64 Comments
- luciferin, on 06/19/2008, -3/+21I've always felt that a therapist fills the role that a good close friend should fill for us. There have been articles lately about how the number of friends people can count to themselves has been in sharp decline. It's likely easier for us to pay to have someone 'care' about us then go actually go through the trouble of depending on another human being. In 99% of the cases this will likely be more be enough.
- cerejota, on 06/19/2008, -5/+21Never.
- Lord Xenu - emmeron, on 06/19/2008, -3/+13Improvement from depression should be expected in 6 weeks? There is some truth to that -- if it is severe enough you should likely be on some medicine short term while getting into the cause of it. The main problem psychologists are seeing with this push towards faster "cure or get out" trends is that it's being sponsored by the insurance agencies. The humanistic approach can take time, as can a cognitive behavioral approach. There should be no firm time frame; they are effective in their own time when used appropriately.
Now, there are a few real issues. More often than not, insurance companies are pushing for either drug therapy or for people to see counselors (Masters of Family Counseling/MSWs/etc) who are simply not trained enough to know if an approach is working. In fact, they are generally taught one or two approaches and believe they are the only solutions (not to insult their work, much of it is very needed -- but they should remember they are not Psychologists).
On the flip side... seriously, therapy for life? less than half a percent of adults in the US have issues that warrant even thinking about that. - mhummel, on 06/19/2008, -4/+13When you can't stand to hear the 9th Symphony playing without killing yourself, you're done.
- insanebrain, on 06/19/2008, -11/+19When should you START going to therapy ? Half of America thinks it needs therapy, but what they really need is more common sense and less *****.
- ricksite, on 06/19/2008, -2/+8Yeah and overweight people shouldn't exercise, they should just loose the weight. Come on, just because you can't see physical evidence of the problem doesn't mean it doesn't exist. The brain is the most complex organ in the human body. Do you really think it is immune to problems when other organs have problems all the time?
- inactive, on 06/19/2008, -0/+5Very smart. That's exactly the role a therapist plays -- and I have a close friend who is one.
- emmeron, on 06/19/2008, -0/+5I dugg you generally agreeing with you, but sadly the statistics are not in favor of what you said: over one third of Americans (as per a now 10 year old text book) claim to have severe issues forming a bond with someone. And those are the ones who can be honest about it! Bonding and/or terror (of abandonment, of being wrong, of insufficiency) are issues that effect many people in big ways. What we often need is to learn to internalize mothering and fathering for ourselves in order that we can live as happy adults rather than constantly reverting to infantile reactions over a number of issues. In many cases it is a social behavioral correction layered on top of another (as we get from friends through approval or disapproval) that eventually cave in, leaving a deep depression evident. This is not a place a friend can always help -- indeed, it is inappropriate to depend on a friend long term in this way (as someone in this place has next to nothing to offer a friendship, also it should be said that unless they can remain constantly supportive and compassionate -- putting their needs aside for an extended time -- they may send mixed messages).
A therapeutic relationship should be clear: payment is made to fulfill one side of the relationship. In return, the therapist should provide the very best and most connected human interaction (with a whole lot of knowledge). - leontes, on 06/19/2008, -0/+5It's different then being able to connect as a friend however. There is a reason that we therapists cannot provide good therapy to loved ones or friends. A good therapist connects with you with you and helps you become the best you that you can be. A friend connects with you to fulfill their own needs and connections, which can muddy the waters, so to speak.
Also therapists allow you a safe environment to explore your past or go deeper into your emotional reality, exploring cognitive distortions, potentially traumatic experiences, or your over sensitivity to real actions. With a friend, you are pretty much mired in those things already, as they probably play out within the dynamic of the friendship. With a therapist, they also play out, but a good therapist will know how to explore those issues safely.
Additionally, techniques that a friend doesn't have, like CBT, DBT or approaches like expressive therapy give therapy far more potential for healing than a friendhsip. - Gangio, on 06/19/2008, -5/+10Never stop, selfanalisys forever.
- arkboysooner, on 06/19/2008, -1/+6Therapy isn't going to fix you. That needs to be understood first. Therapists are there to help guide you and teach you to help yourself. In the end I think it is ultimately up to the individual as to when he or she should stop going to therapy.
