A few questions about starting with a psychologist

Jacket · ‎17-01-2019

TLDR: Just jump to the questions at the end.

Hi everyone. Thank you for maintaining such a positive forum.

I'd like to ask some advice. I just started seeing a psychologist, as I've got anxiety and depression stemming from the fact that my lovely wife and I may not be able to have children. It's been wearing me down so heavily.

I saw a psychologist who specialises in assisted reproductive therapy (e.g. IVF, which we're considering) for one session, and she was great, but before we had a chance for a second session, she cancelled all future sessions due to a family emergency. I was quite devastated but of course, it's important for her to look after that.

So I tried to see another one, that a friend who hadn't liked CBT recommended, who operates from an "existentialist modality". I know those words but didn't know what it might mean for therapy. I went to one session but she asked questions that didn't seem to really help. e.g. "What is anger to you?" when I don't really have anger issues, mainly sadness and anxiety, and "What is a woman?" I could see this working for people in different circumstances like my friend, but it's not helpful for me at this stage, I think. And she asked some really confronting questions that the two friends I've told about say they are very dangerous (leading me down to new unwelcome dark thoughts) and I shouldn't spend any more time with her.

But I don't know. I've only given her one chance, so maybe I should give her another. But I don't want to go too far down this path. I wish the first one was still available.

The first psychologist did recommend some people, but they're about $200 for 50 minute sessions, and though I can possibly afford it and get the Medicare rebate, it seems really high end, higher than the other two.

So, I guess I'd like to know some tips. I'll just number some questions to make it easier, but please don't feel obliged to answer all:

1. Should I try with this second lady some more?
2. If I try to get a new psychologist, should I try CBT or something else?
3. What's CBT all about?
4. Are there other types that might help me?
5. Does anyone know of any other ART therapists around Melbourne? I know you're not allowed to ask for specific recommendations, but is it okay to ask for someone with a specialty?

Thank you so much in advance. I feel lost at the moment.

JessF · ‎17-01-2019

Hello Jacket, I have been to therapists who do existential work before. The questions they ask you are supposed to help get you in touch with your values, what life means to you, and what is important.

I can see how this kind of approach could potentially work well to help you come to terms with the fact that you may not be able to have children with your wife, but the questions she asked you do seem quite odd and off track to me.

CBT is much more focused on your individual negative thoughts and thought patterns, and how those might be affecting how you feel, and then how you behave. You can read a lot about it online, and there are also a lot of teach yourself books available that you can work through the techniques yourself.

What was it you liked about the first therapist? I think the most important thing is feeling comfortable with the person you're seeing, including feeling comfortable enough to say that you don't like what's happening in the session and taking control of it yourself.

Nurse_Jenn · ‎17-01-2019

Hi Jacket,

Welcome to the forum. Great to see you have so much insight to your situation and are seeking help for you low mood and worry. I wonder if you have considered going to your GP to get some advise and perhaps arrange a mental health care plan so you can access psychology sessions at a more reasonable rate?

Seeking support needs to work for you. Quite often you don’t click the first time with a therapy modality or therapist. The most important thing is that you feel comfortable and safe with the person your talking with. It can be difficult to know what works for someone until they try it out. Similarly if you were aiming to recover a shoulder injury you might try a few things like physio or massage and then realise that it is acupuncture that has been the most effective.

As JessF mentioned, CBT can be really useful but then so can existential. It is really up to who your most comfortable with. And if the person you saw first isn’t back for a while and your not entirely comfortable with the second, it could be third try lucky.

Asking people for recommendations can often help you find a good counsellor in your area. You can also ask your GP on someone they recommend.

Wishing you the best possible outcome,

Nurse Jenn

Jacket · ‎18-01-2019

Hello JessF and Nurse Jenn,

Thank you so much for your replies.

I see that existentialist therapists could be useful. And even for me, possibly, in the future if my wife and I give up on having children. At this stage, we're still on that long road, trying things like IVF, so I feel that maybe I need help trying to make decisions around that, rather than just coming to terms with the fact that it might not happen.

