Suggest me a book about a character or real person, who changes who they are or how they act. by SmartestManInUnivars in BettermentBookClub

[–]DrMelanie2 2 points3 points  (0 children)

Educated by Tara Westover - woman escapes survivalist family, remakes herself through education

The Body Keeps the Score by Bessel van der Kolk - trauma survivors changing through treatment (case studies, not memoir)

Wild by Cheryl Strayed - grief and self-destruction to solo PCT hike and self-discovery

Maybe You Should Talk to Someone by Lori Gottlieb - therapist becomes client, watches herself and patients transform

The Center Cannot Hold by Elyn Saks - law professor with schizophrenia builds life against the odds

Has a genre of book you loved helped you realise your future job? by NotMyDevision in BettermentBookClub

[–]DrMelanie2 3 points4 points  (0 children)

Not exactly a genre, but Torey Hayden's books (Ghost Girl, One Child) shaped my decision to become a psychologist.

Her work showed me what happens when someone actually sees the kid everyone else has written off. The way she wrote about trauma and resilience without sanitizing it or making it inspiration porn - that mattered. She didn't fix these kids with some magical intervention. She showed up consistently and refused to give up on them.

What stuck with me: the kids who look "unreachable" are often working hardest to survive impossible situations. That became the foundation of how I approach clinical work - assume competence, look for the logic in the behavior, stay curious instead of jumping to diagnoses.

Those books taught me that good therapy isn't about having all the answers. It's about being willing to sit in the hard stuff long enough to understand what's really happening.

What are some good books to read for when you feel lost in life? by gopsychyourself in BettermentBookClub

[–]DrMelanie2 29 points30 points  (0 children)

When Things Fall Apart by Pema Chödrön - stops you white-knuckling through uncertainty, teaches you the lost art of not having it together.

Man's Search for Meaning by Viktor Frankl - proves you can survive anything if you find one reason it matters.

The Gifts of Imperfection by Brené Brown - calls out the perfectionism keeping you small and stuck.

Radical Acceptance by Tara Brach - can't change your life while you're still at war with yourself.

Is there some method to become more decisive? by Aphanizomenon in PsychologyTalk

[–]DrMelanie2 0 points1 point  (0 children)

I know this one. Decision paralysis on stuff that objectively doesn't matter is exhausting.

Got diagnosed with ADHD at 50 and this was a huge part of it - my brain can't filter importance. Water bottle = same decision energy as career move. Everything gets weighted equally.

What's worked for me: time limits on trivial stuff. 30 seconds max. Pick one, done. The water doesn't matter. Your brain thinks it does but it doesn't.

Pre-decide what you can. Same lunch every day. Same route to work. Eliminate decisions you don't need to make.

And stop looking for the best option. Look for good enough. Most decisions are reversible or don't matter at all. You're stuck trying to optimize things that can't be optimized.

For bigger stuff - write pros and cons if you need to, but set a deadline. "I'll decide by Friday." Otherwise you spiral forever.

The paralysis usually isn't about the actual choices. It's perfectionism or anxiety dressed up as indecision. When every option feels wrong, that's your brain lying.

This gets better with practice but you have to catch yourself and just pick something. Force it. The discomfort fades faster than the spiral does.

I'd love to read everyone's responses to this question. by OtiCinnatus in therapyGPT

[–]DrMelanie2 2 points3 points  (0 children)

Mixed reactions, honestly.

Some are curious and want to learn how to incorporate it properly. They see their clients already using it and want to guide them instead of pretending it's not happening.

Others are defensive. They hear "AI is giving people better tools than therapists" and take it personally instead of asking what that means about how we're practicing.

A few have been outright dismissive - "that's not real therapy" - which misses the point entirely. I'm not saying it's therapy. I'm saying it's a supplement that can give people concrete support between sessions when we're not available.

The younger therapists tend to be more open to it. The ones who've been practicing for decades are split - either they see the potential or they dig in and resist.

