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No Longer Wanting to Die

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Re: No Longer Wanting to Die

#21

Post by NPMaxwell »

wcummings wrote: post #6
DanBC wrote: post #4

In England DBT is patchily available. You'd usually have to be very ill, or persistant, to get it, and wait times can be too long. There has been a focus on CBT. That's great because for most people CBT is effective and short, but as this article says it doesn't work for everyone. Very recently there is a lot of work to improve access to other talking therapies. Patients now have more choice about where to get their…

Having done CBT, I found the complaints in the article really puzzling. Glad the author found something that worked for him, though.

What jumps out at me is that, as far as I know, CBT training focuses on having the therapist provide cognitive tools to reduce awful automatic thoughts and emotions. The therapist empowers the client. Some therapists bring from their own prior experience the ability to manage anxiety, shame, and guilt by leading the conversation, but others approach their work like computer programmers -- for them the task is to get the code in there. If you have ever seen a talented salesperson alternate pushing and withdrawal as they manage the prospect's anxiety and vanity while bringing them to a purchase, you have seen the element that is present in some CBT, but not part of the official training. Without that management by the therapist, the client may feel worse in sessions, and might come away with the sense that CBT is belittling. An irony here is that the greater respect of empowering the client may feel like less respect.

Re: No Longer Wanting to Die

#22

Post by a3n »

japhyr wrote: post #11
zkhalique wrote: post #9

Earlier quoted context omitted.

Was your second session your last because the prayer suggestion made you not want to go again?

Being told to pray is pretty much the antithesis of good therapy.

Not necessarily. I haven't researched it beyond what my doctor told me, but "studies have shown" that for people who have prayer as part of their life to begin with, prayer can be very helpful. Not for the GP commenter, so that suggestion wasn't helpful, but certainly for people already open to it.

And doesn't that make sense? We're not merely bodies and brains, a biological machine built to specification, arriving at a particular day exactly like each other and exactly like we were born. Besides differences in brain mechanics and chemistry from each other and from our birth, we are also each the various experiences of our history. We have as much in difference as in common with each other.

Quite apart from the question of whether prayer and what's prayed to is reality or not, people do believe in prayer and what's prayed to. If that's an effective part of their therapy, I see no reason to question it. If it lifts them out of the horror of depression and keeps them alive, I'm very happy for them, and for me if they're in my life.

-- Signed: a non-partisan, small "a" atheist.

Re: No Longer Wanting to Die

#23

Post by clsec »

Dylan16807 wrote: post #15
japhyr wrote: post #11

Earlier quoted context omitted.

Being told to pray is pretty much the antithesis of good therapy.

How so? Seriously praying is an involved, focused mental state. It's not flippantly wishing.

Being asked to pray is not the right way to go. But, gaining a spiritul practice of some sort and learning/practicing mindfulness can be a tremendous help to someone suffering from major depressive disorder, such as myself. It has helped me quite a bit. Though I am still depressed, as I have been my entire life. It's a good tool in my toolbox of things that I have to help myself.

Re: No Longer Wanting to Die

#24

Post by hessenwolf »

learnstats2 wrote: post #18
japhyr wrote: post #11

Earlier quoted context omitted.

Being told to pray is pretty much the antithesis of good therapy.

I am not religious but I can see the value of prayer. In this case, the therapist could have understood that prayer was not a helpful suggestion - but in general, it's a valuable tool.

When used with caution, perhaps. Separation from a god-belief coincided with the start of my depression, so prayer would be super-not-helpful.

Re: No Longer Wanting to Die

#25

Post by cwp »

japhyr wrote: post #11
zkhalique wrote: post #9

Earlier quoted context omitted.

Was your second session your last because the prayer suggestion made you not want to go again?

Being told to pray is pretty much the antithesis of good therapy.

Depends why the therapist is suggesting it.

If he thinks that praying in and of itself will be valuable, eg, because the patient is religious and a calm, focussed mental state would be valuable, then it is good therapy.

