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September 25, 2011 10:06 AM   Subscribe

How can I change myself?

On October 10th, I'll be starting a new job and a new career after having been unemployed for nearly a year, resuming a path I departed nearly 20 years ago. At the time I was studying Psychology and had a desire to become a licensed clinical psychologist. I left that path because I found it extremely difficult to keep my attention focused on what I was supposed to be studying, especially after some upheaval in a romantic relationship I was in.

I've been told I have problems with following through and in a way this is correct. I lose interest quickly in things, although I'm very bright and widely, although not deeply, read. I have trouble keeping to goals that I set, whether educational, health or career, which leads to a very unfulfilled life, not to mention a lot of problems in interpersonal relationships. I've been in therapy in the past and unfortunately have gotten a number of conflicting diagnoses to the point that I've been frustrated by my inability to overcome this problem or even get a consistent diagnosis.

I want to change this behavior. My new career is in the mental health field and my goal remains to get an advanced degree and become a clinical psychologist. But after taking one class last year at a community college, I can tell that my old problem persists. I almost feel immobilized by anxiety by the simplest assignments and I ended up dropping out of the class I was taking, not because the material was difficult, but because it was causing me so much distress. How do I change this? Is it as simple as just applying more self discipline? Or is there a larger problem at hand? If therapy is what's needed, which type would work best to overcome this issue? (I'm a very skeptical person, so any therapeutic method needs to be firmly grounded in science...)
posted by dave78981 to Grab Bag (12 answers total) 15 users marked this as a favorite
I'm confused as to why someone wanting to study clinical psychology would be skeptical about therapy? Because honestly, therapy sounds like a really good first step. Unfortunately, I don't know what the best kind would be.
posted by trogdole at 10:20 AM on September 25, 2011 [3 favorites]

I suspect one can't motivate oneself, it has to be a reaction to something external, and if your parents don't give you it you need some big event later in life. That means go meta and think what you might react to. Dying people are good. For your field, it might be useful to see people labelled 'crazy' being abused. Whatever makes you angry or motivated. A near life experience always helps.
posted by fraac at 10:24 AM on September 25, 2011 [1 favorite]

Have you ever been screened for adult ADD/ADHD? I think lack of follow through is a good warning sign. Are you distressed because you can't concentrate or because you think you "should" be interested but you're really not? I know that ADD is a popular catch-all for various issues, but it might be worth getting checked out.
posted by Ideefixe at 10:30 AM on September 25, 2011

@TROGDOLE I'm skeptical of certain kinds of therapy where results can't be backed up by studies, or where scientific principles from one discipline are bent to shape for another. Thinking specifically of Dr. Daniel Amen, Byron Katie, Jungian, Freudian psychology etc. I'm not looking for a metaphorical framework for my life. I want specific things I can do on a daily basis to alleviate the problem.

@Ideefixe ADD was one of the diagnoses I got when I explored this fifteen years ago. Unfortunately, I can't take stimulants- I'm an ex addict also. I actually found the material quite interesting but I was having anxiety about completing the assignments to the extent that I couldn't complete the assignments. I'm distressed because I seem unable to set goals and follow them through to the end. This affects every aspect of my life and is extremely frustrating. It led me to settle for a string of unfulfilling, dead end jobs in warehouses and retail when I know I'm capable of much more than that.
posted by dave78981 at 10:43 AM on September 25, 2011

Are you a perfectionist who is so afraid of getting one little thing wrong that you self-sabotage by not finishing things or not even starting them? That's my problem and it's led me down a similar path. A weird one-off thing that a therapist told me got me through grad school (the 2nd time). The magic words were: "If something's worth doing, it's worth doing half-assed." A nicer catch phrase is "perfect is the enemy of good." It sounds counter-intuitive in a society where everyone is supposed to be giving 110%, but it loosened me up and gave me the freedom to just do things to the level that they get done. Don't fuss over every word in a paper. I don't know, it worked for me. Doesn't mean I didn't backslide or fall back into old habits once in awhile, but if you can get it into your head that getting it done, rather than getting perfect is the main goal, it might take away some of the anxiety that is getting you stuck.
posted by kaybdc at 10:52 AM on September 25, 2011 [17 favorites]

Masters Degree in Counseling Psychology here.

