Seeing a Counselor

brb_2013

I struggle with deep issues related to my self esteem, depression, and a lifetime of poor relationship with food. I've lost 100lbs before, through dedicating all of my free time to food and exercise and I broke, couldn't take it anymore and gave up. I've regained 50-60lbs.

The issues never went away, they were ignored and pushed aside to make room for obsessing about food and exercise. So now I'm left with all those feelings, plus the new guilt of having seen myself "smaller" (certainly not healthier), and now being huge again. I disgust myself constantly.

How can I possibly take care of myself when at my core I think I'm worthless? I imagine putting forth efforts to be healthy and losing weight again, but then failing to these same thoughts and feelings that will resurface even if I manage to bury them long enough to reach my goal weight. The mental health issues will still be there.

So I've made the decision to see a counselor. I have an appointment on Monday and I will do my best to keep at it even though it means working more to be able to afford it.

Does anyone have advice on this first appointment? I never have seen a counselor and am feeling apprehensive.

peachyfuzzle

Be honest, and be open regardless of how much it might hurt to dredge up old feelings.

You're paying for it, so unless you give it the attention it needs, you'll gain very little to nothing at all.

snowflake954

I don't have any advice, but just wanted to say---good for you! Tackle that problem, and go on with your life. I agree with above, just be yourself. Best of luck.

CollieFit

It's normal to feel apprehensive. The therapist will expect you to feel apprehensive. Try to be open and honest. It's a two way process. See if you feel you have a rapport. Ask how the counsellor works. There are many different modalities of counselling and psychotherapy (some look at the past more than others, some work entirely in the "here and now", some are more directive, some more client-led etc) and it's a case of finding someone whose approach you feel comfortable with. Good luck and great decision. x

Lourdesong

Ask when you should expect to benefit from their services.

gailmelanie

It would be good to have some goals in mind and at least a vague idea of what you want from the counselor. The real point of going to a therapist is to have someone skilled in guiding you through these issues and helping you build some skills to deal with them. It may not totally eliminate all the issues, but it can definitely help you get some relief. As CollieFit says, it's a good idea to ask the counselor how they work. If you don't feel comfortable with the person, you won't get as much out of it. I recommend looking into a therapist who can do EMDR with you. There may be things in your past which you don't consciously think about, but which affect your self-image and behavior that you need to discover and examine to help you reduce their power over your thoughts and behavior. Don't expect instant results. If it takes less than a year for you to feel like you've made good progress, you'll be doing well.

dubird

Be honest both with the counselor and with yourself. It will be uncomfortable opening yourself up that much, but it's necessary to see where you're at and how to get to where you want to be. And if you go and you don't like the counselor you've seen, it's perfectly ok to find another one or ask for a different referral. If you don't feel like you can become comfortable sharing intimate thoughts and feelings, you won't get any benefit out of it.

On a practical note, you can also write down things you want them to know so you won't forget anything. Maybe keep a log for a few days leading up to the appointment, writing down how you're feeling over the course of the day and any thoughts you had that you think might be important. That can give you a starting point for the conversation, an ice-breaker if you will, and might make the process more comfortable for you.


Edit: wanted to add something. There is a chance they will want you to start medicine. A good counselor or doctor won't default to that, they'll try other things to help. And some of those things may work out well for you. But if you do end up needing some kind of meds to correct a balance, there's no shame in that. Clinical depression is an imbalance in chemicals in the brain, something your body doesn't know how to adjust. The meds aren't 'happy pills' and they're not going to magically fix everything. What they do is bring things back into balance, allowing you to experience normal emotions. For me, they help me balance myself so I'm not stuck in the fail cycle for a long time. I still have those feelings and it will get me down for a while, but I can pull myself out of it now, instead of having to live with it for days on end. Everyone experiences it differently, and hopefully, you won't need to go to meds. But that is a possibility, so be aware of it.

But, I will say if that's the first thing they suggest you do, get a second opinion. That shouldn't be the first thing they suggest unless things are REALLY bad.

Shells918

Write down what you want to discuss, or better yet, print out what you posted here. I think you're doing something wonderful for yourself by going to a counselor. Good luck!

