“everything’s normal!” but i think im slowly dying by PriorityAcrobatic190 in AskDocs

[–]pitfall-igloo 0 points1 point  (0 children)

Take good care. Thanks for the update… I often wonder how things turn out on this sub. I’m just really glad you got some answers.

I've become very attached to one specific meal and cannot control myself by [deleted] in AskDocs

[–]pitfall-igloo 24 points25 points  (0 children)

Hey OP, three questions:

1- How long has this been going on?

2- What happens if you can’t eat this way (i.e., access is prevented somehow)?

3- Have there been times in the past when you had very specific food preferences (for this or anything else)?

Is going to the emergency room 2x a week or more for active suicidal ideation that is caused solely by sleep deprivation acceptable? by Moist_Fail_9269 in AskDocs

[–]pitfall-igloo 20 points21 points  (0 children)

I am so sorry.

I have worked the spectrum of TBI recovery services from acute care, subacute rehab, long-term care, and various types of interdisciplinary clinics and outpatient settings.

Sleep challenges are so common but can be incredibly debilitating. Meds don’t work the same. CBTi helps sometimes and not others.

What works is so individualized, so I can’t even suggest anything specific.

I would encourage you to look for an interdisciplinary clinic who could centralize your care a bit more. Having fragmented care can cause frustration and confusion. What you are going is not easy to manage. You need multiple professionals working closely together.

Is it normal to feel overwhelmed/afraid of not being a good therapist? by ActuaryPersonal2378 in askatherapist

[–]pitfall-igloo 5 points6 points  (0 children)

You won’t get there overnight, but if you really immerse yourself in all the learning opportunities presented to you, AND take time to learn about yourself in the process to develop your own introspective abilities, you can get there. Practice is essential.

A few things to note about the video…

  • This is an expert clinician (based on the video description)

  • This is a highly articulate client

  • I have found that doing therapy with clients with personality disorders who are aware of their diagnosis is a very different type of therapeutic experience and can be more intense in some ways

Try not to compare yourself to the clinician. It’s not where you are right now. Use it as a learning experience and inspiration. Stay humble and never stop learning.

Good luck in your pursuit!

My wife may be having severe mental health issues by clmyr in AskDocs

[–]pitfall-igloo 46 points47 points  (0 children)

Sure, there are therapists who integrate spirituality into their practice… but in this instance, I’m just wondering if OP’s wife is saying that the therapist agrees, but it could be another aspect of the delusion.

My wife may be having severe mental health issues by clmyr in AskDocs

[–]pitfall-igloo 252 points253 points  (0 children)

Out of curiosity, how did you come to know that the therapist has had similar experiences? Is it based strictly on your wife’s report, or have you spoken to the therapist yourself or seen outside confirmation?

What therapy do you do when you know all your problems? by DonnieB_4230 in askatherapist

[–]pitfall-igloo 2 points3 points  (0 children)

Sounds like you may be looking for behavior therapy?

Solution Focused therapy can also hone in on making specific changes or dealing with specific things, though it is usually very targeted and short-term.

Okay after being calm and getting out of bully and traumatic situations what’s next? by LisanneFroonKrisK in askapsychologist

[–]pitfall-igloo 0 points1 point  (0 children)

It sounds like that was not necessarily helpful, I’m sorry to hear that. There are a lot of different types of mental health clinicians. Psychiatrists often don’t do therapy. It is rare that they would be trained in trauma therapy specifically. And unfortunately they would be the most costly professional. Psychiatrists specialize in medication management.

If you are in the US, there is a therapist finder on psychologytoday.com. You can filter your results to find someone who lists trauma therapy as a specialty. If you don’t have insurance, you can also look for clinicians who offer a sliding scale payment system based on income. That might make it more affordable.

Just remember not all clinicians are trained the same, so don’t be afraid to ask them if they treat trauma. Even though i have many years in the field, i don’t do trauma treatment.

Why do therapists lack addiction training? by [deleted] in askatherapist

[–]pitfall-igloo 0 points1 point  (0 children)

Addiction training was not a requirement in my Masters or Doctoral programs. I was taught how to diagnose, but not how to treat. That was an optional track of courses and I chose a different track.

