Tag: Therapy

Posted in Community, science, Therapy

A Broken System: What We Can Do.

Posted on by alidware

I cited an alarming statistic in my post Is Psychology A Science Part 1 (which you can read at the given link) that one of my research professors cited: there are about 40,000 psychological research papers published each year, and, on average, clinical psychologists read about 1 a month. That’s .03% of all research papers. I unfortunately don’t have a statistic for psychiatrists. I’ll work on getting one.

If our doctors are not keeping up with current successful treatments, it means they are also not keeping up with current unsuccessful treatments, which get weeded out in research as well. Remember, the whole point of science is to prove ourselves wrong so we may find what is right. But if we go around thinking we know what’s right (i.e, relying solely on intuition and clinical arrogance), we’ll never investigate what’s wrong. And that’s so backward.

And so the question becomes what can we do to make up for this deficit?

Possible Options:

Educate Ourselves:

This requires us to think differently. Many of us are deep in our pain, and that’s okay. It’s okay to hurt, it’s okay to lack the ability (right now) to do everything you need for yourself. Your goal, at this very moment, is to be kind and compassion to your needs.

Part of being compassionate to your needs is caring for your health. And in order to do that, we often rely on the knowledge of our doctors. This can be more unhealthy behavior however, because it’s giving up our sense of independence and ability to navigate our mind by ourselves.

Some of us don’t have any other option at the moment and I recognize this. When I got released from the hospital, I needed my doctors to listen and manage my medication. They at least managed my medication. This was productive for a crisis. But not sustainable as long-term treatment. It’s not studied for long-term treatment.

Educating ourselves and participating in our treatment can enhance our wellness. If you have access to a college student, or are a college student, primary sources are the best form of knowledge. If this is unfamiliar territory to you, take a quick glance at one of my other posts How To Read A Psychological Research Paper.

If you are not a student and don’t know a student or professional with access to journals, contact me if you want articles on a specific topic. I can provide some.

Secondary sources like textbooks and articles online (including mine) can be okay as long as you take careful note of their references and click on the primary sources they’ve cited. If they haven’t cited primary sources or don’t include references, there’s a good chance the information isn’t reliable.

Any researched information you can present to your doctors and psychologists as ways to participate in your treatment.

Social Media:

This is a strange option because there’s a lot of unreal, invalid information on Social Media. But there’s quite a large mental health community on social media, particularly Twitter and Instagram. Facebook, I’m sure, has one as well. There are researchers who post relevant articles and information which you can investigate.

I don’t suggest spending a lot of time on social media if you are prone to depression. There has been lively debate on whether people spend more time online because they are depressed or if being online too much makes people depressed. Studies are showing more and more that feelings of isolation are increased by online use, not the other way around. Here’s one study. I’m sure there are many more.

If you can balance your health and internet usage, I’d suggest finding people online who model wellness. Not only can you find people who have experienced what you experience, but you can find people who have tried different avenues of treatment and have other perspectives. One of the worst things we can do for ourselves is allow our mindset to be fixed on one perspective.

On social media, there are advocacy groups and pages. You can find programs near you, conventions near you (if that’s something you’re into you), and you can get involved. Giving back can restore a sense of purpose for us, and that is a step in renewing self-esteem.

Think Outside of The Box:

Investigate different perspectives. Build the courage to try new things, not only in treatment but in your everyday experience. For example, my hair was always long, curly, frizzy, and a nice shield between me and the world. I hid behind it in grade school, along with bundling in thick sweaters and baggy jeans, even in the summer. I needed to protect myself because I felt unsafe everywhere and around everyone. When I started shedding sweaters for T-Shirts, I gained a sliver of confidence from it; I was more open and people could sense that. Because people sensed that, they were more likely to smile and/or talk to me.

This month, I chopped off all my hair. The sides are shaved, and the top is a cute, curl-hawk. For me, it symbolized my need to stop hiding. I have to put myself out there, experience new things, make rash decisions, make planned decisions, and enjoy my life. It took 8 solid years of mental health work, psychosis, depression, and deep pain to reach a point in life where I had enough confidence to do this.