Laurasparkle90

If you need anyone to talk to I'm here I had to see a counsellor and go through cognitive behavioural therapy. The best advice I can give is to be open and honest. Also, don't make too many judgements based on your first appointment. I left my first appointment thinking yeah this isn't for me, but I'm glad I saw it through to the end. Best of luck x

lorimc71

May I recommend CBT Cognitive Behavioral Therapy. See if your counselor is trained for it. If not, find one. It saved my life. The first appointment is to be open and honest of what you want to get out of being there. I would also interview the counselor and make sure they are going to do their part. There are some that will just listen to you "forever"but never really give you to tools you need to get better.

NaturalNancy

Good for you!
you are taking a step in making a positive change in your life.
It can be uncomfortable at times and crying and stuff but it will be ok.
I think TJ advice above is good!
Have goals in mind, what u want to get out of it and absolutely ask how they will help you.
Good luck!

CollieFit

Lourdesong wrote: »

Ask when you should expect to benefit from their services.

That is a question no counsellor will be able to answer.

CollieFit

PS: I am a counsellor.

CollieFit

lorimc71 wrote: »

May I recommend CBT Cognitive Behavioral Therapy. See if your counselor is trained for it. If not, find one. It saved my life. The first appointment is to be open and honest of what you want to get out of being there. I would also interview the counselor and make sure they are going to do their part. There are some that will just listen to you "forever"but never really give you to tools you need to get better.

CBT may or may not be suitable subject to what the underlying issues are. If the OPs issues are in her past then other modalities may well be much more appropriate.

Lourdesong

CollieFit wrote: »

Lourdesong wrote: »

Ask when you should expect to benefit from their services.

That is a question no counsellor will be able to answer.

Yes, I know. The OP is working extra to pay for a service that may never end. The potential 'benefit' (and there may quite feasibly be none) for the amount of investment involved on the part of the OP (and most people) is something worth considering.

CollieFit

Progress pretty much depends on the willingness and ability of the client to engage constructively with her material, under the guidance of the counsellor. Sometimes people find out they are not ready to work on their issues, but no one ever finds out until they try.

I don't know what is behind your exceedingly pessimistic "it might not make a difference and be all a great waste of money" thoughts. Perhaps you weren't able to benefit from therapy in the past, but that should not serve as some kind of "warning" to other people wishing to address their own issues?

Some people's defences and patterns of behaviour are so ingrained over the years that it may well take some time for them to change. Assisting someone with their mental health isn't like calling in a plumber and asking them "how long will you be?". Any counsellor who claims that an as yet unknown client can be "cured" within a predetermined timeframe in my opinion would be a fraud.

There are however options to agree a certain number of sessions, such as 5 or 10, and then jointly review the position and see if the client feels she is managing better. Therapy doesn't *have* to be open ended.

Lourdesong

CollieFit wrote: »

Progress pretty much depends on the willingness and ability of the client to engage constructively with her material, under the guidance of the counsellor. Sometimes people find out they are not ready to work on their issues, but no one ever finds out until they try.

I don't know what is behind your exceedingly pessimistic "it might not make a difference and be all a great waste of money" thoughts. Perhaps you weren't able to benefit from therapy in the past, but that should not serve as some kind of "warning" to other people wishing to address their own issues?

So if someone goes to therapy 2x a week, for years, and spent thousands of dollars, and is no better off, it is because they were unwilling to engage and make sacrifices, or weren't 'ready'. Or perhaps they just need a few more sessions, eh?

And please don't psychoanalyze strangers, its rude and presumptuous.

CollieFit

If I felt I had not made progress after years of therapy I would have discussed it with my therapist and possibly looked at seeing another practitioner.

What I wouldn't do is assume from my own experience that all therapy is useless, and then project my dissatisfaction in to innocent others by trying to talk other people out of it, because it didn't work for me. That is nothing short of irresponsible.

Lourdesong

The OP is going to be making a lot of financial sacrifices and sacrifices with her time, and so the financial aspect (the sacrifice) vs benefit (which you pointed out more overtly than I did that no counselor can answer) is worth considering.

