Ask MetaFilter questions tagged with therapy and therapist

How (on earth) do you do therapy in NYC?

theflash — Thu, 18 Apr 2013 15:10:01 -0800

How do you handle mental health in NYC- insurance, out of pocket, other options? I just made a huge move to NYC, and now I'm trying to figure out how I can continue in therapy. I have a referral from my last therapist, but when this new person told me the out-of-network fee, I couldn't believe how high it was. More research indicates that a lot of therapists here don't take insurance and most people are paying out of pocket, with very low reimbursement rates. Even if I find someone in-network, my insurance (Aetna) will only cover a small amount that I assume is not the whole fee. A place with a formal sliding scale probably won't consider me in need since my gross income is high (though with loans, my expenses are also quite high and I can't spend $800/month on therapy).

So, MeFites: what do you do? How do you handle the insurance/out of pocket issue? (And if you have recs for someone in Manhattan or Brooklyn who focuses on relational therapy, I'm all ears.)

Therapist for anxiety/depression in Inwood/Riverdale/lower Westchester?

The Elusive Architeuthis — Tue, 05 Mar 2013 06:53:45 -0800

Asking for a friend-- Can anyone recommend a therapist for anxiety/depression in Riverdale, Inwood, or nearby Westchester? No particular approach preferred, although approaches like CBT that have some literature supporting their efficacy would be better.

NYC therapist for problematic drinking.

Anonymous — Mon, 28 Jan 2013 15:03:44 -0800

Looking for an NYC therapist specializing in treating problematic drinking. It is for someone who is a very private person so 12-step/AA/etc. is not an option. The issue is infrequent binge drinking leading to behavior stressing an otherwise happy and healthy relationship. Anywhere in Brooklyn or Manhattan works. Looking specifically for a psychotherapist, not a psychiatrist. Insurance not an issue. Throwaway email: soothemythroat@gmail.com

Therapy while traveling or in transit.

Anonymous — Wed, 12 Dec 2012 06:59:39 -0800

What are my options for therapy while I am traveling and in the midst of a move to a different part of the world, with a lot more travel on the horizon? I think it's time for me to go to therapy. After struggling with anxiety for most of my adult life and recently realizing that my anxiety is having a pretty big negative impact on my relationship with my SO it's pretty clear to me that I need some help dealing with things.

The issue is that I am bouncing around between locations at the moment. As I type this I am in a major city in North America and I will be here for the next week or so. I have access to my GP, constant access to the internet and some time to do research and figure things out. In a week or so when I move on I will be in a foreign country where I don't have a family doctor and my time/resources will be limited relative to where I am now. How do I get the help that I need?

I have tried working through a few different workbooks (Feeling Good among them) and I've also tried MoodGym and e-couch. None of these things worked well for me. I find talk therapy to be the most helpful. Talking with others really helps me work through my problems and having someone to ask questions and provide an opinion makes a big difference for me. I don't really know what the therapy situation is in my new home country but even if there are therapists available/accepting patients, I will be traveling a lot as part of my new position. I am afraid I am overlooking an option (like a more interactive version of MoodGym or something) and I don't really know where to find the help that I need.

Where can I go to find the help I need and what do you recommend given the circumstances?

Therapist in Asheville, NC?

annabellee — Fri, 16 Nov 2012 15:36:13 -0800

Help me find a psychotherapist in Asheville, NC. A dear friend has just moved to Asheville, NC and is looking for a good psychotherapist for talk therapy. She's not looking for a particular modality or degree, just a compassionate, smart person. She has mild anxiety and depression, just moved to the area and is looking for someone to see weekly. She knows no one in NC, so I said I'd ask for her. I'm sure she'd be delighted if the therapist took insurance or had a sliding scale, but all recommendations welcome.

What would it be like to get therapy from a Blue Devil? What is a Blue Devil?

Keter — Tue, 13 Nov 2012 15:40:25 -0800

TherapyFilter: For a friend--I am looking for a lovely therapist in the Durham, North Carolina area (and reasonably nearby regions as well). The therapist would preferably be more interpersonal or psychodynamically/psychoanalytically oriented versus cognitive-behavioral or purely supportive, be queer-friendly, and also have some experience treating anxiety disorders. Feel free to MeMail or e-mail me if you do not want to post publicly. Thanks, MetaFilter!

Finding a couples counselor in Houston?

Pwoink — Tue, 09 Oct 2012 17:49:09 -0800

Does anyone have recommendations for a couples counselor or marriage/family therapist in Houston, TX -- or, at least, what resources I can use to find a good one? Thank you in advance!

