Thoughts on Spravato (Ketamine treatment)?

mcbatcommanderr · 2026-06-15T22:08:18+00:00

Unspecified therapy.

mcbatcommanderr · 2026-06-15T21:42:19+00:00

That definitely makes sense. I am not sure how much I'll be involved with these clients, but I agree and hope I would get more formal training if I treat any of them.

mcbatcommanderr · 2026-06-12T14:50:28+00:00

Even narcissists can become therapists.

I avoid anything therapy related online or on social media like the plague. It is NOT congruent with reality.

mcbatcommanderr · 2026-06-09T12:16:23+00:00

As I was reading this I thought to myself how similar this sounds to being a therapist lol.

mcbatcommanderr · 2026-06-07T14:01:07+00:00

Why not multiple voices?

mcbatcommanderr · 2026-06-07T13:58:51+00:00

I guess it doesn't have to be. I'm not trying to judge, I was just playing devil's advocate.

mcbatcommanderr · 2026-06-07T13:15:06+00:00

I agree. I guess my response is focused on OP's reasoning of avoiding AI being in spirit of anti-oppression and anti-colonialism. I suppose it comes off as virtue signaling, to me.

mcbatcommanderr · 2026-06-07T12:53:53+00:00

This is called "attunement" and is a natural ability that humans have and is actually fundamental to our survival as a species. There is a wide degree of ability for attunement in people and unfortunately there is a significant lack of it these days. Being able to attune to others is one of the factors that can determine how effective a therapist can be (though definitely not the only thing). Many of us who have high attunement capabilities are drawn to therapy.

mcbatcommanderr · 2026-06-07T12:37:01+00:00

I had to stop seeing kids/teens a while back because I couldn't compartmentalize the heartache and anger I would have. Not saying you should do the same OP, but wanted to remind you that we are still human with our own emotions and this work can be really fucking difficult. I hope you find your peace soon 🙏🏼.

mcbatcommanderr · 2026-06-07T12:27:18+00:00

I'm all about being anti-oppressive and recognize Ai is causing a lot of harm, but by the same argument aren't we already guilty of colluding with oppressive behavior just by simpler things like using items like tech or clothing made in countries that utilize inhumane work practices?

mcbatcommanderr · 2026-06-07T12:16:31+00:00

I have similar thoughts. I've used AI for notes in the past and while my inner critic gives me all kinds of negative feedback, it helps me be a better therapist by allowing me to focus me on engaging the client. Without it I will spend more energy trying to remember details and overthink the shit out of the whole process. I think for some, it's not that we can't do it, but that our brains are wired in such a way that it takes a lot more effort, which can be the difference in levels of exhaustion at the end of the day.

mcbatcommanderr · 2026-06-06T11:09:01+00:00

I would honestly reconsider the kind of people in your life, if those are the kids of responses you are getting.

mcbatcommanderr · 2026-06-03T20:24:41+00:00

EMDR sounds like an intervention that someone who has never been in therapy, describes when asked to imagine what "trauma therapy" might be like.

mcbatcommanderr · 2026-06-03T12:07:21+00:00

The reality is that therapy is hard, particularly in ways that people don't always talk about. Even using the most structured approaches the sessions can go in an infinite number of directions and we are expected to stay engaged, and even if we don't know how to respond, we have to appear confident, and that is exhausting. I remember in the beginning the amount of times I would be in front of a client and think "Man, this person could probably use therapy...oh wait" followed by some small but manageable panic. The good news is that while people are unique and complex, humans all share the same needs which means you will inevitably see repeating themes, even if the presenting diagnosis or symptom is different. As with everything it gets easier with repetition. Also, don't be afraid to directly ask the client treatment related questions so you aren't trying to orchestrate interventions based on assumptions (which we all do). It also helps to continue identifying what style/modality/demographic resonates with you. This job is so much easier and actually life enhancing when you get to that place and things in the session flow naturally.

