# My Stupid Therapist



## ColdFury (Nov 6, 2003)

I've got my appointment with my new therapist tommorrow at 3 PM! I'm worrying about it already!

I'm still worrying incessantly that its all going to be a huge waste of time and nothing good is going to come out of it. I have, after all, done CBT before, and didn't see any benefit, and I worry that its going to be more of the same.

The idea of "staying the same" even for short periods of time is incredibly fearful to me, and I worry thats going to happen. If the therapy doesn't work, I really don't have too many options left, so I'm really quite fearful and worried.

I've decided to ask him about the whole medication thing. Like I said before, they don't deal with medications, but maybe he can refer me to a (competent for a change) psychiatrist, or give me some kind of info. Of course, I might come off looking like a complete idiot.

I just don't know. I'm not very hopeful about CBT part 2. My OCD and depression really really interfers with what CBT does and makes it even more difficult. I want to make this point to the therapist, but I don't know if there's even anything he can do about it!

I really wish I could maintain a positive attitude and be hopeful about it, but instead I just feel dread and worry about it.

Wish me luck people!


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## lilly (Mar 22, 2006)

Good luck ColdFury. I hope that you're able to clear up any points you need to with the therapist. It is a good idea to go along to your appointment.


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## millenniumman75 (Feb 4, 2005)

ColdFury,

You will be fine. The first thing is the positive attitude despite the skepticism. Picture yourself being the calm, confident person - how would you handle the doctor's visit? what would you ask? Could you ask him about his stance on medication? 

Anticipatory anxiety is the worst part of this experience. Once you get there, you'll be fine. They are trained to help you as long as you are willing to continue working with them. :yes


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## Disintegrate (Jun 28, 2006)

Good luck!


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## niceperson (Nov 18, 2005)

Cold Fury, it seems like you have encountered failure in the past. That has on bearing on the future. You have it in you to beat this disease. You say you haid CBT in the past, but CBT cannot completely cure you. You need the help and assistance of a competen therapist to help you figure out what you need to work on in CBT to overcome anxiety. Do not lose hope. You can overcome this thing. I tried CBT for a while, but without advice from a good therapist, it didn't really do anything. you need advice from a therapist on what you need to work on, plus medication helps a lot. I'm willing to bet your therapist will refer you to someone who can prescribe mediaction.


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## ColdFury (Nov 6, 2003)

> tried CBT for a while, but without advice from a good therapist, it didn't really do anything. you need advice from a therapist on what you need to work on


Well, what I was meant was that I did CBT previously with a therapist already. In fact, at the same clinic.


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## ColdFury (Nov 6, 2003)

Well, it was a complete disaster.

As expected, it was the same old CBT crap, that didn't do anything for me the first time. He did nothing but tell me things I learned already.

He kept asking me to "write down the thoughts you have when you feel anxiety." I don't have any specific thoughts! I just feel fear in general! Therefore there is nothing to write down!

I tried telling him this about 10 times, but he just ignored me and kept asking it. He even gave me a sheet to write down "all the anxiety provoking situations you experience during the week and what you think during them." First of all, I try to avoid anxiety provoking situations as much as possible, so I don't have much to write down in the first place. Like I said, I don't have specific thoughts when I feel anxiety!

I guess it doesn't matter too much though, as he didn't even remember to give me the sheet.

I really hate doing stupid crap like "imagine an anxiety provoking situation and write down how much anxiety you feel on a scale from 1 to 100". I can't assign numbers to my anxiety, especially in hypothetical situations! He kept asking even when I told him that!

Another thing "write down your top 10 anxiety provoking situations you've experienced in your life!" My mind just goes blank when someone asks me that! I can't just rattle off the top of my head the "top 10" embarassing situations in my history.

This is why the CBT didn't really help me the last time, because I don't have specific thoughts to "correct" when I feel anxious. Last time I did it, I ended up making up **** just to tell the therapists.

I explained to him about my OCD and severe depression, but he didn't care too much about that. I explained to him that I tried CBT alreay and didn't see much benefit, but he just wanted to talk about the same CBT crap I know already.

I already know about the "anxiety curve" already, and if anxiety goes away once the irrational fears are disappated overtime, then why do I feel anxiety around my family members, with whom I've lived for 20 years!

Oh, and to top it all off, I did ask about medication. His reply was a flat-out "No". So I guess it rules that out. He says medication would interfer with the "treatment".

I guess I'm a freak even among anxiety sufferers. They all act shocked when I tell them I've never had a girlfriend and I haven't had a friend in 5 years, like they've never even heard of that before. Way to make me feel like a freak.