Does anyone have experience of Core Process psychotherapy?

terretu — Tue, 02 Oct 2012 02:36:01 -0800

Does anyone have experience of Core Process psychotherapy? I've been looking for a therapist in my area (Cambridge, UK), and it's confusing, expensive & scary. I've found someone who uses Core Process, and he's significantly cheaper than most of the other therapists, mainly (it seems) because he's in the last year of further studies (though he's qualified to practice). His office is also close to my work, which is a definite plus.

Some cursory research on Core Process has thrown up the fact that it's mindfulness/Buddhist-based. Which, mostly, sits fine with me. I know that mindfulness works for a lot of people, and I studied Buddhism briefly (in an academic sense) and am interested in its central ideas. There's a little cynical part of me that thinks this might be closer to hippie alternative medicine bullshit than I'm comfortable with, but this cynicism isn't strong enough to be a dealbreaker.

The main problem is that my Googling hasn't thrown up any medical or scientific studies on the efficacy of Core Process. The only resources I've found are either from the main place in the UK that trains people to become Core Process therapists, or from individual practitioners advertising their services.

Also, I'm seeking therapy in the hope of getting a better handle on some long-standing issues (history of pretty bad depression & anxiety, whole bunch of family problems, some eating/food stuff). I know that no one seeks therapy lightly, but I want to do some serious work on things which I've been struggling with for a long time, and I want to know before I commit that this is going to be rigorous (and likely to help).

I don't know if I should go with this guy because he's cheap, or suck it up, pay more money and get a different/better-know/more well-tested type of therapy. I know that I really don't want CBT or any kind of traditional analysis, but outside of those limits I don't know what I want or what would be best for me. I also have a history of flaking out on therapy because it's hard and I'm scared and the whole situation makes me really anxious, but I'm hoping that this time (with the added incentive of paying for it myself, rather than taking whatever I can get from my former University/socialised medicine) I'll be able to stick with it and make some real progress.

Tl;dr - I like the look of this one therapist & he's relatively cheap, but I can't find any science or resources on the type of therapy he offers; does anyone have experience of or anecdata around Core Process?

Seeking mental health resources for young Italian man

vincele — Thu, 27 Sep 2012 08:35:45 -0800

What are low-cost or online resources for a young Italian man with anxiety disorder and/or depression in Rome? I'm asking for a friend. What are low-cost or online resources for a young Italian man with anxiety disorder and/or depression in Rome?

I checked the ThereisHelp page but I didn't see anything on Italy. Any resources in Italian or advice about clinics or therapists is appreciated.

Looking for a therapist in Brooklyn/Manhattan

exgeographer — Mon, 16 Jul 2012 13:39:29 -0800

Do you know a good talk therapist in Brooklyn or Manhattan, or can you help me find one? Would you recommend yours? I'm not sure why I'm finding it so difficult. I would like to find a therapist, but the Psychology Today database has so many entries for my area that it's useless.

All I know is that I do not want a short-term/CBT-only person, and I think it would be useful to see a male therapist (I am male), though I would still love to hear from you if your therapist is great, regardless of gender. I would be very appreciative of any suggestions, the more specific the better. I would be paying out of pocket. I think part of the difficulty is that I am not looking for a therapist for one specific issue (as far as I know...) so it's hard to narrow down in that way.

Thank you so much. I will also be checking my Mefi Mail.

(This is a sockpuppet account.)

Best Practices for Ending it with Therapist

little_dog_laughing — Sat, 14 Jul 2012 21:52:34 -0800

Terminating with psychotherapist after six sessions: I think I should. But, I wonder how to do it properly? How much of an explanation do I owe the therapist? I'm not even sure I've given this therapist a fair shot. I had two goals (two issues I hoped to unscramble) upon walking in; one of these goals was fairly straightforward but the therapist and I have hardly mentioned it. The other goal was more vague.

So, I have goals.

It seems we've spent our time so far addressing kind of background-y, superficial things, like how was my childhood and with whom do I live, how's work, and that sort of thing. And, to that end, I've been increasingly put off by my therapist's apparently narrow, disapproving viewpoint up to where, at our last session, I was actively trying to keep my defensiveness in check. (And, I'm not a defensive person, gosh darn it!)

Our sessions thus far have made me not want to open up about the "straightforward" goal. I don't trust her. I think it'd be a waste of time and the sensitive parts of my soul would feel vulnerable! But, if I were to decide to spill the beans to her and her reaction was unkind, I'm sure I'd get over it.

