[MrAbbott]

I have recently started psychological therapy... and I must tell you, it has never helped me in the past. I'd ideally like to find a psychologist that is able to give me tools to work with, self-control tools and a way to communicate to others this hard-to-express feeling: that my psychotic episode has started (just when it starts showing its hand).


Finding the right person is very difficult (maybe you'll agree with me) and psychologists are expensive... I don't want to lay down on a couch and start telling the story of my life from the very beginning while time and money are wasted in exchange for a low therapeutic effect. In the end I've chosen a clinical psychologist with psychoanalytical training and today has been my second session... I'm not impressed ... why it's so difficult to find a knowledgeable professional? He was the only one that mentioned psychosis on his website but I'm starting to doubt his statements: he clearly knows few about it and how to help a patient manage it... what kind of psychologist would you recommend? I truly believe other countries have these matters better figured-out, but I've set my mind into successfully organizing my life better and help identify critic episodes correctly and in a timely manner. Fingers crossed.

Oh... I'll tell you his fee just to know what you think: 65$ for 30-45min.

See you.

[CANDC]

@MrAbbott - welcome to MSF. I am sorry to hear you find it challenging to communicate to others the fact you are moving into a psychotic episode. The people I talked to who are in one, seem convinced it is real so I do not give in to the tendency to tell them "Oh that is all in your head." It may be in someone's head but that seems to be enough to make it seem real.

If you have someone who you trust talking to and opening up, then these tips might be good ones to mention to them when you are able to discuss it with them How to Communicate More Easily with Someone in Psychosis | HealthyPlace

• Keep your statements short, simple, and clear
  Use a calm voice and steady tone
  Give the person physical space rather than crowding them
  Acknowledge what they’re experiencing and how they might be feeling
  Don’t argue with or challenge the delusions or hallucinations
  But don’t pretend to believe them yourself
  Be neutral but not placating—give matter-of-fact statements acknowledging that their experience is real to them
  Ask them to help you understand what they’re experiencing

By the way, $65 for 30+ minute session is reasonable if you are getting value from it. There are also online therapy options. If you are interested in that send me a personal message by clicking on CANDC to left of the post and select Send A Personal Message. I am not a therapist but can describe options I know of. @CANDC

[Soupe du jour]

Hi MrAbott. Is the $65 a copay with insurance, or 100% pay? If 100% pay, many Americans would see that as a very reasonable price, I'm afraid. That especially applies compared to therapists in my native New Jersey, many of whom don't even take insurance. With insurance, I was paying about $40 copay for 40 mins. As I no longer live in the US, I'll guess the copay would have likely increased by now. 100% pay would have been around $150 for a therapist with just a Master's degree. For a PhD level, even more. Fees do vary a little throughout the US. New Jersey is expensive!

I now live in Czech Republic. A psychologist who accepts insurance requires no copay. Those that don't accept insurance charge around 500 czk ($23) for 50 minutes. When I first arrived in CZ, before getting insurance, even the psychiatrist I went to charged only 1000 czk as 100% pay for medication checks. Now with health insurance, I pay zero copay. Healthcare is inexpensive here in CZ. It's not a perfect system, but better than in the US, in my view.

I've had more therapists in my life than I can even remember. I'd say that 80% did relatively little or even worse. However, 20% offered me at least some valuable tools and support. A few didn't suit me initially, but after a bit, they did. First impressions aren't always on target.

[June08]

I'm sorry you are having a hard time finding a therapist. I agree that $65 is a good price if you are paying out of pocket. If I was paying for my counselor out of pocket, I believe it would be $125/50 minute session.

Have you heard of Cognitive Behavioral Therapy (CBT). I do not know much about if/how it helps people who experience psychosis, but I do know there are resources that say it can help with managing Bipolar Disorder.

[Victoria'smom]

I'm a fan of pCBT. The therapists that have helped me out are trained well in crisis therapy. They come to me where I'm at and lightly question my reality but generally treat it as if x was truly happening how do we help her cope. While my pdoc deals with the med part because truly the only thing they can do is make sure I'm safe between sessions. So they take my statements seriously and find ways to cope. Ie. Setting alarms to randomly wake up to check my husband isn't cheating on me while I sleep. Instead of me staying up all night. Pouring drinks into clear cups to make sure they're not contaminated. What does it mean if x doesn't love you? Things like that. Some of my best therapist weren't the brightest but helped me cope.