And so I encourage all of us to remember if something isn’t working, don’t keep doing. If you are someone who wants to stay on medication and your current medication isn’t working, the next logical step is to try a new one, correct? Treat other therapeutic options the same way. If one type of therapy or therapist or psychiatrist isn’t working, try a different one. If no medication has ever worked, try another option. If you’re tired of living one way, live another.

There is nothing that says we must stay stagnant. There is nothing that says we must endure the same pain over and over again. The only people placing limitations on us is us.

These are only a few things we can do as consumers to promote our own wellness while navigating a system filled with cracks. Feel free to post your own ideas in the comments bellow, or contact me on social media/email. People seem to like DMs on Instagram the best.

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Posted in Emotions, Peer Support, psychology, Uncategorized

Quick Post

Posted on by alidware

Hey everyone.

In an effort to keep this blog rolling and the momentum up, I just wanted to send out an update that because of some bad obsessive anxiety and the resulting paranoia, I won’t be able to crank out my usual post for the day. It was going to be about who we let speak for us in mental health advocacy.

As much as I’d love to do that, I need to take some time today and possibly tomorrow to get myself well again.

In the meantime though, please feel free to give a read to yesterday’s post, “What Is Trauma?” And any of the popular featured posts!

If anyone wants to send some positive vibes on my social media accounts or below In the comments, that’s welcome too. I’ll be tweeting and posting an actual explanation on my Instagram, if you’re curious.

I will resume my usual schedule on Thursday, Jan 9th.

Here’s to all of our wellness and the hard work it takes for us to sustain stability. Thank you to my newly dedicated readers and commentators. You’ve truly been another driving force for me these last few months.

If you’d like to join me on social media, they’re here:

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Posted in Emotions, Supporting Friends/Family, Therapy

What Is Trauma?

Posted on by alidware

Today I’m switching up the format a bit. I’ve been doing lists and tips for the past few days because I feel the information has been important and also relevant to many of our lives (if this is an inaccurate perception, please let me know in the comments below). But today has a different vibe to it.

For the longest time, I believed trauma could only exist in the form of a sudden, violent, physical instance, like a car accident or molestation/rape or physical child abuse. It wasn’t until I was 21 did I learn consistently being told to shut up, to not speak, was a form of trauma. It wasn’t until I was 21 did I learn the three years I spent homeless during my childhood was a trauma. I also didn’t know that growing up with an alcoholic and an addict was a very specific type of trauma.

So what exactly IS trauma?

Trauma Is:

Any kind of repeated emotional, verbal, or physical abuse/manipulation that has caused lasting effects. This could range from something seemingly simple like your mother nudging you to lose weight and consistently commenting on what you eat, how much you eat, and what kind of clothes you wear, to your father threatening to kill you if you told the teacher he gave you a black eye.

The thing about trauma is that it doesn’t effect any two people the same way. Not every person who has experienced sexual abuse becomes a drug addict. Not every person who was verbally accosted spends a lifetime struggling with their self-worth. Not every person who was physically abused grows up to be physically abusive.

Many people develop their own ways to process (or not process) their trauma. Some people want to pretend it never happened, and there are times where that helps them move on. We hear a lot that everyone should process their feelings, but as a grief study in Europe showed, sometimes people move on easier and still in a healthy way by just getting back to life rather than diving deep into their feelings. (I will put proper citation for that study when I can find a full copy; I learned of it through my previous professor).

Some people relive the events everyday and it cripples them. It invades their relationships, their school, their work, their own sense of peace.

Some people, like me, don’t really recognize where the trauma has effected their life or how. I think I talked a little about the trauma around my learning to speak for myself in this post, On Mental Health and Freedom.

Some people are in the middle and can function well, but are haunted from time to time with flashbacks or residual effects of their trauma.

Where Is Trauma Located?

Maybe that sounds weird.

What I mean is, where do you feel the trauma?

