Ask a Therapist

What are the factors that influence whether therapy works for someone or not? You said it's difficult to get them to pursue positive changes, but why would they go if that wasn't the goal?

Diaper fetish. Classic material fetish with a twist? Not ab simply like the "material"

Nah like craving and even seeking out people to abuse you like going into abusive relationships just to be abused

It's a very good question. The ones that actually consistently come to therapy always get better. They are great to work with.

The other people consists of people who have not taken their treatment seriously. These folks can be in their 40's, 50's, and even 60's.

Therapy takes A LOT of time to really make lifelong substantive change for severe cases. And the sad reality is that people who have lived longer with their illness are harder to treat.

What if they wanted you to fuck their wives

I do not think that it's necessarily healthy to seek out these kinds of relationships, but sadly, it is exceedingly common. I would ask if there is any distress that stems from repeating this type of behavior?

have you tried telling your crazy retard patients that they should stop eating mcdonalds and chipotle and twinkies and sugary cereal, and start cooking their own food, before they get the idea to start taking medications "for their depression and anxiety"?

Nope, not a chance. I wanna do this job for the next 50 years. Inappropriate sexual contact with a client is career-ending stuff. I can only practice with a State License. If they take my license away, I can never practice again.

I got molested by ny uncle as a kid and now have a bunch of self worth issues. The biggest one is I have some crippling anxiety about my penis which is statistically small.

Since I was abused I figure nobody will want me for more than sex and with a small penis I cannot offer much. I am skeptical that I could be loved enough for somebody to be okay with a small one. Any advice?

He's obviously a jew, how would telling them to eat right instead of prescribing them pills make him any money?

what percentage has severely debilitating conditions as compared to a minor inconvenience in your opinion?

Absolutely. Common sense, basic self care is extremely important. I tell all of my clients to do the simple shit: Monitor diet, get regular and vigorous exercise, get a sleep routine going, limit or avoid substances.

The sad thing is that the vast majority of my clients have already been on heavy-duty medications long before I ever met them.

Thank you for answering, that makes a lot of sense.

It is actually very normal to magnify our imperfections and flaws (physical and otherwise), and to make the assumption that "I am unlovable due to X, Y, Z. Some people might judge you for having a small penis, and others might be totally ok with it.

Ay 1. Your uncles a useless cunt who's going to rot in hell 2. Small dicks arnt that bad 3. There are people who will love you for your personality your probably chill af you do you and someone will come around one day <3

I am not a psychiatrist. I am simply a talk therapist. I cannot prescribe medication.

At my particular job, I exclusively work with the "severe" cases, so my sample size is certainly very skewed. Previously, at least 80% of my clients are on Federal Disability, but over the years, I feel like that number has lessened somewhat, particularly as more young people seek treatment.

you should tell your clients how ingredients in fast food and snack food and ultra processed food contributes to depression and anxiety as well as obesity, heart failure, cancers, and all kinds of chronic illnesses. We wouldn't have such a crisis in mental health if our food supply wasn't literally poisoned with things like caramel color, food dye, artificial preservatives, etc.

Isn't that pretty useless? If you can't write prescriptions how do you compare to an AI chatbot?

I personally really agree that ultra-processed foods are toxic to our systems. Unfortunately, I am technically not authorized to provide "specific" diet and exercise advice, past the point where I tell that that it clinically improves mental health. The state makes it VERY known that providing any services "out of my scope of practice" could potentially lead to problems with the licensing board.

How do you separate your work from your emotional well-being? I feel like it would be difficult to listen to people talk about the worst experiences of their lives and have that not rub off on you.

But do you have any advice for not judging myself? I logically know it is flawed tmand unrealistic thinking but it still happens frequently.

1) kind of
2) ex yelling at me when we broke up helped cement the fear
3) that is the part I struggle with. When my parents found out they didn't really know how to handle it so they just kind of shut down a bit and the relationship is like a strained business relationship. I try to be kind and do what I enjoy bur I'm a bit of a loner and am worried people will not come around beyond
"Man Anon is pretty nice".

I like people and express it with gifts like donuts at work and making a pot of coffee in the morning but then when people are nice back part of me tricks myself into it just being transactional if that makes sense.

Can you give me free therapy?

This is a job that pays the bills very well

said no therapist, ever
there's a reason Dr. Phil got on TV and let his license lapse; there's no money in real therapy
psychiatrists make good money, but they're M.D.s

Also a good question, something I have thought a lot about. I think there are a lot of mediocre and lazy therapists, and for their "style" of therapy, it probably is not more effective than a specialized chat bot.