Actual examples of the therapist in action might help, OK, but if I rattled off a few examples from the most recent session, they would individually sound not-so-bad. Taken together, it just seems like too much. Like we have bad chemistry(?) Examples: she has mentioned more than once that I am financially dependent on my partner, which isn't true. I'm not financially dependent on my partner and I would not leave my partner if suddenly I had a gazillion dollars. It's as if she doesn't believe it. Speaking of dollars, I mentioned that the one downside to my job is the hours. Not the number of hours per week but the fact that I prefer to work in the morning and I am currently busy with work in the evenings to late-night. It's not a huge deal to me, and I'm otherwise quite happy with work, but when I told her that having the AM as my downtime feels like my job saps my entire day, she said, "Well, that's what work is!" as if it's my first job or something. I mean, I've had full time employment for almost 20 years. I'm not a newb. I have a few more examples- she made a bold statement about one of my friends based on a single anecdote- it seemed reckless to toss out a diagnosis-type-thing like that. Etc. Etc. She comes off as judgmental to me, but I give her the benefit of the doubt, we just don't jibe.

At every session she has given me at least one helpful insight or tool, so I held out hope, until our latest meeting, where I left there thinking, "What the crap was THAT?!"

Now, I would think I could just tell her what's on my mind, right? Tell her I'm not so comfortable with the way things are going, and that I think I might benefit more from some other therapist. Right? What do you think?

She has decades of counselling experience. I have had one good and one not-so-hot experience in therapy previously, and I've been told I'm a good patient.

I know I could just walk away, but I want to do this right. When does one know when it is time to move on? What (specifically) do I tell this woman? My first impression of her was great. She is possibly great, just not for me.

Therapist answers texts during our session

Anonymous — Sat, 26 May 2012 17:11:20 -0800

How much does this therapist suck? Or am I being overly sensitive? I've been seeing my therapist for a year and during that year I have asked for guidance as far as social skills, food and money issues---mostly I get from her "I give you permission to work on your issues". She is a psychoanalyst. Her phone goes off periodically during our sessions and at one time ( I have let her know that it's not cool to look at her texts prior to this) she said, "Actually I have to respond to this because it's urgent" and dashed off a quick text.

Another time she asked me if I had experimented with drugs and alcohol and I told her that wasn't really an issue for me. She then said, "Yes, food is far more satisfying, isn't it?" That felt disrespectful to me.

So my two parted question is this:
1. What should I be reasonably expecting from therapy?
2. How unprofessional is it for her to leave her phone on?

Recommendations for a therapist in SF/Oakland area?

Captain Chesapeake — Sat, 19 May 2012 12:05:25 -0800

Life happens. Looking for recommendations for a therapist in SF/Oakland area. Details inside. I'm looking for a therapist to help me sort through some general life issues. My previous therapist introduced me to Acceptance and Commitment Therapy (ACT) to deal with anxiety. He is great and I would continue seeing him but I can't afford $200 a session forever. My health insurance doesn't cover him. The goal of this post is to find a therapist compatible with the issues I want to explore, who takes Blue Shield insurance, and is close to the BART San Francisco/Oakland corridor, as I have no car. I work in downtown San Francisco and live in downtown Oakland.

I would like a therapist who is familiar with ACT (or similar) and can continue to guide me as I implement it. I'm drawn to cognitive behavioral therapy as it is a results-oriented type of therapy. At the same time, there are other issues that don't quite fit that paradigm. I'm open to concepts outside of the psychotherapeutic model.

What I would like to explore:

1. I tend to be fairly judgmental. Developing a better sense of compassion for myself and others.
2. I want to come to peace with who I am today. I want to properly mourn the other conceptions of "who I wanted to become" and move on.
3. I want to start weaving my past experiences into some sort of narrative and accept them as pieces of me. I tend to try and avoid thinking about the past because I consider many parts to be sort of awkward and painful.
4. I want help continuing to develop my meditation and mindfulness practice.

Does anybody have any recommendations for therapists compatible with my issues and takes my insurance? I would prefer that they take Blue Shield, but any other awesome recommendations OK as well. Thanks.

