Therapy Assessment

Or, “One hour of me feeling defensive and being asked questions like, “Why do you use labels like manic depression”?

Because I have this treatable illness called “manic depression” and you were asking about it? I’m fairly well read when it comes to psychiatric diagnosis, mostly because I write this blog and like to be informed. Using the “label”of manic depression comes naturally to me, because I write about it so often. I also find the whole thing easier to understand and explain if I can use the bloody words that describe the illness. I hate this about psychiatry- I do my best living with this, but it does affect my life significantly. I don’t “let it”, I’m not weak, it just does because that’s what it does to me. Just because it affects me and I acknowledge that, it doesn’t mean that I define myself by it. I use the phrase, “I have manic depression” rather than, “I am manic depressive”. If I had another illness that significantly affected my life, nobody would call it a fucking label. People are always very suspicious if you know anything about psychiatry. I have the internet, a library and a curious mind- if I’d been diagnosed with any illness I’d have found out everything about it by now. It is how I make sense of it and deal with it. If it was still this faceless thing, like it was, it would be harder.

They also asked if I was showing them my scars. I wasn’t, I was fiddling with my bracelets because I was nervous.

I did talk about eating issues and body issues (which I find nigh on impossible talking about in the flesh- manic depression, fine, it’s almost my job to talk about that) but fucking hell, that was so traumatic and I feel completely shaken and tearful. I really didn’t expect for it to be so hard, and sitting there in front of two impassive faces was just fucking horrible.

They asked me what I wanted out of therapy. I told them Rob was worried about me, and I wanted to make an effort to try and sort out my eating and body issues as much for him as for myself. And because dysphoric mania is too easily triggered by antidepressants, I’d like some help in coping with depression since I can’t take medication for it. In short, just some help coping with things.

I just hated that whole hour and feel shaken by it. They were nice, it’s just so fucking hard to talk about that kind of stuff in front of strangers when you’re not absolutely pissed. Here’s why I prefer to write than to talk.

I’m repeating the experience next week.  Ah fuck.

At least I went, though! I was so nervous beforehand that I chainsmoked for two hours.

15 Responses

  1. good luck with next week, sounds like you were pretty concise on what you want from therapy. I still haven’t worked that out, but then my therapist says I’m ambivalent so maybe that’s not surprising. Hope you find it easier next time.

  2. Urgh.

    I could maybe see calling yourself a manic depressive as using a label, but saying you have manic depression is the same as saying you have any other disease, because that is what it is – an insidious one but a disease none the less.

    My psychiatrist once asked me if I was trying to show how ill I was by showing my scars, of course it wouldn’t be because it was boiling hot day.

    I don’t like feeling as if they are trying to trip us up, I need to keep reminding myself they aren’t.

    Well done for going in. It gets easier with time.

    lastly your smoking ad had me laughing, hard, something I haven’t done in weeks – well done.

  3. Well I can fully relate to this, since I attended an introduction meeting today for a group therapy thing. I was made to feel welcome but was as nervous as hell and anxious, all I could do was keep crossing and uncrossing my legs and rolling the sleeves up and down my arms… I am not officially part of the group yet, I decided I want to give it and go and feel privileged to have been given the chance to take part from my CPN, commitment for a year seems like a long time but I have to give myself a chance if I am ever going to gain any control over my emotions!

    Whether of not they will accept me at the selection meeting is a different story, but that’s not for two weeks so I won’t worry too much about it now!

    I can only say how you felt and behaved today was a perfectly natural experience, it’s hard talking to anyone especially a bunch of complete strangers!

  4. Congrats on working up to the frame of mind to go, it sounds like it would have been a very uncomfortable and difficult situation so it is fantastic that you managed to bring the eating issues into the discussion. I’m sure iit would have been easier for you to just not mention it.

    I hope it gets easier with each visit and that you can perservere and get something out of it
    x

  5. Well done on going to the session and being able to discuss the bulimia and body image stuff and goodluck for next week

  6. I think you did an excellent job of explaining how frustrating it is to have a conversation about labels. I know for me, I have a hard time talking to complete strangers too – writing is much easier for me in terms of expressing myself. Kudos for going, hopefully next week will be a little easier.

  7. Well done for going chick.

    Yeah my therapist has also asked if I was showing my scars off to her, I was like no have you seen it outside its roasting. And I’m always scared to say infront of her that I have BPD because I hate the way she reads into things.

    Good luck for next week!!!!

    x x x x

  8. Ah yes, therapy assessments. Well, first dates are always difficult. Mine got split into two sessions, as well. They always seem to. Which seems kind of pointless because at the end of it you’ll probably just be offered CAT.

    Anyway, it’s normal to feel emotionally raw and shaken after this kind of stuff. It gets better. Learning to trust someone with these incredibly personal things is hard and it takes time. It took me two or three months of weekly appointments before I could trust my therapist enough to actually discuss some of the scarier stuff with her. It’s still hard, but it feels much safer than it did. You don’t stop feeling shaken, but it does start to feel like it’s for a good reason.

  9. I have little experience with therapy. There were two of them? Bloody hell! It sounds like an interrogation.

    Keep going with it though. In time bonds will form and trust will be established – simply because you are 3 human beings sitting talking about difficult stuff.

