Different types of therapy
August 22, 2008 4:18 PM   Subscribe

Different types of therapy

Can anyone recommend/explain different types of therapy? I have been to some sessions with a shrink, and i kind of found his comments incinderary, like he would make things out worse than they were, and I kind of used those comments to drive myself deeper into a bit of despair. I did one or 2 sessions with a pschycologist, and she was just a sympathizer "That must have been pretty hard." I didn't find this helpful, either. I suppose I am looking for someone to help lead me to better places, and that is not what I experienced with these 2. I think for most people their friends serve this function; I feel like i've been a little depressed for a number of years now, and hence my friends have moved on, and I haven't really made good new ones. So I don't have that to turn to at the moment. I do not have a minister or faith, and anyway I feel like it would have to be someone you knew well and trusted. I met someone I really liked (romantically) a year ago, and it didn't turn out, in part because of my depression or whatever you want to call it, though he didn't verbalize this. Anyway I find myself fantasizing about "what could have been had I been healthier." I know that's not good per se, I am just saying I saw something really good in/with him that I wasn't able to achieve, and know that my current mental state is partly to blame.

So, in short: what kind of therapist is best to help you see reality, i.e. beyond your petty concerns, limits, self-involvement, NOT drive you deeper into them by reciting from some textbook or getting all Freudian. Thanks.
posted by anonymous to Religion & Philosophy (13 answers total) 2 users marked this as a favorite
You can't judge a kind of therapy just from a single experience with a single practitioner.
posted by Class Goat at 4:27 PM on August 22, 2008

While there are some commonalities in approach when it comes to psychologists vs. psychiatrists vs. licensed therapist (LCSW), finding the right person can take some time, and unfortunately is not as clear cut as "a licensed therapist is best for me." For example, I generally dislike interacting with psychiatrists because of the way they seem to relate to the world and thus me, but I have to see one for medication purposes, and I had one psychiatrist who I absolutely adored and was incredibly helpful to me. I've had therapists who I just didn't connect with, but I also have one right now who is amazing and I have been seeing for years. The issues you're describing don't strike me as being endemic to a particular type of mental health professional, but rather are just personality types. You could just as easily come across a sympathizer who was a psychiatrist or an exaggerator who was a psychologist.

Class Goat is right in that it takes quite a few sessions to get to know each other and see if it's actually helping you. Like many thing in life, it also sometimes takes trying with a few different people before you find the right fit. I've had the most success when someone has been able to give me a personal recommendation. I also know people who had success by checking therapists out on yelp.com. If you feel like emailing me, I might be able to give you more focused advice about a good starting point to find a better solution for you. Good luck!
posted by katemcd at 4:43 PM on August 22, 2008

IANAD, but please consider reading "Feeling Good: The New Mood Therapy" or some other cognitive therapy approach. Barring a chemical imbalance or similar, moodiness and depression often stem from faulty reasoning and reactions -- a/k/a "stinkin' thinkin.'" The book suggests (no, concludes) that rehashing the agonies of the past -- a typical approach in psychology -- is not really helpful going forward. It doesn't make you feel better, now or in the future. Recognizing the flaws in our self-talk does. I found myself feeling lighter and happier after reading just the first 50 pages or so. Try it, and see if it helps. I wish you the best.
posted by wordwhiz at 5:25 PM on August 22, 2008

Gestalt therapy is a discipline that helps people stand aside from their usual way of thinking so they can tell the difference between what is actually being perceived and felt in the current situation and what is residue from the past. The goal of Gestalt phenomenological exploration is awareness, or insight. Awareness without systematic exploration is not ordinarily sufficient to develop insight. Therefore, Gestalt therapy uses focused awareness and experimentation to achieve insight. How the therapist and the patient experience their relationship is of special concern for this manner of treatment.
posted by netbros at 5:36 PM on August 22, 2008

So, in short: what kind of therapist is best to help you see reality, i.e. beyond your petty concerns, limits, self-involvement, NOT drive you deeper into them by reciting from some textbook or getting all Freudian.

It depends. Therapy is built upon the relationship between therapist and client. Some therapists will be more compatible with you than others. Some might be excellent shrinks overall but just not equipped to help you, specifically.

Go with your gut feeling. Pick a therapist, tell them what you want from therapy, tell them a little bit about what's disappointed you in the past. Work with them for a few sessions. (Unless they do something horrible or obnoxious, in which case you are well within your rights to fire them.)

Then ask yourself "Is this helping me? Will this person help me get better?"

Listen to the gut-feeling answer that your unconscious gives you. That will tell you what you need to know.
posted by jason's_planet at 6:46 PM on August 22, 2008

What are your conditions? Seek a psychiatrist who can prescribe meds for your condition.

Therapists, psychologists, pastors, friends, whoever, are not the answer. Expanding on your issues makes them bigger than life, makes you think about it more, and can become an obsession

So, if you are seeing a therapist to talk about your obsession, stop. Fire the dude. Its no big deal.

get with a real Doctor who can prescribe meds to get you out of your head.
posted by cvoixjames at 7:18 PM on August 22, 2008

Gotta give a thumbs down to cvoixjames's statement. You won't find many mental health professionals that would support the idea that therapy makes things worse. As for medicine, it works very well for some people, so-so in some people, has no effect in others, and can have really negative effects in still others, hence all the warnings in commercials, in the news, and on pillbottles lately. Talk therapy, at least of the Cognitive variety, has been shown to be as effective as medication, and very often the method is to attack the problem from both ends, using both medicine and therapy simultaneously. Just be sure to have qualified professionals vet anything any of us random internet typers tells you.

