Is it ever appropriate to ask your therapist personal questions????

I wasn't getting this so went back through the thread to figure out how the terms became such an issue since I do not see it as inherently problematic. It is really just personal preference and about how you hear the words and your own associations with those words and with what you think the professional relationship is or means.

I have stated my view and contextualized it while also saying that connotations differ. It wouldn't surprise me at all if there was research on both sides, but I still come back to why it seems to be so heated or matter so much. Honestly, not meant dismissively, just having trouble understanding.

Therapists are in the field of mental health. Mental health is part of health care. Health care usually deals with patients. This is not pastoral or career counseling. There is nothing wrong with the idea that some people think of themselves as patients regardless of what they are called. Some people, lots of people, perhaps the majority, do in fact have a diagnosis of some sort, whether or not it has been made. Again diagnosis implies medical implies health care implies patient. Patients are not subservient. They are the bosses in charge of seeking out beneficial treatment. If they are not satisfied, they move on to another provider who meets their needs. None of that activity is controlled by what they call themselves. Words are just words. They do not equal action. If you think they do involve action it is largely a projection because only certain kinds of uses of words actually perform any action (like pronouncing someone married or hate speech). Words are subject to history and fads. They are constructs not the reality. And words are most often misinterpreted because that is the nature of language. In fact it is a miracle that humans can communicate as much as they do. I for one do not expect understanding to happen. There are too many factors and variables for such a thing to occur. All by way of saying tolerance and openness seems more workable than digging in.

Words do matter a great deal. I remember when lesbian was used to shut women up. Or the term feminist. Or telling someone they are fat or throw like a girl. I mind greatly how language is used by those in power to keep others down and I believe the western medical machine uses it to great advantage to themselves. I don't consider the therapist to be a health care provider for me.

And the point is what exactly that is implied to be opposed to something I wrote?

Good discussion. I guess I consider myself a "patient" of my PCP, but I definitely call the shots in the relationship. I get to ask her direct questions about my meds and make suggestions if I want to change anything, I have a policy of not knowing my exact weight (which is overweight but if I know the exact number I begin to obsess over it) and she respects that--she records my weight in my chart but doesn't tell me the number, just if it's gone up or down, she knows my style and makes referrals to specialists to whom she knows I'd respond well...

Good food for thought.

ETA: posted before I finished... I guess I am more of a "client" of my PCP then?

For those who don't pay cash for therapy--if therapy isn't in the realm of health care, health insurance wouldn't pay for it and access to treatment would be even worse than it is now. For people w/o a mental illness in therapy, insurance won't pay for it unless the therapist commits insurance fraud by billing for a diagnosis.

I guess I look at it beyond patient vs. client. I use client because it's more politically correct. But patient does seem more like a healing relationship to me, whereas client seems more like a business relationship. Much of the healthcare industry is moving towards patient -centered care, but it is still called patient-centered care. Not client-centered., or not that I've ever heard...

I watched a video by experts on borderline personality disorder. They said it's undisputably a medical disorder. Classifying mental illness as medical disorders, under a medical model, allows for research and treatments that wouldn't exist if psychotherapy was part of a business model.

Social workers and psychologists often work/research in university psychiatry departments for that reason. It's promotes using scientific methods for research and treatment of mental illnesses. That's why you see so many non-psychiatrist therapists in the field teach and work in psychiatry at universities.

So I think in terms of healthcare vs. non-healthcare, moving away from the medical model will only hurt those with mental disorders.

My health insurance also subsidizes my gym membership and massage appointments. The trainers at the gym and the people at the spa refer to me as a "client." No one at a health club or spa would say they are working with "patients." Simy doing things that are good for our physical, emotional, and mental health does not mean we are "patients" who have disorders that need treating under a medical model. I run because it relieves stress, makes me feel better, and makes me healthier. Same with therapy. For my insurance, my T is not forced to make-up a diagnosis. Through my University insurance, anyone who wants to attend therapy can for a simple co-pay. I'm very glad that my insurance recognizes that we all can benefit from going to the gym, getting a massage, and doing some talk therapy-- and it is not limited only to those who have a specific illness.

I keep insurance out of it altogether. I don't think the medical model helps talk therapy. I don't think turning everything into a mental disorder (DSM style) is useful for a good many people who go to a therapist.

Yes, that's a good point...

But outside of the language 'client/patient", even if psychotherapy and gym can be used for both wellness AND medical disorders, for those who have mental disorders, psychotherapy as a medical treatment is analagous to physical therapy for medical disorders.

