...well, I kinda have a bit of everything, doc.
October 8, 2012 8:41 AM Subscribe
Which issues do I bring up in a first session with a new therapist? Snowstorm inside.
posted by anonymous to health & fitness (12 answers total) 2 users marked this as a favorite
I have a first appointment with a psychotherapist in 3 days, which is good. I also have a long list of (not neccessarily connected) issues and no idea what to bring up in a first session, which is bad. I need some help to set priorities, if that is even possible. (I was sent away by a therapist a decade ago as "hopeless case" and do not care to repeat the experience.) Part of the problem is that I do not experience all of my issues as issues, yet they may be factors playing into the things I do consider as issues. I don't know if it would help to bring those non-issues up or if it would derail from the actual reasons I made the appointment for.
Issue: Strongly suspected ADD, no H, self-medicating with caffeine from age 15 on (33 now). I have such a high tolerance by now, it's not working anymore. I'm just holding a level, but the attention span gets shorter and shorter. I can't focus on anything, not even things I like and want to do. I got through school with okay-but-not-great grades and the help of a damn lot of Red Bull. Since graduation, I went from odd job to odd job. This is the reason I made an appointment.
Issue: Likely related, I have and never had any structure in my life whatsoever. I sleep and get up at random times, my mind is all over the place and I forget to do basic things. It takes me 1 - 2 hours on average to fall asleep because the inner monologue doesn't ever stop. Obviously, this doesn't work well with school or work and in the past, my go-to solution was "more caffeine" if I have to get up at a certain time. I was given pretty much every available sleeping pill in my youth and none of them changed a thing. Some had no effect at all, some made me tired, but still unable to fall asleep if there were important matters (such as googling what my favorite food is called in other languages) to take care of.
Non-Issue, but likely connected: Strongly suspected Schizoid Personality Disorder ("suspected" around age 19 by neurologists and a PCP who was also a psychotherapist, but it's no official diagnosis). It's not that I dislike people. I just can't be around them. If I am, it's dead certain I'll end up with a burn out diagnosis after a few weeks - I had enough of those in the years I tried to pretend to be "normal" and have "normal" jobs. I do not feel lonely or sad or that something is "wrong" with me, however, this is a big issue with my career options. I feel it is perfectly possible for me to pursue a degree once I get the ADD under control, but the job service is hellbound to not support any kind of class I can take from home and instead tries to send me back to highly social jobs such as call centers.
Therefore, this is only a "practical" issue - a diagnosis would make it a lot easier for me to get the degree I want (which would give me options to work from home/in an enviroment with little social contact). I appear to be a "text book case", including the "unlikely to seek therapy on their own" part. If it wasn't for the ADD - which does interfere with my otherwise working coping mechanisms - I would never consider seeing a therapist about just this. It somehow feels wrong to bring up an issue that doesn't feel like a problem to me, at least not a problem a therapist can "cure".
Issue: I'm transwhatever. I see my physical body as little more than an inconvenience and I have accepted long ago that I will never "pass" as anything but my birth sex. I do not want to the opposite sex either. In a perfect world, I would not have a sex at all, just a blank body. I find both sets of genitals weird. I know that it is not possible to physically transit to "whatever/none" because such surgeries aren't legal, so it might be pointless to discuss this matter with a therapist who can't change it anyway. A part of me wants to try though, in hope to get my name legally changed to something gender neutral, if nothing else. Besides the "whatever" part - text book case of trans.
Issue: Mild social anxiety. It's not being nervous about social situations - in fact, I was a good speaker in school and never had any trouble to talk to strangers. I don't worry about standing out or making a bad impression because I genuinely give a shit what people think. What does give me panic attacks - freezing in shock, "playing dead" behavior - is the door bell and to a lesser degree the phone ringing. I guess on some level it's simply being easily startled, on another level being unprepared for an encounter and having no time to put on my "mask of sanity". (Social situations are mentally draining for me and I need time to prepare - mainly to make myself clear, which then makes people go away sooner and I can mind my own business again.) This wasn't nearly as bad before my attention span went down to the point where it interferes with my life.
Tl;dr: My first experience with a psychologist was him telling me I have "too many symptoms" and am "a hopeless case" and sending me away with some sleeping pills. Don't care to repeat that experience, so which issues do I bring up in a first session with a new therapist?
The options are: ADD, completely unstructured life, Schizoid Personality Disorder, being transwhatever, social anxiety.