Ask MetaFilter questions tagged with therapy

What's the deal here?

Anonymous — Mon, 21 Dec 2009 17:02:02 -0800

I'm thinking of dismissing my therapist over some billing issues, but would like some perspective from other people. My therapist is out of network, and agreed at our initial session to permit me to sign checks from my insurance company over to her as they came in.

Stuff started getting weird in August, when a check from a July appointment never showed up. She started getting impatient, and put me on resolving it, which I did. My insurer said they had never received the claim. She said she was sure it had been submitted, and that this was the sort of thing insurance companies did to frustrate out of network therapists.

She wound up convincing me to go to paying up front, which wound up destabilizing my financial situation as the sessions are $185 each, and the checks were coming in erratically. I wound up having to cancel a session, as writing a check would have put me very close to overdrawing my checking account.

I explained this to her, and she agreed to go back onto the original plan, provided that checks come in within a month, to which I agreed.

Recently, a check for a session came in close to a month after the fact. At our last session, I reluctantly wrote her the check, at which point she said the deadline should be two weeks, and suggested that my reluctance was indicative of some sort of underlying issue, and said that she was being generous by offering to allow me any time at all to write the checks.

I responded by saying that the agreement we came up with at the first session was something she had chosen to do to compete with other in-network therapists, and that I was confused about what was happening with the billing and wanted to talk to my insurance company to figure out whether the checks would reliably come within two weeks.

What I found when talking to my insurance company is that the turnaround on their end has been remarkable, rarely going as far even as three days, and that all checks that didn't come within two weeks didn't come within two weeks because my therapist's biller has been taking her time (10-20 days) to submit the claims.

I feel like my therapist has gradually worked me into a billing situation that is very, very dissimilar to the one I envisioned when signing on with her. We didn't hammer out the details, but I expected things to run relatively smoothly, not to hear about a disputed bill until after 30 days, and that this would have a minimal impact on our therapy. This turned out not to be the case, as a lot of session time has been spent on resolving billing issues.

I believe she expected to be paid promptly, but insurance companies have up to 30 days to turn around a claim, and her biller, as I mentioned, takes awhile to submit the claims. I don't think she understood the role the insurance company and the biller played in all of this.

(In no way am I suggesting that she ever personally guaranteed that I would never have to lay money out.)

Basically, this feels like violated boundaries, because the arrangment changed after the fact. It also feels like everything that's happening that would enable us to come to an arrangment agreeable to both of us is occurring on her end. I don't think the way she attributed responsibility to the insurance company for the first disputed bill was a realistic take on the situation.

Part of the reason I'm seeing her is to work on my boundaries and where I should assert myself, and consequently, I'm feeling extremely stressed out about this. I think this situation shows she's not a good person to go to for advice, but I am open to the possibility that there is something I'm not seeing in all of this.

What I'm looking for is a reality check, to test my assumptions here. Is my therapist being unreasonable? Am I? Would this bother you if it happened to you? How much, on a scale of 1-10?

Or is this just the sort of thing where there are two individuals, both of whom are drawing a line in places they're entitled to so, resulting in an absence of middle ground that can only be described as "unfortunate?"

Affordable therapist in Charlotte

Anonymous — Fri, 18 Dec 2009 09:16:25 -0800

Asking for a family member. We're looking for affordable counseling in Charlotte, North Carolina. Sibling needs counseling, parents can't pay. Can you recommend cheap or sliding scale counselors in Charlotte, NC? Ideally experienced with family counseling and adolescents. Email me at affordabletherapyincharlotte@gmail.com.

Non responsive psychiatrist. Am I missing something or should I look elsewhere?

Anonymous — Sat, 12 Dec 2009 14:09:53 -0800

Third week of therapy. My psychiatrist has let me talk for 2 hours so far and not offered anything much in the way of a response to anything I say. I feel like I am spending a lot of effort and money to talk to a blank wall. Is this normal or should I be seeking a different therapist? I have problems with depression, anxiety and alcohol abuse. I am actively seeking treatment with a psychiatrist, and have had 2 sessions so far.

My sessions have involved me sitting in a chair for 3/4 of an hour, talking, with little or no response at all from the psychiatrist to anything I say. While I am not suicidal I have been experiencing suicidal ideation, and I am also dealing with the fallout from a siblings incarceration for a very serious offense. I am unemployed, not sleeping or eating much and finding it very hard to get out of bed in the morning to deal with the bare minimum of what I need to do. All of which I have brought up with the psychiatrist and been met with a blank stare.

The doctor has given me almost no response to anything I have said, with the exception of nodding when I said I felt like I was drifting. Is this a normal part of therapy with a psychiatrist? Am I missing something here?

I have seen a psychologist in the past who was very thoughtful and gave me feedback and insight on my thinking patterns and behaviour. However they are no longer available. I am attending group meetings for the alcohol abuse.

I am not looking for a prescription, just help. I don't know if this therapist is just completely incompatible with what I need, or if I am just not getting it.

What do I do with my therapy issues?

