Some questions about psychologists and counseling

[MRivers]

1.How many is too many?

I have been to 5 different counselors/psychiatrists over the past 10 years or so. The worst of them (who I was able to get a partial Medicare rebate for) seemed to be a narcissist and I stopped seeing after about four sessions.

The best two the most expensive. One of them who would have been my first choice is no longer in practice, the second choice I would be happy to revisit, but I would be limited in the number and frequency of appointments due to the cost.

The other two were bulk billed which leads to my next question:

2.Bulk billing psychologists: Do you get what you pay for? The two I saw were not particularly inspiring and hard to connect with. One I found to to be too confrontational and the other seemed to stick to a routine or plan so to speak and continually went over the same ground.

3.Can the (depressed) state of mental health we are in influence our view of the professional's ability, and also distort our expectations of the healing process?

I realize there is no silver bullet, and there is a lot of hard work to be done. To be fair 4/5 of the above professionals has given me good advice in one way or another. I have tried to apply these ideas in short bursts but each time I feel I have come out of the hole I seem fall back in. Will there ever be a time when I can climb out and plug the hole for good?

[Sea_Turtle]

Hey MRivers’s

Iv’e had four psychologists, well one wasn’t but I was 17 and we thought she was. She was a councillor, it wasn’t a good experience.

I ask myself the same questions as you have put above. I have seen two private and two public, I connected with one he was in the public system and met me just before I landed in hospital for six months. I was very depressed at that stage.

At a guess, and trying to be logical, there’s probably good and bad in both.

As for point 3 my loved ones seem to think so.

I have had OCD my whole life with a late diagnoses, major depression which is now controlled and I have an ED. I think I should go back and see someone, as certain things aren’t going good. But my mind says that they’ll just tell me what I already know and what if they don’t understand me.

For me depression has definitely got better. But as for the mental health hole in general I really hope so.

this probably won’t be helpful at all. But I hope relating helps.

take care

[mmMekitty]

Hi MRivers,

I've seen Psychiatrists who work from private practices, but I am grateful for Medicare rebates. I could not afford to pay my current Psychiatrist without it. I will pay so long as I can, because my mental health is a priority in my life. The current fellow I see is what I want: not arrogant & self-absorbed, like one I saw before, offers me weekly 50min sessions, unlike another I saw before. She had her good points at the ime, when I needed some help with some practical matters that needed to be cleaned up. But I would not have continued with her for much longer than that. That terrible man I saw before worked both in the public & private system when I had first met him.

I had initial appointments with others in the private system, trying to find one like the guy I met when I first began seeing him in 1993. He left for another capital city far away, so I could no longer see him. I had liked how he treated me, so patiently & giving me all the space in the world tobegin to talk. I realised that had been exactly what I needed back then.

My current PDr is a lot like him, not saying a lot, but he does say more, he will seem to relax more with me, sometimes, I think...it's when I am feeling more relaxed with him (? I'm still thinking this over). He has shown me the best care & compassion,such as I had not expected. He explains why & how very well, like when we were to begin meeting via the phone, & why he isn't seeing people at his practice. &so much more, but NEVER breeching boundaries.

Along the way of becoming Psychiatrists, many, if not all, will have a turn at practising within the public system, for the experience, like any other Doctor training itheir specialty.

I hope this helps, & you do find someone who can work with you, & you with them. You will likely form a significant relationship with this person, so it is important to try to find someone you can relate to, & who seems to understand you, too. You may even be able to negotiate a reduced fee. My PDr has discussed this with me on a few occasions, knowing how difficult it was for me. This, too, is something I am learning from him.😺

mmMekitty

[smallwolf]

hello.

you ask, in some ways, what could be difficult questions to answer. Each persons experience is may be different to the next person.

You also mentioned three groups of the therapists (for lack of a better word) but I will give you my 2c worth for what it matter and based on my experience.

firstly, I see both a psychologist and psychiatrist. (This is just the way my GP works via referral to experts as needed.) The psychiatrist leaves all the head stuff to the psychologist. However, will also provide insight on some matters as needed. Remember they also have different skill sets. The counselor covers other stuff that may not warrant a psychologist?

I was listening to a podcast and the guest speaker was one of the inventors of CBT. He position is the effectiveness of therapy is largely dependent on the relationship between the therapist and client. Otherwise known as rapport. A good relationship will likely lead to a better outcome. Still no guarantees however.

And then... if the goal is to be normal or better, then how to define that? I have given up asking that question as my psychiatrist would reply "what is normal?"

Some people might like the confrontational therapist. I personally would not. I would dread having to go there each week or whatever period.

Going off topic... I have been to a bulk billing eye doctor and found them to be extremely good. Easy to get along with, helpful etc.

In the case of a therapist, I feel that because you will be telling them things you might not tell other people, you will want to feel relaxed and that you are in a safe space. If you are not getting that then ..... ?

[MRivers]

Thanks so much to each of you for taking the time to reply and also to mods for assisting me with getting these questions posted.

To clarify, as far as terminology goes perhaps I should have used psycotherapist? I'm still not completely across the correct title to use (psychologist/counsellor) or whether these are interchangeable.

I'm finding much of the assistance I obtain on these forums is to hear other peoples experiences, whether they are in congruence or a complete contrast from mine, and to know that it is the human experience to often see life differently to others, and that it is ok.