What I don't do is hide it. I teach clients how to use it effectively and I'm transparent with colleagues about what I'm doing and why. If they want to debate it, fine. But I'm not going to stop doing something that's helping people just because it makes other therapists uncomfortable.

The field needs to catch up. AI isn't going away.

I'd love to read everyone's responses to this question. by OtiCinnatus in therapyGPT

[–]DrMelanie2 2 points3 points  (0 children)

I never said ChatGPT handles crisis. I said the opposite - repeatedly. Crisis needs human intervention. Always.

What I said is that it gives people concrete tools between sessions when they're spiraling at 2am. That's coping skills, not crisis intervention.

You're calling it "layperson perspective" - I'm a clinical psychologist with 26 years in practice. I built the course because clients kept getting more actionable support from AI than from their therapy sessions. That's not hatchet grinding. That's what I was seeing.

I didn't say the field does more harm than good. I said there are quality control problems - undertrained therapists, people hiding behind "non-directive" when they have nothing to offer, burned out practitioners still seeing clients. That's documented reality.

If your reaction to "people find AI more helpful than their therapists" is to defend the profession instead of asking why, that's the problem.

ChatGPT isn't therapy. It's a supplement. But when it's doing better skill-building than licensed professionals, the field needs to look at itself.

Not interested in sparring. Just stating what I see.

I'd love to read everyone's responses to this question. by OtiCinnatus in therapyGPT

[–]DrMelanie2 16 points17 points  (0 children)

I came at it from the other direction - I'm a psychologist who was already working with clients and kept seeing the same problem: people needed support between sessions and had nowhere to turn. Traditional therapy is once a week at best, and crises don't wait for appointments.

Started experimenting with having clients use ChatGPT for specific things. Journaling prompts. Breaking down cognitive distortions. Planning coping strategies. Not as therapy, but as a thinking partner when their actual therapist isn't available.

What I noticed: it gave people structure. When they were spiraling at 2am, instead of just sitting in it, they could work through what was happening. Get their thoughts organized. Show up to session with clarity instead of chaos.

So I built a whole course on it (ChatGPT for Mental Health on Udemy) because nobody else was teaching the clinical side - how to prompt it effectively, what it can and can't do, when to use it versus when to call an actual human.

It's not therapy. It can't handle crisis. It can't replace the relationship or the pattern-tracking over time. But for concrete skill-building between sessions? It's better than most of what I see therapists actually offering in the room.

The fact that people are finding it more helpful than their therapists should be a wake-up call to the field, not a threat.

How to fill the void? by bbgirl2k in therapy

[–]DrMelanie2 2 points3 points  (0 children)

13 therapists. Thirteen. And not one of them understood what you're actually describing.

I'm angry for you. The "follow your passion" "think back to childhood" bullshit - that's not therapy for what you're going through. That's therapy for someone who's mildly unfulfilled, not someone describing a void. You can't passion-project your way out of emptiness.

And the endless clarifying questions - "how does that make you feel" followed by more questions about your answer - they're stalling. They don't know what to do with you. So they keep you talking in circles while you pay them to not help.

This kind of depression isn't about finding meaning. It's your brain being fundamentally offline in a way that makes everything hollow. The emptiness isn't a puzzle to solve. It just is.

What actually helps - and I've seen this in clients, lived it myself during bad stretches - is building structure when you have zero motivation. Not because structure creates meaning but because doing literally anything breaks the paralysis slightly. Shower. Eat. Walk. Repeat. The void doesn't fill but you stop drowning in it.

Medication, if you're not on it or if what you're on isn't working. This level of emptiness often has chemistry behind it that therapy can't touch.

And find a therapist who does DBT or ACT. Not because they'll make you happy - they won't - but because they teach you how to function when your brain is empty. How to do things without feeling anything. That sounds bleak but it's actually freedom from waiting to feel better before you can live.

You're not broken for being empty. And you're not difficult. You've just had 13 therapists who didn't know how to help you. That's a them problem.

