too.
I love it when knowledgeable, educated, professionals write in way that is entertaining … and clear. It’s not painful reading like the psych texts were back in college. Every time I read a post from Therapy Doc’s site, I come away with some practical exercises I might incorporate into my mental health program.
1) Let’s start with the name of your blog, and the post where you support your claim that everyone does, in fact, need therapy. I liked your explanation of why therapy is different than getting coffee with a friend, because I’ve been tempted so many times to spend the money I hand to my therapist on a girls’ night out or a nine dinner with my husband.
You write this:
What’s wrong with having a good friend, a shoulder to cry on, or even handling one’s problems ones self?
Frankly, when I hear the advice that caring significant others shell out for free I want to die. My patients have generally suffered from the advice of friends and family, not gained. The advice is often so off the mark, I’m sorry, so wrong, so out of touch with the client, so self-serving, so biased, so blind.
Sorry, guys, but we DO learn a lot in school.
You later say that most of the time the wrong people are in therapy. Ha! I couldn’t agree with you more. So what does that mean? Do the navel-gazers like me continue to sit my butt on the couch while ones in rage just continue getting the aggression out by cutting off as many cars as possible on the way to work?
Funny you should mention ragers. Believe it or not, they do come in for therapy, sometimes court-ordered, but they come for anger-management a lot. The Sopranos did a nice piece on it. It’s not comfortable being angry.
So much to say here, maybe too much. The idea is that the identified patient (IP), the one who seeks therapy, often does so because other people make him sick. Think about growing up with ragers, or “loving” people who neglect or abuse you. Or maybe a boss who refuses to distribute the work equally, allowing some people do it all, whereas their “colleagues” are playing Spider.
When I say, The wrong person is in therapy, I mean, not enough people are in therapy.
As crazy as it sounds, one person’s dysfunction can make another person feel healthy. Feel is the operative word. So it becomes an, If you’re not a part of the solution, you’re part of the problem kind of thing. An identified patient can make a valiant effort at change, but the change is sabotaged somehow.
It’s all about psychological systems of attachment and the idea that we’re assigned, either overtly or covertly, to roles and expectations. The patient is stuck, will comply to expectations, obligated with invisible loyalties. There’s a good book on the subject with that title.
So although docs gently push people to establish better boundaries, to make independent decisions, to be more assertive, and to leave relationships that make them unhappy, it is the family (and that may mean something different to everyone) that ultimately wields and yields power for change.
And therapydocs don’t invite nearly enough of them to visit.
2) In a second post you qualify your blog name with this statement: “Everyone really does need therapy if they have any intention at all to be in a committed, long-term relationship.”
I totally get where you are going at. I agree with your explanation here:
Oh, you want to know how intimacy issues can mess with your relationship? Those fears I mentioned interfere with our ability to talk, to express what we want and need, to say things with sensitivity, to think less about ourselves and more about our partners. They interfere with empathy, our willingness to focus on our partner, to get into his or her shoes.
So they’re huge, okay? You can’t ignore them. They don’t go away over night no matter what you do. They just make you cuter is all, and all the more interesting to get to know.
But, come on, therapy is somewhat of a new invention, and sort of “American.” No one really flinches anymore if you say you’re on your way to therapy. But in Europe, Asia, South America? No, no, no. So would you say that these long-term relationships in other cultures are exra-dysfunctional?
No idea. But much depends upon culture. Certain tribal cultures respect individual differences to the degree that they nurture every member of the community and see to it that there is no shaming or abuse. A person with schizophrenia, for example, is protected, not stressed, treated with gentle attention. In that sort of ideal culture, people don’t need therapy.
The Europeans? South Americans? Asians? I don’t know enough to offer any opinion.
I do know, however, that Americans did not invent psychotherapy and that we have no corner on psychological or social research.
It could be, by the way, that our particular society breeds the need for therapy, that we have inherent morbid stressors. The need to be very skinny comes to mind.
3) I loved the tools you list in your post called “Coping/Managing Stress and Anxiety,” many of which are part of my “12 Step Program for Mental Health,”: exercise, diet, distraction, sleep, therapy, support, and so on.
I was especially intrigued by the imaging techniques you describe—and why you suggest a person to “go directly to the catastrophic expectation, the very worst scenario, and work it how you’d handle that.” Couldn’t that backfire? I mean, I tried to do that two years ago when I was so scared that Eric was going to leave me (because I was so depressed)—I imagined myself as a single mother working downtown as a waitress (because I had dropped all writing … I couldn’t concentrate), and sometimes that would make me shake even more with anxiety. Can you describe the difference between healthy imaging, and the type of catastrophizing that can be harmful?
