Awkward question post

[grammarwoman]

Please forgive me if this comes off sounding ignorant or dismissive, but: how does one get into therapy? I mean, the why/how/whos of it all. Is it to talk to someone who won't judge you, and how is that different from talking to a close friend? Do they give you advice? How do you find one? How do you know you've reached a tipping point that it's a good idea to get one?

The fertility clinic suggested that I talk to someone about donor eggs; I assume that's because they can give me some more medical information, as well as tools and scripts for the future.

But I also want to find a therapist for the Emperor, hopefully someone with experience working with gifted kids who can help him with his presumed spontaneous existential depression, or what we've taken to referring as his Bad Thoughts: what's the point of life if everyone's going to die? How can we be happy? How do we find meaning?

This self-awareness thing can be a royal pain in the ass.

Comments

content note for frank discussion of depression and suicidality

[recessional]

Mleh. I am too braindead to work out the words for answers to your other questions, so I hope someone else will come along, but I sort of have words for one of them (as I have recently explained myself on the subject to someone else), so I'll toss them out:

and how is that different from talking to a close friend?

They're not part of your life or social circle, so you don't have to think about the impact of what you're saying: you can talk really freely because it literally doesn't MATTER what they think of you qua you.

I'll go with a really stark example: when I am badly depressed, I am suicidal. Talking to friends about this, I have to deal with a bunch of shit. I have to deal with their distress and worry. I have to deal with their potential guilt. I have to deal with the fact that this conversation will continue to be a context for how they treat me for weeks if not months if not longer, because "at risk of killing herself" is going to be something they think about - have to think about. Are they agreeing to help me with something because they ACTUALLY have the time/energy/interest, or because they're worried about me? Etc.

But I'd still like to unburden myself about how messed up it is I'm constantly bombarded by [image/scenario], or how difficult it is to plan when my brain keeps tossing up "or you could kill yourself" as a viable option, etc, etc. Psych is a safe place to do that because it doesn't matter what she does, thinks, says or believes outside of the hour I spend in her office.

Mental health professionals aren't actually part of your life. You don't have to deal with them as a part of your general social fabric - and it can be surprising to discover just how much one HAS been self-editing, or eliding, or so on, because "won't judge me" isn't the same as "this admission won't have an impact on my relationship(s)".

Re: content note for frank discussion of depression and suicidality

[harempriestess]

Everything above is what I was going to say!! ;)

I truly believe that therapy is hugely responsible for my continuing existence, amongst other things. But without it I wouldn't be functioning as well as I am now.

They're not being a part of your social life is a huge part. Not only are you having to deal with your friends reactions to what you're going through, you also have to deal with advice from incredibly well-meaning but often times completely clueless people. I've got chronic, severe clinical depression and a raft of personality issues due to it and my upbringing. Therefore while I understand being depressed, I have absolutely no idea what it means to be depressed in regards to what you've been going through.

Ask doctors you trust, even friends perhaps. And much like depression meds, the first or second or even the third therapist may not be quite right. That can cause some hassles but in my experience you usually know it's not a good fit by the end of the first session.

Sometimes talking to a friend or family member can be good, especially when you simply need someone to cry to or vent to or what not. But therapists have studied this stuff, and can give advice, give you tools. It all sounds cliche but honestly, I learned so many new ways to do things in therapy that I'd never thought of before and that without I wouldn't be feeling hopeful for the future.

His school might also be a good place to inquire for the Emperor. It's sad they don't have more direct access to therapists or counselors at school, but they often at least know where to start.

Consider that first session a kind of two-way interview. They want to get into why you need help, but you have to learn where they're coming from, what their background is. For example, due to my complete lack of any connection to religion, when a therapist said something "inspirational" and god-related, I knew she wasn't for me (for many reasons to numerous to list and which are completely irrelevant to this). But it could also be personality-based, or they're not having experience with issues similar to yours.

And sometimes, they do judge you. And sometimes they have to call you on your crap if it's causing you to stay stuck. They may do it in a number of ways, though mine literally called me out like my Mom would. And a child psychologist will know how to do it with kids better than a general psychologist.

It's awkward at times, but honestly, problems of all shapes (size doesn't count here; if you need therapy, you need therapy) can be helped with therapy, I honestly believe that.

And good luck with whatever you choose to do <3

Re: content note for frank discussion of depression and suicidality

[grammarwoman]

Oh my goodness, this is all so incredibly helpful - thank you so much! I will be referring back to this as we go through the process.

Re: content note for frank discussion of depression and suicidality

[grammarwoman]

I am so touched that you shared this with me! I really appreciate hearing how and why it works for you. That gives me a lot to think about. Thank you!

[romantical]

If the Emperor has a pediatrician, I would ask them for recommendations for someone who has a speciality in the kind of thing you're looking for. Also, even the best person in the field may not be a good fit, so you might not find someone right away.

[norah]

Or if the people who did his evaluation for his IEP are people you trust, that can be a good source for recommendations.

If you want a therapist who will help construct solutions, you want cognitive behavioral therapy. If you want a therapist who will help him recognize what he feels and dig out the why of it, you want traditional talk therapy.

I go to therapy because I can talk to someone about myself for an hour a week without feeling like I'm burdening or boring them or talking or interrupting too much. I don't have to keep my social filter awareness up the same way I do otherwise. And ditto on the no repercussions for relationships. She gives me good reality checks, outside perspective, and strategies for working my way out of what I'm struggling with. We problem solve together, which is super helpful.

[grammarwoman]

I'm a little irritated with his IEP team right now, but I should go to them with this, you're right.