For those with illness that require specialized treatments, it's like gym/life coaches : physical therapy/psychotherapy.

I understand the client vs. patient issue, that is preference, but I dont' see any evidence of the benefits of demoting psychotherapy from a medical model to a business model for those with mental disorders. Maybe someone else will weigh in; i'm open to ideas.

ps you're lucky your insurance pays for massage. It's an evidence-based medical treatment but many insurance won't pay for it. I've had 3 different policies that refuse to pay for these treatments even though I have a medical condition that will benefit from the treatment.

Here is a jungian who explains her reasons against it

Treat the diagnosis or the person? | Jung At Heart

But you know that many people can't keep insurance out of it...

Sure, turning everything into a mental disorder isn't useful for everyone. Personally, I don't agree with the DSM as it is behavioral rather than psychodynamic; it's use is limited to billing to serve insurance companies, not treatment imo.

I've never heard of psychodynamic therapists using the DSM for diagnosis or treatment. They have a separate diagnostic manual that I find useful:

https://sites.google.com/a/icdl.com/pdm/

I guess my bottom line is that people with mental disorders, especially those with serious ones, would get shortchanged if not under the realm of medical treatment.

I'll read that article, thanks. My therapist would likely say the same, we don't discuss diagnosis. However, there does have to be some type of classification for research.

She had a more lengthy one on insurance but I can't find it right now. This one is more about diagnosis

I think there is a useful distinction between psychiatry and psychology/therapy. I think psychiatry works well under the medical model and allows people who have mental illnesses to seek treatment and obtain medications in that vein. I think talk therapy, however, works better independent of the medical model, and can serve both those who do and those who do not have mental illnesses. For those who need both services, they can work together and compliment one another. But having them separate allows the client to maintain a level of autonomy and choice over their care. And, for those of us who only need/want talk therapy and do not have a mental illness, it allows us to benefit from this service without forcing us to work within a model that is not helpful for us.

I experienced first-hand the drawbacks that can come with a medical model and the stigma associated with seeking therapy. My medical chart indicated that I see a therapist-- because it had not occurred to me to withhold that information. So, I went to a neurologist for physical symptoms I was having and I was quite concerned given that both of my biological parents have neurological diseases (MS and Parkinson's). The doctor told me that all of the symptoms were in my head (made up) and, when I disagreed, he wrote in my chart that I was a hypochondriac and non-compliant with mental health treatment. I actually had to have my GP and my therapist write addendums to my medical file indicating that I did not have a mental illness and that this doctor was severely off-base. I filed a complaint and found out that he had done the same thing to several other female patients, who had also filed complaints against him. I also fainted three days later and was rushed to the ER in the middle of the night-- guess what?! I actually did have a physical health problem and had to have immediate surgery at 2am. Had this guy taken me seriously, I would not have almost died.

I sorry to hear that story. I too have had things like this happen. There is still enough stigma and misunderstanding about mental health to have medical care denied or botched by people who should know better. That is a social issue about changing attitudes toward mental health, not necessarily something specific to medicine. I've had police do really similar things also because they had backwards ideas about mental health. The answer is not get rid of police though. It is education and changing attitudes.

People with mental illnesses need talk therapy because the medications only is not viable as an option. And almost all the psychiatrists I know do talk therapy. It was the norm for a long time that psychiatrists engaged in talk therapy sometimes intensive kinds such as psychoanalysis. This has changed recently in the US, but it is still the case in other countries. And as mian pointed out many therapists who are not doctors are associated with medical schools or universities with strong research programs because the the powerful connection between medically based research and therapeutic developments. Plus someone has to teach psychology to the psychiatrists who otherwise learn by getting plopped into a locked ward, which is hardly the best model of training.

For people who do not have a mental health issue and still see a therapist, you are fortunate but perhaps unusually so. I am not sure that generalizations can be based on the exceptions though you are entitled to have your own views. Just saying that lots of people aren't this fortunate and so their therapy is hardly like getting spa treatment. Some people need surgery and lots of physical therapy. Some people need chemo. Not everyone has the luxury of just going in for a tune up or growth or whatever other reason.

back to the original question....yes i do believe it is okay to ask personal questions...although you may or may not receive a direct answer...and be prepared for either outcome....just my thoughts

for me...i would prefer to not have too much personal disclosure from t....but that is just my approach to therapy...