[xRavenx]

I know there is a "Therapy" part of the forum, but I am especially interested to hear from people here with BP. How knowledgeable do you feel your therapist is when it comes to Bipolar and its treatment? What has helped you in therapy? Has anything been particularly unhelpful, or are there things you wish your therapist understood more?

I'm starting to get a little frustrated at my current therapist. She means well and has been there for me in a lot of situations, especially when it comes to my grief and loss issues. However, I hate how lately she keeps placing blame on my parents for different things, and not everything has to do with my parents!

Also, yes, there are some things I acknowledge as becoming a bad pattern because of my parents to some degree, but the awareness does not help me whatsoever. It's like....okay, I've been aware of this for a while, but what can I do about it? I don't feel I am getting ahead as far as interventions go.

Also, aside from asking if my Bipolar meds are right, she has not really helped me learn any tools. Occasionally, I'll get broad, text book type suggestions at the very most. I'm glad I have her as someone supportive to talk to, and sometimes helping me problem-solve or steer me into a certain direction. I just don't feel I'm not getting ahead too much though....and I question how much she really knows about BP. I feel I need to teach her things about it.

Can anyone relate? (or any suggestions?)

[BeyondtheRainbow]

The therapist I had when I was diagnosed had never worked with anyone with severe bipolar before. The first several years after diagnosis I was on and off many meds because they didn't work for me and I was never remotely close to stable. She took a few classes and really tried but looking back it wasn't nearly enough. She did her best by providing support but she never made me actually work hard at anything. I don't think we ever talked about anything 2 sessions in a row. When I tried to hide from my emotions she let me. Honestly we mostly talked about our cats.

She left suddenly and I was transferred to the therapist I've seen for 11 years exactly to the day. It was quite a transition. He had some experience with bipolar and he expected me to learn coping skills and work hard in therapy. We had some interesting discussions for a while as I was used to throwing out at the end of a session that I was feeling suicidal and yet was fine. He didn't buy that so much and we really had some conflicts about that kind of thing for a while. But right from the start he knew how to really help me and I've gained so much from him. He knows me well and reads my moods well and doesn't let me hide. I've learned to trust him enough that when I'm manic or mixed I can tell him that I think I'm ok but if he thinks it is time for IP I'll go. That was a huge thing for me to do but now it helps. Having someone who is knowledgeable about bipolar really had made a big difference for me. Lately we've been talking about situational depression from my cats dying versus bipolar depression and again it's good that I trust him because it's a hard concept for me to accept; I feel like if I'm depressed my bipolar could explode at any moment and I'm learning that right now I am just sad (and depressed but not the same as purely bipolar chemical depression).

[Nova567]

I had a really good therapist with bipolar, but unfortunately she just moved on and I am being reassigned (need to set up the appointment).
She did wonders for my anxiety, pointed out my moods, taught me to calm myself and my mind when I'm hypo so I can decide if I'm being irrational or not. I never hit hard depression with her, so I never got to see what she could offer with it. She gave me a lot of good advice I hold very close to me to help me out daily.

[seoultous]

My t is very knowledgeable about BP and helps me identify what I can attribute to my BP state. She knows me and can tell me if I am depressed or just having a bad day. I have been seeing her for 8 years and I can honestly say that without her guidance and support I would not be here today.

[Unrigged64072835]

My therapist is knowledgeable (he taught psychology for many years), but he thinks I am too. I've been in and out of therapy for over twenty years so he really tries to get me to figure out solutions to my issues. I hate that--I'd rather he just tell me.

[Nammu]

Hard to know how much the early Ts helped with the bipoar as the PTSD was always getting in the way. Those early Ts were great with the PTSD but I think they tended to over look the BP moods as exacerbating the PTSD and just put it all down to the PTSD. My last one though knew BP and was excellent at helping me recognizing early signs of mood shifts. She was instrumental in helping me accept that, yes, I did in fact have BP and meds could help with that. Once the PSTD was delt with it was pretty clear she was right. Been on the right meds for 3 years now and stable.

Hmm. I don't have much experience with therapy because I'm 25 and only sought help 1.5 years ago, but I have gone through a few T's already.