More specifically as each of you touched in is that it is the relationship with the counsellor that is a key factor. This is perhaps a significant reason for my continued "searching", as forming close relationships with others has always been a struggle for me, and due to recent (and ongoing) events my trust in others has taken a severe blow.

As I mentioned I will look into reconnecting with one of the private therapists I have previously seen, and connected to the most, only it will need to be telehealth as I have moved from his area.

[romantic_thi3f]

Hi MRivers,

Thanks for your post and great questions here.

1.

Only you know the answer to that one! I have seen quite a few over the years; some I clicked with, some I didn't. It's just too expensive to go with people that you don't click with.

2.

Honestly, I don't think so! The one I'm seeing is brilliant and not bulk billed, but she used to be and financially wasn't able to sustain that. Which for me is the proof in the pudding that it really comes down to the person that you see. Actually my psychiatrist is bulk billing me and he's the best one I've ever seen.

3.

Absolutely I believe it can. Although I suppose that varies- there's probably a fine line there between trusting our own instincts and logically reminding ourselves that we aren't always thinking straight.

I've seen some terrible therapists, and it sounds like you haven't seen spectacular ones either, but it's not always a waste of time. Sometimes even if you don't click with someone or they rub you the wrong way- you can learn more about yourself and what you want and need with a therapist. If you were to decide to find someone new, you now know what you're looking for and the approach that you need.

As for the lingo, psychotherapist and counsellor is interchangeable, and psychologist has its own title. Psychologists by law, have to be registered and accredited by boards. Unfortunately counsellors don't (yet!)- which unfortunately means sometimes people can call themselves a counsellor when they aren't or don't have training.

Best of luck with finding the right one for you.

rt

[David35]

These are just my opinions based on my own experiences. Psychologists are 4-year degree qualified, minimum, some more with Masters degrees. Counsellors have varying levels of qualifications and the professions seems to therefore foster a greater variation in quality.

1) However many it takes to find someone you "click" with.

I had one for grief. He was helpful to begin with, but then tried to persuade me to go on dating sites and meet an immigrant to help with my lack of self esteem. He started only seeing me for 10-15 min and yet charging Medicare for 1 hour. In the end he called me autistic and socially awkward in an attempt to get rid of me. He was eventually investigated by the Deparment of Health.

I saw another one (counsellor) for 2 sessions and once he learnt I had a brain injury wanted to charge me $3500 because a colleage of his could do a full psychological assessment. When I said no, he emotionally blackmailed by saying things like "Well you don't want to be in this situation for the rest of your life do you? Why don't you want to reach your full potential?" I cancelled and he became aggressive towards me.

I had another one for panic attacks associated with mum's cancer. She was okay but started insinuated that I needed to break away from my mum, because she was a negative person and she was a bad influence on me. Bearing in mind that at the time, she had cancer and needed my support.

So my advice is to steer clear of counsellors but to see a psychologist, preferably with a Master's degree. Good mental health professionals put your mind at ease, then don't antagonise you.

I'm currently seeing a pyschologist who is far more intelligent and understanding, but more expensive too. If it is a more medically based problem, a psychiatrist may be better. In the end, you only get what you pay for.

[tmas]

It really depends on the professional. I can’t even count the number of people I’ve seen… at least 5 psychiatrists and at least 8 psychologists/counsellors. the truth is that you just have to find one that gels with you.

Admittedly I saw most of these people as an adolescent, so step one make sure they are age appropriate in both their knowledge and their demeanour. Even adult therapists can be infantilising and it’s really bad for self esteem particularly when depressed.

The best psychistrists I’ve seen: one was bulk billing, though I only saw him once or twice and he handed me off to someone who was also very good (not bulk billing). They both cared about my wellbeing (in the capacity of a doctor) and explained the process.

The worst psychiatrist I’ve seen was also bulk billing, until she wasn’t, which she actually didn't tell us until we started getting bills that we were told not to pay by her, and then the RECEPTIONIST had to explain that she was removed from the public system, and didn’t know my age(BB under 18)!I had a rough patch and ended up in ER in crisis and she could not be contacted, bc she was on a holiday. Finally got to see her and was berated for not talking up sooner - this appt was 2 weeks after ER trip but had been booked for 6 weeks (the earliest we could get bc she worked two days a week and kept taking on new patients). Found out she had been meddling in my relationships too. Once she went private she got WAY too experimental.

This is a major horror story, and I don’t mean for it to scare you. So here’s a miracle. The best therapist I’ve had (also private) was a game changer. He took lengths to tailor the therapy environment and conversation style and ensured I was comfortable, even offered to reschedule without charge when he saw my location wasn’t private and people could hear me (when we ended up on zoom). He took lengths to make our sessions at the exact same time every week in the same place for the sake of my routine and was empathetic and extremely intelligent, but never belittling and allowed me to be honest for the first time. Best thing I’ve ever done.

Honestly, there are dr’s in the public system who care, and private ones who don’t, vice versa. Find someone who works for you and don’t stay in a situation that makes you uncomfortable. If able, raise the discomfort with them bc even a good doctor can't read your mind, but they can work with it. Some priv dr’s have more flexibility, but not always, it varies between dr’s.