Anonymous — Sat, 12 Dec 2009 13:42:56 -0800

My Therapist Lied To Me. Given My Past, It Was Very Important That She Not Do That. What Next? I am at a cross-roads in my therapy. I am a male, working through issues of betrayal and trust stemming from extreme psychological abuse by my mother, a narcissist or a borderline personality disorder person. In short, she was verbally abusive to me and everyone around her everytime she felt anxiety. She would explode in anger quite often and we would tiptoe around these things. Although she occasionally was physically abusive, the real crowning glory was that when she was feeling depressed I would go up to her room, starting about age 6, to console her, where she would usually threaten to kill herself. This behavior continued for a long time, and would come out whenever or wherever she needed a distraction from difficult emotions. I consevatively estimate that between the ages of 6 and 22, she threatened to kill herself to me directly or over the telephone about 1,200 times. This number is unfortunately not an exaggeration, but does include multiple times in the same conversation. Needless to say, I have abandonment issues.

I have had a very hard time trusting women since then, both because of what happened and because I tended to select women for dating who were not very good to me. I've had two real relationships in 20 years. Both cheated on me, with the second one far worse than the first.

These periods of relationships come between long periods of me dating absolutely no one, because I cannot bring myself to trust females. I have become much better at spotting these situations and have gotten to the point where people like that are far less attractive to me than they once were because I am learning to respect myself. This is because of the good work I have done with this therapist.

I have been to therapy several times over many years. All have been productive. This last time, I have been going to see therapists at a local university because of funds issues. (I own my own business and things are tight now). I went through three male therapists at this university which were not particularly helpful, so I requested a female therapist. I got a female therapist who is a post-doc. This therapist was gold. She helped me work through my issues and I learned to deal with my anxiety and anger, which turned out to be reactions to the real problem, a deep sense of toxic shame which infected every part of my image of myself. I have been working through that sense of shame for a few months now and things were starting to get better. We have been working together for a year and a half now. I have sessions twice a week.

The type of therapy is psychodynamic, so there is a deep emphasis on the client-therapist relationship as a method for working through these issues.

Approximately 6 or 7 weeks ago, concerned about how long this takes, and very happy with my current therapist, I asked her how long she was going to be staying at the university, given that she was a post-doc. She responded that she was going to be there at least through June and was considering staying on another year.

Approximately 3-4 weeks ago, she informed me that she was 4 months pregnant and that therapy was going to be terminated with her by the third week in February and that she would not return. I felt funny about it, said it was fine, but I ignored a feeling that something was terribly wrong. What should have come up in my mind, but for some reason didn't, was the fact that only 2-3 weeks earlier, she had said that she would be here until June when she knew full well that was not the case.

Frankly, I had been suddenly feeling way better for about a month since then. But Monday, we were discussing this and she said that perhaps I was doing well because I had "checked out" of the therapy and was not working as hard because she had said she was leaving. We said we would think about it.

Suddenly, I was not doing well. Tuesday was a bad day for me. That night as I sat in bed I wrote a long E-mail to myself on my Blackberry. I admitted that I was afraid about her leaving and what the effects would be on me. I felt better about it.

Today we had a session. As we discussed the matter, It suddenly came to me. She had lied. Despite knowing that she was not going to be there until June, she flat-out lied. A trivial omission in a situation between friends, but a gigantic dagger pointed right at the heart of a client-therapist relationship where I had learned to be completely honest and open with her and had gained so much and where trust with women was a huge issue. We discussed the matter. She became uncomfortable when I pointed out that she must have known that she was not telling the truth to me when she said those things. She admitted it was true and stated it was a mistake that she kept from me because she didn't want to jinx the baby and wasn't sure of her plans regarding maternity leave or quitting. The issue of having lied to me had apparently come up in discussions with her supervisor. As the session came to an end, I asked her why she didn't tell me right away, correct herself, or at least when she realized that I was "checking out," that maybe I wasn't consciously aware that I had been lied to. Her answers were evasive, as she tried to keep my focus on my rising sense of anger and betrayal as she thought it was important.

She stated it was very important that we talk it out and think through this next time. I did not answer and left the room.

I called my aunt, a professor of psychology at a major midwestern university and we talked about the matter. Other than her telling me I did need to not run away from these feelings of hurt, anger and betrayal, we did not go into a lot of detail.

Right now I feel like I cannot trust her. She didn't have to lie and could have said she didn't know. She had multiple opportunities, including immediately after telling me she was there at least until June, to let me know that she wasn't sure without giving the reason. She could have immediately said she mispoke, or corrected it at any one of a number of points. And most importantly, once she had told me that she was pregnant, she could have said that she wasn't truthful with me before and that she was sorry for not being honest with me, but that she was afraid of jinxing her baby. What also hurts is that earlier in the session, I had been reading aloud from the E-mail I sent myself about regarding my fears of changing therapists and it was chock full of how wonderful a therapist she was and that she had done such a bang up job up to that point. She asked that I send that E-mail message to her and suddenly gave me her E-mail address to me which normally she's not supposed to do.

I feel angry hurt and betrayed. I'm also quite angry that her supervisor did nothing to step in and correct the situation and let it fester. I have tried and tried and tried to learn to trust the female figures in my life and I feel so set back by this, so drained, so hurt.

And I don't know where to go next. I cannot afford "real" therapy right now. There are others at the facility that could work with me, and I was scheduled to go with someone else in March now anyway. Do I drop this therapist right now? I really want to work with a woman on this issue and what if they don't have one? Can I trust that the supervisor will not screw up again? I am angry hurt and betrayed and I'm not sure how to deal with all of this. It felt wonderful to be able to be open with a female therapist and to share with her feelings I had spent a long time hiding from women because of what I thought were irrational fears.

