9 months Therapy Free~!

After 16 years of so-called Counseling, and Talk Therapy, I finally threw in the towel. All I was getting was an hour every 2 weeks to listen to myself, and if i was lucky, some social interaction with a sensitive and knowledgible individual. If i was unlucky, I got disturbed and distressed by some unmindful and unskillful provocateur. I will say that I found some usefullness in DBT (Dialectical Behavioral Training), but less than in Awareness Meditation and Calm Abiding Meditation. In the end one concludes that since the actual work must be done by oneself, why not try some self-directed techniques ?

oh your post shows little understanding of a good theraputic alliance, I'm sorry for that, I've gained so much out of therapy. I tried for yrs to do it alone, a narcissitc defence, but found becoming vunrable is very benefical.

Good morning Gus,

I agree with Melbadaze: what a tragedy to have been in therapy for 16 years and not gained much, this would be heartbreaking for me. I was in therapy for 9 years due to severe and complex PTSD and found it life-saving.

Overall, the literature (and my own experience) suggests that the initial 25 sessions is where the most change occurs for most individuals (~75% of those in treatment), then sessions 26-50 see less change or growth (10-20% more change). Beyond this, limited growth/change occurs for most (not all).

The main problem I see is that clients have too often come to accept mediocre or even very poor therapy, often b/c they don't know better or b/c this is too much of what occurs and it has become commonplace. I always suggest an initial meeting (no fee) to see if the client and I will be compatible and for the client to interview me. For example, if they have an eating disorder I quickly refer since this is not an area of expertise for me; however, if the issues surround Bipolar Disorder, Schizophrenia or Borderline Personality Disorder, or couples and family therapy, this is where I can be of greatest service. Clients should interview their therapist and Pdoc before therapy starts, much like they would a prospective employee, a plumber, electrician or gardener-- but most don't and end up in treatment too long and with less than optimal or even negative results.

In the initial "meet and greet" visit, if the client asks no questions b/c they are not well informed or fully engaged, then I ask the questions for them:

• What types of clients do you mostly see?
• What issues do you mostly work with?
• Can you describe your treatment approach?
• What would typical homework look like for someone with my issues?
• Can you describe the types of success you've had with others that have similar struggles to mine?
• etc., etc.

Finally, I find mindfulness (awareness and calm meditation) as you describe it, to be an extremely effective "tool"-- often much more so than talking therapies if the person develops the skills. In the past. I've recommended the excellent: Mindfulness in Plain English, Updated and Expanded Edition.

I'm glad you've stepped out on your own and have taken up meditation, I wish more folks would follow your lead.

Good luck Gus and I hope this helps,
Baaku

I would imagine that many clients benefit most from the first 10 -20 sessions. However, I recall seeing several studies that have actually found that for quite a number of clients, there is an increased benefit for sessions beyond 20. I don't remember the details of the studies, but I would suspect the difference has to do with the types of problems (e.g., single episodes vs. recurrent or underlying personality disorders).

You're right about the 10-20 sessions. Extended therapy is extremely typical for certain conditions, especially for the more severe and persistent mental illnesses in adults and severe emotional disturbances in children. Overall, we're likely looking at <8% of the population, tho.

Thanks for that clarification.

Gus, I am happy that this has worked out well for you. I think it is essential to find a therapist that fits and is a good match. And of course having a qualified therapist is very important.

Sometimes I can't believe how fortunate I was. I picked my therapist simply because he was the only one who I could drive to that wasn't over a bridge. Highway phobic... I exchanged several emails with him, but that was it. He ended up being a perfect match. This is highly unusual, though, I would imagine. My therapist also believed in the powerful punch of brief therapy. I only had about 25 sessions with him and it seems to have worked quite well. But then I did not have have any major conditions going in either...aside from some mild depression and anxiety. I imagine length of time would depend on the individual and their specific needs.

I'm glad that therapy was helpful for you, Baaku.