Thanks for telling me about CBT. When I see your descriptions, I don't see it leaping out as being what I want, but I could try it, I guess. Or read about it. I'll try to find a good article and start from there. Does anyone know one?

JessF, I liked that my first counsellor seemed in tune with my feelings surrounding our potential infertility ("impotency" is a better word for how I feel at the moment). She told me in that first session that my problems were both very complex and very urgent, which made me feel so vindicated, because that's exactly how I felt. (I've only just scratched the surface here.) She was so concerned, she booked in an appointment for two days later, and I was so full of hope for that appointment, and when it was cancelled, it all came crashing down.

I guess that may have led to me being hesitant about seeing the second lady, and that may have coloured my feelings about her, but like I said, some of her questions and statements led me to more doubt about myself and my feelings, so I'm a bit scared to see her again.

Nurse Jenn, thanks for suggesting the mental health plan and GP. I already got the mental health plan, but my understanding is that I will only get $70ish per session for a maximum of 10 sessions over 12 months (with 6 sessions max based on the first referral), so the raw cost is still a concern. $200 for a session will end up as $130, but it's still more expensive than the other two I've tried so far. Also, the two GPs at our current practice seem to be new to the area and when I asked for a referral, they were more or less just looking up lists of names rather than knowing specific people. So I'm just trying to get recommendations for a psychologist regarding fertility issues, and I'm really hoping someone can help.

I guess at this stage, if I hear no more advice, then I might go for that place which is $200 for 50 minute sessions, just because it was a recommendation from the first counsellor, and I have no better place to turn.

Thanks again. I'd love more replies if anyone feels they could contribute.

romantic_thi3f · ‎18-01-2019

Hi Jacket,

I'm jumping in a bit late so apologies if I skip info or unanswered questions -

Here is an article on CBT. I'm happy to send you more complex/easier to read ones depending on what you prefer -

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cognitive-behaviour-therapy

or a video here - https://www.youtube.com/watch?v=9c_Bv_FBE-c

In terms of finding a therapist, I have a couple of ideas:

- You could ask the IVF treatment centre. They would have many clients in the same boat so I would imagine they would know a counsellor/organisation

- You could ask the first psychologist to see if there's someone else who might be in your budget

- You can go to a psychologist directory here https://www.psychology.org.au/Find-a-Psychologist and filter clicking on 'infertility issues' (under the general health category)

- You can google search for a counsellor in your location using ANZICA which stands for Australian and New Zealand Infertility Counsellors Association

- or here http://access.org.au/?p=1404 which has a list of counsellors. This is the resource provided by IVF Australia

Hope this is helpful! Good luck in finding someone who suits your needs.

memorytrap · ‎18-01-2019

Thanks for starting this thread Jacket, I am also in the position of seeing a new psychologist this year. I've seen about 6 throughout my life and never found any particularly helpful. Unfortunately I am also in the position where fees are driving my choice of psychologist. I have had one session with a new person and it was somewhat promising. They initially pushed CBT as the main treatment option but I've attempted it in the past and felt it made things much worse for me. With CBT, my main problem was that was too much unhelpful homework/writing involved and it actually triggered intrusive thoughts and negative self-image more. Not everything works the same for everyone so it's perfectly fine to recognise that within yourself. If something is not helpful to you, it's not helpful.

With my new psychologist I voiced my concerns and told them immediately what thoughts and situations triggered my latest depressive episode. I think what made me feel like it was promising was that they immediately said they could see I was suffering and maybe CBT wasn't the best treatment option. I feel comfortable with this psychologist and feel as if they can really help me, although I have put my hope in people who have let me down before so I am approaching this cautiously.

If there is any advice I can offer, it is go with your instincts. If you are uncomfortable with someone or their ideas seem alien to your problems, don't do it. Don't let them guide the conversation and also, don't let them sit in the back and make you do all the talking, there needs to be a balance. Be upfront and clear about the issue that has triggered your episode and state that this is what is affecting you in the immediacy. Any psychologist worth their degree will be able to immediately understand the root of your problem and suggest the best course of treatment. Psychodynamic therapy (talk therapy) is the other main treatment I know about. Open up about things but be mindful that you don't overcommunicate, give yourself a feedback loop and be receptive to any advice. Let them solve what is affecting you right now and don't be distracted by some weird alternate stuff you are uncomfortable with, I fell into that trap and it made me distrust the profession for a number of years. You need to feel the benefits. At the end of the day the rebate is only for 10 sessions so it's your time and money.

