Posted by barbaracat on September 1, 2005, at 11:49:40
In reply to Re: Holding on - need counselor, posted by Velodog2 on September 1, 2005, at 7:43:54
Yes, I hear you on the Prozac and agree totally on the need to avoid panic and stress, so good for you that you're taking the Xanax as needed. That's the situation with me too. If I can manage to keep stress from getting out of control and thoughts of looming doom, I can manage just about anything. Important to regulate your breathing too cause an imbalance of oxygen and CO2 in blood pH caused by disorganized breathing can easily trigger a panic attack
As far as how to avoid the frogs, well, you pretty much know after the first or second session if they're going to help or not. It's a little more obvious with psychiatrists, in my opionion, because so many pdocs today are medication managers and have no interest or skill in getting into the emotional trenches with someone. They just don't respond to your pain and maintain a professional aloofness that makes you feel like sh*t when you're in need of human kindness. This is not true of all pdocs, of course, but I've met far too many who come off as sociopaths.
With psychologists, there are the various schools with their various methods, but when all is said and done, the healing takes place in the level of compassion offered and the ability to help you access your own inner knowing. Someone who doesn't have any obvious agendas (against a lifestyle choice or promoting fundamentalism of any kind or obvious pathologies). There's got to be a click, you have to feel safe and also in the presence of someone who has wisdom and experience and knows how to listen, but also has the forthrightness to call you on your crap.
The best therapist I ever had in my long career with this stuff was a Jungian analyst who I saw for 3 years. That was back when insurance wasn't so cheapskate. We explored some very deep and dark places because I was ready to go there to understand how my hellacious chilhood was ruining my here and now. But she was also very practical and could offer direction in mundane things. A wise and skilled guide whom I trusted with my life. A mutual love and respect was a potential at the start and blossomed with time. The most valuable thing I learned with her was to not be afraid of the scary places inside me and to honor my feelings as being there for a good reason. I had a tendency before seeing her to beat myself up badly because I was feeling bad - talk about a vicious circle.
I've had a few really awful ones and one that comes to mind was a guy that wasn't too long out of school, was kind of tweaky and twitchy, and kept wanting to steer the session to 'well, now it's time to talk about your inevitable sexual projections onto me'. He should be so lucky!
Another was a born-again Christian who insisted my depression was a product of demonic possession. He even arranged an exorcism for me. He had me so friggin' terrified and seeing demons everywhere I came out of it a wreck. In other words, he had a major agenda but I had no idea before hand. Didn't expect someone like him to be associated with a major university hospital.
Another had an anger problem, took my issues personally and would do things like kick his desk when I didn't do my 'homework' cause I was too damn depressed. Another pdoc told me he should have been a vet because he hated people. Got outta there quickly.
You have to realize that most folks who go into this career do so because they have their own wounds they're trying to work through, and some are healthier than others.
Sometimes these things aren't immediately obvious so your first and second sessions should include you probing them mercilessly, cause they usually will avoid answering real personal questions after that.
Within your lifestyle community (jeez how lame, but you know what I mean), there must be organizations and advocacy groups that are hooked up with therapists. By all means, find someone who has no agenda whatsoever here because it will influence the relationship.
When I said spiritual orientation, don't get me wrong, I am not religious. Far, far, far from it. What I meant was that in my own case, my interests and questions usually veer into the existential realms and so I appreciate someone who also has a leaning that way. I don't do well with purely behavioristic methods but appreciate someone who can at least grok that there is more that goes on here than meets the narrow visual spectrum of the senses. I also appreciate a psychotherapist that has a good grasp of what's going on at the neurochemical level too.
Keep me informed. Considering you're maintaining so well while coming off an SSRI says quite alot about your strength and determination. You'll do fine. And your partner? I can't presume to know the story, but anyone who writes a note and splits has got a few choice issues to bring to therapy himself. - Barbara
> Well I'm hoping that the crisis/panic phase is behind me. I feel relatively in control, and to me that's the most important thing to warding off depression. If I prove incapable of making decisions that need to be made to move my life forward, I will be in danger. That is the reason I would like a counselor/therapist. I guess I was hoping for advice on avoiding the frogs, but other than a recommendation for someone specific, I suppose there is no option but trial and error as you said.
>
> So no, I'm not back on Prozac. I feel like I have come so far, I hate to give it up now. And although I know the withdrawal wasn't the only or even primary reason the relationship failed, I feel like it contributed at least to the timing, and thus it feels like I have paid a very steep price for this independence. And although I may be wrong, I still don't believe I feel significantly depressed. I do have alprazolam that I have begun to use sparingly which has helped.
>
> I'm not even sure my primary therapy need is for depression. Again, I just want help making rational sense of my life, sorting out the emotional responses from the real needs. But I feel that if I could get better at doing that, I could avoid some depression problems in the future. Again I recognize I could be wrong. But it looks like the goal-oriented therapy would be fine. Definitely want nothing to do with 'spiritual' or religious associations. I look at religion as just another form of addiction, and given my particular 'lifestyle' (ugh, hate that word) one that seems fueled too much by hatred and judgement.
>
> I'm off to the yellow pages.
>
> Thanks again for your help Barbaracat. Your posts are perhaps more beneficial than you know.
> Mike
> > Hi Mike,
> > What a difficult time this is for you, but not unexpected. Breaking up is miserable, scary, you think the world is coming to an end and in a way, the one you knew is. You will heal, but right now you need a life raft.
