Psychiatrist Reacts to: "Therapy does nothing"

so it feels like therapists never actually do anything looking to vent my frustrations and advice on what direction to take um for the past six to seven years i'm 26 now my mental health has been in the gutter to put put it quite simply i don't want to be alive it feels like too much work and too much suffering every day the reason i am still alive is because i feel a responsibility towards people that have helped me in the past to get better and keep fighting over this period of six years i've seen many therapists and none of them have actually helped me at all most of it was just me talking about my problems and them sitting there and not offering any advice i gave up on therapy for a while but during the last half year i've been getting into it again out of desperation my theory for why it hadn't done anything for me so far was because i hadn't given my therapist any direction for that reason i decided for my first appointment i would bring a list with all things that i was suffering from ranging from physical responses intrusive thoughts external circumstances and abstract concepts like lack of meaning i asked him which of these can you help me with unfortunately in typical therapist fashion the answer was dodged and soon we were back to me talking to a brick wall uh after four sessions with this therapist he recommended me to search for another one one with a more pragmatic attitude since i seem to be really be looking for answers even though i was disappointed i agreed and found another therapy practice this one was based in act acceptance and commitment therapy the therapists here were actually really nice but act never really clicked with me i did all the exercise they gave me but it didn't really seem to have any effect all of the points they made here seemed like general no-brainer stuff it seemed like they were quoting directly from thanks i'm cured following dr k's advice on how to be a good patient i actually brought this up recently they were very responsive to what i said and yesterday i had to talk with them about general direction unfortunately here i really struggled with getting any answers out of them i asked them again what they could help me with and they gave never gave an answer as to what the therapy was actually meant to bring me i asked them if maybe my suffering wasn't necessarily caused by cognitive responses to stuff and so maybe more so by instinctive physical and emotional reactions like a some scar i was willing to accept that this was not the case and it that it was caused by a cognitive blind spot so i asked them what they thought was more likely here again they would not give me a conclusive answer they again put the ball back in my court and gave me a few options i could switch to a more physical form of therapy try emdr continue with talk focused act or look for a different clinic they also said that for instinctive body focus stuff i would maybe maybe better off in the alternative medicine circuit the problem right now is i simply do not know i was hoping that therapists could offer some form of expertise on on this all i know is that i don't want to be alive and that i want that to change i've lost faith in therapy for the most part and i don't feel like they have much to offer me but i don't want to give up i feel like i'm all i can do is pick one of these options on feeling and hope for the best as i can't really make an informed decision anyone here with a lot of experience in the therapy world that has suggestions on what direction to take i like how dr k is so focused on solving problems and i don't feel any therapist has ever been like that so this is a really good question okay so here's what i'm sort of hearing just to kind of summarize so some people will go to therapy for years and they'll feel like the therapy really isn't helpful and a lot of times what'll happen is a patient will come into a therapist's office and they'll say like or a lot of times you show up right and like you're not really sure what therapy is or they're the expert so you let them kind of lead but they don't really seem to be leading anywhere in fact most of what they're doing is like asking you to lead and it's really confusing because you know you don't know how to lead like if you knew how to lead like you wouldn't be in therapy right like you're there for their expertise and then therapists also were trained in this way to be like very reflective in terms of like if someone comes to us for an answer we kind of like put it back on them it's the classic therapy dodge it's like the most you know simple like reflex that we're taught what can you help me with and then we answer a question with a question what do you think we can help you with and i think this is kind of it's actually like sort of a problem because what this means is that like you know you're kind of like you're not really offering any kind of guidance to patients because that's not what we're trained to do because what what can we how can we really guide them and i think it's a huge issue because a lot of times people are coming for us to us for like guidance like we want a plan about how to move forward and this is where you know i remember when i was trained to be a therap like training to be a therapist like you know i was taught that if someone comes in and says like my goal is to get a girlfriend can you help me with that we were trained to say no we can't because like we can't control anything about their lives outside of here and i think that this is why if we look at like life coaching it's interesting because if you look at like you know the psychotherapy subreddit for example there'll be like a post on there every couple months about how like coaching is a scam and like why are people getting help from coaches and like there's no license there's no training so like why are coaches popping up everywhere right like like what what i think therapists need to understand is that like we've sort of failed our patients or clients or humans in a particular way based on our approach because we're not about problem solving right like that's not really what therapy is about like therapy is all i'm