Often with mental health, we’re told “it’s just in your head”, and with trauma that’s not always the case. As a hypothesis, trauma can also be felt in your body as physical memories. Now, I don’t have a research paper sitting in front of me to back me up with this, all I have is my personal experience of certain physical attributes presenting when preparing certain memories for EMDR therapy.

When I find a paper that has studied this with a proper research method, I will update everyone.

But, if you have experienced trauma, you may get what I’m talking about. You feel certain things in your body. You may feel yourself separating from your body as the result of a specific memory–we call this dissociation. There may be certain words or attitudes or body language from someone else that may activate a tightening in your stomach or nausea or hot flashes with seemingly no explanation.

For me, one of these things is the “inner child”. The last therapist who asked me to talk to my inner child pulled some kind of deep seeded darkness into the light and whenever someone says the words or I think about it, I break down crying. I’m not sad, it’s just my body’s response. I’ll get warm and my chest will tighten and I have no full explanation for it.

So, it’s not “all in your head”, from my personal experience.

We talked a bit about this at a Hearing Voices Network workshop a couple years ago. We talked about how trauma can cause our mind to separate from our body and how that relates to and can be a catalyst for psychosis.

What this means is that, in approaching trauma, we must consider the whole body experience. We must consider reconnecting the mind with the body and this is often done with grounding techniques, similar to those used for anxiety and panic attacks: reminding yourself you are safe, feeling your feet on the ground, pinpointing areas of your body and focusing on them, or pinpointing objects in the room and saying them out loud.

Is EMDR A Proven Therapy?

NO. You’d be surprised to find that mindfulness isn’t either.

For those who don’t know, EMDR (Eye Movement and Desensitization Reprocessing) is a type of specific trauma therapy in which a traumatized patient is guided by someone trained with specific skills in asking particular questions about a traumatic memory (some of which can feel like CBT therapy) while they move a wand back and forth or flash moving lights. The hypothesis here is that eye movement helps your brain process the memory as a whole.

What I will say, for EMDR, is that studies have shown it works for the majority of people. The problem with the majority of the studies is that they often don’t separate the actual therapeutic content (the therapist leading you, asking questions, guiding you to feel your feelings) from the little lights and wand and all that.

So, in order for a valid study to prove that this therapy works, it would need to be compared with CBT with no lights/wand, Lights/wand with no CBT, the full EMDR package of lights/wand, and guiding CBT questions, and of course a control group of no treatment. Haven’t yet read a study like that. (If you know of one, please send it to me or put it down below in the comments! Please link the FULL research article or at the very least the abstract, not a secondary source).

EMDR is very popular. But so is Debriefing Therapy done after a serious natural disaster/crisis and studies have shown that actually makes people worse.

So POPULAR does not equal PROVEN.

What I will say from my current EMDR experience, is that it’s brought up a lot of pain but it also helped me process an incident at work very quickly. And had I not done that, I think the incident would have stuck with me in a different way. A hindering way.

What is Dissociation Like?

Dissociation can become a way of life for those traumatized, and it can also be a savior. It can pull you through tough moments. I’ve been dissociating regularly, and heavily, since I was 14 and I can say the first few years it bothered me. It bothered me mostly because I wasn’t so aware of it happening until I was told I walked into four lanes of traffic and 3 miles home without responding to anyone.

A lot of the time it feels like you, your essence, is somewhere far away and your body is stuck down here in muddy waters. Other forms of dissociation make you feel like your body isn’t real or that none of the earthly objects around you are real. This can be terrifying for a lot of people, and upsetting.

I’ve been experimenting with turning my dissociation into a profit. Not a monetary profit, but a mental profit. Dissociating has helped me learn to share power with my voices and given me a space I can retreat safely when needed.

Am I Traumatized?

Are you? I don’t know. If you experience some of the aforementioned things, perhaps. I’m not going to tell you what you are and what you aren’t, though. If you feel that there are things in the past that hinder your daily activities today or effect your mood or how you interact with people, it may be worth finding someone to talk to about it.