Thank you in advance for your answers.

Lesbian assault help

Anonymous — Thu, 03 Dec 2009 13:00:09 -0800

My first lesbian experience quickly became assault. What do I do to take care of myself now? While I'm a queer female, I've never actually been with a woman before. I was at an event that promoted safe exploration of female sexuality. I'd sussed out the org for a while and did research before going in; they had a long list of rules and procedures and had a history of organising such events so I figured I'd be OK.

I spent most of the night observing what was going on before jumping in. Unfortunately I happened to get the one psycho of the group - a crazy hyperactive (later I found out she was drunk) girl who didn't know what she was going, was rough to the point of pain and bleeding, and was very insistent. Despite me begging her to stop and be gentle (she knew it was my first time), she kept going, or she'd change up and then go back to being rough and painful.

I was in near shock and it didn't hit me that it was assault until I got into the taxi home and started crying. Ever since then I've been having flashes of memories, the smell of people's bodies would set me off, and I just feel so lost.

I've been talking to some friends (esp those active with the queer community here) and they've been fantastic with support and resources. But I'm not sure where I can go for help. Looking up "lesbian assault" on Google gets me porn. A lot of the abuse/assault resources are for women attacked by men; not so much for women attacked by women.

I've emailed the organiser (though I think she knew what happened already, just emphasising the gravity of the situation) and I have a doctor's appointment today to check that there hasn't been terrible damage. I did use to see a psychologist for other things, but I'm not sure if queer sexuality is an area she's experienced in. But where to now? I'm going to a big family event overseas in a couple of weeks and they're really conservative (even my very liberal sister was a little bit judgemental when I told her) and I don't want to start breaking down halfway through the event. My boyfriend has been really supportive of everything, but I don't want to rely on him alone for help.

What can I do to take care of myself? Where can I go? (I live in Brisbane) I seem to go from feeling OK to feeling like crap as a yoyo. I keep feeling like I should apologize to someone but I don't know who. I don't want to press charges - I don't want to go through that whole process and I hardly remember the other girl's name. I just want to be able to heal.

Emails can be sent into agirlinpain@care2.com

Help me make specific suggestions to someone who needs to become more proactive and collaborative, and less reactive and emotional.

Anonymous — Tue, 01 Dec 2009 09:21:50 -0800

Help me make specific suggestions to someone who needs to become more proactive and collaborative, and less reactive and emotional. My girlfriend (who I live with) and I have recently had some major friction around what I perceive to be her less than proactive, largely passive approach to our relationship. She's a very quiet person who lacks confidence in herself (socially and otherwise) despite the fact that she's bright and accomplished (PhD, good publications, etc.). This might sound like an awful thing to say, but in my opinion she hasn't exactly "grown up" and taken on full responsibility for the direction of her life. We've recently had discussions about how she can be more proactive about raising issues in our relationship (versus just getting angry) and suggesting solutions in a collaborative way when issues do arise. We both acknowledge that I'm usually the one to offer solutions.

Yesterday she was informed by her employer that she was not meeting expectations and that she can either accept a demotion or leave the company. Thinking about it objective (as much as I can, of course), I think that it's a strong possibility that some of her behaviors that are negatively affecting our relationship might also have affected her prospects at work. Specifically, she can be quite emotional, non-collaborative, and critical (in a non-constructive way). Her manager confirmed that she wasn't taking enough initiative to drive projects at work.

She is having a very difficult time understanding why her colleagues have perceived her as having shortcomings. I am in the delicate position of trying to be as supportive as possible to her, but also wanting her to recognize this as an opportunity (wake up call?) to work on some serious issues that are impeding her growth in multiple areas of life. We discussed it, and I think that she took it well.

The question that I have is whether anyone has suggestions for dealing with these issues. I've suggested she investigate therapy as a potential avenue, but this sort of problem does not seem very clearly defined (versus, say "depression") and I wonder if therapy can help her with this. On the other hand, I don't want to leave it all up to her, because I think that (like most of us) she clearly doesn't recognize how people see her. The bottom line is that I'd like to make concrete suggestions to her for avenues that she can investigate to address these issues. Her simply saying "I'll be more proactive", without a plan, probably isn't going to inspire confidence at this point.

Whether our relationship works out or not, I still care for her and want her to be successful. I think these issues are really holding her back, and she's young enough (29) to address them before they become a serious impediment to her life.

Thanks very much for any advice.

Waking Up for the First Time

Garden — Fri, 27 Nov 2009 15:49:49 -0800

How do one become less uptight and serious? People say that you just need to find the humor in life and that the rest will take care of itself. The problem is that I don't see the humor in life. I'm constantly worried about one thing or another. I see a therapist and that helps immensely, but it seems that I'm always hypervigilant of danger on the horizon. I think that part of what makes me uptight is the fact that there is so much more to life than I ever contemplated. Being in therapy has made me so much more aware of things that I was oblivious to that I feel like I'm hopping from one foot to another in an attempt to catch up to where everyone else is? I keep discovering new things about myself and the world, that I can't believe I was so oblivious. The conundrum that I find myself is that I basically repressed my entire personality and existence for such a long time that it wasn't until two years ago that I finally started waking up and experiencing the world. I find that I'm discovering so much that it feels enlightening but at the same time it's frightening because I feel as though I am so far behind what everyone else knows at my age. Even my dreams suggest that I am "behind." I frequently have a dream where I am in sixth grade, and all the students from my year are seniors in high school. . I can't stop worrying about everything. I know this sounds like I should be able to just snap myself out of this, but it's not as simple as just thinking differently. As much as I don't want to be oblivious to life, I felt pretty confident about myself when I was so unaware. I'd like to feel confident and comfortable in my own skin again and I'm struggling with how to do this.

