FAQ About Mental Health From A Biased Source...ME! Part 2!!!

So my last blog was pretty popular so I thought I'd start fresh with some more common issues, questions, so on that comes up from time to time in mental health therapy. Again, these are my opinions as a therapist and a lot of people in my position my disagree with me. But, again, fuck those dudes and gals.

How long does an assessment take?

It depends. Usually between an hour or two.

Why do therapist keep bugging me about things that I don't want to talk about?

Because, typically, those are the things that are causing clients distress. When one of my first professors who taught me about resistance used to say that social norms are important in all walks of life except in the therapy room. As opposed to in normal conversation, in the therapy room a therapist wants to jump right into resistance and all the things that people hate talking about.

That said, most therapist try not to force the issue either. You can only really go places successfully when a client is ready. But if you're in therapy and you hate your therapist then I'm sorry. But that might be why you do.

Speaking of resistance, why do therapist ask us about our sexual orientations, ethnicity, culture, religious and spiritual beliefs, and what not?

These questions are a big deal for a lot of people. The two biggest complaints is that it makes people feel uncomfortable and that they have nothing to do with mental health. Well, in terms of the uncomfortable feeling...well, sorry. Again, resistance isn't comfortable and breaking social norms aren't either. But there's a reason why we ask these things.

Which brings us to complaint two. Here's the thing; everything relates to mental health. These questions relate to how the client relates to society and how society relates to the client. The neat thing is the stronger the reaction to the question the more likely there's an issue surrounding that topic. Again, resistance y'all. If I ask a client 'how do you define your ethnicity?' and they respond with 'why are you asking that shit's racist' then I know I'm in on a big deal. It's like clockwork.

How do you talk to parent's about video games especially when they relate back to their kids?

No matter what I say, parents have to dictate what happens to their kids. No matter what I say or how professional I look and sound, the parents' word is the be all end all for their kids. That said, I try to help parents be as reasonable as possible. Often I rely on two things; relating video games to games the parents played as kids and the idea of 'everything in moderation' (because I'm a fan of trite phrases). The 'relating to parents' games' bit is to explain the similarities between video games and those games. Then I bring up the idea of allowing the kids to play in short stints. Usually as a reward for a behavior (which I'm sure kids love me for suggesting).

My last therapist sucked. Also my last medication sucked. So why should I try again?

Every therapist thinks differently. Just like every client thinks differently. So there may be a therapist that just doesn't meld with some clients but is a perfect fit for others. Keep trying. Eventually you'll find one you like. As for medications, I'm no expert. So let me talk about medications for a second. Medications react to everyone differently because of issues like diet, metabolism, heredity, ethnicity (yeah, that concept again), and so. So finding the right medication for the right person is really hard to do. Again, just keep trying and you'll find the right medication and dosage.

That's all I can think of for now. Ask away if you want about anything and I'll try my best to answer your questions as well as I can.

43 Comments
43 Comments
Posted by Video_Game_King

@jasonr86 said:

When one of my first professors who taught me about resistance used to say that social norms are important in all walks of life except in the therapy room.

Does that mean during one of your sessions, I can just let it all hang out?

Online
Edited by JasonR86

@video_game_king said:

@jasonr86 said:

When one of my first professors who taught me about resistance used to say that social norms are important in all walks of life except in the therapy room.

Does that mean during one of your sessions, I can just let it all hang out?

Your penis? I suppose. I might think my diagnosis is wrong though.

Edited because @video_game_king is a jerk.

Posted by Video_Game_King

@jasonr86 said:

@video_game_king said:

@jasonr86 said:

When one of my first professors who taught me about resistance used to say that social norms are important in all walks of life except in the therapy room.

Does that mean during one of your sessions, I can just let it all hang out?

Your penis? I suppose. I might think my diagnosis was wrong though.

I am now confused. The first tense sounds hypothetical, but the second tense sounds like you were sizing my psyche up in the last thread.

Online
Posted by Tireyo

Knowing my current situation, would you suggest therapy?

Posted by JasonR86

@jasonr86 said:

@video_game_king said:

@jasonr86 said:

When one of my first professors who taught me about resistance used to say that social norms are important in all walks of life except in the therapy room.

Does that mean during one of your sessions, I can just let it all hang out?

Your penis? I suppose. I might think my diagnosis was wrong though.

I am now confused. The first tense sounds hypothetical, but the second tense sounds like you were sizing my psyche up in the last thread.

I has terbile typrins n gramars.

Posted by JasonR86

@tireyo said:

Knowing my current situation, would you suggest therapy?

The better question is whether you want to start therapy or not? What I think isn't that important.

