I am so tired of hearing this. Being a friend to some and a therapist to others, I know the difference.
Therapy is about emotional support, sure, but it is also about helping my clients see different ways of viewing themselves and the world, different ways of coping with things they cannot change, and un-learning unhealthy ways of coping while learning new, healthier ways.
I just talked to a client who has panic attacks. She grew up with a mentally-ill mother who sometimes had delusions and lost touch with reality. I helped her see that her panic attacks are probably due to all the emotions about her mother that she doesn’t allow herself to feel. Over the past few weeks, I have taught her to face up to her anxiety triggers and she isn’t having panic attacks anymore. It ain’t all tea and sympathy. It’s hard work and I love it, which makes it all the harder when idiots allege I am nothing more than a paid friend.
I agree we shouldnt be, and it means somethings gone wrong.
But it does happen in my view. Ive found myself doing it, and Ive seen it in others - I do think its a legitimate criticism of the profession at times, particularly for the worried well.
I think they probably mistake the usual non-judgmental and accepting persona of therapists as being “paid friends.”
My therapist is one of the cognitive behavioral school- it’s not sitting around and bellyaching about stuff- I have exercises to do, and homework to do. While I like my therapist, and think that if I wasn’t his patient, that we might be friends, I don’t think of him as a friend per se.
Timely thread, for me. I have been dealing with panic/anxiety for years since my mother died, and it’s just reared it’s ugly head once again over the past few weeks. So, as I am looking at the Yellow Pages, between “Costumes” and “Countertops” I have a question:
My mom’s death from cancer was horrid and ugly and I was too young to even begin processing any of it. I think my situation is like a broken leg that healed wrong, and a “rebreaking” of that leg is in order. Is a counselor/therapist someone who I can just talk to about how bad it all was, and who can guide me through all of those feelings so I can be mentally healthy again? Is this what therapy is for?
Sing it, sister Brynda. If hanging out with my friends was anything like going to my therapist, I wouldn’t be friends with them for long. I’m in psychodynamic therapy (which I would hardly call “sitting around and bellyaching about stuff”), and the time I spend on that couch is so much work, so emotionally draining and challenging. Nothing like shooting the shit with my friends.
Yeah, I like my therapist. He’s good at what he does, and I have a lot of respect for him. He’s helped me immensely. But the relationship is so different from a friendship.
Yep. At least that is what I would do, given what you have said. Unresolved trauma doesn’t just sit quietly where we stuff it; it tends to fester and cause all sorts of problems. Best wishes to you.
There is another side to this you may rarely hear from patients. I have a degree in psychology and was once in a Ivy Leauge PhD program in Behavioral Neuroscience. I only bring that up because it is relevant to a comment like mine.
I found myself on the wrong side of the couch more than a few times over the years. Most of the ones that I have found weren’t paid friends and didn’t expect them to be. I did want them to be more than paid door stops though and at least half of them didn’t even meet that standard. At least a door stop has a useful function and earns its place in the world. Some of them just let me ramble and go after 50 minutes with nothing to show for it week after week until I got tired of entertaining their obvious non-interest and found another one. If someone is going to get paid that much for sitting on their ass all day, they should at least try to add something or suggest something. I don’t care how many degrees you have, a dead person could do the same job as many mental health professionals with fewer scheduling difficulties. The knowledge and schooling of the clinician don’t matter much when many of their styles consist of just listening.
I don’t mean to heard on all of you. I did find a couple of good ones over the years who were strict and gave actual advice and passed on real knowledge but those apparently aren’t the norm based on my own experience and that of many friends and family members. I even wanted to be a clinical psychologist at one point but interactions with practicing ones turned me off of that. It is one thing to stay away from being a paid friend. It is quite another to end a 50 minute session with nothing but inquiries about payment methods and insurance after doing nothing more than sitting in an ample chair for a while.
Maybe that style of therapy helps some people but it hasn’t for anyone in my family. I like a little more hands on and concrete approach. When I hear people here and elsewhere suggest that someone see a mental health professional or a marriage counselor, I feel like saying you might as well see a fortune teller because they will work harder and may give equivalent results for less money.
I’ve bought a couple CBT books before and I just couldn’t accept the purpose of what it was offering. I may as well just get addicted to codeine.
I don’t really want to get into that though.
If the patient can’t trust the therapist then nothing will get resolved. Trust is key, trust is friendship… Therapy always seemed like a dead end to me because the focus is always primarily around the patient… It is a unfulfilled relationship as the patient knows it is only about them and that is what they want it to be otherwise they never would have chose that route.
If the patient could get the focus off of them, that will lead them into happiness…
At least I would think that, seems like it makes sense, I have no proof though.
I guess that would be my reasoning for saying therapy only feeds the problem more… I’d be glad to hear opinions on what I said though, perhaps I’m missing something important?
Therapy was very helpful for me. It’s all about me the same way a personal trainer appointment is: helping me learn needed skills.
I learned how to use coping mechanisms to approach my problems in a way that began to solve them. My therapist was an objective ear and teacher to me. She was not my friend any more than my dental hygienist is, though I trust them both.
