Q: does therapy work for everyone
Hello, Louise. I think therapy can work for anyone who is motivated to do it, but there has to be a good level of trust in the therapist. It might be that your husband's therapist wasn't a good fit for him, or the method of treatment was not helpful. It's not uncommon to have to look around a little bit for the right person. At least he's talking to you, which is good. He is absolutely against trying therapy again? If he is, maybe you could talk to his doctor, who is prescribing the medication, and tell him your concerns (your giving him information does not violate confidentialty) and perhaps see if he won't nudge him into giving it another try.
I wish you the best and hope your husband gets all the help he needs. At least he's on medication and he has a wife who cares about and supports him. Let me know if you need any other information. Take care.
That's too bad, that he feels that way. I think sometimes people think therapy makes things worse but it's usually because it opens up the proverbial can of worms and you are having to stare your demons in the face and feel the feelings you wouldn't allow yourself previously. If the therapist was good, he could have told him/her that he was feeling worse and they could have explored the reasons. Men, especially, have such a mindset against expressing emotions, which is too bad because I think they'd be a lot healthier, overall. We all need help sometimes and getting through life is a little easier when there's some interdependence with other people. Good luck with this and hope you feel free to write again.
I don't know if therapy works for everyone, I suspect the answer may be probably not but it would be hard to prove/disprove your question. I think therapy is just like any field good and bad (assuming we are talking about legitimate licensed therapist). Think back to school how many really good teachers did you have. For most people there are three or four that they would say were good. Well if you had 30-40 profs/teachers over the years that 1 in 10. It is often said that 15-25% of people do 75-85% of the work in just about any field (I know that rings true for a lot of people including me). Well without being down on therapy in general (which I believe can be very beneficial with a good one), I must say the field is riddled with people with credentials but not very good at what they do. Unfortunately this is what gives therapist their bad rap. The real trick is finding a good therapist. There is a lot of generic advice online which I find too simplistic and potentially harmful. When I say harmful I mean that if the therapy isn't working for you (i.e. no change or improvement over a period of time the client or the therapist should be making some change either in their approach (from the therapist side) or changing therapist (client side). While therapy is often thought of as the client has the problem the therapist is there to work toward the solution. If you are giving your money (or insurance money) to a therapist and getting no results and the therapist doesn't do anything to change then the client has to make the change. This is the dark side of therapy that nobody talks about but is true and it's the nature of the beast. Therapy can't be done for free it's a business first and it has to be just like most endeavors. I'm not saying a therapist is in it only for the money here but it does come into play they have to live and pay for their education as well. Like most things the money is in the treatment not the cure (i.e. keep coming back somewhat like a chiropractor). Unfortunately though this creates a situation where compensation dictates behavior (this occurs on the client side as well but different we are talking about a different compensation (I'll discuss later). So the therapist, if he "cures" you no longer has a source of revenue from the client. We all like to hope that it wouldn't be the case but I've worked in a number of therapists offices and have seen where money was largely the motivating factor for some therapist. While others in the office were much more goal oriented and interested in successfully treating and completing therapy. My experience tells me that a lot of people go into the field to help other people or themselves but that changes as time goes on and they become complacent. The key for success from the clients perspective is to find a pro-active goal oriented therapist who specializes in the disorder in question and is willing to change their approach based on the success or lack thereof, of the therapy. If the therapist is just using reflective listening and the client feels better immediately after the therapy but goes right back to his/her same self after a short number of days only to rinse and repeat the process over and over and over. This is damaging in two ways. Sometimes the client and the therapist feel good about the therapy but again no real progress is being made although both of you may feel better after the session unfortunately if this is the case a good friend does the same thing and it doesn't cost anything. This is the most common problem I witnessed over my years working in several therapists offices. While it may appear I'm digging at the therapist the client is more often the instigator of this for several reasons. Probably the biggest mistake made is in the selection process of the therapist. I saw many clients "shopping" for therapist who agreed with them and their world view. I often heard from the better therapist in the office that they had a client they could help but the client never returned to them choosing someone else. By itself this is not an issue, perhaps there is a conflict of some sort that would not boad well for the therapy. Most often though it's the client secretly wanting an enabler and will continue until they find it. Liking your therapist because they are good and liking your therapist because they are a nice person are two different things. In fact people as a general rule tend to want to take the easy/lazy way out of most things, if this is what is happening the client doesn't want to change they really want an enabler and a therapist that they like on a personal level will often create that situation. The best therapists and I'm thinking of several, always in the beginning assessed the client talked with them and had some sense of the severity of the problem the treatment plans that should be followed that best dealt with that disorder and (this is important) have a rough idea of how long the treatment should last and try to measure improvement. Several of the good ones would often say to the client after listening to them that they thought they could help but it was going to take work on their part as well. The therapist would tell them that in the short term they probably would not be "liked" but those that stick it out would have a much better chance at success. For example if you want to do reflective therapy and that is not the best treatment option they wouldn't do it they would say you need to go to someone else and advise them that if they did that therapy they more than likely for their disorder would have poor/no results. If they did stick it out though on the back end there would be success and the client would come to like the therapist because they were good not because they