Couples / marriage therapy in Round Rock / North Austin, TX?

Alias Unknown — Thu, 26 Nov 2009 19:15:35 -0800

Need to find a therapist for my husband and I in the area. Preferably not affiliated with any religious organization. Need to make the appointment soon. Wanted to go to CAMHC, but they're booked up until January. Recommendations?

Discount therapy?

Anonymous — Wed, 25 Nov 2009 15:05:15 -0800

I need a prescription for meds for depression in central/western Florida. And therapy, if that's possible, but it's mostly for the meds. I'm asking for a friend who has no insurance. Therapy isn't absolutely necessary (but is preferred). Is there some search engine or a way to locate a less expensive therapist who works on a sliding scale?

I understand it's possible to get a prescription from a regular doctor for something like Zoloft, is that avenue worth pursuing?

Throwaway email is hazcheapmeds@yahoo.com. Thanks!

Mom at her wit's end / Therapy in San Diego

Anonymous — Mon, 23 Nov 2009 11:49:55 -0800

My mom has always had high anxiety, been prone to fear and pessimism, and has tended to focus on her fears in a very repetitive, verbal way that is often tiring to those around her. Her situation has worsened recently for several reasons. I want to help her find help. This question is both about therapy in general and for recommendations in San Diego in particular. I've been thinking about writing this question to metafilter for several months. This was pushed over the edge this morning when, upon arriving to visit for thanksgiving, my mom opened the floodgates to me, telling me that she now wants to finally take antidepressants after resisting for many years. I told her that I'd like her to at least consider trying alternatives beforehand, particularly cognitive behavioral therapy and meditation techniques, as I (and in the case of the latter, her former therapist) have been encouraging her to for many years. I think both of these hold a lot of potential, as her current method for coping with stress largely involves focusing an incredible amount of mental activity on the problem, usually spinning it out to catastrophic fantasies, and telling stories about both the facts of the situation and her imagined scenarios repeatedly to family members, friends, etc. She seems open to cognitive behavioral, but is skeptical about meditation, as she thinks it is useless because she can't stop thinking when she tries to meditate. When I tell her that is exactly WHY she should keep trying, she gives me a tired look. Part of the problem here, really intertwined with all of the problems I'm talking about, is that I know my mom is a perfectionist and cannot stand the thought of failing at anything. She'd usually rather not try.

I love my mom deeply and don't want to understate my empathy. In the past, it seemed that she had a tendency towards what some call "destructive emotions," forming perceived rivalries with co-workers, losing friends and allies (professionally and personally) through acts that she (often understandably) perceived as deeds based on good principle, and being constantly hurt and dismayed through these processes. It's one thing to be stubborn, quite another to be stubborn AND insecure about people's perceptions of you at the same time.

Recently events have pushed her stress to a boiling point. Her brother died last year at 61 years old of lymphoma. Even though she was never very emotionally close to him, and in fact considered him worth a large part of the blame for the development of her insecurities (he really wasn't a very nice brother when they were young, in terms of self-esteem - putting her down, excluding her, etc.), she says that she still cannot stop thinking about her grief, primarily because she cannot accept that she will never speak to him again. These events have also combined with the condition of my 91-year-old grandmother, living in a condominium in Florida, who seems to perhaps be finally entering a real cognitive senescence, probably not coincidentally as her friends and other points of social contact progressively die and move away. My mom feels great guilt at leaving grandma out there, does not know if she can afford to take her in, and is disturbed by some dementia-like events, such as grandma becoming convinced that her son's (my mom's brother's) body was misplaced and that he is somewhere other than his grave.

I almost hesitate to even describe the next. About two weeks ago, my mom found my dad nursing a bottle of vodka in the garage. He had apparently been going like that (not every night, but consistently) for 2-3 years. Dad called me and my brother to tell us he had a problem, but has insisted to mom that he resolve this on his own, in private. In general, dad is not very emotive (this is largely due to his having a very abusive father), which does make he and my mom an odd couple in many ways. I do not agree with his method and plan to talk with him about possibilities such as AA, as I take his alcoholism to be related to a self-isolation that he should deal with more head-on (an issue perhaps worth its own mefi question, but not just yet.) In the meantime, mom also tells me that my life choices have been grieving her. In particular, as a PhD student, I have taken up field research on the US-Mexico border. Suffice to say for now that I think I have taken the right precautions, but she thinks the whole endeavor is unnecessary, that I am naive, and that it is appropriate on her part to respond by staying up at night worrying about me. Regardless of the impact of each of these individual factors, she tells me that she can barely get to sleep at night these days, and she shows many signs of fatigue and emotional fraying.

