|
|
#
?
Oct 27, 2022 16:40
|
|
|
|
| # ? May 5, 2024 01:07 |
|
|
BiggerBoat posted:I mean...it's not really a major shock or surprise to think about the idea that assembling 5-10 people with varying degrees of mental issues that require treatment into a group situation might devolve into a bit of a poo poo show. Hell, I see it all the time just interacting among groups of people at work - who are varying degrees of hosed up - myself included. And I guess it's certainly ramped up to a degree and another notch when you have a group of people who actually able recognize their problems enough to consider therapy in the first place. Just to be clear most process groups are for people who are high functioning. Corpos, doctors, lawyers, etc. It's not "varying degrees of mental issues", unless I misread what you meant. And there isn't a single person in America who doesn't have "mental issues". It's not possible to live with the knowledge of mass shootings, covid, white supremacy, capitalism, homelessness, intergenerational trauma like slavery, indigenous genocide, japanese genocide of ww2, riots, police brutality, and just shrug it off. The psychic damage of that has to go somewhere. The somewhere is your brain. There are process groups that are incredible in other settings though for people with more intense symptoms. Like outpatient or inpatient DBT programs, if run well, are REALLY great. I have also heard of process groups for inpatient psychiatric hospital settings, but I don't know if that's so common anymore? Chili if you know please chime in! And I don't know what you mean in your question. He sounds like a shithead, I dunno if there's a clinical word for that. People love to feed them and then get mad when they act lovely. Seems predictable.
|
|
#
?
Oct 27, 2022 18:17
|
|
|
spacing in vienna posted:This is how I felt -- she didn't say it was a process group vs a support group, she just said she was starting a group and she thought it would help me. I told her that I couldn't figure out what I'd done to piss Gina off, and she explained that bit about Gina's mother. I don't think your leaving was right or wrong. I'll say if I were in your shoes I probably would not have stayed either. But I don't want to give you the impression that group therapy is a happy rainbow either. People should expect some conflict. The beauty of it is imagine how cathartic and beautiful is to repair the broken relationships with other members, to do therapy with them. Usually therapy is a solo experience, but being able to heal past wounds with other people, in real time together is really amazing. That's really the magic of group and it's profound. I went through some stuff and another person had similar stuff happen in her life and we both did the work together in the room and we feel an strong bond with each other now. Which of course helps other in other ways. Group is a crucible. I left a different process group than the other one I mentioned a while ago after being there for only a month. The facilitator didn't really seem present to me, and there wasn't a lot of containment. She wasn't picky about who joined, and accepted me after one 15 minute "vetting" conversation. The one I'm in now I had to do three 1-hour long sessions with the facilitator to see if I was a good fit. She's very particular about who joins and how they join. It's very very contained and delicate and there are big reasons why people are allowed or not allowed into a group. When a new member joins or leaves, there's an entire process to that which takes around 2 months. To prepare people for a new member, to prepare people for a member leaving. It can be bring up a lot of emotions because unlike a support group, you don't know people's last names and dont know their numbers or emails or anything so you can never contact them ever again (by design), it's a death in a way. thehandtruck fucked around with this message at 18:32 on Oct 27, 2022 |
|
#
?
Oct 27, 2022 18:29
|
|
|
thehandtruck posted:
"Shithead" works but I think there's a term like "gaslighting" or something close that's a technical definition of what I mean. Like where someone says something to you, you kind of don't really react or don't laugh and then they're all "hey, I was only kidding, man. I didn't mean nothin by it" in a way that frames you as an aggressor of sorts. Not explaining it well. Anway, the guy got fired yesterday so LOL. Not for being a shithead (may be part of it) but because he couldn't pass the performance tests we're given periodically and never improved, despite having ample time to do so and to complete them.
|
|
#
?
Oct 28, 2022 11:54
|
|
|
BiggerBoat posted:"Shithead" works but I think there's a term like "gaslighting" or something close that's a technical definition of what I mean. Like where someone says something to you, you kind of don't really react or don't laugh and then they're all "hey, I was only kidding, man. I didn't mean nothin by it" in a way that frames you as an aggressor of sorts. Not explaining it well. Maybe Schrodinger's douchebag or Schrodinger's joke? It's True and Correct unless someone calls them out on it, then it was a joke maaan you're taking it way too seriously calm down
|
|
#
?
Oct 28, 2022 18:06
|
|
|
i can't believe this thread didn't exist before. w so many ppl interested in mental health it's surprising there isn't a whole subforum dedicated to therapy. i've taken a bit of time before posting b/c i realized i needed to work through some reactions i was having to the cbt discussion earlier in the thread. for context, i work as a support worker in a private payer residential (the private payer part i feel worth noting because it helps to define our clientele). our program uses some generalized "cbt" skills, tho none of our clinicians are cbt accredited. i think this is something you were talking about earlier in the thread, handtruck, about certain practices being ascribed to cbt that aren't necessarily cbt specific, yeah? sorry/not sorry to dredge up a previous subject, but i've been thinking about it enough to bring it up w my non-residential therapist buds who practice a queer-centric, specifically anti-capitalist brand of therapy. they are largely indifferent to cbt and don't use it, but i haven't gotten the reaction out of them as strong as some in this thread - that is, of cbt being an indicator of a poor therapist. within the context of the residential program, i've seen "cbt skills" (i keep putting it in quotes b/c i'm now unsure if it is cbt or not) used in conjunction with other therapeutic styles to achieve specific client-driven goals. i also use my minimal amount of training on the subject to support the work they're doing in therapy, particularly in the mindfulness group i instruct. for some context, the goals my clients have might be something like "being able to enter a classroom" or "stop compulsively self harming with cords" or "tolerating crowded public places". i'm curious if you might consider the cbt skillset to have some use in situations like these, cocurrent with more traditional therapeutic practices? often times clients want to develop skills for independence while they are still working thru the truly deep, heavy therapeutic process and what i think of as cbt can help them achieve those goals. i'd be happy to answer any questions about residential therapy to anyone in this thread. it's a fascinating world and i feel privileged to work in the field - it's also in some ways a wet dream (and other ways a glitzy hell) for the therapists that work there as well, because of the very low client load as well as the depth of collaborative information you get with each client - you know where they are and what they're doing almost 24/7 and you see them almost every day. if anyone is curious about becoming a therapist i think doing support work at residentials is a fantastic gateway, it's easy to get into and at least at our facility you get excellent supervision and training. personally, i enjoy support work and really appreciate the natural rapport building/slightly more relaxed boundaries it entails. i also have one private child client outside of the residential that i visit 3x a week, its awesome.
|
|
#
?