How is one supposed to improve with therapy when you feel abject terror just being there?

I don't even know why I bothered. What a waste of. I'm extremely frustrated and angry, and when I got back I trashed my apartment I was so pissed. I feel like ****.

:mum


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## dangat (Jul 11, 2006)

There's so little wisdom out there. It may be too soon to ask (you might still be too pissed to consider it) but how many crap therapists would you be willing to go through before getting to one that can actually help? 5? 10?


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## Stirner (May 16, 2006)

A really bad situation you are in. :hug

Well, i have a suggestion you could try to experiment with, if you are up for it. I know i sound like a salesman but that is not the case. I have been experimenting with something called heart coherence, which is controlling the hearts rhythm with "the brain". The reason why this is important is that it is argued that the heart, like the brain, sends out neurotransmitters (and other stuff e.g. cortisol) thus being important for pcysical and mental health. Here is a good description of a exercise:



> Heart Coherence
> 
> David Servan Schreiber, Healing without Freud or Prozac (Rodale, London 2005)
> 
> ...


I have been practicing this for a month and is now able to control my heart, so it does not race when i interact or is around other people. It might be pretty important in relation to the fight-or-flight response, i mean, if the heart races like crazy, no amount of CBT will do any good for you anyway.

I have seen great improvements in my SA (low to medium). Well, maybe it is just the good ol´ placebo but its a new path to test out, so it might be worth a shot for you as well.

http://www.heartmath.com is the main site to view if you want to judge the research underpinning this.

(sry, for the bad english but im sooo tired..)

Edit: And i have a similar experience with CBT, a complete waste of time.


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## lilly (Mar 22, 2006)

ColdFury I've had a therapist that told me to do "homework" then didn't even mention it at the next session. I'm not going back to her as I feel she just doesn't care.
I think it's a good idea to try another therapy other than CBT if you're not happy with it... maybe one day it will help you though. There are many therapies. Also another therapy centre and therapist sounds like a good idea.


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## bk (May 2, 2004)

That sucks. You think that they would at least pretend to listen to you for the first session. 


> They all act shocked when I tell them I've never had a girlfriend and I haven't had a friend in 5 years, like they've never even heard of that before. Way to make me feel like a freak.


Wow. What a terrible therapist.


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## ColdFury (Nov 6, 2003)

So now I really don't know what to do.

Should I:

- Keep going to him and see what happens?

- Find a new therapist (I don't really know if I can)

- Go behind his back and get medication anyways?

I really don't know.


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## oversad (Jun 1, 2006)

I would go to him a few more times and see if he actually listens to what you're saying. It sounds like he is so certain on his knowledge of how to treat SA that he won't listen to something that contradicts that treatment. 

If he doesn't start being more sympathetic and listening to your specific problems, I'd drop him and look for another therapist. I would definately keep looking though.


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## Disintegrate (Jun 28, 2006)

ColdFury said:


> - Go behind his back and get medication anyways?


 :yes


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## ColdFury (Nov 6, 2003)

The thing that angers me the most is that I have a lot more problems than just SA, and he didn't care about any of those.

I have no hope of treatment if he doesn't consider all my problems together, not just the anxiety, because concentrating on the anxiety alone is missing the big picture.

All he wanted to do was talk about the anxiety curve, blah blah blah. The anxiety curve doesn't have anything to do with my panic attacks, OCD, feelings of self-hatred. He didn't care about any of that!

I need someone who can consider all my problems as a whole and attack them at once!


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## Urkidding (Oct 12, 2005)

Maybe looking for a psychiatrist is the best option at this point. If you can't go to one, I know that some family doctors/internists will prescribe psych medications. I'm suggesting this, though, not knowing all the meds you've tried and if anything's worked (plus I'm not a doctor ).

Rick, while I'm not exactly in your shoes, I know that anxiety is particularly tough to deal with when it arises even when we can't pinpoint any specific thoughts that could have produced it. Exposure, as you've said in another thread, does not work for everyone.

How much do you feel anger and frustration contribute to your anxiety and depression? Venting your anger in your room probably helped, yet I wonder how much preexisted your appointment. I imagine the frustration and anger welled up in you as the session progressed (or regressed). I know it's difficult and sometimes not prudent to bottle up our emotions, but maybe a different tack during the session would be to listen to your therapist, smile smugly at him, peg him as uninformed and a bit amusing in thinking your situation unique, and feeling that you can for now extend to him the virtues of patience and forgiveness.

In short, you can try to use your therapist as the object of your therapy
even as they provide you with techniques you think, because of your experiences, to be a waste of time.