It is very subjective on my part, but I think that a really good therapist will help you figure out problems that you didn't even know existed before. They will critically look at your situation, compare it to the thousands of previous people they have worked with, and sometimes come up with creative and engaging solutions that really help a person. I realize that I sound pretentious and cringey here, but therapy is more of how to have a conversation with others that is compelling. I ask myself with every client, "What is their learning style? How blunt can I be? What language and cadence of speech will make them feel that I relate to them?"

you need to find a way to incorporate that into your sessions. If you're able to tell them that eating healthy will improve their mental health, you should be able to just give them a couple websites on a piece of paper that they can go home with and then read about basic things like "how to cook fried chicken" or "how artificial food contributes to worse mental health". all you need to do is make it seem like your patient was the one to bring up the specific topic. Fuck the state, they're interested in keeping a status quo

If you believe he's a therapist, then clearly one did say that it pays the bills well. Why are you being hateful? Comparing them to doctors (implying the latter is better), and stating that therapists are poor. Is your goal to discourage people from entering a profession that the world needs?

What percentage of people here do you think are fucked up compared to society at large?

The evidence for the existence of learning styles, or their usefulness, is shaky at best.

It can actually be a very emotionally brutal job at times. Hearing people's problems all day really can drag you down. Most newer therapists do not really make it more than a few years. They will end-up in different, adjunctive employment positions instead of providing the direct face-to-face work.

For whatever reason, I am very lucky to do this kind of work because it suits me temperamentally. However, I have had to work very hard to create a philosophical approach to life that makes this kind of work tolerable. I have also a great group of other therapists, with whom I work, and we all support each other through the drama that invariably occurs.

Lol fair. Figured it was worth a though in case it is like a quick tip or suggested way to proceed.

What is their learning style? How blunt can I be? What language and cadence of speech will make them feel that I relate to them?"

Sounds true to me. I'm seeking therapy for more than a year (not in US) and at first my therapist's solutions felt too abstract to me kinda like "Celebrate yourself". Only when we visualized it using some metaphors I feel I'm on a better path on what to do.

Why are you being hateful?

i'm not

Comparing them to doctors

i didn't

(implying the latter is better),

i didn't, i said psychiatrists make more money because they are medical doctors, which is true

Is your goal to discourage people from entering a profession that the world needs?

i don't have a goal

Yeah, try and understand that all of our minds lie to us constantly. This is kind of getting into more complicated territory that you might want to talk with a professional about, but you want to understand that having a self-dialogue like, "I am bad, short, ugly, fat" or whatever, is "just a thought." Just because we have a "thought" does not make it real.

If I were to broadly and generally describe the severity of mental illness, it would be "How much do we identify with our thoughts? Are we able to create distance with our thoughts and understand that they may not be true?"

do you think it would be a good idea if I went to therapy, even though I have no problems (though i used to go regularly and was hospitalized many times, so it wouldnt be unusual) just to chill with a therapist and be like their relief "work" session? Just basically make some bullshit up as an excuse to hang out with someone obligated to listen to me for an hour? It would be tax payer paid

I CAN provide free therapy potentially, that is like $150/hour I would miss out on. Not doing it for anyone here. Just wanting to demystify the therapy experience as much as possible. So many folks are struggling and desperately need help.

That makes sense actually...I just assumed other people's self talk wasn't negative.

Thank you. I'll think on this.

Some therapists get paid VERY WELL. I really mean this, people are paying over $150/hour for average talent therapy. A talk therapist can charge up to $300/hour in big cities. Psychiatrists, who are indeed MD's, often make even more than that. If you see 30 client's a week, you can make upwards of $150,000/year. Psychiatrists make more like $300-400,000/year.

bro to be honest, I used to have thoughts like that until I started replacing the crap food I was eating with actual healthy food. Now, I feel confident in myself. I'm not going to accept that my brain is lying to me constantly, because my brain is telling me "i'm handsome. I'm fit. I'm sharp. I'm capable." and it didnt start with mental gymnastics, it started with drinking water and cooking chicken and rice

Tbh that is way too much money for something with such a simple solution. Scam...

How many people are mentally ill because of some sort of trauma vs just because?

Probably a lot higher on here than the rest of the population. I have read that broad prevalence for mental illness is maybe around 25% at any given time, and estimated that 50% of Americans will meet the criteria for a diagnosable mental disorder in their lives. Probably quite a bit higher here, but different in flavor. My understanding of the Anon Babble demo is that it's mostly men under 40, and there is almost certainly a higher than average Autism Spectrum Disorder prevalence here.

Yeah, it's unfortunately very common to have bad experiences with therapists. Crudely speaking, you're maybe gonna find that less than half are any kind of decent at their jobs. After we graduate from our programs, there is zero oversight or measurement standards that can objectively show therapist skill level, so you tend to get some folks that do whatever the fuck they want in session, and most clients do not have enough experience to know that what their being told is bullshit.

