I have been seeing the same t for five years. I read about all your t's here and a bit about what they do. My t basically just asks me how things are going. We talk a bit. But my life is pretty uneventful, aside from the bipolar. At my last app that I made out of urgency because of the psychosis I was having we basically talked about my knitting.

I saw a paper the other day that she sent my community support worker and my t had called me aloof on it. To my suprize. We never do any type of therapy. And it's not like I can just get a new therapist with the system we have here. I really like her as a person I just wonder if this is normal? All she said about the psychosis is that I seem to handle it exceptionally well. Um even tho I called for an ASAP app because I wasn't doing well at all. ? Confusing to me.

Normal or not would be a hard thing to ascertain, as there's a fair range, some approaches being more helpful to certain people and at certain times than others. Given that, all I can really offer is personal experience, followed by a few thoughts.

Current one's approach: She is very easy-going and we tend to talk over a wide range one session to another (once in awhile not obvious in their connection to psych stuff). It's actually quite perceptive of her. There are soooo many entangled and long-standing issues for me, and having soooo very many years that they were unadressed, it's not as if focusing over and over on any given thing is particularly useful, as the others then run amok. Also, she realizes that I am very cagey, have a lot of well-established walls and have a lot of trouble talking fully about anything. So she takes what she can get out of me, pushing only moderately, knowing full well I'd only retreat further, which would not be good. It helps build trust in knowing she will not push me over, knowing full well I'm already at my limits. The "pushing" tends to be in terms of a question. She knows I will think and write about it b/w appts. She sometimes will send me home with a book to read, knowing it may raise stuff that I am otherwise too overwhelmed to even recognize. About half the time, I return not having been able to focus enough to read, and she knows I really can't (because when I do, I really do! Pages and pages of notes, lol). Perhaps another time. I realized this "don't push too hard" approach worked when one session, I realized I'd told her things I'd never told anyone (sui-related). Not everything, but one small wall of very disturbing stuff. Weirder yet was that I brought it up! At the moment, I was wanting to get off a subject that had been discussed too much, and only very peripheral to what was really going on. Later realized at some level I must have realized that it was only fair to her to admit the giant pink elephant overshadowing and coloring everything else.

All this(!) is to say that it's quite different than a T I had a few years ago. She was CBT oriented (didn't know what it was at the time, but now recognize it) and always gave concrete homework. In this point in time, the current model (ie. less structured) works better for me.

Not quite sure what to make of the paper you mention. Do you think maybe she's thinking you should be the one to direct/re-direct the conversation to the psych stuff? Do you remember how it got off to the knitting? If you initiated it, maybe she thinks it was some kind of avoidance??? (Though "aloof" would be a strange word to use.) I hear you on the frustration of being told you're doing well with something when you really feel you're not. A matter of conveying it maybe? I'm sorry that it doesn't seem (but are you really really sure?) that T's can be changed. It seems frustrating advice to have to offer, but any chance you can take charge topic-wise a bit more? Either in initiation or re-directing? Or even asking for homework? It's unfair to put the onus on you, but if it were to work, the sessions might seem more what you would like them to be. What do you think?

thanks Innerzone, maybe it is just the type of therapist she is. She could be leaving it up to me. I never saw myself as aloof before. I have asked her about types of therapy for me to deal with the psychosis and she simply says there is none. My pdoc thinks I could benefit from CBT . I also learned from my Community Support Worker that the therapist I have is only meant to be short term, 5 years I think is more like long term so I started getting nervous about being let go.

I've always been very shy, so maybe this is where she is thinking I am aloof. Also the shyness makes it very hard for me to just talk, or ask for what I need or want. Maybe at my next app I can make a bigger effort to be open. As for the knitting , she brought it up, she likes to talk about the projects I am working on. The thing that bugs me is she always tells me how strong I am or how good I am doing, and gives compliments, but really I am having problems, maybe she doesn't know how she can help me, it's been this way the whole five years. Maybe it's time to just ask straight out about CBT or other methods. If I can summon the courage. I don't see her often , on a need to basis because I feel it's more like coffee chit chat. However she is great when it comes to communicating to my pdoc when I can't.

[AbeIsAbe]

Liking her as a person has nothing to do with liking her as a therapist. I like my best friend but she would suck as a therapist. If she's not helping you (by talking about things that don't need to be discussed in therapy -knitting- and not talking about things that do matter -coping with your bipolar and any other problems-) then maybe you should seek another therapist.

I often am too afraid to leave a health care provider, for fear that they will be mad at me for leaving or that it will make them dislike me. I have learned that this is just like shopping. If one shoe doesn't fit, try another. Maybe you could search for a CBT therapist. Better to get one who specializes in it.

I also see the pain in the *** -ness of starting over. That's another reason I would always take so long to finally give up a therapist. Then you have to go through your history and rebuild a relationship. Regardless, it's a better turn out in the end.