If the therapist is suggesting that the patient ask God to cure him... well, that's not good therapy.

Re: No Longer Wanting to Die

#26

Post by msutherl »

rquantz wrote: post #3

As someone who has suffered from moderate but not debilitating depression for much of my adulthood, one thing that has always stood in the way of getting treatment has been finding a damn therapist. Back when I was a broke, insurance-less musician, I went to inexpensive sessions with a student therapist who listened to me talk for a semester but offered very little in the way of help. Shortly after getting insurance…

Totally speculative, but I think this might have something to do with a high demand for good therapists. For instance, I spoke recently with a friend who was studying to practice psychoanalysis and when I asked him if he was looking for clients, he turned me down in such a way as to suggest 'you're not on the level of my clientele' or at least 'I have all the clients I need.' This was in New York where I'm sure there's a huge base of wealthy potential clients willing to pay a premium.

If therapists have no problem finding clients, word of mouth may actually be the best system for them.

Please correct me if I'm off-base here.

Re: No Longer Wanting to Die

#27

Post by rquantz »

eropple wrote: post #20
rquantz wrote: post #10

Earlier quoted context omitted.

It was a little more than that - he was talking about the HAARP conspiracy theory as well. It just became clear he didn't approach the world rationally. I'm sure for some people he would be a great therapist, but not a good match for me.

So I'm a sucker for conspiracy theories, and this one's a new one on me: http://en.wikipedia.org/wiki/High_Frequency_Active_Auroral_R...

Yeah, I hadn't heard of it either. He started talking about it and I said, "that sounds like a conspiracy theory," and then ended up looking it up in the session because he wouldn't let it go.

Re: No Longer Wanting to Die

#28

Post by cpncrunch »

colund wrote: post #19

Hacker News unfortunately seems to be more and more about depression/psychology and less and less about positive entrepreneurship and tech/programming. I want to be inspired.

I suspect that it might be because the people who are driven to be entrepreneurs also have a higher likelihood of suffering from depression.

Re: No Longer Wanting to Die

#29

Post by abandonliberty »

stegosaurus wrote: post #13

Treatment for depression is badly handled almost universally... It seems as if people still don't generally understand that it's more than 'feeling a bit sad'. If you break your knee, you will (99.9% chance) go and see a doctor. If the first doctor doesn't fix it, you'll see another. Your knee is broken, unusable, painful and you have a drive to fix it. A more serious injury will generally result in a friend/family m…

This is further compounded by the stigma & blame that surrounds mental illness, which can be quite severe in certain cultures/countries e.g. China

Re: No Longer Wanting to Die

#30

Post by sopooneo »

shanusmagnus wrote: post #12
rquantz wrote: post #3

As someone who has suffered from moderate but not debilitating depression for much of my adulthood, one thing that has always stood in the way of getting treatment has been finding a damn therapist. Back when I was a broke, insurance-less musician, I went to inexpensive sessions with a student therapist who listened to me talk for a semester but offered very little in the way of help. Shortly after getting insurance…

I think this is a general problem with the health care system. Finding somebody that's worth a shit is basically impossible to do in any sensible way, even for something as straightforward as orthopedics -- my journey towards shoulder surgery has been ridiculous to the point of farce. If it's this bad for ortho it must be unimaginably awful for anything touching mental health. What does one do? Get personal recommend…

I can testify to the mental health search difficulty. A close family member is searching for a therapist for emotional help dealing with an occasionally debilitating physical health issue. The first group we found through online searches ended up being a front for a multi-level-marketing group schilling essential oils. The second group, recommended by the overseeing physician at one of the most prestigious hospitals in the United States, was actually a "new age" center, whose main advise was to try homeopathic remedies. The third group, recommended glowingly on its web page, and organized by the hospital itself for sufferers of my family member's very condition, seemed to have vanished without a trace. No one had heard of it. Turns out it went defunct years ago, but no one bothered to update or remove its associated page.

That's where we stand. Infuriating. This is not quality befitting a first world nation.

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