generally speaking if you look at the roots of therapy it was sort of like based on sigmund freud who sat there and was like believed that the more neutral he was the more stuff would come out and if stuff comes out that the goal of therapy is to like let stuff come out and if you let stuff come out that will fix things so that's generally speaking like the the goal of therapy is that you've got stuff buried in there and if we can bring it out of you then you'll move in the right direction i think part of the problem is that therapists are afraid to take responsibility for their patients right like we're afraid to say like oh yeah like i i can't because then it like then it's our skin in the game right because like therapists have we have this really interesting kind of training where it's like we you know we don't really like accept responsibility like if if your patient drops out of treatment like whose fault is that and generally speaking what i find is that when you when you are a therapist and you go to supervision very few therapists will say like maybe you could have done something better like most of the time it's the sort of thing where like you know the patient really couldn't wasn't ready yet so we have all these kinds of things that we sort of tell ourselves as therapists that sort of make it like not our fault and so this is where part of the reason that we kind of have a um and i think that that that approach is useful okay so for the record like i think that therapy is really good like i do that a lot you know i bring things out of people um it's useful but i think it doesn't work for everyone and this is why i think coaching has emerged as like a field and why people are so interested in it because coaches are better at like offering people answers they're like better at being externally focused they will actually sometimes like give you direction give you advice give you things that like therapists are trained not to do so like therapists are sort of trained like don't ever tell your patient to quit your job or break up with someone or something like that what we're trained to do as therapists is sort of say like oh are you unhappy then what do you think you should do if you're unhappy like what are the things that you can change like we sort of like let them come to the decision we don't say like i think you should quit and this is this is kind of interesting because i remember when i was like training to become a therapist i was like doing something like what i do on on stream and stuff and then one of my supervisors was like i don't think i can supervise you anymore and i said why is that and she said well you're not doing therapy and i was like well then what am i doing she's like i don't know your patients seem to like it but it is a therapy and so that i was like really surprised and i think in the history of you know my residency program i'm the only one that i can think of that has ever had like a a supervisor kind of you know fire them essentially it was totally it worked out great uh because i went to you know we went to our program director and and the the supervisor was really awesome she was just like i just don't know what you're doing and i don't think i can help you grow in this capacity because you seem to want to do what you want to do and so we found someone else that was like much more amenable to my style and like really helped me immensely it was really awesome and i really appreciate the supervisor for doing that because she was just like you know really cognizant of like i don't know what this kid is doing but it seems to be pretty good so rather than force him to learn what i do i think maybe you should find someone who can like support you in what you do um which is why mgh and harvard medical school are fantastic places because you sometimes have people like that um so you know i i think that so what we do like and so i understand what this person is frustrated with because a lot of times like therapists are like trained to like not give you an answer and the reason we're trained to not give you an answer is because what if we're wrong oh my god and then then the patient will blame us and if they blame us like that'll rupture the therapeutic alliance so what we're gonna do is like if i order for both of us at a restaurant you don't like the food you're gonna blame me so what i'm gonna do is sit down at the restaurant and never order a damn thing and so therefore if i never order a damn thing you never have any ability to complain you can't hold me accountable for anything if i don't take responsible for anything so this is where like i think it's crazy because i is a as a profession i think therapists like this is just my opinion okay like maybe people disagree but i'm sure people disagree but i think like as a profession we're trained to not take responsibility for our patients right and it sort of makes sense like if you're working with someone who's suicidal you can't really like ultimately it's that it's gonna be their choice like whether they kill themselves or not you can't make them do anything you can't control another human being so i understand where that lack of responsibility comes from but there's also like a lack of responsibility right which is kind of weird and so this is where like you know i think that this needs to change and i think this is why coaching is is growing so much is because like people want to make actual changes in their life like they want to fix things and sometimes they're looking for answers and part of what i'm a big fan of is like giving people bad answers because when you give someone an answer you're like hey man try this and then they're like yeah that didn't work and then it's like okay you want me to give you another suggestion and then eventually they're like that's kind of funny they're like no no your suggestions suck and i was like and i'm like fantastic so if my suggestions suck what do you think we should do and there's a huge difference between doing that and sort of starting with what do you think we should do because if we establish that i'm incompetent like it's actually really healthy for the therapeutic relationship because then