It took me years to realize that the reason I struggled interacting with people wasn’t because I was strange, weird, or a freak, but because I’d been taught my words were invalid, my thoughts were useless, and I didn’t have any right to speak. That mentality has continued to follow me into my adulthood, and it’s only been in the past year I’ve been able to rationally confront it.

So, as terrifying as facing pain can be, if it’s something you feel you need to get off your chest, if it’s something that’s been keeping you from living the life you want to live, it may be worth working toward gaining a new perspective and reaching out for guidance.

I don’t think I’ll want to talk about all my trauma for all of my life. I’d get tired of being weary over it. But a couple sessions of half-ass studied EMDR won’t hurt.

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Posted in science, Therapy

Exposure Therapy May Drown You

Posted on by alidware

My absence is attributed, this time, to preparation for a presentation that I did for my research course. We had great fun: saturated the Google Slides with relevent, cheesy memes, and presented our failed experiment data and had a great laugh about it all. I’m quite satisfied.

Finals week is next week, and all of this stress has had me tossing and turning in my sleep (partly because of my still injured back too) and has had me waking in the morning shaking, sweaty, and on edge. The other night I got minimal sleep because I went to bed angry, woke up a few hours later to a quite the slew of annoying voices, broadcasting really, and I could not sleep without some earbuds playing loud, chaotic rap music. I did not sleep soundly.

But it’s got me thinking about exposure therapy for some reason. I’ve been more talkative than usual, and although shaky the morning of my presentation and not quite as coherent as I wished to be, I was able to start out the presentation, get through my portion of the work, and relate my own experience with psychosis to our study on non-verbal cues and the effects it can have on interaction. The professor was surprised, I could see, and very rarely does anything from his students shock him, so that made me giggle internally.

If you remember me from the Mental Truths blog, you’ll have read tons of rants years old about my past battles with anxiety. So I’m not going to regurgitate everything here. Just know it’s been bad since I was about 5 years old. And every therapist I’ve been to has told me “Face your fears”. That’s the only way to rid the social anxiety–show yourself that you can do it. Prove your brain wrong.

It make sense.

Except that it doesn’t. And let me explain why.

Expose therapy, as a technique, has been proven not so much for specific phobias, but for PTSD. And when I say PTSD, I don’t mean emotional traumas. I mean physical traumas like a car crash you survived or a plane crash. It’s been speculated that it can work in other areas, but there’s no definite research with viable, proper experiments.

Remember, experiments can make claims to findings without being legitimate; it all depends on the method they used. An improper method can invalidate the entire study.

And so I’ve tried exposing myself to social situations in the past. Integrating into groups. Being nice to kids in class. And no matter what I did it seemed I always failed. I’d talk to someone or a group and still end up as the outcast. I concluded exposure therapy is a lie.

This time though, things are different. I’m doing the same things I did back then: taking risks, embracing the risks, following through with them, refusing to let the anxiety dictate whether I do something or not. So what’s the difference this time?

Readiness.

If you struggle with social anxiety and have been to a therapist who constantly tells you that the only way to conquer your anxiety is to face your fears, he/she is not entirely wrong. What he/she is wrong about it is pushing you into it.

If you attempt to face your fears with low self-esteem, showing yourself that you can engage successfully with people will look like a failure regardless. If anything, your therapist should be helping prepare your self-esteem. They should be encouraging you toward readiness, not tossing you in the pool without any floaters.

What helped made me get ready had a small fraction to do with the people around me. Some of it was support from friends. Some of it was a particular conversation with my therapist that, without intending to, made me realize I need to give myself permission to speak. So far, I’d been the only one holding myself back. I’d internalized this idea that I was only allowed to speak when spoken to, and that when I did speak it didn’t matter. People could tell me the opposite all they want; if I don’t believe it, them shoving it down my throat won’t make me believe it.

And so I told myself one day: you are allowed to speak.

And I continued to do so.