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## whiteclouds (Mar 18, 2004)

ColdFury, that therapist sounds like an incompetent arrogant jerk. I would definitely keep my eyes open for a better one.


ColdFury said:


> He kept asking me to "write down the thoughts you have when you feel anxiety." I don't have any specific thoughts! I just feel fear in general! Therefore there is nothing to write down!


It is very hard for an anxious person to identify such thoughts because the thoughts happen so quickly in the mind and lead to fear. I had a therapist in the past who realized this, so he wrote up a worksheet for his patients to help them identify troublesome thoughts. Most of our anxiety thoughts follow along the lines of these suggestions below. Whenever you are feeling anxious, see if any of these sentence stems apply to you and fill in the blanks. Pick the ones that trouble you the most. From there, you can challenge those thoughts. It helped me articulate my thoughts better, so I thought I'd share it here. I hope this helps. Good luck. 



> "Identifying Automatic Thoughts: Sentence Stems"
> 
> ANXIETY THOUGHTS
> 
> ...


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## ColdFury (Nov 6, 2003)

> Maybe looking for a psychiatrist is the best option at this point. If you can't go to one, I know that some family doctors/internists will prescribe psych medications. I'm suggesting this, though, not knowing all the meds you've tried and if anything's worked (plus I'm not a doctor ).


Well, I've been going to a psychiatrist for a long time up until now. He told me he was out of ideas, so I should try therapy (again). I'd be glad to find a new psychiatrist, but now that my therapist has told me not to, I'm not sure what to do and if I should disobey him or not. :stu



> How much do you feel anger and frustration contribute to your anxiety and depression? Venting your anger in your room probably helped, yet I wonder how much preexisted your appointment. I imagine the frustration and anger welled up in you as the session progressed (or regressed). I know it's difficult and sometimes not prudent to bottle up our emotions, but maybe a different tack during the session would be to listen to your therapist, smile smugly at him, peg him as uninformed and a bit amusing in thinking your situation unique, and feeling that you can for now extend to him the virtues of patience and forgiveness.


I pretty much always feel angry now. Anger, rage, frustration, jealousy, bitterness, those are the only types of emotions I feel anymore. Its definitely pre-existing. I don't think I can forgive anyone anymore, its just automatic for me.


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## ColdFury (Nov 6, 2003)

> It is very hard for an anxious person to identify such thoughts because the thoughts happen so quickly in the mind and lead to fear. I had a therapist in the past who realized this, so he wrote up a worksheet for his patients to help them identify troublesome thoughts. Most of our anxiety thoughts follow along the lines of these suggestions below. Whenever you are feeling anxious, see if any of these sentence stems apply to you and fill in the blanks. Pick the ones that trouble you the most. From there, you can challenge those thoughts. It helped me articulate my thoughts better, so I thought I'd share it here. I hope this helps. Good luck.


Thanks. The problems I have with such charts though, is the chart is never handy when I actually feel the anxiety, and if I have any thoughts at all (and I really don't think I do), I don't remember them by the time I get the chart again! I try really hard to think of thoughts that were on my mind, but I just draw a blank.

It also doesn't help that I'm sooo avoidant, that my life is built around avoiding anxiety provoking situations. Therefore I don't have much material to work with, because I avoid anxious situations automatically and therefore don't experience the anxiety and therefore can't analyze my feelings.

For example, I'm probably going to spend most of the weekend in my apartment, where I'll be nice and insulated from any anxiety. It makes it really hard.

I don't know, after this I just feel entirely lost and hopeless. I was holding this entire thing as one of my last opportunities and I feel like I'm totally set back.


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## millenniumman75 (Feb 4, 2005)

ColdFury,

I think addressing your feelings about what happened is a good start. Three boogies for even going :boogie :boogie :boogie.

I would start by thinking about one thing you would really like to do, but are afraid to because of anxiety - for some, this might be just going out to the mailbox. Start small and think of various scenarios of things that "could" happen and their chances of actually happening. Then try it and compare what really happened to what you thought would have happened.

How we think determines how we feel - my first lesson in CBT.


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## ColdFury (Nov 6, 2003)

> I would start by thinking about one thing you would really like to do, but are afraid to because of anxiety - for some, this might be just going out to the mailbox. Start small and think of various scenarios of things that "could" happen and their chances of actually happening. Then try it and compare what really happened to what you thought would have happened.