Long story short, I pretty much ditch a T right away if we don't connect and if I'm not making any progress. I usually give them 4-5 sessions to "prove their worth" before I call it quits. This is because after 4-5 sessions, you've pretty much gotten a feel for their techniques and whether or not you have personality clashes, etc.. I mean, if you spend 4-5 sessions with them and you're not making progress AT ALL, then what's the point? Either your therapist isn't the right fit for you or you're not making the most of your time. Or maybe both. However, a *good* therapist will poke and prod so that you do make the most of your time. They'll make you open up so they can help you with your problems. They won't let you sit there and wallow in your own misery. But of course there is some effort to be made on your side too; it's not a one-way street. Though I think you get what I mean.

Anyhow, onto my T experiences...

My first T was a dolt. She didn't specialize in mood disorders, and when she found out that my pdoc said I was depressed, she said I wasn't. "He's wrong." lol wat. I was going to terminate with her, but she beat me to it. She left for another therapy office.

My previous T was really sh#tty too. He let me babble on all day about random sh#t (much akin to BeyondtheRainbow's first therapist) and didn't poke and prod AT ALL. But the worst part was that he blamed me for literally everything (including my mood swings) without offering any advice. Pretty much "it's all your fault; you're a horrible person". Or at least that's how I felt. He actually "specialized" in mood disorders, too. That's the sad part.

My current T i did a lot of research on before I stuck with her. I made sure she specialized in mood disorder stuff *and* ADHD *and* anxiety issues (cos I have all 3). She couldn't have been a more perfect fit. She also pokes and prods, which is what I like.

*phew*

All that said, it sounds like you and your therapist get along well, but maybe it's at the point where you need a different set of eyes? You did say that you feel you have to teach her, which I think is a sign that you need someone who specializes in what you want to get out of therapy. But it's not uncommon for people to have more than one T at a time. (I've never done this, but some people in the psychotherapy forum do this and it works for them... e.g., they have someone who does EMDR and they have another who does DBT.) I'm not saying I recommend or don't recommend having two T's, but I'm just putting that out there as an option in case you're considering terminating with her.

[xRavenx]

Thanks everyone for your input.

bluebicycle, I agree it could be beneficial if I can work with 2 different therapists, if that is allowed with them in treatment. Therapy is expensive for me, so I definitely want to make sure I make progress. I do have a good bond with my therapist and value her listening to me. It's just that some of the Freudian psychodynamic theories that some old-school therapists seem to use are at odds with some of my own beliefs.

Yes, I believe completely that early communication, attachment with family members, and our childhoods help shape who we are.....but I don't like when therapists are quick to put down a family member (in this case, my mom) before having more background. There's too much bias too early on. For instance, I know I was really difficult to handle in adolescence (and sometimes as a child) due to my BP issues.

My mom had some mood swings herself and can have a quick temper when frustrated, but there were times where I definitely hold myself accountable for things. My therapist dismisses that I should hold myself accountable for any of my actions involving my mom that I bring up to her, without understanding that it is hard to deal with having a Bipolar adolescent, and no one would be a perfectly patient mom when dealing with me at that time in my life. Also, there was a lack of awareness when it came to mental health back when my mom was growing up as well as stigma. My parents were not equipped to deal with it. A lot of her family on that side went undiagnosed, at least until later, and/or turned to drugs or drinking (not my mother though). My mom has made some mistakes in parenting. Besides, who hasn't? I do acknowledge some of my anxiety problems might have to do with my mom's mood swings growing up, but innately, I was an anxious kid. My mom and I have had our differences over the years, but I know she's always wanted the best for me.

Yeah, if you want two T's, you can always ask... Your T might be fine with it if you explain why you want a 2nd T, or it might be against her personal philosophy. Who knows. You'll obv have to ask. But you'll find in the psychotherapy forum that some people inform both T's about each other, while some don't inform either T. Some even only inform 1 of the T's. In the end, it's up to you if you want to tell your T's. But some say it's helpful informing both T's because then the T's can work together. So that's another way to look at it. Again, up to you though. Just giving you options based on what I've seen.

