Does our askme's number one go-to answer actually bring about the desired effect? July 14, 2011 10:13 PM Subscribe
I'm wondering how often the advice to get therapy actually results in someone realizing, damn, I need therapy.
It just SO seems the default answer in any thread where anyone expresses a personal or emotional conflict, that I'm starting to wonder how useful it really is. I'm totally happy to hear stories of people who realized, after posting and seeing the responses, that they should be in therapy, and then seeking therapy. Do people have such happy tales?
I've started feeling like it's the knee-jerk response for people who want to be helpful but have nothing concrete to advise. Especially when someone says they're already in therapy (and then, of course, it's 'talk about it to your therapist') or that they don't want to be advised to go to therapy (which just invites even more passionate arguments for it), I just kind of wonder if it is helpful. I mean, it's probably not harmful, so that's already something, right?
It just SO seems the default answer in any thread where anyone expresses a personal or emotional conflict, that I'm starting to wonder how useful it really is. I'm totally happy to hear stories of people who realized, after posting and seeing the responses, that they should be in therapy, and then seeking therapy. Do people have such happy tales?
I've started feeling like it's the knee-jerk response for people who want to be helpful but have nothing concrete to advise. Especially when someone says they're already in therapy (and then, of course, it's 'talk about it to your therapist') or that they don't want to be advised to go to therapy (which just invites even more passionate arguments for it), I just kind of wonder if it is helpful. I mean, it's probably not harmful, so that's already something, right?
Nice, there are probably other good ones. It'd be encouraging to see them.
posted by namesarehard at 10:36 PM on July 14, 2011
posted by namesarehard at 10:36 PM on July 14, 2011
You know it's a trite, reflexive answer when it gets recommended by *counts*... seven different commenters after the OP mentions she's already had "years of therapy."
Also when it's a go-to jab in Encyclopedia Dramatica's parody of AskMe.
posted by Rhaomi at 10:39 PM on July 14, 2011 [12 favorites]
Also when it's a go-to jab in Encyclopedia Dramatica's parody of AskMe.
posted by Rhaomi at 10:39 PM on July 14, 2011 [12 favorites]
I got into therapy "ecause a casual conversation with my friends lead to one of them saying 'hey, you're probably depressed. you should try therapy'. It saved my life, probably.
posted by Lovecraft In Brooklyn at 10:54 PM on July 14, 2011 [1 favorite]
posted by Lovecraft In Brooklyn at 10:54 PM on July 14, 2011 [1 favorite]
Ugh, I really wish I hadn't seen that Encyclopedia Dramatica entry.
posted by katillathehun at 11:03 PM on July 14, 2011 [1 favorite]
posted by katillathehun at 11:03 PM on July 14, 2011 [1 favorite]
Frankly, I don't think "find a therapist" is such a fantastic answer. Sure, maybe for some serious issues and maybe for certain individuals but not everybody needs (or even wants) therapy, and not every situation calls for it either. [not therapist-ist-
posted by 1000monkeys at 11:05 PM on July 14, 2011 [2 favorites]
posted by 1000monkeys at 11:05 PM on July 14, 2011 [2 favorites]
Frankly, I don't think "find a therapist" is such a fantastic answer. Sure, maybe for some serious issues and maybe for certain individuals but not everybody needs (or even wants) therapy, and not every situation calls for it either. [not therapist-ist-
A therapist can let you know if you need therapy, though, and get you out of whatever hole your brain is stuck in.
posted by Lovecraft In Brooklyn at 11:10 PM on July 14, 2011 [2 favorites]
Not every situation calls for it. Sometimes people are just assholes and need to be called on their behavior more regularly. More people than not could use a little therapy, at least, though.
posted by rtha at 11:16 PM on July 14, 2011
posted by rtha at 11:16 PM on July 14, 2011
Being called out on being an asshole is a kind of therapy in itself.
posted by geckoinpdx at 11:18 PM on July 14, 2011 [3 favorites]
posted by geckoinpdx at 11:18 PM on July 14, 2011 [3 favorites]
namesarehard, you should consider therapy for your obsession.
posted by Ardiril at 11:27 PM on July 14, 2011 [1 favorite]
posted by Ardiril at 11:27 PM on July 14, 2011 [1 favorite]
(Thematically related youtube post) "That boy needs therapy!"
posted by Lynsey at 11:40 PM on July 14, 2011 [10 favorites]
posted by Lynsey at 11:40 PM on July 14, 2011 [10 favorites]
I think a lot of people recommend counseling as a sort of generic panacea for any question that seems to have a vaguely psychological component. It's frequently not a helpful answer. In other cases, though, it makes sense.
As with any question, the OP has to sort through the answers and figure out which answers are actually responsive to the question and which ones make sense. I think when it makes sense, answerers can explain why it makes sense, and the OP will take it more seriously. Hopefully, when it's a non-responsive, knee-jerk answer, the OP will ignore it, and move on to responses that are actually trying to answer the question.
posted by nangar at 11:53 PM on July 14, 2011
As with any question, the OP has to sort through the answers and figure out which answers are actually responsive to the question and which ones make sense. I think when it makes sense, answerers can explain why it makes sense, and the OP will take it more seriously. Hopefully, when it's a non-responsive, knee-jerk answer, the OP will ignore it, and move on to responses that are actually trying to answer the question.
posted by nangar at 11:53 PM on July 14, 2011
If someone really wants to answer a question: How do you find a decent therapist? In my experience, my doctors recommendations have been consistently horrible.
posted by Ardiril at 12:02 AM on July 15, 2011
posted by Ardiril at 12:02 AM on July 15, 2011
Over the years we've talked a lot about what mefi "does well" or "does not do well" and askme questions about mental health are something that mefi does "very well". And I'm proud to say that my own mefi history backs that statement up.
When I see comments saying find a therapist, it really is because the poster can't be cured by internet comments. It's not people being harsh, it's people being real. And I would disagree that get therapy is the default answer to these types of questions. It's used sparingly and on purpose.
You seem to be framing the suggestion of needing therapy as some sort of insult. Therapy is a gift. The world doesn't get easier, we get better.
posted by pwally at 12:08 AM on July 15, 2011 [26 favorites]
When I see comments saying find a therapist, it really is because the poster can't be cured by internet comments. It's not people being harsh, it's people being real. And I would disagree that get therapy is the default answer to these types of questions. It's used sparingly and on purpose.
You seem to be framing the suggestion of needing therapy as some sort of insult. Therapy is a gift. The world doesn't get easier, we get better.
posted by pwally at 12:08 AM on July 15, 2011 [26 favorites]
Giving concrete answers to challenging mental health issues is impossible when all you got is a couple of paragraphs from some stranger. Also, your average Mefi is a lousy mental health professional. It might not be much but recommending therapy makes sense because people's issues need to be properly understood and managed by professionals over a longer period of time, not just when an Askme is on the frontpage.
posted by Foci for Analysis at 12:37 AM on July 15, 2011 [9 favorites]
posted by Foci for Analysis at 12:37 AM on July 15, 2011 [9 favorites]
I've started feeling like it's the knee-jerk response for people who want to be helpful but have nothing concrete to advise.
Suggesting therapy *is* concrete, and sometimes it *is* the only solution. Sometimes it's a way of saying "this is serious or might bring harm to you or your life, so you need serious help." Also, sometimes, it's clear that the asker should have someone who knows them and can monitor how they're doing. Other times, it seems that the asker's problem is something that needs to be worked out at length over a long period of time, consistently, with someone who knows what they're doing.
I don't agree with those who think medical or mental health questions should be banned, or the only proper answer to them is "see a medical professional," and not all problems are like what I've described above, and in those cases, people go ahead and give other advice. I don't really see people suggesting therapy just for lack of something to advise -- anyone can pull concrete advice out of their butt at any time.
posted by Ashley801 at 12:46 AM on July 15, 2011 [4 favorites]
Suggesting therapy *is* concrete, and sometimes it *is* the only solution. Sometimes it's a way of saying "this is serious or might bring harm to you or your life, so you need serious help." Also, sometimes, it's clear that the asker should have someone who knows them and can monitor how they're doing. Other times, it seems that the asker's problem is something that needs to be worked out at length over a long period of time, consistently, with someone who knows what they're doing.
I don't agree with those who think medical or mental health questions should be banned, or the only proper answer to them is "see a medical professional," and not all problems are like what I've described above, and in those cases, people go ahead and give other advice. I don't really see people suggesting therapy just for lack of something to advise -- anyone can pull concrete advice out of their butt at any time.
posted by Ashley801 at 12:46 AM on July 15, 2011 [4 favorites]
katillathehun: "Ugh, I really wish I hadn't seen that Encyclopedia Dramatica entry."
Ugh, on second look the parts of the article outside the parody are a lot more nasty and personal than they were when I saw it originally. Sorry for putting it here.
posted by Rhaomi at 1:06 AM on July 15, 2011
Ugh, on second look the parts of the article outside the parody are a lot more nasty and personal than they were when I saw it originally. Sorry for putting it here.
posted by Rhaomi at 1:06 AM on July 15, 2011
I wonder whether posters aren't looking for insights into their situation that they wouldn't have thought of, or experiences from other people's life that reflect or resonate with their situation, which might not be empirical answers of the kind that . Usually when it comes up, the "see a therapist" reply seems only a little more specific than "do some stuff".
When you refer to "a therapist", what exactly are you talking about? Only CBT, because there are some supportive statistics somewhere, or do any or all of the other therapeutic methodologies count?
Would it be germane to ask people to respect a "no therapist recommendations, please" request on an AskMe question (which would suggest that the querent is aware of that approach, which is all that a recommendation can do, really, anyway)?
posted by Grangousier at 1:17 AM on July 15, 2011 [2 favorites]
When you refer to "a therapist", what exactly are you talking about? Only CBT, because there are some supportive statistics somewhere, or do any or all of the other therapeutic methodologies count?
Would it be germane to ask people to respect a "no therapist recommendations, please" request on an AskMe question (which would suggest that the querent is aware of that approach, which is all that a recommendation can do, really, anyway)?
posted by Grangousier at 1:17 AM on July 15, 2011 [2 favorites]
"empirical answers of the kind that AskMe prefers."
