Anonymous asked:

what did you mean by enforcing boundaries (in the '10 things i wish clients knew' article)?

(This is the post anon is referring to). 

I mean that in therapy, a set of boundaries are established. Some of them are professional boundaries- things that the profession require that stay in place between the therapist and the client, like preventing conflicts of interest (take a look at the APA code of ethics, for instance, for more information). Some of them are boundaries that the therapist decides to set based on how they understand their professional duties and ethics, and what makes them feel the most comfortable and most able to serve their clients effectively. Some of them are boundaries that the client decides to set based on their own preferences for the therapeutic relationship and how they feel they will benefit most from therapy and what will make them the most comfortable.

Hopefully all of these ideas about boundaries are fairly compatible and overlapping. Sometimes the client- usually unintentionally but occasionally intentionally -will attempt to overstep a boundary. This might be for a thousand different reasons including that the client wasn’t aware of the boundary and doesn’t mean anything bad about the client. But in those cases, it’s a part of the therapist’s job to re-establish that boundary, usually by having a discussion about it. Often it’s not a big deal and can be dealt with quickly, but sometimes it needs to be a more complex discussion. I hope that’s helpful!

Anonymous asked:

I am disabled and left alone for long periods as everyone else works. Two months ago, I began talking, debating with, and doing activities with a person who isn't real. Is an adult-onset 'imaginary friend' an acceptable coping and support mechanism, or possibly dangerous, as I am disabled for mental health reasons as it is?

I can’t give individualized treatment or diagnostic advice. I really encourage you to seek treatment with a competent professional in your area if you are concerned.

I’m sorry, I really can’t answer this question. If you are concerned about what you are experiencing I really encourage you to talk to a psychologist in your area and get an updated diagnosis to take any new information into account. Someone who is able to take your personal history and current experience into account will be able to answer questions about what this means for you and whether it should be considered functional or problematic. I hope that’s helpful. 

Anonymous asked:

If you are underage and tell your therapist for the first time that you are experiencing suicidal thoughts quite regularly but don't have a lot of intention...will they tell your parents and/or send you to the hospital?

Here are some asks that are similar to yours. If those don’t answer your question, please send me another ask. I hope that’s helpful! 

If you are in a crisis, please don’t hesitate: www.imalive.orgcrisis lines, or go to your closest crisis center or ER. 

Anonymous asked:

I feel completely insecure in my therapeutic relationship with my therapist after she said something that upset me. I feel so hopeless, the one person who I felt believed in me, basically doesn't think we are making any progress. I am feeling so low and I just don't know what to do anymore. I'm not going back to her but I don't think I can trust therapy ever again. Do therapists always give up so easily with 'high risk' clients?

So I’m not sure whether you’re the same anon as this post or whether you just have a similar question. I think most of that post applies to you, so take a look at that (and definitely message me back if that’s not helpful).

As far as whether therapists give up easily with high risk clients… obviously I don’t know your therapist so I don’t know what she usually does. But in general, the therapists I know don’t. I don’t. Generally I don’t really hear about therapists “giving up” on clients unless the clients have already given up. What I mean by that is, if the client doesn’t come to therapy, and doesn’t call, and doesn’t do the homework, and doesn’t participate when they do come, then there isn’t much the therapist can do. So often we get to a point where we say- if you’re not going to respect the therapeutic contract and be a part of therapy, then there isn’t a reason to continue. That may feel like we’re giving up to many clients, but for me, I see that my client has decided not to be an active part in therapy, and they’re the most important part- I can’t do it on my own -so we have to stop until they decide they want to be a part of therapy. I always hope they’ll decide to do it in the future, with me or someone else. I hope that’s helpful, and that you’re feeling better, anon. 

