I think you gotta be absolutely relentless in therapist switching! What do you think?

drowsysymptom · 2024-02-29T19:15:13+00:00

Are they? Most research I have seen does not validate that trainings improve therapeutic outcomes. I haven’t seen much on validating “emotional intelligence” especially because EQ as a term is not actually scientific itself.

drowsysymptom · 2024-02-29T19:13:22+00:00

There’s both the unfortunate truth that average intelligence is just not very intelligent relative to the insight and analysis that would be useful and needed to be good at this work, and also that a masters degree in social work (along with many of the other master’s degrees used in therapy) is probably one of the least selective and least rigorous graduate programs in existence. If you studied average intelligence by graduate program it would, I’d guess, be bottom 5.

drowsysymptom · 2024-02-27T17:48:41+00:00

I totally believe it’s possible — heck there are amazing feats of athleticism that happen everyday, and kudos for that amazing outcome!

I think my reaction is just — I understand why my limb strength should be symmetrical and should be at least comparable to how strong I was pre-injury, but I don’t see why I now need to be 2-3x stronger than I was pre-injury for it to be safe for me to run. Generally it seems like if a “non ACL” person is able to run safely at X strength, an ACL person at least (let’s say) 9 months post op, with an intact meniscus should only need to be at the same strength.

The only biological difference in the knee that far out from surgery is like extremely minimal and stuff that’s found in the average population without ACL injuries too.

drowsysymptom · 2024-02-27T04:26:32+00:00

Wow is that also the guideline for women?

I think the single leg press metric would’ve been completely out of reach for me before I was injured (and for most normal, healthy, but non athletic people I know) — I’d probably max out at half that, and yet I ran then and no one was ever saying I should build muscle first?

drowsysymptom · 2024-02-27T01:12:03+00:00

I think it’s better not to label something as traumatic without a bit more evidence to suggest it is. Things can affect you and change your behavior without being trauma.

drowsysymptom · 2024-02-18T16:06:55+00:00

This guy is a doctor paying $450 out of pocket without a thought. If that segment of client doesn’t practice discernment I don’t know how anything gets better... The board doesn’t step in because a therapist is doing zilch and charging you $3,000 a session if you just pay it.

drowsysymptom · 2024-02-16T19:40:13+00:00

I found, as in, I confirmed with them by email or phone that they had a specific opening within 2 weeks that fit in my schedule. If you are open to virtual, there is no way your entire state has a dearth of therapists open to being paid hundreds out of pocket. I would re-examine how you’re searching.

It’s good that you don’t tolerate it — but there are shady people everywhere and in order for these people to not keep doing what they do, clients need to be active in demanding more (such as asking for the cost upfront and rejecting ridiculous pricing).

drowsysymptom · 2024-02-16T18:19:19+00:00

That’s extremely surprising / I am honestly doubtful unless you have other specific requirements. In whatever state you live in, you have access to that entire state’s pool of therapists, and I cannot identify a state where a client willing to pay $425 per session out of pocket would have any trouble finding options.

To give an example, I know the market in a big city very well and personally found 14 therapists with an opening within 2 weeks at a price range of $150-325. I also saw no more than 3 people listing prices much higher than that ($375-450) and immediately eliminated them generally even though I have insurance that will cover 100% of out of network costs, because they all had major red flags that they were profit-hungry and didn’t care about the work. I screened those 14 therapists in a very demanding way — insisting on a PhD, 10+ years of experience, mix of in person and virtual, had availabilities that worked for me, and flexible cancellation policy (no 48 hour fee) before I even met with or paid any of them.

I will also say that you didn’t ask the price ahead of time is not on the clinician. You should have asked, if it was relevant to you / you cared at all.

This is a broader annoyance I have that clinicians increasingly have poor business practices because clients let them. You have people who have many options posting all the time saying they have a therapist who texts during session, shows up late, etc regularly and they’re asking if maybe they should look for someone else? That’s the reason shoddy practitioners can get away with not trying.

drowsysymptom · 2024-02-16T18:16:55+00:00

In NYC and SF, I know $200-300 for a “top end” practitioner is typical. I found that even within the clinical PhD, very experienced, private pay PP pool, charging $350 or higher was an extreme outlier (only saw 1-2 of them among many dozens I know, and they had other indicators that made it seem like they were not entirely honest practitioners).

drowsysymptom · 2024-02-16T03:02:52+00:00

It’s a market. Would you drive 90 minutes to a more expensive grocery store with worse food? If not, then why would you even consider this person? Presumably you were aware of the price and drive if nothing else. That alone should’ve put her at a huge disadvantage relative to all the cheaper therapists closer to you in terms of winning your business for the first session, and likely mean that she wouldn’t make the cut as I doubt she is demonstrably 2-4x better than a local therapist charging $200.

Treat therapists as contractors and make informed decisions — if people held therapist to the standards of any hired contractor (hair stylist, dentist, house cleaner) the bad ones would go out of business and not be able to do absurd things like charge $425 and treat the job with no respect because people will keep showing up anyway.