Therapist Recommendations around Westchester County NY

en el aire — Thu, 17 May 2012 07:04:27 -0800

I am looking for suggestions for a great therapist in the Westchester County, NY area. I am thinking one that focuses on cognitive-behavioral therapy may be best, but am open to suggestions. A little backstory that might help: a close relative is in her early 50’s and appears to be terribly depressed. She has tried therapy several times throughout the years but has never gotten much out of it and seems to have given up on the idea. At this point she doesn’t think anything is going to change. My family is hoping that we can get her to try one more time, but we are at a loss as to where to go for help, or what more we can do ourselves to help her. She has always been fairly quiet and withdrawn, but this past year has seen her get much worse. Her goal each day is to get through work as quickly as possible so that she can get back to her room and watch tv – quietly and alone. Watching television consists of staring blankly at the tv for hours on end - she rarely remembers what it is she has been viewing. She is exhausted all the time, and attempts to get her to do anything she once enjoyed (go for walk? do a little gardening? visit with her sister?) are met with the common refrain of “I just want to be alone – I’m tired.” Possibly relevant: she is under regular endocrinologist care for Hashimoto's and is on the correct dosage of synthroid for her physical symptoms.

It is discouraging and if I’m being honest with myself, annoying. We (immediate family) are at the very unhelpful point of just wanting her to snap out of it already, but of course know it is not that simple. Mostly, we just want her to enjoy life at least a little but we don’t know how to help her. There is more of course but for brevity’s sake I’ll stop here.

TLDR: Searching for a great therapist in Westchester County for someone who has been to several and is at the end of her rope. I am searching for someone who will actively point out where her thinking is broken and give her the tools to help her feel better moving forward. I believe a woman is preferred and someone who accepts insurance would be ideal.

Thank you and please don’t hesitate to email: helpmefindatherapist@yahoo.com

Too much anxiety, therapy isn't working, help?

Anonymous — Tue, 15 May 2012 13:11:20 -0800

My anxiety is running my life. I've been to therapy, it made it worse. What next? Basic problem: I have really high anxiety mostly related to my work performance, I live in fear of public failure, I have high expectations for myself, and I can't be proud of much about my work since objectively I have achieved less than some of my superstar friends/peers and I feel I'm underperforming even relative to my own capability.

I have a tendency to quit things that make me feel bad rather than stick them out, so I can have down time to feel calm again, even if I know I shouldn't quit for some good reason. I think a work project is going poorly because I'm getting stuck and making mistakes, so I ignore it until my boss demands to see progress, even if I liked the project for its own sake at the start. I am terrified that my career is going to stall or even worse that I will get fired, that I'm not good enough to stay in my field and I'll need to find a whole new less ambitious line of work, but that will be "settling" and will also make me miserable. I am a decent cook but constantly feeling guilty about how much I eat out because I'm stressed and busy and just want someone else to worry about the food preparation. Same with exercise; I bike and jog short distances inconsistently but its not enough and I feel bad occasionally that I'm still unfit, and I know exercise would help. I should probably be more proactive about socializing even though I have a bigger social network now than I ever have. But the main goal is to improve enough so I don't risk my job at this point.

So I need therapy, obviously. I went for several sessions. I said that the main problem was that my work was suffering because I couldn't manage my time, I was constantly stressed, not having many good days where I felt calm and mentally sharp, which I really need to do my kind of work, which is intellectually taxing. She said I was just secretly telling myself I sucked and that deep down I think I'm a terrible person all the time, and that I had to stop that (I don't think that was true, but okay, she's the therapist). Then we talked about my social life, and she thinks I am too cold or introverted. I guess this is true, that I am slow to establish intimacy with people, but I think I'm well liked in general but I never want to push closeness on someone who doesn't indicate they want it, so I have quite a few friends I have fun with, none of whom are best friends or people I regularly tap for support. She focused on this problem, and the work stuff was getting ignored in sessions. This made me feel like even more of a failure than when I started therapy, so I quit (see problem with quitting previously mentioned). Apparently I misled her or something, or I was doing therapy "wrong." I feel like most of my worries are totally rational and normal but I just can't set them aside long enough to be super productive, and that's what I want to be able to do.

Questions-
1) I am putting my career at risk if I don't fix the work performance anxiety eventually. I am smart, I don't suck at my work, on a good day I find it interesting, but I'm not a superstar. My boss just says I need to work harder and be more passionate/committed. That's not helping. We have a plan for some concrete things to fix but if I can't turn around the anxiety, the plan won't work. That means I have a few months to get this under control and find some calm source of inner motivation or I will probably end up fired, broke, and in an even deeper hole. Are there any stopgap measures I can implement RIGHT NOW that will help me avoid this outcome?

