Starting Therapy (hopefully)

I've probably needed therapy for several months now.  It's not something I could have handled in the months following my psychotic episode, but I definitely could have used it when I learned that my relationship is cracked to its very foundations.

I didn't seek counseling at that time because I felt I couldn't afford it.  We needed couples counseling, and I knew I'd need to see my doctor for med checks pretty often once winter really swung into high gear.  My pdoc isn't in network, so that would ultimately cost a few thousand dollars.

Since the death of my cat, I've felt overwhelmed by feelings of sadness and hopelessness.  I've lost a lot of motivation.  Though I know I don't really want to die, at times I felt ... well, kind of like I wanted to die.  It's clear that I need help.  But I can't afford to spend a few hundred dollars a month.  Not after spending a few thousand on vet bills last month.

Finally it occurred to me that my clinic at UCSF, which takes my health insurance, has one of the best mental health outfits in the country.  They probably also take my insurance.  I called them, and while they themselves are booked up, they could recommend a few people who had the knowledge to deal with my problems and who also take my health insurance.  

I think I've found someone I can work with (*fingers crossed*) and I hope to start late this week or early next week, depending on availability.  He's knowledgeable about both depression and ADHD, which I think will help me a great deal.  I've always wondered how depressed I would be if my ADHD weren't such a problem.  I underachieved in elementary school, and was constantly shamed by my teachers.  I came to believe that I was actually stupid and wished to hell everyone else would catch on and stop expecting so damn much of me.  When things got better in junior high and high school, I sort of felt like a fraud; when I got to college I hit a brick wall and was finally diagnosed with ADHD and learning disabilities; as an adult I've been chronically unemployed and underemployed.  Under these circumstances it's hard to have much self-confidence.  It's easy to get depressed.  

So I'm pretty glad to have a therapist who understands both mood disorders and AHHD.  One lesson I've learned is that if a therapist doesn't really understand ADHD, all sorts of problems can arise -- for instance, if you're chronically late, it's time to explore why you might be resistant to therapy.  Oh, of course you have ADHD, but what's really going on?  What's "really" going on, dammit, is that people with ADHD are chronically late.  That particular therapist was excellent in all other respects, so I kept working with her.  I guess the only good thing I can say is that I damn well learned to be on time to appointments.

Last week I was feeling pretty hopeless.  Just knowing that I'll be getting help has made a big difference.

Gottman Institute Comes Through (WAS Frustration with "Gottman Certified" Marriage Counselors)

This post originally was about my frustrating experience with the Gottman institute regarding our incompetent marriage counselor.  He had been misrepresented by his clinic director as having "advanced training and certification" in the Gottman method of couples counseling, when in fact he had neither.  In order to seek redress from this situation, we needed a letter from the Gottman institute stating that fact.

Due to star-crossed emails, as well as a manager being out of the country, I didn't receive any communication from the Gottman Institute regarding this matter.  After what seemed like no communication, I got peeved, and ranted about it where I rant about everything -- this blog. 

This morning, I did receive an email promising the letter we need.  It turns out that the Gottman folks sent us an email, but gmail ate it (it's been doing that lately).   They restated the offer to help us find a real Gottman therapist, and better yet, the chain of command is getting involved.

I thus retract my rant.

The Gottman Method of Marriage Counseling: It Might Not Be What You Expect

UPDATE:  Thanks to a google alert (presumably), an employee at the Gottman institute got in touch with me regarding this post.  This individual was able to ascertain that my couples therapist is not, as we were led to believe, Gottman Certified, and they've kindly offered to help my partner and me find someone who is. 


I hope to learn how to verify Gottman Certification, at which point I will write a post about that.  As for this post, I will be leaving it up for the sake of informing others how misrepresentation in marriage counseling can go horribly wrong.  I may revise it or remove it in the future depending on how events play out.


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When it became clear that my husband and I needed marriage counseling, we found an outfit that used the Gottman Method.  We signed up with a local counseling clinic that offers a series of 12 sessions designed to Improve Your Relationship by Building Intimacy and Communication Skills.  Counselors who work with the Gottman method are certified by the Gottman research institute.

Six sessions into our twelve week session, I thought I'd evaluate my experience with the Gottman method and its effectiveness so far.  It's a big topic so it's going to be a series of posts.  This, the first post, will discuss the assumptions and expectations I had going into it and how they've played out.

First, a few words about the Gottman method and why we chose it.  The method is based on two things:  Dr. John Gottman's years and years of psychological research, and Dr Julie Gottman's years and years of clinical experience.  We chose this method because of its research and evidence-based foundation. Based on Gottman's own website, we thought that

Gottman Method Couples Therapy is a structured, goal-oriented, scientifically-based therapy. Intervention strategies are based upon empirical data from Dr. Gottman’s three decades of research with more than 3,000 couples.

I have ADHD.  We have some serious issues gnawing away at the foundations of our marriage.  We're kind of floundering right now.  In other words, structure sounded pretty good.

The Innermost Circle of Hell: Relationship Counseling

My partner and I started seeing a couples counselor last month.  What with my partner's travel schedule, and the counselor's travel schedule, our second visit wasn't until a few days ago.  And it was awful.

The therapist we're seeing uses the Gottman Method.  We chose this method because it's evidence based, and we're both big fans of that sort of thing.

Another thing that appealed to me about the method is that you start with exercises that help you build positive feelings your relationship.  This is supposed to give you a strong foundation of love and affection from which to work on conflict management.  Conflict management, by the way, is supposed to be one of the later steps in the process.

For some reason, our therapist chose to bypass this step.  My partner mentioned one of his frustrations, and the therapist asked me if I was OK with using the session to address it.  I wasn't, really; but I figured, hey, this process isn't always going to be comfortable for me, right?  Besides, our therapist was there to help us if things got bad, and maybe he could teach us some new skills to keep it from getting bad in the first place.

Nope.

Taking Lamictal (or Prozac, or Seroquel, or Whatever)? You Still Have to Deal with Your Shit.

I've recently had conversations with several friends that have me thinking about the way North Americans (and perhaps the English-speaking world in general) have come to define and treat mental illness.

One friend of mine, who has had symptoms of depression for as long as I've known him, is finally considering diagnosis and treatment -- specifically, medication.  He says he has "bad genes".  In his view, I guess, medication will correct the expression of these genes and make him less depressed.

As an example of his "bad genes", he described an incident in which his mother took off for the bar, leaving him sick with the flu and in charge of caring for his two-year-old sister.  Later in the conversation, he made repeated references to his frustration with many of his colleagues, and how he had to "do their work for them".  Hmmm.  Kind of like you had to do your parents' work for them?  How do you feel, by the way, about your mother abandoning you while you were sick?  But he's not interested in therapy.  He just needs help for his "bad genes".