CBT is a way to exercise your mind into wellness. It is far superior to a codeine addiction because it creates freedom rather than dependence.
I’m not understanding what you mean. You also have to trust your dentist to tell you which teeth need to be filled, and to perform that task in a workmanlike manner. Yet that doesn’t make you his/her friend, does it?
Again, I don’t understand your meaning here. Distracting someone from their problems doesn’t help, else ‘drowning your sorrows’ would actually help you rather than harm you.
Are you saying you can only guess at your reasoning?
But I share very personal and intimate details with my doctors. The issue is separating trust from friendship. I can trust many people, even with personal details, though I wouldn’t be friends with them all. And I wouldn’t automatically trust any doc or therapist either. It’s a relationship, but not a friendship.
To add to my post above, how do you feel about studies that show that almost all therapy approaches are either useless or equivalent to placebo treatment except sometimes Cognitive Behavioral Therapy for specific conditions? This is the Straight Dope after all.
I will give you plenty of cites but you should have those handy being in that specific profession that generates those studies. I am not knocking you personally. I just want to know how so many people make a good living doing essentially nothing even if there some good practitioners around.
Are you game to defend it? What types of practices do you think work best? Which are waste of money overall?
I won’t deny that there are some lousy therapists. I hate, hate, hate when I see someone acting unprofessionally or hear about someone who thinks listening is therapy. It isn’t. On the other hand, I know I am a good therapist. I have seen some of my clients transform themselves with my help. Not all, but some.
Research has its flaws, and clinical research is damned hard to conduct. I was part of a study back in graduate school in which we had to use a “canned” therapy to maintain consistency across therapists. Not a shock, canned therapy isn’t effective.
Some clients want me to just listen, and are very, very difficult to re-direct. I personally hate those sessions. I don’t feel that I am living up to my potential. Anyone can just listen. Shagnasty, I don’t know you, so I don’t know if you are that type of client, but you know you can always ask for feedback, advice, tools, etc. You can even ask someone how they practice before you meet with them. I often have clients tell me that I am the most “active” therapist they have had. I always take that as a compliment.
Wow I get attacked everywhere. I tried so hard to make things simple and then someone comes along and makes it complicated so give me a second NintyWit and I will provide a response after I unclog it all.
To the Ivory, I’d probably be considered crazy to you but I wouldn’t share my personal and intimate details with anyone unless they are doing the same towards me. They definitely would have to be my friend before I would even think of doing so. I’d be cautious in doing so if I were you, some people know how to use your weakness against you, saying this because your actions make you vulnerable.
I’m a non-professional, but I may be able to give you some insight into what therapy can do for someone like me.
I lost my mom to cancer over ten years ago when I was 21. At the time, I had no way of dealing with it, and it was very bad. So I buried everything and have had panic and anxiety ever since.
Now, I don’t have anyone I feel comfortable really talking about not only mom’s death, but also my panic issues. I have a wonderful husband, and close family, but I just can’t discuss it with them (which, I suppose, is something else I can work on). I know enough about my condition to know what I need to do (i.e. - dredge up and deal with the horror, and CBT for dealing with the panic) but I have no skills on how to do this.
My husband is cynical about going to therapy as well - he thinks that no one will try to cure me, if it means I’ll stop paying them for their help. I’m sure there’s crappy therapists out there, but I’d bet the lion’s share are on the level. As I pointed out to my husband - would you have a problem with paying for the skills of a plumber or an architect?
Well, I don’t consider someone’s personal preferences “crazy”, so there you go. I came away from therapy free of my anxiety attacks and with better communication skills. I went for nine months, got what I needed and moved on. No one manipulated or abused me.
Please know that you have revealed your thoughts and feelings and we’re not friends, so I’m a bit confused.
Telling someone that the vast majority of practitioners in their field are lazy charlatans who do nothing but take money without offering anything in return could never be perceived as knocking them. You’re just telling it like it is, right?
Correct because I know there are some good ones. Lots of auto mechanics suck too but we have some good ones on this board. I just wanted t hear the inside perspective. The difference is that auto mechanics are pretty clear cut. Either it runs or it doesn’t. Some mental health professionals can do the equivalent of going to school and learning lots about it while listening to the customer’s complaints for 50 minutes and claiming it is a beneficial service while doing nothing tangible. These are real dollars and time being spent on it.
Real auto mechanics come down hard on charlatans. Mental health professionals and even medical specialties aren’t as quick to correct others in their professions because many patients get better on their own and the data is dirty. The placebo effect is very real as well and not something to be shunned when there is nothing better available.
The only therapy approach that has empirical support that I am aware of is Cognitive Behavioral Therapy but I would be thrilled to be corrected on that. Keep in mind that Freudian psychoanalytic therapy was in vogue for decades before it ever got exposed yet countless people wasted big bucks on it. Mental health therapy does not have a good scientific history although I have no doubt it is getting better with the newer approaches as the hard scientific analyses come in.