2) I probably need to go back to therapy but I don't know how to do therapy right, apparently. I'm not even sure it will help because I'm just realizing how bad the anxiety is and how much it feels like just part of who I've always been, and it's not always at some crazy dysfunctional level, I'm just bad at managing/ignoring it even when it's mild. How do I do better with the next therapist? I won't have much choice for the next therapist, I will get one pretty much at random, and there are only a few available to me that are covered by my insurance.

3) Is there ANYTHING else I can do to get some traction other than trying my best to make therapy work on the second round? First therapist said drugs won't help me, but do I need to demand to try benzos for the short term until this is under control?

I'm transgender and I need to go (on the) straight (and narrow).

sokkupapetto — Tue, 01 May 2012 20:46:26 -0800

I am transgender (transsexual MTF). I am self-medicating and I need to go legit. I am looking for a recommendation for a therapist in NYC (and possibly an endocrinologist) who is accepting new patients and is willing to work with the fact that I am self-medicating (and hoping to stop self-medicating and go legit). I am over 25. I am currently employed but without health insurance. I make 110k/yr but am somewhat in debt, so a sliding scale might screw me. I have no idea what an endo will bill. I've had blood work done myself, and I'm pretty sure* I'm doing it right, although an endo may want me to stop self-medicating in order to get a baseline. I might refuse to do this. I am aware of the various informed consent options in NYC, but I would rather that be an absolute last resort. I can't talk to the family doctor, because I am not out to my parents, and the doc will blab. First and foremost though, I am looking for a therapist, so help me with that.

[*] On the other hand, speaking to an employment lawyer today taught me that lay(wo)men shouldn't pretend to be lawyers as I clearly know nothing about law; and I figure I shouldn't pretend to be an endocrinologist either. I am a little worried I'll fucking kill myself if go off my meds though.

Looking for first time therapy tips + therapist recommendations in Vancouver.

Anonymous — Fri, 30 Mar 2012 14:16:24 -0800

I've come to the conclusion that some therapy/counselling would help me a lot, but as a life-long introvert I find the idea very intimidating and nerve-wracking. Looking for tips and encouragement on starting therapy, and recommendations for a good, preferably female and affordable, therapist in Vancouver BC. I've had what I think are some definite issues throughout most of my life. On a few occasions, I've fallen into deep pits of gloom for a few months at a time that seem similar to depressive episodes. I get anxious a lot, especially around strangers, and have a concern about my health that verges on hypochondria. I'm also at a confused "quarter life crisis" period right now where I'm not sure what to do with my life, and my anxiety about it is getting a bit out of control to point where I go on long crying jags. I don't like telling people these things, but I recently had a very drunk, cathartic conversation with my friend where he suggested that I really need to talk to someone, and he's probably right.

Unfortunately I am very, very uncomfortable talking about my feelings and rarely do, and the thought of going to a therapist makes me pretty anxious. Of course these feelings just seem like part of the reason I need to talk to one in the first place. As stupid as it is, just going to a therapist makes me feel like a 'damaged', 'crazy' woman and that I'm admitting that I have issues, while I've spent all my life trying to hide them. Any advice about getting over this first hurdle will be very much appreciated.

I would also like a recommendation for a therapist in Vancouver. I am a young woman (25), and would feel more comfortable with a female therapist but this is not necessary. I mainly just want someone who is understanding and unintimidating, and who will not push medications right away (I'm willing to take them if necessary but anti-depressants make me nervous). I am also not in school, and don't have a job with benefits, so I would prefer someone affordable. I don't even know how much I would expect to pay for therapy. I live in the downtown area but I can go pretty much anywhere within the city as long as it's accessible by public transit.

Thank you so much, in advance.

Talk therapy in NYC?

Anonymous — Thu, 29 Mar 2012 19:40:06 -0800

Looking for a great talk therapist in Brooklyn. I've resisted it for a long time but I think it's finally time for me to get into talk therapy as an adult. I tried with a few different therapists during adolescence but never found a therapist whose style I clicked with and didn't have the resources/autonomy to find someone more compatible. Now I do.

The therapy style that strikes me as ideal is similar to the therapist in In Treatment (caveat: I only watched the first season and obviously I'm not talking about any of the questionable medical ethics stuff, just the style of therapy!). I'm very analytical and I'm looking for someone who can help me unpack what's going on with me. Not necessarily specific advice (e.g. "write a letter to your ex", advice I've gotten from a therapist before) but definitely offering feedback and insights (as opposed to a past therapist whose method was to sit in total silence waiting for me to speak).