Anonymous asked:

I would always admire a social worker to be in therapy themselves but I wouldn't go so far as to judge them as you said if they aren't in therapy! Maybe they're just resilient, can cope, they have other great mentors, they don't have the resources, time, maybe their therapist is across the country, who knows? As long as they can be a good professional in the present? -MSW student enthusiastically in therapy :)

I have a hard time with this. I think that it’s important for mental health workers of any kind to make sure they are doing good self care at all times and paying attention to the reactions they are having during their work (as you’re saying), but I would never judge someone who hasn’t been to therapy themselves. I agree with the anon- not everyone needs it or decides to use other methods to cope. I’ve never been a fan of the “just going because” camp that seems to exist in some training programs- if there’s no therapy goal, it’s going to be aimless chatting and that’s a waste of the therapist’s time and not real therapy anyway. 


I think what I meant with my comment is that I judge social workers who are not presently in therapy, and have never been in therapy. I think it’s essential for a social worker to understand what it’s like to be on the other side, and this work is really freaking hard and you need support to get through it, and most people get into this field because they have been through a ton of their own shit, and that can be brought up in this work in really intense ways so you need to be able to deal with that, and that usually requires someone helping you do so. That’s just my opinion though! 

I think it’s essential for a social worker to understand what it’s like to be on the other side

This reasoning has never made sense to me. Therapy is such a personal and individual experience! I do not think that my experience in therapy has lead to me understand what my clients are going through, because we are different people who react to things in different ways, and have different therapists and are going to therapy for different reasons and are doing different things in therapy, etc. My “this is what therapy is like” perspective may not be anything like what my client’s “this is what therapy is like” perspective is like, and I would never want to make that sort of assumption about them. 

Just my two cents :) 

Anonymous asked:

to the anon whose T said that therapy was pointless: my T and i had an unexpected significant abruption in our relationship last winter when we just could not get on the same page.... it was incredibly hard work to repair it but we did and now the therapeutic relationship is better than it has ever been... i did take a month's hiatus to sort things and i found that especially helpful (for me, anyway.. YMMV).. the way things are now makes all that history worth having lived thru... best to you

Thanks for sharing your experience! Working through ruptures can be tough but sometimes makes therapy better than ever. I’m sure the original anon will appreciate your thoughts!

Anonymous asked:

I've been seeing my therapist for two years, and today she said something in our session that upset me. She said our therapy was pointless since I don't know what I want in life. She said this after I told her I had suicidal thoughts. Now I just feel worse. I've come so far and now I just feel like I've done nothing worthwhile. She said I've made progress but have had too many set backs. I feel so worthless and I'm thinking I'll never go back to her. Does this happen often with therapists?

I can’t give individualized treatment or diagnostic advice. I really encourage you to seek treatment with a competent professional in your area if you are concerned.

I’m really sorry you’re feeling so poorly. That’s really not the intention of therapy and I don’t want you to feel like you are worthless or your progress is worthless, because that’s just not the case. So while I can’t tell you what’s going on with your therapist or the interaction you had with her, I can just say some stuff about those sorts of communication failures and issues in therapy. 

So, yeah, therapists do mess up. Sometimes we say stuff that makes sense in our heads and is supposed to be helpful or insightful, but when it comes out it really really isn’t. Sometimes we just don’t think before we speak. Therapists are people and are imperfect, and so don’t always do as well as we’d like in therapy. And that sucks. Therapists who really want to help their clients (which is most of us) really hate messing up like this, and feel really awful when we realize we’ve done it. In that sort of case, I think a open, clear discussion about what’s happened and what to do next helps and can even help propel therapy forward. 

A small proportion of therapists are not as thoughtful about their clients. Just like in every other profession, there are unfortunately people who are not invested and who aren’t working hard to do a good job- and in therapy, that can have some really negative effects. Fortunately most therapists don’t fall into this group, but the ones that do sometimes don’t really follow ethical and other guidelines of the profession. That’s terrible for their clients and for the profession at large. In that sort of case, I’d say the client should get a new therapist ASAP. 

