Terminology - childhood issues

[jaathom]

I went to a therapist (psychologist) for 18 months --- with poor results --- for anger and stress management. I feel like the therapy there only skimmed the surface and did not delve deeply into childhood issues. The therapist had me do some listing and writing about these, but again that seems to have only skimmed the surface.

If I want to get a psychiatrist to delve deeper into these issues, what terminology should I use about that sort of therapy? What therapy options are there for this?

Thanks

[Mark]

If you want to deal with childhood issues, you need to find a therapist who is psychodynamic by orientation. You may have had a therapist who was cognitive behavioral, and cognitive behavioral therapists don't get into the past stuff - they try to help you cope better in the present by working on the ways that you cope. Psychodynamic therapists are interested in the ways that difficult, unresolved past events affect present events. There are tons of psychodynamic therapists around - it should not be too difficult to find one.

[jaathom]

Yes, you are exactly right about my last therapist. Thank you for the advice.

I suppose the only way to find out about a therapist is to ask.

[appleby]

yep and it really is good to ask.

You have right to know how they work, what their philosphy is etc. This is your treatment and you are paying for it. There are guidelines around about what to ask therapists as you are exploring the idea of working with them. There may even be some on this website (don't have time to check that out right now.

Any way good luck in your search for a therapist who can help you deal with the things you need to.

AB

[gordian knot]

hi jaathom,

I just wanted to encourage you in your search for a therapist. I am currently working with a psychodynamic psychotherapist and it has been so helpful for me to go back and talk about my feelings and experiences from childhood. It is amazing how much we remember and yet it is hard to put it into context from an adult perspective without a trained professional to help. Our memories, feelings, traumas and experiences (even happy ones) from our earliest years drastically affect how we approach the world as adults.

I hope your search goes well. When you go for an intake appointment with a new therapist, make sure to let her/him know what you are looking for and (in general) what kinds of things you want to explore. The therapist can usually make a good recommendation if they do not specialize in the style or issues you would like to cover.

I look forward to hearing more about your journey in therapy.

Best,

Sean

Edited October 25, 2008 by gordian knot

[jaathom]

In rooting around on the Internet, it sounds like most therapists are not psychodynamic in their approach. Have you found that to be true?

Also, do you find that most psychiatrists in your area do not do therapy, but rather stick to managing medecine? So far, that is what I have found. They usually have an LCSW that does the therapy part.

[appleby]

Most Psychiatrists don't do psychotherapy (though some do) they mainly prescrbe and monitor medicine. Psychotherapy is generally done by licenced psychologists, social workers, marriage and family therapists and mental health counselors. Also, creative arts therapists like art , music and movement therapists are trained often psychodynamically and can be licensed. The actual license titles vary from state to state -- but LCSW, licensed psychologist, LPC's. LMFT's are some on the titles that you might find that indicate formal training and supervision to be able do psychotherapy. And then it is necessary to check out the actual person and the specific traning and interests they have and how you feel about them as you talk with them...

AB

[gordian knot]

I intentionally looked for a psychiatrist who did psychotherapy so I could do "one stop shopping" for meds and talk therapy, and there were not very many in my area. I live right in the city (Portland--about 1 million people in the metro area), yet there were fewer than 10 psychiatrists within a 5 mile radius of downtown who do both meds and psychotherapy.

I really lucked out since I found a doc who was everything I was looking for (psychiatrist who does therapy, female, same age as me, psychoanalytic/psychodynamic by approach). I can see how it could be difficult to find a psychiatrist who does both meds and therapy (much less one with the preferred theoretical orientation) in a smaller town or rural area.

Are you in the U.S.? If so, this website (mentalhelp.net) and the Psychology Today website (http://www.psychologytoday.com) both offer free therapist finder databases which allow you to search based on certain criteria, including credentials and theoretical orientation.

The two most important things in finding a therapist are finding someone with an approach you agree with (e.g. psychodynamic psychotherapy) and finding someone you personally feel like you connect with in some way. Whatever connection you feel to them will become very important in the psychodynamic process, since the relationship you build with the therapist will help teach you both about the dynamics of your earlier relationships in life.

If you find someone who describes their style as 'psychoanalysis' but they will do sessions once a week or twice a month, that is the same as psychodynamic for our purposes. You are correct though. There seem to be a whole lot more CBT and humanist therapists out there than psychodynamic and psychoanalysis therapists these days. Your local psychoanalytic society should be able to refer you to someone nearby if you have difficulty finding someone.

Best,

Sean

[WinterSky]

Years ago I had a psychiatrist who did therapy and meds. It is really nice to have one person do everything. But that changed years ago and my current doctor just does medication. Frequently I have asked for longer appointments because I would need to discuss things that required a doctor, because he is the one that does the diagnosing. He has accommodated my needs in the past but has made it clear to me that he does not like to do that.

Now with two people, a therapist and a psychiatrist, the trick is to get the two talking to each other. I feel that my therapist knows me better than my doctor. But after the last few weeks my doctor knows me much better now I am sure. But trying to get them to talk to each other is difficult. I gave them written authorization to speak to each other and they still do not.

Does anyone else here feel that it is important that an individual's therapist and psychiatrist ought to be working together? How well do you feel that your doctor knows you and your issues? Is 15 minutes per session enough time for you with your doctor?

[jaathom]

An update: Identified two prospective therapists (with helpful information from this board), met with both, and selected one. I had my second session tonight, but I am convinced that this therapist can help me.

Thanks again for all the advice.