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Old Nov 10, 2009, 04:30 PM
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sunrise sunrise is offline
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Member Since: Jan 2007
Location: U.S.
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Medicated, that sounds so difficult to be bounced around like that. I can understand why you would be tired of trying to make it work, and having to keep starting over again with new practitioners. That would be hardest under the best of circumstances, but when you are fighting depression, it could easily be just too much.

I think once you find a decent pdoc, you should just be able to keep him/her. Do you know why you are being bounced from pdoc to pdoc? Is it to do with your ability to pay or insurance?

As for therapists, the way you write about being "bounced around", it sounds like it has been out of your control who you go to see. What control do you have? Are you restricted by insurance? Must use a community health center? Must do a particular type of therapy? Are you getting bounced because you are diagnosed with one thing, so you see a T who specializes in that, then the diagnosis changes, and you are passed to another T who specializes in that, etc.? If so, I wonder if a good all-around therapist with a broad scope of practice would be a solution? Then if a diagnosis changes, they can handle it without having to refer you to someone new.

Are you having any say in what type of therapy you enroll in? If a main issue is depression and what you most want to work on, there are a number of different therapeutic approaches that can help depression. Maybe ones you have tried are not the right approach for you, they don't "click" with you, or fit your personality or natural way of interacting well. Could that be? You mentioned DBT. That is a variety of CBT, right? So if you didn't like DBT and quit it, maybe now doing CBT would be too similar an approach and you wouldn't find it helpful either. Maybe you can talk with the counselor about treatment options for depression and ask her to describe different therapy approaches. Perhaps one will really stand out to you and you will feel that yes, that could be helpful! And then you could get a referral to someone who practices that kind of therapy. I know that sounds like yet another person, but it stood out to me that you were quitting DBT and now starting over with CBT, which is kind of similar. But it did sound like perhaps the main problem was the DBT counselor's lack of listening to you, so maybe if the CBT counselor is personally a good fit for you, it wouldn't matter what approach.

My T is really focused on health rather than pathology and doesn't go in big for diagnoses. Since you don't think the BPD diagnosis fits, and the therapist did, I can see this would be a big conflict. Maybe being with a T who doesn't focus on diagnoses would be helpful. You could focus on solving specific problems in therapy (you are depressed, your relationships are unsatisfactory, you are stressed out, etc.--whatever the case may be), instead of focusing on what is "wrong" with you, which to me is what a diagnosis-centric approach does. Maybe to start, it would be helpful to have a T who can provide some good old fashioned unconditional positive regard and hope for the future.

If you are emotionally exhausted, maybe you shouldn't tell too much too soon in therapy. You can explain that to the T, and spend a few sessions getting to know each other, talking about lighter topics, not going deep and dark too fast. It is hard to do intense therapy if you are exhausted.

Another option is to take a break from therapy now and emotionally "rest". Sometimes we need some time to not work on our problems and can then return to therapy in a few months, when we are rested and ready.
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"Therapists are experts at developing therapeutic relationships."
Thanks for this!
Medicated