How to Choose a Technique, "Shop" for a Therapist?
August 8, 2017 5:01 AM   Subscribe

Seeking new therapist after 15 years. Hoping answers to this might be meta-useful: (a) Does a listing exist, understandable to patients, of different therapeutic techniques? (b) How can you intelligently shop for a technique or therapist or life coach? (c) What metrics help you judge if it's working? After the fold, I describe some of my history/issues - (d) recommendations as to specific techniques or Chicago-based therapists would be useful.

Trying hard not to wall-of-text it. Apologies.

History, for specific technique/therapist recommendations:

Got the shit beat out of me repeatedly by peers. They'd shit on my sleeping bag. One got sent to a mental hospital for a few weeks.

Was held to, and held myself to, high performance standards. Considered "gifted".

Family was economically insecure thanks to dad's job career, we eventually went bankrupt and got foreclosed upon. I'd get calls from creditors (before laws restrained them), calm my mother down from crying jags, or watch my sister during my father's cardiac surgeries. I'd try to be a Vulcan as a result, or be a ruthless unfeeling anti-hero. That was how I dealt.

College. Small college campus I couldn't get off of. Constantly politely excluded from everything.

20s/30s. Two best friends -- people close enough to be a big sister or brother -- abruptly betrayed those relationships.

Now. Unguarded me = too weird for most. But I understand the "unwritten social" very well, though, and can fit into the baseline generic pretty okay -- not stand out.

Putting myself in circumstances where I'm called upon to be emotionally vulnerable in a relationship that will continue (as opposed to, say, being candid with an Uber driver or an elevator conversation with a stranger) ... or called upon to trust someone not to hurt me down the road ... causes a strong panic/aversion reaction. So I can't do the repeated exposure necessary to build up a friend base and romantic base.

A few years into 40s. I have only the scantest amount of friends, I avoid socialization, and I'm a morbidly obese virgin. I also only expect the worse of the future: I expect to be unemployable and homeless as a senior, if I don't die of a heart attack before then.

After 15 years with therapist, left her because nothing has changed for years. During our closedown, she said that her plan had been to keep the therapeutic room a safe space, and hopefully, by teaching my brain I was safe there, I could learn to feel safe elsewhere. That didn't seem sensical to me. I can trust family. It's that pre-start situation that's the problem.

Two existing thoughts: (a) am theorizing that by pulling responsibility back on myself from "therapy", I could fix myself. I could work through Learned Optimism, Feeling Good, Daring Greatly, and many books I own about trauma and forgiveness. (b) Medication. Wil Wheaton's story (YT) inspired me on what psychiatric medicine can do.
posted by anonymous to Health & Fitness (5 answers total) 6 users marked this as a favorite
 
I'm not a therapist, I have been in therapy, some of it for a traumatic incident. First off, congratulations in making the progress you've made so far. All strength to you from here, for your continued progress.

What strikes me about your writing here is that you seem to have done a lot of processing of the events of your childhood/young adulthood, and how they have affected and influenced how you feel and behave today. It seems like you have sort of "done the work" in that respect, and might now benefit from moving on to breaking the negative thought patterns and false logic (not your fault) which trap your brain in reactions and behaviours that stop you from living the way you want to.

So, instead of talk therapy, perhaps think about trying CBT? (or DBT, I've never done that but some people swear by it).

CBT, in my experience, is like physiotherapy for your mind/emotions - for when you've done a lot of healing from your wounds or an illness, but need help to get things working smoothly and make life more comfortable.
posted by greenish at 7:15 AM on August 8


Trauma therapist here. A safe space is not enough. It is the start but that alone isn't going to alleviate the symptoms of early childhood trauma. I would suggest finding a trauma therapist. Someone trained in EMDR or IFS or a somatic approach. You can use psychology today website to search in your area. Here is a list of therapy modalities. Good luck!
posted by rglass at 7:31 AM on August 8 [1 favorite]


Yes try body based trauma therapies. Sensorimotor psychotherapy, EMDR, IFS would be good options. Also keep in mind that working alliance with your therapist is often more important than the model. And also, next time you're feeling dissatisfied with the process, speak up as soon as you can manage to do so. Good therapy is the consequence of exactly that sort of dialogue and sometimes breakthroughs even happen during said dialogue. Don't spend another 15 years on a process that isn't getting you the results you want.

Also consider yoga. I'm a therapist and a Yogi and I have had therapy myself and yoga was profoundly helpful on a level that most therapy hasn't been. It moves you into your heart which is exactly what you said you're wanting to do more skillfully. (Disclaimer: YMMV, IANYT, and lots of people would say that this is a reckless statement. I'm just speaking as a person who hit a wall in talk therapy and even with EMDR and was able to break the wall with yoga.)
posted by crunchy potato at 5:33 PM on August 8


I've found that reading up on modalities of therapy (via the public libraries ebooks) has been helpful in figuring out what might be helpful for me. For example, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, has been really eye-opening.
posted by spamandkimchi at 7:36 PM on August 8


Years ago, in response to a similar question, I wrote this answer on how to get the most out of therapy.
posted by OmieWise at 11:06 AM on August 9


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