people are like okay at least the dude's trying and i'm invested but i'm just incompetent and then help me i ask the patient to help me help them because i really want to help them i'm not quite sure how can you help me do it and that's where like that's where the real money is because then the two of us are working together right it's not like they're coming to me for answers and it's not like i'm absolving myself of all responsibility it's sort of like i can't do this on my own i can't fix you i've tried i've tried to fix you as a therapist and then they're sort of like well you know i know you can't fix me but i can't do it on my own either and then we get to this conversation that's like let's do it together and it's when we start doing it together that real progress starts to happen and the problem that i'm seeing is that like a lot of therapists and this is what keeps people unsatisfied is that a lot of therapists don't try to do it with you right they just tell you to do it by yourself and they're just going to bounce things back at you and so it's tough but i think that like you know if you're in this situation so first of all props to this person for looking for therapists after therapist after therapist and i'd say that like this is where you know you just got to be a little bit careful because i i don't know if like i think it you can get a lot from therapy especially if you've got a clinical illness but i'd say that like lean a little bit towards um you know lean a little bit towards spirituality uh maybe work with an hg coach i mean they're trained in a lot of the stuff that um you know a lot of the stuff is gonna sound somewhat similar to therapy but they're not trained to be therapists they'll try to help you sniff out of some scar things like that and we're actually going to offer additional training to our coaches about problem solving so you know trying to help people make external changes in their life which is something that's a weakness of our program right now because too often they try too hard to problem-solve they're like oh just do this and this is the problem is because like just do this is like just work out just eat healthy just go practice and talk to five people a day go up to five strangers then just talk to them that's how you'll overcome your social anxiety so that's the problem with solutions right like it's like you can offer people solutions but if they're not ready to like meet them then that's a challenge just don't be depressed exactly just win forehead just get better rng in your loot boxes noob um yeah so here's what i'd say you know if you're you know if you're struggling with therapy like i think that it's good to let people know that things don't seem to be working for you let people know that you're trying hard that you've seen a bunch of therapists but that you're actually like looking for answers and you'd like like their help doing it i think on the one hand i'm really happy with the way that this person has been treated by his therapist because they kind of say like i don't think i can help you it's not what i do and at the same time like because you got to be professional about it i'm also disappointed because like what i'm not hearing from these therapists is hey i don't know how to do this but i'm gonna try to learn right like i understand you're suffering you've seen a bunch of people it's not what i'm trained in but like i'm willing to try to figure things out with you will you give me a chance even though i don't know how to help you and it it's just not something you know what we see is like oh yeah try this other form of therapy like it's like a pass the buck kind of thing right like oh like sorry i can't help you like go see someone else like sorry i can't help you go see someone else and then we end up with people like this and you know a lot of times these people wind up in my office and and like the people who wind up in my office have been in therapy for like 10 years they're like yeah like it doesn't seem to work and then they show up here and i'm like well i'm probably not better than them but let's see if we can figure something out you know like i i can't help you but i'm willing to try and it works out well yeah i mean i think like you know therapists i think need to start taking a little bit more responsibility for the outcomes of their patients it blows my mind you know like i know it sounds absolutely crazy but like therapists don't measure outcomes for their patients like you'll measure you know like you'll you'll do things like that's patient specific right so people will administer like depression scales and anxiety scales and things like that so you'll do that like for an individual case which is standard of care but i've never seen a a you know a group therapy practice that takes all of their client data and compares it like oh like i tend to improve depression by 25 and my colleagues actually improve it by 45 what are they doing that i'm not doing right we don't do that there's no like form of feedback like i don't even know it's also like part of kind of bizarre but like how do you give feedback to a therapist you know how does a therapist know if they're doing something wrong it's it's weird it's like almost like the education system like i think part of the reason that coaching is cropping up and i think part of like what makes our coaching program like pretty successful is that like we measure outcomes very diligently and we like notice when someone is not doing a good job and then we like intervene with them so so the answer is try coaching instead of therapy like it's worth a shot right so like if you've tried therapy for six or seven years and tried a bunch of different things i'm not saying stop doing it but i'm saying maybe try something else maybe try something that's a slightly different approach um and and for people that are you know like trained differently right if you're looking for answers not to say that our coaches can necessarily give you answers um but i i do think that they i mean the data suggests that they seem to be helping people and they're certainly not trained as therapists so like they're doing something that isn't therapy so

