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From psychiatrist to psychotherapist


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Hey guys... I haven't been around on here for ages. Like I tend to do, I put my finger in my ears with my mental health issues as soon as things felt slightly better which also meant no longer frequenting CB... maybe someday I'll learn that the head-in-the-sand tact doesn't work because everything has come crashing down around me. I'm more anxious than I have ever been in my life and not functioning the best. 

 

So I've decided to finally try talking therapy for the first time in 4 years and for the first time ever I feel like I could actually commit to it.

 

The problem is at the moment I see a psychiatrist who is focused on the medical side and would ordinarily refer me to a psychologist within her clinic, however my dad who is bankrolling my therapy says he doesn't see the point of a psychiatrist that isn't also for therapy and wants me to find a psychotherapist... my sister has agreed with him saying that the kind of therapy she got from her psychotherapist has been much more helpful than previous psychologists.

 

I was wondering what people thought? I have had really really awful experiences with CBT in the past so I'm not looking down that road which is what my psych suggested... but at the same time I get major anxiety with doctors so given I have a psychiatrist I like I kind of am a bit scared of having to find a new one.

 

Cheers!

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Most psychiatrists no longer do therapy as they are trained as medical doctors. It was more common in the 60's-70's but now such docs are few and far between. I've seen psychiatrists for 30 years and never encountered one. Of course only psychiatrists can write prescriptions, at least in the US. 

Edited by notfred
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Actually, notfred, that is very dependent on your country and area.  In my country, many pdocs do psychotherapy and a significant portion of their training is devoted to it.

 

Alllowercase - honestly if you have a good psychiatrist for the medical side, who knows a good psychologist who can see you - that's a good set up.  Have you asked your psychiatrist to talk to your father and explain?  In some ways it is more efficient to have one person do both, but there are drawbacks too.  Perhaps you could see a psychologist who does something other than CBT?

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notfred - just to echo what tryp said. Where I live its kind of like one in four psychiatrists are also psychotherapists. The psychiatrists who also do therapy have done a lot of extra training. 

 

Yeah I have a catchup with my psych soon so I'll see what she says.. who knows she might even agree about switching? I'm getting too old for her clinic regardless as they focus on young people..

 

The other issue is that in Australia you can claim sessions with psychiatrists from the gov't but not psychologists after the first 10... bizarre rule but true. So if it's going to be a long term relationship I'll have to look at how the dollars will pan out too. 

I just hate all of this. When it comes to medical professionals I kind of hate them until proven worthy of not hating... 

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DBT has been suggested for me by my pdoc but I just don't know how open minded I am. I want to give it a try because it's helped my mum and sister a lot but the problem I had with CBT was all the buzz phrases like "negative self talk". I understand DBT is very like that so I don't want to waste my money on something I don't think I will let help me (I'm completely aware it's me blocking it not the therapy itself)

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When I was considering going into CBT, I read a book called "A Guide To Rational Living" by Albert Ellis. It was helpful and spurred my decision to do CBT.

 

The point being this: why not try a DBT self-help book first and see if it might be beneficial for you?

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That's actually a really good idea Lemon. I might look up that one you mentioned too because I think that given I haven't had CBT since I was 20 I should try and give it another go if my doctors feel confident that is the best thing for me... Maybe I was just using up the last of my stubborn teenage-ness in not wanting to engage in the process. 

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It's the same in Canada - government reimburses psychiatrists but not psychologists.

 

About DBT - I have BPD and I hated CBT - mostly for the reasons that you said.  It seemed very cold and clinical, and it didn't seem to address the root of my problem - which is really feelings.

 

Even though DBT has some cognitive behavioural roots - it's actually very different to experience.  I am doing it now and I find it extremely useful.

 

I agree about looking at a workbook - which one I would recommend depends on your specific needs.

 

There is a green Dialectical Behavioural Therapy Skills Workbook that is very popular - but if you want to know what DBT therapy is actually like, and you have enough background to get into it, I would actually recommend reading Linehan's original works - Cognitive Behavioural Treatment of Borderline Personality Disorder (big red book) and Skills Training Manual for Borderline Personality Disorder (little red book).  The former is directed at therapists and is very theory based, so maybe not so good for your purposes.  But the latter is the one that all the DBT handouts that you would get in classical DBT come from, so you can take a look there and see.

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