Taking fear to a higher level by catastrophizing, will only work if the process de-catastrophizes, of course. Talking it out has the potential to take the terrifying zip out of an imagined event, but that depends upon who you’re talking it out to. Doing it alone might not cut it, you’re right. Doing it with a therapist or a friend who gets it, might.
Here’s how it works. Take a hypothetical situation, a woman thinks she can’t make it alone, is terrified by the thought of abandonment by a significant other. I’ll use your example with Eric, although I’m admitting at the top that I don’t know your history or your history with him and am not giving you advice, just using your name and the idea that you could be upset by his leaving and might obsess about it.
if Eric left, life would go on. Each day would pass, just as it did when he had been there, and yes, you would be unhappy and heart-sick, and your quality of life not as good, but you would not be dead. And where there’s a pulse, there’s hope.
And as time goes on, as the grieving process plays itself out, if you allow yourself to properly detach by not talking to him or seeing him, you would emerge with a greater sense of independence, always a good thing, which would replace the sense of emptiness, a bad thing, and the self would grow, which is a very, very good thing, and the feeling of dependency would fade, which is a very, very, very good thing.
So that’s how you’re supposed to think.
Even though people can and do think this way, it doesn’t make the pain just go away, not right away. You can’t control that. It’s the light at the end of the tunnel, however, that mitigates the anxiety, and the emphasis upon staying rational. The idea is to find the light.
If a person knows that taking thoughts that make them fearful and magnifying them will increase anxiety to unmanageable proportions, then for sure, for sure, this wouldn’t be an effective technique to do alone. I always recommend community mental health centers for excellent treatment at relatively low cost.
4) Your post about the holiday blues was also enlightening. You mention how money is a big player here – all the commercialization surrounding the holidays can get you down. I completely agree. And I’ve had this conversation already twenty times this year: “Hey, guys, can we not do gifts this year?” What do you do if you’re in a family where the other members actually LIKE to shop and give gifts. Do you graciously accept the presents, but not reciprocate—risking harsh judgments that you are cheap and rude? Or do you get online at the last minute (because I’m not going near the mall) and ship a bunch of stupid stuff that no one is going to use across the country to accommodate expectations?
I don’t know. Honest. The guilt kills everyone. The guilt and the shame are merciless. Say someone gives me a Waterford salt and pepper. I gave that person a scarf. I’m a loser. But not accepting the s & p is probably taboo. But not always, depends upon the giver, who might want the gift back if all she got was a crummy scarf. Who knows?
But let’s look at the catastrophic expectation in such a case.
Say I wrote a poem, instead of buying a scarf, and used the poem as a gift, and within the poem I expressed regret that this year there wasn’t a way to DO Xmas and still pay rent or the IRS. What’s the worst thing that can happen?
The family/friend says, She’s broke. Or, She doesn’t manage money well. Or, She’s cheap. If this is the worst thing people can say about me, perhaps it’s for the best.
And if you follow what I said in question two, time passes, the days roll by, and nobody remembers or cares about what they got for the holidays anymore. Maybe next year all I’ll get is a poem, which would be fine.
The whole thing is insane, seriously.
5) I’m just curious: does the input you get from your blog contribute to your psychotherapy sessions and vice versa?
Nah.
Although the input I get from other bloggers makes me think a little, it’s not going to have any overall impact upon the work that I do. I’ll read links, and stay abreast of research, but for the most part, being a therapist is an art and a skill.
My work is based upon a way of looking at illness and health that has evolved over many years. Assessing and treating is based upon many, many variables, all having to do with the patient and his or her particular situation.
Any one comment about a post, albeit interesting, is not going to affect the way a therapydoc does the job. At least not this therapydoc.
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posted 6:17:35am Feb. 07, 2012 | read full post » |
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Therese J. Borchard writes the daily blog, Beyond Blue, on Beliefnet and is a regular contributor to the award-winning blog, World of Psychology, on Psych Central. Therese is the author of Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes and The Pocket Therapist: An Emotional Survival Kit. Subscribe to Beyond Blue, visit her website, or follow her on Twitter @thereseborchard.