Gah.
posted by Grangousier at 1:22 AM on July 15, 2011
Gah.
posted by Grangousier at 1:22 AM on July 15, 2011
Would it be germane to ask people to respect a "no therapist recommendations, please" request on an AskMe question
Only if it starts the question, cuz as we know, only 6% of responders actually read a question to the end.
posted by Ardiril at 1:37 AM on July 15, 2011
Only if it starts the question, cuz as we know, only 6% of responders actually read a question to the end.
posted by Ardiril at 1:37 AM on July 15, 2011
"Therapy" is, very often, a not-great answer in my opinion. It seems like most people are either already in therapy, or have never really been exposed to it.
To those people, even if open to the idea of therapy, the phrase "see a therapist" is meaningless. Am I just supposed to open the yellow pages to "therapy" and pick one? I'm certain there are different types of therapy, what kind should I look into? &c. Personally, as someone with no primary care physician and no friends in therapy, I wouldn't know where to start.
I'm not at all asking that people stop suggesting therapy; I'm sure therapy would be helpful to many askers on the green! Just, AT THE VERY LEAST, explain why you're suggesting it, and maybe whether they should be looking into a social worker, a psychiatrist, a psychologist, or what. If you can't supply either of those things, maybe you aren't really qualified to answer the question.
My main issue is that I worry that "go see a therapist" has become part of the AskMe groupthink, where people will rush into a thread to be the first (or the tenth) to say it. People come to Ask looking for personal experiences and first-hand insight. If you can answer "I was in a similar situation, and here's how seeing a therapist helped me", that's awesome! But if you're just coming in with a three word answer, then just maybe you don't know squat.
I'm certainly guilty of it myself, but I think too often people confuse what's helpful to the asker with what's easy to type into the box.
This has been irking me in Ask recently. I should get outside more.
posted by auto-correct at 1:50 AM on July 15, 2011 [10 favorites]
To those people, even if open to the idea of therapy, the phrase "see a therapist" is meaningless. Am I just supposed to open the yellow pages to "therapy" and pick one? I'm certain there are different types of therapy, what kind should I look into? &c. Personally, as someone with no primary care physician and no friends in therapy, I wouldn't know where to start.
I'm not at all asking that people stop suggesting therapy; I'm sure therapy would be helpful to many askers on the green! Just, AT THE VERY LEAST, explain why you're suggesting it, and maybe whether they should be looking into a social worker, a psychiatrist, a psychologist, or what. If you can't supply either of those things, maybe you aren't really qualified to answer the question.
My main issue is that I worry that "go see a therapist" has become part of the AskMe groupthink, where people will rush into a thread to be the first (or the tenth) to say it. People come to Ask looking for personal experiences and first-hand insight. If you can answer "I was in a similar situation, and here's how seeing a therapist helped me", that's awesome! But if you're just coming in with a three word answer, then just maybe you don't know squat.
I'm certainly guilty of it myself, but I think too often people confuse what's helpful to the asker with what's easy to type into the box.
This has been irking me in Ask recently. I should get outside more.
posted by auto-correct at 1:50 AM on July 15, 2011 [10 favorites]
It's also true of recommendations of meditation (which I think I've been guilty of in the past): there are a number of different techniques and exercises which all look the same from the outside and are bundled together as somehow the same thing, but which aren't really - exercises to focus the concentration (exemplified, I think, by zazen); or to defocus the attention and engender awareness that is non-specific (vipassana); or to work with distributing positive emotions rather than concentrating them on specific individuals (metta); in addition to other exercises that work with visualisation or mantra and have other uses and effects. They are not the same thing any more than bench presses, bicep curls, jogging and sit-ups are the same thing. They may be the same kind of thing, but that's different.
(The potted definitions of different kinds of meditation are merely intended to be illustrative of the diffferences between techniques. Probably not as accurate definitions as an actual expert would be able to provide.)
posted by Grangousier at 2:28 AM on July 15, 2011 [2 favorites]
(The potted definitions of different kinds of meditation are merely intended to be illustrative of the diffferences between techniques. Probably not as accurate definitions as an actual expert would be able to provide.)
posted by Grangousier at 2:28 AM on July 15, 2011 [2 favorites]
I had it that response in reply to one of my marriage questions and it surprised me (duh), and yes, we did seek therapy. We are now separated (not with the help of that therapist, though, it took me a while longer to get really tired of what was going on) and I am glad that I tried everything I could to make our marriage work.
posted by b33j at 2:36 AM on July 15, 2011 [1 favorite]
posted by b33j at 2:36 AM on July 15, 2011 [1 favorite]
GET TERRAPIN! It's turtles all the way down.
posted by stavrosthewonderchicken at 2:38 AM on July 15, 2011
posted by stavrosthewonderchicken at 2:38 AM on July 15, 2011
Sean Connery: I'll take "The Rapists" for $200.
Alex Trebek: That's "Therapists."
posted by bwg at 3:03 AM on July 15, 2011 [1 favorite]
Alex Trebek: That's "Therapists."
posted by bwg at 3:03 AM on July 15, 2011 [1 favorite]
One of the nice things about spending too much time reading AskMe over years and years is that I get reinforced, over and over again, about what kind of problems are helped by therapy, what kind of problems are serious enough that one should get therapy for, etc. As a result, when I actually needed therapy I managed to get myself there without too much kicking and screaming. It's a nice side effect.
posted by Jeanne at 3:25 AM on July 15, 2011 [9 favorites]
posted by Jeanne at 3:25 AM on July 15, 2011 [9 favorites]
I asked an anon question once where part of my question was wondering if therapy would help me and going into my misgivings about therapy. Many of the answers helped me understand how therapy would help me, and quelled my concerns. I didn't end up going that route, for a multitude of other reasons, but I did become more open to the prospect.
posted by litnerd at 3:57 AM on July 15, 2011
posted by litnerd at 3:57 AM on July 15, 2011
If someone really wants to answer a question: How do you find a decent therapist? In my experience, my doctors recommendations have been consistently horrible.
Since my last two days on Metafilter have, apparently, been all about my mental health issues I'll share this: When I needed a therapist I started by asking my doctor to recommend someone. She couldn't do it. Had no idea who to send me to. It was like she had never, ever gotten that question before. Which left me, frankly, sort of stuck with either looking in my insurance directory or the phone book. (Asking friends was out.) This would be why the "get therapy" answers always infuriate me.
posted by anastasiav at 4:33 AM on July 15, 2011 [2 favorites]
Since my last two days on Metafilter have, apparently, been all about my mental health issues I'll share this: When I needed a therapist I started by asking my doctor to recommend someone. She couldn't do it. Had no idea who to send me to. It was like she had never, ever gotten that question before. Which left me, frankly, sort of stuck with either looking in my insurance directory or the phone book. (Asking friends was out.) This would be why the "get therapy" answers always infuriate me.
posted by anastasiav at 4:33 AM on July 15, 2011 [2 favorites]
Being dismissive of "see a therapist" makes me wonder how seriously people actually take mental illness.
If someone posted on AskMe wondering if he had a raging infection, most of us would say, "Get to a doctor," because the consequences of ignoring an infection are serious.
When someone posts on AskMe saying that he feels like a horrible person, or his depression is getting in the way of everyday life, saying "Get to a therapist" is, to me, saying, "We take your health issue seriously enough to not try and diagnose it over the internet."
posted by xingcat at 4:41 AM on July 15, 2011 [22 favorites]
If someone posted on AskMe wondering if he had a raging infection, most of us would say, "Get to a doctor," because the consequences of ignoring an infection are serious.
When someone posts on AskMe saying that he feels like a horrible person, or his depression is getting in the way of everyday life, saying "Get to a therapist" is, to me, saying, "We take your health issue seriously enough to not try and diagnose it over the internet."
posted by xingcat at 4:41 AM on July 15, 2011 [22 favorites]
It would be nice to have a moratorium on responses which amount only to "seek therapy," without any further personal observations or advice. Having asked a few AskMes on these subjects, the answers I find most valuable are the ones where people say, "When I was feeling like this, I noticed X, Y and Z..." Even if, in the end, they suggested therapy, it's their story I remember.
That's why people ask things here, isn't it?
posted by overeducated_alligator at 4:48 AM on July 15, 2011 [2 favorites]
That's why people ask things here, isn't it?
posted by overeducated_alligator at 4:48 AM on July 15, 2011 [2 favorites]
If someone really wants to answer a question: How do you find a decent therapist? In my experience, my doctors recommendations have been consistently horrible.
Kind of ridiculous, but what I did was basically google all the therapists in my area that my insurance covered. Some small fraction had some kind of web presence. This one volunteered with certain kinds of victims, that one published a book, etc. I found one who seemed really great and great for me and called him. He was booked, but he was able to recommend the person he thought was best.
I'm sure a lot of great therapists aren't apparent from google and that this method is far from foolproof, but it worked for me.
posted by callmejay at 4:50 AM on July 15, 2011 [2 favorites]
Kind of ridiculous, but what I did was basically google all the therapists in my area that my insurance covered. Some small fraction had some kind of web presence. This one volunteered with certain kinds of victims, that one published a book, etc. I found one who seemed really great and great for me and called him. He was booked, but he was able to recommend the person he thought was best.
I'm sure a lot of great therapists aren't apparent from google and that this method is far from foolproof, but it worked for me.
posted by callmejay at 4:50 AM on July 15, 2011 [2 favorites]
huge swaths of comments on the sub-section MetaTalk are devoted to working out just how offended people are.
QFT
posted by nathancaswell at 5:21 AM on July 15, 2011 [1 favorite]
QFT
posted by nathancaswell at 5:21 AM on July 15, 2011 [1 favorite]
My general feeling is that if people wanted to talk face-to-face with another human being about their problem, they probably wouldn't have posted it anonymously on the Internet.
posted by DU at 5:24 AM on July 15, 2011 [2 favorites]
posted by DU at 5:24 AM on July 15, 2011 [2 favorites]
Not wanting to talk about it face to face is often part of the problem.
posted by Obscure Reference at 5:35 AM on July 15, 2011 [5 favorites]
posted by Obscure Reference at 5:35 AM on July 15, 2011 [5 favorites]
Will having therapy make me think Woody Allen is funny? I'd rather not be conflicted about that creep; he made a brother-in-law out of his son. If I start thinking he's funny, I'll be just a step away from admiring Polanski. Then, who knows what kinds of things I'll start thinking about? Better to nip that one in the bud, so to speak.
posted by Ice Cream Socialist at 5:36 AM on July 15, 2011 [1 favorite]
posted by Ice Cream Socialist at 5:36 AM on July 15, 2011 [1 favorite]
Woody Allen used to be funny. I watched Hannah and Her Sisters a few nights ago and was shocked that this was made by the same person who made his more recent movies.
posted by Obscure Reference at 5:40 AM on July 15, 2011
posted by Obscure Reference at 5:40 AM on July 15, 2011
DU : "My general feeling is that if people wanted to talk face-to-face with another human being about their problem, they probably wouldn't have posted it anonymously on the Internet."