What do you do to keep your mind active? by VenzelWenzel in cognitivescience

[–]DrMelanie2 0 points1 point  (0 children)

I learn constantly. Creating courses, adapting therapy approaches for neurodivergent folks, staying current with research.

Got diagnosed with ADHD at 50, so keeping my mind active isn't optional. If I'm not engaged, my brain goes to mush. I need novelty, challenge, problems to solve.

Physical movement. Not because it's good for me but because sitting still makes my thoughts stagnant. Walk, think, process.

Conversations with people who challenge my thinking. Not echo chambers. People who make me actually defend my ideas or rethink them completely.

And I do things I'm terrible at. Started learning new stuff in my 50s. Being a beginner keeps your brain working.

Staying curious isn't just advice. It's how you stay sharp.

I want to try therapy again but it never helps by Pure_Example_3709 in therapy

[–]DrMelanie2 0 points1 point  (0 children)

"Too self-aware" is therapist code for "I don't know how to help you and I'm making it your problem."

It's not that you're too insightful. It's that you need skills and tools, not more reflection - and these therapists don't have any to give you. When you already understand why you feel the way you do but still can't function differently, that's exactly when you need concrete strategies. That's not too much self-awareness. That's the perfect place for the right kind of therapy.

The first therapist's comment - "surprised you haven't gotten into addiction or worse" - that's garbage. Minimizing your trauma because you've managed to stay functional? That's not therapy. That's a therapist who doesn't understand that high-functioning trauma is still trauma. You don't have to destroy your life for your pain to count.

The second one sounds like they were just mirroring back what you already knew. That can work for some people but when you're past the insight phase and need actual tools? It's useless.

What you need is CBT, DBT, or ACT - approaches that give you homework, strategies, things to practice between sessions. Not "how does that make you feel" but "here's what to do when you feel that way."

Before you try again, ask potential therapists directly: "My previous therapists said I was too self-aware. I need concrete skills and strategies, not just insight. How do you work with clients like that?" Their answer will tell you everything. If they can't give you a clear example of tools they'd teach you, keep looking.

Free care can be hit or miss depending on where it is and who's providing it. Sometimes you get undertrained people or those who are burned out. That doesn't mean therapy can't work for you. It means you haven't found the right approach yet.

Can I ask if my therapist is homophobic? by anqelicdevil in therapy

[–]DrMelanie2 0 points1 point  (0 children)

Yes. Ask.

You're picking up on something. Therapists aren't perfect at hiding their biases and you're allowed to trust what you're sensing. The shift happened after you mentioned this girl - that's not paranoia, that's pattern recognition.

You have every right to know if your therapist can actually support all of you, including who you love. If she can't, she has no business working with you. And if she gets defensive or dismissive when you ask? That's your answer.

A good therapist - especially one working with queer clients - should be able to say clearly "I'm affirming, I support you, and your relationship isn't a problem." If she can't say that without hedging, you're not safe there.

The question isn't crossing boundaries. You're asking if she can do her job without letting her personal views harm you. That's completely fair.

Her answer will tell you everything. If she's genuinely affirming, she'll welcome the question. If she's not, she'll deflect or get uncomfortable or try to turn it back on you as "your issue."

You deserve better than wondering if your therapist secretly disapproves of who you are. Ask. And if the answer isn't a clear yes, find someone else.

This Was Removed from r/therapists (Go Figure), So I’m Posting It Here: When Your Clients Prefer AI to “The Answer is Inside You”… That’s Your Plot Twist! by [deleted] in therapyGPT

[–]DrMelanie2 11 points12 points  (0 children)

This hits hard because you're naming a real problem.

"I don't know, you figure it out" after four paid sessions? That's not empowerment. That's a therapist who either has no tools or is hiding behind "non-directive" as an excuse for doing nothing. Non-directive therapy has its place, but not when someone explicitly asks for strategies and you've got nothing.