[MrAbbott]

Originally Posted by CANDC

@MrAbbott - welcome to MSF.

If you have someone who you trust talking to and opening up,



By the way, $65 for 30+ minute session is reasonable if you are getting value from it. @CANDC

Hi CANDC, thanks for your message, I actually live alone with my elderly mother and, occasionally, my two young children... my mother actually feels overwhelmed and I can't count on my couple because I'm divorced. This is one of the reasons I'm trying to find help and organize my life... I don't lose total grasp of reality during my crisis, thanks god, but I still need to find a better way. I appreciate your offer but my mother has insisted she needs to be able to communicate with my psychologist in person, so it has to be a local practitioner. I'm comforted by you and others that say 65$ for 30min is an acceptable fee, but to me it's a bit too much on the high end, I wish prices were a bit more reasonable. Yes I pay it 100% out of my pocket.

Thanks and see you then . D.

[MrAbbott]

Originally Posted by June08

Have you heard of Cognitive Behavioral Therapy (CBT). I do not know much about if/how it helps people who experience psychosis, but I do know there are resources that say it can help with managing Bipolar Disorder.

CBT is the most spread kind of therapy in my area. I tried it long ago, when affected by OCD, but it truly gave me no comfort. Taking meds plain and simple have always gotten results faster than talking in my case. Who knows, it may work better now. Thanks .

[MrAbbott]

Originally Posted by Soupe du jour

First impressions aren't always on target.

Hi Soupe, yes I pay 100% out of my pocket, no copay. I do hope you are right about first impressions with psychologists because I have the feeling mine is just getting comfortable for a long period of sessions . I told him I can't see him every week and he felt disapointed. But it's true, Idk if a psychologist can give me the kind of help I had idealized...

Thanks for your input.

[MrAbbott]

Originally Posted by Miguel'smom

I'm a fan of pCBT. The therapists that have helped me out are trained well in crisis therapy. They come to me where I'm at and lightly question my reality but generally treat it as if x was truly happening how do we help her cope. While my pdoc deals with the med part because truly the only thing they can do is make sure I'm safe between sessions. So they take my statements seriously and find ways to cope. Ie. Setting alarms to randomly wake up to check my husband isn't cheating on me while I sleep. Instead of me staying up all night. Pouring drinks into clear cups to make sure they're not contaminated. What does it mean if x doesn't love you? Things like that. Some of my best therapist weren't the brightest but helped me cope.

Hi M's mom, I'm glad CBT worked for you, this is what I'm going to try if psychoanalysis doesn't work... yes too soon to tell, but I've lost some hope. I like that they give you some practical applications to help you feel more at ease.

Thanks for your input.

[CANDC]

Originally Posted by MrAbbott

Hi M's mom, I'm glad CBT worked for you, this is what I'm going to try if psychoanalysis doesn't work... yes too soon to tell, but I've lost some hope. I like that they give you some practical applications to help you feel more at ease.

Thanks for your input.

The good part of CBT that I have heard is it involves mindfulness. Mindfulness does not try to figure out the past but helps us cope right where we are in this moment.

If you want some youtube videos I can send you some links. @CANDC

[Tart Cherry Jam]

$65 for a 30-45 minute session with a psychoanalyst (with an emphasis on psychoanalyst) as out-of-pocket cost without insurance is almost free by California standards, and California is where I live. You are in Spain. There are not a lot of users in Spain on this forum and it is hard to compare the price you are quoting against a reasonable local benchmark.

You said that you want to organize your life. For that, if you have a bipolar diagnosis, there is an awesome evidence-based therapy called Social Rhythms. Interpersonal and Social Rhythm Therapy | Psych Central. Interpersonal and Social Rhythm Therapy | Home

Look into it. If you cannot find a local practitioner, you can buy the (fascinating) book and do many things by yourself. Amazon.com

[Tart Cherry Jam]

Also, what antipsychotics have you tried besides Invega?

[MrAbbott]

Originally Posted by Tart Cherry Jam

Also, what antipsychotics have you tried besides Invega?

Hi, I have tried seroquel and also zyprexa now that I think of it.

Thanks.

[Tart Cherry Jam]

Zyprexa is very bad in terms of metabolic side effects but very good otherwise. Due to the metabolic side effects, it is almost a last resort medicine (Clozapine is the official last resort medicine but it helps some people very well).