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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by fallsfall on November 2, 2004, at 20:11:09
Hi Sunny10,
There are some therapists who do more than one kind of therapy - they usually call themselves "Eclectic". If you happen to be working with such a therapist, then they can switch from one type of therapy to another (or combine them).
Here is a link to a site that describes the differences between the types of therapy: http://www.grohol.com/therapy.htm. (I'm not sure this is the best site for this - anyone else have a suggestion?)
I did 8 1/2 years of CBT. It was valuable and important. But it wasn't enough. I knew that I needed to go "deeper", but that wasn't the kind of therapy that my therapist did. I switched to a Psychodynamic therapist. This therapy is very different, and I think that it has allowed me to makes some important progress.
Different people need different kinds of therapy, and an individual may need different kinds of therapy at different stages in their life (and/or recovery).
If you call a potential therapist, they should be able (and willing) to tell you what kind of therapy they do. You should also be able to describe what you are looking for (more inner child stuff, less changing thoughts stuff), and they should be able to tell you if they will be able to give you what you are looking for.
Good luck!
Posted by Miss Honeychurch on November 3, 2004, at 8:28:46
In reply to CBT vs. Psychodynamic Therapy (Sunny10), posted by fallsfall on November 2, 2004, at 20:11:09
I've been in therapy for over a year now with a therapist who concentrates on CBT and psychodynamic with me. It has been the PERFECT combination. I highly recommend it!
Posted by sunny10 on November 3, 2004, at 8:59:53
In reply to CBT vs. Psychodynamic Therapy (Sunny10), posted by fallsfall on November 2, 2004, at 20:11:09
Actually, I went to online searching yesterday after reading your earlier post.
So far, it seems like the CBT and the psychodynamic both expect the patient to talk through what's bothering them, and deals with how we react to day to day current life situations based on our perception of our upbringing.
I know what my childhood was like, I know that resent everyone, including myself, on a day to day basis, just for having lived through that childhood. I know that "my inner child has not grown up"- my adult self has grown up and I LOGICALLY can see these things, but I understand how this world works, what is "expected" of humans in the 2000's (and what I can expect from them) and I hate it all.
I don't understand why the doctors "had" to save me all three times- I also don't understand why, when I was 36 last March and overdosed (I tried to take a lot of stuff to sleep,-I was sleep deprived and wound up od'ing in my desperation to sleep), so I went to the ER because I didn't want a bad liver on top of hating life already). The doctor on call in the emergency room looked at me, looked at the nurse and asked how old I was. She said "36" from my chart, and to me he said, "ok, let's check your heart rate and temperature and get you out of here". Apparently if I had just slit my wrists that time, I wouldn't have even BEEN sewn up just 'cause I was 36! Even the hospital staff knew my life wasn't worth saving at this point. (Although, frankly, when I was 28 and had slit my wrists, the nurse asked the on-call doc if she should call the plastic surgeon and he told he I should have to live with the scars to remind myself how stupid I am)
All I ever wanted out of life was to love and be loved (not necessarily romanticly). To me, there is no other reason to live. But, by the nature of my upbringing, I usually cause friction in my relationships by being convinced that the other person (lover, friend, whatever)is going to abandon me physically or emotionally. So there is no love, only unhappiness.
What is the "right" type of therapist to convince me that life is worth living? I've tried to not watch the news, I try to bury my head from the knowledge of what humans do to each other on a daily basis, but I am still aware and frightened by it all (mostly that I have to be in a world like this- not scared of someone knifing me, that could be a type of favor to me!)
Meanwhile, I have a 13 yr old son who is ADHD co-morbid with depression. I have HIM in therapy, 'cause I certainly can't help him be happy- I haven't figured out how yet, myself. I spend a lot of personal energy just putting on an "everything is hunky-dory" act. If I did kill myself, he is now old enough to remember me and miss me and be even worse off than he is now. I feel guilty for not knowing about my clinical depression before I got pregnant. I unknowingly condemned him to this horrid world.
What type of T can help with that?
By the way, I am not currently "depressed"- this is me at my most logical/rational.... Not pretty, hunh??
Sorry,
sunny10
Posted by Bent on November 3, 2004, at 11:15:27
In reply to Re: CBT vs. PDT(will probably trigger, sorry) » fallsfall, posted by sunny10 on November 3, 2004, at 8:59:53
I am sorry you are hurting. Please dont apologize. Your post was very powerful. I am thinking of you.