Meet others on the journey in
Therese’s community group
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Therese J. Borchard writes the daily blog, Beyond Blue, on Beliefnet and is a regular contributor to the award-winning blog, World of Psychology, on Psych Central. Therese is the author of Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes and The Pocket Therapist: An Emotional Survival Kit. Subscribe to Beyond Blue, visit her website, or follow her on Twitter @thereseborchard.
posted December 7, 2007 at 11:57 am
Good interview. (Hey, I knew I wasn’t going to be the featured one for more than seven days — LOL.)
There is the question, which I’ve raised seemingly as a gag on BB but is hardly one, in fact — how do you know, after years of depression, that the light at the end of the tunnel isn’t an oncoming train?
There’s also the issue of title of the blog. Yes, the philosophy behind it is sound; but people can take it on a facile level and say if everyone is sick, NO ONE IS SICK.
“I don’t understand what your problem is,” my mother said to me last night. “Half the people in the world have depression anyway.”
Ugh.
posted December 7, 2007 at 1:22 pm
Larry: I think some people feel helpless when confronted with illness , any illness. They can’t fix it , maybe they want to help, even understand but they just can’t and the fact that they can’t is their aggrivation, not the illness it self. My son Mr. type A does not understand my depression he see’s it as a fixable problem, something that will completly disappear eventually, fixed then move on , if all the right things are done.He cannot relate to me at all, he has never had to really deal with anybody elses illness for very long.He cannot understand, he cannot fix therefore it is an aggrivation to him.I understand this about him and accept it. I do what I can to help myself, I also honor the feelings that come up and try very hard not to exagerate and over react. I accept my depression as a living part of myself, I know that from experiance something eventually brings me out of it. When I feel hopeless I hang on for dear life.I am also a hermite, I only have a small amount of social contact. I like this because my mind does not get cluttered up by other peoples opinions and philosophys.Perhaps this is a bad way to cope but it works for me. My depression is mine,I try very hard not to make it anyone elses problem. Lots of people can’t relate to depressives at all so it aggrivates and frustrates them. That is their problem, not mine . I have enough of my own thank you!!!
posted December 7, 2007 at 2:54 pm
Well, Lynn, as I always say, my mother is in “De-Nile” with the crocodiles snapping behind her.
She has no trouble accepting that my sister (who has Type I diabetes) has a chronic, incurable disease. She has also gone through what must have been the lifelong, painful experience of seeing her own mother with bipolar disorder — from a day when there was really no way to treat it.
(Not to mention a grandmother, my great-grandmother, having to be institutionalized with schizophrenia — and I know her father/my grandfather would never have submitted to “One Flew Over the Cuckoo’s Nest” conditions for his own mother if there was any conceivable way he could have cared for her. Lord knows he tried.)
She criticizes me for not making enough progress with my therapist (which she defines as “getting a job”; it’s not like she’s in the room); she’s constantly on my case to switch professions (entry-level at age 38? No, thank you); and in general she says I do a terrible job at self-care (even though she’s been praising me for exercising more and losing weight this year).
Yet once in a blue moon reason strikes. My mom and stepdad think my support group in New Brunswick (N.J.) is some sort of cult — the way evangelicals think Mitt Romney and the Osmonds are part of a cult for being Mormon.
My stepdad said, “Depressed people shouldn’t be around depressed people. Depressed people should be around happy people.”
To which I replied, “Ever get tired of someone saying one of your ideas or personality traits is crazy? What if you could be in a group where, if you tell about something that’s going on with you, instead of being told it’s crazy, the response is, ‘Hey, that’s something that’s happened to me’?”
He was dumbfounded for a moment.
“You know, that actually makes sense. I never thought of it that way.”
As Homer Simpson would say, “D’OH!!!!!!”
posted December 7, 2007 at 3:59 pm
“I don’t understand what your problem is,” my mother said to me last night. “Half the people in the world have depression anyway.”
Ugh.
Posted by: Larry Parker | December 7, 2007 11:57 AM
hey now… look at the bright (?) side… she is right. ;-O
posted December 7, 2007 at 4:43 pm
We all have each other here on BB and the understanding is palpable. I think you are doing a great job and for the short time I have been a part of BB you seem to have progressed alot. What about AA? Drunks around Drunks, drunks supporting other drunks? seems to have worked for them.There is nothing better than a great support group!!!!!!!! Rock on Larry we all love you!!
posted December 7, 2007 at 4:46 pm
Hi Therese
Here is the problem with conventional medicine in this country.