I thought about that, but I'm really not sure what to do. My anxiety really comes out in social situations, and I have no ability to stage such a situation, and honestly, my anticipatory anxiety is so so strong, I would never be able to go thru it willingly. Less social situations cause anxiety, but to a lesser extent, and its hard to come up with actual thoughts I think during it.


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## ColdFury (Nov 6, 2003)

I've been trying to do what the therapist asked, but I'm really struggling. Nothing to write down yet! Sigh...


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## KimberlyK (Nov 11, 2004)

Coldfury, I can relate to trying to write down how your are feeling about a given situation. I don't have all of these thoughts in my head before or during an anxiety provoking situation. I feel anxiety coursing through my body and I don't like the feeling so I avoid situations that bring it on. If you touch a hot stove and it burns you do you go back again and again to reburn yourself? No. You avoid what hurts you. I used to experience anxiety all the time and I thought if I put myself through these experiences the anxiety would get less and less. Instead, the reverse was true. I became depressed and my anxiety got to the point that I couldn't do anything unless my husband was with me. Now, I live a quiet life and don't force myself to experience anxiety. I still have anxiety and depression but I have noticed a significant reduction since I quit forcing myself to be someone I'm not.


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## reticent (Jul 10, 2006)

Maybe for you, it isn't the thoughts, its the physical manifestations of anxiety that is causing the problem. From what I'm hearing, and I could be wrong, you seem to move into the zone of sensory overload and the mind is a powerful thing it's protecting you by disassociation. So you might want to explore what is happening to you physically, try to think of physical manifestations that occur before, during, and after high anxiety. Plus the feelings of them. It may also be helpful to consider the total length of the manifestations from the first twinge until you return to what is normal for you. If you can tune into that maybe you will soon be able to tune into you pattern of thought before, during, and after a high anxiety situation. try to carry a pocket pad and a small key chain pen. then you'll be sure to have these things.


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## Guest (Jul 29, 2006)

I say give him a shot. He probably gets a lot of clients that deny things and don't want to try his ideas at the first meeting. So he thinks he just needs to persist, but if he sees that your problems really are different he might have some new strategies. I mean, if you put yourself in his shoes and you have a client who comes in and says he's different and your stuff won't work on him, you're probably going to at first assume he just doesn't want to give it a chance.


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## ColdFury (Nov 6, 2003)

daaaaave said:


> I say give him a shot. He probably gets a lot of clients that deny things and don't want to try his ideas at the first meeting. So he thinks he just needs to persist, but if he sees that your problems really are different he might have some new strategies. I mean, if you put yourself in his shoes and you have a client who comes in and says he's different and your stuff won't work on him, you're probably going to at first assume he just doesn't want to give it a chance.


Thats true I suppose, though he is well aware I've done CBT (and even the same program) before.


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## bk (May 2, 2004)

Personally, I would probably sit through at least three or four terrible sessions before giving up on them. Mostly because it is a pain in the *** to find a therapist.


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## ColdFury (Nov 6, 2003)

Well tommorrow is my next appointment and I still haven't managed to write down any thoughts. I'm worried he's going to be mad. :hide


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## Urkidding (Oct 12, 2005)

ColdFury said:


> Well tommorrow is my next appointment and I still haven't managed to write down any thoughts. I'm worried he's going to be mad. :hide


Right there is your anxious thought that you can write down.


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## Pistachio (Aug 1, 2006)

Urkidding said:


> ColdFury said:
> 
> 
> > Well tommorrow is my next appointment and I still haven't managed to write down any thoughts. I'm worried he's going to be mad. :hide
> ...


 :fall You just hit on it! I've been trying for the last two weeks to get out of the house. I didn't have a therapy appointment this week since he's in Virginia at some conference, so last week he told me to get out of the house and do something. The only time I left the house was to go grocery shopping. I've so far been unable to write down any specific reason like he asked. Everytime I tried I simply hit what I call the "blank loop" where my mind starts racing and I get stuck thinking of nothing over and over (if that doesn't sound like an oxymoron.)

But now I at least have one thing I can write down. All this last week I've had this gnawing feeling that when I go next week he's going to be angry or disappointed because I didn't leave the house. There! Written down!


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## ColdFury (Nov 6, 2003)

*Second Appointment Outcome*

Well, the second appointment was quite strange to say the least.

For one thing, he had me spend a good portion of the session standing on my chair! He said doing so would trigger my anxiety and thus help me get a handle on what my thoughts are when I feel anxiety.