Over the course of a few months, reminding myself of this, engaging positively with classmates, roping them into my craziness with humor, leading my team toward good ideas, has shown me that I can communicate effectively. Speaking in front of others reminds me that I struggle with coherency sometimes–

Okay, I’ll finish that sentence in a second. I just saw these twin men who I saw the other day who had made direct eye contact with me and that was the night something was broadcasted to me and the fact that they’re walking into the library I’m in right now tripped me out for a second.

Squirrel!

Okay, back to the important stuff.

Speaking in front of others shows me that I still need to work on coherency, and being able to say what I want to say. I always thought Anxiety was the culprit. I always thought it made my mind blank, and it does, but not to the extent I believed it did. Once I stopped believing it was ruining my life, once I worked on my confidence and depression, the effect it’s had has been infinitesimally smaller than it used to be.

In the past, I took my incoherent speaking as a sign I would never improve. Because that was my mindset. Improvement was impossible.

Now that improvement has become possible, the coherency issue hasn’t disappeared but it’s become an obstacle instead of a brick barrier.

What is the point of this post? Well, I want us to do some critical thinking here.

It is true that some people learn to swim by being launched into the deep end of the pool.

It is also true that some people learn by not being launched into the deep end of the pool, but first by gaining confidence to step into the water.

Mindset effects our ability to take advantage of therapeutic techniques which have potential to assist us: that is my hypothesis. As a rough example, were I to test this, I’d do so with those controlled by severe social anxiety as I was. That would be screened with a questionnaire. Those chosen would report their levels of anxiety so we can get a baseline. One group would be given regular, well-defined exposure therapy depending on their greatest social fear. One group would focus on their mindset, specifically their confidence in all aspects of their life with CBT. The third group would be given no technique or put on a waiting list (I know, soooo cruel). This would have to be double blind obviously, considering my intense bias.

At the end of the study, which I would hope I’d have enough resources/money to run this for months, not a puny amount of weeks, I’d ask for a self-report of anxiety but also for them to return to that social situation that makes them the most anxious and rate their anxiety during that time as well.

Would the results be significant? Who knows. I can’t base a generalization to people on how this has helped me. Just as the European study which found people handle grief differently, and that for some “getting back to life” is actually more helpful for them than therapy and being forced into the “five stages of grief”, I would expect to find severe individual variation.

The study I read about non-verbal cues (related to the experiment we did for my course) and their relation to schizophrenia, how patients labeled with such are often influenced by their psychiatrists’ non-verbal cues, is something else I’d like to study. That is, if the psychiatrist is smiling, sitting straight, not monotonous in their tone, their “patients” tend to show a decrease in their symptoms and better satisfaction with their care. I had to find this study from a European research group because there is very little information like this from U.S researchers. That I am capable of finding.

There are so many more things to study in psychology in regards to mental health than pills and there is so much more to mental health awareness than vomiting stale definitions of disorders as “information”.

It’s technique here that makes a difference. That’s another hypothesis I’d like to study. Pit pills and well-researched techniques together and see which comes out on top.

They say that medication and therapy are most successful together. I haven’t read the research on all this yet, but I will. I think there are some things which technique could be better for than medication. This has been shown a few times I believe. But I think it can include certain cases of psychosis.

Post acute episode, of course.

Cognitive Behavior Therapy isn’t going to convince you mid-episode that your neighbor isn’t part of the F.B.I.

Or can it?

Let’s research.

Posted in Peer Support, psychology, science, Therapy

Is Psychology A Science? Part 3

Posted on by alidware

You’re here–great! This post would have been here yesterday, but I took an extra two shifts at work this week and am worn out for other reasons.

In the last post, we talked about the Clinical Method and the Actuarial method, and declared the Actuarial method more accurate. We are still under bullet point number 1: practitioners and their intuition/expertise, or what I’ve been calling Clinical Arrogance for years.

Now, why is there such a level of clinical arrogance out there? Well, it probably has something to do with the lack of push for randomized clinical trials in psychology and this idea that case studies are the best way to identify/predict other client’s behavior.