Oct 29, 2022 15:01
|
|
|
Sprue posted:i'm curious if you might consider the cbt skillset to have some use in situations like these, cocurrent with more traditional therapeutic practices? often times clients want to develop skills for independence while they are still working thru the truly deep, heavy therapeutic process and what i think of as cbt can help them achieve those goals. IMO you can teach any skill but some skills have a higher cost than others. You can abuse a child into eating his food, or not stimming, whatever, but there's a cost to that. Usually anxiety, depression, etc. I've seen it directly when I did ABA therapy for a very long time. If somebody has a gambling addiction one can use cbt to curb the gambling addiction, but at what cost? If the underlying reason isn't dealt with (CBT founders EXPLICITY STATE THAT AXIOMATICALLY CBT IS NOT FOR DEALING WITH UNDERLYING CAUSES) either the behavior will come back or you're trading one bad behavior for another. Ok great the client doesn't gamble their life away, now they work their life away. Turning alcoholism into workaholism even, big whoop. I personally believe this it's unethical to take a client's money with the pretense of "help" and sell them a washing machine that I tell them will work for the rest of their life only to have it break down at the worst possible moment in a year or two. Not to mention the added stress on their system. I recommend checking out some of the studies I linked previously, especially the electro shock therapy one with the place that is condemned by the UN for torture lol The second a CBT therapist says "wow, that must be hard" they are factually, objectively, no longer using cognitive behavioral therapy. They are bringing themself into the room and using another modality/theory (rogers, gestalt, whatever, there's tons). CBT is explicitly about changing behaviors and thoughts by brute force. By not taking into the account the reason, systemically and internally for the behaviors and thoughts, trying to change them harms the client. But maybe you have an example in mind. If you posted it we could talk more concretely about it.
|
|
#
?
Oct 29, 2022 23:02
|
|
|
ABA therapy is seriously hosed, that def gives some context to me re: this discussion of cbt. it's really sad that that is still being pushed in most places on kids. i know they've tried to soften it up a bit, but i don't think that it's something that can be fixed. the problem with aba is that it attempts to correct behaviors by "normalizing" them. historically, i understand why it was developed, but in current practice, it's terrifyingly out of date. i'll go so far as to say *all* autistic behaviors that are considered problematic are rooted in self soothing for a person who's experience of this world is by definition traumatic, so "fixing" those behaviors is inhumane at best, because what needs to be addressed is the stress of the person with autism. of course, once someone has been conditioned for decades that the only way to make intolerable stimuli go away is violent acts against caretakers or self harming behavior that results in serious injury... but the first step should have been taken years before that by providing the individual with appropriate supports. if anyone is interested, there are a lot of groups around these days that advocate for change in the education system, it can be worth plugging in. instead of this being a pro/anti-cbt debate, maybe the more interesting question to ask is "what is therapy and why"? in the context i work in, one element, and again, only one part of the therapeutic process, is equipping clients with skills that will allow them to move towards and achieve their life goals. we have a client, JP (to protect the innocent her initials have been changed lol as well as some details), who wants to go to college. she is 24, has never moved out of home, only leaves her room to use the bathroom and once a month to visit a game store. she has no social connections outside of her family and a history of SA. so we get her. she tells us she wants to go to school for game design. JP immediately begins serious work with her therapist digging into the meaty stuff. at the same time, she is sick and tired of being in her room 24/7 so she enrolls in a local college. however, when she shows up to class she starts shaking terribly and can't tolerate to sit through an entire lecture. using graduated exposure therapy, she challenges herself every week to tolerate a little bit more. she also practices a breathing technique she learned in one of her sessions to help sooth her nervous system. after an intensive 6 months she has learned to tolerate class - we didn't try to talk her into exploring other routes (such as online classes, dismantling capitalism, etc) because she came with the goal of going in person and so we supported her in her goal with skills we have available. JP is still in therapy to process her history of trauma, but now she is able to move towards her goal of a degree. the skills we taught JP could be thought of as a band aid, and the truth is she's likely to be in therapy for the rest of her life processing her childhood SA, but right now, today, she's moving towards her goal and her immediate well-being is greatly improved. to answer my own question of what is therapy and why, i just don't think i can for every client, but i would say for myself something along the lines of "therapy is a process by which you learn yourself and through yourself the world and how to move as you wish in it". the moving through the world the way i wish to is an important part of my own therapy, it's awesome! - even if i don't get to control what world i live in, i get to learn how to mediate my experience with it in a healthy way. hopefully when i read all this tomorrow it still makes sense and seems true, sometimes words come out and i'm just learning how to talk about this stuff - i'm not 10 years in like handtruck 
|
|
#
?
Oct 30, 2022 00:56
|
|
|
Sprue posted:ABA therapy is seriously hosed, that def gives some context to me re: this discussion of cbt. it's really sad that that is still being pushed in most places on kids. i know they've tried to soften it up a bit, but i don't think that it's something that can be fixed. the problem with aba is that it attempts to correct behaviors by "normalizing" them. historically, i understand why it was developed, but in current practice, it's terrifyingly out of date. i'll go so far as to say *all* autistic behaviors that are considered problematic are rooted in self soothing for a person who's experience of this world is by definition traumatic, so "fixing" those behaviors is inhumane at best, because what needs to be addressed is the stress of the person with autism. of course, once someone has been conditioned for decades that the only way to make intolerable stimuli go away is violent acts against caretakers or self harming behavior that results in serious injury... but the first step should have been taken years before that by providing the individual with appropriate supports. if anyone is interested, there are a lot of groups around these days that advocate for change in the education system, it can be worth plugging in. Thanks for the story. And I'm not ten years in, I meant ten is a good rule of thumb when searching for a therapist.
|
|
#
?