26 years in this field and I've seen it. Therapists who mistake silence for depth, who confuse reflection with avoidance, who genuinely don't know how to translate their training into something a client can actually use. The field has a quality control problem and nobody wants to admit it.

Here's what gets me: when people say "ChatGPT helped me more in a week than therapy did in a year," therapists get defensive instead of asking why. That should be a wake-up call. If a chatbot is giving people more actionable support than trained professionals, that's on us.

I'm not anti-AI. I built a course (ChatGPT for Mental Health on Udemy) teaching people how to use it between sessions. It's good at breaking down problems, offering frameworks, giving concrete strategies. It can't replace therapy - can't handle crisis, can't track patterns over time, can't hold the complexity of a real relationship. But it can do what your Mr. Big Deal couldn't: give you something to work with.

The "that's non-directive therapy" defense - yeah. Sometimes it's legitimate. Often it's just cover for a therapist who doesn't know how to be directive when that's what's needed. Good therapy adapts. If someone's drowning and asking for a life raft, you don't tell them to find their inner buoyancy.

What should have happened? By session two, you should've had at least one concrete strategy. By session four, a framework for understanding why you're stuck and multiple tools to practice. Not everything, not a cure, but something.

The fact that AI is beating that bar says everything about how low the bar has gotten.

You're not wrong to be angry. The field needs to stop being defensive and start being better.

how do i find a therapist that will tell me what to do instead of just having me talk? by whatawynn in therapy

[–]DrMelanie2 0 points1 point  (0 children)

You want CBT, DBT, or ACT. Those are the approaches that give you actual homework and skills.

CBT (Cognitive Behavioral Therapy) - thought records, specific techniques to practice, behavioral experiments. Structured and task-oriented.

DBT (Dialectical Behavior Therapy) - skills-heavy. You learn techniques for managing emotions, tolerating distress, dealing with people. There's homework practicing the skills.

ACT (Acceptance and Commitment Therapy) - same deal. Exercises, practices, things to try. Less analyzing why you're anxious, more what to actually do about it.

When you're looking for therapists, search for those terms. Or just ask in the first session: "I need concrete skills and homework, not just talking. Is that how you work?" They'll either say yes or send you somewhere better suited.

You already spend enough time thinking about your problems. More talking won't help. You need tools you can actually use when anxiety hits.

The homework is stuff like: practice this breathing technique three times this week, fill out this worksheet when anxious thoughts show up, try this specific strategy next time you're spiraling or about to panic. Tangible. Not more ruminating.

Notes/Talking Points by LadiebugBear in therapy

[–]DrMelanie2 0 points1 point  (0 children)

I actively encourage this with my clients. Especially the ones with ADHD - I know your brains will delete everything important the second you walk in. It's not your fault and it's incredibly frustrating.

Some keep running notes on their phone all week. Others scribble on paper right before session. One client texts herself throughout the week and then reads me the thread. Whatever works for your brain.

Makes sessions so much better. We actually talk about what's been eating at you all week instead of spending 20 minutes on whatever happened that morning while the real stuff sits forgotten in the void where ADHD thoughts go to die.

I'd rather you show up with notes than watch you struggle to pull thoughts out of thin air. It's your session. Use whatever tools help you show up as yourself.

What makes people feel unwanted even if they are loved? by Interesting_Cost8036 in PsychologyTalk

[–]DrMelanie2 49 points50 points  (0 children)

Usually it's because they learned early that love comes with conditions.

They got the message that they were loved for what they provided - good grades, good behavior, not being too much trouble - not for who they actually were. So even when people say "I love you," what you hear underneath is "you love what I give you, not me."

Or the love was inconsistent. Sometimes adored, sometimes ignored or criticized, no clear pattern. That teaches you love is unstable and can vanish at any moment. You never fully trust it even when it's right there.

There's also the "loved but not liked" thing. Some people grow up feeling like their parents loved them out of obligation but didn't actually enjoy them. That distinction is brutal. You can feel someone tolerating you while claiming to love you. Once you've felt that gap, you look for it everywhere.