But anyway, I can see why you're a bit upset with your T putting down a family member w/o having more background. I would feel the same way. Have you talked to your T about this? Like specifically tell her how you feel when she puts down *any* family member? Because what you said makes a lot of sense, and if you haven't given her that explanation, then def tell her that! What you wrote is not offensive -- in fact, it's gentle -- and it's well written enough to get the message across. I know it can be hard to confront someone like that, though... but sometimes a therapist doesn't know if what they're saying upsets the client unless the client specifically tells them.

[glowsinthedark]

my current therapist has straight-up said that in many ways therapy can't do much for bipolar per se, because it is biological. in my personal experience this is kind of true...therapy has never "helped me help myself" out of a depression. however, therapy has helped me a lot with things such as anxiety (CBT and mindfulness), self-awareness, interpersonal relationships etc., which helps the overall experience/effects of mood swings. so i guess therapy has helped with bp indirectly.

that said, i would not want to see a therapist who didn't have a lot of experience with bp because i simply wouldn't trust them to understand me. i don't want to be someone's learning tool, i want someone who has "seen it all" so to speak. i had a therapist for a long time who helped me greatly with anxiety/ocd stuff but when it came to odd behavior/thoughts due to mood swings she would look at me like "wtf"?? and it made me incredibly self-conscious and untrusting.

[Wander]

In the past I have been to T's who focus on Freudian psychoanalysis and other psychodynamic techniques. Some of it was helpful for my PTSD but it did not help me manage the Bipolar. My current T is schooled in almost all techniques but predominantly uses evidence based techniques like DBT, CBT etc. He is also trained in medication and qualified in the USA to diagnose and prescribe (he now works in Australia where the laws are different in regards to prescribing). Having his skill and knowledge about treating Bipolar both psychologically and medically is invaluable. I trust him more than any pdoc I have seen.

Over the last 6.5 years that I have been seeing him he has saved my life several times and improved my life immensely. I think it is crucial to have a T skilled in Bipolar to make significant progress. How to find one is another story. Word of mouth got me to mine. I am very lucky. You seem attached to your current T so that relationship may be beneficial to you and difficult to end. Perhaps the idea of seeing someone else in tandem for a while to kind of dip your feet in might help. I wish you all the best. Having a skilled T you really connect with is so important.

[xRavenx]

Originally Posted by bluebicycle

Yeah, if you want two T's, you can always ask... Your T might be fine with it if you explain why you want a 2nd T, or it might be against her personal philosophy. Who knows. You'll obv have to ask. But you'll find in the psychotherapy forum that some people inform both T's about each other, while some don't inform either T. Some even only inform 1 of the T's. In the end, it's up to you if you want to tell your T's. But some say it's helpful informing both T's because then the T's can work together. So that's another way to look at it. Again, up to you though. Just giving you options based on what I've seen.

But anyway, I can see why you're a bit upset with your T putting down a family member w/o having more background. I would feel the same way. Have you talked to your T about this? Like specifically tell her how you feel when she puts down *any* family member? Because what you said makes a lot of sense, and if you haven't given her that explanation, then def tell her that! What you wrote is not offensive -- in fact, it's gentle -- and it's well written enough to get the message across. I know it can be hard to confront someone like that, though... but sometimes a therapist doesn't know if what they're saying upsets the client unless the client specifically tells them.

It seems my T will challenge me when I try to focus on the positives when it comes to my mom and the values she instilled in me. She will automatically bring me back to the negatives and has used the term "verbally abusive," when I was telling her something my mom just said out of anger that didn't really affect me that much. Also, she'll keep prying for information on my dad and what I remember of him (there's really no point--I see him all the time). She's asked more than once, although I told her some memories.

I will challenge my T back at times when she talks negatively about my mom, so that has been my way of trying to get across to her that she's made much more of a positive impact on me, rather than a negative. Maybe I need to be a little bit clearer or more assertive. I'll see how next session goes. I do see my pdoc Monday...maybe I can talk to her about it and get a new perspective.

I guess I've just been a little frustrated since I have awareness....I just want her to tell me how to go about trying skills. Therapy is so expensive for me ($40 per session with my insurance), so I don't think I would even be able to afford a second therapist.