Now that I have aired an incredible amount of dirty laundry: do people think that I am right to suggest that she try other things before antidepressants? My main issue is that I see a coping problem. I think my mom is deeply, problematically "in her own head," and that if she could spend time with someone skilled at disassembling her kneejerk emotional pathways, that maybe she could begin to deal with her problems differently, find more empathy with others, take solace in what she has, and not dedicate so much mental energy to catastrophizing. She has always been an extremely high-stress person; she has also alienated herself from people, for as long as I can remember, due to her way of turning social interactions into a forum for a sort of firehose-let-me-tell-you-about-all-my-problems activity. (Her immediate family members deal with this differently. She considers me the only one who consistently listens and actively talks with her about it. My dad and brother both tell me that they frequently tune out because they feel unable to grapple with all of it.) It seems to me that this is about more than antidepressants, and that if she took more time to step outside her normal pathways of mental storytelling, maybe she could gain perspective and deal with these things differently.

So, depending on your answer to the question about antidepressants, I wonder if anyone has advice on therapists in the San Diego area who might be good for this situation, whether because they specialize in cognitive behavioral therapy, work on mindfulness techniques, or something else. I thank you for even considering the situation and apologize for the lack of succinctness. It's a tough one for me.

Tell me how to choose a child/family therapist.

Anonymous — Tue, 17 Nov 2009 08:05:56 -0800

Should I go for the in-plan, cheap co-pay therapist or pony up more cash for the therapist who seems a better fit for my family? Would it be bad to switch therapists shortly into the process? My family needs some help from a therapist. Specifically, my daughter needs some help. She's young (in elementary school), and she was adopted into our family a few years ago. It was a huge trauma for her, and we're all still dealing with the after effects, including huge and frequent tantrums and bedwetting that would be more typical in a child much younger than she is (among other issues). She's still grieving and she's really suffering.

My understanding is that children who were adopted do best when dealing with therapists who understand adoption and how that can hurt a child years after the actual adoption, and so I would like a therapist who has worked with similar issues and similar kids.

I have a pretty good health plan for mental health issues. However, in my area, there are only one or two therapists who are in network, with a reasonable co-pay (around $15), who work with kids and who seem to have knowledge about adoption. I haven't spoken with any of them yet.

There's another practice in my area which specializes in dealing with adoption and dealing with kids who are in foster care or who were adopted. They work with everyone in the adoption triad (ie adoptive parents, kids, birth/first parents). They are out-of-network. My insurance company would cover some of the fees, but we might be looking at $60+ per session.

My inclination is to go right to the therapists who specialize in adoption. But should we give an in-network therapist a try first? Being able to have a low copay would probably mean we could afford much more therapy for much longer.

Will it mess up my daughter if we start with one therapist and switch?

I'd welcome any advice you have on choosing a therapist, especially one who works with kids. Thanks.

Asking all therapists, counselors, social workers, and psychoanalysts etc.: what books are on your must read list?

space_cookie — Fri, 13 Nov 2009 11:22:24 -0800

Asking all therapists, counselors, social workers, and psychoanalysts etc.: what books are on your must read list? Do you have a core set of books that have shaped both your professional and personal development? What are they? Why did you choose them? Feel free to be as wide ranging in your list as you would like - novels, philosophy, neuroscience, religion, psychology, language/linguistics, history, cultural criticism, popular self-help etc. etc.

Thanks So Much!

Have you tried therapy-by-email? Would you recommend it?

ixohoxi — Mon, 02 Nov 2009 19:31:05 -0800

Have you tried therapy-by-email? Would you recommend it? I'm interested in trying therapy (for depression, social anxiety, and related concerns).

I'm considering therapy-by-email, for a few reasons:

It's generally a bit cheaper than face-to-face therapy (and I'm strapped for cash at the moment, and that's not likely to change unless my mental health improves).
In my limited past experience with therapy, I've been frustrated by the format. An hour a week doesn't feel substantial enough to me. With email, I could take as long as I like to consider the therapist's comments and compose my reply, without needing any more of his (expensive) time. I would be glad to put several hours a week into this.
Similarly, I'm an intensely private person, and it takes me a long, long, long time to feel comfortable enough to open up to anyone, let alone a stranger, about my inner life. However, I seem to have no problem spilling my business semi-anonymously on the Intertubes. I think the detachment of the email format might actually help me develop a more productive relationship with a therapist.
I'm much more comfortable and capable expressing myself in writing anyway.
I live in a rural area, and there aren't many therapists around here. Email would broaden my options significantly.

I realize that everyone's experiences will be different, and that finding the right email therapist may take as much trial-and-error as finding the right face-to-face therapist. I'm just trying to get a sense for whether this is a wholly bad idea (or maybe a super-fantastic idea).

If you can recommend a specific email therapist, well that'd be great. I might ask you a few (not too probing) questions about your experience, in that case.

search engine for techie therapists?

bleary — Mon, 02 Nov 2009 10:22:19 -0800

Is there a search engine for finding techie therapists? A long time ago I had a few therapy sessions, but stopped after a while because I didn't click with the person. Maybe part of it was due to me being a nerd.

Are there resources out there to help people do searches on therapists who have experience with techies? I'd also like tips on questions to ask a therapist on a first visit to see if you both match.

Knee pain above and to the outside of my kneecap

Popcorn — Mon, 02 Nov 2009 05:58:36 -0800

Knee pain concerns: I have a small pain that feels like it is coming from the upper outside of my left knee. I've had this issue on and off for a long time and it doesn't prevent me from doing anything, but it has me worried. I'm in my mid 20's and am a pretty hardcore mogul skiier and I do lots of mountaineering. I'm unable to see a doctor for a few months and I'd like some insight into what this might be.