Well, I certainly felt silly doing it, and maybe felt a bit of anxiety, but I certainly didn't come up with any thoughts to speak of! (Besides the afore-mentioned ones, which are too general to be of much help)

He said in the future we'd do more exposure exercises, to get a better grasp of my anxious automatic thoughts. Some things he brought up were "Go to the mall and stare at people until you can remember all their eye-colors", and "Go to a restaurant, order something, then change your mind after its rung up". These sound pretty anxiety provoking, though I don't know if I'm going to have any concrete anxious thoughts to show for it!

I hate the way he asks questions! If I can't reply or I reply not long enough, he just stares at me! I end up starring off into the distance and suffering very uncomfortable silence. Its especially bad when he asks the same questions over and over!

One of the questions he always asks is the stupid SUDs crap. Its basically giving a number from 0 to 100 rating your anxiety. Its so arbitrary. I can't assign a number of my anxiety so easily. I end up struggling and picking a number nearly randomly. I mean, how can someone distinguish if their anxiety is a 50 or a 55?

We talked about my previous treatments a bit and I was a bit surprised when he didn't know what EMDR was. Its kinda silly when the patient knows more than the therapist!

Another thing that seriously peeved me was when I asked him the difference between SA and Avoidant Personality Disorder. He went into an explanation of what a personality disorder is (which I already knew), but then said "How about you print out a list of the criteria for avoidant personality disorder from the DSM-IV, and show it to me next time. Then we can look at it more." Seriously, what the hell? Why do I need to print it out, shouldn't he know? Its very strange.

I'm still worried that he's not concentrating at all on my other problems which are going to affect any treatment. Nothing about the OCD, GAD, depression, etc, etc.

Moreover, a big part of my anxiety problems are connected to avoidance behaviors and anticipatory anxiety, which we're not really dealing with.

Anyways, he gave me more forms to fill out to list my "anxious thoughts" (if I even have any, which I probably won't). I'll try to fill them out, but I don't know how successful I'll be.

I'm thinking about going behind his back about the medication issue.


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## tuna (Jun 25, 2006)

Coldfury,

I seriously think you should get a new therapist because this one does not know how to effectively treat SA. The therapist has to be able to make you feel comfortable or as comfortable as you can be with them in order for the treatment to work so that when you do talk about your feelings/thoughts and do exposure work the therapist will feel like a safe haven. I think this person knows the general idea of CBT but does not know how to put it to use. I dealt with a therapist like that before and it didn't help me at all. It actually made me feel even more stupid and nervous.

I can definitely relate to the stupid SUDS score thing too. I don't see the point of it at all and it's really annoying. I can also relate to the therapist staring too. That just means the therapist is not skilled enough to deal with patients especially ones with SA. They don't know how to move on to a different subject or realize when they're making you uncomfortable.

I don't think it's important to know what exact thoughts you are thinking when you're feeling anxious. All I know when I'm anxious is that I *feel* anxious like my body is programmed to act a certain way in certain situations without any logical thought behind it. I think trying to see a situation in a new, more rational perspective is more important than trying to find out every little negative thought you may have when you're anxious.


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## Urkidding (Oct 12, 2005)

*Re: Second Appointment Outcome*



ColdFury said:


> For one thing, he had me spend a good portion of the session standing on my chair! He said doing so would trigger my anxiety and thus help me get a handle on what my thoughts are when I feel anxiety.
> 
> Well, I certainly felt silly doing it, and maybe felt a bit of anxiety, but I certainly didn't come up with any thoughts to speak of! (Besides the afore-mentioned ones, which are too general to be of much help)


Were you a bit anxious because you thought you would look silly or fall off the chair? Would they be "too general" in your opinion or in his, or do you know? Are you anxious or worried that they would be "too general" and therefore not good enough? Maybe something you could write down.



Coldfury said:


> He said in the future we'd do more exposure exercises, to get a better grasp of my anxious automatic thoughts. Some things he brought up were "Go to the mall and stare at people until you can remember all their eye-colors", and "Go to a restaurant, order something, then change your mind after its rung up". These sound pretty anxiety provoking, though I don't know if I'm going to have any concrete anxious thoughts to show for it!


I'd worry about people sneering or telling me it's rude to stare. At the restaurant, I'd worry about inconveniencing the employee, causing them frustration, making other people wait, doing something out of the ordinary. You're not me, I know. Just giving you ideas.



Coldfury said:


> I hate the way he asks questions! If I can't reply or I reply not long enough, he just stares at me! I end up starring off into the distance and suffering very uncomfortable silence. Its especially bad when he asks the same questions over and over!


Could you write this down? Extended silence creates anxiety in you.



