Bipolar 2 From Inside and Out

Posts tagged ‘therapists’

Naming Names

A lot of us I know write about our bipolar disorder or other mental conditions, whether it’s in a letter, journal, blog, or elsewhere. One of the problems that comes up is how to refer to other people who have affected your story or been involved in your life.

When I blog, for example, I try to disguise – at least thinly – the person (other than me) I’m writing about. For family members, I usually leave it at “my sister,” “my mother,” “my aunt,” “my cousin,” etc. Admittedly that’s not much of a disguise, as I’m estranged from my sister (which is a story I’m not likely to tell) and my parents have both passed away. But I have only one sibling and two parents, which makes their identities easy enough to guess, if you know my family at all.

My husband I refer to as Dan, having gotten his permission and never using his last name, which is different from mine. And my doctors I simply call Dr. G and Dr. B, or “my psychiatrist” and “my therapist.”

For friends or others who have affected my life, I invent pseudonyms, usually beginning with the same letter of the alphabet – Brandon for Bob, Joan for Julie, and the like, or a descriptive phrase – my friend the artist, my friend the writer, the rotten-ex-boyfriend-who-almost-ruined-my-life (I assure you he would be unable to recognize himself from that, even if he read my blog, which I’m sure he doesn’t). Some of these people are vital to my past, my present, and my stories, but I don’t feel I have the right to divulge their names.

If I write about these people in my other blog, the non-bipolar one (butidigress.blog), I might – and sometimes do – call my friends by their first names: Peggy the artist, Michael the writer, or sometimes leave them anonymous. In those blogs, I mention them with no pejoratives attached, or I use pseudonyms if I do.

When you’re writing in a letter or a journal which someone else might read (journals are not as sacrosanct as you might think or wish), it’s hard to avoid naming names. Once I was writing in my journal and a nearby person happened to glance over my shoulder and see what I was writing. Or you might let your therapist read a few pages of your journal to explain a situation that you were reacting to in the past. That’s safe, though. Your therapist is your therapist and not allowed to discuss your case with anyone you know.

Letters, however, are dangerous. First, there’s the kind that your therapist has you write to a person who hurt you, for example, as an exercise on how to express your feelings. Never send these letters. Even if you want to tell the person exactly how you really feel or felt, your raw, uncensored emotions and view of events are more likely to do harm than good. Especially if you’ve been in an abusive relationship or have been gaslighted, never reach out. It gives the person another way to be involved with your life, which is what you don’t want.

Then there’s the possibility that whoever you wrote about accidentally reads the letter or journal. This can ruin whatever chance you might have had to repair the relationship (if that’s what you really want to do). Tear letters up, delete them, put them in a file called Never Send if you feel you must keep them to remind yourself of how you felt back then. But don’t send them or show them to anyone other than your therapist. (And keep in mind that your letters can be found accidentally, or after your death.)

I have known a couple, one of whom wrote to the other to present an ultimatum, and it didn’t work. The oblivious partner simply ignored it, which you’ll understand also caused great pain. It was a significant factor in breaking up their marriage. They were both, by profession, supposed to be good with words, but in this case, neither writing the letter nor reading it succeeded.

I suppose it’s time to resurrect that old adage, “Sticks and stones may break my bones, but words will never hurt me.” When used to “encourage” children who have been bullied, it is a lie. But keep in mind that your words can definitely hurt someone else – or yourself – too. Try not to do that.

When Your Therapist Tells You What to Do

The classic examples of non-directive therapists are Sigmund Freud and his disciples, who legendarily sat at the head of their couches and made comments like, “Hmm,” “Tell me about your dreams,” and “How do you feel about your mother?”

Freudian psychiatry is, thankfully, now out of vogue. But there are still therapists who believe that their job is to listen, not to instruct.

On the other hand, there are more directive therapists who assign homework. This can be anything from “Listen to this podcast on mindfulness” to “Write a letter to your ex telling him/her what you truly feel.” They probably won’t tell you to kick the bum to the curb, but if you decide to do so they’ll help you prepare for it.

But, although I am far from a Freudian and shy away from those who are (not many these days), I prefer non-directive therapists. I am not averse to doing a little homework or having a therapist ask me in a session to vocalize what I would like to tell a person or even to write a list of the coping mechanisms I’ve developed. My preferred dynamic, however, is to give-and-take with the therapist and then go home to contemplate what was said and how I feel about it.

I have had therapists who have given me homework and I can’t say they were wrong to do so. Sometimes writing something down or throwing teacups against the basement wall (or whatever helps you get your anger out) is a good thing.

My most recent therapist was a combination of the two. She mostly listened while I rambled on about what was happening in my life or what had happened in my past. Then she suggested ways that I could think about the events or pointed out coping mechanisms that I had developed or suggested ways I could put those coping mechanisms to use.

All in all, I felt that our sessions were mostly non-directive. She did suggest that I listen to a podcast on mindfulness, but she never quizzed me on whether I did and only listened when I told her what I got from it. She never told me that I should delve deeper into mindfulness or listen to more podcasts. She left that up to me, if I thought it might be helpful.

I understand that some therapists, particularly those that work in community mental health facilities, are required to file treatment plans and I can see where giving homework can flesh one out more than “talk about feelings.”

Perhaps there is something I’m missing. Perhaps at different stages of therapy, directive psychological interaction is more beneficial. Perhaps my particular problems lend themselves more to non-directive therapy. Perhaps I just have an aversion to being told what to do, especially where it concerns my memories and my feelings.

Of course, everyone has the option not to do the homework. This can be seen as resisting treatment, or disagreeing with the treatment approach, or simply lacking the wherewithal to carry it out. Sometimes it may be more helpful when the therapist sacrifices part of the session to doing the assignment there instead of leaving it to be done at home. In this case, the therapist is being really directive, though of course the client always has the choice not to do the assignment. It’s much harder, though, when the therapist is sitting there waiting for you to make a list of your dreams, your feelings, or your interactions with your mother, or to bash an empty chair with a pool noodle.

What it comes down to, basically, is therapeutic philosophy and therapeutic style. And a client is not bound to pursue whatever style of therapy that is favored. Although it is sometimes difficult to realize, a client has the option to request or to seek a therapist whose therapeutic style matches what the client feels is most helpful.

Remember, your therapist works for you, not the other way around. If you need a more or less directive therapist, it is your right to seek one out. Therapy has been known to stall and a different approach or philosophy may be just what you need.

 

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