Oct 31, 2022 22:10
|
|
|
I can agree on the suppression of stimming behaviors being harmful, from experience. My own were punished, and now I'm very anxious and nervous around people who engage in stimming. Brain still says, "this is going to lead to trouble" even though there's nothing bad that will happen. Question to OP: how hard is it to turn off your game face, so to speak? Do you find yourself unable to disengage from a work demeanor in normal life, or do you compartmentalize well enough? Is it stressful to do so?
|
|
#
?
Nov 22, 2022 18:52
|
|
|
“Therapy/psychology usurps the role that religion typically plays/played in one’s life, especially since widespread secular practice didn’t really start until the beginning of the last century.” What do you think of this statement? Pretend the person saying it thinks it’s true whether or not it factually is. (In other words I don’t want to hear a reply like “well actually, renaissance era monarchs talked to secular mind men” or whatever.) My entire patrilineal line is comprised of Lutheran pastors (bunch on my mom’s side as well), and while I don’t go to church anymore, it’s always been hard for me to take therapy seriously because a pastor will always see you for free while a therapist will not. That motivational differentiation really puts me off of secular therapy. I’ve never been able to look at a therapist in session and *not* think, “This person wouldn’t be listening to me if I didn’t give them money. They don’t actually care about me or my outcomes; in fact it is in their best interest to keep me coming back a long time so their client base keeps them flush.” I’ve always found it hard to compare it to the fact that a pastor will not only meet you where you’re at, but will do so for free. How do I reconcile this notion? I’ll grant you that a lot of counseling from pastors basically boils down to “Obey the ‘Lord’”, but it’s not like there isn’t also non-soteriological wisdom to dispense from religious texts and training.
|
|
#
?
Nov 26, 2022 04:59
|
|
|
Jedi Knight Luigi posted:“Therapy/psychology usurps the role that religion typically plays/played in one’s life, especially since widespread secular practice didn’t really start until the beginning of the last century.” I will be interested to hear what the therapists in thread say, but from my perspective as someone who grew up in an insular religious community, and who as an adult has been to therapy myself many times, the entire premise is vastly, fundamentally, different. As you point out, pastors dole out "advice" and "wisdom" and they are usually extremely eager to tell you, specifically, what you should do. Therapy could not be more different-- foundationally it functions only as a guide for self discovery, which then may lead to empowerment, healing, etc. "Advice" is not the point. You are not meant to look to the therapist as the expert on how you should run your life -- but that is exactly how most pastors operate. And yes, therapists charge money up front, but really wouldn't anyone who actually talks to many American pastors on a regular basis get guilted into giving the church vast quantities of time and money with literally no cap to it? From that perspective, isn't there an honesty to the price of secular therapy that's worth something? I was definitely able to end my relationships with multiple therapists infinitely easier than I was able to extricate myself from a religious network. I'm glad you clearly had good experiences with kind hearted relatives in your case, and I'm glad that people like that are available out there. In my case, my pastor-relative refused to offer a normal religious rite to the child of one of my high school friends because my friend, as a teen mom, had left the childs abusive father. In my pastor-relative's world, teen mothers must marry their babies fathers and stay with them forever or their kids had no place in his community. From discussions at family events more generally, I can guarantee that his pastoral advice must have been quite terrible in many other cases as well, I just didn't know anyone involved. There definitely are bad therapists, but still something can be said for the licensing process. There is a minimal floor, and like any medical professional, you can complain to a licensing board in cases of serious breaches of trust. While that can be sort of true for some particular religious denominations, it's absolutely not true in general. So maybe it's generally ok to go to a "Lutheran pastor" like your relatives to get advice (not therapy), because the insane ones didn't graduate seminary or were revoked (i have no idea if this is true or not, guestimating here), but across all faith groups together, "pastor" in general is a meaningless term with respect to quality (or safety). jemand fucked around with this message at 05:51 on Nov 26, 2022 |
|
#
?
Nov 26, 2022 05:48
|
|
|
Most clergy aren’t trained as therapists. At most some pastoral guidance classes might be offered at seminary but most of that kind of thing is learned on the job. When you go to confession you’re just supposed to confess what you’ve done wrong rather than talk about your feelings. A good pastor/priest will know their limits and refer you to a psychologist if you have any issues that need deep analysis or treatment. My priest is actually a trained clinical psychologist and won’t take on any of his parishioners as clients due to the differences in pastoral and clinical approaches.
|
|
#
?
Nov 26, 2022 15:47
|
|
|
I'm currently seeing a therapist due to issues at home (mainly with conflicts with my wife). It turns out my parents are narcissistic and this seems to be the root of almost all of my issues. Is there a point where therapy has run its course though? I only ask because each week we seem to be retreading the same, parents are the source of your errors, ground. I'll highlight something that went sideways with my wife that week, it'll be traced back to the behaviours I've developed with narcissistic parents and I'll be told I should have done x, or try y next time. In our last session there were times where I kinda struggled to come up with anything new to say. Things aren't improving quickly enough for my wife and I'm just wondering if it's more about me trying to apply the things the therapist told me rather than continuing to pay to be told the same stuff each week.
|
|
#
?
Nov 29, 2022 00:29
|
|
|
Kin posted:I'm currently seeing a therapist due to issues at home (mainly with conflicts with my wife). If the main thing you're working on in therapy is conflicts with your wife then your wife should be in the room, tbh. You may be hitting a wall because what you actually need is couples work, where you can actually find out not just what behaviors are causing problems, but why they do that, how they impact your wife, and how you can work together as a team in order to help you both grow in the relationship. A good couples counselor will not just give advice to try for next time, but have you practice it in the room with them. As in they will interrupt you in the middle of a fight (you will find it easier than you think to fight in front of an audience, I've never had someone unable to do it) and remind you to do X, Y, or Z or not do A, B, or C and give you an opportunity to try again. ...it's certainly not foolproof, and a lot of couples either enter couples counseling too late to save the relationship or discover that they simply don't want to put in the work in order to be with this person. But in my experience as a couples counselor and having been in couples counseling myself, when it works it's extremely rewarding all around.
|
|
#
?