The issues that I'm looking to discuss are mostly relationship related, not specific relationships but more to do with the way that I interact with people in my life, especially in romantic relationships. Some of those relationships have been non-traditional/kinky so it's important to me to work with someone who won't view those relationships as intrinsically dysfunctional because they're not the norm. I've also dealt with mild depression and anxiety for most of my life but am not interested in being medicated.

I'd really appreciate personal recommendations for therapists in Brooklyn or lower Manhattan, as well as any keywords or terms you might use to describe the style of therapy I'm looking for (so I can search more effectively for myself). Here's a throwaway email: seekinggabrielbyrne@hotmail.com

Yup, another therapist request.

small_ruminant — Wed, 14 Mar 2012 15:24:37 -0800

Can anyone direct me to a good therapist in Berkeley, Albany, El Cerrito, or Richmond, California? I'm not in any sort of crisis but do have a lot of the usual grown-up sorts of life changes going on these days (combining households with my honey, taking care of aging and clinically depressed parents, etc) and don't want to lay it all on my partner.

Female, please. 12-step-friendly would be a bonus, but isn't required. Bonus if they don't remind me of my boomer parents.

North Oakland would be a stretch, but possible.

?

Tarumba — Wed, 29 Feb 2012 08:24:35 -0800

I have major depression. My therapist is pushing for meds like crazy and I am kind of scared. Several general questions about antidepressants inside. I had my intake session with my first therapist last week, and she diagnosed me with major depression, which apparently has been going on for most of my life. She inmediately said I should continue doing therapy and supplement with meds, and I have a few questions.

- how did she decide I need antidepressants so quickly? shouldn't we try just therapy first?
- I know nothing about antidepressants: Are they going to make me a drone? Am I going to gain weight? Will I be addicted? Will I have to take them for the rest of my life? What if I lose my insurance, will I go crazy without them? do you have any specific recommendations?

I'm very nervous. My second appointment is tomorrow and she was singing the glories of meds last week, so I know she will go on tomorrow, and I wouldlike your stories, reassurance, warnings, etc.

:) Thank you.

Fall five times. Stand up six?

Anonymous — Wed, 29 Feb 2012 07:56:10 -0800

All attempts at establishing a relationship with a therapist have failed. Now what? Late 20s, female, living in the southern suburbs of the Twin Cities and dealing with a lot of stress, loneliness, unemployment/underemployment (Problem #1) and increasing amounts of anxiety. My only requirements for my therapist have been

1. reachable under my own power in one bus trip or less (I do not have personal transportation and cannot involve friends or family members [Problem #2] as I wish to handle this privately) - this allows me to go to sessions and return before anyone realizes I've been gone for very long

2. willing to work with me with regards to my finances (I have some tax refund money (> $1000) to work with, but as I am unemployed currently I have to make it last indefinitely)

3. willing to hang with me on a religious level (I am Christian but progressive and increasingly anti-mainstream)

My experiences so far:

I've done my research mostly through the Psychology Today directory. There are four therapists practicing within walking distance of my home and one free walk-in clinic within a short bus ride. Other practitioners are either too far away or too expensive/do not offer a sliding scale. I thought that at least one of the four would be able to accommodate me and that it wouldn't be an issue. However, of the four, two never responded to my initial email, one sat me down in her office, rejected my attempts to work out a payment plan after I explained my situation, and very much made me feel like she did not want to work with me for financial reasons but for ethical reasons could not say so outright, and another refused to see me and referred me to a therapist in a distant city well outside my transportation range despite my briefly mentioning my issues.

When I entered the walk-in clinic, the therapist on hand quickly determined that the answer to my issues as I described them was "to think happy thoughts" (I confirmed this with her); we then argued at great length over the value and efficacy of that advice until she stated to me that she wouldn't give anything to be me (or a person of my age) in the current economic climate. I said, "It sounds like you're saying it sucks to be me," and she confirmed this. I found the statement shocking for a therapist and offensive. (Aren't therapists supposed to at least be empathetic, or at least not flatly rude like that?) When I told her that I could not believe she had said such a thing, she could not understand my incredulity. I walked out.

These experiences have left me at a loss. I have had a therapist relationship before while underemployed about 5 years ago where I was unable to continue seeing the woman because I had nearly run out of money and she suddenly announced that she was moving her practice much further than I could reasonably travel. I have come to the conclusion that either I have the misfortune of having inflexible therapists in my area or that my requirements are unreasonable, and that I cannot seek therapy until I either acquire a job with health insurance (so far impossible over the past 8 years and even then not a guarantee of anything) or magically acquire a large amount of money.