Sometimes, it's possible to know something is wrong and needs to be worked on, but not know how to go about changing things for the better. Therapy can seem quite scary to a first-timer, especially when the topic which needs to be brought into the open is some form of abuse of physical or emotional trust. Fears might range from having someone judge them, to committing to something that they aren't quite sure they're ready for.
Online anonymity can be a shield. But perhaps for some people also a stepping stone towards getting the help they need.
posted by zarq at 5:44 AM on July 15, 2011 [1 favorite]
Sometimes, it's possible to know something is wrong and needs to be worked on, but not know how to go about changing things for the better. Therapy can seem quite scary to a first-timer, especially when the topic which needs to be brought into the open is some form of abuse of physical or emotional trust. Fears might range from having someone judge them, to committing to something that they aren't quite sure they're ready for.
Online anonymity can be a shield. But perhaps for some people also a stepping stone towards getting the help they need.
posted by zarq at 5:44 AM on July 15, 2011 [1 favorite]
Fact is "Get a lawyer" is not necessarily the answer the questioner wanted and will be ignored but is actually the correct one.
posted by Obscure Reference at 5:52 AM on July 15, 2011
posted by Obscure Reference at 5:52 AM on July 15, 2011
I should amend or clarify my earlier comment by saying that even when I think the person's main problem is more that their assholery needs to be called out and less that they need therapy, I'll often recommend therapy (or stay out of the thread). I do this because mental health issues can be serious, and like physical symptoms, deserve to be dealt with by a competent professional.
posted by rtha at 6:07 AM on July 15, 2011
posted by rtha at 6:07 AM on July 15, 2011
Might as well out with it -- this was my Ask. I didn't mean for it to become a referendum on the "get therapy, nutbag" response -- I am still in therapy, although I can only afford a session once a month (which isn't sufficient, most likely, but better than no port in an asshole storm, I guess) and the method is a combination of CBT and psychodynamic therapy. I will admit I hadn't considered a group therapy option, so that opinion was totally helpful, actually. I have also tried volunteering at DV shelters to get out of my own selfishness and help someone else who actually needs it, but occasionally shy away from that as it hits a little too close to home. I should have been a bit more clear in the question, as I wanted to see if anyone else had personal experience with either making peace with inappropriately steamrolling over social cues or sorting out the problem. That being said, I've been lurking here for years, and I'm confident that most of the Asks with "get therapy" answers are such because the answerer truly thinks that's the best option for the asker. I'd also like to thank all the folks that took time to read and answer my question.
posted by sinnesloeschen at 6:10 AM on July 15, 2011 [7 favorites]
posted by sinnesloeschen at 6:10 AM on July 15, 2011 [7 favorites]
Oh, and --
MetaFilter: better than no port in an asshole storm
posted by sinnesloeschen at 6:24 AM on July 15, 2011
MetaFilter: better than no port in an asshole storm
posted by sinnesloeschen at 6:24 AM on July 15, 2011
I think that therapy is often beneficial and sometimes necessary. That said, I have two problems with the "get therapy" answer when it's unaccompanied by any other advice.
First, in cases where the poster doesn't seem to be in crisis, it seems somehow not enough. If someone has a heart attack, yeah, "go to the ER" is the only answer, but if someone has a flu, "see a doctor" is actually a frustrating answer because it's only part of a longer list of potential solutions but it sort of forecloses other solutions because it's so... I am having trouble expressing this... like oh, good, someone suggested a doctor, doctors are experts, my work here is done. But in truth there are lots of good suggestions when someone has the flu (Mucinex! Chicken soup!) that can make someone feel better, and when you're not critically ill, seeing a doctor (which is varying degrees of difficult and expensive) needs to be weighed against alternatives. So it bothers me because it feels insufficient while giving the illusion of sufficiency.
Second, I increasingly see support for the idea that therapy is the best or only adequate solution for interpersonal conflicts, stress, anxiety, sadness, and generally all emotional and interpersonal struggles. Therapy is *a* solution, but there are so many concrete ideas that can help someone work through such problems. I really, really object to the idea that we're somehow not the experts when it comes to figuring out how to be happy or accept difficulty or overcome problems. Look, if someone has a mental illness, I am the first to tell you that we are not the expert, but there's a lot of shit and unhappiness that happens to people who are not mentally ill. They can probably benefit from therapy, but they can also benefit from the collective wisdom and life experience of a community of other human beings.
So yeah, sometimes it troubles me that we get so much "get therapy" in AskMe because I think it subtly chills other, potentially useful advice. However, it doesn't seem like there's much to be done about it, especially because "get therapy" is definitely sometimes the best answer, and often a useful piece of advice.
I guess I would probably be on board with a policy of discouraging answers that say literally nothing apart from "get therapy" just as we discourage single-word yes or no answers without more.
And I would encourage people not to see 10 "get therapy" answers in a thread and move on thinking the question has been answered if they had advice of their own.
posted by prefpara at 6:38 AM on July 15, 2011 [11 favorites]
First, in cases where the poster doesn't seem to be in crisis, it seems somehow not enough. If someone has a heart attack, yeah, "go to the ER" is the only answer, but if someone has a flu, "see a doctor" is actually a frustrating answer because it's only part of a longer list of potential solutions but it sort of forecloses other solutions because it's so... I am having trouble expressing this... like oh, good, someone suggested a doctor, doctors are experts, my work here is done. But in truth there are lots of good suggestions when someone has the flu (Mucinex! Chicken soup!) that can make someone feel better, and when you're not critically ill, seeing a doctor (which is varying degrees of difficult and expensive) needs to be weighed against alternatives. So it bothers me because it feels insufficient while giving the illusion of sufficiency.
Second, I increasingly see support for the idea that therapy is the best or only adequate solution for interpersonal conflicts, stress, anxiety, sadness, and generally all emotional and interpersonal struggles. Therapy is *a* solution, but there are so many concrete ideas that can help someone work through such problems. I really, really object to the idea that we're somehow not the experts when it comes to figuring out how to be happy or accept difficulty or overcome problems. Look, if someone has a mental illness, I am the first to tell you that we are not the expert, but there's a lot of shit and unhappiness that happens to people who are not mentally ill. They can probably benefit from therapy, but they can also benefit from the collective wisdom and life experience of a community of other human beings.
So yeah, sometimes it troubles me that we get so much "get therapy" in AskMe because I think it subtly chills other, potentially useful advice. However, it doesn't seem like there's much to be done about it, especially because "get therapy" is definitely sometimes the best answer, and often a useful piece of advice.
I guess I would probably be on board with a policy of discouraging answers that say literally nothing apart from "get therapy" just as we discourage single-word yes or no answers without more.
And I would encourage people not to see 10 "get therapy" answers in a thread and move on thinking the question has been answered if they had advice of their own.
posted by prefpara at 6:38 AM on July 15, 2011 [11 favorites]
I've asked anon questions where the answers suggested therapy. But I never went because it seems most therapists won't take insurance and make you pay up their absurd fees upfront and then file some out of network bullshit. For a person struggling, that can seem impossible.
posted by melissam at 6:43 AM on July 15, 2011 [4 favorites]
posted by melissam at 6:43 AM on July 15, 2011 [4 favorites]
I guess I would probably be on board with a policy of discouraging answers that say literally nothing apart from "get therapy" just as we discourage single-word yes or no answers without more.
We'll often do that, the same as when people are like "Lawyer. Now" or "Why are you still reading this, go to a doctor" That said if someone is like "This is why therapy might help when you think it won't help" that seems like germane advice. Therapy is tricky in that it works, for some people, very well, but it's not a cure-all obviously. Also unlike some medication options, you have to be a little invested in it for it to work for you. If I recall correctly, someone made up some "How do I find a therapist" page on the wiki a while back... ah it's a sub-section of the ThereIsHelp page.
I think one of the big things that is true of our heavy AskMe users is that a lot of them have been to therapy, for better or worse, and if you see someone having a hard time who has not at least tried that [or especially saying "therapy not an option"] it seems like an obvious next step. Also it is the fundamental equivalent of "We don't know, talk to a trained professional" answer in a lot of cases and seems like a prudent thing to say if someone has problems that need more than just "Get more sleep/exercise" approaches, as many people seem to.
posted by jessamyn (staff) at 6:52 AM on July 15, 2011 [4 favorites]
We'll often do that, the same as when people are like "Lawyer. Now" or "Why are you still reading this, go to a doctor" That said if someone is like "This is why therapy might help when you think it won't help" that seems like germane advice. Therapy is tricky in that it works, for some people, very well, but it's not a cure-all obviously. Also unlike some medication options, you have to be a little invested in it for it to work for you. If I recall correctly, someone made up some "How do I find a therapist" page on the wiki a while back... ah it's a sub-section of the ThereIsHelp page.
I think one of the big things that is true of our heavy AskMe users is that a lot of them have been to therapy, for better or worse, and if you see someone having a hard time who has not at least tried that [or especially saying "therapy not an option"] it seems like an obvious next step. Also it is the fundamental equivalent of "We don't know, talk to a trained professional" answer in a lot of cases and seems like a prudent thing to say if someone has problems that need more than just "Get more sleep/exercise" approaches, as many people seem to.
posted by jessamyn (staff) at 6:52 AM on July 15, 2011 [4 favorites]
Q: I have a problem with my car. It's like this... [details details details]. What should I do?
A: See a professional mechanic.
It might be the prudent answer that nine out of ten lawyers and insurance agents would approve, but when you went to an online forum with a question about your car, you didn't go there just to be referred to a professional mechanic.
When someone comes to askme with a mental health issue, you (collectively, the Green Unwashed) are the therapist they have paid their five bucks to see. If all you can offer is "you should spend time with a professional therapist who has a diploma on the wall" you are not really helping. You should at least give your own opinion as an unpaid on-the-spot therapist. They want to know what you (the grocer, the keyboard jockey, the student, the auto mechanic, the mom, the crack addict, the dude in his mother's basement) think is the real problem and the real solution.
posted by pracowity at 6:53 AM on July 15, 2011 [3 favorites]
A: See a professional mechanic.
It might be the prudent answer that nine out of ten lawyers and insurance agents would approve, but when you went to an online forum with a question about your car, you didn't go there just to be referred to a professional mechanic.
