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The buffet

February 25, 2009

As assessment for therapy is like a buffet for the therapist: The plates are the client, and they pick and choose what they wish, as they wish. By this I mean that all the plates are areas of your life, so for example today my therapist was talking about the 5 main causes of depression: family, social, work, economic and relationships. So 5 plates on the table. Pick a plate as you wish, then you can talk about it. She’s had a feast, seeing as we talked about all of those and more. I told her straight up about my eating, how the last week had been and she’s written it down, in the notebook of doom. TBH, I don’t mind people writing, as long as they’re going to use it to help me. The thing with today though, is that after tasting all these plates, she spat them all back onto the plates. So now, my head is a bit jumbled, confused and trying to put all the food back on plates.

First of all, we’re going to look at my routine, and getting things into it that I enjoy, and make me feel that I’ve achieved something. I did this when I first started with the MHW, and it’s hard to realise you’ve lost sight of that technique; it slips gently from your mind, like a satin slip from the body until you are feeling helpless; you can’t remember what to do. I’m going to try, try because it’s what I can do. I’m going to give this a good shot; in comparison to counselling, I think this is what I need. At counselling we discuss things, but nothing ever comes from it; I feel there I already know the answer anyway, seeing as I’ve already reflected upon it before. I’m thinking about counselling, whether to continue or not. Last night, we sat in silence for the first ten minutes or so, she didn’t say a word. Then we had the good old debate about the role of a counsellor. Finally we actually got somewhere, after I’d told her what to do, and it felt pretty alright. I’m just not sure, I’m still a bit annoyed she sits in silence and doesn’t say a word; it makes me angry. We talked about how I never take the lead, she asked whether I do in friendships, then she asked me about my ‘friendship’ with her. I told her it was a professional relationship, it’s very different and she looked a bit confused. Is she trying to be my friend? If so, I’m scared!

10 Comments leave one →
  1. February 25, 2009 5:48 pm

    If she is trying to be your friend you should be scared. There can often be silences in counselling (or therapy) but ten minutes is just silly. It sounds like she doesn’t know what to do, or she knows and hasn’t the confidence. It’s not surprising that nothing ever comes of this.

    I don’t think of assessment as plates of food — more like finding a jigsaw puzzle and turning over all the pieces. And yes, some pieces always seem more interesting than others. Those are the ones to start with. Did she really find none of your pieces interesting?

    The five main causes of depression? Tripe. Er…sorry…tripe in my opinion. Even so, it’s great that you feel good about what she’s proposing.

  2. February 25, 2009 6:25 pm

    I’m with CBT: it sounds very simplistic and she seems to be characterising your depression as reactive, but if you feel positive about it then good stuff.

    As for therapists and silences, urgh.

  3. February 25, 2009 6:37 pm

    ten minutes of silence? eeek. x

  4. February 25, 2009 7:36 pm

    The silence thing isn’t just counselling I’m afraid – I have psychoanalytic psychotherapy, which is like the hard-core variety of therapy, and my therapist doesn’t talk when I don’t. I hate it! I’ve sat in silence for half an hour before!

  5. February 25, 2009 10:28 pm

    CBTish: I’m considering stopping the counselling; I’m not sure what’s coming from it, well apart from me missing climbing and spending 2 and a bit of my evening getting there, being there and then coming back.

    To me it didn’t seem like any of them stood out; we discussed each of the 5 things in quite a lot of detail, but it seemed she was pretty hot on me telling my parents, but I soon put a stop to that. So she just settled for routine thingy. I just see all the enquiries as something to understand me better, so she can make it all more specific than poking around with a stick for things which may, or may not be relevant (a la beating the blues style).

    La: Yeah, I think she is. Even if it turns out that it isn’t reactive, I’ve still had a chance to work on things. Perhaps it is reactive, I mean this time around I feel it began after my assessment for the first CBT, so is kinda reactive. I dunno really though.

    Ruby: Yep, ten whole mins. The carpet was very interesting.

    Into the margins: half an hour?! I’d be fuming at the thought of wasting time! And the long name sounds a bit scary!


  6. February 25, 2009 10:41 pm

    On the contrary, psychoanalytic approaches are the most soft-core. They take much longer to work than more modern forms of psychotherapy, they are much more likely to fail completely, and there is greater risk of dependency.

    Instead of sitting in silence for that length of time, you would be better off going for a coffee and returning in half an hour to continue the session.

  7. February 25, 2009 10:51 pm

    In CBT theory all depression is reactive. It’s just called “reactive” when the thing that it’s a reaction to is obvious, and “endogenous” when the thing is not so obvious.

    The point of therapy should be to identify what the depression is a reaction to and fix the source of the problem. Poking around with a stick does not seem to be a good way to identify anything, though.

  8. February 26, 2009 4:40 pm

    I know poking around with a stick is useless, that’s why I stopped with beating the blues! It seemed completely pointless to be doing it when it wasn’t getting at what I needed.

  9. Lola Snow permalink
    February 27, 2009 9:06 pm

    I prefer the buffet analogy. I didn’t fancy anything on the table, but ate it all anyway and then threw it up again because it made me feel sick.

    I used to get the silence thing a lot from first shrink. Sadly he misunderestimated how stubborn I can be, and so he usually gave in first. Try humming and if she says anything, tell her it’s “hold music”. Or whip out a pocket notebook and have a game of suduko whilst your wait.

    Lola x

  10. February 27, 2009 9:15 pm

    I like the sudoku thing! Ultimate insult me thinks! xx

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