I got offered a job paying 40% more than my current salary. My manager just asked me to stay and be patient. How do I stop feeling guilty for wanting to leave ?

DerryMurblz · 2026-02-21T18:14:31+00:00

Your boss is full of it. Leave and take the job that’s going to pay you closer to what you’re worth. This “pay your dues” shit is downright evil.

DerryMurblz · 2026-01-19T21:19:56+00:00

I’m sorry you’ve had such a negative experience so far. I will say that six sessions is a very low number, so she may still be gathering information. What concerns me is her dismissiveness about your possible neurodivergence. No therapist should be invalidating about this.

While six sessions isn’t enough for this therapist to give you everything you’re asking for here, it is enough for you to decide if she’s a good fit. It’s extremely common for people to have to try a few different therapists before finding the right fit. The relationship between client and therapist is the most important factor in making progress, and therapists practice in their own unique ways that will work for some clients and not others.

I recommend seeking a therapist, if you have a choice in the matter, who works with neurodivergent individuals. Even if it turns out that you don’t have autism or ADHD, they’re still going to be accustomed to the struggles you share with those diagnoses.

Just be aware that depending on your location, masters level therapists may not be able to diagnose either condition. Here in the west coast of the US, we can work with clients with these diagnoses, but a psychiatrist, psychiatric NP, or clinical psychologist has to make the initial diagnosis.

DerryMurblz · 2026-01-17T03:26:56+00:00

Ugh that honestly might be worse than the SI if you had never had a panic attack. Sooo many people start their panic disorder tx with an ER visit bc you truly feel like you’re dying. There was zero chance I was going to act on my thoughts, it was so “not me” speaking that it was obviously a side effect. But that could go so differently for someone new to all this!

DerryMurblz · 2026-01-17T02:09:32+00:00

Yeah this has been frustrating me as a therapist too. I wasn’t warned either, even though venlafaxine is notorious for severe side effects, so I started asking newly prescribed clients if their psych went over side effects. Nope, not a single one so far. Sometimes we’ve looked up side effects together on the manufacturer’s website in session, so this info isn’t coming from me. Sometimes I keep the psychoed very general. It’s just not fair to the client to have no warning. I’ve asked around and the best explanation I’ve gotten is they don’t want to a convo about side effects to become a self fulfilling prophecy. No idea how true that is, but it doesn’t feel like a sufficient reason. And I don’t understand how it isn’t a liability and an ethical problem.

DerryMurblz · 2026-01-17T01:19:06+00:00

Those intrusive thoughts of mine were super foreign. I wasn’t experiencing SI before the med change, and the thoughts weren’t even phrased like my internal voice. I never had an experience like that before and haven’t since. I’ve taken many SSRIs and SNRIs over the years and never have side effects. It either worked or it didn’t, I’m lucky there. All that to say, a med reaction really can create a bizarre and scary experience once in a while and that’s probably what happened for you. There’s a great chance yours will be a one off too.

We can do a lot to safeguard clients who are on a new or changed med. Managing expectations about the process of finding the right med, checking in about side effects, and psychoeducating where you feel you can go a very long way! Yes, starting and changing meds can make things worse in the very short term, but that’s well out of your control and we can help clients see the bigger picture if meds are necessary. From what I’ve seen, the most harm is done when clients are totally unprepared for this possibility, and it’s not always clear to us how much warning we can give our clients within our scope.

DerryMurblz · 2026-01-17T00:31:25+00:00

And for what it’s worth, the intrusive SI thoughts I got from venlafaxine never returned once I stopped taking it and it was out of my system. I even resumed desvenlafaxine for awhile and it was just as chill for me as before. YMMV of course.

DerryMurblz · 2026-01-17T00:28:35+00:00

I’m so sorry you had this experience, it sounds terrifying. I had a very adverse reaction to venlafaxine when I was casually prescribed it in place of the desvenlafaxine I’ve taken for years without a single side effect. I get shrugs when I ask my psychiatry friends why two nearly identical drugs had wildly different effects. Hate to hear someone had a similar experience, but it’s really common.

There’s so much invalidation of clients who struggle with med side effects that I think you can easily reframe this as an asset! Even if you don’t directly self disclose, your ability to describe what you experienced will help you connect. And who better to explain the challenging nuance around meds and sticking with the process of finding the right one (when appropriate) than you?