Nov 29, 2022 01:13
|
|
thunderdome winner
|
Kin posted:I'm currently seeing a therapist due to issues at home (mainly with conflicts with my wife). Without more info I can only kinda guess at what might be going on here but. I grew up with emotionally immature parents and thought that I had escaped childhood relatively unscathed. Then I entered into a serious relationship. As it turned out, I didn't leave childhood unscathed. I spent a year doing weekly EMDR, internal family systems (parts work), and nervous system healing. One day it was obvious to me and my therapist that we were just done our work together. So yes, therapy works and it will change your life but you need to access the right kind of therapy.
|
|
#
?
Nov 30, 2022 01:48
|
|
|
Chernobyl Princess posted:If the main thing you're working on in therapy is conflicts with your wife then your wife should be in the room, tbh. You may be hitting a wall because what you actually need is couples work, where you can actually find out not just what behaviors are causing problems, but why they do that, how they impact your wife, and how you can work together as a team in order to help you both grow in the relationship. A good couples counselor will not just give advice to try for next time, but have you practice it in the room with them. As in they will interrupt you in the middle of a fight (you will find it easier than you think to fight in front of an audience, I've never had someone unable to do it) and remind you to do X, Y, or Z or not do A, B, or C and give you an opportunity to try again. After the first few, my therapist did suggest pausing our sessions for me to try and find a couples Councillor. The challenge is that I can tell my wife thinks I'm 90% of the problem, initially using the fact that I'd agreed to go to therapy as an admission of that. There's a lot of things I know she does that aren't "healthy" for the relationship (I've googled a lot of things), but it's convincing her to do it too which will be difficult as logistically it's a challenge too. We have a 10 month old son with no immediate childcare support nearby. It might be possible to juggle something about next year with nursery, work, etc, but I know my wife well enough to see that level of "effort" will be too much to change the status quo. My therapist has highlighted things from the experiences I've described, like emotional flooding, love language, child/adult/parental states, being mindful of how comments and criticisms might be perceived by the other person, etc. I've explained these to my wife and she has seemed accepting to them as a notion but then we just fall back into the same routines. I then take these routines to my therapist and we repeat how the above played a part in the argument (which is where I think I hit the wall). It does feel slightly better in generalb(I'm tempering my anger a lot but still fall into the trap of saying stuff reactively that I shouldn't). Things will be fine for a while, then an argument will happen and its right back to the usual stuff with my wife saying what's the point if therapy if I'm not changing.
|
|
#
?
Nov 30, 2022 09:08
|
|
|
e: wrong thread
|
|
#
?
Dec 2, 2022 11:17
|
|
|
Does the fact you're only getting one person's framing of events or interactions ever make it difficult to help them? Presumably you're occasionally seeing clients who are the lovely partner in a relationship, whether because they're a narcissist or for some other reason. Are you taking their recollection as the gospel truth, or are you reading between the lines and thinking "yeah, sounds like you started this fight." How do you respond when folks aren't able or aren't willing to see themselves as the aggressor?
|
|
#
?
Dec 2, 2022 15:12
|
|
|
whoops! forgot about the thread lol. I'm gonna take a solid read and get back to you all today!
|
|
#
?
Dec 3, 2022 20:49
|
|
|
DicktheCat posted:I can agree on the suppression of stimming behaviors being harmful, from experience. My own were punished, and now I'm very anxious and nervous around people who engage in stimming. Brain still says, "this is going to lead to trouble" even though there's nothing bad that will happen. Yep. When our inside and outside don't match, we're in pain. This applies to stimming, gender, sexuality, personality, anything and everything. DicktheCat posted:Question to OP: how hard is it to turn off your game face, so to speak? Do you find yourself unable to disengage from a work demeanor in normal life, or do you compartmentalize well enough? Is it stressful to do so? You know, I don't think I'm that much different in and out of the therapy room. I conduct myself pretty similarly because when I first started I noticed that changing my personality was harmful to me and made me worse at my job anyway. So I just kind of embraced my personality. This made me come off more authentic and genuine (because I was) and made me more relaxed and enjoyed the work more. The big difference is in the overt containment both myself and the client agree on. "This is the therapy room, we do therapy here." It's different than going out to eat with friends because we know that's not what this is. But if I'm with a friend and they say, "hey I need to vent about something, and I'm really confused, can you listen and tell me what you think?" Yeah then the containment and intention changes and it might look closer to therapy. Here's a simpler way to look at it. I'm probably not going to ask a friend, "where in your body do you feel that anxiety?", but it's not exactly taking on and off a gameface mask. It's just me in different situations. BUT! There are rare situations where I do feel myself wanting to kind of get into the therapy mode with someone where it's not appropriate. It happens when I feel I've seen their path before either through myself or through a previous client. I've learned to notice that and not do it. And it's not like I'm going to suddenly get really annoying and go "SO TELL ME ABOUT YOUR MOTHER" but I find myself having a strong desire to rescue and it kind of stops there. That's my own poo poo though.
|
|
#
?
