Difficulties Understanding Treatment

[P12]

Counsellors and psychologists to whom I have spoken have told me to identify my long term goals and strive for their achievement. But my attempts have been unsuccessful because I lack the practical skills for achievement and that has caused me greater dissatisfaction than before I attempted to achieve the goals. What is the reason for this strategy and why are counsellors and psychologists unwilling or unable to give me practical advice?

I identified the technical topic most interesting to me, looked for collaborators, and asked for support to pursue my interest. I found only two people in Australia with similar interests and believe they are unwilling to collaborate with me because by discrediting me their circumstances will improve. The feedback I received about my requests for support is that the topic is not relevant to society. Instead I am expected to perform a job for which I am imperfect and therefore I am excluded because my processes and ideas are different to the industry. Is it true that society's objective is for greater normality and what is the reason for such a strange aspiration? Why does society reject people who are different? Why does society not allow me to pursue my individual interests and talents? What is the purpose of living if society has no use for my talents and the role that society would have me fulfil causes me trauma?

I was told that independence will not cause me long term satisfaction. Yet, as I have tried unsuccessfully for more than ten years to form a friendship, I question this assertion. The prevailing strategy suggested to me for gaining friends is to participate in activities I enjoy as there I am most likely to meet others with similar interests and beliefs. What is the purpose of living if society directs me to one outcome but it cannot provide the means to achieve that outcome? Surely independence is a far more effective solution.

I'm pretty sure I am lonely. I would like to have a friendship or at least feel welcome in society. But my efforts never seem to work. People make suggestions but I must be special because they don't work for me. The harder I try, the more independent I become, because my methods appear stranger to others, and the less liked I become. I really don't understand the society in which I live. I wish I wasn't so sad.

I often cry uncontrollably and am unable to sleep when I realise I will not achieve my desires and there is nothing I can do about it. My life is apparently meaningless.

[P12]

I continue to feel stressed, anxious, depressed, and lonely. I think that during the past two weeks I have been more stressed and depressed than anxious. My head feels dizzy because I have been either trying to overcome these feelings without success, or trying not to overcome the feelings but still not achieving my goals.

I was looking forward to doing a three day bushwalk next weekend but sadly the three people who expressed interest have withdrawn and I am not willing to do the walk on my own. I felt shocked to receive the news, especially because they have now joined a different walk that was announced after mine. I wish I knew why the people thought that way and why I am unpopular. I went to my local park and cried for a few minutes, but I had to leave before I could relieve my distress.

Otherwise I have received some support by praying to God. From what I can tell, the supernatural world is far more satisfying than the society I live in.

I have meetings scheduled with four different counsellors, psychologists, and coaches over the next month so I hope I will receive some guidance about how to achieve my goals. Most people tell me that it is unusual to visit several practitioners at once, and some practitioners refuse to speak to me because I have more than one, but I know not how to receive support otherwise. I tell practitioners that I am not visiting others during the moment that I am speaking with that practitioner, but I believe my mind thinks on a different level to the people who society has entrusted to help me.

I also enquired to one organisation about whether they could diagnose me with a mental disorder so that it might help me to become eligible for some initiatives or that I could give it to my employer, but they told me it would cost more than double the advertised cost and there would be a eight month wait. I read that the Ancient Greeks had a rule whereby disagreements were forgiven after seven years. I think this has basis in human psychology. As I have been trying for roughly that long to relieve my distress but it hasn't gone, I think there is simply something wrong with the system in which I must live. Obtaining a diagnosis could be a way of protesting against it.

[P12]

Two days ago I had a small win when I discovered that someone I have known for three years shares my interest in fracture mechanics. I think he is the only person I have met organically who shares my interest. It made me feel a little better.

[P12]

In two days time I will attend my next meeting with my Clinical Psychologist. It is our first meeting for three months.

I am going to try to express the major troubles I have at the moment, in the hope that she can give me some high level guidance. I don't fully know how to interpret my troubles, but I think that if I did I would feel better.

- Roughly one month ago I experienced a mental breakdown. It came from receiving two pieces of distressing news in short succession, after a build up of smaller pieces. I felt like my heart broke because despite the huge effort it puts in, it could not cope. I suppose it could have handled one but two was too much. My emotions were out of control. At the peak I cried while trying to sleep, slept for only three hours because my mind and body were overloaded, then cried when I woke. These feelings and symptoms remained for 1.5 weeks. I have had experiences like this once or twice a year for several years. I think they occur because my subconscious mind thinks much faster than my conscious mind, and prevails in making me realise that I am simply not achieving my goals and sadly there is little I can do about it.

- Since our previous meeting I have made an appointment to try to receive a formal diagnosis. I think that while theoretically it is not necessary because I suspect the paper will not tell me what I don't already know and do, practically I am hoping it will help me progress, especially by helping me accept myself, and serving as a milestone that I can be proud of.