Posted by TheHT

Do you enjoy being a therapist? Ever get tired of hearing other people's shit?

Posted by JasonR86

@theht said:

Do you enjoy being a therapist? Ever get tired of hearing other people's shit?

I enjoy it. At times I can feel overwhelmed, frustrated, exhausted and whatnot. But I think I would say that with every job. I went through a stretch early in my career where I really worried about my client's and it would fuck me up. Keep me up at night. Things like that. But I've gotten better at handling that.

Posted by DarknessMyOldFriend

@tireyo said:

Knowing my current situation, would you suggest therapy?

If someone asks a question like that the answer usually is "yes".

Posted by JasonR86

@tireyo said:

Knowing my current situation, would you suggest therapy?

If someone asks a question like that the answer usually is "yes".

No, not necessarily. Like I said before, people who should be in therapy are people who want to be in therapy. There's not like a certain level or time frame or whatever when therapy is the right thing to do or not. It all depends on the client.

Edited by Tireyo

@jasonr86 said:

@tireyo said:

Knowing my current situation, would you suggest therapy?

The better question is whether you want to start therapy or not? What I think isn't that important.

Good answer.

Posted by JasonR86

@tireyo said:

@jasonr86 said:

@tireyo said:

Knowing my current situation, would you suggest therapy?

The better question is whether you want to start therapy or not? What I think isn't that important.

Good answer.

It's a non-answer really. But it's the best one honestly. If you feel forced or if I just pronounce you therapy-worthy I'm just being blaming and shitty. And really what makes a good client for therapy is one who wants to be there because they will be more likely to work to improve themselves with the therapist rather then expecting the therapist to simply offer some solution that may or may not work.

Edited by falserelic

If you don't mind me asking.

How old are you?

Posted by JasonR86

If you don't mind me asking.

How old are you?

27.

Edited by Yummylee

I'm desperately trying to think of a question to ask, since you've gone to the trouble to write up another therapy FAQ..

Soooo... what's the strangest phobia you've ever encountered? Ever had to treat someone with a fear of doctors, otherwise known as someone with *google search* Iatrophobia?

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Also, have you ever recommended someone to read a book, or watch a movie--maybe even play a video game--to help with their condition? I suppose that may fall under 'homework', though. But merely suggesting a particular book I would imagine is relatively lax all the same.

----------------------------------------------------------------

Oh, I've also seen you mention that you've wanted to start up your practise. Why is that? For more freedom to work the way you want, or as a way to help you feel like you've achieved something grander in life? To help validate your choice of career. And on that note, how would you describe your relationship with your parents?

...OK, that's not all a joke, I'm genuinely curious to know why you would want to run your own practise. I suppose that's sorta the next 'step' in your career ladder so to speak?

----------------------------------------------------------------

Allllsooooooo, what's the longest time you've spent with one client?

----------------------------------------------------------------

Aha, and finally, have you ever received any complaints for your service?

...OK, I'm done.

Online
Edited by JasonR86

@yummylee said:

I'm desperately trying to think of a question to ask, since you've gone to the trouble to write up another therapy FAQ..

Soooo... what's the strangest phobia you've ever encountered? Ever had to treat someone with a fear of doctors, otherwise known as someone with *google search* Iatrophobi?

----------------------------------------------------------------

Also, have you ever recommended someone to read a book, or watch a movie--maybe even play a video game--to help with their condition? I suppose that may fall under 'homework', though. But merely suggesting a particular book I would imagine is relatively lax all the same.

----------------------------------------------------------------

Oh, I've also heard you mention that you've wanted to start up your practise. Why is that? For more freedom to work the way you want, or as a way to help you feel like you've achieved something grander in life? To help validate your choice of career. And on that note, how would you describe your relationship with your parents?

...OK, that's not all a joke, I'm genuinely curious to know why you would want to run your own practise. I suppose that's sorta the next 'step' in your career ladder so to speak?

----------------------------------------------------------------

Allllsooooooo, what's the longest time you've spent with one client?

----------------------------------------------------------------

Aha, and finally, have you ever received any complaints for your service?

...OK, I'm done.

Awwww, thinking of question for ol'me.

Well, I haven't really seen any strange phobias yet. I've developed a fear of webmd and people using it though. Myself included. I haven't recommended a book or a game yet. Or anything else really. I don't think my clients would be receptive to that. I want to start my own practice for more freedom, for better pay, and for getting out of working with medicaid because I hate working with that busted ass system (it's a long story). I've got a good, healthy relationship with my parents by the way. I've spent nearly 3 hours with a client once. I have yet to hear a complaint either! So I'm either perfect or forgettable!