Posted by sunny10 on November 3, 2004, at 11:56:19
In reply to Re: CBT vs. PDT(will probably trigger, sorry) » sunny10, posted by Bent on November 3, 2004, at 11:15:27
thanks, Bent, it makes me feel a little better that there are SOME kind humans in this world.
-sunny10
Posted by sunny10 on November 3, 2004, at 11:58:42
In reply to Re: CBT vs. Psychodynamic Therapy (Sunny10), posted by Miss Honeychurch on November 3, 2004, at 8:28:46
Sorry I didn't acknowledge your post. Just because I'm skeptical that it would work doesn't mean I don't appreciate you trying to help, too.
Forget about my post and have a nice day,
-sunny10
Posted by Miss Honeychurch on November 3, 2004, at 12:53:59
In reply to Re: CBT vs. Psychodynamic Therapy (Sunny10) » Miss Honeychurch, posted by sunny10 on November 3, 2004, at 11:58:42
Sunny, no need to apologize. I didn't find your post dismissive at all, simply honest.
I tried therapy two times before I found what was right for me. The first guy wanted to put me on drugs right away and the second therapist wanted to be my best buddy. Luckily, and I mean luckily, I found my current T from a reference from my insurance company and I only picked him because he was the only T out of 10 who even bothered to call me back.
I suffered emotional neglect as a child, some sexual abuse, as well as a sexual assault in college. I don't think just doing CBT would help me deal with all of those things. ON the other hand, I don't think pure, psychodynamic therapy would have helped me to better deal with my anxiety and depression. Both are a complement to eachother to deal with different parts. The psychodynamic part of therapy is cathartic and insightful, and the CBt aspect helps me DEAL with things I was never taught how to properly deal with as a child.
So, there is hope. The problem does not lie in whether therapy will actually help you. I believe the problem lies in finding the right therapist.
Posted by littleone on November 3, 2004, at 15:04:12
In reply to CBT vs. Psychodynamic Therapy (Sunny10), posted by fallsfall on November 2, 2004, at 20:11:09
I have a few things to say to this, and I think I have to tell them the long way around, so if this is long winded, I apologise in advance.
The first T I saw was CBT orientated. He used to say things to me, and to steal a line from The Castle, all I used to think was "get your hand off it". However, in saying that, I have a real *sense* about people. I instantly know if they are a good person or a bad person. My radar immediately picked up bad person blips from him and I later found out he wasn't the most ethical of T's. So I think it's pretty safe to assume that the therapy failed because of our dynamics rather than because it was CBT.
To be honest, I really believe CBT can be very helpful to people who are kind of generally okay, but might just be having some troubles in some areas, eg either they just need someone to talk to, or if they have faulty thinking patterns. Or alternatively, if they are just interested in getting better enough to be functional again in the shortterm.
If however, you have more widespread problems with dealing with life, eg faulty thinking patterns, difficulties with setting boundaries, difficulties dealing with a wide range of people, etc, I would tend to think that this would indicate a more deep seated developmental problem. CBT can certainly help with the symptoms that arise, but I don't really think it adequately assists with the root problem.
** Slight trigger here **
For example, I'm currently a cutter. I find that if I really put my mind to it, I can stop the cutting for long periods of time. However, during those periods, I tend to do other things instead, like picking a lot or pulling out my eyebrows or whatever. I find that CBT helps with stopping each bad practice, but it really isn't addressing the underlying problem of me not being able to adequately face and deal with bad feelings.
** End of trigger **
After I dumped that T, I saw a psychodynamic T. I have no idea what orientation he took because he would never answer my questions. Kind of the old "and why do you ask" scenario. I can understand why they do this, but I believe it is really wrong that they don't provide you with basic information you are entitled to as a consumer purchasing a service. He was a real blank slate type and I found this so upsetting and offputting. Anyway, I think that whatever orientation he did take, he was very set and limited in his methods.
When this therapy wasn't working either, my GP referred me to my current T. He is a behaviouralist and the GP's logic was that I didn't need to learn that I had p**is envy or whatever, I just needed to learn better ways to cope with the world. I needed to learn new behaviours (which, by the way, is pretty much going back to CBT).
So we started off with Behavioural therapy, then when that wasn't sufficient, he switched to something else (sorry, but I've now forgotten what it was). I personally wasn't really open to that particular method/style and so then he switched to Interpersonal.