Baaku, Thanks for your interest and advice. It's clear that I could have used someone like you, after i regained some of my cognitive functions. I continued so long in counseling without significant progress because i was so Isolated, my counselor provided half of my human contact, which for years was only 4 to 8 hrs per month, for months on end. Support Services failed me, believing that psychiatric symptoms were ugly and didn't have to be tolerated, weren't "really disabling", etc., a very rural and lagging social environment. The wonderful thing about relinquishing my counselor was that I had been able to develope a more natural social support system, doing volunteer work and developing a part-time job helping people like myself. This is a dream come true for me, and I try to turn away from worrying that I will fail, mess it up, be found unacceptable, etc. Learning to let go is apparently not a one-time lesson,, LOL

I have not seen any other threads or links leading to people with an "Acquired" brain chemistry disorder. This adds a whole new dimension to the recovery process. I don't know how many of you have seen individuals who have had "bad reactions" to psych meds, but it is truely horrifying to be one of them. When I began my "self-directed rehabilitation" the doctors laughed at me, and said the damages were permanent. I have proved them wrong, even tho it took 18 years to do so. Just let me encourage all of you who read this to NEVER stop working for a full recovery, never settle for just symptom management, and always believe that, as long as we are alive, there is no better use of our time than learning how to be better people, more kind, less afraid, wiser and gentler. Climb that mountain, because it's there.

Gus, I can imagine how well you have done. My tai chi teacher was in a horrible motorcycle accident and had severe head and body injuries which had psychiatric ramifications but started learning tai chi in the hospital from a fellow patient and took it up seriously and we, his students 10+ years later couldn't tell he'd been in such an accident.

I'm very glad you figured out what would work for you and made it happen.

It makes me a little uncomfortable to read this, since I think I am at greater than 50 now. It makes me wonder if am not getting "enough" benefit now, at least according to those statistics. I still feel like I'm getting benefit, and I guess we're all individuals so it's better to go by my own experience than statistics. I guess I have always been slow at things, so maybe I'm just slow at therapy too. My first therapist I saw off and on for 9 months and she commented rather confidently early on that I would not need to see her for more than 15 sessions (an insurance limit). She turned out to be wrong, and I always wondered how she could be so confident without even knowing me or the scope of my problem? I think now that maybe she was reading this same study you cited, Baaku, and just going by statistics when she told me that. My second and current therapist, who I've seen for 3 years, has never tried to put me in the box of the "average client" like that, and I really appreciate it. He's accepting of what my individual needs are.

I agree with you in that I too feel uncomfortable reading this. I've been in therapy for over a year for an anxiety disorder that I've had under control since...last fall I believe? I keep going back and don't feel I deserve it or even need to because I feel under control and, even though I hate the word in this case, "normal". I still see some benefit, though, I guess it just depends on the session and the person.

Only you can prevent neurotypical jerkiness!

most studies i've read have confirmed what baku has posted. however, i'm well over the 100+ session mark, and i know the benefits for me have only increased exponentially recently.

not everyone goes into therapy with the same issues. i accept that most people find limited benefit for therapy after x number, but that hasn't been my experience and i only need to focus on what is working for me.

gus - i have recently (like, literally within the past week) started looking into various forms of meditation. that's the pull i'm getting as the next step for me. it's exciting to see someone else have benefited from this. i have been drawn to zazen in particular, but i'm not sure about the differences between approaches. i want something secular, but with a focus on awareness, not "relaxation".

Good morning Sunrise and Indie,

I know the stats can be disconcerting, but I want to keep them in perspective: these outcomes are for only ~75% of the population that seeks treatment, the remaining ~25% continue to benefit and grow greatly from longer term therapy and there's absolutely nothing wrong with that (hopefully that's not what I'm suggesting, especially in light of my own 9 years of therapy for severe and complex PTSD). It depends largely on the condition and it's severity and duration that one seeks help for, the competence of the clinician, how much the client is really willing to work for change, the clients social and cultural make-up, the client's temperament, the client's support system, and so many variables having little to do with the actual treatment itself.

Thanks for responding to my posts and I hope this clarifies this a bit,
Baaku

Sunrise, I wouldnt take to much from someones opinion on a message board, one doesnt know what motivation lies behind such posts. I'd go to therapy for ever, Infact I think I will lol!

I'm glad you clarified this Baaku. The reason for my previous post was a recognition of how many people on this board may fall into that 25% that you mention. Now some of us may be in therapies that are failing them, but many are with caring, competent therapists who recognize the need for deeper work that cannot be accomplished in 15 sessions.

If anyone ever hears a therapist say that he/she can help you feel better in 15 sessions, without having met you or learned about your problems, he/she is at best trying to instill hope, or at worst naive and is going to blame you if CBT or some other short-term therapy is not helping you.