were enablers. The therapy would often end with the clients coming back only occasionally when there were significant things like a death of a parent or child. We even heard one story of a person whose husband passed away and she went to therapy for 30 years. Talk about enabling and building a career. The other problem and this is where the insurance companies come in is that because of the potential chance of suicide or other severe behavior (criminal behavior comes to mind) the liability for insurance companies comes into play i.e. you don't want to deny/limit someone's access to mental health treatment and something go horribly wrong creating a lawsuit. So the insurance companies will continue to pay. Well now the situation arises where the claimant is not paying much of the bill. Because I worked in the finance side of this industry I've witnessed how money effects the industry. If insurance is picking up the vast majority of the tab both the therapist and the client are much less proactive in their treatments. Where as if the client is paying and can't afford treatment forever they have a vested interest in getting better as quick as possible. The therapist also has the burden of treating the client with financial limitations and must actively treat the client so they get better in an appropriate amount of time. Most therapist are good people and try to do the right thing but to pretend money and who pays is doesn't affect the treatment would be disingenuous. So how to pick a good one. I think the person has to keep in mind the pitfalls of the industry and if the client is getting better. A good friend as stated above can help but for real therapy you do need to see a therapist not a friend. If you're not getting better in an appropriate amount of time change therapist. I would say don't pick a therapist based solely on who you like, expect results if you're not getting them move on. If not discussed by the therapist the client should also ask after the assessment approximate treatment times given their circumstances (the therapist will not be able to say blank number of session but don't let them get away with "well different problems different people different time lines) they need to be more specific than that. If that the answer you may want to ask how long before you should see some benefit or at what point you both together should determine if it's working. if they don't give a reasonable answer it should be a red flag. I do believe therapy works I've seen it work. It's just getting around what is described above is the difficult part but it can be done.
Bravo! Finally someone exposed what I have long suspected. I really wanted to believe therapy worked but my expierience was really telling me otherwise. My on again off again girlfriend (I would like to get married but we have to get by this depression/bipolar first and thats why we are on again off again). She does exactly as above "shops" for a therapists and no suprise 5+ years later is no better. I know this illness isn't exactly a broken leg to diagnose, set, cast and heal but her choice in therapist's over the years has been to find someone who just does the reflective listening and while not claiming to be an expert (but I'm well read on the subject of bipolar) one of the better treatments for this disorder Cognitive Behavior Therapy (CBT). For those who don't know this is where the therapist tries to actively change your thought process so you don't repeat the same behaviors that are often so self destructive (simplistic definition I know but you can look it up for yourself for more info). Not once has one of the therapist she's chosen to see worked this method. Yet its well known that multiple approaches particarly with CBT is the route to take. While my girl is somewhat secretive about her therapy (and it is a private thing) I believe the secretiveness is due to the fact she doesn't want me to make an evaluation of her therapist because she likes the enabling. I have found myself on more than one occassion stating you can't get better with 1 hour on the couch once a week telling somebody your problems. You need to be doing some homework so to speak when not in therapy. This is where the laziness or her taking the easy way out becomes the factor. She doesn't want to or says she doesn't need to be doing anything like that. Well not just a boyfriend but as a person I can see there is really no change over the last 5 years (3 different therapist). All have basically just done reflective therapy and none have specialized in bipolar and I know that is who she needs to see. She has gone to those therapist and stopped almost immediately because she realized as the person stated above this therapist was not going to be an enabler and she would have to work outside the therapy to get better. Well what do you say not as a boyfriend but just someone who wants them to get better? She is protective of her therapist and psych. doc. and tends to take what they say as gospel while everyone around them is saying your doing the wrong thing. Now I don't know about you but people who are around you and love you family and friends can give good advice (not counciling but they see your behavior and know when its not normal and tell you as much yet she'll not listen to that advice because it doesn't jive with her "worldview" (like that word when used above). Then will go to the therapist and return with something like my therapist says how I feel is normal for someone with my situation, meanwhile her family/friends say its not. Now who's right the people your around all the time or the person who hears you an hour a week/month? What is really going on is my girl filters the info she gives to the therapist and then filters the advice she receives when she does discuss it with us. So basically she is lying to the therapist (in which case she will never get better) then lying to us. That may be a harsh word but when you take things out of context or leave out something that is related to the story you lie through omission. Anyway, my girl is caught in a loop a catch 22 if you will. I can't force her to change therapist but if she's ever to get better she need to see someone who will not enable her and I feel just collect the money and do it over and over again because insurance is picking up the bill. My girl isn't in total denial its just she wants the therapy on her terms and thats just not how it works. I would suggest to the person who proposed the question that they try to see a specialist in his field and has a good reputation. I suspect the enabling will stop. Now if I can just convince my girl of the same, she doesn't see it because she's too close but if she would just do this one thing and work through not neccessarily liking the therapist she would get better and this nonsense of constantly going to the therapist would decrease. I know bipolar is a condition that never goes away and some therapy will probably be needed from time to time but what is occurring now under the umbrella of therapy is just a continuation of the status quo. I believe Einstein said it best to do the same behavior over and over and expect a different result is the definition of insanity well I wouldn't call my girl insane but her attitude toward therapy seems to be because all she wants to do is the same behavior over and over.
