Thoughts on therapist

[DoxieMoxie 316]

Hi all,

As you know, I really struggle with thoughts/feelings/symptoms related to neurological diseases, in particular ALS.  I previously suffered from mild to moderate OCD, which was largely manageable, but my HA exploded in May this year out of nowhere.   

I am currently on medications: 30 mg of an SSRI (Paxil), which is still a fairly low dose for an OCD sufferer per my psychiatrist, and close to completely weaning off my anti-anxiety medication (Lorazepam/Ativan at only 0.25 mg a day - from about 1mg a day initially since June).  The medications have really helped to temper the anxiety, keep me calmer, and more rational, and have prevented any anxiety attacks.  Of course, they do not address the whole problem, because HA and OCD are thinking disorders, and so therapy is a very essential component.

I have seen a therapist now for about 7 sessions over the last 2 months.  She was definitely helpful in the beginning to teach me some relaxation techniques and coping skills, but I just have a sense that we've about hit the point where she does not have much more to offer.  I don't think she has a lot of experience with HA and OCD treatment just based on some of her comments.  I know she has quite a few patients were a fear of germs, but that is so very different.  For example, upon discussing my fears of ALS, she would often say things like, well the body has an amazing ability to fight off disease, which is of course true, but utterly meaningless when it comes to ALS or motor neuron disease.  When a therapist says seemingly empty things or things that are factually inaccurate, it leads me to then doubt them and not really help my progress.  She also suggests replacing anxious thoughts with thoughts about happy things and activities, peace is a position of power, etc. etc. all of which just seems a little to generalized, trite, and easy.   Don't get me wrong; she is an incredibly sweet lady, well meaning and kind, but I just wonder if I should not try to find someone with a bit more experience in my particular problems.   My brother has been through OCD treatment before, and as I recall, the treatment was quite a bit more aggressive, involving elements of exposure therapy, acceptance and commitment therapy, etc.  In my sessions, we mostly just talk, which was fine initially, but I feel like I'm not making further progress.

With all the above said, I'm also cautious about just searching for a new therapist, because I know that I, as a HA and OCD sufferer, often overanalyze things and can be too clever for my own good, and perhaps I am jeopardizing my own therapy? Or does it just sound like it is not a good fit?

Honest opinions please.  I can take it  

  

  

[BeeDot 29]

I'm so glad you're taking an active role in your management of OCD/HA. Seriously. Please recognize what an amazing thing that is. It's hard to accept that you have a problem and that you need help and then it's even hard to actually do the work to try to make things better:-)

 

I think you need to see someone who does CBT or ACT. From everything I've read and everyone I've talked to and my own personal experience, these are the two best therapies for what we have going on. Recognize that it may take some time. I have seen so many therapists for a short amount of time because they just didn't work for me. And the one I'm seeing now, I love to death, but I have to have a tough conversation with her tomorrow because I don't feel like I'm making any progress and I don't see how she's helping me. We have to take an active role in our recovery. 

 

From what you said about the therapist you're seeing -- I think you need a new one. She might be the nicest person ever, but talk therapy alone often isn't enough. The great thing about CBT and ACT is that you can take actions towards recovery. Talking about your feelings and experiences IS important -- please don't misunderstand me -- but it's not the answer. 

 

I have found my therapists on psychologytoday.com, recommendations from friends, and just google searching. It takes some leg work, but its so helpful. 

 

I know you're struggling, but I think you've put a lot of thought into identifying what you need from a therapist and that's awesome! I don't know if what I've written helps you at all, but please ask me to clarify anything or ask me more questions. I've had HA my entire life (yay!) and been up and down with so many therapists that I have a fairly deep well of experience. 

 

All the best,

Bee

[Mark G 1187]

I completely agree with Bee, if you feel that it's stalling or if you have any doubt then swapping may be the best thing to do.  I can only go by my experience here in the UK and i know it's different for the US etc so i don't know how difficult switching would be.  Talking therapy is ok but sometimes it does need a bit more and CBT as well as other techniques should be offered as part of the recovery package.  I think it's also worth noting however that when in therapy, you will feel like they should be doing more to help sometimes, that's just part of our own reassurance seeking and is something a decent therapist will certainly not offer.

[BeeDot 29]

33 minutes ago, Mark G said:

 I think it's also worth noting however that when in therapy, you will feel like they should be doing more to help sometimes, that's just part of our own reassurance seeking and is something a decent therapist will certainly not offer.

I like that you mention this. We do have to help ourselves and a good therapist will be there WITH you and will help you, but won't do things FOR you.

[Mark G 1187]

3 minutes ago, BeeDot said:

I like that you mention this. We do have to help ourselves and a good therapist will be there WITH you and will help you, but won't do things FOR you.

Exactly right, they are the guide for your journey to recovery.  So if you feel like the guide is not guiding, find another that does..

[philb 92]

I hit the same wall with my therapist. Was super refreshing at first to talk with him, but after about 6 months of conversational therapy and "some" CBT, I have found that it's time to see a specialist in CBT. 

[Mark G 1187]

Best bet Philb, conversation therapy only gets you so far with anxiety.  The process of cognitive thought changes takes more than just talking.  Most of it involves rationalizing using the thought tools they give you.

[Holls 1505]

I guess I do talk therapy. I've been going for about a month. I always feel so amazing the day I see her and the few days after but then I slump down again.. I wish I could bring her home with me lol.. I guess it will just get better with time. I want instant results. 

You definitely have to do what's best for you.. do some research and find a therapist that best suits you. 

[DoxieMoxie 316]

Thanks, everyone.  I think I will do some research and find someone who focuses on CBT.  I just wanted to check in, because I know that we can sometimes second guess everything, including our therapist's advice, so wanted to check in with my sounding board  

[AmelOK 18]

I would at least do a few more sessions although I admit I am about ready to put a pause with my current therapist. However, early on after a few sessions I was ready to call it quits and just like that the next few sessions became more helpful. Now, we've kind of hit a wall but definitely try for sure.

[olivet 37]

I definitely have ebbs and flows. Sometimes I'm doing well and feel like I don't have much to talk about so we go biweekly instead of weekly. I recently had a bit of a slip and am now back to weekly. Sometimes I feel like I'm not progressing but I still am, it just takes time. My therapist uses combo approaches- it's mostly traditional talk but incorporating CBT tools.

[xijof 0]

I think your concerns are completely reasonable. Your therapist may be kind and helpful, but that doesn’t necessarily mean she’s the right person to treat your particular form of OCD and health anxiety. When looking for more specialized support, I’d also make sure you understand how ABA billing services for behavioral health are handled, since insurance and billing can sometimes affect which providers or treatment options are available. If you’ve reached the point where sessions mostly consist of talking and general coping techniques, it makes sense to look for someone who has specific experience with OCD and health anxiety, particularly CBT and ERP. You can appreciate what she’s helped you with while still deciding that you need a more specialized approach.