Coldfury said:


> One of the questions he always asks is the stupid SUDs crap. Its basically giving a number from 0 to 100 rating your anxiety. Its so arbitrary. I can't assign a number of my anxiety so easily. I end up struggling and picking a number nearly randomly. I mean, how can someone distinguish if their anxiety is a 50 or a 55?


Can't tell if this is making you anxious or just frustrated. Do you fear anything close to randomness? I don't think he'd be all concerned whether you chose 50 or 55, but it seems to be fairly important to you and maybe anxiety-provoking.



Coldfury said:


> I'm still worried that he's not concentrating at all on my other problems which are going to affect any treatment. Nothing about the OCD, GAD, depression, etc, etc.
> 
> Moreover, a big part of my anxiety problems are connected to avoidance behaviors and anticipatory anxiety, which we're not really dealing with.


Could you write this stuff down? You sound anxious that not all your concerns will be addressed.



Coldfury said:


> Anyways, he gave me more forms to fill out to list my "anxious thoughts" (if I even have any, which I probably won't). I'll try to fill them out, but I don't know how successful I'll be.


Is this anxiety or frustration, or a mixture of both? Sounds like a fear of failure, a fear of meeting expectations (yours and his--or what you perceive to be his), fear of not being precise enough.

I might be wrong, but from my perspective, it looks like you have a lot you could write down.


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## whiteclouds (Mar 18, 2004)

*Re: Second Appointment Outcome*



> "Go to a restaurant, order something, then change your mind after its rung up". These sound pretty anxiety provoking, though I don't know if I'm going to have any concrete anxious thoughts to show for it!


That does sound daunting! :afr I have some ideas for what thoughts I might be having in that situation: "They might be mad at me for inconveniencing them." "They might think I am an indecisive loser for suddenly changing my mind."



> I hate the way he asks questions! If I can't reply or I reply not long enough, he just stares at me! I end up starring off into the distance and suffering very uncomfortable silence. Its especially bad when he asks the same questions over and over!


That sounds very awkward. :hide I guess he's not exactly a "people person". Excessive silent pauses and repetition in therapy are frustrating to me, because I only have an hour (or less) to work with the therapist before my time is up, and this is a needless waste of my time and money.



> One of the questions he always asks is the stupid SUDs crap. Its basically giving a number from 0 to 100 rating your anxiety. Its so arbitrary. I can't assign a number of my anxiety so easily. I end up struggling and picking a number nearly randomly. I mean, how can someone distinguish if their anxiety is a 50 or a 55?


I never liked the SUDS crap either. In my opinoin, it is just an attempt to objectively measure subjective emotions, a pathetic attempt by psychology to assign numbers on abstract things in order to become more like a traditional science. (There has been debate through the years if psychology can ever actually be a "true science". I don't know if it can or can't, but God knows they try.) The numbers aren't so important in the long run, just as long as the guy has an idea if you are just a little anxious, or incredibly anxious.



> We talked about my previous treatments a bit and I was a bit surprised when he didn't know what EMDR was. Its kinda silly when the patient knows more than the therapist!


Red flag!!! I have been in similar situations with therapists.



> Another thing that seriously peeved me was when I asked him the difference between SA and Avoidant Personality Disorder. He went into an explanation of what a personality disorder is (which I already knew), but then said "How about you print out a list of the criteria for avoidant personality disorder from the DSM-IV, and show it to me next time. Then we can look at it more." Seriously, what the hell? Why do I need to print it out, shouldn't he know? Its very strange.


Another red flag! Most therapists have a copy of the DSM-IV right in their office, and refer to it when diagnosing, right in front of the client. There's a good reason they call the DSM, the "Bible" of psychology, because they always have it handy and refer to it a lot. I'm surprised he didn't pull the DSM off his shelf then and there, to go over the criteria with you when you made the inquiry about APD. Perhaps he was just too lazy to get into it, or he figured he didn't want to "waste" time discusing criteria when you can just look it up on the Internet. Similarly, it would be kinda freaky to visit a priest for information, and he doesn't even have a Bible in his room for reference, and he proceeds to tell you to bring HIM a list of all the apostles.



> I'm thinking about going behind his back about the medication issue.


Probably a good idea. It won't hurt anything to visit a med doctor get his opinoin, at least. It's your life. You're the one who has to live with the anxiety, so you should be allowed to take an active role in your treatment, and seek out options, rather than let one lone dingbat call all the shots.

Good luck, ColdFury. Sorry if this post sounded somewhat ranty.


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## ColdFury (Nov 6, 2003)

My third appointment is tommorrow and I'm really dreading it. I'm considering not going.

I just don't see how 30 minutes a week is enough to help all of my problems!


