128 Comments to
10 Secrets Your Therapist Won’t Tell You

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  1. What was the objective of this post? If it was to diminish the value of psychotherapy, then I ask next what is the point of this blog? Some of the points above have merit, I will say that freely, but the tone is demeaning overall, and I am offended to read this at a site that is supposed to support mental health issues and interventions.

    At least that was what I thought this blog was about. The take home message I would like to offer readers is this: being a mental health care professional is a life long committment if you are invested in the job description. And it is nothing less than perverse and disgusting how many non-mental health care professionals have stuck their intrusive noses into the profession and truly screwed it up, and us as the alleged gate keepers of the field have contributed to this sizeably! Too many whores and cowards, that is what I see in my travels.

    Let me end with this little pearl: if drugs were such a simple intervention, why aren’t most people with mood and anxiety disorders so much better that they don’t seek out further treatment? I’ll give you my take: because it is not a simple “biochemical imbalance” problem, but a psychosocioeconomic problem that requires a multifaceted approach to treatment to see real improvement and return to function.

    Dr Grohol is right about the sales pitch for meds though. Treatment is NOT cookie cutter, so if you go to a provider who uses one or a few meds alone, run, do not walk, to the nearest exit!

    Skillsnotpills, board cert psychMD

    • I totally agree. Bravo!

    • “Too many whores and cowards, that is what I see in my travels.”

      …what the f*ck kind of therapist are you, that you would call people you don’t even know such things? Can’t you find a better way to express yourself? Mind boggling, that, given your so-called “profession”. O.o

  2. The point of this post is like all the others here — to inform and educate and do so in an engaging manner. This blog is not to promote nor demean any particular treatment modality, but to help demystify the process of treatment. By shedding light on things like psychotherapy, medication choices, etc., I hope it helps someone better understand these treatment options. And removes some of the mystery surrounding them, and the stigma.

    You don’t have to agree with everything or every post, but constructive feedback is far more appreciated than “What’s the point of this?” Not every post or entry is going to speak to a particular individual and his or her needs, or be 100 percent consistent with their point of view, nor would I expect it to.

  3. Excellent post John. Number one is very important.
    Skillsnotpills – Lighten up for goodness sake. Remove the chip off your shoulder, take off that hair shirt and stop whipping yourself. Having an irreverent sense of humour about life, especially something as heavy as psychotherapy is important. It’s not all bleak bad news. Even my mother laughs occasionally.

  4. Excellent post as always. A sequel to the other one that graced everyone’s website on therapist faux paxs.

  5. Excuse me, but I am entitled to an opinion that can be voiced here if it is not excessively rude or personal. If you are just looking for the choir to hoist you up, like having T Borchard who is another author at this site commenting above, then your select company will only insulate you from the reality of differing opinions. I did not expect you to appreciate my comment, but that is how I interpreted the post, and I hope other readers who are not simple choirboys or girls will chime in supporting or dissenting.

    And, I did finish noting you were correct in commenting about how physicians can be narrow minded in offering psychotropics. Seems like a supportive comment to me. Hmmm?

    And to Sonia, I’ll “lighten up” when insurance companies stop intruding into the psychotherapy process, like starting with allowing reimbursement for psychiatrists to provide such care. Maybe if such a disruption into your job description occurs, you might not be so jocular!

    Some topics just don’t come across as funny or enlightening to those who are negatively impacted by the issue. Think about that a bit.

    Constructive enough now?!

  6. So the one point in the article you agreed with was the one critical of drug companies. Interesting.

    And what does insurance companies reimbursement have to do with anything? Oh, yeah, I see that’s another point you agree with from the article too. Okay, so 2 out of 10 isn’t so bad. But #9 is certainly true too, no? (but maybe related to your issue with insurance companies intruding on the therapy process) and I hear #10 from my colleagues all the time.

    In other words, these points are taken from real life because they are real, they happen all the time, and they happen because therapy is as much an art form as it is a scientific process. And that, skillsnotpills, is the point of disseminating such information to people who are not on the “inside” of this profession.