Dec 3, 2022 21:04
|
|
|
Jedi Knight Luigi posted:“Therapy/psychology usurps the role that religion typically plays/played in one’s life, especially since widespread secular practice didn’t really start until the beginning of the last century.” This is an awesome post and you've asked me not to answer it in a factual political/societal way so I'll try to honor that. There are also a lot of rules and boxes coming from your post. I don't think the notion mentioned has to be reconciled. When working with people who express an adherence to their religion I am overt in suggesting they talk to their pastor or rabbi or imam if that helps them. But sometimes they don't, they choose to talk to me even though the pastor is free and I'm not. The reason they and I cite is that I don't come with a normative set of rules that have to followed, like the pastor does. Therefore they can explore their story without having to fit it into that box. They can't be wrong, or fail. Their BODY can't be wrong, their thoughts and feelings can't be wrong. There's literally no way to be or do anything wrong in my therapy room because even resistance in all forms is the mind trying to find its way to safety. I don't know if the same can be said for the confession box or the rabbi's office, at least not in my experience. And paying for something adds boundaries in this case. Often people have had their boundaries invaded (many times BY religious institutions). Money, lovely as it is, helps uphold those boundaries. I outline a detailing of my service and they make a consented decision to obtain said service. Also, I can't terminate the relationship out of nowhere and abandon them due to legal and ethical reasons. Whereas a pastor can do that for whatever reason. Lastly I'll just say that I am not anti-religion or anti-spirituality both as a person and a clinician. I go where the client wants to go and use the "language" they want to use. Why don't you go to church anymore?
|
|
#
?
Dec 3, 2022 21:29
|
|
|
thehandtruck posted:This is an awesome post and you've asked me not to answer it in a factual political/societal way so I'll try to honor that. Thanks for the reply here. I don’t go anymore mostly because of a bad experience with internecine conflict within the synod my dad, a pastor, was a part of while I was in college (in fact it took years for the synod he was colluquizing to to accept him when it usually only takes a few months), and while these are admittedly pretty personal reasons, the whole experience kind of helped me realize that the only forces on earth are that of fellow humans. And that sort of led me to acknowledge that texts like Revelation are probably more so about a Zionist, temporal revolution than about the “literal” end times. I started to ask myself for the first time, “what do I gain materially as the author of this ancient text” instead of just accepting it blindly. Christianity does a good job of dissuading that thought by pointing out that most of the authors of the books of the New Testament were martyred. Conveniently, private Christian colleges don’t tend to talk about Helen and her son Constantine and what they had to gain by making a religion with one centralized god the official religion of their empire. And how that same reasoning affected the decisions of medieval Scandinavian and Slavic rulers w/r/t converting. My wife’s family had it even worse—she’s also a pastor’s kid—but if I’m honest with myself it seems like their problems were more about her dad not getting along with his congregations and constantly fracturing into smaller and smaller synods than it was about jealousy and vindictiveness from fellow pastors like it was for my dad. Like I said though, I still believe there’s wisdom to be found in the Bible. I’m especially a fan of the passage talking about how to call out someone acting badly. Matthew posted:If your brother or sister sins, go and point out their fault, just between the two of you. If they listen to you, you have won them over. But if they will not listen, take one or two others along, so that ‘every matter may be established by the testimony of two or three witnesses.’ If they still refuse to listen, tell it to the church; and if they refuse to listen even to the church, treat them as you would a pagan or a tax collector. Quite often these days it feels like people go straight to the last option without giving the person a chance to come clean individually and privately. Whether Jesus of Nazareth was a true deity or not is sort of immaterial: his message of pacifism and constant grace toward one’s neighbor was radical then and is still radical now. I just don’t think I need to give a robed man $20/week to remind myself of that. Especially after being steeped in it for so long as a kid.
|
|
#
?
Dec 4, 2022 03:48
|
|
|
Kin posted:I'm currently seeing a therapist due to issues at home (mainly with conflicts with my wife). Definitely seems like couple's therapy might be helpful here. I'm also not usually a fan of, "Well have you tried X?". In my experience there's something unprocessed either within one person or within the couple as a whole system. In most couples, that thing is dodged for years and there's a kind of agreed-upon amnesia that happens but the thing is in charge of every interaction. The question of does therapy run its course is interesting. I have seen people who have "finished therapy" but it's pretty few and far between and none have been my clients. By my definition and the way I learned it is that the person has healed from all of their traumas and is no longer beholden to them, meaning their fears and traumas don't decide what they will and won't do. It doesn't mean the person stops getting anxious or depressed, still fight with their spouse and family because that's part of being human. It also means that person has sloughed off the role they were given in their family system and isn't beholden to that either. The people that I have in mind are in their early 50's and older and have been in therapy for at least 20 years (not that I'm saying it needs to take that long). And you know it takes different amounts of time for different people because they all lead different lives with different events and upbringing. If one person had a family where getting help was the prime form of shame control it might take them longer to get some traction on their journey. Or if someone loses a child, that's gonna take some time to heal and re-focus back on childhood traumas. And they are all still in weekly therapy. thehandtruck fucked around with this message at 14:50 on Dec 4, 2022 |
|
#
?
Dec 4, 2022 14:11
|
|
|
Baronash posted:Does the fact you're only getting one person's framing of events or interactions ever make it difficult to help them? Presumably you're occasionally seeing clients who are the lovely partner in a relationship, whether because they're a narcissist or for some other reason. Are you taking their recollection as the gospel truth, or are you reading between the lines and thinking "yeah, sounds like you started this fight." How do you respond when folks aren't able or aren't willing to see themselves as the aggressor? Nah, I don't spend a lot of time trying to figure out "what happened". I take my client at their word because you have to, even if it sounds outlandish. If I have a client who's pretty out there and they suddenly they tell me their partner raped them and is planning to kill them, I need to take that seriously even if I think there's a chance they are in a manic state. What if I don't take them seriously? On a less drastic note I believe my clients because I can't be on their side if I'm constantly questioning them. It helps when they recount a story I will often move to the cliche of how an event made them feel rather than the details of the event. Sometimes clients will try to flood you and them with details because it's safer than touching whatever hurts. To your last question, I probably wouldn't get into that situation with a 1 on 1 client due to what I said above. I am an advocate for my client, I'm their ally and I "have their back" in all ways. I may challenge them of course, but only when that's all contained in the room. How would I know if "they're the aggressor" if I don't see the situation? Now I'm inserting myself in their house and life and relationship, that's bad. In couple's therapy there are many ways and interventions to do that though. You can make yourself really big in the room for example. Or you can say, "Wow I'm not even on the receiving end of that and I feel extremely angry and defensive right now!" Lots of ways. This is one of my better areas of therapy I feel because I enjoy breaking some unhealthy dynamic by intervening the right way right then and there. Couple's work is really loving fun but very draining. Couple's come to you when they're in crisis not when things are working. People in crisis aren't usually empathizing and that's a big part of being in a relationship. thehandtruck fucked around with this message at 14:53 on Dec 4, 2022 |
|
#
?