When someone comes to askme with a mental health issue, you (collectively, the Green Unwashed) are the therapist they have paid their five bucks to see. If all you can offer is "you should spend time with a professional therapist who has a diploma on the wall" you are not really helping. You should at least give your own opinion as an unpaid on-the-spot therapist. They want to know what you (the grocer, the keyboard jockey, the student, the auto mechanic, the mom, the crack addict, the dude in his mother's basement) think is the real problem and the real solution.
posted by pracowity at 6:53 AM on July 15, 2011 [3 favorites]
When I needed a therapist I started by asking my doctor to recommend someone. She couldn't do it. Had no idea who to send me to. It was like she had never, ever gotten that question before. Which left me, frankly, sort of stuck with either looking in my insurance directory or the phone book. (Asking friends was out.) This would be why the "get therapy" answers always infuriate me.
Um, how did you find your doctor? No, I'm serious. Finding a therapist is just like finding a doctor or a dentist. You can't expect someone to point to a therapist and say "Go see them; they are the answer to your prayers." Just because your doctor or friend thinks their therapist is the cat's meow doesn't mean you'll like them. You have to call around and see if you can find one you sync with. This is your mental health we're talking about -- you need to take control of it. If that means starting with the therapists your insurance covers or googling therapists in your area, then what's wrong with that? A therapist isn't going to come knocking on your door offering their service, you have to go to them.
posted by patheral at 7:07 AM on July 15, 2011 [3 favorites]
Um, how did you find your doctor? No, I'm serious. Finding a therapist is just like finding a doctor or a dentist. You can't expect someone to point to a therapist and say "Go see them; they are the answer to your prayers." Just because your doctor or friend thinks their therapist is the cat's meow doesn't mean you'll like them. You have to call around and see if you can find one you sync with. This is your mental health we're talking about -- you need to take control of it. If that means starting with the therapists your insurance covers or googling therapists in your area, then what's wrong with that? A therapist isn't going to come knocking on your door offering their service, you have to go to them.
posted by patheral at 7:07 AM on July 15, 2011 [3 favorites]
Would it be germane to ask people to respect a "no therapist recommendations, please" request on an AskMe question
It's fine to ask, but it's not really enforceable; you ask your question, you take your chances, basically. We keep an eye out for two word GET THERAPY stuff and to an extent will try to help make sure answers don't go off in a completely different direction from what's in the question. But between people sometimes not catching a bit of the More Inside and people taking good faith "you may want to consider x after all" tacks, there's likely to be some of that especially in questions that have more of a request-for-advice feel than a what-is-the-factual-answer-to-this-query feel.
posted by cortex (staff) at 7:33 AM on July 15, 2011 [1 favorite]
It's fine to ask, but it's not really enforceable; you ask your question, you take your chances, basically. We keep an eye out for two word GET THERAPY stuff and to an extent will try to help make sure answers don't go off in a completely different direction from what's in the question. But between people sometimes not catching a bit of the More Inside and people taking good faith "you may want to consider x after all" tacks, there's likely to be some of that especially in questions that have more of a request-for-advice feel than a what-is-the-factual-answer-to-this-query feel.
posted by cortex (staff) at 7:33 AM on July 15, 2011 [1 favorite]
Unless the question is specifically about therepy, suggesting someone go to therepy is like telling an alcoholic who needs help that they should "consider not drinking"...they probably already know, they're asking for something else.
posted by BozoBurgerBonanza at 7:34 AM on July 15, 2011
posted by BozoBurgerBonanza at 7:34 AM on July 15, 2011
A therapist isn't going to come knocking on your door offering their service
They should. I bet there's a huge untapped market for home therapy and door-to-door therapy sales. They get a foot in the door, they size up the home and the occupants, and they make their play: "Do you ever feel like everything is just spiraling out of control?" or "...problems are just piled too deep to get out from under?" or "...you aren't being appreciated for who you really are?" or "...time is just slipping away and you have nothing to show for all of your care and effort?" or "...you chose the wrong mate?" or "...no one loves you the way you deserve to be loved?"
The therapist could even pull up in a van ("The Misery Machine") with a comfortable couch in the back and diplomas on the wall and have the driver take you somewhere while you talked. Maybe pick you up after work and talk during the rush hour traffic home, or leave you at the gym where your physical trainer would take over.
Or the therapist could be your trainer: work your mind and body at the same time.
posted by pracowity at 7:51 AM on July 15, 2011 [6 favorites]
They should. I bet there's a huge untapped market for home therapy and door-to-door therapy sales. They get a foot in the door, they size up the home and the occupants, and they make their play: "Do you ever feel like everything is just spiraling out of control?" or "...problems are just piled too deep to get out from under?" or "...you aren't being appreciated for who you really are?" or "...time is just slipping away and you have nothing to show for all of your care and effort?" or "...you chose the wrong mate?" or "...no one loves you the way you deserve to be loved?"
The therapist could even pull up in a van ("The Misery Machine") with a comfortable couch in the back and diplomas on the wall and have the driver take you somewhere while you talked. Maybe pick you up after work and talk during the rush hour traffic home, or leave you at the gym where your physical trainer would take over.
Or the therapist could be your trainer: work your mind and body at the same time.
posted by pracowity at 7:51 AM on July 15, 2011 [6 favorites]
Unless the question is specifically about therepy, suggesting someone go to therepy is like telling an alcoholic who needs help that they should "consider not drinking"...they probably already know, they're asking for something else.
No, it's more like telling them they should consider AA. Yes, they probably already know, but sometimes with a hard solution to a hard problem you need a lot of people restating the obvious.
posted by that's how you get ants at 8:12 AM on July 15, 2011 [9 favorites]
No, it's more like telling them they should consider AA. Yes, they probably already know, but sometimes with a hard solution to a hard problem you need a lot of people restating the obvious.
posted by that's how you get ants at 8:12 AM on July 15, 2011 [9 favorites]
Sometimes the repose see a therapist is the right one, there iare issues that are to complicated/severe for internet help. In the same way that the response to the question: "What should I do -- I have a productive cough that is red and frothy and the skin on my fingers and toes is turning black?", is "See a doctor," not "Try aloe." How good we are at it, I don't know, but I think that being a little too quick to recommend (which we may be) is better than being a little too slow.
A useful trick for finding a therapist -- call the nursing stations of psychiatric units of local hospitals and ask a nurse. If you are polite and somewhat apologetic (for taking up their time) about it, you can get excellent advice (especially if you do it a few time at a few places and get overlaps). DO not ask them who not to see or ask them to rank people as that would be (a) unprofessional and (b) potentially job threatening. But most nurses are happy to pass along names of (and possibly throw clients to) therapists they think are good.
posted by rtimmel at 8:12 AM on July 15, 2011 [3 favorites]
A useful trick for finding a therapist -- call the nursing stations of psychiatric units of local hospitals and ask a nurse. If you are polite and somewhat apologetic (for taking up their time) about it, you can get excellent advice (especially if you do it a few time at a few places and get overlaps). DO not ask them who not to see or ask them to rank people as that would be (a) unprofessional and (b) potentially job threatening. But most nurses are happy to pass along names of (and possibly throw clients to) therapists they think are good.
posted by rtimmel at 8:12 AM on July 15, 2011 [3 favorites]
If that means starting with the therapists your insurance covers or googling therapists in your area, then what's wrong with that?Well, for one thing, if your particular mental illness involves crying jags triggered by having to cold call strangers, most of whom are going to reject you, if anyone even picks up at all...
posted by Karmakaze at 8:48 AM on July 15, 2011 [9 favorites]
Everyone needs therapy, everyone is being abused, everyone needs to DTMFA, everyone needs a lawyer, everyone needs a doctor -- there are answer biases, sure. Some of these are excessive. But people are coming at this with their own experiences, and having to project when imagining the asker because there's no way to really picture what the person is going through. This is unavoidable.
And the willingness of a person to listen to advice to see a therapist doesn't necessarily change whether it's good advice. Some people need therapy, even if they are unwilling to get it.
posted by J. Wilson at 8:50 AM on July 15, 2011 [1 favorite]
And the willingness of a person to listen to advice to see a therapist doesn't necessarily change whether it's good advice. Some people need therapy, even if they are unwilling to get it.
posted by J. Wilson at 8:50 AM on July 15, 2011 [1 favorite]
Ugh, I really wish I hadn't seen that Encyclopedia Dramatica entry
Aversion therapy.
posted by Blazecock Pileon at 8:52 AM on July 15, 2011
Aversion therapy.
posted by Blazecock Pileon at 8:52 AM on July 15, 2011
More people than not could use a little therapy, at least, though.
Seconding this. Therapy starts with you where you are, helps you articulate goals for growth, and then helps you achieve the goals. Plenty of people in therapy are working on problems that might not even seem that serious to you - and maybe they're not that serious - but those people are working to become better people, better able to cope with the slings and arrows of life. It's a health service that really, almost everyone should avail themselves of in the ideal world. And the important thing about therapy is that it's individualized. In a way in which comments from well-meaning people who don't know you are not and can never be. Therapists are trained - we're not (for the most part). Therapists operate by a code of ethics - we don't. Therapists are being paid to pay attention to your case - we're not. Therapists have learned how to be very careful with your emotional stability and what you can handle hearing and working on at this particular moment in your life - we haven't, and are often pretty damn nasty and blunt and (perhaps unintentionally) dismissive and offensive. We're at best clumsy, well-meaning laypeople who might or might not have something useful to say to you. You can get a lot out of an AskMe, but compared to what you can get out of therapy for problems having to do with emotions, life challenges, relationships - it's a drop in the bucket.
As for advice on how to find a good therapist, yes, there are resources for that in the MeFiVerse - see ThereIsHelp on the Wiki.
Finding a good therapist is challenging - but it can be done. It's definitely at least as hard, probably more hard, than finding a good primary or GYN, but I put a lot of effort into those choices, too. It's going to be a pretty intimate relationship - you want someone who you trust, who strikes you as competent and helpful with your type of problem.
posted by Miko at 8:58 AM on July 15, 2011 [3 favorites]
Seconding this. Therapy starts with you where you are, helps you articulate goals for growth, and then helps you achieve the goals. Plenty of people in therapy are working on problems that might not even seem that serious to you - and maybe they're not that serious - but those people are working to become better people, better able to cope with the slings and arrows of life. It's a health service that really, almost everyone should avail themselves of in the ideal world. And the important thing about therapy is that it's individualized. In a way in which comments from well-meaning people who don't know you are not and can never be. Therapists are trained - we're not (for the most part). Therapists operate by a code of ethics - we don't. Therapists are being paid to pay attention to your case - we're not. Therapists have learned how to be very careful with your emotional stability and what you can handle hearing and working on at this particular moment in your life - we haven't, and are often pretty damn nasty and blunt and (perhaps unintentionally) dismissive and offensive. We're at best clumsy, well-meaning laypeople who might or might not have something useful to say to you. You can get a lot out of an AskMe, but compared to what you can get out of therapy for problems having to do with emotions, life challenges, relationships - it's a drop in the bucket.