- triont, on 06/19/2008, -0/+5Scientologists hate Xenu.
- leontes, on 06/19/2008, -0/+4I'm a counselor and counselors do get a lot of clinical training these days including 2 years of internships and at least 2 years of post masters clinical work. Psychologists are also responsible for learning statistics and testing, which can distract from the clinical side. Psychaitrists spend so much time in psychopharmacological training (drugs). If you are looking for a psychotherapist in some ways you are best off with a counselor if you are looking for someone who has had the most clinical training. The distinction between clinical psychology and counseling continues to fade, and the mantle of best therapist, in many ways, is being picked up by the counselors.
- hapax, on 06/19/2008, -3/+7Not really on topic -- I got reminded of this game where you get to play as a therapist to stuffed animals:
http://www.parapluesch.de/whiskystore/test.htm - sodade, on 06/19/2008, -0/+4Who could digg this down? "The unexamined life is not worth living."
- MaryCait, on 06/19/2008, -1/+4I thought too many people were going on medications without seeing a therapist at the same time?
- inactive, on 06/19/2008, -0/+3Yeah of course they need therapy now. Both are wrecks. But is just feels like therapy was what put them here in the first place. It's like going in for a mild case of depression, and leaving with rapid changing bipolar disorder and needing 5 different drugs a day to cope. The therapy obviously didn't improve anything. They both went in for fairly mild reasons and left with their lives ruined.
- leontes, on 06/19/2008, -0/+3I believe being a good therapist is more artistry than it is theory, although your point is also well taken. I think that the field does need to do more policing, but I know a lot of social workers and counselors who make excellent therapists; more than those who really shouldn't be in the field. I think we need to educate consumers on how to choose a good therapist as well as try to provide ongoing education and training for those that aren't as of yet doing great work.
The need for good therapists is so great, I am glad that a Doctorate is not required to practice and am glad that with a Masters I can work now: but, as well as society economic realities there are also personal economic realities: we therapists don't get paid nearly enough for all of us to get our doctorate. I think the answer is greater self-policing and encouragement of clients to be more self-selecting on their type of therapist. - ricksite, on 06/19/2008, -0/+3Not going to therapy seems to have worked for you!
- emmeron, on 06/19/2008, -0/+2While I agree, and I mean no offense to you when I say this: this is a trend based on the economics of health care. It is also true that Psychologists need to do a great deal of research based work. The PsyD programs are an alternative that provide much more training focused in the clinical direction.
My main issue with the trend towards counselors -- this does not apply to you, you clearly do have an educated background -- is the lack of training I have encountered. For example: I have a relative who has worked as a professional artist (and earned her BA in fine arts) and is now about to graduate as an MFC. She has, a maximum of nine undergraduate credits in Psychology. This would Never happen in a PsyD or PhD program, but it seems there are plenty of MA programs that will take those who will pay. My wife is working for a PsyD and I am now gearing up for related studies -- frankly, I am a better diagnostician than the soon-to-be MFC.
This alarms me greatly. There are enough good ones, I know this to be true. The field does not police its self well enough though, and where at one time five to ten PhDs might graduate per school, we're now seeing dozens more go through quicker programs. It really isn't an attack on the field, but it is a concern of mine that it will both cheapen the field and bring standards down.
As for the issue of Psychiatry, I agree completely. They are overused drastically and have little to no training in counseling. I am currently studying for my MCATs to pursue either Psychiatry or Neurology, and I admit the issue freely (and side on Neurology as a first choice, but frankly that is much harder to get into and I am an "adult" student).
In any case, your point is well taken, but I wish someone of your mind would go on to the PsyD direction... and I wish that the field, as it were, would be more supportive of those who further their educations in that way. Either way, glad you are there -- could use a few more like to to lessen the impact of the many ill-trained I've met (I make assumptions based on your obvious education, lets pretend I can trust this? hah!) - BrendanSheehan, on 06/19/2008, -1/+3You got one of the good ones.
- shadowman99, on 06/19/2008, -0/+2I sense a great deal of frustration in your comment. Let's explore that further. Do you experience similar feelings in your other relationships?
- Kzoo, on 06/19/2008, -0/+2Yeah, sounds like they didn't really need all that, but their parents were too uncritical.