Please stop inventing stories about me just because I'm not in here singing the praises of your profession.

brb_2013

CollieFit wrote: »

There are however options to agree a certain number of sessions, such as 5 or 10, and then jointly review the position and see if the client feels she is managing better. Therapy doesn't *have* to be open ended.

This is helpful, I didn't know that. I may need to limit it at first, I can only take so many extra babysitting jobs so I can't guarantee being able to continue 6 Mos from now so my counselor should be aware of that right?

brb_2013

Lourdesong wrote: »

The OP is going to be making a lot of financial sacrifices and sacrifices with her time, and so the financial aspect (the sacrifice) vs benefit (which you pointed out more overtly than I did that no counselor can answer) is worth considering.

Please stop inventing stories about me just because I'm not in here singing the praises of your profession.

You're both coming from kind places, please don't continue to argue. Lourdesong, I do have concerns about benefits of course no one wants to waste time or money but I will pay attention to chemistry between the counselor and I and see if he's someone I can see myself really opening up to- and I just have to see how it goes. I have tried to made this call (for an appointment) for years and years. Sat on the floor with the number dialed just not able to execute. I'm glad I made it that far.

CollieFit

brb_2013 wrote: »

CollieFit wrote: »

There are however options to agree a certain number of sessions, such as 5 or 10, and then jointly review the position and see if the client feels she is managing better. Therapy doesn't *have* to be open ended.

This is helpful, I didn't know that. I may need to limit it at first, I can only take so many extra babysitting jobs so I can't guarantee being able to continue 6 Mos from now so my counselor should be aware of that right?

Absolutely. :-)

Be very open about your financial position. If the time is right for you and you've found the right person, there is plenty that can be achieved in six months. I am always really humbled by how hard people work and how motivated people are, and certainly would never "drag out" a therapy to keep someone paying when they are not benefitting. I would consider that completely unethical. The most important thing is a strong rapport between you and your therapist. I think it's really essential, as telling someone your innermost stuff takes MUCH courage and trust. Personally I like to do joint reviews every six weeks to see how we're getting on, if the client desires a change of focus etc. My approach is one of "team work", rather than the "doer" and the "done to" and find it is what most people also like best. Sometimes people can have unrealistic expectations and think we have a magic wand which we can wave around and fix things with no real input or cooperation from the client, like someone dropping the car off with a mechanic kind of thing. That can be very difficult, but you sound really motivated. I hope things go well for you. xx

htimpaired

lorimc71 wrote: »

May I recommend CBT Cognitive Behavioral Therapy. See if your counselor is trained for it. If not, find one. It saved my life. The first appointment is to be open and honest of what you want to get out of being there. I would also interview the counselor and make sure they are going to do their part. There are some that will just listen to you "forever"but never really give you to tools you need to get better.

I'm speaking from the experience of being in therapy and being the therapist. You have every right to ask what their credentials and specialties are. The only person giving medications should be an MD (or maybe an NP or PA). But they usually don't do talk therapy. They should be discussing what your goals for treatment are, and working with you on how you know you will reach your goals. And like others said, be honest with them about all aspects of treatment, including your financial situation.

Cognitive behavioral therapy is useful for depression, anxiety, low self worth...and what I like about much of it is that there are tools you can take home and work on in between sessions. The effectiveness of treatment has so many factors-the relationship between the therapist and client, the issues, the work the patient does outside of sessions, other stressors that arise during treatment...and sometimes it does take a few tries to find a therapist you "click" with. Don't hesitate to ask for a referral to someone else if you don't feel that "click". A good therapist worth their salt should be able to recognize when it's best to refer on for the benefit of the patient, or when they know of another provider who would be better suited for their situation.

My first therapist was a psychoanalytic therapist (think Freud-daddy issues and all that). We did NOT work out and I quickly stopped going. My second therapist was CBT oriented-and was able to obtain an accurate diagnosis, which helped her to focus treatment much more effectively ot my situation. She made a difference for me.

Best wishes as you move forwards!