Dec 4, 2022 14:34
|
|
|
I have a hard time comparing the methods and goals of psychiatry with religion, beyond the fact that both ostensibly are aiming for some form of inner peace. Except receiving counseling from your church has to start with the conclusion first (be more christian or whatever) and approaches every problem with the same tool box (bible/whatever) and those tomes are so ambiguous and difficult to parse that, unless you are predisposed to believe it in the first place or have fully committed yourself to faith, as a healing tool it seems relatively worthless. Like, OK. Human suffering exists because God is mysterious or testing you and, hey, what are you worried about? When you DIE, you'll have eternal happiness. Just suffer through the remainder of your life and pray harder. Some treatment. I don't knock people that find that helpful but I guess what I'm saying is that seeing a shrink and going to church should be looked at as two separate endeavours. Like, for instance, what if the root of your psychological problems stem from questioning or being ashamed of your sexuality? Are you just supposed to not be gay or bi? Or let's say you fought in a war, killed people and have PTSD. Are intended to simply pray for forgiveness for the murders you committed? Maybe you accidentally hit someone with your car and paralyzed them or feel bad about having an abortion when you were a teenager? Seems to me with therapy that even though there are templates, rules, science and certain doctrines, each patient is viewed differently, with varying degrees of illness/problems and that any treatment that might be effective would vary rather drastically from patient to patient. I doubt there's a one size fits all approach to it that's simply culled from books, let alone a single book. Full disclosure: I am atheist/agnostic.
|
|
#
?
Dec 4, 2022 17:01
|
|
|
e: .
Baronash fucked around with this message at 18:34 on Dec 4, 2022 |
|
#
?
Dec 4, 2022 18:19
|
|
|
thehandtruck posted:Nah, I don't spend a lot of time trying to figure out "what happened". I take my client at their word because you have to, even if it sounds outlandish. If I have a client who's pretty out there and they suddenly they tell me their partner raped them and is planning to kill them, I need to take that seriously even if I think there's a chance they are in a manic state. What if I don't take them seriously? I know a couple serial sexual predators who were in private therapy (not court-ordered or anger management or anything) and I definitely do not understand how that goes down. He gets antidepressants and reassurance and unconditional support and "you have to stop being so hard on yourself, we're all human, the fault is in the middle." That seems not great, as a system?
|
|
#
?
Dec 4, 2022 20:02
|
|
i like nice words
|
Anne Whateley posted:What about the flip side of this, though, where your client is like [tw: sexual assault] "so my ex is telling everyone I raped her but she's a crazy bitch, all I did was take off the condom and everybody knows you can't stop in the middle. Maybe I hit her a couple times but who doesn't like rough sex? What the gently caress is wrong with her?" Well then yeah I make a report lol. The question I replied to was more along the lines of who's being meaner in an argument with your spouse. Anne Whateley posted:I know a couple serial sexual predators who were in private therapy (not court-ordered or anger management or anything) and I definitely do not understand how that goes down. He gets antidepressants and reassurance and unconditional support and "you have to stop being so hard on yourself, we're all human, the fault is in the middle." That seems not great, as a system? Mmmm no I'd have to fight you on this. I don't think any therapist, at least any that I know, will work with predator and say the fault is in the middle. Everyone reacts negatively to anyone pressuring them into realizing something is their fault, or whatever phrase we want to use. Me standing on my chair and screaming at them that they're evil isn't going to do anything. But, after trust is built, and safety is established, yeah there may come a time when I challenge them, but it's not in the way I imagine you're imagining. Sorry if this is too aggressive but I think you're projecting a lot into what you imagine those sessions look like. What therapists might do, and what I've done, is create a space where they can understand how they got to be that way. If they're lucky, that will allow them to heal the wound that made them a predator in the first place. Secondly, they may become a strong person instead of the weak person they are currently and become able to truly grasp the horribleness of their crimes. Hurt people hurt people, as they say. It takes a long time. What are your thoughts?
|
|
#
?
Dec 4, 2022 22:00
|
|
|
Tbh I'm extremely over "hurt people hurt people." In my personal experience, it's only ever been used to remove agency from people deliberately making decisions to abuse others. Also, spreading the stereotype really harms people who were hurt in the past, since it carries the assumption that they will become like their abusers. It's not even useful as a predictive tool, since a person who was a victim of CSA may internalize it and/or grow up being extremely shy and careful not to harm anyone, while another person who was teased a few times for being short may externalize it and decide to shoot up a school. It also places the focus on the abuser and casts them as a victim, while ignoring the abuser's victims. I guess we could go with "some hurt people and some relatively unhurt people decide to hurt people, and some hurt people and some relatively unhurt people do their best to avoid it" I think there are a number of other damaging assumptions generally in play, about the type of person who would do such a thing, their lack of interior knowledge, if they know what they did, if it was deliberate, etc., and these usually work to the benefit of the abuser. I'm not sure to what extent progress can be made in a setting where they aren't required to be there (Why Did He Do That?, etc.) because obviously if you start telling people things they really don't want to hear, they won't want to keep coming and paying. Sorry I kind of derailed this. I think my original question was more along the lines of, if you don't try to figure out what happened, believe everything your client tells you, and take their side unconditionally, how can you even tell when you're working with a predator and how does that play out for the better. Anne Whateley fucked around with this message at 22:27 on Dec 4, 2022 |
|
#
?
