DR apptments

[nightfalls]

I have chosen to not post

Edited December 5, 2008 by nightfalls

[Mark]

Forgetting,

Different therapists have different approaches, but maybe we can say that there are two extremes that a therapist can take. On the one hand, a therapist can be reactive, and basically say "whatever you want to talk about and address" to the client. On the other hand, a therapist can be proactive, and say "we're going to make this therapy be about addressing a specific goal, and we wont' address stuff that is off topic". Which position a therapist gravitates towards will have a lot to do with how they were raised up - what the underlying philosophy of therapy they are subscribed to is.

The humanistic tradition of therapy which was popularized by Carl Rogers in the 1960s and 70s is a reactive philosophy of therapy because it is based on the premise that people know how to heal themselves if they are given the proper opportunity (the proper acceptance and attention). So it's not stupidly reactive - it is reactive on purpose to create a particular effect - the self-sculpting of the human being releasing him/herself from his/her chains. The earlier psychodynamic tradition was much in this vein also - it used the patient's free association, for instance, to help the therapist (and then the patient) gain insight into the patient's motivations.

The behaviorist and cognitive behaviorist therapy philosopy is much more proactive. This therapy style is all about picking a problem, designing the most efficient method of addressing that problem, testing the method with research on actual patients and tweaking it so that it gets better and more efficient with time. This therapy is sharp but not always broad. It is designed to give relief for a focused problem. the therapist will often ask the patient to prioritize what the problem is that most needs addressing and then ask the patient to stick to that agenda for the duration of the therapy.

So what is happening to you is a sort of culture clash, i think. You are expecting therapy to be open-ended and about what you want to talk about, becuase that is what we learn about what therapy is about in our culture (we are all still thinking therapy is psychodynamic therapy or humanistic therapy), but the actual therapy profession has gravitated towards the newer cognitive behavioral approach, which is less open ended. And that is the type of therapy you are doing, as I recall. I don't think this is anything more than a mismatch of understandings, and I encourage you to have a "meta" conversation with your therapist about this issue. I say "meta" becuase this would be a conversation about the therapy itself and not about what the therapy needs you to learn in order to get better with the depression. It's important for your motivation to buy into the rational for the closed structure of this therapy. It is not a betrayal of your other problems for you to focus on the worst of them, one problem at a time.

Hope this helps!

[nightfalls]

I have chosen to not post

Edited December 5, 2008 by nightfalls

[Mark]

These things are not mutually exclusive. I think it will be a good idea to complete your course of CBT - both becuase it is helping you (by your own report - yay!) and becuase it doesn't last long. most CBT is over in something like three to six months. When you're done with the CBT therapy, you can look around for something more open ended, either with this therapist you've got now (if s/he does that sort of thing), or with someone new. Ask any new therapists about what sort of therapy they do, and tell them what you are looking for in a therapist is the best way to understand what you're going to get from a particular therapist.

in most people's minds, I think, all therapists offer open ended therapy. that is what is portrayed in the movies and on TV and that is all most people see before they have actual therapy experience. Also - it is still the case that the majority of therapists will offer open ended therapy in the humanistic or psychodynamic vein even today. The reason CBT people don't offer it that way is becuase they are very results focused - they want to create change in a particular problem area, and they have found that keeping to a relatively strict focus is the best way to do that (in combination with the CBT methods).

Anyway - very glad I could help.