  7. My therapist and I did in fact have a discussion once about how difficult dealing with insurance companies can be for therapists. He assured me that mine had been okay. I would want for him to be compensated for his services. I was also very aware that he would have to make a diagnosis in order to receive payment. It would be nice if it were possible to treat the person and not their label, but if that is how it works, then I would certainly understand. I always considered myself very fortunate to be able to see him for a $20 co-payment, but I would really want for him to get the money that was due to him.

    I’ve been running right into every blog that triggers me this week. Wonder what that is all about? I get a little uncomfortable with the “not a friend” being brought up time and time again. I like to think of it as that we couldn’t ever act as friends do because of the nature of the relationship, but that knowing and respecting this (as I always did) would not lessen the relationship’s value. And it also doesn’t mean that I’m not friendship-worthy or that we couldn’t have been friends had we met under different circumstances. But just because I can’t ever socialize with him does not mean that I don’t care about him. This relationship is just different and unique. It’s still pretty special and always will be to me.

    As far as #10 goes, well I certainly have a great deal of respect for anyone in this profession. I know it can’t be easy at times, but therapists really can and do make a difference. My therapist helped me tremendously and I have always appreciated that. I hope that my progress gave him some contentment in knowing that he’d done his job well. I still miss him a great deal.

  8. Sonia you really made me laugh out loud! This is an excellent post and I do find that most of these points hit the nail right on the head especially with the insurance issues…I wish I would have known some of these things before I started therapy, not that it would have changed my choice to enter therapy but it would have been nice to have the heads up. I didn’t find the post demeaning or negative at all, I found it practical and informative.

  9. I thought it was a very good, informative article. Kudos!

    Just to throw this out there, for those who seem to think otherwise, therapy is not all rainbows and butterflies, nor will it ever be. I did not find this article demeaning in the least, rather, it revealed the truths that most people wish to ignore. As someone going into the mental health field within the next few years, I definitely appreciate the article for its accurate, raw, and truthful message.

    Skillsnotpills, whatever your damage is, is it necessary to take it out on those simply providing you with the facts? And there is a solution to your issues with managed care intruding: pay out of pocket. That’s the only way that managed care will ever not be involved, so try that if you have such an issue with the people paying for your therapy.

  10. Skillsnotpills…you seem to be the one that always has something negative to say and yes we get it you are always making references to being “anti” medication. Almost every comment you make has something to do with using medication as a last resort. Sometimes since our insurance gives us problems regarding psychotherapy and stated in the blog, medication is the only thing some of us can afford!

  11. I’m not a big fan at all of people perscribing medication for mental illness all the time. I think it’s a preventative measure until the problem is solved.

    What I do hated about this post is psychotherapy is only one type of therapy amongst many. One that is also not recommended.

    I think this post really discourages people from seeking help which is dangerous. This most could be doing more damage than good, not what I would like to see froma site named psychcentral. It would be particularly off putting for theose already anxious about seeing someone or males who are often more reluctant. Many people need therapy. It is good for them to speak it out. You’re almost poo pooing on these people for doing so.

    Therapists, councillors, psychologists etc at the end of the day are like all people. Some you will get along with, others you want, because hey they’re human too. The point is trying to find one that works for you.

  12. Many of these ‘secrets’ explain why I dropped off insurance panels three years ago. My office sends in claims for my patients as an out-of-network provider. They get reimbursed to the fullest extent of their benefit after paying my fee for service directly. This system has proven incredibly liberating.

    I absolutely do love my job so much more now that I have control over the business aspect of my practice, not the insurance company! I see patients pro bono or slide my fee when it’s appropriate, but I get to choose. Only my patients can say if being off the panels has made me a better therapist. I just know from my end, I have more energy and focus available to them and that is oh so gratifying.

    It’s not for all therapists, not for all settings. I have great respect for the community mental health centers, or hospital based services that must contract with insurance companies. But for private practices I highly recommend emancipating yourselves from the insurance companies. Come on in, the water’s just fine.