Dec 4, 2022 22:25
|
|
|
thehandtruck posted:Well then yeah I make a report lol. The question I replied to was more along the lines of who's being meaner in an argument with your spouse. That's not what I was trying to get at. If you have a client, and they are manipulative to people in their life, or treat their spouse in an emotionally or verbally abusive manner, what does a session with a person like that look like? How do you avoid validating a lot of negative behavior as you're working to build trust with your client?
|
|
#
?
Dec 4, 2022 23:59
|
|
|
Anne Whateley posted:Tbh I'm extremely over "hurt people hurt people." In my personal experience, it's only ever been used to remove agency from people deliberately making decisions to abuse others. Also, spreading the stereotype really harms people who were hurt in the past, since it carries the assumption that they will become like their abusers. It's not even useful as a predictive tool, since a person who was a victim of CSA may internalize it and/or grow up being extremely shy and careful not to harm anyone, while another person who was teased a few times for being short may externalize it and decide to shoot up a school. It also places the focus on the abuser and casts them as a victim, while ignoring the abuser's victims. No need to apologize. It's a good question and not a derail. I do disagree with every statement you made here though. I'm just not understanding why trying to figure out what happened is helpful in therapy. That's not what therapy is. It's not a court of law or a community tribunal. It's a safe space without judgement where people can learn their own story and heal. You have added a LOT of projections onto my past few posts. For example when I say "hurt people hurt people" I'm not absolving anyone of anything. I'm saying it because it helps me understand people how became the people they are. That understanding helps me (and them) get to the places that need attending to. A person then has the opportunity to develop agency, own their actions, etc. The abuser you mentioned in your first post is in denial about his actions. Do you think me shouting at him about how evil he is moves him closer or further from denial? Closer or further from continued predation? In a predator's case therapy is a place where they can heal, which sometimes leads to them not being a predator anymore. Rape for example is one of the heinous things a human can do to another human. It's almost surreal, unreal even. I can't fathom it. But I do believe someone who's raped someone would need to take in the size of such an act in order to heal and stop their behavior. Something so big and awful, the brain is doing everything it can to pretend it didn't happen or wasn't that bad. People's minds' don't open to take in something so painful on a whim. It takes time, safety, love even. All the things that we say predators shouldn't get. It's paradoxical but this is what works, not attacking them, as much I wish that's what works. Trust me I wish that. But I mean, I'm guessing we're missing each other by miles. So I'll ask, if you were a therapist, 1) How would you work with a predator who no longer wants to be a predator? 2) How would you work with a predator who is in denial about being a predator but is court-mandated to see you? 3) How would you work with a predator who ambled into your office through couple's therapy and over time you're starting to see it? Hopefully if you answer these I'll be able to see more where you're coming from. thehandtruck fucked around with this message at 00:13 on Dec 5, 2022 |
|
#
?
Dec 5, 2022 00:03
|
|
|
I'm not trying to project. I don't think your goal is to minimize abuse, harm people who were abused, etc., but I do think that's usually the unintended result of the "hurt people hurt people" meme. I have also never mentioned shouting or attacking anyone in session, and obviously I agree that would be counterproductive and dumb. I do think that determining the truth has value (Baronash's question is what I was getting at), even if that means questioning some of what a client presents to you. I guess we disagree about this, but I don't think unconditional positive regard, support, and self-esteem boosting are good things to give deliberate predators. I think that's unlikely to lead to change for the better, and so I think it's important to determine whether that's what one would be doing. I guess to a degree we can break it down into types -- - people who don't realize what they're doing is wrong, it's just all they've learned - people who realize it's not good and genuinely want to improve - people who are happy knowingly hurting other people and there for some other reason I think hand-holding and sweetness can work for #2 and possibly #1. I think there are also a lot of #3s out there that don't seem to be taken into account, but I think it's important to do so.
|
|
#
?
Dec 5, 2022 00:38
|
|
|
Anne Whateley posted:I don't think unconditional positive regard, support, and self-esteem boosting are good things to give deliberate predators. Pastoral care would probably be aligned with this outlook. Not saying that’s a good or bad thing.
|
|
#
?
Dec 5, 2022 00:52
|
|
|
I'm not a therapist, but I think that everybody should be treated as the focus by their therapist, even if that means not getting admonished, because that's likely to make the relationship between practitioner and client adversarial and non-productive. It's not a therapist's job to deliver justice for their client's victims, they're there to help fix bad brain. Ideally after the client has done the work of fixing themselves they can go back and address the poo poo they've done but that's not going to happen without change, and change requires safety and containment.
|
|
#
?
Dec 5, 2022 01:35
|
|
|
Anne Whateley posted:I'm not trying to project. I don't think your goal is to minimize abuse, harm people who were abused, etc., but I do think that's usually the unintended result of the "hurt people hurt people" meme. I have also never mentioned shouting or attacking anyone in session, and obviously I agree that would be counterproductive and dumb. But look how again you've inserted words and ideas into my posts that I didn't include. Safety, lack of judgement, containment, even love is NOT hand-holding and sweetness. I used the word love, sure, but that doesn't mean being polyannish and saccharine. Parents can love their child by giving boundaries with an appropriate firmness in looking both ways before crossing the road. Sitting across from someone/ANYONE and listening without judgement is an act of love. It's an intensely binary view that you've imposed here and I don't feel like I have solid footing with which to respond. And, I was still looking for a more in-depth response in how you would work with those 3 types of cases. Would you challenge them when they brush over their crimes? Would you speak up? When they ask you what you think of their purported crimes would you use that opportunity to get to the bottom of things? Would you ever say "your court report says the opposite of what you just told me"? Would you say "that sounds unlikely"? If your goal is for predators to stop predating, what would you do?
|
|
#
?
Dec 5, 2022 03:03
|
|
|
Jorge Bell posted:I'm not a therapist, but I think that everybody should be treated as the focus by their therapist, even if that means not getting admonished, because that's likely to make the relationship between practitioner and client adversarial and non-productive. It's not a therapist's job to deliver justice for their client's victims, they're there to help fix bad brain. Ideally after the client has done the work of fixing themselves they can go back and address the poo poo they've done but that's not going to happen without change, and change requires safety and containment. I think the responsibility ultimately rests with the patient as far as being honest and open. You can go in there and bullshit or lie about stuff but that's not going to get you anywhere and I agree that it's not up to the doctor to ascertain truth from fiction. If someone is not being as forthcoming as possible with their therapist, they're just wasting everyone's time.
|
|
#
?