Sometimes there’s another sort of communication misfire, as well. Sometimes when a therapist says something well-intentioned, but maybe a little tough or challenging, their client may interpret it far differently than the therapist intended for whatever reason. Maybe the therapist didn’t have the best word choice, or picked a bad moment to bring up the issue. Maybe the client feels very sensitively about the topic or often interprets challenging discussions as personal criticisms. Maybe it’s a combination of things the therapist could have done better and ways the client could have been more open-minded about the discussion. This is just another example of nobody being perfect. In this sort of case I again think it can often be worked out by talking about it. Sometimes when clients come in and say, “you said X last week” (even when they thought it was a good or neutral thing), I’m very surprised because I didn’t intend to communicate that at all. By discussing those communication issues and how it impacts the client and the therapeutic relationship, often things in therapy can get better and it can help move therapy forward. 

Obviously it is up to you to decide what to do next. I would say that no matter what you decide to do about your current therapist, please don’t let those remarks and your experience with her hinder your recovery process. Recovery is hard and includes setbacks- and that’s okay (although frustrating). You are allowed to feel how you feel, and your therapist is the person to talk to about your feelings and struggles. If this therapist isn’t the one for you, there will be another one who understands where you’re coming from and appreciates your hard work. Best wishes :) 

Anonymous asked:

Why is homosexuality not pathological?

I think the better question is, why would homosexuality or any sexual orientation that doesn’t cause harm, distress, or loss of functionality be considered pathological? There’s never been evidence that any particular sexual orientation caused pathology, including symptoms, harmful behavior, or loss of functioning. Sexual orientations and sexual behavior outside of heteronormative orientation and behavior as it is currently viewed by Western cultures have always existed across cultures and there’s no indication in historical records that this was pathological behavior or the cause of psychopathology- in some cultures it was expected or even revered. So that leads me and many others to the conclusion that it’s not the sexual orientation that’s the problem, it’s the culture. 

Anonymous asked:

Same Counseling PhD here P1. Counseling programs obviously train you in "counseling" as you are referring to it, but also therapy. If you want to be a therapist you can focus your course work in that direction. That is why I think the title "therapist" should be associated with your job function. So in my opinion, you would definitely be a therapist, but so would I or a clinical social worker who is doing therapy. Many of my classmates only do counseling and call themselves counselors.

P2. Counseling programs often don’t only learn counseling. We also learn the DSM and how to treat mental illness using empirical methods, just like good (keyword good) clinical social work and MFT programs do. The main difference is that we do not treat severe clients. So I do CBT and ACT to treat depression and anxiety, but refer out clients that need a higher level of care or are struggling with more serious/chronic MI (ex. I am not at all trained in treating schizophrenia).

P3 If I were doing counseling I would call myself a counselor. You are right that we should go with what is the most accurate based on the work we do. I do not at all have an issue with Counseling MAs or MSWs using that title too if it is what they do and don’t think it should only be reserved for psychologists. Ex. why should a trainee psychologist get to be called a therapist but a “counselor” doing CBT for 10 years shouldn’t? It confuses clients and makes them less likely to select us.

Thanks for your thoughts! I think we’re mostly on the same page. 

don’t think it should only be reserved for psychologists

I completely agree with this.

why should a trainee psychologist get to be called a therapist

I continue to be confused about why you (I believe) and other anons are using this sort of language (“get”) about the use of the term “therapist.” My stance is not that “therapist” is better than other terms (like “counselor” or whatever else)- and there’s no reason it should be. It is certainly a privilege to be able to use the term “therapist,” but it is also a privilege to use the term “counselor.” 

Anonymous asked:

I'm not sure if you knew about this but just didn't mention it for some reason, but perhaps the previous anon should look into the orientation "asexual"? It's rather broad, but on the most basic terms, means to not be sexually attracted to people. It's pretty normal, and a lot of other asexual people (though not all) are repulsed by the idea as well.

I did know- I try my best not to label anyone unless they have already identified an orientation or other label for themselves and feel comfortable being associated with that orientation or label. I also know that because of my professional status people might take my word choice more seriously so I try to avoid labeling for that reason as well. 

Your definition is absolutely correct, and you’re also absolutely correct that not being sexually attracted to anyone is completely normal.