Thursday, February 26, 2009

Never Take Advice From a Therapist!

Not only is advice given by therapists usually bad, but if it doesn't work and you report back to the therapist stating such, he or she will use one of three "escape methods" (i.e. methods they will use to try to get out of it), all of which are bound to make you feel frustrated. [note: all the following scenarios are real - they are drawn from my own actual experience.]

Method 1 - the therapist attempts to "flee", when she finds out the advice was bad. Example: In a previous session, our therapist has given the client bad dating advice. The client then reports back - the conversation goes as follows:

Therapist: "What are you perceiving today?"

Client: "I perceive you gave me a bad recommendation last session - it did not work."

Therapist (in a huff): "It wasn't a recommendation - it was a suggestion."

Client: "Okay, it was a bad suggestion. Whatever - you screwed up."


Method 2 - the therapist attempts to "merge advice", i.e. make his (revised) advice compatible with that from someone else which turned out to be correct, thus making it appear that his (the therapist's) advice was never wrong in the first place. Example: The therapist has been telling the patient to drink eight glasses of water per day:

Client: "You're wrong about drinking eight glasses of water every day. I started doing that, and found myself getting drowsy and even occasionally dizzy."

Therapist: "Yes, but did you suffer any ill effects?"

Client: "Hello? My doctor said to stop drinking that much water because it dilutes one's sodium level, thus throwing off their electrolyte balance, resulting in these problems."

Therapist (in a huff again): "Well..if it bothers you, don't drink so much!"

Client: "Thanks for the retro-active advice, barf-bag."


Method 3: "Transition viewpoint" - shift advice which was given previously as if it had some general validity, to become instead focused upon the client as if it was tailor-made at the time given specifically for him or her. Example: As do all therapists, the one in this scenario has advised the client to join Toastmasters, since "it is known to improve peoples' confidence, especially when they are speaking in front of others":

Therapist: "How is Toastmasters going?"

Client: "You screwed up again. The meetings with them had been making me extremely nervous and anxious, even continuing well after the conclusion of each meeting. I then found out that research has been done, which has shown that people who are in Toastmasters have a disproportionately high rate of abnormal EKG's*. In other words, your dunce-ed-ness, they are under an unhealthy amount of stress."

Therapist: "Well, if it bothers you, don't go!!"

*a knowledgeable health professional gave me that information about Toastmasters and EKG's approximately eleven years ago.


The moral of all this? Limit validity of the therapist's advice only to subjects pertaining to the therapy itself:

Therapist: "I advise you to see me text Tuesday."

Client: "Yes, I had predicted so, since that is the normal day for our sessions. Is it okay if I wear a blindfold then, however? I really would rather not see you."

Friday, February 13, 2009

Case Files: Therapist puts patient in double bind, then tries to weasel his way out of his mistake


Scenario: it is the beginning of a therapy session, and the patient "John" walks into the therapist's office and sits down.

Therapist: "Hello, John, how's everything going?"

John (the patient): "Well... basically okay...

Therapist: "I perceive that you are a little excited...what's that about?"

John: "When I was driving through the McDonalds just a short while ago, the girl at the window really pissed me off! She messed up my order - she didn't know what she was doing!!"

Therapist: "Well...it's dinner hour, maybe she was too busy and got confused. Isn't it being kind of hard on her to hold her to blame?"

John: "Okay, if you say so. I acknowledge to your royal jackass-ed-ness that I am a terrible monster."

Therapist: "Good. Now, how did things go at work today?"

John: "Could have been better. I made a mistake and the boss got mad at me, he kind of shouted at me...he made me feel bad...”

Therapist: "Let's talk about your sensitivity to criticism, and let's also discuss how you can avoid making mistakes at work."

John: "But, shouldn't you now be suggesting that maybe my boss was out of line, and also be telling me that perhaps I am not to blame for my mistake? In other words, why do you not now apply the same type reasoning toward me, that you did to the McDonalds worker? Aren't you kind of putting me in what you guys call a 'double bind'? "

Therapist (while trying to pull his pants up): "Uh...hmm...wait a minute - well, you're being too philosphical. Er, I mean...you can only control your own behaviour...wait! I mean, can you pretend for a moment, that I'm not a complete loser?"

John: "Sorry, I've tried to do that before but realized I was acting in bad faith. You have been debunked. Dee-bunked. Hah! You're fired!! You are free to seek a new patient!!!"

Tuesday, February 3, 2009

What It Says in My Psychology Text - Part 1

I purchased and looked over a revised edition of my college psychology text a few days ago. I came across a couple of interesting things.

One is that it turns out that the reason for the ever-expanding list of diagnoses in the DSM*, is so that insurance companies will pay for treatment! HMO's and the like are not going to pay for years of treatment by a therapist for something vague like "adjustment problems" - they're more likely to pay if the patient's problem is given a medical-sounding name like "Borderline Personality Disorder".

Of course thanks are due the profession for helping to give more people access to treatment. And at least this dispels the notion that the ever-increasing number of ailments is due to some industry obsession or panacea, or the psychologizing of our society. I mean, it does dispel that notion..doesn't it?...


*Diagnostic and Statistical Manual of Mental Disorders - what shrinks and other professionals use to diagnose their patients, i.e. to label the patient's "condition".