  13. I sometimes wonder if some of the commenters who comment regularly here are in the same reality I am in. You get what you pay for folks. I have part of my practice as out of pocket, and people are cheap, because they seem to think that insurance guarantees them care for little out of pocket expenses. And my rates are fair, as I get that reinforcement from those who also are in my reality. If your insurance only reinforces a meds only mentality, go back to my last comment: if meds are so effective, why aren’t most people with mood and anxiety disorders so much better?

    Take your shots, live in your alternative reality, and when the reality I sense is the truth of this society bangs on your door, don’t open it. It might be knocking to save you, not harass you!

    Man, you sure have a choir, Dr Grohol!

  14. I’m having a hard time understanding skillsnotpills’ English (the syntax is very confusing).

    I can understand, however, to a certain degree, why John’s post can be taken as slightly offensive. Personally, as a patient (and non-therapist), I really appreciate the tips and insights into your profession that you are giving us outsiders. And I know that much of the impetus to share this information comes from a very genuine attempt to educate and help. Yet, when I read these kinds of posts, I often also feel a slight hint of pent up resentment and frustration with your patients and profession looking for an outlet. Moreover, while your experience may speak for you and your colleagues, I imagine it doesn’t speak for all therapists (I know my therapist would agree with some points and disagree with others). I wonder, perhaps, if skillsnotpills would have bristled less had you not taken it upon yourself to speak for all therapists and instead, more bravely, titled the post “10 secrets I don’t tell my patients.”

    That said, I still appreciate the post.

  15. Geez…based on the posts here from skillsnotpills, he/she sounds bitter and angry and I can’t imagine ever opening up to and trusting this person with my life.

    My therapist has been straightforward about how insurance works, from having to diagnose me with something on the preprinted form he must fill out to his dislike of insurance companies when it comes to mental health, but he deals with them because he doesn’t want to treat “just the rich people”.

    I’ve been in therapy for over a year and still read posts/articles like this one because it helps keep me centered and focused on the facts of therapy. Every so often he reminds me that our relationship is contained to his office, not to diminish me or our work together but to continue to establish and protect the trust that I have with him by the boundaries he made clear on day one.

    I’m of the belief that if I’m involved with something – especially my health/wellbeing – that I have the right to all the facts, whether positive or seemingly negative. Why would you want anything less from your therapist than complete honesty?

  16. Elvira,

    What works for you is great. However, it doesn’t always work for patients. I have excellent insurance but it has poor out of network mental health benefits. My therapist’s fee was 200/session; insurance wound up reimbursing $28 – after a $4000 deductible was met annually. Needless to say, it didn’t make a bit of difference. I saw her for two years, the second of which she saw me at a 50% discount, and simply could not afford to continue.

    I’m looking for a new therapist now who will have to be covered under my insurance. Please don’t convince all other decent therapists to take your route! 😉 (Said with a smile, but a fair bit of seriousness!)

  17. Skills not pills is entitled to his opinion. Stop bullying him everyone! (I’m surprised that therapists, etc. wouldn’t be more self-aware in this aspect).

  18. In talking with (potential) clients, I’m upfront about each of these that applies to me.

    I don’t file insurance so 8 & 9 don’t apply. And 7 & 10 are simply not true of me/my practice.

    I do, however, put these points more respectfully than presented here; which seem to be phrased for maximum emotional impact (quite appropriate to the style and intent of the piece, IMO).

    I do the first 6 because it’s The Right Thing, however, most of them are in fact required or at least suggested by some combination of professional ethics, state or federal regulation, and/or best practices.

  19. I agree with skillsnotpills. This article seemed to discourage people from seeking help from a psychotherapist. I’m glad I didn’t read it when I had a deep depression. I probably wouldn’t have gone to see a therapist after my attempted suicide.


