What are the best strategies for getting the most out of preventative therapy?

May 7, 2011 8:33 AM

I'm thinking about therapy for the first time, but nothing's specifically wrong. What type of therapist should I look for, and what can I do in the weeks leading up to it that would help me along the way?

I'm in my late twenties, with a good job, a great girlfriend and a nice life. I'm also quite happy with where I am; I just had a birthday, and listing the accomplishments of the past year made me really feel good about myself.

With that said, I have some nagging issues I'd like to address with a therapist. Depression runs in my family and I feel, at times, I suffer from it, but it's never overwhelming. Some symptoms:

1) I am a bad drunk; I know everyone kind of is, but in my younger years, I would cheat or steal when I was drunk, and now I just act like a dick to the people I love. I don't drink very often (maybe once a month) but I feel like the severity of my actions when I do is troubling.

2) I am always fighting feelings of being underwhelming to the people around me. I embellish the successes in my life, I suspect, because I feel like people aren't going to be impressed with who I really am. So, I mention to people way before the process begins that I am up for a promotion (when in fact, I'm one of 40 people competing for a particular lateral-move job), and I do this so often that people are impressed and then I feel like I have to keep lying to keep them that way.

In short, I tend to catch myself lying more often than I should be, and I think it's related to issues with self-worth and the need to be something better than I am.

3) I have a difficult time concentrating on and really diving into assignments. I've found it difficult, ever since I was a kid, to sit down and ignore everything and just work on something that needs to be done. It hasn't helped that every step of the way, I've been able to get away with it, but I want to be one of those people who prioritize and don't watch TED talks on YouTube rather than write the blog post they're meaning to.

4)I'm an ideas guy. I like to start things and then I don't do the actions required to make it a reality. I've started 30 or so blogs, each with the intention of analyzing things, and I get 3-4 posts in and never really manifest the "put the work into it" part. Often times, I feel like if I put a ton of effort into something and it doesn't pan out, I'm going to feel terrible. I'm not sure that's ever really happened, though, so I don't know where I got that line of thinking from.

Sorry this is long, but the point is, I want to head to therapist before anything major happens to figure out if I have depression (or ADD, or something) and to do some preventative maintenance to get over some of the nagging things about myself that I feel are holding me back.

Have you done this? What type of therapist should I be looking for? My insurance kicks in three weeks from now, so I have some time to do some work on my own.

Are there things I can do before walking into the office that would allow me to really make significant progress? Any experiences with seeing a therapist when nothing's really that wrong would be helpful.

posted by anonymous to health & fitness (5 answers total)

Quit drinking altogether. Seriously- it's not good for you physically, emotionally, or mentally. Also, it sort of sounds like you have low self esteem. Nothing except for being happy about what you have accomplished and not relying on the approval of others will help you with that.

Good luck.
posted by TheBones at 8:40 AM on May 7, 2011

What type of therapist depends really on your personality and what you're looking to get out of it. There are so many different types and techniques, and studies have shown that they all have the same rate of efficacy - I think it's really a matter of what works for different people. Personally, I talked to a bunch of therapists about their style and experience and told them what I was looking for, and made my decision based on what I felt was best for me. For example, I can't fathom going to therapy and just talking for 45 minutes and having the therapist not say anything, but just nod and listen. However, this approach does work for a lot of people. My therapist is very interactive and practical, and that's what works for me.

When you meet with a therapist for the first time, it's different from all the other times that you'll meet with them. They usually will ask you what brought you to therapy -- that's when you can talk about what you've brought up in your post -- in fact, a list like that is going to be really helpful for them to get started with you.

As to what you can be doing now - I would talk to a number of therapists and make a few initial appointments. Many will offer a free initial phone or in person consultation, so you can do this without the insurance being ready. Good luck.
posted by sweetkid at 9:37 AM on May 7, 2011

I don't think that drinking is the problem here. Sure, if you don't like who you are when you drink then don't drink, but that doesn't seem like the real issue.

There isn't enough information here to tell you what TYPE of therapist you should see. Really, the type of therapy is less important than finding a therapist you are comfortable with. You have the luxury to shop around since you aren't in crisis.

Make a list of questions and personal goals. Take these into your first appointment (or appointments since you have some time to pick the right therapist). Ask how the therapist will hope you approach these issues. When you get an answer that makes a certain kind of sense to you (is intellectual, rational, or creative enough for your personal needs), then you'll know you've found a therapist.

Read up on different styles of therapy: Cognitive Behavioral, Psychodynamic, Humanistic, Gestalt. In my experience, most therapist will employ a combination of theories in their practice. But a little research will give you a basis for evaluating a therapist's style and finding the right match for you.
posted by dchrssyr at 9:38 AM on May 7, 2011

but nothing's specifically wrong
So why the four bullet points?
Those four issues are exactly the kind of thing you would discuss with a therapist. Call a couple of people up, and ask them what their approach to therapy is. You want someone who wants to discuss your problems, not someone who wants to talk to you about your dreams or your relationship with your mom. Pull the trigger and address this, like now, since it's not going to get better all by itself.
Best of luck to you.
posted by Gilbert at 9:39 AM on May 7, 2011

I agree that it's good to read up on different styles, and to ask friends what they've found helpful. I knew after my first meeting with my first therapist that he was too CBT-focused for me, and I went back to my GP and asked for a different style. That helped us find the next therapist, who used several different modalities and was a Great fit. You also might try browsing the therapist finder at Psychology Today to see if someone in your area looks like a good fit for you.

PS - I also thought there wasn't much Wrong, because a lot was right in my life. But therapy helped So Much with self esteem and the dysthymia she diagnosed me with that I heartily recommend therapy all the time on askmefi and person. Good on you for seeking to make your life better.
posted by ldthomps at 6:23 PM on May 7, 2011