    Is that a common technique then? Therapists trying to trip people up? The post and the comments make it sound like it’s widely done. Why? Wouldn’t that just make anyone already feeling lousy feel worse? If there’s some secret reason they have for it I’d like to know it but it strikes me as underhand.

    If they insist on labeling you as a labeler, tell them that as a sentient human being you use words to describe things and it is their profession that has happened to have come up with the terms manic depression and bipolar.

  10. Well first of all, a big well done for having the courage to go; then on top of that you managed to bring up your disordered eating. Good skills.

    Experimental chimp hit the nail on the head – therapy assessments are hard. I’m sure you are already aware [ being such a web queen and all], but the phrase ‘it gets worse before it gets better’ features in discussion forums about therapy A LOT. So keep up the strength and stick with it.

    I have been rejected for psychotherapy twice by a mental health nurse come psychotherapist come eating disorder specialist. But in July I have another assessment with a more general psychotherapist (having been referred by a regular psychiatrist) I hope I am accepted this time; because I know a lot of people whom having experieced therapy consider it a wise move.

    Stay safe
    xXx

  11. I wonder if it gets any easier. I had therapy for teh first time some days ago… it was a total disaster. He argued with me and told me something like I was using “depression” as an excuse not to live the world…

    I need to keep doing it for my family. And I know that one way or the other therapy has to help… but it takes time I suppose. Maybe when time passes and you start feeling a little more confortable with these people it might be better.

    One question, Would you allow your therapists to read this blog? That would be easier for you to talk about something that is already familiar to them… you wouldn’t have to start from scratch like you were introducing yourself to strangers… which is a very hard thing to do.

  12. Is that a common technique then? Therapists trying to trip people up? The post and the comments make it sound like it’s widely done. Why? Wouldn’t that just make anyone already feeling lousy feel worse? If there’s some secret reason they have for it I’d like to know it but it strikes me as underhand.

    My experience is that therapists don’t actively try to trip people up. It just feels that way at first.

    For the first few sessions there’s not much difference between a therapist and a really nosy stranger. In order to understand people, therapists have to ask lots of questions. Until they get a handle on things, they don’t know how you react to certain ways of questioning, what you’ll find critical, what you’ll take as an accusation or an insinuation. They don’t know what’s hard for you and what’s easy to talk about. Everyone has odd triggers buried inside them that aren’t always predictable, and therapists can easily stumble upon them.

    After a while, though, a good therapist will get this kind of stuff and adjust the way they work to fit what you need from them. Set up ways to deal with the negative feelings that inevitably get raised by talking about this stuff. But it takes a while.

    There are bad therapists out there, but unless they’re telling you about Xenu it’s probably hard to tell at first. I do think I lucked out with my therapist, though it’s not like I have anything to compare her to..

  13. Like you said in your last line, at least you went – a lot of good people don’t make it that far. As for showing your scars, I’m curious as to whether or not a person is actually deemed healthier by a therapist for trying to hide and cover their scars?

  14. Just found your site and WOW; you’re quite the f’ing cynic! …but I love it.

    Your issues are your own, and we are all the same in that. Everyone needs an outlet, to let someone or something know what maintains your singularity; your identity. If you want to continue with therapy, do it – but only if you like your therapist; keep hunting for the therapist that is your personality warms to. If you can be fulfilled purging yourself on the internet, then do it. Kick the drugs; they are just another substitute for separation from the rest; not to mention, the anti-psychs are meant to tame you, as if we are wild dogs. But we aren’t animals and we can moderate our behavior.

    Good Luck and Best Wishes,
    Expression is the truest form of therapy and I look forward to reading more of your blog.

  15. I second what cazyasuka said about letting yor therapists read this blog. I think it could really jump start the therapuetic process and help them to know ahead of time (so they don’t have to ask stupid questions like “why do you label yourself manic depressive/are you showing us your scarrs”) how to best relate to you to get things accomplished and what many of your issues are that you should be focusing on without having to spend 10 or 12 visits just getting to know the basics.
    Hopefuly they are good therapists and would be willing the take the time to read thru at least a portion of this blog so that your therapy sessions can be the most productive they can be ASAP.

    I am glad to hear you’re doing therapy. It can be a hard experience for a lot of people. I guess for me I am just lucky in that I don’t much care about what the therapist thinks of me in so long as they are giving me useful advice and coping tools… so it’s easy for me to be open with a therapist (unless they are a complete dickhead) because if I am going to pay someone $90 to $200 to spend an hour talking with me about my issues and suppossedly helping me, well I am not going to hold anything back or try to take it slow cause that is a lot of money to be spending just to beat around the bush because I care too much what that person thinks of me on a personal level.

    Sounds like you really pushed ahead and mentioned the issues you want to deal with in therapy and that is great. It does get a whole heck of a lot easier after the first dozen visits or so. But definately you should mention your blog to these therapists in your next visit, I think that is the best thing you could do, the most efficient way to get the therapists to know a lot of what’s up with you, and then you can add on top of that knowledge anything else you want them to know about that is too private for you to write about here.

    Good luck with your next visit.

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