Yes ... I just realized how right you are! I fabricated the numbers to support my opinion--- which was, by the way, purely motivated by greed and the lust for unbridled power.
I agree 100%. Short term therapy is certainly not for everyone, and neither is longer term treatment.

I think my main point is more about whether we are getting the right therapy for ourselves at the right amount and at the right time, and is it effective. Nothing more really matters.

It's hard when you know nothing about therapy, and they say things like that. In retrospect, my first therapist was not very good, although she was certainly a nice lady. I think she was kind of CBT, but I'm not sure, as I didn't know that there were different approaches back then. But I don't have a lot of distorted thinking patterns, or if I do have some, they were not at the root of the issue I went to see her for, so my best guess is she actually had no clue how to proceed. When she told me we would not need 15 sessions, it actually did give me hope. After all, she was the expert, she should know, right? I felt reassured by that--we will solve my problems in 15 weeks! Woo hoo! When a client walks in the door wanting to dissolve a 20 year marriage, is totally terrified of her husband, and has become basically immobile, how can you fix that in 15 sessions using the minimalist methods she was offering? She was so naive. She did help somewhat with the "immobile" part, but that really wasn't my main problem, just symptomatic. She used to say stupid things to me like take a bubble bath. How does that help me solve my marriage issue? My current therapist went to the heart of the matter (the fear), which involved doing some work on my past experiences, which is something my first T never even inquired about. I just don't think she ever "saw" me or perceived my issues correctly. I think people like her are too superficial and cookie cutter to be effective therapists. It is probably partly her training to prefer short term therapy and partly her personality. My current T likes to "go deep"--why mess around on the surface and not really solve what is causing the problem? I don't think my first therapist knew what "going deep" meant, and if you don't ever go deep, perhaps your clients do rarely continue with you for more than 15 sessions (it's like a self-fulfilling prophecy). Yet when I walked in her door, I would not have known that "short term therapy" was not what would help. How would someone like me know that? I depend on the professional to know that. And she didn't say we would be done within 15 sessions at the first session, but after at least half a dozen sessions.

Well, that's a big diversion, from your original post, Gus, but I find this idea that most people don't change after 26 sessions to be somewhat lacking in data interpretation. I think a number of people may stop changing after 26 sessions (or whatever) because they exhaust the therapist's skill set. They've gotten all the benefit they can from that practitioner, so they do stop growing. The best solution is to move on, which they do--either finding a new therapist or just relying on self, as you Gus are now doing--and then they show up as misleading statistics in studies such as the one cited. Gus, I wish you well with the meditation. I took a mindfulness meditation class a few months ago and have found it useful at the times I can remember to give it a try. For me, it's almost like a new habit I'm trying to incorporate, and it takes effort and memory to keep with it. Good luck. (I did find taking a class in this technique to be really useful and reinforcing and motivating.)

I find even a year and a half removed from my last therapy session that I am still extremely sensitive and protective of the experience. All I have to do is read something about how transference interferes with therapy or a description of therapy being presented in a "correct" way which didn't occur for me in my therapy, and my blood starts to boil. Therapy is a unique experience...as intense as it is limited...and the journey belongs to us. I have always wanted to hold that experience and still very much treasure this short time in my life that I shared with my therapist.

In my second to last session, my former therapist told me about the very same study. He did so very gently and, by doing so, nudged me toward the door. I think in my case I was (mostly) ready and so it worked for me. Was it a bit too soon? I think maybe. My therapy wasn't perfect, but it was mine and I keep that by living now what I learned during my time there. He told me once that transference was "just a word." The word itself can't possibly minimize my experience or my feelings from my experience. Letters don't define an experience. Numbers are numbers too. They are useful as a guide, much like a diagnosis is. But, Sunrise, you know well how healing your experience in therapy has been and continues to be. And that belongs to you.

I've known Baaku for about a year now. He's helped me in a dark hour or two. I never did get an invoice for those services...

i think when one has really finished with therapy, figures would feel irralivant, therapy is a personal journey of love, figures can and are misguilding at best. Who attracts me the most are those that speak from the heart, those that live their life in the wprld of stats and numbers do not have much to say, in my mind. I'm sure stats and figureS are very, eemm, rewarding?

I'm definitely a speaks from the heart type of person. Everyone has different styles and approaches to life and what works best for them. I imagine also the way one approaches therapy...The beauty of diversity...

I also have a strong tendency to want to protect and take care of my friends, as I was trying to do here with both of them.