The pain seems to happen when I am extending my leg under load, for example, when I'm climbing stairs. It also comes up when I'm riding a bike. I've never had any major knee injuries but this feels like it is gradually increasing over time. Sometimes, when I'm running up stairs I get a little twinge and I have to stop running up stairs for a day or two before it goes away. When this happens in the middle of a multi day climbing expedition I can still continue but I have to be a little gentler on the knee. So this is not debilitating pain, I just want to make sure I'm doing everything possible to preserve my knees.

Looking at this picture, It feels like the LCL but I'm not sure. If you are looking at my left knee from the front, the pain is at about 2 o'clock, about 1-2cm (radially) out from the edge of the kneecap.

So I'd like some attempts at diagnosis, is this a tendon problem? Cartilage? Muscle? (I know this is frowned upon here, but I'm not able to get proper medical attention for a few months and I'm going to be climbing a mountain soon) Also, some advice about what I can do to prevent further damage. Would a brace help? If so, what kind? Are there exercises or stretches that would help? Currently I try to stretch the affected area by pulling my heel up to my butt. Seems to help.

Also, for many years I think I was riding my bike with the seat too low and I get a feeling that this is related.

Thanks!

If it's BS, call it BS

teg4rvn — Fri, 30 Oct 2009 09:12:03 -0800

What is the purpose of couples therapy...from a therapists perspective (specifics inside)? I'm trying to take view of couples therapy from 35,000 feet rather than from in the trenches. Before going into therapy, I thought the therapist would get to know us a bit, including inquiring about our past(s), see what the conflicts were and then assist in working through them. In addition, I thought a therapist would "call out" either of our beliefs/hangups/bellyaches as BS and say something to the effect of (and this is totally made up), "Yes, being married and having kids did kinda preclude you from becoming an explorer in Antarctica, but it is not his/her fault." Instead, I feel like our therapist will take anything we say is earth-shattering and just go down the road of, "So how do you feel about what your spouse said?" Frankly, it reminds me of a lot of political discourse you see on TV nowadays (e.g., intelligent design vs. darwinism) where one person has science on their side and the other a belief system, and the media just portrays it as a debate with equal merits.

So, therapists, how do you approach therapy? Do you call people out on their BS? is it counterproductive? is it productive?

And the rest of you (non-therapists), what do you think is valuable to do is couple therapy? Would you expect your therapists to call you out?

Looking for a Therapist for a Friend in Richmond, VA

Anonymous — Mon, 26 Oct 2009 19:32:32 -0800

TherapyFilter: Asking for a friend of a friend—can anyone recommend a competent therapist accessible to someone living in Richmond, Virginia... especially someone especially good at handling issues of anxiety and panic? (Anonymous for the privacy of the individual[s] in question, in case someone could track them through me.)

Specifically, the friend-of-a-friend (a straight, white male in his early 20s, for what it matters) seems to be having issues with anxiety that increasingly have been manifesting in ways that resemble classic panic attacks—I'm thinking specifically the catastrophizing of physiological arousal leading to the positive-feedback cycle of anxiety that potentiates the attack. A doctor prescribed him an anti-anxiety medication of some sort, but he's considering therapy to help as well. However, to my knowledge, this doctor wasn't really able to proffer any suggestions as to who he could or should see to get some therapeutic assistance. As such, we're looking for recommendations for an excellent mental health professional to help him through his problems. I've heard that while many therapies tend to have similar therapeutic effects for many problems, panic disorders do have a history of better treatment through Cognitive-Behavioral Therapy, so maybe keep that in mind? (That being said, if you or someone you know had a positive experience with someone from a different therapeutic modality for similar problems, feel free to recommend them, too!)

(There's also a thread wherein said friend identified said friend-of-a-friend's mannerisms as rather remarkably fitting the diagnostic criteria of Paranoid Personality disorder; however, this is a Wikipedia diagnosis, neither of us are clinical professionals, and the friend-of-the-friend is interested in dealing with his anxiety, so speaking in terms of both pragmatism and respect for his own ability to manage his well-being, anxiety/panic would be the primary specialty he'd be looking for. Nevertheless, it does characterize at least some issues as an individual close to him—and, to an extent, he—perceives them, so could be relevant if you have numerous doctors in mind and someone has a relevant specialty.)

If you don't have any specific recommendations, you can still be helpful! As is evident by my asking the question, neither I nor the friend (nor the friend-of-the-friend, I would imagine) have the faintest idea of how to find a high-quality therapist anywhere, nevermind in the Richmond area. If there are any general sites or resources we can look at—especially that provide something approximating reviews—that'd be excellent as well!

If you don't feel comfortable posting here, toss me a line at mefi.richmond.therapy@gmail.com

Thank you in advance for your help!

Good couples counselor in San Francisco?

roxie110 — Mon, 26 Oct 2009 10:43:00 -0800

Can anyone recommend a good couples counselor in San Francisco? We're a late 30s-early 40s hetero couple who have been together for 6 years. Neither of us particularly wants to delve into childhood issues (I did that for years in my own therapy; my boyfriend "isn't into that kind of thing"); we're mostly trying to figure out if we want to continue to stay together. In terms of working out relationship issues, my guess is that someone oriented toward cognitive/behavioral approaches might be best.