As for advice on how to find a good therapist, yes, there are resources for that in the MeFiVerse - see ThereIsHelp on the Wiki.
Finding a good therapist is challenging - but it can be done. It's definitely at least as hard, probably more hard, than finding a good primary or GYN, but I put a lot of effort into those choices, too. It's going to be a pretty intimate relationship - you want someone who you trust, who strikes you as competent and helpful with your type of problem.
posted by Miko at 8:58 AM on July 15, 2011 [3 favorites]
Um, how did you find your doctor? - Um, finding an ordinary doctor is easy. Finding a therapist who didn't just squeak by to get a certificate is not so easy.
posted by Ardiril at 9:01 AM on July 15, 2011
posted by Ardiril at 9:01 AM on July 15, 2011
On second thought, I will post what I originally intended. Finding a therapist who has the intelligence to adequately relate to me is not so easy. ;-P
posted by Ardiril at 9:02 AM on July 15, 2011
posted by Ardiril at 9:02 AM on July 15, 2011
Finding an ordinary therapist is indeed easy. They're a dime a dozen.
Finding a therapist who is a good choice for you is not easy. But finding a doctor who is a good choice for you is also not easy.
posted by Miko at 9:03 AM on July 15, 2011 [4 favorites]
Finding a therapist who is a good choice for you is not easy. But finding a doctor who is a good choice for you is also not easy.
posted by Miko at 9:03 AM on July 15, 2011 [4 favorites]
Well, part of the reason that therapy is a good response for some personal/emotional AskMe questions is that the poster is already doing something that is known to be a key component and benefit of therapy itself -- asking for third party advice/help from people who can look objectively at a situation. So that's part of why people mention it -- it's like, you're asking for impartial advice from a bunch of strangers on the internet, so why not ask for impartial advice from a professional? Especially when people post these multipart Asks like "Hey! It's me again! Still having a x problem" and they link to their old questions. We're not set up to help guide people along their specific path in life. THat's what therapy is for.
Also, just "Get therapy" isn't a great answer because they don't come in packs of three at kmart. You have to really research, meet people and find the best fit for you. The best fit for me isn't the best for you. It's really hard work and frustrating and the therapists who aren't so great can make you feel even worse, but the ones who are good help get your life on track. Ideally, people would start the relationship before they get into a time of crisis, but like all things it doesn't quite work that way a lot of the time -- people don't go to the dentist until "man, my tooth is killing me!" The wiki does have good advice on how exactly to find a therapist, but I'll personally recommend the Psychology Today website. It lets you sort people by specialty, and also has a feature where you can write what's going on and then the therapist will call you, already knowing a bit of the situation.
posted by sweetkid at 9:04 AM on July 15, 2011 [2 favorites]
Also, just "Get therapy" isn't a great answer because they don't come in packs of three at kmart. You have to really research, meet people and find the best fit for you. The best fit for me isn't the best for you. It's really hard work and frustrating and the therapists who aren't so great can make you feel even worse, but the ones who are good help get your life on track. Ideally, people would start the relationship before they get into a time of crisis, but like all things it doesn't quite work that way a lot of the time -- people don't go to the dentist until "man, my tooth is killing me!" The wiki does have good advice on how exactly to find a therapist, but I'll personally recommend the Psychology Today website. It lets you sort people by specialty, and also has a feature where you can write what's going on and then the therapist will call you, already knowing a bit of the situation.
posted by sweetkid at 9:04 AM on July 15, 2011 [2 favorites]
Miko, I don't disagree with you, but I just want to point out that your post is an example of what troubles me in that it sets up a false choice between the advice of the community and treatment in therapy. My sense is that because others share your view that therapy is superior, the result is that some people don't give advice and only suggest therapy or skip threads once they see that therapy has been suggested. I agree that it would be better much of the time if the asker sought therapy, but this often does not happen for a variety of reasons, and I do feel like the result is that askers get less of our advice, imperfect though it may be. It's kind of a "the better is the enemy of the good" dynamic.
That said, perhaps I'm imagining things and there is no "more therapy less other advice" effect.
I'm just thinking out loud. The Ask community is an incredibly valuable resource, and I think it's worthwhile to consider how it can be most helpful.
posted by prefpara at 9:08 AM on July 15, 2011 [3 favorites]
That said, perhaps I'm imagining things and there is no "more therapy less other advice" effect.
I'm just thinking out loud. The Ask community is an incredibly valuable resource, and I think it's worthwhile to consider how it can be most helpful.
posted by prefpara at 9:08 AM on July 15, 2011 [3 favorites]
"Get therapy!" is advice, but therapy is not advice.
posted by Obscure Reference at 9:13 AM on July 15, 2011 [1 favorite]
posted by Obscure Reference at 9:13 AM on July 15, 2011 [1 favorite]
I'm a frequent proponent of therapy, as it helped me in very tangible ways and I honestly believe it would have substantially improved some areas of my life if I had initiated it sooner.
I try to be attentive and not suggest it to people who have clearly stated they have already got it, and I try to be specific - explain what about my experience makes me feel it might provide a specific benefit to their experience. And I try to be mindful that my own positive experience biases me and to allow for that.
Still, as "obvious" as the answer might be, I feel that there is lot of general resistance to and onus on therapy. I think the idea that therapy has become ubiquitous and that the (particularly American) population is generally over-counseled is a myth, that the opposite is true, that many people who could very much benefit by talking to a professional are held back by cost, by fear of how it might affect their employment, by how society looks down on those who seek help for mental illness and how it trivializes mental illness in general.
Just saying "get therapy" is a pretty trivial answer though I see it as in a sort of inevitable class of safe, "couldn't hurt" answers - go to the doctor, get a lawyer, don't eat it. It might be reasonable to complain about it but I doubt it's fixable.
At the risk of re-opening a sticky topic, but I think this is far enough back in Metafilter history that it is not common knowledge especially to newcomers, we have had some pretty substantive discussions about the propriety and potential harm of people seeking advice from the general, semi-anonymous "public" of Ask. That debate inevitably becomes very contentious, but I think it is worth thinking about. The strong dissent of some individuals who felt any concrete medical advice on AskMe was unacceptably risky hasn't convinced me of their case but it makes me think a lot harder about whether and when and how I throw my non-professional, anecdotal 2 cents into the pot.
posted by nanojath at 9:14 AM on July 15, 2011 [5 favorites]
I try to be attentive and not suggest it to people who have clearly stated they have already got it, and I try to be specific - explain what about my experience makes me feel it might provide a specific benefit to their experience. And I try to be mindful that my own positive experience biases me and to allow for that.
Still, as "obvious" as the answer might be, I feel that there is lot of general resistance to and onus on therapy. I think the idea that therapy has become ubiquitous and that the (particularly American) population is generally over-counseled is a myth, that the opposite is true, that many people who could very much benefit by talking to a professional are held back by cost, by fear of how it might affect their employment, by how society looks down on those who seek help for mental illness and how it trivializes mental illness in general.
Just saying "get therapy" is a pretty trivial answer though I see it as in a sort of inevitable class of safe, "couldn't hurt" answers - go to the doctor, get a lawyer, don't eat it. It might be reasonable to complain about it but I doubt it's fixable.
At the risk of re-opening a sticky topic, but I think this is far enough back in Metafilter history that it is not common knowledge especially to newcomers, we have had some pretty substantive discussions about the propriety and potential harm of people seeking advice from the general, semi-anonymous "public" of Ask. That debate inevitably becomes very contentious, but I think it is worth thinking about. The strong dissent of some individuals who felt any concrete medical advice on AskMe was unacceptably risky hasn't convinced me of their case but it makes me think a lot harder about whether and when and how I throw my non-professional, anecdotal 2 cents into the pot.
posted by nanojath at 9:14 AM on July 15, 2011 [5 favorites]
The strong dissent of some individuals who felt any concrete medical advice on AskMe was unacceptably risky hasn't convinced me of their case but it makes me think a lot harder about whether and when and how I throw my non-professional, anecdotal 2 cents into the pot.
My professional 2 cents is that there's a tremendous potential for both help and harm; it's really important that people be aware of this potential and that it be a subject of discussion.
posted by fuq at 9:42 AM on July 15, 2011 [3 favorites]
My professional 2 cents is that there's a tremendous potential for both help and harm; it's really important that people be aware of this potential and that it be a subject of discussion.
posted by fuq at 9:42 AM on July 15, 2011 [3 favorites]
Usually people say "Get a therapist/lawyer/mechanic/doctor" because the question is so extensive that strangers on the Internet can't really cover or solve it for you. That's all. People who are asking these questions probably know they need a therapist/lawyer/mechanic/doctor, but are hoping there's some magic way of not having to pay to go to a professional, hence why they are asking the random strangers on the Internet. And lo, frequently the random strangers are all, "Uh, this is way too advanced for us. Find a professional. Sorry, you can't get around that one." Sometimes that's all we can do.
For the record, how to find a therapist:
(a) Look through the listings of the ones that your insurance will pay for. (Or if you're me, I went to my work's counseling service and got recommendations.) Or go through lists in the phone book/Internet if insurance isn't an option.
(b) Call every single one of them up (if you can and that's an option). Have a conversation. Find out what kind of therapy styles they do, how much they charge, how they operate, what free time they have in their schedule. But also, see if you hit it off with them personally or not during the course of the conversation. In my experience, if you aren't relating to them right off the bat-- find them cold or whatever-- therapy is not going to go well. No, really, YOU NEED TO LIKE TALKING TO THIS PERSON LIKE YOU WOULD A REALLY SMART FRIEND. I can't stress that enough. Even if you are a person who hates therapy and expects shrinks to be Freudian assholes, it doesn't have to be like that, and it shouldn't.