I really believe that what has made him a good T is the fact that he is so flexible in the approaches he takes. Some T's tend to find the method that *they* are most comfortable with, not necessarily customising their approach to their individual clients. As Yalom says, you need to invent a new therapy for every client (BTW, don't you just love his work! Although, it often makes me wish HE was my T. :(
I find all the different orientations so facinating, Freud vs Jung vs Horney vs Rogers vs etc. However, I believe they are basically just saying the same sort of thing, but going about it in different ways.
sunny10, it sounds like you have problems that are more deeprooted and probably won't be adequately dealt with by CBT alone. Your best bet is probably not to find a T who concentrates in a particular area, but one who is flexible enough to adopt whatever style and techniques he sees work best for you.
Posted by fallsfall on November 3, 2004, at 20:08:05
In reply to Re: CBT vs. PDT(will probably trigger, sorry) » fallsfall, posted by sunny10 on November 3, 2004, at 8:59:53
Sunny,
You have a difficult life. I wish I could snap my fingers and make it "all better", but I can't. I do, truly, believe that therapy can help you, though. The challenge is to find the right therapist.
There are some people who could be helped by just about any therapist. Their issues are such that many different approaches might work for them. I am not such a person, and it sounds like you aren't either.
Those of us who are "challenging" need to shop more carefully for a therapist - if it is at all possible, try to find someone who has 15 years experience (or at least 10). Therapists really do learn a lot from their patients - I (and you?) need a therapist who has already done a lot of learning and made a lot of their mistakes already.
I have mixed emotions about eclectic therapists (those are the ones who do a lot of different kinds of therapy - depending on what they think will help an individual client). On one hand, this would allow your therapist to change the approach as needed - either to find something that will help, or as your needs change. On the other hand, I worry that perhaps their expertise in any one type of therapy might be diluted by the fact that they haven't been focusing on that one type of therapy. I think that the decision to go with an eclectic vs. single-type therapist might well be influenced by how much you know (right now) about what you need.
I started with CBT. Nobody thought I was going to be a tough case. This was a logical place to start. My therapist was very competent, and I learned important things from her (like how to stay alive when I was suicidal, and how to be open and honest in therapy, and what emotions were). I did some DBT, as well (because I was diagnosed with Borderline Personality Disorder), and that helped add to my chest of skills. This therapist has just recently started branching into Interpersonal Therapy, but she is really quite focused on CBT.
I read a lot of Psychology books (from the University library in my town), so I have quite a bit of exposure to the different kinds of therapy. I like to read case studies, and see how the different kinds of therapists interact with their patients. When I would read Psychodyanmic case studies (or Psychoanalytic case studies, which in my mind are similar to Psychodynamic - except Psychodynamic therapy tends to be a little more focused on particular current issues, but it does go back into the childhood causes for feelings and behaviors - ??) I would feel comforted. Somehow I knew that was what I needed. I wasn't really aware just how much transference was going on with my CBT therapist (and I don't think she was aware of it either). As I interviewed different kinds of therapists (I was looking at therapies that weren't CBT), the transference factor became clearer. My understanding is that a CBT therapist would be more likely to discourage transference, and talking about and working through transference, whereas a Psychodynamic therapist would be interested in working with the transference.
I don't know what would have happened if I started with this Psychodynamic therapist instead of the CBT one. I really feel like I needed the skills that I learned from her to be able to deal with the issues that we are dealing with now.
This is a long-winded response that basically says that everyone is different. And that is one reason there are different kinds of therapists and different kinds of therapy. Psychodynamic might not be a good kind of therapy for you - it is good for me, but that doesn't mean that it will be good for you.
If you can have an honest discussion with your CBT therapist (do you have a current one? my memory is terrible...) about different types of therapy, s/he might be able to help direct you towards a type of therapy that can be most helpful to you. In most cases, a therapist will help you find a different therapist if their orientation isn't helping you. Alternatively, if you can find a very experienced eclectic therapist, you might be able to do a consultation with them and have them point you in the right direction (or you might decide to see them!).
Some people can pick a therapist (or a hair dresser, or a doctor, or a plumber) out of the yellow pages and get what they need. But for some of us finding the right professional can make all the difference.
It is really worth it to find the right therapist. I wish I had changed sooner than I did.