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## ColdFury (Nov 6, 2003)

Well we basically went over the things I had written down for almost the entire time. He wants me to begin keeping a journal of all my anxious thoughts.

I was feeling terrible anxiety the entire time he was reading the things I had written down. I tried to concentrate on what I was exactly thinking to cause the anxiety, but nothing was there. The way he read some of the things I wrote down made me feel like such a fool. Now I think next time I do it I'm going to be even more embarassed and anxious.

He wants me to begin doing exposure exercises soon, which I'm not looking forward to too much.

We talked about Avoidant Personality Disorder just a little bit. He basically said, "Well it doesn't matter what you have anyways because they're both treated the same".

Still considering getting medication behind his back.


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## Atticus (Nov 10, 2003)

I don't mean to be a wise ***, but could you talk to your therapist about your feelings in therapy, and about therapy? That clearly causes you anxiety. If that offends him, he's not worth continuing in therapy with. 

As to automatic thoughts, I'm not sure they're really identifiable after a while. I think they form more of a mindset, and your reaction to a situation happens without any internal verbalization. But if someone says "therapy" to you, I bet you have a noticable reaction. You can probably figure out that you feel pessimistic about therapy in general, or specifically for you. Your reaction may indicate a belief that people can't change (general) or that you can't. You could attack those likely beliefs by refuting them or acting against them. These are just examples, but the process might go like I describe. 

On a different track, could you look at this therapist, or any therapist, as someone who keeps you accountable? Maybe there aren't any insights left for you to discover about your issues, and maybe what that leaves is the effort you need to make to get more comfortable (less uncomfortable) in situations you now find intolerable. Knowing that someone else expects you to do some things, or to explain why you didn't, might be enough to prod you on. Good luck.


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## whiteclouds (Mar 18, 2004)

Atticus said:


> But if someone says "therapy" to you, I bet you have a noticable reaction. You can probably figure out that you feel pessimistic about therapy in general, or specifically for you. Your reaction may indicate a belief that people can't change (general) or that you can't. You could attack those likely beliefs by refuting them or acting against them.


That sounds like the core belief exercises I used to do in therapy. I basically wrote up worksheet with my deep rooted negative belief, and I wrote evidence contradicting it to challenge the belief. I faithfully did this exercise everyday, sometimes twice a day, as my therapist told me to. My therapist said that the more I do the exercise, my belief will eventually change. I literally have over 100 of those worksheets that I filled out during my therapy with this guy, all of them attacking the same specific core belief. I saved every one of those worksheets and I still have them today. Those 100 worksheets didn't even put a dent in my faulty thinking. I have a feeling it is much harder to change a deep rooted belief than they make it out to be. The therapist told me that he realizes this, and I just have to keep doing the exercise, and my thoughts will eventually change. I just wonder exactly how long I have to do it to change. Years? And exactly how many worksheets is it gonna take to get the job done. 500 worksheets? 1000 worksheets? 5000 worksheets? This is the kind of stuff that makes therapy frustrating. Sometimes it feels no different than him telling me to drink a glass of milk everyday to change my core beliefs.


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## Atticus (Nov 10, 2003)

whitecloud said:


> I just wonder exactly how long I have to do it to change. Years? And exactly how many worksheets is it gonna take to get the job done. 500 worksheets? 1000 worksheets? 5000 worksheets?


I have a question. If someone told you it would take 3 yrs and 10,000 work sheets and then you'd see a significant change, would you say "too much time, too much effort"?

I've given up on therapy and my -on my own- efforts with CBT often enough to believe that its the giving up that may be the real problem.


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## moejo (Aug 29, 2005)

After reading all the negative things here about therapy, it seems like a waste of time for SAers.


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## RicknOH (Jan 1, 2006)

ColdFury, I have had good and bad experiences in therapy also. I also wanted it to always lead to improvement in my life but as I found out, there is no guarantee of that.

First of all, its important that you have a good connection, a good "fit" with your therapist. The first 3 or so appointments are your time to evaluate that. If you don't feel like its working, then its time to try someone else. Don't stay in therapy with the wrong person for a year and accomplish nothing. I wonder if you've ever had a good therapist since you don't seem to already know this. 

And I'm not saying anything that a good therapist wouldn't themselves advise you. Its OK to say it isn't working and try someone else. They are supposed to expect that. They are trained to expect that.

Now, my "Personal Opinion" is next. Take it or leave it. I don't buy CBT. It never rings true to me. I think its very impersonal and ignores me as a feeling human being. Its very simplistic. Too simplistic. I've been there and tried it for a few years. I did not grow ANY as a human being during that time. There was no self-discovery, no insight, nothing. I think your gut is right about this.