Probably not a good use of time if you don't really don't have anything to "work on." Ethically, (although many people don't do this) we are supposed to terminate ongoing sessions if we feel that there can be no discernable benefit to the client .

Yeah, that's a common complaint of therapy. But, the research suggests that any person going to ANY kind of therapist will typically show some measurable improvement in their lives (objective shit like reduced psychiatric hospitalizations, reductions in use of drugs and alcohol, fewer arrests). The basic premise is that the vast majority of people have never ever taken a basic Psychology class, so they really have no idea how to emotionally cope in their world, particularly if they came from a history of trauma and dysfunction in their families-of-origin. Therefore, ANY therapist, even if their mediocre, will be able to share some kind of very simplistic information that is statistically likely to help the client. Even if it's something like, "Hey, maybe getting black out drunk and calling your ex isn't a great idea to do every weekend."

It's not that your brain IS lying to you, it's just to introduce doubt and skepticism about your thoughts. It's a principle of Cognitive based therapies. To understand and recognize what our minds are doing, and then intentionally utilizing other thoughts that might be helpful in counterbalancing the automatically distressing thought.

Personally, and this is not necessarily scientifically backed, I think it's almost all trauma based. If you look into research about Adverse Childhood Experiences, there is significant data showing a powerful and direct correlation between instances of childhood trauma and ever conceivable negative outcome as adults.

Notnthat anon but the other one with lying thoughts. You seem like a bro. Thanks for being chill. I'm off to sleep but i hope you enjoy work and see more successes and don't burn out.

This is so fascinating. Obviously I don't know how ACE scores are calculated but it just makes intuitive sense that messing around with a young mind would cause problems later.

However, there is absolutely a genetic component to mental illness. There are a lot of theories about how this might actually unfold, but our best understanding is that there are certain conditions that are purely biological (you either have the genetic potential to show these symptoms or you do not) such as Schizophrenia, Bipolar Disorder, Autism. Another theory is Diathesis Stress Model that suggests trauma and stress CAN trigger the initial onset of a mental illness, but if that level of stress is never met, the person does not show symptoms.

How do you deal with people who tell you about illegal shit? Do you think many clients usually hide it for you or just avoid therapy because they are afraid it is known even though it might be a crucial piece of information?

It can be the case that if you had ACE you are likely to end up with a mental illness but that if you have a mental illness it's not necesarilly as likely to be due to ACE, as opposed to something else.

Yeah, the field of Clinical Psychology is constantly evolving. I honestly think it's getting better over time, and we're getting better training and data about how to help people.

It's insane to think that the first EVER ACES study of childhood trauma only occurred in the 90's. Another shocking way to think about it (for non-biological conditions) is that mental illness originated as the cope strategies that a child instinctively developed to emotionally survive in their home. If it temporarily works to to not leave your room playing video to avoid mom or dad who was drunk and angry, then it might become a feature of that person's mental illness later when it isn't healthy to no longer leave their room.

Mostly, people do not tell me about illegal stuff they have done, but MANY of my clients have criminal records. Most of it being very petty, teenage and young adult mischief, but some people have done really bad things. I met a man who was served 25 years for killing his wife (he insisted that he did not kill her). Mostly, the real sociopathic bad people will never come to therapy because they typically lack insight about their behaviors. The reason they end up as sociopaths is that they genuinely to not understand that their actions are wrong, so why would they come to therapy if they are perfect?

I forgot to add: Yes, that is correct. ACES are considered a "risk factor" for mental illness, but is not 100%. The other really important thing to understand is that theoretically, almost anyone can "potentially" become mentally ill if you cause enough grief or hardship for them. But, I also think it's possible to develop iron-clad mental Jiu-Jitsu to stem the onset of mental illness if you work hard enough at it.

Anyway, that's it for me for tonight. Thank you for the questions everyone. I will try and come back next weekend.

Final thoughts, if you are not doing well in your life or in your mind, seriously think about talking with a professional of some kind. It doesn't even have to necessarily be a formally trained and licensed therapist. Could be a religious leader, a drug and alcohol counselor, family doctor, etc. Mental illness is extremely common, and treatment actually works if you stick with it. I have seen absolute miracles occur with people who were profoundly depressed and suicidal, and then came back in a couple weeks and were finding happiness for the first time in years.

What are your thoughts about the use of drugs and the onset of mental illness? Have you had or heard of any clients that used something and were permanently changed?

Thank you for answering.

Thanks for sharing on here, appreciate your time and was glad to have it!