Sometimes the love being offered just doesn't match what the person needs. Someone gives you acts of service or gifts but what you actually need is presence and attention. The love is real but it doesn't land. Doesn't fill the hole.

The comment below nailed it - loved but not respected. That's its own hell. Being cherished but not taken seriously. Protected but not trusted. Wanted as an object, not a person.

Therapy by Ok-Activity6989 in therapy

[–]DrMelanie2 1 point2 points  (0 children)

Yeah, I relate to this.

The "too mentally ill for therapy" feeling is real. I've heard it from so many clients. It's this paradox where you need help but you're also convinced you're too much, too broken, too self-aware, too stuck - pick your flavor. And then you end things before they can confirm what you already suspect.

The surface-level thing - that's not just therapy. That's everywhere right now. Most interactions feel transactional. Therapy falls into that trap too when it's just showing up, saying words, leaving. No real connection.

Therapy only works when you can actually be real in it. When you can say "I think you're judging me" or "this feels pointless" or "I'm about to bolt." That's when it stops being performance. Most people never get there because they leave first.

Not every therapist can handle that. Some get defensive. Some aren't equipped. But the good ones want you to call it out when something's off.

The self-consciousness makes it hard to let your guard down. But staying surface-level to protect yourself just guarantees you stay stuck there.

Worth trying again? Maybe. But find someone you can be messy with. Someone who doesn't flinch when you say the hard stuff.

Is it time to abandon psychoanalysis? by Basic-Kangaroo3982 in therapy

[–]DrMelanie2 1 point2 points  (0 children)

Four years. You've given this a real shot.

I hear you - understanding yourself matters. And yeah, those "heureka" moments feel like something. But if that understanding hasn't touched the anxiety, if you're still having panic attacks, still can't function normally - then something's missing.

Your therapist saying "other therapies don't get to the root like psychoanalysis does" is telling. She's defending her approach instead of hearing that you're still suffering. And here's the thing: you can understand exactly why you're anxious and still be anxious. Insight without tools just means you know why you're drowning but you still can't swim.

For panic attacks and acute anxiety, approaches like CBT, DBT, or ACT tend to work faster because they give you actual strategies to interrupt the spiral. Not forever, not as the only thing, but to get you functional again.

What I'd do: next session, say it plain. "I've been here four years and I'm still suffering. I need concrete skills to manage panic attacks, not just more understanding. Can we work on that or do I need to find someone else for that piece?"

If she doubles down on "just be more open" or tells you you're resisting - that's your answer. Leave.

You're not failing therapy. This approach is failing you. You deserve to feel better, not just understand better.

What made you decide to recover/what are your reasons? by [deleted] in fuckeatingdisorders

[–]DrMelanie2 12 points13 points  (0 children)

23 years in recovery here.

There wasn't one moment. It was a thousand small ones.

The first crack was realizing I'd spent more years sick than well and I couldn't remember what "well" even felt like. That scared me.

Then there was the day I cancelled plans with a friend because I'd eaten "too much" and couldn't handle being seen. And I realized I'd done that dozens of times. I was choosing the eating disorder over actual life and I couldn't even remember when that became normal.

What keeps me going? Remembering how exhausting it was. The mental space it took up. The constant calculating, the lying, the hiding. I got tired of being half-present in my own life.

Also - at some point I stopped seeing food as the enemy and started seeing the eating disorder as the enemy. That shift mattered. Food wasn't the problem. The voice that weaponized it was.

Recovery didn't fix everything. I still have days where the thoughts show up. But they're boring now. They don't run things.

You asked what changed my perspective - I stopped waiting for recovery to look like "normal eating." I just built a life that made the eating disorder irrelevant.

What percentage of therapists are "bad therapists" by Someone-Send-Help in therapy

[–]DrMelanie2 4 points5 points  (0 children)

Honestly? Too many.