Posted by falserelic

Alright I got a question and its probably going to sound very weird.

But have you ever had to deal with a patient. That was having unexplained paranormal experiences, and if so did you believe them?

Posted by JasonR86

Alright I got a question and its probably going to sound very weird.

But have you ever had to deal with a patient. That was having unexplained paranormal experiences, and if so did you believe them?

...no?

Posted by falserelic

@jasonr86 said:

@falserelic said:

Alright I got a question and its probably going to sound very weird.

But have you ever had to deal with a patient. That was having unexplained paranormal experiences, and if so did you believe them?

...no?

Just curious...

Posted by Yummylee
@jasonr86 said:

I want to start my own practice for better pay

I knew it, it's all about the cash, you vile snake oil salesman. The only true empathy you have is for Mr. George Washington.

Cheers for the blog again, too. The idea of pursuing this sorta of work was floating around my head at one time, but while that idea's past me now, I still have an interest in the general subject and it's great to read about it all from the inside.

Online
Posted by Slag

Alright I'll bite Jason

How do you manage the stress for your own well being? And maybe more importantly turn therapist mode off at the end of the workday? I would think your work would be an easy to "take home with you" if you will, especially since conversation is a big part of what you do (unless I'm wrong?).

Something I've always marveled at therapists like yourself is how you guys seem to be able to function emotionally while continually dealing with a lot of other people's major problems, especially since I imagine you got into the field because you probably are an empathetic person.

I think your job would absolutely wreck me, I don't think I could emotionally disconnect enough from the patient's situation (whatever that may be).

Posted by JasonR86

@slag said:

Alright I'll bite Jason

How do you manage the stress for your own well being? And maybe more importantly turn therapist mode off at the end of the workday? I would think your work would be an easy to "take home with you" if you will, especially since conversation is a big part of what you do (unless I'm wrong?).

Something I've always marveled at therapists like yourself is how you guys seem to be able to function emotionally while continually dealing with a lot of other people's major problems, especially since I imagine you got into the field because you probably are an empathetic person.

I think your job would absolutely wreck me, I don't think I could emotionally disconnect enough from the patient's situation (whatever that may be).

For about the first half year of seeing clients I had a hard time not worrying about my clients and no being Mr. Therapist every where I went. It is still something that comes up. But I'm better at keeping things separate now. There's a few things I do. First, no matter how hard I try I can't make anyone change by the force of my own will. Clients need to meet me half way. And, in the end, the client is responsible for their own change. That keeps me from feeling guilty when things go poorly or don't move at all. Another thing I tell myself, because it is very true, is that when I get home from work there is nothing I can do that will fix a client's situation. The only influence I really have is in that hour-long session. So worrying at home only hurts me. It does nothing to help my client.

All that said it can be very hard to keep work and home segregated. But as I keep working it becomes easier and easier. Which is at times a little disconcerting because it tells me that I'm numbing to significant stressors and emotionally disconnecting from strong emotions. So I try to keep a balance so that I can be empathetic and caring during work and have my own personal life free of those stressors when I get home.

Posted by Rick_Fingers

How do you feel about your job title basically being 'The Rapist'

Posted by JasonR86

How do you feel about your job title basically being 'The Rapist'

Disinterested.

Posted by Rick_Fingers

@jasonr86: That is a much better answer than "aroused"

Serious question now, do you find your age impacts how you feel when dealing with particular patients? Does it impact how they look at you, or who you attract as patients in the first place?

Posted by Slag

@jasonr86 said:

@slag said:

Alright I'll bite Jason

How do you manage the stress for your own well being? And maybe more importantly turn therapist mode off at the end of the workday? I would think your work would be an easy to "take home with you" if you will, especially since conversation is a big part of what you do (unless I'm wrong?).

Something I've always marveled at therapists like yourself is how you guys seem to be able to function emotionally while continually dealing with a lot of other people's major problems, especially since I imagine you got into the field because you probably are an empathetic person.

I think your job would absolutely wreck me, I don't think I could emotionally disconnect enough from the patient's situation (whatever that may be).

For about the first half year of seeing clients I had a hard time not worrying about my clients and no being Mr. Therapist every where I went. It is still something that comes up. But I'm better at keeping things separate now. There's a few things I do. First, no matter how hard I try I can't make anyone change by the force of my own will. Clients need to meet me half way. And, in the end, the client is responsible for their own change. That keeps me from feeling guilty when things go poorly or don't move at all. Another thing I tell myself, because it is very true, is that when I get home from work there is nothing I can do that will fix a client's situation. The only influence I really have is in that hour-long session. So worrying at home only hurts me. It does nothing to help my client.

