Discussion The Ideal Therapy Session

[Forever Sleep]

I have to be honest and say that I've only ever had a few sessions with a therapist at uni. They were actually pretty insightful. I never discussed suicide with them though.

Really- I'm going off of a lot of the experiences I have heard here. There has been the occasional description of a therapist who has been refreshingly open about suicide- even acknowledging that the person may end up doing it. Still- the majority of posts seem to suggest they are either totally unwilling to discuss the subject. Or- the person is just too afraid to tell them- in case they are involuntarily commited.

I'm curious as to what people think. @TAW122 has made an excellent post as to WHY they are likely reluctant. (Fear of liability if the person does CTB.) Still- is this likely for one? Do you suppose being able to talk about these feelings would somehow validate them and make you more likely to act on them? What do you think would actually be helpful from a therapist? If they let you be utterly honest about how you felt? Should they then even endorse that feeling? 'I can see why that would upset you to that degree' type thing. It's not like they are likely to agree that CTB is our best option but surely- it would help to actually be able to be honest with them?

As a tangent, I get the impression it is far easier to end up being sectioned in the USA than in the UK and other parts of the world. Do you think this is the case? I wonder if it is the liability thing (suing culture) that influences this.

I'm just curious as to people's experiences. I know there are people here who have had extensive therapy. Some who have found nothing works. Do you think it is because some of us are treatment resistant or, do you suppose the practices just aren't good or perhaps not open enough to help?

 

[TAW122]

It's hard to answer as it is different for each patient as well as each therapist. I too, have never discussed about suicide with them, again, for fear of the situation spiraling out of control. I would say yes, a good of patients who fear involuntary hospitalization and forced detainment will not speak about the topic or even suggest anything that could raise red flags as of risk of harm to themselves or others. As for whether they will be more likely to CTB, I don't know, but I would think it would be neither because if someone wants to CTB, they will do so, regardless of whether they talk about it (perhaps I'm just speaking for myself or a few others but not everyone). Also those who don't talk about it may just bottle up more until they CTB (once they hit that breaking point or have a catalyst(s) be the final push towards action).

What I think will be helpful from a therapist is acting as a outlet (similar to how SaSu is run) and being able to "truly" open up without risk of involuntary commitment, forced detention and medical decisions made for the person. I think the current mental health system needs a serious overhaul. Just this one change, being able to express your "real, true" opinion without the risk and threat of detainment, and other consequences would be a game-changer for sure. While not all therapists or mental health professionals may not agree or share the same sentiments about CTB, it would at the minimum allow a patient an safe space and outlet to vent. Perhaps that may even allow some passively suicidal people to hold off CTB'ing knowing they have an outlet and not being threatened with punitive action just by speaking their true opinion.

In the US, I suppose it depends on the state, like CA and FL (notorious for the Baker Act), it would be almost too easy to get locked up (despite having done nothing illegal nor broken any laws) for simply meeting the criteria for being a danger/risk to oneself or others. I can't speak for the UK or other places (and answers may vary depending on who you ask), but I suppose they may have a different criteria and threshold for determining risk and what warrants detainment. As for the US, yes definitely, the litigious culture has a big influence on healthcare policy as well as many other areas and industries.

For the last question, I cannot answer that, but I do know that there are people with treatment resistant depression and/or other conditions that are permanent and cannot be cured. Additionally, even if there is a "cure" (for the sake of discussion) it does not necessarily mean that one wishes to go that route because of the cost and benefits from doing so.

 

[Dead Ghost]

I'm just curious as to people's experiences. I know there are people here who have had extensive therapy. Some who have found nothing works. Do you think it is because some of us are treatment resistant or, do you suppose the practices just aren't good or perhaps not open enough to help?

The problem with psychologists in Spain is that there is an important part of the group of psychologists who have no vocation whatsoever. They studied psychology for whatever reason... maybe they thought it was an easy way to obtain a university degree, I don't know. Then there is another part that has simply suffered and believes that it is a good way to help other people (although again many have no vocation whatsoever and just get in your way or prevent you from recovering).

The worst psychologist is the one who believes that by simply talking about your problems with him he has already helped you and then everything depends only on you... and so they make ends meet, taking advantage of the miseries of others.

There are many ways of leaving you aside or not wanting to help someone. There are those who simply look the other way and there are those who tell you that we all have problems... many psychologists have the polite way of sending you to hell or telling you to make do with the following phrase: "everyone has their own backpack".

Most of them can't help you, and that's because they don't understand anything about the suffering of others, they don't have any adequate human training, or their experience with life is bland or without adequate courage to help others.

Many years ago, but many years ago, psychiatrists were doing therapy and not just prescribing drugs to get out of the way. Today's psychiatrists seem to be afraid to get involved with patients and do nothing but delegate their work to psychologists.
Between psychologists and psychiatrists they have made their own the phrase that the main difference between them is that "some prescribe medicine and others do therapy".