- Also since our previous meeting I have held three meetings with two other practitioners, and I have two more planned in the two weeks after our meeting. One is a Psychologist with a slight speciality in my apparent disorder. One is a Social Coach. I have also held approximately five meetings with EAP counsellors since the beginning of the year. I have often been told that seeing a practitioners more regularly could help, but resisted it. Now I have tried to embrace it more.

- I feel lingering discontent. I experience both positive and negative events, but recently the effect of the negative events seems to be a bit disproportional

- I have decided to adopt more of a "so far as is reasonably practicable" strategy to my life in the past month. The principle says that if you do everything to the absolute fullest extent that you can, eventually you will be content because you have exhausted all options. Unfortunately because my brain 

- I continue to have difficulty understanding ACT. It seems to be fundamentally at odds with my beliefs about progress.

- I am feeling that I need to revisit my first Clinical Psychologist in some way, because his more direct approach has benefits that my current Clinical Psychologist does not, though I haven't determined how to do it practically, because my MHCP is addressed to my current Clinical Psychologist and the cost of seeing them privately would be high.

[Croix]

Dear P12~

I can sympathise with your difficulties if you feel your current psychologist is not giving you what you  need. Under Medicare Mental Health Plan I believe you can return to your referring GP and ask to be referred to another psychologist wihtout losing any of your remaining plan visits.

I suggest you talk over the matter with your GP, after all you should get the most appropriate therapy.  If you have a particular therapist in mind it might be worth first seeing if you can afford the gap fee they charge.

My own experience is that I have to have a good relationship with any therapist and also understand what is wanted and in time see some sort of benefit. I have in fact (though not though the MMHPH) changed therapists with my doctor's approval when I found the existing one was actually not helping. I've felt much better wiht the new one.

A while ago Nurse Jen (a Beyond Blue staff member) addressed this very point, and while some conditions have changed I think this point still holds true:

https://forums.beyondblue.org.au/t5/treatments-health-professionals/mental-health-care-plan-changing...

I hope this helps

Croix

[P12]

Thanks for your suggestion, Croix. My understanding of changing practitioners is similar to your's. I have completed the process previously.

Here is my update:

- Overall, I feel confused about my recent meeting. She appeared a bit questioning and afterwards she gave me email feedback.

- I feel she is trying to suggest that we aren't well suited and I may be better suited to a different practitioner.

- She appears to be recommending that I focus on one practitioner and one treatment method to the full extent. Using CBT and ACT concurrently is likely to cause conflict, which causes distress.

- I do agree that if I do everything to the fullest extent I will eventually receive contentment by the method of exhaustion. I have found this law in several aspects of society. However, my perspective is that the fullest extent extends beyond one practitioner and one treatment method. For example, by questioning the limitations of one treatment method and therefore using two concurrently. I believe conflict is a central part of society, e.g. in class struggles.

- She appears to be persistent in her approach and confident of herself regardless of what effect that has on others. e.g. the concept of monogamy. However, I am naive about it.

- However, I think I will try to persist with her, at least for the duration of my current MHCP. Learning her treatment method is difficult because it doesn't come naturally to me, but I can see that its principles are theoretically sound, even if practically I question some of its effectiveness.

- ACT says to simply allow life to pass without action or judgement. And only acting on one's values. It is possible to interpret it as saying that life is meaningless. If everyone followed their values fully they would not interact. Sustainability would occur. But because the world is highly populated, greater intellectual effort required to remain independent. Sustainability requires great intellectual activity, perhaps more than one's brain can withstand.

- I am beginning to think that I genuinely am something of an outsider. Socially I feel I have reached the age where many people have succeeded, though I haven't. My mind thinks far more abstractly and slowly than almost every person I have met is willing to accept. I guess I just need to wait for them to come out the outside side and continue my relationship with nature while I wait for situations to return to my favour, though it might be decades.

- I am going to try to speak more at our next meeting. I am going to try to express the thoughts and feelings in my mind more fully to try to establish greater compassion.

- I have two other practitioners who I have visited for the past two months. I feel their slightly more direct methods complement the guidance I receive from my Clinical Psychologist.

- The direct methods are about what else I can do to achieve my goals. What makes me upset and what would make me happy?

- I will keep using trial and error to search for other who mutually want to spend time with me.

- I will remind myself that true and strong values permeate all aspects of life, and that if I believe in them I will find ways to follow my interests if I keep looking long enough. Governments and businesses value all values, but some are prioritised more than others. Work is a large portion of my life. Most people don't intentionally exclude me and value differences. I can explore ways to benefit from this, it just requires substantial effort because it is adverse to popular methods.

- I can persist with volunteering exercises, though I have not found designated volunteering roles in my interests.