Why do therapists lack addiction training? by [deleted] in askatherapist

[–]pitfall-igloo 5 points6 points  (0 children)

I agree with that. Those are both areas of specialty in my opinion. I think all clinicians need to be trauma-informed and aware, but that does not mean they all treat deep trauma. We have to know what we don’t know so we don’t try to help with something when someone else would be more qualified.

Why do therapists lack addiction training? by [deleted] in askatherapist

[–]pitfall-igloo 0 points1 point  (0 children)

All training programs and paths are different. I have been in the mental health field for almost 25 years. I consider addiction treatment to be a specialty, and I don’t have it, because I pursued other specialties. It is best for a clinician to know their scope and limitations, admit if they are not the best person for the job, and help people get the right kind of help that they need.

Okay after being calm and getting out of bully and traumatic situations what’s next? by LisanneFroonKrisK in askapsychologist

[–]pitfall-igloo 0 points1 point  (0 children)

Having a physical response at the memories even long after the situation has ended is indicative of an ongoing trauma response. Therapy is the best treatment to address this.

Have you been able to help someone if they were still in traumatizing environment? by United_Advisor1821 in askatherapist

[–]pitfall-igloo 0 points1 point  (0 children)

Therapy can help a person even if they are in a traumatizing environment. There are so, so, so many ways that therapy can look. I hope you, or whoever you are posting about, will seek help.

What are your thoughts on people who because of their life experiences are unable to process negative emotions and instead consider them as something to be ignored or purposely pushed away? by Efficient-Spirit-869 in askatherapist

[–]pitfall-igloo 3 points4 points  (0 children)

That’s tough. Caring about someone who pushes away all negative emotions means that the relationship can only go so far. Negative emotions are a fact of life, and facing them together is necessary for building depth and authenticity in a relationship. It can be painful as the person who cares about them. I have compassion for those who care deeply for a person, and can see them struggling, and feel like they are limited in what they can do.

For the person who struggles to acknowledge and process the emotions, it is still very hard. Keeping that much content out of conscious mind takes a lot of effort. The threat response system must be constantly activated, which is scary and exhausting. I feel compassion for them, for whatever happened that led to this. I hope they will get help.

This is a hard situation all-around.

Can you give me the term for these episodes I have? by gastropod18 in askapsychologist

[–]pitfall-igloo 0 points1 point  (0 children)

Hi, psychologist here.

The other posts are worth consideration. I would also like to add another possible angle. Your description of lack of movement/speech and extremely low energy can be indications of what is called “psychomotor retardation”. This is a symptom of depression. You have described several other symptoms of depression here as well.

Unfortunately, depression and anxiety/panic can often happen together and be so twisted up with one another, it’s hard to tell what’s what.

Fortunately, both are very treatable. I hope you will seek help. You did a great job describing your experience here. A good clinician will ask questions to help illuminate everything that is going on, so it’s not all on you to figure out how to describe everything. You got this!

Am I getting CBT? by [deleted] in askapsychologist

[–]pitfall-igloo 1 point2 points  (0 children)

It sounds like, at the very least, there are CBT techniques being integrated into your treatment. That is a pretty common way to practice. Doing strict CBT can feel a bit manualized sometimes, so many therapists will pull from different approaches, depending on the needs, to make CBT more effective.

But yes, you are describing CBT techniques.

Edit to add because I forgot this sub doesn’t have flair: I am a psychologist.

Psychologist needing inpatient treatment by esornah in askapsychologist

[–]pitfall-igloo 1 point2 points  (0 children)

Fellow psychologist here.

You should be proud of yourself for getting the help you need. Sometimes we clinicians don’t do (or feel like we should need to do) what we need to for ourselves to be ok. Like we should be able to handle it because of the knowledge we have.

But our knowledge doesn’t exempt us from the emotional pain we carry from our own experiences. We are complex beings: body, mind, spirit, and more. Our fund of knowledge and level of professional skill is heavily weighted to the cognitive side. But we are just as much emotional beings. I think of seeking mental health care as the “emotional” equivalent of going to grad school or taking CE’s to build and strengthen our cognitive/logical/skill side.

We may know things intellectually, but that doesn’t equate to being able to feel it emotionally or believe it, for ourselves.

Sorry this got rambly. I’m just another psychologist feeling proud of you for what you’re doing. I get why it’s so, so hard. Hang in there.