All of these therapist believe that their way is the only way. Your a twelve-stepper so you know the capacity we have to keep doing the same thing over and over again trying to get different results. I am not blaming this person as everyone can only do what they “know”. But when evidence shows that what were doing is not working, that there is something wrong with this picture, it is time to try another way or at least consider a different perspective on the situation.
This therapist does not know it but her “closed mind” renders her incapable of helping another person. If you consider the fact that these appointed professionals are human beings like the rest of us coupled with the fact that there are “no non-grievers” in society we have a situation where the blind are leading the blind.
In order to help others we must have learned how to help ourselves. Our education system does not address this aspect of our lives. You should have asked that therapist, “How many classes she attended on “Grief” throughout her education?” And, if she did it does not matter because what is being taught about this natural and normal life process is geared to exploiting the public.
Quote:5) I’m just curious: does the input you get from your blog contribute to your psychotherapy sessions and vice versa?
Nah.
Although the input I get from other bloggers makes me think a little, it’s not going to have any overall impact upon the work that I do. I’ll read links, and stay abreast of research, but for the most part, being a therapist is an art and a skill.
My work is based upon a way of looking at illness and health that has evolved over many years. Assessing and treating is based upon many, many variables, all having to do with the patient and his or her particular situation.
Any one comment about a post, albeit interesting, is not going to affect the way a therapydoc does the job. At least not this therapydoc.
All I can say is, “God Help Us!” and thank him for answering that prayer as he has in my life. See my journal on Depression= Grief Recovery.
posted December 7, 2007 at 9:04 pm
It hasbeen my experience–and i’ve worked with several different therapydocs over the [ast forty years or so–that it’s kind of like choosing a pair of shoes; you try them on and walk around a little to see if they pinch. No one therapy doc or ethod is going to be the best “fit for everyone, so there’s nothing wrong with (I even think it’s ADVOSABLE!) sewong a doc a few times to see if it ‘pinches” before you commit to a long-term doctor/patient relationship. I’ve had two WONDERFUUL therapists, two who ‘pinched WAY too much for me to see them for any length of time (One of them was actually the head of the psychology department in the college I attended at the time…scary!) and some who fell in between the two extremes. Without a doubt, my MOST positive experience was with the therapist who was one of the leaders of my “Adult Children of Alcogholics support group because she had more understanding of the dysfunction of the alcoholic family, the birth order roles and the “scripts those roles assign to us in our formative years. I think I grew more during that particular ten week period than I did in all my other therapies combined! Of course, the group work supported that as well. What I yjnk is key is not just settling for a therapist becauses/he has the credentials; keep searching unril you findd one who not only has the academic background and knowledge but also the “people skills” to balance those letters behind his/her name. In other words, one who “fits”
posted December 8, 2007 at 5:03 am
Oh my God! … After reading all of BB this week, I just came to the realization that the only difference between me and all the rest of you is you can either afford or are willing to sacrifice your income for psychotherapy! … Thank God, I’ve been independently poor most of my Life (I’m actually a millionaire now, but only on paper, if you catch my drift!…My goal in Life was to charge a million dollars and then die…and I’m dam close!) I could never afford to go to a shrink (although they did force me to, for a while, and even then I had to agree)… of course as I’ve mentioned a few times, I cheat! My shrink is God, and I have to admit, He charges quite a bit too! … My whole Life! The upside? … I’m Way beyond all this Organized Religious Life BS, and am just into God’s sense of humor(which nobody thinks is one dam bit funny but God!) … in fact I even do “Stand Up (for) God Comedy” (which, not too many people find funny either, but I don’t care!)…What’s laugh worth? … Ask Robin Williams!
LUV 2 ALL
Wisdum
posted December 8, 2007 at 11:48 am
100% agree with Margaret Balyeat. I am a therapist and know there are many who will not fit anyone, and there are those who have walked the walk and are willing to help others along the path. I do take offense to always hearing a reference to how much a therapist makes. I never went that route, as I charged only what insurance paid, and $25 if no insurance. My plumber made more than I did, and I couldn’t afford the fees for someone to clean my house. My gardner got $10 a week for 7 minutes of cutting the grass. Point is, after 8 years of college, a therapist has to charge something. Most are too high, but again that is a choice of those who go to them…look around. Cheap doesn’t mean no good. I charge from compassion. And if your insurance stopped paying I kept the sessions going; there is no ethical way I could have told someone with depression that we had to stop treatment. But that is me, and I retired on $800 a month SS. But I can look back and agree with M. Balyear that therapy does work, if you get the right therapist. It’s all about the client not the therapist. If there is no movement in the problem, is it because the therapist is wrong or is the client still in denial of a problem.
