is my psychologist a waste of time?

[joannap]

hi all. my gp refererred me for what i thought was cbt. i had my first session before xmas and was a bit surprised that we didn;t get straight into stuff - he just asked me what i did for a job etc and what anxiety felt like for me.

i did expect some kind of schedule or what he would be teaching me etc but anyway - had 2nd appointment today and i know i will not be able to get on with this man. i spent the whole time i was there asking him what i should be doing re anxiety/intrusive thoughts - he just kept going quiet and looking at me. i felt i directed the whole session and when i asked about observing my thoughts and changing negative ones to more realistic/positive one's he never said anything!? i thought this was the basis of cbt? turns out he is not a cbt person but one who uses several models of thought. he was more interested in my phobias as a child re germs etc and kept asking - where do you think that came from?! sorry - but that is not helping my anxiety in the here and now.

i have come away with the advice to check myself when i wake up and ask myself "do i have anything to be anxious about" and if not - then to tell myself it is habitual anxiety and relax. unlike counselling - there is no reassurance given whatsoever - i did expect him to say something like - intrusive thoughts are a part of anxiety etc etc but he honestly makes me feel much worse and i don;t want to dread the appointments. frankly i have learnt much more from this forum.

my gut instinct tells me not to go - that this man's approach will not help me. my gp did warn me that a lot of people do not like him - what do you guys think?

[PUGLETMUM]

no not in my experience, but i did go private. the nhs cbt i got was over a 2 year period and it was by a trainee and i did not recieve cbt, it was more just person centred therapy - he did help me but not in the way the private therapist did, who btw was his boss in the nhs at the time.

[Lilith1980]

I think if you dont feel comfortable with him, then dont go.

To sit there and say nothing when you are putting questions to him, expecting him to help, is bound to make you feel frustrated. But maybe that is not what he does.

Something has gone wrong somewhere down the line as you wanted CBT and this man clearly doesnt do CBT. Personally, I'd forget him and go back to your GP and say you want someone who uses CBT techniques.

xxx

[joannap]

hi emmas

i expected it to be challenging but in a positive way. if i dread going and i come out feeling worse - that can't be helping me. i only had to wait 6 weeks for an appointment but like i said it is not cbt afterall.

[Bill]

Hello Joanna,

In my experience when we are referred by our doctor, the mental health team then decide which treatment they think would be most helpful to the sufferer based on the doctors report.

Different therapists work in different ways. Some like to get a full background before they begin to show alternatives but I've found most don't offer reassurance because they like to help sufferers to find their own answers because that way they build their own confidence so become stronger for themselves. We also often need patience and then in time we realise we're feeling better because of the therapy.

This therapy wasn't what you were expecting and nor were you treated in the way you were hoping for.

I guess I think like a psychologist because I like to look back before working out how to go forward but if someone said to me they had a dog phobia, I'd suggest they try exposure therapy with dogs.

I'm not going to advise you either way because I can't remember your problems offhand . I think in the end it comes down to your choice whether to persevere a while longer or stop but you could ask your doctor why they thought a psychologists approach could help you before you decide.

[Oceanblue]

Hi There,

Was this a Psychologist or a Psychiatrist ?

From what you've explained it sounds asthough you have been referred to a Psychiatrist first, which is usually what happens. You are then assessed by the Psychiatrist, he/she should then put you onto the appropriate therapy or medication they think you may need.

As Bill say's, they do usually work in this way, they don't talk very much at all to be honest as they want to know your character/personality and how you are as a person. They want to know your background and get to know you to try and find out where your anxiety has stemmed from. It's just the way they work. I also feel they test your reactions in a way, to get to try and get to know you better.

They rarely ask many questions, I understand it seems odd.

It can be really confusing at first, because you're right they can make you feel worse at times, and small - "Guess their not called Shrinks for nothing" lol.

