How does therapy actually work, how do you find a good one, and what’s the difference between counseling/therapy/psychiatrists/psychologists/etc.?
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In my experience, therapists are often more of an informed 3rd party that you bounce ideas off of without fearing judgement. Something most people lack in their lives. Genuinely, I’d advise even healthy people to see one. You can think of it as your primary doctor is for physical stuff and your shrink is for mental stuff. Even if nothing is wrong you should check up with both occasionally.
Why do some people need regular therapy/counseling throughout life and some don’t? My sister and I grew up in the same household and are and have always been very close and similar, but she goes to counseling every week and has been for years. I have no desire or need for it and live a very happy fulfilled life. We have gone through many of the same good and bad life experiences yet the ways we cope with them are very different. Is there any psychology behind this?
Cognitive-behavioral therapies and most other therapies that are popular assume that you know what’s wrong with you (your ‘symptom’) and then they try to fix it.
Psychodynamic and psychoanalytic therapies assume that you don’t necessarily know what the problem is — that the problem is unconscious, and that there are reasons that you want the problem there. Understanding those reasons is the *real* problem.
I’m a big advocate of the latter, even though they’re “out of fashion” because people want quick fixes. Go find a local psychoanalytic institute, and be prepared to spend a lot of time. In exchange you will get to know yourself and change in a far deeper way than is likely with other therapies.
I once went to one in a bad neighborhood. She was more like a social worker, but I was depressed and that’s all I could afford. It was 25 dollars every visit. Basically, we sat and talked and she pointed things out to me that I wouldn’t have noticed on my own. I always felt a little better after talking to her.
Speaking as someone with generalized anxiety disorder, who has seen therapists, councellors, and psychologists, and whose work focuses on understanding interpersonal relationships and dynamics, my take is as follows:
Psychologists, therapists, and councellors have one job: to help you develop coping skills and to train you to modify the functioning and reinforced behaviours of your brain to help you achieve personal goals. E.g., managing and reducing anxiety.
Having someone who is a “good fit” for you is key. People find this hard to quantify, but it’s generally relates to what we can call “belonging cues”. Social behaviours that signal you to:
– feel safety
– share vulnerability
– align you to a purpose
These three elements together allow you to have faith in the person you’re looking for mentorship and support from, energizing you to act on their advice.
When these three factors don’t happen, you tend not to trust or feel comfortable with the professional.
On the different professions, think of it similar to a hospital:
– you have care workers, who support you through your daily life
– you have nurses, who provide you the medical support you need for your ailments
– you have doctor’s who diagnose complex problems and prescribe complex treatments to remedy them.
It’s the same for councellors, therapists, and psychologists. You need to decide whether your issue falls into basic support through your life, treating an ailment, or dealing with a complicated problem. E.g., stress vs mild depression vs major depressive disorder.
I’m pretty sure I was a narcissist in my early 20s when I started psychotherapy. The way I would describe my treatment is imagine having a closet where you’ve been putting all sorts of shit all your life. Some stuff is dirty, some is broken, some is rotten. But some is clean, some is valuable, some has sentimental value, etc. Now, this closet is big and deep and you can’t see everything in there from the outside. You remember some things but mostly you’ve forgotten about the things you can’t see.
Psychoanalysis for me was opening that closet and taking things out one at a time, and seeing what’s in there. Some ugly stuff you can’t throw away because it’s valuable, but now you know it’s there. Maybe something rotting could be cleaned so it doesn’t ruin what’s next to it. Maybe what you remember as something big, is actually quite small, and so on and so forth.. at the end you have an inventory of your closet (aka you as a person in case you didn’t get the metaphor) and learn to accept the good, the bad and the ugly. This way you can approach life knowing that some things trigger you, some things you don’t care much about, some things are to be cherished, and some things are not worth wasting your time on.
I’m no psychiatrist but this was my experience with 3 years of therapy, which honestly, saved my life. I’ll be eternally grateful to that psychiatrist
I’ve had psychologists and a psychiatrist.
Psychiatrists prescribe drugs.
Psychologists worth their salt work with you to put you on a healthy path in your life. Whatever is broken, they try to guide you. They give you advice. It’s your job to do the work to improve your life.
The sober you are open and honest the better. They are not there to judge you. Be honest though and they’re an amazing asset!
I developed OCD when I was a kid but didn’t get diagnosed until going to a string of expensive doctors much later on. I got recommended to see a counselor/therapist to do Cognitive Behavior Therapy. It’s been IMMENSELY helpful in my life.
Even without ocd though, therapy is great to teach you how to properly think through tough issues and handle particular problems. It’s your mind and emotions—everyone should go occasionally and it shouldn’t be viewed as any bigger deal than regular physical checkups.
Make sure you find a good one. i left my first psychiatrist and never went back because she kept challenging me when I would express things and say “this is how I feel” she would constantly say no you dont. She also got upset at me because I didnt listen to her enough about what she thought my problem was, going so far as to ask “why are you even here?”.
She was rude and demoralizing, ive had severe trauma and PTSD from military experience and a violent and abusive upbringing. Make sure you feel comfortable saying how you feel and just remember, because they’re “the authority” doesn’t mean they’re good. if you dont feel like things are going in a good direction, you have the right to find another.
A psychologist has more assessment-based training. They specialize in providing assessments and interpreting assessments. While counselors specialize in the therapeutic process and specific interventions. Counselors can do assessments just like psychologists can do therapy, it’s just that each profession specializes in one aspect of the field more than the other.
Both can assign diagnoses, but psychologists typically are sought out for this due to the in depth testing they can provide.
Psychiatrist is a medical doctor who specializes in mental health. They are the only mental health professionals who can prescribe medication so they are highly sought after, expensive, and often the demand from patients far exceeds the supply of doctors. Counselors and psychologists can oversee the impact of medication and make recommendations, but only a doctor can prescribe.
The terms counseling and therapy are typically used interchangeably nowadays. In some cases, therapy is thought of as more formal or for more severe psychological issues.
When seeking counseling, a good place to start is looking at your health insurance and what they cover. Then, look for a counseling center that takes your insurance. If they have a website, they may have a list of professionals that note what they specialize in (I.e age groups, topics, type of therapy).
The key is to find a therapist/counselor that is a good fit for you. If you aren’t comfortable with them, it will be difficult to make progress. Ask them questions just like you would a doctor or any other person you are choosing to be on your “team.” Ask them how this works, how they like to do sessions, how they’d help you reach only our goal, etc. The first step is just trying it out and seeing how you feel. You don’t have to discuss anything that makes you uncomfortable and you can go at your own pace. You can stop and start at anytime.
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