By the way, Atticus asks a few good questions. They are worth answering for your own insight. Good luck!


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## ColdFury (Nov 6, 2003)

> I literally have over 100 of those worksheets that I filled out during my therapy with this guy, all of them attacking the same specific core belief. I saved every one of those worksheets and I still have them today. Those 100 worksheets didn't even put a dent in my faulty thinking. I have a feeling it is much harder to change a deep rooted belief than they make it out to be.


I did much of the same thing the last time I did CBT. I literally had a massive pile of worksheets I was doing every single week for the therapy. I sure did identify a lot of thoughts I guess, but not one of them changed, and I worked on it for hours a day.



> I don't mean to be a wise ***, but could you talk to your therapist about your feelings in therapy, and about therapy? That clearly causes you anxiety. If that offends him, he's not worth continuing in therapy with.


I've made some effort to bring up the issue, but he just brushes it aside quickly.



> First of all, its important that you have a good connection, a good "fit" with your therapist. The first 3 or so appointments are your time to evaluate that. If you don't feel like its working, then its time to try someone else. Don't stay in therapy with the wrong person for a year and accomplish nothing. I wonder if you've ever had a good therapist since you don't seem to already know this.


I know, but I don't think there's any therapist I would feel comfortable with. I mean, my anxiety is so bad on some days I can barely leave my apartment, yet I'm supposed to feel comfortable talking about my inner-most thoughts with a complete stranger? It doesn't make sense to me.



> I don't buy CBT. It never rings true to me. I think its very impersonal and ignores me as a feeling human being. Its very simplistic. Too simplistic. I've been there and tried it for a few years. I did not grow ANY as a human being during that time. There was no self-discovery, no insight, nothing. I think your gut is right about this.


Unfortunately there aren't many alternatives!


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## ate16am (Dec 23, 2005)

I just started seeing a therapist and she is recommending something called Lifespan Integration Therapy for me. We're starting it on Monday. She is pretty confident that it will help me, she says has seen a lot of success with it. I'll post about it afterwards; if it seems worthwhile maybe you can seek out a therapist who knows about it.


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## RicknOH (Jan 1, 2006)

[quote="ColdFury]Unfortunately there aren't many alternatives![/quote]

Well sure there are. There's traditional Psychotherapy. You know, where you talk and the therapist listens, asking pointed questions here and there to help you feel your feelings and talk about them. When you call for an appointment with a new therapist, ask what method they were trained in and what they use. Tell them upfront your problems with CBT.

I would suggest finding a Marriage and Family Counselor since they have to deal with real life counselling and often understand family dynamics well.

As for feeling comfortable with a therapist, a good therapist will allow you to talk about you fears, even about how you feel about them, and will try to understand those feelings, to empathize and get a feeling for how you tick. A good therapist will make you feel comfortable and trust them. They will be trustworthy. And slowly you will open up because deep down you WANT to talk to someone about all of the details of your life.

Like I said, I can tell you've never had a good therapist. Go look for one. They are out there.


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## ColdFury (Nov 6, 2003)

> Well sure there are. There's traditional Psychotherapy. You know, where you talk and the therapist listens, asking pointed questions here and there to help you feel your feelings and talk about them. When you call for an appointment with a new therapist, ask what method they were trained in and what they use. Tell them upfront your problems with CBT.


I've done traditional psychotherapy as well. Didn't help too much either.

I know what you mean about feeling comfortable, but I just don't see it happening. I don't even feel that level of comfort with my close family.


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## whiteclouds (Mar 18, 2004)

Atticus said:


> I have a question. If someone told you it would take 3 yrs and 10,000 work sheets and then you'd see a significant change, would you say "too much time, too much effort"?


Good question Atticus. If a significant change was guarenteed, I would probably go for it and commit to the 3 years and 10,000 worksheets. I think my major problem is that nobody truly knows how long it takes for major changes to occur, or if they will even occur at all. The therapists keep dangling that carrot in front of us, that if we just give it a little longer, we will find relief to our problems. Next thing you know, you've been in therapy for five years. It's a drain on my finances too, even with insurance contributing to the payments.


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## ColdFury (Nov 6, 2003)

Well today he changed his mind and now he says I shouldn't keep a journal, because his supervisor told him not to. Okay....

He tried exposure exercises today, but they didn't go well. First I had to call information, which was hard enough. Then he had me call comcast, but I freaked out right away and hung up and had a panic attack. Blah.


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