I suggest that you go read some information about Aaron Beck and cognitive therapy. This is not a diagnosis over the internet, but I'll bet if you do some exploring of your thoughts and self talk you'll find that the anxiety over completing assignments stems from a belief of "it's not good enough". Where the "not good enough" belief came from is something you can explore with a therapist and you won't necessarily find the answer in one session. See also: analysis paralysis. Your mind starts thinking about all of the things that could go right or could go wrong with the project, or you worry about how others will "judge" you based on your project and the anxiety about all of that keeps you stuck instead of moving forward. So if you want to go to a therapist, find one that is good in cognitive therapy.

I also want to challenge you to rethink your skepticism on therapy. If you want to be a psychologist, you MUST be able to put yourself on the "other side of the desk" at some point so that you can understand where your clients are coming from. It doesn't mean you have to have every ailment they have, but you have to understand what it's like being vunerable to a relative stranger, and how freeing that can be to a person. In a good therapeutic relationship, a therapist isn't doing anything to you as much as they are guiding you to find your own solutions. Sure, some approaches are more grounded in researched theories than others but in general if the therapist is a good one they won't harm the client. You'll learn all of the different counseling theories and approaches in your classes, and you'll also get to try a bunch of them out to see which ones you tend to gravitate more towards in your practice.

Insurance companies today require a DSM diagnosis in order to bill, but that doesn't mean it's a label for you to carry around forever. Just because a therapist says you have "Generalized Anxiety Disorder" doesn't mean that it's permanent (some are, some aren't). Most therapists will work on the problems that's causing you the anxiety, not just the "disorder" part of things. Also, therapists and psychologists do NOT prescribe meds...they can suggest them, but only an M.D. psychiatrist prescribes. A psychiatrist will only spend 15 min with you for a med check and will tend to focus on how well it's working and the side effects, not daily problems you need to talk through (that's for the therapist). Also, just because you get a diagnosis doesn't mean you need meds, and it doesn't mean you need meds forever and ever. A lot of people take a short course of medication to clear their thinking enough so that they can cognitively address the issues that lead to the anxiety/depression/etc. Some need meds permanently. It all depends on the person.
posted by MultiFaceted at 10:54 AM on September 25, 2011 [5 favorites]

To back up kanata and multifaceted (not that they need it) but I was doing cognitive therapy when I got the (for me) life-changing advice about just getting stuff done.
posted by kaybdc at 10:57 AM on September 25, 2011 [1 favorite]

After reading your update, I can tell you there are very few people out there who actually practice Jungian or Freudian techniques anymore. You do need to have a grasp of the theories because it's the history of the profession and it is where things evolved from, but a huge majority of therapists today don't actually practice Freudian psychoanalysis. I tend to think Jung has some good stuff about personas and the shadow self, but once again that doesn't really directly translate into practice. I'd say most therapists working with criminals and maybe sociopaths would use Jung more than those working with depression, anxiety, etc. Everyone mentions those two because they are kind of the theories that put therapy on the map (so to speak) and their stories have a dramatic twist (sex with patients! deception! betrayal!) so people remember them. Random people don't walk around talking about Marian Breland Bailey (google her...I was a student of hers back in the day) or Marsha M. Linehan because while they have done great things for the profession, their stories aren't exciting to the mainstream population.

I've seen that Byron Katie has written books, and read the back cover of one but it didn't interest me so I can't speak on her stuff. I know nothing of Dr. Daniel Amen, so can't speak to that either. However, if their theories are sound, they will hold up to research. It could be that they are so new they haven't been fully tested yet. Or they could just be creating to grab the "self help book" market....who knows? Time will tell.
posted by MultiFaceted at 11:04 AM on September 25, 2011

ADHD medication (Adderall) helped me with this, but it sounds like that's out for you. I want to second the perfectionism advice as something that has helped me as well. I recently had my Adderall dose lowered, too, because I found it much easier to focus once I quit thinking about everything I *could* be doing at a given moment instead of what I was doing; being able to value what you're doing with fewer doubts will help somewhat, if you think that might be an issue. When I couldn't do this, it caused me anxiety. It just takes practice catching the impulse to do other things and talking yourself through the reasons to finish your current task, but I also found that being overly strict about this is counterproductive; if I'm doing something for fun and lose interest, I let myself do whatever new stuff interests me without feeling guilty.