As to other countries, I lived in Europe for ten years, and the problems are the same, just as human beings are the same with hurting, anger, etc. We Americans are more open about having a problem, so when I was in Holland, the problems were denied until they surfaced in ways that couldn’t be hidden. Ditto in Germany. Does anyone remember the 1940-50′s when it was a stigman to have depression, anxiety, etc. Now, it at the other end of the spectrum.but better out and exposed than in and massacres happening. And we put our woes on the front page, whereas in Europe it is on the back page, if at all.
Have a happy holiday season, and remember to be honest in all of your encounters. They may come back to haunt you if not. Only the truth shall make you free…lies kill. So, be truthful if in therapy, choose the best you can find for the price you can afford. Health to all.
posted December 8, 2007 at 6:36 pm
Something tells me people didn’t quite “get” me. That’s okay. It’s hard to please everyone. Thanks for the interview, it was a lot of fun. I’m going to link to your blog soon. Hope your season is blessed and that you continue to inspire others.
posted December 8, 2007 at 8:49 pm
“Fantasies and illusions fade away. Fight the madness every day”.
Exercise your right to good health and happiness. No one should have led you to believe that life would be easy for everyone. Everyone faces challenges both internal and external. There are hundreds of resources available, but you have to do the work for yourself. Develop your own therapy and work it, work it, work it till you’re done. Most anxiety and depression are caused by repetitive thoughts that are difficult to reject. If you suffered a traumatic brain injury and had to re-learn how to walk, talk, eat, and dress yourself that would be a difficult task, but you would do it. It is possible to gain control over your thoughts and mental activity. Studies have shown that regular physical exercise can be as effective as anti-depressants in many people. I decided to stop whining and start shining. I’m working hard every day. It’s time to take back control and rise above.
Google it:
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2007-09-
posted December 8, 2007 at 11:44 pm
I once had a therapist fire me.
She had Tourette’s syndrome. I felt bad for her; but really, she wasn’t a very good therapist — and the whole thing was like something out of Seinfeld.
posted December 9, 2007 at 2:01 am
Larry; i wish you could see the visual your post inspired in my “creat”ive brain! Hopefully when she “fired you” she wasn’t in the middle of a “Tourette’s moment” (That was my visual! something like “get your #%^*&%!!@&%** A– out of here, scumbag, you’re wasting my time!” Anyway, thanks for the laugh; it helped me edge my head out of the abyss.
posted December 9, 2007 at 6:47 am
Steve: As one who HAS suffered a traumati brai injury (in the for, of a massive stroke) and had to relearn how learn to walk, eat, smuile and do daily dasks one-handed, let me point out that those things are accomplished (Is indeed they ARE; many remain “forgotten” for most of us, let me point out to you that the “relearning” is accomplished with the help of other kinds of therapist: physical, occupational and speech. while it does indeed require commitment and effort on the part of the injured individual, it isn’t a matter of “Just do it!” ( apologies to Nike!) And since most CVAs, or traumatic brain injuries also effect mood/personality disorders as well, (especially depression by exacerbation or onset for those lucky enough to have been spared thse issues prior to their CVA, those issues require the services of trained professionals as well. (Who WOULDN’T GET depressed having lost so many daily functions we all take for granted? Your point about finding resources is well taken, but I know I wouldn’t have made what little recovery I HAVE made had it not been for the many wonderfil(for the MOST part) therapists assigned to my case. Trust me, you don’t jumpstart the brain on your own!Nor does perserverance ALONE get you through it! It obviously plays a part bevause the work is tedious and frequently physically painful–and no therapist can do that part for you–but it is the therapy and therapist(s) that get(s) you there, especially when you hit the many plateaus which are a part of the recovery process. Support groups and other resources can HELP, but they’re not a substitute for the trained professional!
posted December 9, 2007 at 11:23 pm
therapydoc:
I’m sorry to hear you say that.
This reminds me, sadly, of when Therese interviewed Jane Chin of Chinspirations. I had a genuine question for Jane about her medical regimen; for some reason I didn’t quite understand her and she didn’t quite understand me, which left her very frustrated.
In the end, I wasn’t frustrated because I didn’t get my question answered — hey, this is life, you don’t get all your questions answered ;-P
But I felt like she felt like we were inhospitable. I regret that with Jane, and I certainly wouldn’t want you to leave BB with that impression
Larry