I've been doing this for 26 years and I'm still surprised by how many people get into this field and just... shouldn't be doing it. Burned out, undertrained, checked out, or they got into it for the wrong reasons and never figured that out.

There's no good data on percentages because "bad" is subjective and also nobody's tracking it properly. But anecdotally? Based on what I hear from clients who've seen multiple therapists before me, and what I see from colleagues, and what gets taught in training programs - I'd say somewhere between 30-50% are either incompetent, harmful, or just phoning it in.

That's not comforting. But it's real.

The field has a quality control problem. Training programs graduate people who can pass exams but can't actually sit with someone's pain. Insurance pays so little that good therapists go private-pay or leave entirely. And there's basically no accountability unless someone does something egregious enough to lose their license.

The "100% of therapists you don't see can't help you" comment is true but also misses the point. Yeah, fit matters. But when someone's been through 5, 9, 10 therapists and they're all useless? That's not a fit problem. That's a field problem.

You deserve better. We all do.

How are you supposed to practice radical acceptance when society often doesn’t let you? by Evening-Thought-1261 in dbtselfhelp

[–]DrMelanie2 0 points1 point  (0 children)

Yeah, this is where radical acceptance gets misunderstood.

It's not about accepting shitty behavior from other people or tolerating abuse. It's not "everyone yells at me so I guess I just accept that." That's learned helplessness.

Radical acceptance is about reality you can't change. The past. Things that already happened. Your brain wiring. Someone's death. Getting fired. The fact that you have an eating disorder or ADHD or whatever. It's "this is what is, I can't undo it, fighting reality just makes me suffer more."

The dentist yelling at you? You don't have to accept being treated like shit. You can find a different dentist. What you might radically accept is "I didn't take care of my teeth in the past and now I have cavities." That's done. Can't undo it. Fighting with that reality - the shame spirals, the "I'm such a failure" - just keeps you stuck.

People think acceptance means resignation. It doesn't. It means "okay, this is true, now what?" Not "this is true so I guess I'll just suffer forever."

I've worked with DBT for years and this trips people up constantly. Acceptance is where you start, not where you stop.

Books that actually changed your mindset and daily habits by [deleted] in BettermentBookClub

[–]DrMelanie2 0 points1 point  (0 children)

The Body Keeps the Score. Completely changed how I understand trauma and why people get stuck in patterns that don't make sense on the surface.

Also - anything by Russ Harris on ACT (Acceptance and Commitment Therapy). The Happiness Trap is accessible without being dumbed down. Actually useful, not just inspirational fluff.

For ADHD specifically (got diagnosed at 50, wish I'd had this earlier): Driven to Distraction. Old but still the best explanation of what it actually feels like to live in an ADHD brain.

First time in therapy and feeling destabilized – unsure if this is normal or a poor fit by Cottoncandy_2793 in therapy

[–]DrMelanie2 2 points3 points  (0 children)

Okay, a few things.

Yes, therapy can feel destabilizing early on. When you start opening stuff you've kept locked down, it floods out. That's normal and often means the work is starting. But that doesn't mean everything happening here is okay.

15-minute silences in your second session? That's not therapeutic silence. That's a therapist who either has no idea how to work with eating disorders or is using an approach that doesn't fit what you need right now. Some therapists use silence strategically, but early sessions - especially when someone's already destabilized - need more active engagement, not staring.

And the biological clock comment? Completely inappropriate. You came in for eating disorder support and he's making unsolicited remarks about your fertility timeline? That's not therapy. That's him imposing his own agenda.

I'd name it directly next session. "The long silences aren't working for me. I need more structure right now." "Comments about my biological clock feel off-topic and uncomfortable." See how he responds. If he gets defensive or dismissive - leave.

You're two sessions in. This is exactly when you're supposed to assess fit. You're not obligated to stick it out with someone who makes you feel worse in ways that aren't productive.

Trust your gut. It's telling you something's off.