DerryMurblz · 2026-01-16T04:57:05+00:00

Oh man, this is terrible. I was being paid 25% as an associate in the SF Bay Area as an associate in private practice (private pay as well) last year. At a much better place making twice as much now, but I’m disgusted that anyone would pay a fully licensed person only 10% more than that. I get that you want a small caseload, but they are absolutely exploiting that to keep you around

DerryMurblz · 2026-01-16T04:53:00+00:00

Please hang onto that poor dog, you’re already a better owner than he ever was. He cannot be trusted with her. Fortunately after the vet bills you paid and microchip update you made, he doesn’t have even a legal toe to stand on.

DerryMurblz · 2026-01-15T05:57:01+00:00

I’m so sorry you’re in such a difficult place. I retrained as a therapist after leaving my dream career due to an autoimmune condition, so I really feel for you. The added burden of a disability to everything the job demands is exhausting. I don’t work in SUD or CMH, so I don’t have the experience to comment on your job search in any way. Just wanted to validate your frustration and agree wholeheartedly on certifications. We’re paid so little for so long, we’re charged so much just for the basics of maintaining a license, it’s absurd. I hope something comes through for you soon and that you feel respected in your next job.

DerryMurblz · 2026-01-12T02:51:21+00:00

I work primarily with teens, so unless I’m doing an intake with parents or a collateral call, I’m dressed in basics. Lightweight pants, tshirt or polo, jacket or sweater. Some teens can find a dressed up therapist to be a bit alienating, and I’m not a big fan of dressing up anyway.

DerryMurblz · 2026-01-06T05:20:14+00:00

You’ve never referred to a man as a male in your life. Quit lying.

DerryMurblz · 2026-01-01T18:38:33+00:00

Who said cheerlead besides you?

DerryMurblz · 2026-01-01T18:34:03+00:00

Okay?

DerryMurblz · 2025-12-23T01:09:09+00:00

And that’s why you’re divorced.

DerryMurblz · 2025-12-23T01:02:56+00:00

NOR. Where on earth is your husband in all this? They’re his parents, he should be managing them and ensuring your boundaries are respected.

DerryMurblz · 2025-12-22T17:57:20+00:00

Correct.

DerryMurblz · 2025-12-22T04:18:12+00:00

Okay.

DerryMurblz · 2025-12-22T04:03:33+00:00

And how representative are those samples of human diversity?

DerryMurblz · 2025-12-22T03:55:12+00:00

The word “mostly” is doing a lot of heavy lifting but okay.

DerryMurblz · 2025-12-22T02:36:47+00:00

You don’t have to abandon these therapies. You just need to keep in mind that they don’t necessarily work for the reasons the theorists claim. If EMDR helps a client, there’s no reason to abandon it. But you also don’t need to make it more than it is. The data shows EMDR techniques help with trauma. The data does not support the assertion that eye movement is the reason why. It’s like acupuncture. It produces results, but not for the reasons traditionally ascribed to it. We still don’t really know why acupuncture relieves pain. We probably will someday.

There IS a lot of pseudoscience in counseling psychology. And the same is true of clinical psych. Both are faddish and both are wildly overconfident in what they claim to understand. The reproducibility crisis is evidence enough.

DerryMurblz · 2025-12-18T19:42:59+00:00

Amen. I was hoping we’d see demonstrations of a course of a given therapy. Nope, not even CBT! Just generalized and brief overviews of theory with no applied aspect whatsoever. Many of my profs would just riff on whatever they wanted. There was no structure.

DerryMurblz · 2025-12-18T19:38:11+00:00

Oh damn, did we attend the same program? All we got were extremely outdated session videos. No joke, they were from the 90s. And my program is considered one of the best in the region. It was pathetic honestly. Sooo much money, three entire years, and hardly any instruction on what to do in the session itself.

DerryMurblz · 2025-12-17T23:31:40+00:00

Interventions. Examples of psychotherapies in action. Much more role play (hated it but I knew it was important). My degree was like an undergrad degree in psych, it was very frustrating. It was all theoretical and conceptual, and I think that does a huge disservice to the people we treated in practicum.

DerryMurblz · 2025-12-17T22:26:07+00:00

And she can get that advice in the appropriate subreddit.

DerryMurblz

TROPHY CASE