I was 11 when I was first put in therapy, I didn't know why I was there or what they wanted from me. Fortunately my parents didn't make me keep going or keep taking the pills that weren't doing a thing. Realize now why I was there, but I wasn't going to benefit then. I wouldn't be surprised if their schools asked for it. My school told my mom I was suicidal (which I wasn't; I remember a lot from that age, and I would've remembered something like that). - brundlefly76, on 06/19/2008, -1/+3Schaedenfraude: congratulatory self-affirmation by criticizing the unfortunate plight of others.
- Kzoo, on 06/19/2008, -0/+2"as someone in this place has next to nothing to offer a friendship"
Having been on both sides, this is probably one of the most true things someone could've said about this particular point. When what makes you 'you' is constantly overshadowed by insanely deep depression, hopelessness, and whatever other particulars you get to go along with it, you don't make very good company. And it's too much for a friend to take, because they can't do anything, they know it, and they feel guilty for something that's not their fault. - emmeron, on 06/19/2008, -0/+2There are appropriate times for a therapist to be upset with a missed appointment. Any time it happens without a really good reason, for example. It is a sign of childlike egocentric behavior to do so and not notify, a scolding is absolutely appropriate in most of these situations.
I cannot comment on group therapy, I have little information or experience with it. - Kajon, on 06/23/2008, -0/+1I have no idea how it should be to have someone like that...
A person you can talk to about all the crazy ***** going trough your head... and have awesome sex with!
My life would be quite different if that person existed... and the crazy deppressing thoughts and insecurity would proably be gone.
It's not possible to meet that person now because of all the ***** in my head.
Catch 22.
Oh.. i'm rambling. But this is one way of therapy I enjoy. Doesn't really care if anyone reads it. It's enough just to put my thoughs out to the public. - johnhummel, on 06/19/2008, -2/+3I guess it depends on what you mean by "cured." I think one thing that everyone needs in their life is someone who listens to them, gives advice or a sounding board. For some, this role was the priest - you could confess your "sins", have someone that (in a good situation) would still care about you unconditionally.
Perhaps its a spouse or certain family member. Maybe paying someone $100 a week just so you can vent, if that's what it takes. Or an Internet friend. Either way, I think that *everyone* needs someone in their life that they can share things with, their darkest secrets to, and know that no matter what, that person will just listen. Perhaps not always agree or understand.
So if you're going to therapy because you want to stop smoking or because every time you try to have sex you freak out, or you can't seem to focus because your mind keeps returning to something bad, then "cured" is simply "When I can function the way I want to." If you're going to therapy just to have someone to listen to, that might not be a bad thing (as long as it doesn't replace some other addiction).
For me, luckily, that person is my wife - someone that I've learned over 14 years of marriage, that no matter how much I think I've ***** something up, I know she'll still love me. Then again, I try not to screw that often, so it balances out ;). - BrendanSheehan, on 06/19/2008, -2/+3I though Xenu hates psychiatrists? After all it's the only way a sane person could possibly escape their claws.
- inactive, on 06/20/2008, -0/+1Scientology is worse. Labeling everyone who puts down Psychiatry as a Scientologist sure sucks for the people who are actually listing the faults in a faulty system without trying to push you on an even more faulty system. I think doctors, therapists, heck, parents in general should pay more attention to cases like I listed, and try and prevent them from happening again.
- Kzoo, on 06/19/2008, -0/+1I'm sorry you had a bad experience. Unfortunately it sounds like you had the same problem I did with my first place. They weren't consistent (I don't like being asked to do something and then it's completely forgotten the next time I come in), and they gave up too quickly. Thing to do isn't not go, it's go different places until you find the right one (which, yes, is hard).
Some people can't be helped by simple hope. When you're not even sure such a thing exists anymore, and you don't have the first clue how to help yourself, it's just not there.
Side point, you do realize your other medical doctors don't need a doctorate either, right? http://en.wikipedia.org/wiki/Doctor_of_Medicine , yes, the first sentence says it's a doctoral degree, but as in the second sentence, in the US it's not really equivalent. Just because it's not technically equivalent to a doctorate doesn't mean it's not a good degree, and all medical professionals have to pass supervised practical training besides their coursework. - Wackoman, on 06/19/2008, -1/+2SERENITY NOW! SERENITYNOOOW!!!