Posted by sunny10 on November 4, 2004, at 12:40:10
In reply to Re: CBT vs. PDT(will probably trigger, sorry) » sunny10, posted by fallsfall on November 3, 2004, at 20:08:05
I really appreciate the feedback from you all. (A very long post here, sorry)
The biggest problem is that I don't KNOW what I need. I am what has been called a "long-cycle major depressive"- although one pdoc in the past wound up prescribing a Depakote and Desipramine combo, which my current T thinks would indicate that he thought I was bipolar. I'm not sure, tho, because I do know that we went through a lot of different meds that I simply couldn't "operate" with. The D& D combo was sort of a last resort kind of thing.
My body cannot handle too much med interference, though, I've been known to develop some side effects they never even heard of (? marketing excuses, maybe?). But I don't last on the meds for long. No, this isn't in my head. I had my tonsils removed when I was 3 1/2 yrs old because I couldn't tolerate the antibiotics.
And I don't NEED them on a day to day basis. Yes, I had a bad childhood, boohoo, and yes, life in 2004 is quite stressful. None of that is "in my head"- I don't make it up, I don't hallucinate, et cetera. What the pdoc has diagnosed is a "long cycle" in which my nuerotransmitters don't QUITE work up to speed, but they slowly lose effectiveness either shooting or uptaking the neurons. I am usually fine for about five years. By the start of the sixth year, I am hypomanic- making poorly thought out choices, et cetera. Which are in every way self-destructive.
I wind up messing myself up so badly that I literally have to start my life all over. New clothes, new job, et cetera. The last time, in that sixth year, I quit my job, dumped my boyfriend; throwing out every article of clothing this man saw me in (my contact lenses, everything)et cetera. Then the depression started when I realized what I've done- had no clothes, no job, no boyfriend, nothing except my 13 yr old son to support (and then me, with no job)... that time I got lucky. A friend of mine stopped by, took one look at me and sent me off to the T. The T stuck me into a day treatment center and the drug treatment starts again.But when I'm good for 5 yrs, chemically, I don't want to hurt my body with meds that I don't absolutely need. I am going to stay off of them for four years, then start up the lowest dose there is to "maintain" for a year until I can go off them again.
So, if I were to tell my T that being told to "practice thinking/reacting differently" method wasn't working (and where's the lesson book exactly- do I pull it out of my butt??), and that I hate this world/time we live in, she'll have the pdoc stick me right back on meds! A poor attitude which has been ingrained since childhood is NOT a chemical issue.
But you guys keep telling me that this life is worth wanting. I want to believe it, I just can't. Would a pyschoanalyst be able to "figure me out" so he can figure out HOW my psyche can be treated, not my chemicals??
thanks,
sunny10
Posted by fallsfall on November 4, 2004, at 13:02:31
In reply to Re: CBT vs. PDT(trigger, sorry)- Everyone, posted by sunny10 on November 4, 2004, at 12:40:10
The short answer is "Yes".
(also, you always have the option of refusing medication - which might make sense for you in years 1 - 4)
Ask your therapist to tell you what other kinds of therapy might be helpful for you.
Let us know how it goes.
Posted by sunny10 on November 4, 2004, at 13:06:12
In reply to Re: CBT vs. PDT(trigger, sorry)- Everyone » sunny10, posted by fallsfall on November 4, 2004, at 13:02:31
Posted by sunny10 on November 5, 2004, at 12:05:35
In reply to Re: CBT vs. Psychodynamic Therapy (Sunny10), posted by littleone on November 3, 2004, at 15:04:12
sorry, littleone, I've been off on another tangent...
I guess my question is what is the type of therapy that I NEED called?
Would that be psychoanalysis, then?
thanks,
sunny10
Posted by fallsfall on November 5, 2004, at 20:32:05
In reply to Re: CBT vs. Psychodynamic Therapy (Sunny10) » littleone, posted by sunny10 on November 5, 2004, at 12:05:35
Psychoanalysis is not all that common these days. It usually requires very frequent sessions (someone please correct me if I"m wrong!!), and so insurance isn't too crazy about it. There are some on this board who are in analysis, and they like it a lot.
Check into Psychodynamic, Humanistic, Interpersonal, Relational (?), Family Systems. It is hard to know what type would be most helpful for you without knowing you better.
There is also another thread below about finding a therapist, there may be information there that would be helpful to you, too.
Posted by fallsfall on November 7, 2004, at 10:20:49
In reply to Re: CBT vs. Psychodynamic Therapy (Sunny10) » littleone, posted by sunny10 on November 5, 2004, at 12:05:35
This is a good short description of the types of therapy:
This is the end of the thread.
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