(c) Go to an in-person appointment. Continue the conversation. Again, see if you hit it off and relate to each other or not. If you do, great! If you don't, TRY SOMEONE ELSE until you do. If you do not feel strongly confident about the person you're talking to, don't waste your time and theirs continuing with them.
posted by jenfullmoon at 10:50 AM on July 15, 2011 [1 favorite]
For the record, how to find a therapist:
(a) Look through the listings of the ones that your insurance will pay for. (Or if you're me, I went to my work's counseling service and got recommendations.) Or go through lists in the phone book/Internet if insurance isn't an option.
(b) Call every single one of them up (if you can and that's an option). Have a conversation. Find out what kind of therapy styles they do, how much they charge, how they operate, what free time they have in their schedule. But also, see if you hit it off with them personally or not during the course of the conversation. In my experience, if you aren't relating to them right off the bat-- find them cold or whatever-- therapy is not going to go well. No, really, YOU NEED TO LIKE TALKING TO THIS PERSON LIKE YOU WOULD A REALLY SMART FRIEND. I can't stress that enough. Even if you are a person who hates therapy and expects shrinks to be Freudian assholes, it doesn't have to be like that, and it shouldn't.
(c) Go to an in-person appointment. Continue the conversation. Again, see if you hit it off and relate to each other or not. If you do, great! If you don't, TRY SOMEONE ELSE until you do. If you do not feel strongly confident about the person you're talking to, don't waste your time and theirs continuing with them.
posted by jenfullmoon at 10:50 AM on July 15, 2011 [1 favorite]
Um, how did you find your doctor? No, I'm serious. Finding a therapist is just like finding a doctor or a dentist.
In a lot of places (my prior hometown included) the doctor and the dentist you see are simply the only doctor or dentist in town. Before I moved to "the big city" of Portland, Maine that was my choice (or drive 45 minutes). My doctor was my doctor because they were the only practice in town.
posted by anastasiav at 11:00 AM on July 15, 2011
In a lot of places (my prior hometown included) the doctor and the dentist you see are simply the only doctor or dentist in town. Before I moved to "the big city" of Portland, Maine that was my choice (or drive 45 minutes). My doctor was my doctor because they were the only practice in town.
posted by anastasiav at 11:00 AM on July 15, 2011
At the bizarro parallel world Rightwingiverse AskMeFi, instead of "therapy" the standard refrain is "open your Bible, son!" (Which also is the prescription for how to appreciate bizarro parallel world Rightwingiverse Woody Allen's humor, it's all Biblically-based.)
posted by XMLicious at 11:30 AM on July 15, 2011 [1 favorite]
posted by XMLicious at 11:30 AM on July 15, 2011 [1 favorite]
I've started feeling like it's the knee-jerk response for people who want to be helpful but have nothing concrete to advise.
Yeah, that's pretty much true. And I've made this argument before. 99% of the population knows that therapists exist, and if they're asking a bunch of strangers on the internet for help, I think we should at least treat them like adults and assume there's some reason they're asking us instead.
Another thing that "see a therapist" glosses over : it's actually really hard to find a therapist! Lots of them don't know what they're doing, and even more of them may be competent, but won't jibe with your personality. And then you've got to deal with the insurance mess, find the right time to go, etc. Seeing a therapist can be almost as stressful as not seeing one!
However, I do think that in a small minority of cases, "see a therapist" is the only good answer. Makes me wish there were two buttons in every AskMe thread, one that says "See a Professional" and another that "No Really, See A Professional, Like NOW" and then two little counters that tallied up the responses. And then we could reserve the comments for actual substantive advice.
posted by Afroblanco at 12:14 PM on July 15, 2011 [2 favorites]
Yeah, that's pretty much true. And I've made this argument before. 99% of the population knows that therapists exist, and if they're asking a bunch of strangers on the internet for help, I think we should at least treat them like adults and assume there's some reason they're asking us instead.
Another thing that "see a therapist" glosses over : it's actually really hard to find a therapist! Lots of them don't know what they're doing, and even more of them may be competent, but won't jibe with your personality. And then you've got to deal with the insurance mess, find the right time to go, etc. Seeing a therapist can be almost as stressful as not seeing one!
However, I do think that in a small minority of cases, "see a therapist" is the only good answer. Makes me wish there were two buttons in every AskMe thread, one that says "See a Professional" and another that "No Really, See A Professional, Like NOW" and then two little counters that tallied up the responses. And then we could reserve the comments for actual substantive advice.
posted by Afroblanco at 12:14 PM on July 15, 2011 [2 favorites]
(b) Call every single one of them up (if you can and that's an option). Have a conversation. Find out what kind of therapy styles they do, how much they charge, how they operate, what free time they have in their schedule. But also, see if you hit it off with them personally or not during the course of the conversation.Where is this magical universe where therapists answer cold calls? I've never gotten anything but answering machines and receptionists.
posted by Karmakaze at 12:14 PM on July 15, 2011 [3 favorites]
Although, I have to say, "see a a therapist" doesn't rankle me nearly as much as its evil twin, "start taking meds". How nice of people to appoint themselves psychiatrists and start doling out prescriptions.
posted by Afroblanco at 12:20 PM on July 15, 2011 [1 favorite]
posted by Afroblanco at 12:20 PM on July 15, 2011 [1 favorite]
Where is this magical universe where therapists answer cold calls? I've never gotten anything but answering machines and receptionists.
New York maybe? I didn't have that experience and my therapist doesn't have a receptionist at all.
posted by sweetkid at 1:06 PM on July 15, 2011
New York maybe? I didn't have that experience and my therapist doesn't have a receptionist at all.
posted by sweetkid at 1:06 PM on July 15, 2011
it's actually really hard to find a therapist! Lots of them don't know what they're doing, and even more of them may be competent, but won't jibe with your personality. And then you've got to deal with the insurance mess, find the right time to go, etc. Seeing a therapist can be almost as stressful as not seeing one!
this is true, but I don't know that people should be asking AskMe questions of a deeply emotional stripe and expecting easy answers. Therapy is a difficult answer; but that doesn't make it a bad answer.
posted by sweetkid at 1:09 PM on July 15, 2011 [2 favorites]
this is true, but I don't know that people should be asking AskMe questions of a deeply emotional stripe and expecting easy answers. Therapy is a difficult answer; but that doesn't make it a bad answer.
posted by sweetkid at 1:09 PM on July 15, 2011 [2 favorites]
Therapy is a difficult answer; but that doesn't make it a bad answer.
Totally agreed. However, maybe it shouldn't always be the first line of defense?
posted by Afroblanco at 1:25 PM on July 15, 2011
Totally agreed. However, maybe it shouldn't always be the first line of defense?
posted by Afroblanco at 1:25 PM on July 15, 2011
Yeah, I agree that just telling people to "Get therapy" without any other explanation why or how or any other relatable experience/advice is bad form in most cases. And I think it is valuable for people to know how hard it is to find quality therapy, but they should still be encouraged to push through the difficulty.
posted by sweetkid at 1:34 PM on July 15, 2011
posted by sweetkid at 1:34 PM on July 15, 2011
there is no "more therapy less other advice" effect.
I don't think there is such an effect. There are some problems that we really can't help with, regardless of how much verbiage we throw at it. In those cases, the quick "get therapy" is probably not always taking the place of a lengthier, more personal answer; it's probable that much of the time, it's taking the place of a non-answer.
99% of the population knows that therapists exist, and if they're asking a bunch of strangers on the internet for help, I think we should at least treat them like adults and assume there's some reason they're asking us instead.
I think it is treating them like adults to suggest it where appropriate. People do indeed know that therapists exist, but the reasons people have for not seeing them are many, including: not really knowing what therapy is or does; being in denial about having a need for therapy; being skeptical that therapy will do anything for them; feeling confused about how to find or pay for a therapist; feeling like they really should have the wherewithal somehow to solve the problem on their own; being ashamed that they're not able to solve the problem on their own; feeling concerned about a stigma resulting from being in therapy; feeling that their problem is too weird/special/twisted/inconsquential for a therapist to deal with, etc. In these cases - of which there are many - seeing a chorus of 15 or 20 people whom they've asked for responses saying "therapy can help you solve this problem" does indeed carry some weight.
It's precisely because the people who would most benefit from therapy are often the most resistant to it that it's important to recommend it early and often in cases where it's probably the most productive and direct solution.
I am having trouble recalling any threads where users recommended therapy for a problem that really just couldn't be solved, or didn't need to be solved, through therapy. No doubt those exist, but therapy can improve your life in myriad ways, and the recommendation essentially does no harm and might do a world of good.
posted by Miko at 1:36 PM on July 15, 2011 [3 favorites]
I don't think there is such an effect. There are some problems that we really can't help with, regardless of how much verbiage we throw at it. In those cases, the quick "get therapy" is probably not always taking the place of a lengthier, more personal answer; it's probable that much of the time, it's taking the place of a non-answer.
99% of the population knows that therapists exist, and if they're asking a bunch of strangers on the internet for help, I think we should at least treat them like adults and assume there's some reason they're asking us instead.
I think it is treating them like adults to suggest it where appropriate. People do indeed know that therapists exist, but the reasons people have for not seeing them are many, including: not really knowing what therapy is or does; being in denial about having a need for therapy; being skeptical that therapy will do anything for them; feeling confused about how to find or pay for a therapist; feeling like they really should have the wherewithal somehow to solve the problem on their own; being ashamed that they're not able to solve the problem on their own; feeling concerned about a stigma resulting from being in therapy; feeling that their problem is too weird/special/twisted/inconsquential for a therapist to deal with, etc. In these cases - of which there are many - seeing a chorus of 15 or 20 people whom they've asked for responses saying "therapy can help you solve this problem" does indeed carry some weight.
It's precisely because the people who would most benefit from therapy are often the most resistant to it that it's important to recommend it early and often in cases where it's probably the most productive and direct solution.
I am having trouble recalling any threads where users recommended therapy for a problem that really just couldn't be solved, or didn't need to be solved, through therapy. No doubt those exist, but therapy can improve your life in myriad ways, and the recommendation essentially does no harm and might do a world of good.
posted by Miko at 1:36 PM on July 15, 2011 [3 favorites]
I live in a small town and I have managed to have conversations with potential shrinks over the phone. You leave a message, they call you back and you talk about potentially seeing them or not. Nobody has a receptionist here, but my shrink does have her phone automatically answered by a service on default since she's usually at work. Guess what, she called back. If they don't call you back, maybe don't go to them?
posted by jenfullmoon at 1:49 PM on July 15, 2011
posted by jenfullmoon at 1:49 PM on July 15, 2011
seeing a chorus of 15 or 20 people whom they've asked for responses saying "therapy can help you solve this problem" does indeed carry some weight.