My question, having said all of this, is what, if anything, should do now? I have tried Mood Gym and personally found it flawed, limited and unhelpful (not that that should stop anyone else). I feel that I have no options unless I acquire money as previously mentioned or find myself in a crisis situation, and having been told first-hand stories about being dropped off by an ambulance in a random neighborhood by HCMC for being a low-income self-committed mental health patient and therefore "not worth it", that doesn't really sound like an option either.

Disposable email address: nozomashikunai@hushmail.com

Matchmaker, matchmaker ...

jessca84 — Tue, 14 Feb 2012 12:24:00 -0800

Do you know a great therapist in Brooklyn or Manhattan who helped you or a friend cope with depression? I'm trying to find a good fit. It's not her, it's me.

I've been meeting with a therapist in Park Slope for about a month now, but I think I'd like to break up with her.

The (abridged!) story: I'm dealing with some pretty serious depression and am on the hunt for a therapist who can help me develop coping skills to combat it rather than just listen to me talk. (My poor friends have proven to be great for that.) So I'm thinking a CBT practitioner would be best, although I'm open to anyone willing to help me challenge my f-ed up thought patterns and hold me accountable for my efforts between sessions.

Thank you SO much.

(Oh! Insurance is United, though I would consider someone out of network if they offer a sliding scale.)

Who can help me with my mental issues?

SNWidget — Tue, 10 Jan 2012 07:07:31 -0800

Looking for someone to help me with practical aspects of my ADHD - life coach, psychiatrist, therapist? What am I looking for? In contrast to previous years, I'm sticking to one new year's resolution, but it's a big one. I'd like to get my time management under control. I'm fighting this on a number of fronts (including medication from my primary care physician), one of which I've decided should be some form of therapy or coaching to help me address ADHD, anxiety, and depression. I think addressing some of the ADHD issues related to time management could lessen the effects of the anxiety and depression, which tend to be at their worst when deadlines are looming or I haven't allotted enough time to give a task my best.

Last summer I consulted a therapist at my university. While it was somewhat helpful, it didn't provide me with practical insights or tools that would help me address ADHD and time management. I'd like to see someone who specializes in ADHD (and secondarily depression and anxiety) that can help me with some of the practical tools.

I'm interested in hearing from those who have gone down this road. From whom should I be seeking help? A clinical psychologist? Other type of therapist? Some sort of life coach? (If a life coach is the way to go - how do I find one? I live in the Dallas area.)

Any other thoughts and tips are welcome and appreciated.

Should I find a new psychotherapist?

chameleon — Mon, 09 Jan 2012 11:38:26 -0800

I think it might be time to start seeing a new therapist. My current therapist disagrees. So now I'm confused. Convince me that I'm right. I’m a 38-year-old man (gay, if that's relevant) and I’ve been seeing my current therapist for just over 11 years, far longer than any previous therapist. I feel like I’ve done therapy "right" -- I’ve talked to death about my issues and my past, I always try to be honest with my therapist about my thoughts and feelings, including my thoughts and feelings about her, and I try to explore topics that make me uncomfortable. I try to put it all out there in therapy. I like her as a person and we have a nice rapport. At this point I feel I have a great deal of insight into why I am the way I am.

The thing is, I still can’t seem to change the way I approach my life or my issues. My issues are basically: chronic dissatisfaction with my life, overthinking, excessive fear about life, some discomfort about sexual issues, occasional thoughts of despair, being too hard on myself, lifelong inability to find a meaningful career, indecision over whether to end my relationship with my partner. (I realize there is a parallel between that last one and this particular AskMe -- whether or not to end a particular relationship -- but I put it last because I think it's a symptom of my issues rather than a core issue itself.) A lot of my problems seem to have to do with the way I was raised, but whenever I ask my therapist, “How do I get over my past?” her response is always, “By continuing to talk about it.” Okay, but I’ve been talking about it for 11 years. Whenever I ask her how much longer this is supposed to take, she never has a solid answer.

She seems pretty traditional in her therapeutic orientation -- she likes to talk about Freud, she's interested in my nighttime dreams, my childhood, etc. But that approach doesn't seem to be working for me as well as it used to.

She says I have unquestionably changed for the better over the years. Fine, but I'm still not where I want to be and I'm doubting whether she can get me there. My goal is to lead a reasonably happy and fulfilling life and I am not there. I don't want to still be feeling this way when I'm 80. I think it's time for a new approach.