If you're not into going deep and the thought of Freud puts you off, you'll probably want to try something other than psychoanalytic therapy. Cognitive and cognitive-behavioral therapy are among the other options. Cognitive sounds like it might be a good starting point for you, as it deals specifically with overcoming negative thought patterns caused by irrational thinking and distorted perspectives. The book mentioned above, Feeling Good, goes into the various forms of irrational thinking and gives you methods for overcoming them. This is the type of thing you might expect in cognitive or cognitive-behavioral therapy.

You might also start more generally with someone like a licensed clinical social worker, clinical nurse specialist, counselor, etc. and tell them what you'd like to get out of therapy. After a bit of background, they should be able to make some recommendations for you or perhaps help you themselves. I agree with the above poster who mentioned the weird vibe with the psychiatrist. I felt like a lab rat with the one I saw. That's essentially what I was. He was strictly into chemistry, not about resolving anything. Maybe there are different kinds, but for me therapists were much more helpful.

One thing to be aware of is that often the need for therapy arises out of the refusal to face something internally. Therapy attempts to steer you to a point where you do face it, confront it, and then have the opportunity to resolve it. So if you feel a strong aversion to going deep, just be aware that it's possible that's part of the problem.

Find a generalist that you like, don't be afraid to tell them what you want, and and be ready to devote a rather long time to it. Consider at least trying medicine if they suggest it.
posted by kookoobirdz at 8:04 PM on August 22, 2008

get with a real Doctor who can prescribe meds to get you out of your head

This is an individual's opinion and doesn't represent the truth of the extensive research on the topic. The efficacy of cognitive therapy in treating depression is proven and in many cases has benefits over drug therapy (no side effects, prolonged effectiveness). This is not to say you might not benefit from drug therapy or to deny that some conditions resist therapy and require drug treatment. But to dismiss therapy particularly for depression would be an ill informed decision.

Here is a short article with many references on the efficacy of therapy and short descriptions of many different styles of psychotherapy. My personal experience was with an individual who did not subscribe absolutely to a particular method, a flexibility I thought was a good initial sign. I really think the individual and the relationship is more important than a particular method. In the end they're all a bunch of talking and trying to change the way you think to a way that works better. I think a significant (at least a full session, perhaps two) initial discussion about what your goals are, and what the therapists approach is, is important. I also agree that you need to give it more time. You should definitely get a good vibe from a therapist and think what they have to say about your goals and their method makes sense. But it sounds like you are talking about significant, long-term depression. You are probably looking at fairly long-term therapy (i.e. years). Change won't happen overnight.
posted by nanojath at 8:28 PM on August 22, 2008

One thing I meant to add is that a therapist does not fill the role of friends or of a minister or vice versa (I don't discount the value of either, my dad is a pastor but he is sure not a substitute for someone who needs a mental health professional and he'd be the first person to tell you that). Finally, if something someone you're working says is bothering you, bring it up, see what they have to say about it.
posted by nanojath at 8:39 PM on August 22, 2008

I have been to some sessions with a shrink, and i kind of found his comments incinderary, like he would make things out worse than they were, and I kind of used those comments to drive myself deeper into a bit of despair.

Was he actually making things out to be worse than they are, or were you just perceiving things that way? I'm not saying he was a good therapist (how could I know?) but therapy often makes you feel worse before you feel better. For me, accepting that things really were/are that bad was a big part of being able to deal with them. They're definitely feelings you need to talk about with your therapist, though.

I went through (in fact am in my final few sessions of) cognitive analytic therapy, which is a UK thing, but is fairly close to cognitive behavioural therapy. It's been very useful for me. CBT is very goal-focused. It's centred around identifying and changing negative patterns in our life, which sounds like something you want to do. There's also a reasonable evidence base for it, unlike many types of therapy.
posted by xchmp at 5:40 AM on August 23, 2008

There is also "RET" rational emotive therapy, where you use logic to trick your brain into realizing that your feelings are controlled by your thoughts, so you work on changing the think patterns of your brain, thus adjusting your emotions.

Example: I feel depressed. Why? (make a list): my girlfriend left me (thought: I am not worthy of affection) Feeling: low self esteem, depression.

OK, now try it this way: I feel content. Thought: my girlfriend left me, but now I am a free man and it was not working anyway, I can now focus on that new project and meet new people. Plus I am going to call my mother and tell her I love her and be thankful for all I have.
I am going to cook a great meal tonight and watch that new movie I have been wanting to see.

Feeling: centered, content, confident

google Abraham Maslow, he is one great source on psychology.
posted by cvoixjames at 6:34 AM on August 23, 2008


link for above post
posted by cvoixjames at 6:44 AM on August 23, 2008

I also have had good experiences with CBT & the Feeling Good book. My CBT therapist was the first (of many over the years) who really got me implementing specific changes in my POV and my life. We figured out that I really needed to be assigned homework, and that I had to write it down before I left her office!

Of course, at the same time I changed my medication, and I know that made a significant difference as well. These things often work in tandem.
posted by epersonae at 10:55 PM on August 23, 2008

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