Channel: HealthyGamerGG

Views: 451,545

Keywords: mental health, drk, dr kanojia, healthygamergg, healthy gamer gg, twitch, psychiatrist

Id: 1xrKMSySQOQ

Length: 17min 36sec (1056 seconds)

Published: Wed May 26 2021

Reddit Comments

[u/Dogfromheavenworld]

I wanted to respond to this because I'm a therapist and I don't find this to be a fair overview. I'm disappointed because I'm a big fan of Dr. K and usually find myself to be in agreement with what he shares, but I think there are a lot of generalizations here about the field of therapy and that Dr. K's response could discourage people from seeking support from qualified mental health professionals. It's true that some of the traditional methods of therapy were not oriented in problem solving (Freudian- psychodynamic /Rogerian- Person Centered" etc.), but as the field has grown and evolved there is a vast pool of evidence-based modalities and techniques which have a collaborative approach. There's even an entire theory of therapy that's called "Solution Focused" that takes a problem-solving approach at its basis. As a therapist I'm trained in Dialectical Behavioral Therapy Skills (derived from Eastern wisdom and practices) as well as EMDR (eye movement desensitization reprocessing) a somatic experiential therapy that has a wide body of research literature around its efficacy. Both of these methods provide a lot of structure and active support. I don't doubt Dr. K does a great job training the Healthy Gamer team, but in general giving yourself the title of being a "coach" requires no training structure, supervision, or specialized learning. I know navigating the field and finding a therapist that fits can be a daunting and difficult process, however the process is easily even more challenging if you're looking for a coach because there's no standardization or accountability in their field. As a therapist if I harm one of my patients, there's an entire state licensing board that will be there to discipline me, no such structure or protections exist for the public when dealing with an unlicensed individual. Please Dr. K, as someone who's on the same team as you with the same mission, don't discount what we do for our clients.

[u/HealthyBeunhaas]

OP here, don't know where to ask this, but is it possible to change the title?
The original post says nothing about money. I live in a country where therapy is relatively affordable.

I mean, I agree American healthcare is ridiculous, but it's kind of weird to put something in quotations that I never said. :/

[u/Lufernaal]

The guy complained about therapists not providing any effective way to handle your mental health issues and Dr K didn't provide any effective way to handle mental health issues.

He basically just said "this guy is right" in a whole lot of words, saying they're trained to give no answers, no plan, no direction, nothing like that. That's about it.

I've read similar problems with therapy before, but to be fair I've only tried twice. If anything, therapy just made it worse, kind of like if you went to the doctor with a cold and came back with multiple malignant cancers... and the cold.

Going to someone whose profession implies a solution and hearing that there's none is kind of weird.