What kind of therapy do I want?

October 16, 2020 9:13 AM

I'm a man in his 50's who has trouble perceiving his own emotional state. I should talk to someone about it. What sort of therapist should I be looking for?

For example, every time I've gotten really visibly angry, it's come up on me without any warning - like, I'm listening to myself going off on somebody and my face is hot and it's just now occurring to me that maybe I have strong feelings on this topic. This has happened a relative handful of times, never for longer than a few seconds, and so I have not considered it a problem to spend a lot of time on. It's also not just anger - I couldn't tell you how I'm feeling most of the time, I just feel "normal".

Most recently I've been getting snippy with my wife over trivial stuff. I think she senses a deeper well of anger there although I wouldn't know. Perhaps it would be more accurate to say I don't know where it's coming from. I need to get a handle on this, and am looking to set up appointments with a couple of therapists to see if that's a helpful approach. I'm wondering if I should start with a certain kind of practitioner to focus specifically on this issue.

If you are someone who has dealt with this, what helped? Is there a therapeutic modality that I should investigate? The only one I'm familiar with is CBT and that doesn't seem appropriate since the emotion is coming with no specific thoughts attached to it.

posted by five toed sloth to Human Relations (8 answers total)

This experience is called male normative alexithymia, and there's a treatment for it called alexithymia reduction treatment. Finding a therapist familiar with it may be a challenge, but it is a thing.
posted by shadygrove at 9:20 AM on October 16, 2020 [4 favorites]

Best answer: I don't think you need to start with high specialization here, you can start Managing Emotions 101 with any therapist you feel rapport with.

Anybody can assess you for depression (a common cause of short temper, and also basically everyone has it now so learning management skills there aren't going to go to waste), trauma (a common cause of emotional distance from oneself), anxiety (I mean look around) and start coaching you in emotional intelligence.

I think most therapists are not doggedly single-methodology, they will have toolboxes full of tools they can use which include CBT but also other things. People tend to get anxious about that part, mostly because it feels like control, but as long as you see someone degreed and credentialed and they don't set off your creep/scam detector it is probably okay to let them, the expert, recommend a course of treatment. If you don't like it or don't like them, you can try someone else. It's really hard to get in the door of any therapist anymore, even if you're paying out of pocket they're just all very busy and it's hard to find someone taking new patients, so don't specialize yourself out of any treatment at all.

In the meantime, though: go get a physical, with bloodwork, and talk to your GP about this too. All the therapy in the world won't help a huge amount if you're having thyroid or vitamin issues.
posted by Lyn Never at 9:59 AM on October 16, 2020 [11 favorites]

Best answer: I am a similar age to you and have had similar problems recognising and understanding emotions. I've seen a couple of different therapists at different times and I would pretty much second Lyn Never's advice - the specific mode of therapy has not really been a big factor - what made the difference was that I felt comfortable talking to the therapist and within that range, just having that space to talk was incredibly useful in finding my own way into understanding my feelings. Feel free to memail if you want to talk more.
posted by crocomancer at 10:43 AM on October 16, 2020 [2 favorites]

I think you're correct that approaches like CBT or DBT will probably not be helpful. You want someone who is going to help you work on getting more connected to your emotions, which might take a while. While CBT is often more short term and more about changing self-defeating thoughts ("I'm a failure at everything." "Everyone hates me.").

If you search for someone through Psychology Today listings, try searching for specialities like Alderian, Psychodynamic, Emotionally Focused, Person-Centered, or Humanistic.

Good luck!
posted by EllaEm at 10:49 AM on October 16, 2020 [2 favorites]

I've become much better at tracking and understanding my emotions since I started meditation. It might be worth a try. I use the book The Mind Illuminated; some other suggestions are in this recent thread.
posted by HoraceH at 2:29 PM on October 16, 2020

+1 I had/have trouble identifying my emotions and I don’t think you need a specific modality here. My CBT therapist was helpful, and this was something my ACT therapist was also helpful with, although overall we weren’t a great fit. Therapy is pretty much having a conversation about your emotions for an hour, alexithymia isn’t an uncommon problem, the best therapist is one you can see soon and feel at least a bit comfortable with.

Meditation can help, but I do think it would be useful to you to talk to someone openly about this, ideally someone you feel is safe and unbiased = usually means a therapist
posted by momus_window at 4:40 PM on October 16, 2020

"Emotional regulation" is a term you can use: Google it, tell your therapist it's something you want to work on.
posted by Miko at 8:10 PM on October 16, 2020

I want to back up what Lyn Never says - if you're not after something super specialised, I would look for the right person rather than an exact set of skills.

I've seen five therapists over my adult life, and two of them were helpful to me. With those two, I felt an immediate connection - walked out of my first session feeling tangibly optimistic and looking forward to getting started with them.

With the other three, I wish I'd trusted my gut and not spent time (and money!) going back to them to try and make it happen.

This is not to say that it will always be fun and exciting. In my last set of sessions, recovering from PND, it felt like gruelling work at times and I looked forward to sessions in the same way as the dentist - I knew they'd be painful but it needed doing.

But the connection with the therapist has always been the best signpost, for me, of how successful the therapy would be.
posted by greenish at 5:12 AM on October 21, 2020