- insanebrain, on 06/19/2008, -0/+1no
- leontes, on 06/19/2008, -0/+1And a good therapist will also have a supervisor to turn to when things get dicey or unmanageable. A friend will sometimes become scarce.
- BabyWookie, on 06/19/2008, -1/+1Psychopherapy is the definition of pseudo-science and is a big rip-off. If you're a smart guy (or a girl) and can't figure how to straighten your ***** out on your own, what makes you think that some douchebag, who barely even knows you, can do it for you? All those guys can do is listen to your bitching and whining and then offer some "No *****, Sherlock!" type of advice. You' are better off with some pills and a good friend to share your ***** with.
- BabyWookie, on 06/19/2008, -1/+1Yes, we get. Psychiatry is evil. Thanks, Tom Cruise.
- kurtsmom1, on 06/19/2008, -0/+0Actually psychologist is a very stringent term held only to individuals with a doctorate. Anyone who practices without a doctorate is considered some type of counselor.
- mnky9800n, on 06/19/2008, -0/+0Care to share your information source? I would love to know how someone figured out that only half a percent of US adults need therapy.
- theherbalguy, on 06/21/2008, -0/+0There are claims that behavioral therapy worked to cure depression symptoms. I guess that therapy sessions might have stimulated a positive response to reinforce a depression sufferer's disposition but know that there is a physiological explanation to neurological disorders. Now that would require the treatment of underlying systemic or organic defects that is trigerring depression or anxiety attacks.
- jamesdew, on 06/19/2008, -2/+2see these are the kind of people who I think DO need therapy. Maybe they just needed better therapy? Also I don't think therapy can help you unless you actually want it to.
- norbiu, on 06/19/2008, -1/+1God forbid we go off topic on Digg, the universe would implode!
- mnky9800n, on 06/19/2008, -0/+0You do have the ability to see a psychologist that does have a PhD or a psychiatrist that has an MD. Just because you chose to go to someone who has less training really only means that you made a bad decision.
- emmeron, on 06/19/2008, -3/+2Usually xkcd is at least mostly accurate. This one just sucks on that scale. The first four statements are about 1/2 true. Besides, ever see a chemist and a physicist debate the structure of an atom? Yeahhh...
- enolaguy, on 06/19/2008, -2/+1When you realize you have become the therapist, when your therapist is upset with you for missing a session, and when the group looks forward to what you have to say. That is when one ought to find a New Song. e
- tripm, on 06/19/2008, -2/+1When you feel good. PRETTY PRETTY PRETTY GOOD.
- lamtower, on 06/20/2008, -1/+0Therapists are people who profit off the misery of others. Quit as soon as you can.
- inactive, on 06/19/2008, -4/+2I know two people who I swear therapy has barely helped. One started therapy when he was 9, another when she was 11. Both are 23 right now, still living with their parents, still taking incredible amounts of prescription drugs to stay afloat, and can't hold even a part time job or a semester of school, let alone keep a friend for more than a year. Both have liver and kidney damage from all of the crap they're taking, and are so dependent on prescription drugs, all given by their doctors, that if they miss even a day's worth of pills, they go insane. The only thing therapy has done to them is rationalize all the drugs they're taking, and give them false hopes.
These two have inspired me to stay away from therapy altogether. I'll deal with my problems on my own thank you.
The strange thing is that one originally went in for ADHD, and another because he was having trouble interacting with other students. Such simple problems, and now their lives are totally ruined. - inactive, on 06/19/2008, -2/+0obviously i have? how else would i know what its all about smartass. all it did was make my life worst, fat and homicidal, however. it was me moving away that finally cured me and gave me hope for the future. and that is truly the only cure for depression. no amount of medication and talking to someone who doesn't give a ***** about you will help. and just because im swearing doesn't mean im angry. it is a way to emphasize.
- cdigioia, on 06/19/2008, -4/+2You should stop when your therapist tells you you're ready. Your therapist who gets $100/hour every time you come in.
Or whatever they make...cuz I wouldn't know...cuz I'm not crazy...you're the one that's crazy! AhhhH!!!!! -
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