> >
> > You didn't say whether you restarted the Prozac. I know you wanted to see how things really were without the drug, but this may not be the time to muscle through when you need all the help available. Life gets weird enough in the best of circumstances when a person is rebalancing chemically. If you're hyperventilating, sure sign of major stress and important to get that under control. A mild tranquillizer could go a long way to keep things from spinning into panic. Ugh. Hate panic.
> >
> > So, there are plenty of kinds of counselling therapists, basically and simplistically divided into two camps, psychoanalytic/depth where past issues are examined, family of origin dynamics explored. You'll find Freudian psychoanalysis, Jungian depth therapy, Gestalt in here and the time frame is usually long and ongoing.
> >
> > The other is a present day goal oriented focus, the primary example being Cognitive Behavioral Therapy where you recognize and label thoughts and behaviors that contribute to depressive feelings. The timeframe is usually 10 sessions. Sometimes you'll find therapists who combine aspects of both.
> >
> > There are also spiritually oriented therapists that put more of an emphasis on integrating what's going on from a transpersonal basis.
> >
> > Insurance companies generally aren't going to pick up the tab for long-term therapy so the kind you're going to most likely encounter from a main-stream medical standpoint will be the Cognitive, or CBT, or derivations of it (Dialectical Behavioral is another good one). This kind would be more likely to focus primarily on what's going on in your life now and what you're going to do about it and so would probably be the one to go for. You need quick tools to call on to get you through the day and CBT types of therapy provide that.
> >
> > Even if very relevant to your present situation, depth therapy can be intense and you don't need to dive into your past and stir additional stuff up on top of present day issues. Later on when you're out of crisis and ready to deal with your deep unconsious, depth therapy can't be beat. Ideally, you can find someone who is skilled in both goal oriented and depth therapy and can apply whichever focus is needed for a particular session.
> >
> > There's also group therapy which can be extremely helpful down the line, but probably not when you're in the midst of a meltdown. Being in a group where you know you're not alone in your feelings is a great comfort. Kinda like this board, but right now you need more.
> >
> > Also subspecialties, such as Eye Movement Desensitization Repatterning, or EMDR, hypnosis, breathwork, bodywork. But these are generally tools used within the framework of the 2 main categories. It's good to know, however, if a therapist has these additional tools in their bag of tricks.
> >
> > How you find someone is to look in the yellow pages under Psychotherapists. There will sometimes be a referral service. Sometimes you get a hit on someone and call them and see what they offer and how they feel to you. There will also be clinics listed (sometimes under a separate yellow pages section) with a number of therapists. There's usually an intake person who gets a brief history from you on the phone and suggests a good fit. As you've seen, not all turn out to be good fits.
> >
> > You can also call the main office of a hospital, explain that you're looking for a therapist and you'll be connected with some department that can offer suggestions.
> >
> > If you're inclined towards the transpersonal approach or even a religious affiliation, call a church or organization and ask for suggestions. Sometimes the person won't be a clinical psychologist per se but will be trained anyway. I gravitate towards New Thought and Buddhist philosophy and have found some wonderful therapists who gear their work within that context instead of a purely secular one. I've found them by calling Unity churches, Buddhist meditation halls, going to metaphysical bookstores and looking on the bulletin boards or publications. Sometimes these bookstores just provide a haven to hang out in, whether you're spiritually inclined or not.
> >
> > You can also call the psychology department of colleges, briefly say what you're looking for to the receptionist who will most likely put you in contact with someone to get a referral from.
> >
> > In other words, there's no sure way to find a DECENT therapist but there are plenty of ways to be directed to those whom other's think are good. Sometimes you have to kiss a bunch of frogs. But you usually know pretty quickly which ones are frogs or at least not quite right for you. Kind of like looking for a roomate. Sometimes you get lucky right away and sometimes it takes a little more footwork.
> >
> > When I mentioned in a previous post that it's important to have your support system ducks lined up before stopping an AD, this was a big part of it. But you'll find someone and finding someone will provide a sense of purpose that will provide a good distraction and focus. Hang in there, Mike. It will get easier. - Barbara
> >
> >
> >
> > > Hey all
> > > I'm hanging in, although the weekend was pretty much horrible. Treated to the new 'ex' coming by to get the rest of his stuff saturday am, and being able to watch him drive away for the last time. Had to call a friend to come over after that as I completely lost it and actually started to hyperventilate. Otherwise I've hit a few moments of depression, but It's not a problem yet. Mostly sadness, anger, panic, etc.
> > >
> > > I'm thinking that half of the pain is coming from the life upheaval. I need to make a new life and the sooner I can get a direction established the sooner I can start recovering. My primary care physician gave me a couple of references for counselors, but they were pretty much dead ends (and turned out to be marriage counselors anyways, which I'm not sure is most appropriate here as the relationship is already dead).
> > >
> > > What is the best way to go about finding a DECENT counselor in my area? How many 'kinds' are there? I know of psychologists and psychiatrists, and then I guess there are various levels under those as well. I just need someone to help me make sense of my mess of feelings and help me pick the most reasonable next step!
> > >
> > > Anyone?
> > > Mike
> >
> >
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poster:barbaracat
thread:545377
URL: http://www.dr-bob.org/babble/wdrawl/20050822/msgs/549648.html