Good Luck in whatever you choose.

[dejavu65]

My T has not mentioned any kind of therapy other than talking. I like and respect him but I have learned more personal information about him than I would ever have thought. I have never been to another therapist so I have nothing to compare him to.

[AniManiac]

I was having therapy from my last pdoc, but she really irritated me by asking me about the same (non-relevant) things over and over - like the research methods I'm using for my graduate work, etc. I don't like repeating myself, so to me it seemed like she was "testing" my story. I don't mind that she asked every week about triggers because that was relevant, and it was also making me more conscious of observing these things. But she also seemed to expect me to take a lead somehow, for example asking about a dx when that's what I went for originally, so I assumed she'd tell me when she had it worked out. Not so much. I spent a ridiculous amount of money that I really can't afford (my hubby was actually also quite irritated about it and said I should just quit going instead of paying $300 to tell her I'm not going to see her anymore, and in hindsight I agree!) but then when I had to cut it off and asked about the dx, she said that would just be a word (which kinda gave it away, actually) but it should be a conversation. What a cop-out!

I realize that I was resisting her advice (a lot) but much of that is because she was suggesting things that I considered unacceptable, without giving me any rationale for why I should consider doing those things, like for example giving up on my career dreams for a "less stressful" position. However, I'm the kind of person who won't give up before I've tried, so that was just never going to fly with me. She never said that I'm at a higher risk for having more episodes with a high stress job. I respond well to logic and evidence, which is pretty darn obvious if you talk to me for a couple hours, so it was a complete failure to communicate on my level. She also didn't give me any parting advice except to continue taking my meds, but I still need someone to prescribe and although I asked she gave no suggestions at all. The sad thing was that she's considered a good diagnostician and pdoc. The whole experience made me think she's just in it for the money.

Eventually I quit seeing her because she was out of network, way too expensive and my insurance was reimbursing only a tiny fraction of the cost. I will start seeing a new T next week, hopefully this one will work out better.

[hamster-bamster]

Originally Posted by AniManiac

She also didn't give me any parting advice except to continue taking my meds, but I still need someone to prescribe and although I asked she gave no suggestions at all.

In California this is considered "patient abandonment" and the medical board would prosecute.

[sugahorse1]

Mine used to ask me how I was, and I'd start talking about what was on my mind. She'd ask me challenging questions to make me think more and see a different perspective.
I think I would have liked more out of therapy, but I don't know what.
I eventually asked her for homework - a comment that would challenge and make me think. I'd mail her during the week about what I was feeling. She wouldn't reply (I was ok with that) but it gave us a spring-board for the next session

I wonder if I would have liked to do different types of therapy - hypnotherapy, music therapy, EDMR...

[AniManiac]

Originally Posted by Natalya

In California this is considered "patient abandonment" and the medical board would prosecute.

She knew I'd go back to my university's Health Services and said I could call her for another appointment if I couldn't find a prescriber. So not totally ethically bereft, but that doesn't address the problem of not being able to afford her rates, so it wasn't really useful! She actively discouraged me from going to the place that I'm heading to next week, saying a bunch of her patients used to go there but came to her instead for a reason.

I leveled with the LPN that I see at Health Services, and after a behavioral health evaluation, the determination was that bipolar is so likely that they won't prescribe anymore if I don't go to therapy (even though ironically I used to be considered one of their most stable patients for controlled rx's!) So even though every therapy experience I've had has totally sucked, I'm now stuck with it.

[Beezup2]

Boy I have a lot of thought on this one but I have to go quickly this evening. First what struck me is it might not be a matter of a CBT vs. whatever kind of therapist. What made a difference for me was my current one specializes in BIPOLAR patients. It has made a world of difference in how i feel I'm helped, understood and the progress i have made as well as help during crises. He spots so many things and since I live alone, I don't have that self-awareness or others' feedback when i am getting in trouble. I agree with what you said bout getting help with him/her by being a good communicator with my pdoc, who really respects him. This has saved me countless times, his intervention and action. I have had 3 therapists over 10 years.

Second, I believe a lot can come of those off-handed, let's talk about ordinary stuff sessions. Once it falls away, it could be I'm denying. Or there's way more going ion that the obvious meanings.

Funny, everytime I feel like dumping my t. in anger, confusion, whatever, I fight through it til the next session and usually it is wonderful and I can move forward.

I learned there are some things helpful to give: I listen. I journal, especially when I'm stuck. I talk even when I'm afraid or don't feel like it. I try to apply the suggestions, lessons I've learned. I am certainly totally honest with him. I guess my style is the spill your guts style. It wasn't always this way until m t earned my trust. And he knows more about me than anyone on earth. But that's fine with me. That's how I feel I am helped. And it takes work!

Anyway, just some insights on how I work it in case it helps you some way. Plus, there's always the option to change.