And I also practice doing stuff for hours at a time when the impulse is there, without second-guessing myself, because it has helped my long term attention span greatly; that means when I actually feel like marathon game playing or tv series watching, I do it. It used to be that I couldn't even do those things, in large part because of the inability to settle on one activity without letting go of the others, so this was more productive than it sounds. Now that I allow myself long periods of doing dumb shit, it's psychologically much easier to committ to long periods of focusing on more involved things, too. Coming to accept that my focus will naturally wax and wane (just like with non-ADHDers) and recognizing that everyone, including me, tends to have less focus as the day wears on, has helped me to plan to do stuff when I need the focus and save other activities for when I don't.

In short, trying to tell myself to have perfect focus made me in fact unable to quit analyzing how I spend my time and made it worse, but acknowledging the logistics and working around my strong and weak focus times helps immensely. So be careful about how you think of self-discipline, because a lot of us who lack it tend to dig ourselves into holes trying to be perfect and burning out, which just creates more discouraging problems. It takes years of practice to notice big progress, so don't be hard on yourself!

Past that, when you feel anxious try to stop and analyze why. For example, do you feel like you're not going to have time to do an assignment? Do you feel you don't know where to begin? Do you feel you will do it poorly because you don't understand it? Because you have low self-esteem despite managing to always get good grades? Because you've always gotten bad grades? All these things have different solutions (and maybe there are multiple problems -- there usually are!) you just have to unpack them. You don't need therapy to do it, but it can help. Anxiety can be overwhelming because it can just be a big wall of suck, and you can get so distressed in the face of it you short-circuit and don't face down the source. Again, it just takes practice catching the thoughts.

Good luck! You can do it!
posted by Nattie at 12:14 PM on September 25, 2011 [7 favorites]

For the specific part of your question about being 'immobilized by anxiety' when doing assignments, the ideas in the following piece of writing got me through a PhD that I hated and a challenging clinical qualification:

I also sometimes wait out my anxiety. I pick a whole day where I am going to do nothing except sit in front of my computer. The only rule is that by the end of the day I have to have a complete first draft/be under the word count/have written a chapter (the goal should take you under half the time you have allocated if you did it efficiently). Then I sit there with my computer, usually with the internet turned off, and I wait. Usually boredom overcomes anxiety eventually.

Actually, who am I kidding? I did that with every single piece of work I had to complete and continue to do it with any written work I have to do outside my paid job.
posted by kadia_a at 12:31 PM on September 25, 2011 [3 favorites]

You describe yourself very much like I would have described myself. 12-step work on codependency is very very powerfukl. Codependency in my opinion being subtle but pervasive locus of control issues, intertwined with family patterns of dysfunction.
posted by krilli at 1:03 PM on September 25, 2011

Well thanks everyone for offering some advice. I want to clarify that I'm not skeptical of therapy in general, but specifically some approaches that haven't worked for me. For example, I once saw a MFT for some drug and family related issues and a lot of what she talked about and had me do was way too hokey for me. I quit going to her but I readily recommended her to a friend who believed in that new agey stuff. Also, maybe I wasn't as clear as I could've been that I've actually tried a fair number of therapies over the years in trying to overcome this and other problems so I'm familiar with the different roles psychologists, counselors, therapists and psychiatrists play and what their functions are.

For the people who suggested this is a type of perfectionism, I think you're all closest to the truth. I often have grand ideas that I discard because I think I'll never be able to do them well enough for my standards: writing, exercise routines, household projects, etc etc etc. What I really feel is frustrated that I have all this potential that seems locked up and wasted because I can't seem to focus it.

Again, thank you all. I will move past this...
posted by dave78981 at 4:56 PM on September 25, 2011 [1 favorite]

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