Concerns about therapy


Concerns about therapy


your avatar   Pat, 45-year-old woman

I am married, have 2 wonderful children, and am employed outside my home. I have suffered from depression and migraines off and on for over 20 years. Each time I see my doctor, he puts me on an antidepressant, and sometimes tranquilizers for anxiety. I always end up feeling so emotionally numb that I stop taking my medication. I can go OK for a while, but the depression always comes back. I try really hard to control, or stop it, but as I get older it gets harder and harder. The reasons I get depressed, I believe, are because of the numerous personal problems I have: I felt emotionally neglected as a child, was jealous of my sister, and now resent my mother. I am having difficulty being a parent to 2 teenagers, even though they are good-I fear doing what my mother did to me. My husband is not emotionally supportive; he is a good man and I love him, but has his own problems, which include an addiction to phone sex (he just began medication for this at my insistence.) At this point in time, we are simply co-existing, waiting for things to get better. I have just started taking another new antidepressant (Effexor) 8 weeks ago. I am already beginning to feel the numbness. I can't even cry.

A few months ago I went to a psychology training clinic at the local university. It is free, and the students are supervised, but they work on a semester-by-semester basis for obvious reasons. At the time I was going to weekly sessions, I became basically obsessed with the therapy. I couldn't stand waiting a whole week between times, and found myself having imaginary conversations with the therapist throughout the week. I started a journal, which he said was a good thing, but when I wrote it was as if I was writing to him. At the time I thought nothing of it. I was not aware at all of my obsessions. When the winter break (5 weeks) came, and I had to end it with my therapist I became very upset and depressed. I plan to continue next semester but it will be with a different therapist. Now I am very concerned about how this therapy has affected me.

Is this normal? I was not attracted to my therapist at all and he doesn't remind me of my father, which I've read can sometimes happen. It was just like he was in my head. I think I'd be too embarrassed to tell this to the next therapist, they probably know him. Will I start acting the same way again, as far as not being able to think of anything else? I had so much trouble concentrating on anything but my therapy and thinking about myself that I wasn't able to focus on anything else. I'd like to not have to take the antidepressant, because I don't feel like I feel anything anymore, but I am afraid to stop. It hasn't been very long. And if you're going to say I should try a different one, I have been on so many I can't count them. It seems my only choices are either depressed or emotionally numb. Do you think I can get good help from this clinic, or should I try and find a way to afford a "real" therapist? I do like the idea of helping the students to learn, but my main concern is for my mental health/stability. If you can help me, I'd appreciate it very much. Thank you


    Bob Rich, Ph.D.

Dear Pat,

You have supported the pharmaceutical industry long enough. A good rule is, "IF SOMETHING WORKS, DO MORE OF IT. IF IT DOESN'T WORK, DO SOMETHING ELSE." Drugs have not worked for you, and I am not surprised. My firm belief is that drugs NEVER cure depression and anxiety. What they can do is to ease the anguish enough to allow the sufferer to deal with the problems. A person may be in too much distress to be able to do self-therapy, or accept it from others. But without addressing the problems themselves, how can drugs possibly 'cure' a problem consisting of emotions and thoughts? And even if drugs work for some people, they certainly haven't worked for you. I therefore find it amazing that you got your husband to take medications for HIS problem.

You have mentioned a long list of past issues. These are important, in so far as they affect you now. Problems are kept going by what happens within your mind right now. Beyond this, your history does not matter. I think you are a survivor, a battler who always wins against all the odds. Here is my evidence: despite all, you have two teenage children you are proud of. How many parents can say the same thing? If they are good kids, it must be because, basically, their parents are OK. Depression is like wearing doom-colored glasses. It makes you see the bad in everything, and ignore the good. In just a short note, in which you were asking for help, you unknowingly managed to say a whole lot of good things about your situation. For example, your husband is a good man and you love him. (Introduce me to a person who HASN'T got problems!) You write that you WERE jealous of your sister. The implication is that now you are not. I don' t know why you resent your mother, what the situation is, but when you are on top of your depression and anxiety, you might approach her and talk it out with her in a friendly way. You might be surprised at the result, and even if it fails you can say, "I did my best to make peace. She rejected it, and that is her problem, not mine."

About your student therapists. There is nothing wrong in making your therapist a temporarily important person in your life. This is nothing to be ashamed of, and if you go back, the new person is bound by ethical considerations to maintain your confidentiality. You say it yourself: it's not as if you were in love with the guy. You just used him as a tool for personal growth, and what's wrong with that? I don't know what approach these students are being taught, but if you were the client of someone using Cognitive Therapy or Narrative Therapy techniques (or both), I would have expected you to show significant improvement well within a school term. Aaron Beck estimates 8 sessions to be needed for major depression. So, my concern is not that they are students, but that after some months of therapy you are still in distress. I suggest you wean yourself off the medications (under a doctor's supervision, these things can have withdrawal effects), and seek out a counselor using Cognitive Therapy or Narrative Therapy.

Good luck

Bob Rich

This question was answered by Dr. Bob Rich. Dr. Rich has 30+ years of experience as a psychotherapist. Dr. Rich is also a writer and a "mudsmith". Bob is now retired from psychological practice, but still works with people as a counselor.For more information visit:


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