Seems there is a lot of people questioning their therapists or their value. I too believe therapy to be beneficial but the shopping comment is hysterical. Its exactly what my husband did for 10 years. Finally I told him he needed me to go with him and together we would select the right therapist. He relented after I pointed out the fact that almost nothing had changed over the last 15 years we've been together (we dated for 5 years prior to marriage). Oh, he battled me but I just pointed out that he still pushed me away when he was depressed, even though he knows I've never given him bad advice, in fact he says I have almost been right. That didn't mean that he would listen though. I can't tell you the number of times he came to me after coming out of the depressive episode saying that I was the only one who really cared to try as much as I could (many others prior to me and he was very promiscus pariticularly in his youth) had either used him outright or were so destructive to someone with bipolar. He refused to believe it when we first started dating but I didn't hesitate to point it out. We had some trouble early on with him still behaving like Tiger Woods and we weren't really exclusive so while I was hurt I did my own thing during that time as well. As time went on though he grew tired of that stuff and we grew together. He was always distant though whenever depression set in. In fact I thought we wouldn't make it after a nasty spell (serious family incident that ended in tragedy). He just couldn't seem to get over it. After a considerable amount of grieving (way too much for a normal person) we began to come back together and I finally told him we need to get someone who specializes in bipolar and that we both need to agree on that person. After conceeding we went to a number of therapist who I thought would be the same as he had attended before (he would like them I wouldn't) we found one that I felt fit the bill. Sure enough he began treating my husband and there was a significant turn around. My husband at first as someone previously described was lazy and really didn't want to change. He was on medication that made him partially this way but it was more his resistance to change that was the hardest part to overcome. CBT was the biggest benefit for him and no other therapist actively used it. What a difference it made for him he's not perfect today but the change was so dramatic even he commented that he wasn't sure how he lived so long in the same cycle. In fact that became a little depressing for him but because he had began to think differently he snapped back and our relationship blossomed. Some things he told me (he always failed to say what he was feeling which became a huge problem trying to read him became a full time job) afterwards was that I had been right so many times but he didn't want to say so and that he knew I was great for him and that I was what he really wanted but felt undeserving of the kindness I had showed him over the years. So to me therapy does work but you have to have the right one. No I didn't attend his sessions other than when we decided but he asked me to come afterwards something he didn't want to do with the "enabling" therapist. So keep up hope and keep searching.
When I first became depressed, I tried therapy for 6 months. After about a year being depressed, I lost the ability to sleep without meds.
I think therapy does work with a trained/skilled therapist and lots of patience. For me I have been suffering from clinical depression for about 2 years. However, I have probably been suffering from it since I was a toddler due to extreme abuse from my mother, both physical and psychological. As we all know, physical abuse/emotional abuse are highly correlated to depression in adulthood. My depression was always up and down and I did have good moments in my life; however, over the past 3-years I have sank to an all-time low and I wonder if there is a bottom sometimes. My clinical depression was triggered by divorce and my wife getting full custody of our child. At that time, I was living in another country which really has not family law and not joint custody. Even though I was never physically abusive, nor did I have a substance abuse problem, and was a fantastic father my ex allowed me very minimal contact with my son. This triggered the onset of very severe depression, which is with me to this day.
Last year I had severe insomnia for 10-months, severe depression and suicidal ideations. I was living in another country and the cost of seeing a psychiatrist/therapist was too high. I was also paying a lot of child support in order to see my son, which as I mentioned was limited, but at least I was able to see him and tell him I loved him. I had gone to therapy in the past to deal with my abuse issues, and now that I am back in my country I went back to see a psychiatrist about 4-months ago and see him weekly. He is very good and never forced me to take medication; however, I decided in March to start taking an antidepressant. I took one for 2 months, but the side effects were too great. I am trying another and have been on it for 1-month with limited effects. The next step may be to try a third medication. It is really a process of hit and miss and this is just the world of antidepressant medication. I have always been health and exercised a great deal, but over the past 2-years my energy level and motivation have been devastatingly low, but I do exercise a little every day either walking or doing a 10-20 km (6-13 miles) bike ride. There is research that exercise helps greatly with depression by increasing certain chemical in the brain, but the research is not fully conclusive yet. However, if one feels it works for them then do it. I feel it is great for reducing stress and anxiety and getting out of my head as I tend to have a lot of ruminating (unending thoughts) that continual go around in my head telling me what a failure I am. This is just part of depression.