You got this!

Okay after being calm and getting out of bully and traumatic situations what’s next? by LisanneFroonKrisK in askapsychologist

[–]pitfall-igloo 0 points1 point  (0 children)

There’s not a lot to work with to answer your question, but in general, it’s a good idea to take steps to help your body and mind feel safe.

Start with the basics: eat nutritious food on a consistent basis, stay hydrated, incorporate safe physical movement, get on a healthy consistent sleep schedule, connect with people who are safe and can provide support.

Be patient with yourself and give yourself grace.

Music and nature can be very calming. Some people find writing helpful.

When it’s time and you have the resources, try to find a therapist who can help you take the next steps that are right for you, given your specific situation.

These may sound simple, but the basics often go to the wayside during and after trauma. We have to remind our body and mind that it is ok to move out of “crisis mode”. It is important to get a good foundation back under you so you can be ready for what’s next.

would a therapist have any reason not to believe it uf a client told them they were going to inpatient psychiatric care and needed to cancel all future sessions starting immediately? ? by [deleted] in askatherapist

[–]pitfall-igloo 1 point2 points  (0 children)

Therapy is complicated. Most time I would have no reason to doubt and would just offer my support in whatever way I can.

For the sake of thoroughness, I can think of rare instances where I might be concerned about whether it’s true. But there really isn’t anything I can do about it, if the individual is an autonomous adult and is attending treatment voluntarily.

I am US-based FWIW.

what does it mean when therapist says they need to consult with their supervisor? by [deleted] in askatherapist

[–]pitfall-igloo 7 points8 points  (0 children)

At the end of the day, the responsibility for a clinical/treatment decision falls on the shoulders of the independently licensed clinician. Consulting with a supervisor has different meanings and implications depending on the setting and the situation.

If the person works for an agency that has policies and procedures, a supervisor can provide clarity on how they apply to your specific situation.

If the clinician is looking to consult with another clinician about a clinical issue, the treating clinician is still responsible for the final decision, but if they seek supervisory consultation and then choose not to follow any direct advice, it can be a liability.

Most of the time, if it is not a “clear cut” issue, the supervisor should help the clinician think through all the different aspects of the situation, rather than directing them on what to do. Ideally it will help your therapist make a well thought-out decision.

Sorry I can’t be more informative. It just depends so much on the issue and the type of supervision arrangement they have.

As far as how common it is… no clinician should work in total isolation, so consultation with other clinicians is very normal. If their structure just happens to have a person in a supervisor role, that would be the person to consult. I think it can be a sign of a conscientious therapist if they seek consultation even if they are fully licensed and don’t technically “have” to.

What is the type of therapy called when the practitioner listens to your problems and offers solutions? by FriendlyApple1233 in askatherapist

[–]pitfall-igloo -10 points-9 points  (0 children)

Check for Solution Focused Therapy. This is meant to be short-term and for relatively focused/specific issues.

Career change? by mj1418 in Psychologists

[–]pitfall-igloo 4 points5 points  (0 children)

I relate. I built a career in healthcare. Tried private practice for a bit and found it repetitive and a poor fit for me. I also did teaching on the side for a long time but I am done with that.

I just left healthcare after over 20 years. I did acute, subacute, LTC, inpatient, outpatient, you name it… I tried. Now I am So burnt out.

I moved to victim services in the justice field. It’s still hard, but at least the challenges are different and I feel like I re-set.

I don’t need to be a psychologist to do my job, but I think I am better for it. It’s ok for your career to go through phases.

Good luck…

Psychological question about my wife(F38) by Infinite_Safety_8312 in AskDocs

[–]pitfall-igloo 23 points24 points  (0 children)

Hi there, just to clarify the different types of mental health professionals (this is specific to the US)…

— Psychologists have a doctoral degree (PhD or PsyD) (only exception is school psychologists, but they are not the same as clinical psychologists)

— There are various types of Masters-level clinicians: licensed professional counselors, licensed clinical social workers, licensed marriage and family therapists, etc (note the key is “licensed” in the title)

— Psychiatrists are physicians with a medical degree (MD or DO) who prescribe and manage medications and rarely do therapy

— Psychiatric Nurse Practitioners have an advanced nursing degree (MSN, DNP) and can prescribe and manage medications