  20. Very interesting……… extremely

  21. This was a great article. I have received therapy, and I can see why these are things to keep in mind, from the therapist’s perspective. I think this article brings to light some challenges the therapists encounter on a daily basis, such as getting you to open up but not be a friend, etc. I know for myself that my therapist always encouraged me to explore all avenues regarding my treatment, such as using medication, exercising more, interacting with others and the like. Most people unfairly assume therapy “doesn’t work”, but it is a component for you to heal yourself. Most of the heavy lifting falls on your shoulders, and it’s difficult. But, you have to work on it in order to get better. :)

  22. Realistic and practical. Thank you.

  23. I have been planning to go back to school to become a therapist. This article is making me rethink my decision.

    • Well I think that is a real shame. Not all therapists are so incongruent. In fact humanistic person-centred therapy advocates that the therapist be transparent and honest with their clients and not set themselves up to be superhuman. This article(whilst bringing up some interesting points) generalises about therapists in what could be perceived as being in a very critical way. I have worked as a therapist for 30 years in the UK NHS and in my experience most therapists try not to be something they are not and strive to be genuine. I think it is those who are inexperienced who are most likely to struggle with congruence. I am disturbed by the recent roll of blogs on here that seem to be slating other therapist in what could be seen as rather holier than thou manner.

  24. I thought the article was well written and gives another perspective to clients. It certaintly has brought up some interesting issues related to reimbursement practices and other areas, based on the comments. Great job!

  25. This will be my last comment for this post, and I hope it will be illuminating at the very least.

    I am angry because I care about the work I do, and that is helping people help themselves, and do it in the least invasive and paternalistic manner as possible. The hassles and intrusions are beyond acceptable and tolerable, and I am sick of those who practice the adage “hear the lie enough and it becomes the truth”! Insurance has only deaded and demeaned this field of mental health, and I defy any active provider who engages in mental health care to say otherwise, meaning such provider is at peace with the state of affairs of their practice and collegiality with others. The people I have met in the past 5 or more years who have no issue with mental health care as is are usually clueless or in their own little niche practice that does not serve the general community.

    I’ll end with this: Dr Grohol’s post has validity to issues, that is not the gripe. It just does not come across as a positive posting to me, and I read above today some others agree with my perspective. I do not want him to lie or be overly cynical, like me the latter, but also do not defend choices and disruptions that should be rejected as interfering with the skills and intentions we as providers should be able to offer and provide without interference, as long as it is in the realm of standards of care.

    That is my position. And guess what, to those who take exception to what I have wrote: the patients in my private practice, by in large, appreciate my position and thank me for taking a stand. So, to those who do not know me outside this medium, infer what you want, ’cause in the end I know in my heart I am fighting for what is right. Deal with it!

    Have a nice day.

  26. I think all points in the article are valid – I can relate to them after working in a variety of settings.

  27. I disagree that it doesn’t matter where your therapist went to school and got their training.

    As a general rule, some training programs tend to be more selective about whom they accept than other schools. I want my therapist to have gone to the most selective training program possible, because the selectivity tends to reflect the degree of the therapist’s past commitment to their undergraduate studies and previous work history. It’s not a golden rule, but it helps.

    Case in point. If I had a choice between a therapist with a Ph.D. in clinical psych from the University of Southern California, one of the premier CBT training programs in the nation, and someone who attended a far-lesser school? I’ll go with the USC grad. The USC grad will study with far more qualified professors.

    Maybe it doesn’t matter as much fifteen or twenty years after graduation, when a therapist could have made their reps on their own. But as another indicator of competence? I care.

    By the way? In my totally anecdotal experience with various therapists, my theory seems to hold. No, they don’t all have to go to USC or NYU and then train at the Ackerman Institute or Tavistock. But it can’t hurt.

  28. Just a note that this is very US-specific and it might be good to state that overtly or try to provide some information for other jurisdictions. For example, if you see a psychiatrist in Canada (at least in British Columbia) it is through the public system – so insurance companies don’t come into it (the doctor is paid by the government) and there aren’t covered and non-covered diagnoses that I’m aware of. And I’ve only ever been prescribed generics. You also don’t generally “choose” who you see – you might be given a selection but you’ll be referred by your GP.