Yeah, we've had this discussion before, and no, I'm still not buying it. For one thing, I don't think "repeat it till it sinks in" qualifies as treating someone like an adult. Secondly, you're assuming that your answer is the right answer. If it isn't, you're just repeating the wrong answer a whole bunch of times. And sure, therapy is a "safe" answer, in that it usually doesn't cause any harm*, but it isn't always the best answer either.
* although I would argue that seeing a bad therapist is worse than seeing no therapist at all
posted by Afroblanco at 3:32 PM on July 15, 2011
Yeah, we've had this discussion before, and no, I'm still not buying it. For one thing, I don't think "repeat it till it sinks in" qualifies as treating someone like an adult. Secondly, you're assuming that your answer is the right answer. If it isn't, you're just repeating the wrong answer a whole bunch of times. And sure, therapy is a "safe" answer, in that it usually doesn't cause any harm*, but it isn't always the best answer either.
* although I would argue that seeing a bad therapist is worse than seeing no therapist at all
posted by Afroblanco at 3:32 PM on July 15, 2011
pracowity: "You should at least give your own opinion as an unpaid on-the-spot therapist. They want to know what you (the grocer, the keyboard jockey, the student, the auto mechanic, the mom, the crack addict, the dude in his mother's basement) think is the real problem and the real solution."
Maybe. But we only have their question to go by, which of course is biased, and we don't know anything else about them than the details they remembered to put in, especially if the question is asked anonymously.
A therapist can ask follow-up questions, get your medical history if necessary, find out what mental issues run in the family or not, and even call you out on obvious bullshit when you try to make yourself look good.
And a therapist is better than an anonymous AskMe for the questioner, too, because any information you give them is confidential; a therapist won't try to figure out who you are by context and then post someone's username on the grey, which asshats have actually done here and which pisses me off; and you're paying a therapist a lot more than $5 to work for you so they can't just glibly toss in anecdotal advice and walk away as your world comes crushing down around your ears.
Sure, I'll give my opinion on AskMe sometimes, but when the problem's beyond me, I hope I have enough sense not to post potentially harmful advice.
And sometimes it just takes a consensus weighing in to say, "Yes, this is not okay, and you should really, really look into therapy" for someone to realize that life is really not supposed to be that hard and seek help.
posted by misha at 3:35 PM on July 15, 2011 [4 favorites]
Maybe. But we only have their question to go by, which of course is biased, and we don't know anything else about them than the details they remembered to put in, especially if the question is asked anonymously.
A therapist can ask follow-up questions, get your medical history if necessary, find out what mental issues run in the family or not, and even call you out on obvious bullshit when you try to make yourself look good.
And a therapist is better than an anonymous AskMe for the questioner, too, because any information you give them is confidential; a therapist won't try to figure out who you are by context and then post someone's username on the grey, which asshats have actually done here and which pisses me off; and you're paying a therapist a lot more than $5 to work for you so they can't just glibly toss in anecdotal advice and walk away as your world comes crushing down around your ears.
Sure, I'll give my opinion on AskMe sometimes, but when the problem's beyond me, I hope I have enough sense not to post potentially harmful advice.
And sometimes it just takes a consensus weighing in to say, "Yes, this is not okay, and you should really, really look into therapy" for someone to realize that life is really not supposed to be that hard and seek help.
posted by misha at 3:35 PM on July 15, 2011 [4 favorites]
So I sucked it up and went to therapy recently (partly because it comes so widely and highly recommended here) and it wasn't very helpful at all. After two months my therapist asked me what I wanted out of therapy and I didn't have an answer. I mean, it's not a magic wand to poof me into a pretty pretty mentally healthy princess, but I don't know what is reasonable to expect. She suggested I may not need therapy, but I've still got problems with the same issues. I ended therapy with her because I obviously don't know what I want. Now I am not sure what to do, because I got way better help from spending $20 on used self help books than $600 to a therapist. How sad. I may well try a different therapist but I'm kind of discouraged and blocked because still don't have a good answer to the question 'what do I want out of therapy'. Is this some kind of key that will unlock therapy superpowers, and I'm SOL without it? Should I even bother if I don't know?
It seems to me that 'go see a therapist' might do more harm than good in some cases. Some people truly cannot afford to lose $600 and not be helped.
posted by griselda at 4:29 PM on July 15, 2011 [3 favorites]
It seems to me that 'go see a therapist' might do more harm than good in some cases. Some people truly cannot afford to lose $600 and not be helped.
posted by griselda at 4:29 PM on July 15, 2011 [3 favorites]
If they don't call you back, maybe don't go to them?
Well, that's how it's worked out so far. Apparently I leave such terrible voicemail that even therapists don't want to talk to me.
posted by Karmakaze at 4:30 PM on July 15, 2011
Well, that's how it's worked out so far. Apparently I leave such terrible voicemail that even therapists don't want to talk to me.
posted by Karmakaze at 4:30 PM on July 15, 2011
MetaFilter: damn, I need therapy
posted by bwg at 5:04 PM on July 15, 2011 [2 favorites]
posted by bwg at 5:04 PM on July 15, 2011 [2 favorites]
griselda, sorry to hear that your sojourn into therapy didn't help, but I will hasten to say that because this one didn't help doesn't mean the next one will not either. I had to visit *several* medical doctors before one would listen to me and finally cured me of an ailment that I suffered with for years. If I'd quit at the first one, I'd probably be dead by now.
Seriously, not all therapists are alike, not all types of therapies are alike. What works for one person will not work for another (I loathe CBT but others laud it). And I stand by my earlier statement: Finding therapist is just like finding a doctor or dentist. A person has to find one who will listen to them, and sometimes a person will have to go through a couple (or dozen) before they find the right one. If they're not happy with the first therapist/psychologist/doctor whatever, stop seeing them and move on to the next one. The only one in charge of a person's mental health is themselves -- no one else. It's up to the patient to find the one they're comfortable with.
posted by patheral at 5:32 PM on July 15, 2011 [3 favorites]
Seriously, not all therapists are alike, not all types of therapies are alike. What works for one person will not work for another (I loathe CBT but others laud it). And I stand by my earlier statement: Finding therapist is just like finding a doctor or dentist. A person has to find one who will listen to them, and sometimes a person will have to go through a couple (or dozen) before they find the right one. If they're not happy with the first therapist/psychologist/doctor whatever, stop seeing them and move on to the next one. The only one in charge of a person's mental health is themselves -- no one else. It's up to the patient to find the one they're comfortable with.
posted by patheral at 5:32 PM on July 15, 2011 [3 favorites]
I was a teenage schizoid
The one your parents despise
but because of AskMe
I got Psycho Therapy
Now I got glowing eyes
posted by jonmc at 6:23 PM on July 15, 2011
The one your parents despise
but because of AskMe
I got Psycho Therapy
Now I got glowing eyes
posted by jonmc at 6:23 PM on July 15, 2011
still don't have a good answer to the question 'what do I want out of therapy'.
It's hard to help you answer this without knowing what the problem is that initially caused you to seek therapy. No one else, though, can articulate a vision for what your life would look and feel like once you were free of your problem, healthy and feeling good. It might help you to spend some time considering your goals before you begin the search for another therapist, and feel free to really interview them in your initial meeting about what their process is like, what their philosophy is, how much success they've had treating people with your issues, etc. It's completely true that the first practitioner, or the second or third, might not be a good fit - but anyone who needs help deserves to find the good fit.
One thing a lot of people don't acknowledge - or maybe don't know setting out - is that therapy is work. You don't get to just show up in the office and sit there silently while the therapist does...something...that makes you feel better. Therapists often challenge you, give you homework and assignments, ask difficult questions, and ask you to talk about memories, feelings, and problems you'd really rather avoid thinking about, let alone talk about.
One thing that makes therapy work is the client's own willingness to work at it. I'm not saying you or any other person is unwilling because that's not something I can possibly know, but it's true that when in therapy you do need to articulate a goal - otherwise no one (you or the therapist) knows what you should be working on, thinking about, writing about, talking about, setting goals for, or even what success would look and feel like. And therapy without a point, a goal, an issue to explore, would indeed be a recipe for bad therapy or, at best, a waste of time for all concerned. Whatever the failings of your past therapist, at least they had the good sense to call a stop to it when it seemed as though things weren't progressing for you. Less ethical folks would allow you to show up indefinitely and spend a lot more money making no progress at all.
If you're still feeling unhappy I'd encourage you to spend some time thinking about what you would like to feel like and act like as opposed to what you're experiencing now, and interview some more therapists.
posted by Miko at 7:12 PM on July 15, 2011 [2 favorites]
It's hard to help you answer this without knowing what the problem is that initially caused you to seek therapy. No one else, though, can articulate a vision for what your life would look and feel like once you were free of your problem, healthy and feeling good. It might help you to spend some time considering your goals before you begin the search for another therapist, and feel free to really interview them in your initial meeting about what their process is like, what their philosophy is, how much success they've had treating people with your issues, etc. It's completely true that the first practitioner, or the second or third, might not be a good fit - but anyone who needs help deserves to find the good fit.
One thing a lot of people don't acknowledge - or maybe don't know setting out - is that therapy is work. You don't get to just show up in the office and sit there silently while the therapist does...something...that makes you feel better. Therapists often challenge you, give you homework and assignments, ask difficult questions, and ask you to talk about memories, feelings, and problems you'd really rather avoid thinking about, let alone talk about.
One thing that makes therapy work is the client's own willingness to work at it. I'm not saying you or any other person is unwilling because that's not something I can possibly know, but it's true that when in therapy you do need to articulate a goal - otherwise no one (you or the therapist) knows what you should be working on, thinking about, writing about, talking about, setting goals for, or even what success would look and feel like. And therapy without a point, a goal, an issue to explore, would indeed be a recipe for bad therapy or, at best, a waste of time for all concerned. Whatever the failings of your past therapist, at least they had the good sense to call a stop to it when it seemed as though things weren't progressing for you. Less ethical folks would allow you to show up indefinitely and spend a lot more money making no progress at all.