[P12]

Today one of my psychologists did not attend a meeting we had scheduled. I went to the venue but it appeared to be closed. Then I sent them an email but I have not received a reply. I don't have their phone number. I called the Beyond Blue phone service seeking a advice on what I was planning to discuss. I was asked what I could do today to make a small step toward achieving my goals. I said I would try to find the reason why my psychologist did not attend and I would search for another service which could provide me equivalent support to compensate for the cancelled meeting. I was asked why I sought support. I said I would like to achieve my goals, but I have encountered obstacles imposed by others, which have made me traumatised. I was asked to focus on actions that are in my control. As I have taken from work to attend our meeting and the time it will take to find equivalent support and overcome the trauma I have received in trying to overcome the obstacles is dispropportional to the benefit I will receive, I think my disillusionment with mental illness and life in Australia is justified.

[P12]

Apparently some people find success after several years of trying to achieve their goals. However, I am still trying to achieve mine. So I would appreciate if you gave me time. I am going to keep trying to achieve my goals even if it takes me the remainder of my life. I would like to have confidence. I have learnt cognitive skills to create delusion in my mind. But ultimately I fall short because the world is real and I have little practical skill. I have learnt how to be friends with God and nature. I wish I could make a human friend, but I haven't met someone whose mind thinks as abstractly as mine, therefore most people prefer to spend time separate from me because they think I am strange. I would like to study nature and share my insights with others, but I haven't learnt how to stop other people from damaging nature so that I can study it, and I don't know of anyone who appreciates my insights.

[P12]

Generally I have felt fatigued recently. I think it is largely because I am performing a work role where few people think the same as me so I am constantly in opposition. My head hurts. I wake in the middle of the night with my head spinning. Then when I wake in the morning I am drowsy.

I feel better about my most recent meeting with my Clinical Psychologist than the previous one. We have now held nine meetings in sixteen months.

I also feel positive about my two meetings in a mentoring programme in which I am participating.

Though my effort with both doesn't seem to have any effect.

I have a meeting with my social coach scheduled for tomorrow. I can't say I have made any recent progress in my goal of making a friend. It seems most people I meet are unwilling to speak with me at all. Of those who give me a chance, it seems most ignore me when they discover my disorder or because of my religion. Some advisors recommend I might find a friend in those groups, but I feel like an outsider there too because I don't seem to have the same beliefs as the people I meet. I don't understand this strange aspect of society.

I guess I am strengthening my friendship with God and nature by becoming more lonely of human friends and by creating imaginary friends with people I've met who I would like to befriend but whom appear to reject me.

[Croix]

Dear P12~

Please excuse me if I intrude on your conversations, I'm not familiar wiht everything you have said or the advice you have received. So if I repeat something already said or misunderstand something you mean my apologies.

The reason I'm responding is a couple of things resonated wiht me. You appear to have a number of clinicians whom eihter your are seeing at the same time ,or are still perhaps influenced by ones you have used in the past as well

I to have has a number at the same time GPs, psycologies and a psychiatrist, and there is no way that they all said the same thing or make the same recommendations -not even on selection of medications, let alone therapy.

I now have multiple GPs, who I leave in charge of medical matters, a couple of specialists on unrelated medical matters  and the one psychiatrist and I find this combination lets me feel much more in charge, much more able to have my own views, and not try to sort out conflicts. It also means I can seen the effects of less medications more clearly.

I would be the first to admit it is not ideal, my psychiatrist has ideas I"m ot 100% in favor of, and I have been allowed sufficient room to say yes or no. With the GPs it is a function of the way the medical center works, and by keeping my own notes I'm able to steer matters towards consistency.

I do not think any 3rd party, no matter their qualifications, is going to see everything my way, however I'm not sure that is necessary, it can be worked out. It is certainly less worrying not to have to try to understand and adhere to multiple views.

I also feel that in social life the same applies. I'm lucky enough to have a partner and we are very different on all sorts of matters, from religion to food - with very different interests. In a way it does not matter. We love and enjoy each other's company and rely on each other.

I truly believe kindness and empathy are the most important things, and if others hesitate at your beliefs, then it is their lack -they are not seeing the whole intelligent person wiht wide ranging capabilities and specific beliefs. On does not have to be anything like the same.

Please try not to imagine how a friendship might go, firstly because you might then find real life does not match and secondly because it only has your input, and real relationships have two. Love of God and nature are not necessarily a divisive force.

I hope things become more comfortable for you

Croix

[P12]

Hi Croix,

I appreciate your support. I am interested in your insights. Would you be willing to clarify some of them?

You say that I should avoid setting expectations for a friend and instead be more accepting of what presents. How do you recommend I obtain a friend? I have been trying for 14 years, and especially for 7 1/2 years.

I infer from yours and others advice that physical pleasures will not bring me joy because they are unpredictable and short term. However, while I am alive I am able to experience pleasure and I think my body and mind naturally seek it. Is the advice suggesting that I avoid obtaining pleasures and instead seek intellectual joy?

I think avoiding physical pleasures causes psychological distress. It also seems to suggest that there isn't any purpose in being alive, and that the purpose of life is to wait for it to be over, because more joy can be obtained after life when only intellectual joy can be obtained.  However, I know this is contrary to most advice I have received!

I have many imaginary and unreciprocated friends which makes me feel sad. I have not determined how to make a real friend.