JessF · ‎18-01-2019

Can I just add that I think if you're going into seeing a psychologist expecting your problem to be solved by them, then you will likely leave disappointed. I've found over the years that it is a partnership, and it does require work on your behalf as a client or patient. I see it as more like going to see a physiotherapist when you have an injury. They're going to give you exercises and stretches to do as part of your rehabilitation, but you have to actually do those exercises if you're going to get better.

Going to see a psychologist will not always be comfortable either. Things may be brought up that are deeply uncomfortable, and it can sometimes be the avoidance of these issues that has you currently feeling depressed or anxious. It takes courage to be emotionally present, ask questions and work through these feelings.

I don't think it's fair to expect the person you're seeing to be a mind reader, they have systems and tehcniques and processes they can use to help you work through your problems, not a set of magic wands. They rely heavily on what you tell them, and being in an environment where you feel comfortable enough to talk. This is why I think the most important thing is to see someone that you first and foremost feel a sense of trust with.

Jacket · ‎18-01-2019

Thanks romantic_thi3f and memorytrap. I'd like to say again how much I appreciate this community.

I found the video on CBT a great overview, with that article being a bit more in depth. I think my behaviour is without major issues, so maybe just the cognitive side of therapy will help. Of course, this could be combined with other types of therapy.

I realised that trying to wait for more answers before taking action was not productive, so I took your advice, romantic_thi3f, and went through that list. I called the IVF clinic but they didn't get back to me, so I had the daunting task of using those lookup sites. I'm sure anyone can agree, it's so hard to look at a list on the internet and just see a couple of photos and names and brief descriptions and know if they're right for you. I really would have preferred recommendations, but that just wasn't going to happen.

So 30 minutes ago, I took a deep breath and called the most local clinic, spoke to the receptionist and told her my problems and she recommended someone. I won't see them for 3 weeks, which seems so far away, and some of my problems really do feel urgent, but I'll continue to try to rely on my friends until then. I don't want to go back to that second psychologist. Fees are high at the new place but it seems the Medicare rebates are somehow $120, higher than what I saw at other places.

Thanks for sharing your experience too, memorytrap. Interesting about the homework. When I started this, my appointment was 3 weeks away, and I wasn't given any homework, but I am the type that needs to feel like I'm making progress, so over the 3 weeks, I took it upon myself to write a chronicle of all the major events in each year of my life. Some years were very difficult; some were easy. Now I've got some writing that I can hand to anyone who will see me. I wrote a condensed version of my fertility story and showed it to my wife and some friends, and they cried while reading it. Hopefully this self-awareness and self-reflection will help me make progress.

Thanks memorytrap for the advice on overcommunicating and the feedback loop too. I'll really do my best to be open to that. I think this is where professionals can be more useful confidants, but having both is good.

Thanks JessF as well. I understand it won't be fixed straightaway, and that trust must be built. I've only had one bad experience so far, so I'm lucky.

Thanks all. I'm still sad but feel like progress is being made.

memorytrap · ‎18-01-2019

I'm glad you made the decision, Jacket, it seems like this is for the best. Fingers crossed this will go well, trust me, I know that 3 weeks seems like an eternity when you need help right now. It is great that you gain benefit from writing and that it helps deal with challenges. Our problems are different and so are we and how we cope is entirely personal, so if something works for you then use it as often as you can. In fact it might be something to bring up in a session, articulate your needs and what's been working and maybe the psychologist can implement additional support that will draw out your resilience further. You can get through this.

JessF · ‎21-01-2019

Hello Jacket, just wanted to say well done on writing down the summary of your good and difficult years. Those kinds of exercises can be really helpful, particularly when you look at the good years and see what was working well in them. Sometimes there are strengths we take for granted, and it's only when seeing them written down that we can remember we have them, and draw on them during the tougher times to help us solve problems, and just push on through.