  29. It took me 12 different therapists (from 1971-1996) to get a diag. & treatment that worked. I was put on Haldol by the 1st (court-ordered) psychiatrist. Court ordered b/c I was arrested during a huge protest in Washington DC & fought the police. That psych’ took me off meds 3 mo. later & pronounced me “cured of schitzophrenia.” I tried: Primal Scream, cognitive, behavioral mod’, guided meditation, biofeedback. ETC working hard.
    It wasn’t until my MD & I talked that I was diag. (after a week of tests & discussions, Q & A w/a psychiatrist) with seizures, OCD & bipolar dis. After 5 years of heavy therapy & trial & error, I got on the right medication. ONLY after taking seroquel for 6 weeks did my suicidal thoughts (previously 5-10 times/day) go away. I am rarely depressed now, my insomnia is gone–manias are only happy, not wild. OCD only comes out if I am super-stressed (like the day I was attacked by a dog.) So to put down meds as pushed by Pharm. companies is NOT OK. Many people (like me) tried very hard with just therapy & no meds, with bad results. Why denigrate a methodology that works great? I have been on meds w/out a therapist for over a year & am doing great. I’ve had poems published in recognized journals, am in 2 writing clubs. Involved in local theater. My marriage (23 years) is great. More friends now than ever. I am 57 & healthy physically & mentally. I credit my wonderful MD, therapist & great medications (Depakote, seroquel & folic acid with xanax just for the super stressful events.)

    • DIxie, I agree, I also went through years oof therapy before i was diagnosed with Bipolar I, tried out on a variety of meds, and then in combination with therapy (that I could now put into action) finally could get my life together). Without my meds, my life doesn’t exactly go completely back to how it was, because i have learned better coping and symptom managing, but it is far less managable.
      I am lucky I respond well to meds and realize there are people who do not or who are overmedicated or wrongly medicated, but therapy alone doesn’t work for everyone. That said, I myself in my work try to work pedagogically with the teachers and parents before I send a child with a suspected attention disorder in for a further evaluation beccause I know the Psychiatrists will push meds, and often, there is so much that can be done at the classroom level that can help the whole class before we need to go that route.

  30. Michelle, Well said! I hear you and appreciate your sentiments. I hope you find a good therapist soon who fits your needs, both psychological and financial. /Elvira

  31. Dr. Grohol, you state: “There’s no evidence to support the idea that…. a Ph.D. is better than a Psy.D. for your feeling better, sooner.” But what about LICSW’s? I’m looking for a therapist, and the referrals I’ve gotten are for social workers. Is a psychologist a better?

  32. It’s been my experience that it doesn’t matter what degree or degrees social workers, psychologists and psychiatrists have or where they got this knowedge from, it is the relationship between client and therapist and most importantly the level of empathy that is displayed.

    Empathy is something that cannot be gained through education.

  33. Hi. Thanks for the insight to a therapists mind. I doubt other therapists including my own would be this honest about the profession.

    Just a few points. In my country it is illegal for the drug companies to push drugs onto the doctors however they can still do it and get away with it, in ways disguised as education for doctors. Also our government pays the balance after the patient pays the co payment. So our therapists wouldn’t have to chase insurance. They however get the secretary to ask for the cheque which gets posted to the patient. So could be chasing cheques! 😀 :)

    I also think that if people make important decisions based on a blog on the internet, they are in serious need of psychotherapy. People can’t say “oh Johns post made me re think therapy” or “made me think suicide was an option.” That is ridiculous. Have responsibility for your own life and own choices.

    Psych Central always encourages people to get professional support and I don’t think that this post goes against that value at all.

  34. “I also think that if people make important decisions based on a blog on the internet, they are in serious need of psychotherapy.”

    I could not have put that better myself.

  35. half of these issues should be addressed in the therapists informed consent or they are doing their job. I do not work with insurance companies so I have no idea what it is like to work with them. But I found the article silly. Therapists don’t push medication, they don’t use medication. Did the author mean psychiatrists? Has the author ever met a therapist or is this from having watched a movie or TV show that had a scene about therapy in it? just plain uninformed.

  36. Eliza says: ‘I think this post really discourages people from seeking help which is dangerous. This most could be doing more damage than good, not what I would like to see froma site named psychcentral. It would be particularly off putting for theose already anxious about….”

    Eliza, psychotherapy can be very dangerous, indeed, and it’s really naive to believe that only medications cause damage. both therapy and medications have the potential to cause great damage, and great benefits, as well as both of the above.