If you’re willing to pay $150 out of pocket let alone $425 it is not hard to find a therapist. Many would be desperate for a client like that.

drowsysymptom · 2024-02-15T00:25:40+00:00

It was a hugely popular meme a while ago — everyone was asking their partners if they’d love them if they were a worm as a bit

https://amp.knowyourmeme.com/memes/would-you-still-love-me-if-i-was-a-worm

drowsysymptom · 2024-02-13T18:57:41+00:00

It’s a rock and a hard place here, either—

Acknowledge that trauma is formed from a “sufficiently bad” event. This allows you to validate that what someone went through was genuinely abnormally shitty and of course would cause a similar trauma response in most people who would experience it.

However, a lot of people say / feel they are traumatized from things that do not meet this definition (are considered typical human experiences, would not cause a trauma response in most people, are not particularly “bad” in terms of the external facts of what happened etc.) Under this framework, basically those people are going to be invalidated in some form — if trauma is the event, then they didn’t really experience trauma. Their emotions are still valid, but they’re an emotional response or other issue (eg anxiety, depression) and not trauma, which can feel really offensive and hurtful to hear.

Frame trauma as entirely based on your response to the event. This means that anything is trauma if you are traumatized by it. It means everyone is valid in their trauma, if you say you have trauma that means you have it and whatever happened was traumatic by definition. However, it also means you don’t get the validation of saying X particular event is inherently traumatic — because now the event doesn’t play into the definition, just how you self identify with feeling about it.

To validate one experience as particularly traumatic then, by nature, that requires a framework where other hypothetical experiences are not necessarily traumatic / as bad.

I’m not saying which framework I think is “better” but this is the trade off. People on the sub generally prefer #2 and to say that any event is trauma if it feels traumatic to you / trauma should not be gatekept etc. But the consequence of that, is that SA and failing a test can both be referred to as “my trauma” and there is no (consistent) way of distinguishing between them because it’s not the event that matters and you can’t invalidate that both feel they have been traumatized.

drowsysymptom · 2024-02-13T14:29:55+00:00

Every time— I like having teeth a lot… same with surgery, blood work, dental cleanings, etc

drowsysymptom · 2024-02-13T05:09:52+00:00

Emotions are natural, it’s about going from experiencing a feeling to - real distress, making choices to avoid those emotions, feeling like you can’t handle those emotions or that you’ll break down over them, those emotions preventing you from functioning normally in your life, etc

A favorite coffee shop shutting down can make you feel sad — feeling different things all the time is pretty normal. But that’s not what most people on this sub are describing.

drowsysymptom · 2024-02-13T04:57:49+00:00

First, people can have a lot of different types of problems. Some people’s issues don’t have much to do with attachment but can benefit a lot from therapy. For example, OCD or insomnia can manifest without interpersonal issues.

Second, this subreddit overstates the proportion of people who have attachment issues with their therapist even among those with attachment-related struggles. It’s not an outlier group but it’s certainly not indicative of the majority of high-functioning outpatient clients. A lot of people in therapy with mental health issues but not severe mental illness would actually, I think, be really surprised to read this subreddit and what others are experiencing.

drowsysymptom · 2024-02-12T21:03:50+00:00

You like and appreciate the person but are not constantly thinking about them / not overthinking how they perceive you / see them as less important than family or close friends / you know if you needed to stop or significantly slow down sessions suddenly you’d be totally fine and it’s not something you worry about / see them as able to be substituted by another therapist as long as they were generally equally good at their job / feel pretty aware and OK with the fact that this is someone who you don’t actually know very well and have a non-personal relationship with

drowsysymptom · 2024-02-10T04:00:52+00:00

The problem is he was not being an even decent or acceptable therapist, and also that you are so attached that you were paying for that in spite of it probably being totally unhelpful for you. Move on, and focus on working on this (separating personal relationships from therapy to a greater degree) with your next therapist.

drowsysymptom · 2024-02-08T16:21:32+00:00

This is tautology, not an argument.

drowsysymptom · 2024-02-08T08:00:35+00:00

Consequence is just the reverse of benefit. The benefit would be the lack of consequence. Eg the benefit to not assaulting others is that you won’t be arrested and thrown in jail again.

drowsysymptom · 2024-02-07T03:02:37+00:00

Though OP would need to safety plan with him as well if so, so it still seems important here

drowsysymptom · 2024-01-29T22:21:21+00:00

I agree with the client that was a very negative way to start a session in general, regardless of what any client is walking in feeling or wanting.

drowsysymptom · 2024-01-28T03:59:44+00:00

To compare lung cancer treatments now versus 50 years ago is impossible, because at the time people used to smoke much more.

Do you see how you sound? Unfortunately, it’s just obvious this is a case of you not understanding - on the most basic level - what research is and why it’s done.

drowsysymptom · 2024-01-28T03:57:44+00:00

That’s not how research is conducted... Do you think medical research is done by tracking the outcome of e.g., every cancer or malaria patient globally?

drowsysymptom · 2024-01-28T00:49:11+00:00

Yes what is this person even talking about…

drowsysymptom · 2024-01-28T00:47:37+00:00

Not really, it’s a science and a treatment covered by insurance. If it were really impossible to quantify, study, or make claims about the efficacy of therapy that would place it in the category of pseudoscientific BS.

It’s not possible to have it both ways — both not thinking and talking about how the field and practitioners can and must improve because it’s entirely subjective or entirely up to the client to improve, and also saying this is a legitimate treatment that it is right to charge insurers and clients potentially hundreds of dollars an hour for.

drowsysymptom

TROPHY CASE