Dec 5, 2022 03:10
|
|
|
Feel free to replace "hand-holding" with "unconditional positive regard and support" if that helps. I'm not sure where to go with your analogy where a therapist is the parent setting rules for a child; that doesn't fit into my understanding of modern therapy. I certainly don't have all the answers about how to treat abusers. If I did, I would be revolutionizing the field and raking it in presenting and writing books. I'm not an expert, and I'm sure you know a lot of things I don't. I came here to ask: if as you say you don't attempt to establish what happened, can you / how can you identify when a client is an abuser or a predator? And do you / how do you treat one any differently? This is not directed just at you but at therapists in general. Am I correct that you would say it doesn't matter, you don't treat them differently in any way, that predators' primary needs are love, attention, and lack of judgment? I personally believe that might help some change, but a minority, and that's where we differ.
|
|
#
?
Dec 5, 2022 04:00
|
|
|
I'm following along and appreciate this latest conversation. I want to go back to the "three scenarios" concept and ask some questions of my own. thehandtruck posted:
My impression for 2 is that this is probably a specialization in therapy, and that potentially society at large, the court system, etc are equally important "stakeholders" for the engagement as the predator themselves. You'll be expected to employ specialist tools and techniques and also be ready to provide recommendations to parole boards etc based on an assessment of the persons potential lasting danger to society. So yes, I would expect some of those specialist tools would be to deal with trying to identify a potential reality behind a possible mask by the participant. Is this not what you would be thinking here, and if not, why not? Only scenario one would be similar in my mind to the purely individual therapeutic relationship you've been primarily describing. Even there, I would expect the therapist to use care to make sure it actually is a relationship that was helping, and if not, to discontinue. Similar to your previous discussing on working with addicts, if someone is coming to a session while high, the ethical thing is to arguably refuse to work in that state. Predators have a different test, but still I would think it part of ethical therapy to regularly assess if the participant is truly interested in getting better or in something more dangerous, and to not help in the latter case. Maybe this happens outside of the time in room with patient, but I would think it does have to happen, right? Again if not, why not?
|
|
#
?
Dec 5, 2022 17:22
|
|
|
|
| # ? May 5, 2024 01:07 |
|
|
Anne Whateley posted:Feel free to replace "hand-holding" with "unconditional positive regard and support" if that helps. I'm not sure where to go with your analogy where a therapist is the parent setting rules for a child; that doesn't fit into my understanding of modern therapy. No bc hand-holding/sweetness like you've said are not interchangeable with unconditional positive regard!! The words have very very very different meanings!! From the Carl Roger's site, who invented person-centered aka humanistic therapy: "While unconditional positive regard is a cornerstone of client-centered therapy, it isn't always easy to put into practice. Imagine a situation in which a therapist is working with a sex offender. In their book, "Counseling and Psychotherapy Theories in Context and Practice," Sommers-Flanagan offers some advice to practitioners who encounter such difficult situations. Rather than focusing on the behaviors themselves, the authors recommend seeking positive regard for the suffering and fears that such behaviors might represent. "Rogers firmly believed every person was born with the potential to develop in positive, loving ways," they suggest. "When doing person-centered therapy, you become their next chance, maybe their last chance, to be welcomed, understood, and accepted. Your acceptance may create the conditions needed for change." ------ I can't answer your question the way you want me to because that's not how things work! I don't look at someone and say, "ope! abuser. racist. sexist. rapist. predator" People are more grey than that. Again, it's not binary. You have probably hurt somebody in your life but you're probably not an abuser in your eyes. Have you ever emotionally abused your partner? Ever yelled at them? Ever ignored to the point they were hurt by it? What about your child? Ever ignored your child for over 24 hours? Some would say that's abuse, coercion through silence, etc, I certainly would! Does that make the parent an abuser? A predator? It's grey! There's no identifier for -*-Predator-*-. It's not like some tag in a youtube category. So I don't have to identify anything like that to conduct therapy. I have a singular goal for all clients which is to create a space where somebody can learn their own story and grow IF they want to. That's it. That might not be enough for the outside world, that's fine, then they can develop a new system of getting people to stop hurting other people because at the current moment showing lovely people the safety and love they never got is the best option we have. It doesn't work all the time, but it works more than whatever the justice system does. Maybe that's where I could have been clearer, I specifically use the same overarching position for EVERY client. Even with the 3 that I outlined (wasn't trying to gotchya you or anything was just trying to figure out where you differentiated them). Because I don't have a clear identifier of "bad person" "good person" and because it doesn't matter! All human brains function basically the same way. If you damage it, there will be *some* kind of response. Some responses, depending on familial/systemic/material conditions end up more destructive than others. Like I mentioned before, I have a legal and ethical duty in some extreme cases but not if someone just has the label "PREDATOR". This varies a little bit from state to state but domestic violence is in its own category and it's actually even harder to report on. https://www.camft.org/Resources/Legal-Articles/Chronological-Article-List/domestic-violence-and-the-duty-to-make-mandated-reports tldr: it can get dicey Adding this one more time: "Rather than focusing on the behaviors themselves, the authors recommend seeking positive regard for the suffering and fears that such behaviors might represent." If you apply that to your earlier post where you posited therapists minimize or apologize for their awful behaviors, there might be a closer understanding to what I've been poorly explaining. And since I'm interested in your ideas, for this comment, "I personally believe that might help some change, but a minority, and that's where we differ," how do you tell the difference between the majority and the minority? What would you do with the majority in that case? Execution, life in prison? If not those then what other treatments do you suggest. thehandtruck fucked around with this message at 20:13 on Dec 5, 2022 |
|
#
?
Dec 5, 2022 20:11
|
|