All that said it can be very hard to keep work and home segregated. But as I keep working it becomes easier and easier. Which is at times a little disconcerting because it tells me that I'm numbing to significant stressors and emotionally disconnecting from strong emotions. So I try to keep a balance so that I can be empathetic and caring during work and have my own personal life free of those stressors when I get home.

That sounds reasonable, but I bet that's a lot harder to actually do than you are making it sound.

Yeah I bet that is disconcerting to feel a little numb, but I don't see what choice you really have. The alternative is likely completely unworkable over the long term and as you pointed out unproductive for both parties involved.

Sounds to me you're walking a neverending tightrope between getting sucked in or getting jaded. I don't envy you one bit, but fwiw you have my respect for doing it.

Posted by mindgarden418

Nice thread. Not sure if I have a specific question but I went through therapy for something like 9 years, with a 1 year break when I moved overseas.

As you said earlier in the thread, people who want to be in therapy should be, if not it would be hard. Despite my going every two weeks for so long, I had to hit rock bottom, badly, before I could actually accept the help I was offered for so long. That's when the real work progressed rapidly. For me anyway! But I digress, very interesting read!

Posted by JasonR86

@jasonr86: That is a much better answer than "aroused"

Serious question now, do you find your age impacts how you feel when dealing with particular patients? Does it impact how they look at you, or who you attract as patients in the first place?

In my job we as a staff dictate who works with what client based off of capabilities, personality, and the client's wishes. My age has effected a few clients. I thought it would effect the elderly but more often then not parents think that I don't know what I'm talking about because I'm younger. It doesn't bother me personally. I'll address it in therapy and if the clients still have a problem with working with a younger person then we can initiate a transfer to a new therapist.

@slag said:

@jasonr86 said:

@slag said:

Alright I'll bite Jason

How do you manage the stress for your own well being? And maybe more importantly turn therapist mode off at the end of the workday? I would think your work would be an easy to "take home with you" if you will, especially since conversation is a big part of what you do (unless I'm wrong?).

Something I've always marveled at therapists like yourself is how you guys seem to be able to function emotionally while continually dealing with a lot of other people's major problems, especially since I imagine you got into the field because you probably are an empathetic person.

I think your job would absolutely wreck me, I don't think I could emotionally disconnect enough from the patient's situation (whatever that may be).

For about the first half year of seeing clients I had a hard time not worrying about my clients and no being Mr. Therapist every where I went. It is still something that comes up. But I'm better at keeping things separate now. There's a few things I do. First, no matter how hard I try I can't make anyone change by the force of my own will. Clients need to meet me half way. And, in the end, the client is responsible for their own change. That keeps me from feeling guilty when things go poorly or don't move at all. Another thing I tell myself, because it is very true, is that when I get home from work there is nothing I can do that will fix a client's situation. The only influence I really have is in that hour-long session. So worrying at home only hurts me. It does nothing to help my client.

All that said it can be very hard to keep work and home segregated. But as I keep working it becomes easier and easier. Which is at times a little disconcerting because it tells me that I'm numbing to significant stressors and emotionally disconnecting from strong emotions. So I try to keep a balance so that I can be empathetic and caring during work and have my own personal life free of those stressors when I get home.

That sounds reasonable, but I bet that's a lot harder to actually do than you are making it sound.

Yeah I bet that is disconcerting to feel a little numb, but I don't see what choice you really have. The alternative is likely completely unworkable over the long term and as you pointed out unproductive for both parties involved.

Sounds to me you're walking a neverending tightrope between getting sucked in or getting jaded. I don't envy you one bit, but fwiw you have my respect for doing it.

Thanks man.

Nice thread. Not sure if I have a specific question but I went through therapy for something like 9 years, with a 1 year break when I moved overseas.

As you said earlier in the thread, people who want to be in therapy should be, if not it would be hard. Despite my going every two weeks for so long, I had to hit rock bottom, badly, before I could actually accept the help I was offered for so long. That's when the real work progressed rapidly. For me anyway! But I digress, very interesting read!

I'm glad you've seen success. It's really hard work to look back at yourself and make changes so you should be very proud.

Edited by rebgav

I have two questions;

Question One: How many times during the typical work day do you find yourself wishing that a client would just shut the fuck up?

Question Two - a follow-up: How many times a day do you verbalize that sentiment?

Posted by JasonR86

@rebgav said:

I have two questions;

Question One: How many times during the typical work day do you find yourself wishing that a client would just shut the fuck up?

Question Two - a follow-up: How many times a day do you verbalize that sentiment?

1: It kind of depends on my mood. Which I try to keep fairly consistent with each session. It also sort of depends on the client. Lately not often. But I'd be lying if I said never.