    And the more highly trained that therapist is, I believe, the more dangerous it potentially is.

    The reason psychology and religion hate each other so much is because they have so awfully lot in common.

  37. Sonia said : “It’s been my experience that it doesn’t matter what degree or degrees social workers, psychologists and psychiatrists have or where they got this knowedge from, it is the relationship between client and therapist and most importantly the level of empathy that is displayed.

    Empathy is something that cannot be gained through education.”

    I agree with this 100%. Book smarts offer knowledge, but it can’t teach you how to relate with another human being. It can’t teach a therapist how to care about and understand a client.

    Most of what was written in this article were things that I already knew going into therapy. And my therapsit did in fact discuss a lot of these things with me. He may not have been as blunt as this article has been, but nothing in here really surprises me.

  38. TK — Unfortunately, while that certainly can be a person’s preference and you could make an argument that it somehow impacts their ability to be a top-notch clinician, the research data simply doesn’t support it. There’s little evidence to suggest a PhD from Stanford is going to be a better clinician and create better outcomes for their clients than a PhD from OSU.

    Donnalee — I used the doctorate degrees as one example, but the evidence doesn’t really care what the degree is when it comes to client outcomes. Research shows little difference in client outcomes between a doctoral-level trained professional and one with a master’s degree.

    Here’s an article about the differences between different professional degrees”


    But at the end of the day, the degree doesn’t matter nearly as much as the individual therapist themselves.

    skillsnotpills — I’m an equal opportunity critic. I’ve written plenty of positive and informative articles about psychotherapy, and this one joins the group. Because the more you know, the better you are to make an informed decision about treatment choices. My recommendation for most people seeking treatment remains that if you want to feel better, fastest, you consider combined psychotherapy plus medication treatment for most of the major mental disorders. Sure, ideally, I’d love it if people did psychotherapy only first, but that’s simply not realistic thinking.

  39. After writing a lengthy comment and having it disappear into nether-land, I’d like to add that I too am bothered by Dr. Grohol’s article. I am a therapist and feel that his article is way too slanted toward the negative about the work, and attitudes, of therapists. I also felt it was discouraging to potential clients who are probably already nervous about starting therapy. Not to mention people who are considering joining the profession.

    In short, I think Dr. Grohol took tidbits of truth and oversimplified them to make them look agregious. Therapy is about so much more than diagnoses and reports and what label is put on the relationship.

    Dr. Grohol asks for constructive feedback. I would ask that next time he offers a more nuanced and textured picture of the “inside story” of therapy, and to remember that sometimes, every now and then, a life does hang in the balance of whether they seek out therapy or not. People do put stake in what they read and are influenced by a professional’s point of view. It’s not just about making an article “sell.” Even the title sounds like he’s ratting out a car salesman – oops – I mean, “therapist.”

  40. The article seems like one among many resources for what information to cover during the “informed consent” process when engaging a client in therapy. Describing what the client is getting into (unnatural relationship, types of approaches, what goes into a treatment plan, etc.), challenges to the therapy process (pharmaceutical ads, discomfort, confusion about therapists’ qualifications/competence), benefits (learning how to fish – how to help oneself and cope with biopsychosocial stressors), costs (insurance companies, fees, being labeled with a diagnosis), etc. Also needing to be covered are alternatives to treatment and the costs and benefits of these as well (doing nothing, diet, exercise, support groups, meds only, sun lamp, etc.). I agree that the message should be encouraging and hope engendering, but also objective and thorough. The standards of informed consent mandate that the client know what they are getting into. Thank you for the post.

  41. Dr Grohol:

    Since you addressed me in your last comment, I will run the risk of being hypocritical and comment once more.

    “I’d love it if people would do psychotherapy only first, but that is simply not realistic thinking” only reinforces my comment about ‘hear the lie enough and it becomes the truth’ as insurers have drummed into the heads of too many providers that therapy is not an easy option.