CBT (Cognitive Behavioural Therapy) is very helpful for treating depression, anxiety, stress, and other mental/emotional health issues along with mindfulness (meditation and being aware of one's thoughts...it also incorporates relaxation and yoga). Check out Dr. Jon Kabat-Zinn who was the founder of Mindful-Based Stress Reduction Therapy, and they recently developed Mindfulness-Based Cognitive Behaviour Therapy for depression, and other mental health issue. It can be done in a group or individually. Many hospitals are now doing groups as it is more cost effective and cheaper for the patients. They have apparently had much success and in research it indicates that it is as effective if not more effective in relapse prevention (preventing depression from reoccurring). I went for an assessment by a clinical psychologist and am considering starting an 18-week CBT group for depression and anxiety. I think one has to explore all options in therapy as one type of treatment does not fit everyone. It also takes time for medication and proper treatment to work. I guess that when dealing with mental health issues we must develop patience. I use the Kabat-Zinn tapes on a daily basis to do meditation, yoga and the body scan. It has been priceless when I have been very depressed and wanting to be alone and not being able to socialize.
In addition to medication, I have been doing regular meditation which consists of 1 or 2, 20-30 minute session of deep breathing and not buying into my negative thought process. It takes time and dedication to get good at this practice and have the patience, but it is helpful. I would suggest finding a group to do meditation with, getting some CDs, or taking the mindfulness-based stress reduction treatment, which is usually 1 a week for 8 weeks. Other options are to go on the internet and listen to guided meditations, which help you through the process. They even have ones that are for depression. A few good sites that I go to are:
www.tarabrach.com (clinical psychologist)
http://www.dharmaseed.org/talks/
http://www.awakeningjoy.info/materials.html (online program on becoming more joyful and the guest speakers are renowned in areas of psychiatry, psychology and neuropsychology, and so on).
http://mindfulnesstapes.com/ (Jon Kabat- Zinn…pioneer of getting mindfulness into the medical health system of the US. These tapes are fantastic. I use series 1 and you can do it by yourself or with a family member or friend. They have guided meditation, body scan to relax your entire body and mind, and also 2 yoga practices of about 40” each, which are not difficult. The great thing about these CDs is that you don’t have to go anywhere. If you are too depressed or unmotivated to go out, then you can just do it at home. Of course, if possible socializing and talking to friends is very important to help with depression. Although being alone at times is important-isolating yourself can further intensify the feeling of loneliness, sadness and depression).
So, therapy, medication, mindfulness, group work, yoga, meditation, exercise, good diet/nutrition (possibly vitamins for depression and a multivitamin, but I would not get into taking too many as there is little evidence they work even for St. John’s Wort, and they can be expensive…it is trial and error with vitamins and other supplements. There is also SAM-e and ATP that some say are just as effective as antidepressants, but the jury is out on their effectiveness). There is also acupuncture, shiatsu (pressure massage on specific body points) and massage (I would only go to a certified RMT (register massage therapist). Check out your company health plan (if you have one) to see what it covers. Some cover RMTs, Naturopaths, Psychologists, and so on. Socializing is very important. I would suggest joining a gym doing volunteer work, finding a support group that deal with depression and other mental health issues as they understand what you are going through and you know that you are not alone in this suffering.
There is no easy answer to mental health issues, but there is always hope, and trying a wide variety of solutions is the best approach. If you rely on only 1 approach it may not work. We cannot feel that therapy and medication are the only answers as it is much more complicated than that. Do everything possible you can and surround yourself with friends and supportive people, and stay away from toxic people, places and things as they/it may trigger your depression. If you are religious get support from your church. If you love animals and don’t have one then get one if you have the time. Save a beautiful animal from your local shelter. If you are serious about suicide talk to someone or get yourself to a hospital. It takes time to heal and please remember that there is always hope. Oh yes, keeping a journal about your feelings and at least once a week write in it what you are grateful for (research shows that doing it daily is less effective as it becomes too habitual and has less meaning). I can tell you that writing this entry has already helped to improve my mood. Now, I am going to take my antidepressant medication, do some meditation, write in my journal and go for a bike ride. I still feel depressed, but it helps and I hope in time that I will find happiness and joy as I hope everyone with this terrible illness will also.
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