I recently got a recommendation for a different therapist and I made an appointment with him. When I told my current therapist about this, she was displeased. She seemed irritated that someone else would "disrupt our 11 years of work." She also analogized it to the desire to have an affair -- i.e. escaping from the hard work of a particular relationship by starting a new one -- which frankly I was insulted by, because I have thought about this on and off for a long time and have brought it up with her several times over the years. It's not like this is a whim.

Over the course of my conversation with her, she became more resigned to the idea that I was going to at least check this other therapist out, but she still didn’t seem happy about it or think it was the right idea.

So far, I’ve met with the new therapist once, and I’m intrigued enough to meet him once or twice more. He seems less "Freudian," not as intently focused on exploring my past and my dreams. He says those are somewhat important, but he is more focused on the here and now. He also seems more interactive; when he asked me a question and I started to ramble, he actually cut me off and tried to direct me back to the question, unlike my current therapist, who I feel indulges my tendency to overthink.

Also, he is a gay man like me, so working with him might give me new perspectives on things that my current therapist, a straight woman, might not be able to provide.

I don't yet know whether he can provide what I'm looking for, but I think I need a new therapist regardless. I just feel like I need a fresh approach, even if I’m not sure what that approach should be.

I am continuing to see my current therapist right now but I want to make a decision pretty quickly because I don’t want to pay two different therapists.

Am I right here?

What are some other things I should think about in trying to decide?

(Or is this whole question a symptom of my tendency to overthink?)

Confused about a confrontation in therapy

Anonymous — Thu, 05 Jan 2012 09:54:32 -0800

In my last session, my therapist kind of forced a confrontation with me and I feel weird about it. How do I handle this? TL;DR: I feel like my therapist misread my body language in a way that made about ten minutes of our session about him and not about me. How should I handle this next week?

Long version: I've been seeing a therapist for about five months now: first for acute depression and panic (which has subsided) and now we're working on ways for me to live in a more self-aware, positive way with my own natural emotional responses to life. It's been generally good, although this is my first time in therapy so my ability to assess it is limited.

Yesterday, we were talking about my tendency to defeat myself by adopting a hopeless posture toward life in general. (e.g., thoughs like "yes, I have a job now, but I owe so much in student loans that I'm going to be paying them for the rest of my life so it doesn't matter"). My therapist is big on this idea that we absorb "energetic patterns of behavior" from those around us, especially as children, and that one of the patterns I've absorbed gets a lot of pleasure in cutting me off at the knees whenever it seems like I'm starting to stand up.

So at some point I said something like, "what I'd like out of this is some kind of method or understanding or process where I can stop defeating myself when I feel that part of me taking hold."

I kind of smiled as I said it, which I intended to mean "I understand that this is kind of a tall and specific order and that therapy doesn't work like a fast food drive-thru."

(Side note: my therapist also seems to believe that inadvertent smiling can come from a place of patronizing and self-victimizing -- he often reads smiles as meaning something like "here, let me help you: you'll never succeed at anything and that's just the way it is. Sorry.")

So: when I said what I'd like, he kind of turned it around onto himself. He said (and I'm paraphrasing here) "then stop defeating yourself. I don't have the answers for you. Do you see how you just put me into a bind? Only you have the power to defeat yourself or stop defeating yourself, so if I give you something to do and it doesn't work (and you're in control of it not working), then your need to defeat yourself extends to me."

He continued, "It's like you came in here tired and defeated, but you had a searchlight out for positive energy and self-confidence. So you latched on to me -- here's a successful therapist: let's see if I can defeat him, too -- and tried to put me into a bind where you can control whether I succeed or fail."

This felt kind of confrontational and uncomfortable but I was trying to process what he was saying. We continued to talk about self-defeat and he pointed out that when I was "trying to defeat him" my physical posture changed and I became more awake and upright and that this is because a part of me enjoys the power of trying to defeat people and that's why I keep undermining myself.

I feel like his hypothesis might be true, but I also feel like this was a kind of weird and possibly shitty was to bring this to my attention. I also feel like he made the confrontation about himself, which seems odd to me. I'm not sold on his theory about smiling and I've found myself thinking "don't smile" when I'm in sessions -- which I worry is me trying to game the
therapist-patient relationship. I also suspect that my posture changed because I was sensing potential danger (in the form of this confrontation) from him, rather than because I wanted to undermine his self-confidence.

Is this sort of thing par for the course in therapy? Should I expect these sorts of confrontations? How do I know whether I'm uncomfortable because I'm being challenged in the right ways, and when I'm uncomfortable because it's not a good fit? Should I bring it up with him next session?