For example, Ronald Fox, a previous president of the APA is quoted with:

“Psychologists do not have to apologize for their treatments. Nor is there any actual need to prove their effectiveness.”

Why Many People Perceive the Study of Human Behavior Unscientific

For those unaware, the APA is the American Psychological Association. They argue over the DSM and other irrelevant things.

There was a push for randomized clinical trials to become a staple for the understanding of the mind, for understanding better avenues of treatment for mental health adversities, but this would have sprung detailed instructions for treatments (backed by the research) and standardized treatments. Psychologists had a somewhat valid argument, that there needs to be some flexibility in treatment. Standardized tests are shit, and I believe there’s probably a huge chance standardized treatment could end in the same category. However, I’m not sure if the standardized tests given in school are backed by any research saying they are accurate predictors of a student’s knowledge. These standardized treatments would be developed based solely on the research.

But clinical psychologists disagreed for other really stupid reasons too, rest assured. They believed psychology is an art, not a science. It doesn’t need to measure variables. Intensive case study analysis gives better understanding and insight anyway.

They’re quoted with:

“Alternative ways of knowing [case study, intuition], for which the scientific method is irrelevant, should be valued and supported in the practice of clinical psychology.”

Defining Psychology: is it worth the trouble?

Another APA president was found to say starting up randomized clinical trials would be “fundamentally insane” .

Why is this a thing? Well, I could think of many reasons. Some reasons revolve around the fact that psychologists are educated in psychology minus research. They take a couple courses maybe in their career, but there is no effort put into helping them really understand the value research has in their practice, and so we have many clinical psychologists who firmly believe psychotherapy techniques emerge from experience. Research says differently: there are certain techniques, like CBT, that work better for certain adversities, but because no one reads the research, no one implements the technique when it’s most appropriate.

This provides for a very naive group of professionals. And what does naivete strengthen?

Well, drug companies for one. They could have research that says a medication has zero efficacy and it will still be prescribed by practitioners.

For example, Abilify has no efficacy above 10mg. It’s in the physicians desk reference. I read it. Back when I was on medication, my psychiatrist kept pushing me to 20mg because it would “help my voices”.

She obviously doesn’t read, obviously doesn’t know much about Abilify, and obviously doesn’t understand anything about the spectrum of voices.

It’s a well known fact that insurance companies, drug companies, and the APA are all very connected. That can be another series I’ll push out when I’m less worn out. It’s a very tangled web.

The issue with ignoring research which says certain treatments are more likely to have an effect over others is that psychologists never learn from their mistakes–mostly because they don’t know they’re making any mistakes. If a treatment doesn’t work, it’s because the client isn’t focused. The client isn’t “putting in the work”. While that can be the case, it can also be the case that the psychologist hasn’t kept updated with the information in their field and therefore has some build up clinical arrogance.

There was a push in 1990 for evidence based practices to be the center of psychological practice. The APA’s response? Let’s lower what it means to have “evidence”; more things will be approved and more treatments will be made.

A group of scientists and researchers realized their efforts to drill logic and intelligence into the APA was vain. They then formed the APS, the Association for Psychological Science.

In the same way that Peer Respites and peer alternative programs were started out of the need for compassion in mental health care, the APS was started out of the need for competent practitioners and valid research in psychology. They sponsor science-based clinical psychology and there are many universities in the united states which hold their Psychological Clinical Science Accreditation. More are being accredited each year. UC Berkeley is one. I mention them only because I plan to attend that program for graduate school assuming I continue with psychological research.

So there are many elements of science within psychology. The issue isn’t with whether or not it’s a science. The issue is with whether or not the science is embraced and whether or not we are too limited in our human ability to learn anything worth while. Is human variation too much of an obstacle? Is that what pushes clinical psychologists to believe their intuition can outsmart a math formula? Math formulas, after all, can only describe what we observe and what we observe is inherently limited. We can generalize behavior from a sample size, we can generate neurological predictions when observing the behavior of neurotransmitters but none of it ever seems to be certain; even what we’ve studied, the effects we see, are simply based in probability.