Any information about why you're recommending the therapist would be much appreciated. Many thanks!

Paralysis by Analysis

Garden — Fri, 23 Oct 2009 09:48:32 -0800

Has anyone gone through a period in their life where they've just become too overanalytical and serious? I started therapy a little over a year and a half ago and it has been great. I've gained a lot of additional understanding of myself which has been helpful but at the same time I think it's actually detrimental in other ways. I've discovered a lot of positive aspects of my personality but I tend to focus on the deficiencies. I've been diagnosed as having some Asperger like traits (not the full blown Syndrome), ADHD (inattentive type), and a large amount of social anxiety. I feel stuck right now due to the fact that I don't know how to grow relationships with people that I'd like to have.

Before all the therapy, I would have described myself as an introverted, calm and empathetic individual. I struggled socially, but I always seemed to get by. I've always had a handful of friends to hang out with and that seemed sufficient for me (quality over quantity). The problems with these friendships is that most of my friends are now married and they're on a different course in life right now while I'm single and I need to find friends with similar interests that are single.

The problem with the therapy is that I'm so focused on all of my weak areas. I'd love to become a social butterfly, but I don't think that it's a realistic goal. I've read several books on conversational skills and social anxiety and they are interesting but I have a hard time implementing them into my life. I get into conversations and I am polite, I listen well, I ask people all sorts of questions about themselves, but it lacks the fun factor that I used to have in conversations. I don't know how to explain it, it just seems like I'm following too much of a script and it lacks spontaneity.

Does anyone struggle with this in conversations? I find myself thinking all the time what should I say? Sometimes my mind just goes blank and other times I just beat myself up. The weirdest part is that when I'm with friends or family I'm fine with the conversation. I can talk about anything with them. When it comes to meeting new people or people that I know only a little, I really struggle.

The other aspect of myself which has changed for the worse is that I'm pretty serious all the time and I hardly laugh anymore. I'll laugh if other people are laughing at something but it's not really heartfelt. I've asked my therapist about this and he says that once I relax and start enjoying myself that laughter will return and that I'll be less serious as well. I don't know, I feel stuck right now. I'm doing the things that I need to do, but I'm struggling with them.

I just think too much these days. I sit there and analyze everything and start reading about whatever I'm thinking about. For example I'll start reading about mindblindness as it relates to Aspergers Syndrome or theory of mind. Anything that I think about psychologically, I'm reading it.

I'd love to start some new hobbies, but I'm not even sure what would be a good hobby to start as my only goal in doing a hobby is having a shared interest with other people so as to facilitate better friendships.

If anyone has any advice about these issues or of some other time in their life when they've experienced similar issues, please let me know. It would be reassuring to know that I'm probably just going through a stage.

Online self-managed coginitive-behavioral therapy solution?

Josh Coe — Fri, 23 Oct 2009 05:18:22 -0800

I found an article where researchers experimented with online self-managed coginitive-behavioral therapy (http://www.medscape.com/viewarticle/566048). Does such a system exist online?

I hated my job, but now that I got let go, I feel even worse.

greatalleycat — Thu, 22 Oct 2009 21:42:04 -0800

How to deal with unemployment + feeling like crap? Just got let go last week from crap job I hated, but now feeling more miserable than ever. I am the girl in this question that got a DUI a few weeks back and said my life is over. Due to this and me not being able to give definite answer about getting occupational privileges (in OH, where draconian laws just got worse) I was fired on Friday at 4 after busting my ass all day. They can go to hell, I was still doing my job. They were just looking for people to drop I guess, was convenient excuse for them.
How do people who were abruptly laid off/fired structure their days? I can't spend all day job-searching, how do you fill time?

My firing came after a several-months long bout of depression related to seeing everything fall apart at work. I should have dealt with it earlier, perhaps my life would not suck now.
However, I thought I would be happy to be gone from work, but I feel even worse. Before, I was just angry, now I am just miserable and have problems going to sleep because I am thinking my life is ruined forever and I am a total failure who should be really successful because I came from good family and went to good schools.

I would like to get this addressed medically since I don't know how else to feel better. I used to think job was what made me miserable, but I guess it wasn't all of it because I am just sad now instead of angry constantly like before.
I am delaying help because I don't know how to seek out a therapist (who would be best for me and not really $$) and a doc to give me meds. I'm also waiting to see if I can afford COBRA. I also have to rely on getting rides from family as I probably won't be able to get driving privileges since I don't work. I am in the Cleveland area in a place where I cannot walk or bike to work easily, especially as winter comes on.

I believe I was not let go with "just cause" so I believe I can get unemployment benefits in OH.
I know I sound like a whiny brat, but I would like to feel for one day I haven't completely ruined my life.

Therapy in LA

insectosaurus — Sun, 18 Oct 2009 11:14:21 -0800

Asking on behalf of a friend: She (age 26) is looking for a sliding-scale therapist in LA. She lives in the Culver City area and works downtown. Complication: she works 9-5, and her job is not flexible, so evening or weekend hours are a must. She would prefer someone who specializes in body image (she is an emotional eater and overweight) and/or in working with queer/gay individuals. I think her income is about $40K per year, but she also supports her boyfriend; they have completely merged finances. He is a full time student and works about 16-20 hours a week on top of that for about $10/hour. She is also a part-time student on top of her full time job. She thinks she can afford about $30 an hour.