Psychologists are not trained in medicine, psychiatrists are, and their obligation is to treat the patient in a manner appropriate to his or her abilities, not to refuse to treat him or her because they are afraid.

An "old school" psychiatrist once told me that he had had patients come to him diagnosed with anxiety or depression when they had nothing of the sort. He told me of a patient who only had hyperthyroidism and could tell with a simple blood test after suspicion by doing therapy himself.

Psychologists are not doctors, they have no training whatsoever to know what is wrong with the person sitting in front of them and they show it too many times. I suppose pride blinds them to the delusion that a person's suffering has more to do with a poor personal perception of self than with a simple undiagnosed physical health problem.

There are good psychologists and psychiatrists, but when you are sick you gamble your life trying to find them among all those who contribute nothing to the health system and only to their pockets.



... gee, I've become too aggressive and heartbreaking... I'll give it some thought.

//

El problema dels psicòlegs a Espanya es que hi ha una part important del conjunt d'ells que no te cap tipus de vocació. Van estudiar psicología ves a saber per qué.. potser van pensar que resultava un mitjà fàcil d'obtenir un títol universitari, no ho se. Després hi ha un altra part que simplement ha patit i creu que es una bona manera d'ajudar a d'altres persones (tot i que altre vegada molts no tenen cap tipus de vocació i només fan que destorbar-te o impedir-te recuperar-te).

El pitjor psicòleg és aquell que creu que simplement parlant dels teus problems amb ell ja t'ha ajudat i llavors ja tot només depén de tú... i així arriben a final de mes, aprofitant-se de les miséries dels altres.

Hi han moltes maneres de deixar-te de banda o no volguer ajudar algú. Hi ha qui simplement mira cap un altre costat i hi ha qui et diu que tots tenim problemes.. molts psicòlegs tenen la manera educada d'engegar-te o de dir-te que t'apanyis amb la següent frase: "cadascú te la seva motxilla".

La majoría no et poden ajudar, i es així perquè no comprenen rés del patiment aliè, no tenen cap formació humana adient o la seva experiència amb la vida és insulsa o sense el valor adequat per ajudar els altres.

Fa molt anys, però molts, els psiquiatres feien teràpia i no es dedicaben només a preescriure medicaments per sortir del pas. Als psiquiatres actuals sembla que els hi ha fa por implicar-se amb els pacients i no fan mes que delegar la seva feina als psicòlegs.
Entre els psicòlegs i els psiquiàtres han fet seva la frase de que la principal diferència entre ells es que "uns recepten medicines i d'altres fan teràpia".

Els psicòlegs no tenen pas formació en medicina, els psiquiàtres si i la seva obligació és tractar el pacient de manera adequada a les seves capacitats, no negar-se a atendre'l perquè tenen por.

Un psiquaitre de la "vella escola" em va dir una vegada que li havien arribat pacients diagnosticats d'ansietat o depressió quan no tenien rés d'això. Em va parlar d'una pacient que l'únic que tenía era hipertiroidisme i es podía saber amb un simple anàlisi de sang després de les sospites al fer-li teràpia ell mateix.

Els psicòlegs no són metges, no tenen cap tipus de formació per saber que li passa a la persona que se'ls asseu al davant i ho demostren masses vegades. Suposo que l'orgull els cega als creu-re's ells mateixos l'engany de que el patiment d'una persona té més a veure amb una mala percepció personal de si mateix que amb un simple problema de salut física no diagnosticat.

Hi ha bons psicòlegs i psiquiatres, però quan estàs malalt te la jugues intentant trobar-los entre tots els que no aporten res al sistema de salut i si a les seves butxaques.



... coi, m'he tornat massa agressiu i punyent... faré un pensament.

 

[Rainy_days]

Do you suppose being able to talk about these feelings would somehow validate them and make you more likely to act on them? What do you think would actually be helpful from a therapist? If they let you be utterly honest about how you felt? Should they then even endorse that feeling? 'I can see why that would upset you to that degree' type thing. It's not like they are likely to agree that CTB is our best option but surely- it would help to actually be able to be honest with them?

In the hands of a skilled and compassionate therapist I think being able to talk freely would make people less likely to act on suicidal impulse. I know I could use a sympathetic listener who understands, or at least tries to without judgement, when I am in those dark moments. The threat of sanctioning makes this very hard and introduces an element of fear and intimidation that just makes things worse. But again it would highly depend on the character of the therapist - not all of them are capable of compassion and tact on this subject.

I'm just curious as to people's experiences. I know there are people here who have had extensive therapy. Some who have found nothing works. Do you think it is because some of us are treatment resistant or, do you suppose the practices just aren't good or perhaps not open enough to help?

I'm lucky to have found a couple good ones amongst many bad experiences. Of course I can't be fully honest but we're both smart enough to know the drill and manage to at least speak around the subject without crossing the line where they're obligated to commit me.