Hope your next appointment's goes better for you. x

[PUGLETMUM]

im not being picky here, but in my experience you dont always get referred to a phychiatrist,before you go on to see a therapist. as far as i know the only way you will get to see shrink is if your in crisis/have no support. if you are really struggling on meds you may eventually get to see a shrink, but i think youd be more likely assesed by a psycotherapist, shrinks are the ones who can prescibe meds(but your gp can prescribe them as well) and they are there to treat mental illnesses, i dont think they are experts in 'therapy'. they are doctors in mental illness. there is a big difference. ofcourse every health authority is different,but in mine you dont get to see a shrink unless you are in a mess or you ask to see one, in which case you will still be assessed by some other mental health people before you would be deemed as needing to see the shrink. hope this helps?

[Oceanblue]

I know that Psychiatrist's prescribe medication, and Psychologists use therapy. But some people need a combination.

Joan - I was just saying that it could be a possibilty from what you have described and by my own experience that you may have been referred to a Psychiatrist first. Otherwise, I guess it sound's asthough the Therapist starts off his work this way. You could ask him to explain things to you/how he works and what you can expect and see what he says. I suppose all Psychologist's work in a variety of different ways. If you feel that his technique isn't suitable for you, then you can try asking your GP to be referred to someone else.

[joannap]

hi all - he is not a psychiatrist. he is a consultant psychologist that visits our surgery one day a week. basically my doctor offered me cbt as a method of dealing with anxiety long term - the waiting list was short so i thought i would be mad not to accept. i could be referred to harrogate to see a psychologist (long waiting list) but there again - i do not know if these use cbt.

on my first appointment when i was rattling on about cbt and what i had read - he told me he was not a cbt therapist (in fact he said that was only the treatment of the moment because of all the hype attached to it!) and that he used various models of thought.

i understand about not giving reassurance but when you directly ask a therapist something about anxiety that is bothering you and he just looks at you and says mmmmmmmm - doesn't that make you even more confused, upset and frustrated? i don't expect him to do the work for me but i do expect to be pointed in the right direction. my expectations would be that he would be positive and motivated and arm me with lots of cbt techniques! I know its only the second time but i really feel he is not going to give me what i need.

i have been down the counselling approach and have only ever seen my gp re: meds. the counselling helped to some degree. i do agree with you bill that it can be enlightening to look at the past and see where these feelings stem from but as a method of treatment i feel it actually does more harm than good. i have been over my childhood time and time again and although i can effectively trace where my anxiety came from - it actually makes you feel worse not better!

my gp did warn me that a lot of people have complained about Dr Skinners approach so i do realise that i am not the first person to find him not for them. she thought a more cognitive rather than counselling approach would be helpful to me but i truly feel it will cause me more harm to dread going to the appointment each time. i do know quite a lot about cbt myself - the trouble is i find it hard to put into action but maybe instead of going to see someone and doing it because i have been told to - i should get on with it myself!

[PUGLETMUM]

im sure this therapist would defend his method of therapy, and also like everybody else he may be wouldnt see himself as rubbish? this is where the 'human' element comes in.

joanna, my therapist is a qualified pshchologist practising cbt, which may be the therapy of the moment - i wonder why?

i want to illustrate to you how it can work, firstly you are correct in that you need insight and you need to be commited and in agreement and also prepared to feel alot of discomfort? but my tharapists aim was to help me 'to be your own therapist'. to prove the point that cbt can work, but you are key in the process is illustarted by my experience TODAY.............

stay with me if you can? - right i have spent years dependant and with a small safety zone, i have multiple phobias (the agoraphobic cluster) but they really all boil down to a fear of fear and low self-esteem. this year(2007) i had another crisis(yawn) but i have also had 15 sessions of cbt in that year and i can now comfortably go to the supermarket with my daughter or alone, i can go into heavier traffic, i can go to my shopping mall in my town with my daughter or alone, and today i have been to my college about 3 miles away and donr an nvq assessment alone. im by no means where i want to be, but i was never 'normal' anyway,so for me these acheivemnets put me back to where i was 10 years ago, only further because i did it alone and with no meds!!! 10 years ago i was doing some college stuff - little part-time rsa courses, but i was on prozac&propranolol so okay it was me doing it, but i was in a nice little safe bubble away form any anx sym[ptoms. today i have gone there DESPITE my anx symptoms -i have been awake since 5am! and i feel brill. it can be done joanna, just dont give up! emmaxxxxxxxxxxxxx