    Truly disappointing to read that from you. And, I think Katrin’s comment of “the more highly trained the therapist is, the more dangerous [the therapy] potentially is” is so over the top; good luck to you ma’am if you seek mental health services in future times. That is exactly the problem: too many people without the training hang a shingle as a ‘therapist’ and demean the field with substandard care, and then someone attempts to validate it. Well, I go on record as saying your perspective is unfortunate to believe, but do as you will.

    Hey, as I said earlier, why aren’t we seeing people improve as a majority with these wonderful interventions of this millenium? Maybe the quick fixes aren’t so lasting, eh?

    “If you want to get better, take a pill, but if you want to get it right, face the truth.” Won’t be accomplished in 6 visits or less, oh ye insurance worshippers!

  42. Dr. Grohol — Being an empirical kind of person, I’m always willing to have my mind changed by facts. Might you post the Google search terms that would lead me to the research about level of degree/institutional training/patient outcomes to which you allude? Or post a couple of links so I can read the actual study or studies? I’m really interested. Thanks so much.

  43. Skills, my words are not written in stone..never!

    What I mean is not that higher up the ladder therapists are worse than lower down the ladder therapists. It did sound that way so let me just explain what I meant.

    I meant that the higher up the ladder a therapist is, such as a psychiatrist and/or PhD psychologist, the more sure he/she is about her ‘knowing best’, and also the more sure the patient believes him/her to be ‘GOD’.

    And the more protected this professional is by her/his license.

    But of course, when transference and dependency hits, I guess most patients are so vulnerable to being hurt.

    I think this article is very good. Why? Dr. Grohol, as we may have noticed, writes an awful lot of articles, and all the time.

    It is completely unrealistic to expect him to cover every single point of view, and ever ‘but’ and ‘also’ and ‘different’ in each and every one of his articles.

    Of course he knows that therapy also has all those other great and good points and he has covered those points in many other articles.

    I think it would be more productive to look at what he did discuss rather than pointing out every single point he did not discuss.


  44. I myself was in long term, intensive, psychodynamic therapy with a psychiatrist for years. The only one he was guilty off was NR. 5 and even then when I think about it, he really was not.

    He was extremely conservative with medications. I mean he gave them as little as possible.

    The worst thing he did was that he didn’t make me sign the same kind of form that patients have to sign before surgery, and that this may kill them or damage them.

    On top of that, every patient should be aware off, and sign a form, that the moment he/she steps into this shrink’s office, her ‘rights’ are forever gone. (legal rights, human rights, etc) GONE!

    And so lets just hope it never comes to that, and I don’t mean with the therapist per se, but in general…ever.

  45. Oh, and just before we terminated, I was allowed to, even offered, to read all my charts from the beginning.

    There were stacks of them and each session had at least a one page typewritten page or more with incredibly organized observations, questions the therapist asked himself, and about what took place. it was amazing, and he did say that most other therapists do not take nearly as much care.

  46. My former therapist is a clinical psychologist and most definitely does NOT think he is “all-knowing” because of his education. In fact he was always very real and human with me, which I appreciated tremendously. That being said, I don’t feel that it’s his degree that makes him effective…I think it’s his person. He is very empathetic and very ungod-like.

  47. I think you are right, Beth. I’ll take what I said back and limit what I said to Psychiatrists, and well…Social Workers.

  48. I appreciate the clarification from Katrin. That said, degrees don’t infer expertise, it is experience and reliability, and a sizeable dash of humility and realism what you can do as a doctor, not as a director or tyrant or god.

    I am about to put up in my office my “ten commandments of psychiatry”, and the last reads as this:
    You can only help patients as much, NEVER MORE, than patients can help themselves.

    Have a nice evening.

    Addendum: I hope Dr Grohol sent a notice of warning to a prior posting by another writer he removed that was completely inappropriate. I for one will never dialogue with said individual again.

  49. I think I knew all those points, but liked reading them. Not one comment affects my opinion.
    I look forward to another ‘ten something.’

  50. I am on the same page as Beth. My therapist is a clinical psychologist and does not throw that in my face at all. He doesn’t even address himself as “Doctor” he does by his first name, that action alone in my opinion makes him down to earth. He is also very human and actually one of the most unpretentious and humble people I have ever met. He definitely does not posess the “god complex” cliche.

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