The emotional eating/ body image is, I think, the most major factor contributing to her depression at the moment. She would like to start seeing a therapist, but can't afford to spend very much right now. She has Kaiser insurance and is looking into that, but she is hesitant to see a Kaiser therapist, because she is worried that they will be clueless on queer issues and the number of sessions will be limited.

How do I sue an abusive step-parent?

Anonymous — Thu, 15 Oct 2009 15:43:51 -0800

How does an adult find a lawyer to sue an abusive step-parent more than a decade after the fact? I want to sue a step-parent for damages. They've ruined my life and made it a living hell of dysfunction.

I suffered over 10 years of extreme physical and emotional abuse as a child and it has wrecked me, my self confidence, my ability to function. We're not talking about a "I never got my pony" scenario. We're talking about severe physical violence from a grown adult to a child along with very severe psychological/emotional abuse.

I'm not at all interested in hearing anything about "letting bygones be bygones", or "forgive and forget". I've tried that. I'm tired of blaming myself for being broken and damaged like it was somehow my fault I had the shit kicked out of me on a daily basis.

The goals of the lawsuit are,

1. I want punitive, monetary damages to pay for therapy and treatment so I can have what's left of my life as functional as I can manage.

2. I want to help set a legal precedent that abuse isn't tolerated and parents are indeed legally and fiscally responsible for the crimes they committed under the umbrella of "parenting".

3. I want this step-parent to realize that what they did was not ok and that after many attempts at communication and reconciliation they've willfully denied their responsibility and haven't even attempted to offer an apology.

How do I find a lawyer? How do I find a pro-bono lawyer that will consider my case?

Psychotherapy? Psicoterapia? Psychothérapie? психотерапия?

Keter — Wed, 14 Oct 2009 12:50:35 -0800

With regards to psychotherapy, a common opinion I've noticed on MetaFilter is that Cognitive-Behavioral Therapy is perceived as being the most efficient way to go, in addition to being one of the very few therapies likely to be reimbursed by health insurance. However, this may be coming from a largely American perspective. As such, I'm curious: What are some major features of psychotherapy in countries other than the United States? What are modes of therapy with which Americans might be familiar that are more popular elsewhere than they are in the US, and why are they more common in other places? Are there any psychotherapeutic traditions I as an American would be unlikely to have heard of or considered? Similarly, are there any therapeutic modalities that are distinctly American (or, in a less absolute sense, are more commonly found in the US or in Anglophone countries)? Within therapeutic modalities that might be familiar to us (CBT, psychodynamic, psychoanalytic), are there any schools or features of those modalities in other countries that may not be common in the United States? (For the last question, I have the general impression that French psychoanalysis is hella Lacanian, but have absolutely nothing of substance to back that up.)

On another train of thought: Who goes to get therapy—and who pays for it when they do? Are there places where psychotherapy is viewed with more or less stigma than it is in the United States?

I realize these are many, many questions, and I certainly don't expect to have all—or even most—of them answered. All-in-all, I'm just interested in learning more about how psychotherapy is perceived, researched, and practiced in places other than my home country... and why these psychotherapeutic landscapes may differ.

(For what it's worth, my own attempts to answer these questions have been rather fruitless, though I haven't the faintest of where to look. Some random searching on MeFi found me an interesting thread suggesting that psychoanalysis is really huge in Argentina. I also seem to recall an assertion I'll paraphrase as something like: "In France, psychoanalysis is therapy.")

(Where) should I go to grad school to be a (psycho)therapist?

tacoma1 — Sun, 11 Oct 2009 18:28:35 -0800

I’m hoping for specific information and opinions about programs and degrees, hopefully from people who are very educated about the world of psychotherapy. I’m thinking of applying to school this year but am unsure about a few things. First of all, I wonder if this is the best time for me to pursue this (I know no one can answer that question for me; I'm just trying to give a fuller picture of my situation.) I already have one master’s degree (MFA in poetry) but feel more naturally drawn towards being a therapist than going into teaching or publishing, which is typically where an MFA leads career-wise.

Secondly, what degree should I get? There’s the MSW, which therapists have told me is the quickest way to get a degree that will get you hired by agencies and allow you to start a private practice. There are masters in psychology programs, and then I guess I’d get licensed as a counselor…? Then there’s the MFT, which, if I understand correctly, is most valuable in California…? Is this true?

In terms of specific programs, I’m interested in Pacifica in Santa Barbara, a primarily Jungian school that focuses on depth psychology and body/mind connection work. It’s fairly alternative and has a great reputation. The students spend lots of time learning by participating in group therapy, feeling out the boundaries between patient, clinician, and student, an approach that appeals to me. Pacifica prepares people to practice psychotherapy, as opposed to cognitive-behavioral, etc. I’m also interested in the MSW programs at Smith and NYU. They’re both clinical programs. I just worry that, while extremely interesting, I might not get some of what I’m looking for (things that Pacifica offers) in an MSW program. I’ve also looked into the various Antioch programs (New Hampshire, L.A.) Any suggestions for other programs?

I love where I live but am also open to moving. The most likely places where I would end up living and practicing are North Carolina or New England or New York. (Also Cali and Oregon, but those are less realistic.)

So, I know this is a mess of information. I’m really asking for advice in relation to all of this: degrees, which degrees work in which states, specific programs, etc. Thank you!