Sound familiar?

Tomorrow we’ll talk about bullet point number 2: how this probability relates to other sciences and why I call psychology the quantum physics of human study.

Posted in psychology, Therapy

Let’s Talk About Therapy

Posted on by alidware

For those of you unfamiliar with the mental health system or are unsure about therapy or whether or not a psychiatrist is a good idea, this post is for you.

For the rest of us, it’s also a good post for you. It’s a good post for everyone.

Anyone (with a degree and some version of licensing of course) can be a therapist. That could be a LCSW (Licensed Clinical Social Worker), a MFT (Marriage & Family Therapist/Master’s of Family Therapy), a clinical psychologist (Ph.D) or Psy.D (Doctorate of Psychology). A psychiatrist (MD) could as well, but many of them have zero background in psychology other than your average level of undergraduate study.

An LCSW and MFT will indeed make less than a Clinical Psychologist or Psy.D. Those two will generally make less than any Psychiatrist depending on where you live and what clinics each individual works. If you feel that someone with a Ph.D will be much more knowledgeable and better trained than an LCSW, you would be terribly, terribly wrong. In fact, the main difference between them is the amount of money they make.

Studies (and the lecture in my research course) have shown that credentials have no effect on success rate; that is, just because you have a Ph.D doesn’t mean your “clients” do better than an LCSW’s clients. That includes the M.D’s.

This might seem obvious: it depends on the clinician, right?

Wrong.

It depends on the techniques. If a clinical psychologist with a Ph.D is certified as an International Board of Repression Therapist (a non-scientific therapy) and their colleague in the office next to them is an MFT certified in Cognitive Behavioral Therapy (a scientific therapy) and one client experiences IBRT and the other experiences CBT, chances are CBT will provide a hefty affect over the IBRT. Yes, there are other factors which play into this, some important ones being what the client is seeking support with and their drive level. Connection to the provider plays a role as well. However, speaking from a technical point, there is no solid (well-done) research supporting IBRT, and plenty of well-done research supporting CBT.

That doesn’t mean IBRT is useless. One day perhaps someone will come up with some verifiable, testable, and reliable data. But until then, I won’t be seeing anyone specializing in IBRT. The Inner Child exploration therapy is another “non-scientific therapy” and I’ll have a post on that later, as I have experienced it and have mixed reviews.

There are three basic differences between a Psy.D and a Ph.D.

  1. Scientific training.
  2. Clinical training.
  3. Cost

Colleges which offer Psy.D programs are by far much easier to get into and much less regulated. They also cost thousands of dollars more (unless you’re trying to get Ivy league training in which case good luck paying out of pocket for your Ph.D from Yale. I suspect school type also doesn’t correlate with client success rate) compared to your average Ph.D training.

There is a school which I had planned on attending back when I was ready to transfer for a Psy.D until I realized their training isn’t really based in any science. And psychology is supposed to be a science of the mind, right? (More on THIS in tomorrow’s post). The success rate was large, in the 80 percent or so, the school was still working on its accreditation, and the classes they required were scant. In fact, they didn’t really require anything other than a couple of psychology classes. They claimed integrated, client-centered approaches, which is great. And I’m sure once we have more actual data on the effectiveness of their techniques, that school will be booming.

I believe they got accreditation some months after I learned they weren’t yet accredited.

I have seen MFT’s, LCSW’s, Psy.D’s, M.D’s, and now my first Ph.D therapist.

And so how do you pick?There’s all these choices, all this research you have no access to, all these articles online pulling you this way and that and are probably based more in opinion than actuality.

I used to choose my therapists by their profile picture and their degree level. If they looked friendly and had a high degree from a reputable school, I’d try them. And every time I left them.