2: I never have and I never will (or I shouldn't). People talking to me is kind of the point and even if the words coming at me are designed to hurt me that's still an important part of therapy. So I'll take 'talking too much' over 'not talking at all' any day.

Posted by HerbieBug

Nice thread. Not sure if I have a specific question but I went through therapy for something like 9 years, with a 1 year break when I moved overseas.

As you said earlier in the thread, people who want to be in therapy should be, if not it would be hard. Despite my going every two weeks for so long, I had to hit rock bottom, badly, before I could actually accept the help I was offered for so long. That's when the real work progressed rapidly. For me anyway! But I digress, very interesting read!

That was true for me as well. Therapy requires the patient be receptive to it, and have hope to make improvements from it, for it to be most effective. Or effective at all, maybe. If I had done CBT at a time when I didn't think I needed it, I probably would have tuned out the whole thing and stopped going after a session or two.

Edited by ArtelinaRose

Because I'm self important and everything revolves around me:

Have you had any clients(do you refer to them as clients or patients? I've noticed it differs from person to person..) come out as believing they may be transgendered or knowing that they are? If not, have you considered how you might react or what you might tell someone if or when that happens?

Edited by JasonR86

@artelinarose:

I say 'clients' because I think it subtly hints at the idea of the professional relationship being a partnership and not a dictatorship.

I haven't had any transgender clients yet but I've done assessments for transgender clients.

Posted by ArtelinaRose

Did your schooling/training ever lead to you diagnosing yourself or turning into a case of "doctor, heal thyself"?

Posted by JasonR86

@artelinarose:

We had a term in undergrad called 'medical student syndrome' where, with every disorder taught, students either thought they, or every one they knew, had that disorder. Recently though I haven't thought that way.

Posted by ToTheNines

Seems like the right place to ask, since I've been pondering this lately. Are most sociopaths aware of their own condition? If anyone knows or find themselves qualified enough to take a guess, I'd love to hear your thoughts.

Posted by JasonR86

@ninessc2:

I don't really use the term 'sociopath' and can't really think of what it would refer to. But most people, no matter what issues they might have, are aware of not only their own uniqueness but also people's reactions to them.

Posted by Rick_Fingers

I admire how levelheaded you seem to be. Thanks for taking the time to do this.

Edited by JasonR86
Edited by GaspoweR
@jasonr86 said:

I don't really use the term 'sociopath' and can't really think of what it would refer to. But most people, no matter what issues they might have, are aware of not only their own uniqueness but also people's reactions to them.

I think the only time that one would probably use that term "appropriately" is when it is applied to criminals who are also diagnosed with anti-social personality disorder, right?

I'm not a therapist btw...still have to take my board exam. I graduated with a BS in OT. Also if you don't mind me asking are you a psychiatrist? Wasn't able to read you first blog so I'm not sure but I'm just guessing since you made an implication that you were a medical student in one of the comments.

P.S. Also the health system at the moment is busted so I do kinda understand your sentiment but I'm not incredibly knowledgeable with how it all works ATM. Also if you do start a private practice, you would still need to be connected to or be part of an ACO right?

Posted by JasonR86

@gaspower:

I didn't really answer that question very well. Sociopath is a bit of an archaic term. It's not in the DSM (basically the US' mental health bible) and is not something I can diagnose. It's in the same category as lunatic as in its a commonly known term but not one professionals really use legitimately.

I'm not a psychiatrist. I'm a psychotherapist. When people go into private practice they are usually on the board of a health insurance group (think Blue Cross or places like that). They may work with Medicaid or Medicare but most of their clients have private insurance. At my agency we see people who have Medicaid and through a sliding fee pay scale.

Posted by GaspoweR

@jasonr86: Yeah, I'm familiar with DSM. DSM V wasn't out yet when I was doing my psych subjects back in college so I'm just more familiar with DSM IV TR and we used Kaplan as one of our textbooks.

Thanks for sharing, sir. It's great seeing a professional who is in the mental health field who is also in GB. I might ask you some questions from time to time if you don't mind. Hahaha! Also good luck with being able to start your own practice some time in the future. :)

Posted by mindgarden418

@jasonr86: Thanks mate!

@herbiebug: I went through CBT as well, as part of my therapy. And yep, I completely understand what you are saying. One has to be receptive to that type of thing for it to help.

Truth be told, I was diagnosed with major depressive disorder and generalized anxiety disorder at 15. I dropped out of school, not to make light of the situation, but my god. Ultima Online saved me, and I haven't been able to really play any MMO since. That was a fucking fantastic game!