I hope this helps you to 'work' better in therapy. Feel free to reply and let me know what you think!

Dr. B

'Trapped' replied on November 30:

What you said did help, in fact so much that I am now finished with therapy. When I realized I have to take more responsibility (esp. with trying out new ways of thinking) I did that and lo and behold, it worked. Thank you!

Tuesday, October 10, 2006
Suzy Q writes:
My therapist forgets everything I tell her from one session to the next. I asked her about this and she just asked me back how would it be helpful if she remembered. I told her because I feel she doesn't care when she forgets. But she still does it. It feels weird. Is this normal? Don't therapists read over their notes before the patient arrives? What can I do, I like her well enough otherwise.

Dear Suzy Q:

No, this is not normal! If your therapist cannot remember important things about you and does this session after session, then I don't think she can be helpful to you. You may like her well enough but I doubt that she will be able to tune into you enough to be truly helpful. Most therapists do check their notes before seeing their clients so they jog their memories about the issues their clients are struggling with. I would move on to another therapist ASAP.

Dr. B

Tuesday, October 03, 2006
What am I? writes:
I am a 34-year-old accountant from Louisiana . I have been diagnosed with depression and attention deficit disorder. I don't generally feel depressed. I've probably had ADD all my life. I am taking Effexor and Adderal XR and feel better than I have in my life, but there are some things in my personality that are not explained by either of these diagnoses.

I am very forgetful. When I don't take my meds, I change into a totally different person. I become fixated on my oldest son's father and my every waking thought is of how to see him and be with him and primarily have large amounts of slightly bizarre sex with him. Well maybe blood drinking is a little more than slightly bizarre. I want to dress in all black, listen to hard rock music and drive really fast. The story about JT's father is a very long one and it's not like he's prince charming. I am very intelligent and realize (when I'm taking my meds) that the fixation has nothing to do with the father, but of the association with the excitement and pleasure that he represents. I really become this dark person and I like the way it feels. The fantasies of being with him become my only reality. They are continual from morning til night, at work and driving. That doesn't sound like depression to me, but the antidepressants help. But is this forever.

I'm married and too cowardly to ask my husband for a divorce. He's crazy too, but this is about me. I have 4 kids.

Although these symptoms are bad, they were actually worse in my teens with more outlandish fantasies about violent sex, superpowers and sex which I hated because I was raped at the age of about 8. That is the very very short version of the problem. Again HELP.

Dear Who Am I?

You're right. There is a lot more to what is going on with you than depression and ADD. Those diagnoses do not capture the suffering that is attached to your sexual abuse. I would imagine that the abuse has caused a split within you between your wild and risk-taking adolescent and your responsible adult. I'm not sure what you want to work on but I think that therapy could help to heal the split within you so that your wild side and your responsible side could co-exist and work with each other so that you would not feel the need to swing from dangerous behavior to super-responsible but boring. You could benefit from therapy--there is more to you than uncomplicated depression and ADD!

Dr. B

Monday, September 25, 2006
A struggling trainee welfare worker writes:
I am currently in training to become a welfare worker and I would like to understand how to enable and empower my clients to make their lives better. Also how to apply empowerment to practice. Any help would be much appreciated.

Dear Struggling:

What a great question you have raised! Many of the things which I say in my book apply to all types of helping relationships, not just those in psychotherapy. Here are the things I've learned over the years to help you help others:

• You can't change anyone but yourself. There are 6 (or 7) billion people in the world but only one you get to do very much about.
• If others want to change, if they are motivated to change, and they are looking to you for help, then you can influence them (but you can't make them change).
• Work on connecting empathically to those you want to help but don't tell them what to do--that is their choice. Respect their right to change or not change.
• Work on "having a life", that is, invest in your family and friends in a way which is satisfying and growthful for you. Work on being a healthy, well-differentiated person.

Dr. B

Saturday, September 16, 2006
Ali writes:
Dr B, I've been seeing my therapist for 2 1/2 years. My therapist wants me to go to couples therapy with my husband so that we can work on parenting our son who possibly has ADHD (Attention Deficit Hyperactivity Disorder) and/or ODD (Oppositional Defiant Disorder). He tells me this a few sessions after I told him about moving out of state in 2007, so I probably won't see the therapist again. I have been feeling very upset about this. I feel like I have wasted time, his and mine. I don't understand why I can't work on *my* issues and take care of my family's later. Is it possible to go to couples therapy and also have individual therapy? Is there some sort of "conflict of interest" between these?

Dear Ali:

Your question raises a number of very important questions.

First of all, when you say that your therapist wants you to go to couple counseling it does not mean you have to. Remember, your therapist is a consultant to you, not a judge or a parent. You don't have to do what your therapist wants. After all, you're hiring him! So, you can talk to your therapist about what it is you want and listen to his reasons for saying what he did and then make up your own mind. If you feel that now you need indivdual therapy only, then I would stick to that.

Second, couples therapy does not always have as it's goal getting the couple closer together. The goal, decided on by the clients, can be to learn to separate in a healthier manner or it can be learning to co-parent more effectively.

Third, couples therapy does not have to be in conflict with individual therapy--but it can be, depending on the agendas of each. If in couples therapy the clients decide that they want to work on making their marriage work better and one of the parties is in individual therapy working on ending the marriage, that is obviously a conflict! If, however, that same client is working in indivdual therapy to become healthier as a person and that includes working on their marriage, then the two therapies are working together and they are compatible.

Agendas are so important in therapy! Define yours as clearly as you can! Best of luck.

Dr. B

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