If you're still feeling unhappy I'd encourage you to spend some time thinking about what you would like to feel like and act like as opposed to what you're experiencing now, and interview some more therapists.
posted by Miko at 7:12 PM on July 15, 2011 [2 favorites]
Right, not all therapist are alike, and you have to try many to find one that's right for you. But if there are only, say, five in your area, and they are all not right for you, what are you suppose to do? Or, how many would *you* go to before you start to think "maybe this isn't for me"? 5? 10? 100? 1,000? Really, how many?
posted by cupcake1337 at 7:21 PM on July 15, 2011
posted by cupcake1337 at 7:21 PM on July 15, 2011
Got Goals? 3 Therapy Basics
Setting Goals in the Counseling Process
How to Set Counseling Goals
Kind of a nice breakdown of six possible categories of therapy goals
posted by Miko at 7:22 PM on July 15, 2011 [4 favorites]
Setting Goals in the Counseling Process
How to Set Counseling Goals
Kind of a nice breakdown of six possible categories of therapy goals
posted by Miko at 7:22 PM on July 15, 2011 [4 favorites]
But if there are only, say, five in your area, and they are all not right for you, what are you suppose to do?
This is probably one of those more theoretical obstacles, but if there were someone for whom this was actually a problem - they had legitimately tried every single therapist in their usual travel radius - then the answer is, drive, or find a ride, or find someone to help you arrange a ride, or go less frequently like once a month so you can get to a major city and back, or find someone willing to do phone or online therapy, or move temporary or permanently to a location where you can avail yourself of good therapy. Somewhere along this spectrum there is probably a solution.
I wish it were more commonly available too, but in reality, if you can get to a decent hospital in time to save your life, you can probably also find an adequate, if not a fantastic, therapist. Most recently, I drove 45 minutes each way to see the last person I saw, and had to make arrangements to leave work early, yadda yadda yadda. The more life challenges you have the harder it is to line up, but that doesn't make it a worthless endeavor - in fact, it makes it more valuable to do whatever you can possibly do to get the help.
posted by Miko at 7:28 PM on July 15, 2011 [1 favorite]
This is probably one of those more theoretical obstacles, but if there were someone for whom this was actually a problem - they had legitimately tried every single therapist in their usual travel radius - then the answer is, drive, or find a ride, or find someone to help you arrange a ride, or go less frequently like once a month so you can get to a major city and back, or find someone willing to do phone or online therapy, or move temporary or permanently to a location where you can avail yourself of good therapy. Somewhere along this spectrum there is probably a solution.
I wish it were more commonly available too, but in reality, if you can get to a decent hospital in time to save your life, you can probably also find an adequate, if not a fantastic, therapist. Most recently, I drove 45 minutes each way to see the last person I saw, and had to make arrangements to leave work early, yadda yadda yadda. The more life challenges you have the harder it is to line up, but that doesn't make it a worthless endeavor - in fact, it makes it more valuable to do whatever you can possibly do to get the help.
posted by Miko at 7:28 PM on July 15, 2011 [1 favorite]
I think the answer to "how many do you try" is, realistically, more than 10 and less than 100. It is really hard to imagine trying 100 therapists and finding not a single one with whom you can have a productive relationship, but it's probably possible to run into 10 that don't make a good fit, though I never have had to go through that many myself. This is why the initial phone consult, and then your first meeting in person, is really important. Don't go beyond the first meeting with anyone you think won't work for you. That's a timesaver. You should have the feeling that you're welcomed, that you have the therapist's attention, that you want to talk to them and feel safe in their company, and that you can have the confidence that they can help you progress.
posted by Miko at 7:31 PM on July 15, 2011 [2 favorites]
posted by Miko at 7:31 PM on July 15, 2011 [2 favorites]
I talked to eight. Some were nice but not a great fit, some didn't talk enough, one told me I was lazy and needed a "personality overhaul" and then the eighth one was my super awesome perfect fit therapist.
posted by sweetkid at 7:37 PM on July 15, 2011 [1 favorite]
posted by sweetkid at 7:37 PM on July 15, 2011 [1 favorite]
As a therapist, I sometimes really wish people would answer "talk to a therapist" INSTEAD of giving their own totally uninformed opinions such as "probably you have OCD/Asperger's/ADHD."
posted by so_gracefully at 7:47 PM on July 15, 2011 [6 favorites]
posted by so_gracefully at 7:47 PM on July 15, 2011 [6 favorites]
Where is this magical universe where therapists answer cold calls? I've never gotten anything but answering machines and receptionists.
Agreed, I've never heard of this either.
posted by desuetude at 8:51 PM on July 15, 2011
Agreed, I've never heard of this either.
posted by desuetude at 8:51 PM on July 15, 2011
Well, if someone's running their business like that and you cannot talk to the therapist whatsoever before you have your first appointment, then I guess you're stuck with that. (Sounds like shitty business practice to me though. But also I don't know of any private practice shrinks with enough money to have a receptionist here to filter you.) But my rule of "if you don't hit it off whatsoever in the first conversation, don't keep going to them" rule still applies there. The phone call would save you money, but if it's not an option, it's not an option. I guess I got lucky in that the lady whose office turned out to be way too far for me to get to without a car actually told me this over the phone without me having to pay money to find that out.
I have had the issue of having few to no options due to lack of car myself. (And yet somehow there was still a pretty large availability of shrinks I could try out that worked close to my job and I could get there on a regular basis. Maybe that's just a quirk of my town though.) But yeah, if all five are not right for you (and I'm well aware of the joys of lack of public transport and trying to get a ride to therapy every week-- who's going to be tolerant of that?) and you don't drive and can't move, then I guess you are stuck without therapy. But then it saves you money, so there's some plus to that minus. And it's better to have no therapy than shitty therapy that sets you back emotionally anyway.
posted by jenfullmoon at 8:56 AM on July 16, 2011
I have had the issue of having few to no options due to lack of car myself. (And yet somehow there was still a pretty large availability of shrinks I could try out that worked close to my job and I could get there on a regular basis. Maybe that's just a quirk of my town though.) But yeah, if all five are not right for you (and I'm well aware of the joys of lack of public transport and trying to get a ride to therapy every week-- who's going to be tolerant of that?) and you don't drive and can't move, then I guess you are stuck without therapy. But then it saves you money, so there's some plus to that minus. And it's better to have no therapy than shitty therapy that sets you back emotionally anyway.
posted by jenfullmoon at 8:56 AM on July 16, 2011
I'm not sure it's totally unreasonable to have to pay for a first appointment in order to have that evaluative conversation. You can't do that with a doctor, either (or even a physical therapist, chiropractor, masseur) - you have an initial consultation in which you pay the professional for their time, and then it's up to you whether to pursue this or not, beyond the initial visit.
You might be able to call and ask things like what their training, approach, philosophy is and get a simple response, but beyond that, I don't think most would let you launch into your personal details on the phone - they would naturally steer you into an actual face-to-face appointment, which is the appropriate way for both of you to make judgments about the likelihood of successful treatment, and for which it's appropriate for you to pay for their time.
For therapists working outside a group practice you may not have a receptionist to interface with. I would still expect calls to be returned, though, regardless of the content of your call.
I think "bad therapy" is indeed terrible but there's also OK therapy, which is better than no therapy without being as bad as bad therapy. Then there's great, excellent therapy, which is the ideal, but if my mental health were in danger and causing me serious life problems, and all I could find was an OK therapist, I would still use that service. If all I could find was a really bad therapist, I think I would kind of document the badness and find the channels to report it. BAsically, I think it's not binary - there's more and less effective therapy, there's ineffective therapy, and then there's damaging therapy. That last category is really pretty rare. With ineffective therapy, there's some continuum there about why it's ineffective, and some of the reason might be in the patient's sphere of influence.
posted by Miko at 9:41 AM on July 16, 2011 [1 favorite]
You might be able to call and ask things like what their training, approach, philosophy is and get a simple response, but beyond that, I don't think most would let you launch into your personal details on the phone - they would naturally steer you into an actual face-to-face appointment, which is the appropriate way for both of you to make judgments about the likelihood of successful treatment, and for which it's appropriate for you to pay for their time.
For therapists working outside a group practice you may not have a receptionist to interface with. I would still expect calls to be returned, though, regardless of the content of your call.
I think "bad therapy" is indeed terrible but there's also OK therapy, which is better than no therapy without being as bad as bad therapy. Then there's great, excellent therapy, which is the ideal, but if my mental health were in danger and causing me serious life problems, and all I could find was an OK therapist, I would still use that service. If all I could find was a really bad therapist, I think I would kind of document the badness and find the channels to report it. BAsically, I think it's not binary - there's more and less effective therapy, there's ineffective therapy, and then there's damaging therapy. That last category is really pretty rare. With ineffective therapy, there's some continuum there about why it's ineffective, and some of the reason might be in the patient's sphere of influence.
posted by Miko at 9:41 AM on July 16, 2011 [1 favorite]
I'm sorry, I don't understand why a therapist should have to give anyone an hour of her time for free. This is a client-centered profession, yes, but that doesn't mean the therapist isn't entitled to the respect of a working professional. Presumably the client got something out of the hour, even if it's just sharing their pain.
posted by namesarehard at 10:20 AM on July 16, 2011
posted by namesarehard at 10:20 AM on July 16, 2011
It's like a sales meeting in a way. Therapists in private practice are responsible for marketing and selling themselves, and the free intro meeting/phone call is a way for the potential client to test out the "product," and see if it's something they want to buy. They get more clients this way.
posted by sweetkid at 5:46 PM on July 16, 2011
posted by sweetkid at 5:46 PM on July 16, 2011
There may be some people with lots of room in their schedule and not many referrals who need to market their services that way - but (a) that would concern me in and of itself and someone who has that much time available would cause me to ask why they do this and how it fits into their practice and how many clients they typically carry, etc; and (b) it should certainly be at the discretion of the individual practitioner, and not an expectation of the general public that every therapist would do this. Most don't need to, and many of the really good ones have the opposite problem - too many referrals to take them all.
posted by Miko at 5:16 PM on July 17, 2011
posted by Miko at 5:16 PM on July 17, 2011
Reading other people's problems in AskMe and reading advice to "get therapy" helped me realized that I needed to get (back) into therapy myself.
As far as finding therapists, the time I had to do the cold-call thing was EXCRUCIATING; holy cow it's hard to do when you're having a hard time talking to anybody, let alone total strangers over the phone. Although, the one person who really helped me feel at ease on the phone turned out to be a good therapist, so there's that.
posted by epersonae at 10:24 AM on July 18, 2011
As far as finding therapists, the time I had to do the cold-call thing was EXCRUCIATING; holy cow it's hard to do when you're having a hard time talking to anybody, let alone total strangers over the phone. Although, the one person who really helped me feel at ease on the phone turned out to be a good therapist, so there's that.
posted by epersonae at 10:24 AM on July 18, 2011
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posted by nangar at 10:30 PM on July 14, 2011