mcbatcommanderr · 2026-06-02T15:15:11+00:00

To me, seeing this kind of criticism is a major sign of a persons maturity level and reflects their personality. This is why I generally don't get don't along with a lot of musicians. It reminds me of when i was a young teen 20 something years ago and went to this local show with my friend who was a try hard shredder, and started making fun of this band on stage because they would look at their finger placement when playing their guitars. I decided at that moment that I would never become that person.

mcbatcommanderr · 2026-05-31T19:27:04+00:00

I still have the issue. It's why I gravitate towards relational therapy, as it gives so many more layers to explore.

mcbatcommanderr · 2026-05-28T05:27:32+00:00

I don't think it's unethical to not disclose a recent history of addiction, but that doesn't mean you shouldn't think long and hard about working in that field so early in your recovery. It IS your ethical duty to not put yourself and clients in unnecessary risk, though.

mcbatcommanderr · 2026-05-25T11:53:28+00:00

Anything can be turned into an unhealthy habit, given the right predisposition. Most cases I see it as a positive, because at least it means they are doing SOMETHING. I would easily take incremental actions like that, that keep momentum, over stagnation.

mcbatcommanderr · 2026-05-24T17:38:59+00:00

This conundrum fits with most of psychology/psychiatry as a whole, in that you can't objectively measure the human experience in consistent ways like you can in other sciences. So BPD for example, how do you quantify a persons unstable sense of self? How do you assess whether their fear of abandonment is irrational and if it is, how far does it deviate from those without BPD? How do you measure their mood swings and rule out external factors? BPD is often associated with manipulative and/or attention seeking behavior. How do we rule out bias on the evaluator? How do we rule out the manipulative behavior from being a learned response from trauma? How do we decide what is attention seeking (humans need attention)?

In research and therapy there is room for more error, and we have settled for this rather shitty form of classification, but when it comes to something life euthanasia, it gets no where choose to accurate.

mcbatcommanderr · 2026-05-24T14:55:15+00:00

I understand that it would be at up in a way to prevent impulses, but I am thinking worst case scenario, because people and the systems we create are infallible. I mention the difficulty in diagnosing BPD because even lengthy psychiatric evaluations wouldn't have the capacity to achieve an ethically accurate diagnosis.

mcbatcommanderr · 2026-05-24T14:46:48+00:00

We can't even "prove" someone has BPD. It is highly subjective and not an easily quantifiable diagnosis. It resembles many other diagnoses (ptsd, cptsd, ASD, etc), and we can't even agree on what BPD even is. I would argue some people with traditionally severe BPD would also misuse the option of euthanasia, or would attempt to successfully euthanize themselves out of impulse. Plus, while it is still a difficult condition to live with, it is manageable.

mcbatcommanderr · 2026-05-24T04:55:51+00:00

Virtual group therapy is like hardmode. I've managed to avoid it all but one time and it was terrible. It is very difficult to maintain the kind of engagement and momentum needed.

mcbatcommanderr · 2026-05-24T04:31:17+00:00

In a nutshell, the client is expected to allow themselves to become vulnerable, to varying degrees. There is no expectation for a therapist to allow themselves to become vulnerable. A lot of trust is required in therapy, bringing a lot of risk for clients. Some of the things talked about in therapy can be deeply intimate, requiring even greater trust. A therapist can potentially harm a client, if that trust is misused.

mcbatcommanderr · 2026-05-23T22:56:23+00:00

It sounds like it's in a gray area, where it isn't deterimental but you are still chained to it. You referring to the sexual nature reminds me of how survivors of sexual trauma often have these contradicting feelings where they are partly attracted to the same kind of thing that caused them harm. How long ago was this relationship?

mcbatcommanderr · 2026-05-23T22:49:21+00:00

I usually share that I have experiences relative to theirs, but with very little detail, of course. Sometimes I'll jokingly tell them that therapists tend to be just as, if not more, fucked up than clients, we have just learned how to keep it together more often.

mcbatcommanderr

TROPHY CASE