This time I tried a different approach. I searched for therapists in town at all degree levels. If they didn’t have a website explaining their practice methods, mission, and specialties, I did not consider them. If their picture seemed unfriendly or strict, I also did not consider them (and that’s a totally unscientific, personal preference). If they did have a website but didn’t meet my specialty requirements, I crossed them off too. If their website wasn’t fully developed or seemed unprofessionally dull or full of metaphysical intuitive opinions about nature and life, I also crossed them off.

I love philosophy and enjoy metaphysics. But I’m also aware that people with that mindset are more inclined to tell me “if you believe it, you can achieve it” and I don’t need cliche sayings. Believing the demons will go away will not make them go away. I need to learn how to work with them, not shove them off a metaphorical cliff that I created in my mind and watch as they tumble helplessly into the locked drawer which I also created in my mind. Not my type of therapy.

Now, if someone had a decent, updated website that laid out their specialties which coincided with my needs, what insurance they accepted (if any), their location, phone number, and a blurb about their practice and themselves, I’d investigate further.

I eventually came down to three people: two women and one man.

I eventually crossed off the man because he had been in practice for many years, thirty or forty, and while that’s not a bad thing there is also no notable effect between years of experience and better rate of client success. I’ll explain why in tomorrow’s post as well. The reason the years influenced my decision is because many still maintain old views of specific “disorders” and treatment methods. I refuse to see a psychiatrist who graduated in 1979 and below.

The two women: one was a LSCW and the other a Ph.D. Both had well defined websites and structure to their treatment methods. I went for the LSCW because the Ph.D had listed their G.P.A and grades and I considered that rather conceited.

The LCSW was on vacation and when she got back she called me to let me know she wasn’t accepting new patients.

As disappointing as that was, my last choice was the Ph.D. I was nervous because of her degree and her listing of her G.P.As. I predicted she’d have an arrogance about her and see me as less than. I was indeed very wrong. This will be relevant in tomorrow’s post as well, how intuition can lead us far astray.

This particular therapist and I connected immediately. I have only connected in such a way with two other people in my life, one girl when I was in first grade and a guy when I was 14 in high school.

She is attentive and didn’t seem to mind that I hadn’t mentioned on our phone consultation that I hear voices and have experienced psychosis. She did believe that voices went away with medication (which isn’t the case for most of us, and I filled her in on my experience) and that schizoaffective can only be diagnosed under the condition that psychosis appears alongside depression (I didn’t correct that because I felt awkward doing so; it’s in the DSM-5, she can check it out if she wants. I have a DSM-5 PDF copy if she needs it) but overall she validates my feelings but also challenges me when something doesn’t seem quite right.

She will help me see alternatives and consider alternatives. She is full of humor, and gets my humor, and I’ve never laughed as much with a psychologist as I have this woman. I don’t feel judged usually, and have felt free talking about my voices with her. I have not talked in depth with anyone else about my voices, and I certainly haven’t told anyone else that I hear both internal and external.

Why did she work out? Because I didn’t follow my intuition, I followed a set of criteria I set for myself that weeded out those who were specializing in what I needed support with versus what I didn’t. And her listing her G.P.A has nothing to do with that.

And so what it comes down to is:

  1. Test the waters. See what kind of people you like. Don’t get disappointed if some don’t work out. You don’t make friends with every person you meet, do you?
  2. Don’t choose solely on degree level: you’re disgracing science and ignoring data.
  3. Take your time. You might not pick the right person on the first try, but you want to get as close as you can so you don’t have to go through 20 different people. That can happy very easily.
  4. Do your research. See what others say, but also recognize people can be picky about things you might not care about.
  5. Come up with your own criteria for the qualities that would be helpful for you. Make your stance clear at your first appointment.
  6. Get ready to work and be open to opinions that don’t match yours. Don’t assume CBT will work just because it’s a proven technique. Put some effort into it. Cry. Feel things. Process things. Think about things. Get frustrated and angry and annoyed. That’s literally the whole point.
  7. Don’t rely on your intuition solely.

And most importantly? Remember you have a say in your treatment. Make the therapy and partnership and it could become one of the better relationships you’ll establish in your life.