Thanks for breaking down the differences between CBT and talk; that's good to know. Thank you, too, for sharing your personal experience with therapy. I appreciate getting an idea of what to expect. :)

[grammarwoman]

We haven't seen the Emperor's pediatrician in a long time, so this is good advice and a useful prod. :) Thanks!

[kass]

I suspect different people go into therapy for different reasons. For my part, I find it helpful because my therapist a) doesn't judge me, b) helps me see things clearly, c) helps me notice patterns in my life, d) helps me devise smart workarounds to those patterns as needed. Also she's a safe person to cry on or vent to or whatever as needed. But mostly I value her perspectives, because she can often see things which I can't (since I'm in the thick of it and she's an informed observer looking in from outside.)

Re: the Emperor's bad thoughts, that's tough stuff. I know what my own answers to those questions are, but they probably wouldn't be helpful to him. Hmm.

[grammarwoman]

Thanks for the perspective! I think I'm getting a clearer idea of what a multipurpose tool a therapist can be. :)

[princessofgeeks]

I found a therapist by asking a doctor I knew if she would recommend anyone. If you know people who are in therapy, you can ask them if they like their therapist or would recommend them.

Therapy for children is a specialty -- I'd ask the school counselor if they know anyone, or the pediatrician, or the suggestion for the IEP team is good too.

I went to therapy two different times -- once because I was miserable and in a bad marriage and could not figure out how to get out of it or what was wrong with my life. The therapist I saw was very eclectic in her approach. But cognitive behavioral therapy, as others have said, is great for dealing with a person's habitual patterns and breaking out of them. The second time it turned out it was my husband who needed the ongoing appointment, not me. :)

I enjoyed having someone's undivided attention who could deal with my stuff in a professional way. If you vent to friends or family it's hard for them to remain detached. She really helped me understand some misconceptions I had about life and relationships, and some bad patterns I had gotten into because of my childhood. Not all therapy delves into your history, though -- the more "here and now" approaches can be very good.

For your son, I think you summed it up exactly that someone smart and prone to "big picture" thinking starts asking these questions about the meaning of life -- they are huge and important questions. Some people deal with them through religious faith, but there are also other approaches, some of which center around the idea that just because something is transient doesn't make it less valuable or meaningless.

I am hoping the best for all of you!!!

[grammarwoman]

Thank you! I really appreciate hearing about your experience, and the advice. :)

[franzeska]

It looks like other people have said it all already, but FWIW:

A therapist is someone you can dump on with impunity, even during those days/moths/years that you are miserable company and not able to hold up your end of a friendship. How often have you said "X is going through a rough time right now" and meant "Man, remember when X used to actually be fun to spend time with?" and how often have you felt awkward telling a friend about the same depressing problem you already told them about because surely they can't really still want to hear this? Your therapist is paid to keep on listening to the hundredth repetition, and their day is filled with other such appointments, so you never need to think about self-censoring. Therapists also have a lot of training in eventually steering the navel gazing and whining in a productive direction and not letting you shut down all constructive criticism. And, possibly most importantly, when your therapist tells you things you don't want to hear and you're furious at them, you haven't just had a fight with a friend. (Plus, they're never going to attend a dinner party at your house and turn purple because they just remembered that TMI thing you once told them about your sex life. But I'm a pretty TMI person, so the freedom to be a leech-y, wet blanket instead of a reciprocal friend is the part I notice more. There is no friend, no matter how saintly, who really wants to listen as much, as frequently, and as repeatedly as one needs to talk sometimes.)

Last time I was in therapy, I was 13, an age at which no sane person wants to listen to one's self-involved moaning and all of one's friends are equally terrible (assuming one has friends). It was an ideal time for someone who was paid to listen to me.

The actual style they use in sessions is highly variable. The one I went to at 13 had an amused, no-nonsense approach. She rolled her eyes at me a lot and told things flat out like: "It's okay to think things and not always say them. They're still valid even if nobody else hears about them." So, yeah, sometimes they give very specific advice ("Stop telling everyone the entire plot of Star Wars"). Some are more noncommittal and hands-off, but I think the "And how did that make you feel?" type tend to infuriate nerdy, awkward kids who want some kind of definite statement and interpret that other approach as mind games.

There's not necessarily a specific tipping point unless you think therapy is humiliating and only for sick weirdos, which... well... it's not. Even if you don't judge friends with serious issues for being in therapy, there's an insidious tendency to think it's somehow a sign of weakness or not quite the done thing if you're basically a happy, healthy, strong person under normal circumstances ("It's fine for them, but..."), but all types of people find therapy helpful during times of major life stress. Among other things, it's a way of scheduling a little time for yourself, which can be helpful above and beyond the content of the session. I've been twice: once as a little kid when I was forced to go and resented it bitterly and once as a teenager when it was my idea. I can't remember a specific incident that made me realize I wanted to go. Having gone before made the idea come to me more readily, I think. I was depressed and wanted someone to talk to. I went to her weekly for 8th grade and then she told me I didn't need any more therapy and I should give high school a shot without her. "Well, couldn't hurt..." is more than sufficient reason to go looking for a therapist if you feel like it.

You do have to like your therapist and the approach they take. It's no insult to shop around until you find one who works for you. Times a million for a kid, especially since I can attest to the fact that kids don't always understand or believe that the therapist isn't reporting back to their parents. But I definitely recommend childhood therapy if the kid is on board with the idea: kids are even less likely than adults to have the kind of friends who can listen to their problems in a helpful way, and they have much less control of their environment with fewer coping strategies.

[grammarwoman]

That is a really useful perspective - thank you! I'm really hoping we find a good fit for the Emperor, because he can clam up like nobody's business when he gets a good snit going on. I think it will help that he's asking for one, and not being forced into it.