First therapy session soon. What to say?

[Wren]

I was coaxed by my gf to "get professional help" and she booked an appointment with her therapist. I'm going there in a week. Hopefully she'll prescribe me some meds (dysthymia, depersonalisation) and that's all I need I guess. I believe there's no need for a therapy or more visits.

Any advice on what to say to sail through smoothly? I'm sure as hell not bringing up my suicidal ideation and won't say anything that could land me in a hospital.

I'm worried, so anything helps.

 

[k75]

I don't think you need to worry much about it. The therapist usually guides you through it. First off, they'll likely introduce themselves and tell you kind of how they operate. Discuss confidentially and things like that. They ask questions like if you've been to therapy before, what you're hoping to get from it, what is bothering you, if you've ever been diagnosed with anything, etc. It's pretty much a getting to know you visit and tends to go quickly.

Therapists aren't generally the ones who prescribe meds, by the way. That's usually a separate psychiatrist or psychiatric nurse.

Some places require you to see both, so beware of that.

 

[seho_j]

I've been to several different psychiatrists/therapists/counsellors and in the first sessions, they are the ones that talk more. In my experience, they will ask you a lot of questions about why you are there and about your past. They might ask you what you want to achieve by going to therapy.

Just answer honestly about your symptoms except for the suicidal ideation. You might want to write down the symptoms if you get nervous and forgetful like me.

It is okay to say you have thought about suicide in the past, but I understand if you don't want to talk about this at all. I actually have been honest with this and was not hospitalised (in the UK), but some are not so lucky.

 

[Wren]

@k75
Thanks for the feedback. I'll have half an hour for that so I'll try my best. I'm not sure what her title is, but she sees people and gives them receipts for meds which is exactly what I need.

@seho_j
Thanks. I expected so much. although I'm a very honest person, I read a lot about other people's experiences and will lie and bullshit my way through if I must.

 

[seho_j]

Thanks. I expected so much. although I'm a very honest person, I read a lot about other people's experiences and will lie and bullshit my way through if I must.

Understandable, haha. It is very difficult to be honest and vulnerable to a stranger, especially when that person has the power to commit you into a hospital. But most sane doctors will not do that unless they think you will cause harm to others or yourself so just avoid that! Good luck on your first session :)

 

[k75]

I'm not telling you to do this, especially if you're not comfortable, but I have told most of my therapists about my suicidal ideation. I was brutally honest EXCEPT for the whole planning to actually do it part. If they don't think you're going to leave their office and hurt yourself or someone else, it's generally ok. I said I fantasize about it and it scares me, I'd never do it but I can't get rid of the thoughts.

The reason you might want to consider being more open about that is maybe they can actually help. I was prescribed lithium specifically because I was suicidal, and it helps. It's the only drug proven to help with that. It could be worth trying.

 

[Wren]

@k75
I'm not actively suicidal and am not doing anything for at least several years. No past attempts or self-harm, so playing along will be easy.
I don't think I need continuous therapy as my problems are purely existential. No traumas or wounds to heal here. Just need some magic candy to calm the chemical brain storm.

 

[k75]

I'm glad to hear that! I just wanted to throw that out there just in case. I hope your visit does what you need.

 

[TAW122]

@k75 has summarized it up pretty well and that was pretty much my experiences when I went to seek professional 'help' in the past.

@seho_j I also agree about not 'mentioning suicidal stuff' for the possible risk of being locked up.

@Wren If you are asked, you should be direct and firm while emphasizing that you don't have the means to harm yourself nor are you planning on actually harming yourself. This is to prevent you from being hospitalized or locked up against your will.

 

[beatlegirl]

Good luck @Wren

Remember to have a calm demeanor going in and out of there. I really don't have much advice except to stay calm and try to be as specific as possible, as to not let the therapist introduce more topics that could lead to prolonged therapy.

I hope it all works out, you can do it. x

 

[Wren]

@beatlegirl
Thanks! I see it as an opportunity to practice my acting skills :)

 

[Backwood_tilt]

Just need some magic candy to calm the chemical brain storm.

You will need to see a psychiatrist then, as therapists are not licensed to dispense medications.

I'm also somewhat fearful of the way you describe this. Unless you have an actually treatable illness that there are effective meds for, you might be getting yourself into more trouble than you need. Please be aware of the risks.

 

[Wren]

You will need to see a psychiatrist then, as therapists are not licensed to dispense medications.

I'm also somewhat fearful of the way you describe this. Unless you have an actually treatable illness that there are effective meds for, you might be getting yourself into more trouble than you need. Please be aware of the risks.

I'm not sure about the terminology, but my girlfriend sees this doctor, goes to sessions, and gets prescribed medication. She's doing much much better and recommends this lady, so I'll describe my symptoms as best as I could and see what happens. I'm aware of the risks, but it's worth a try. Thanks for the concern, appreciate it!

 

[Sensei]

Hopefully she'll prescribe me some meds (dysthymia, depersonalisation) and that's all I need I guess.

How serious is your depersonalisation? If it's serious, it could be depersonalisation disorder, and then you should get psychotherapy, not medication.

 

[Wren]

How serious is your depersonalisation? If it's serious, it could be depersonalisation disorder, and then you should get psychotherapy, not medication.

Not serious. It's annoying but not interfering with daily life. None of my symptoms are serious. They are there, but not severe enough to worry. Or so I think. I'll see a professional and hopefully figure it out.

 

[Sensei]

Not serious. It's annoying but not interfering with daily life. None of my symptoms are serious. They are there, but not severe enough to worry. Or so I think. I'll see a professional and hopefully figure it out.

Yes, I think it would a be good idea to check it out. You never know.

 

[shoganai]

Are you seeing a psychologist or a psychiatrist? Psychologists (generally referred to as therapists) cannot prescribe medications, which it sounds like is what you want. Psychiatrists can prescribe you medication, though.

Perhaps you could bring it up to your therapist? They may be able to refer you to a psychiatrist, or at least give you a recommendation.

 

[Wren]

Are you seeing a psychologist or a psychiatrist? Psychologists (generally referred to as therapists) cannot prescribe medications, which it sounds like is what you want. Psychiatrists can prescribe you medication, though.

Perhaps you could bring it up to your therapist? They may be able to refer you to a psychiatrist, or at least give you a recommendation.

I should have clarified. It's psychiatrist. The mind reading magic man.

 

[shoganai]

I should have clarified. It's psychiatrist. The mind reading magic man.

Great. I was worried I'd come off as pedantic, but didn't want you to end up disappointed.

 

[Wren]

UPDATE:

I went to see the mind-reading witch that gave me magic beans today.
Well, I mostly failed at bullshitting my way through. Nothing went as I planned and she asked a lot of open questions I had to half-heartedly answer and felt like a failure the whole time. I didn't bring up a lot of things I felt would keep me there for longer. I couldn't open up and talk to her with ease and it felt like interrogation. She gave me a prescription for escitalopram and scheduled another appointment a month from now. I got the pills from the pharmacy downstairs and am on my way home.

 

[randomz]

UPDATE:

I went to see the mind-reading witch that gave me magic beans today.
Well, I mostly failed at bullshitting my way through. Nothing went as I planned and she asked a lot of open questions I had to half-heartedly answer and felt like a failure the whole time. I didn't bring up a lot of things I felt would keep me there for longer. I couldn't open up and talk to her with ease and it felt like interrogation. She gave me a prescription for escitalopram and scheduled another appointment a month from now. I got the pills from the pharmacy downstairs and am on my way home.

well, it could have gone worse. I'd advice you to be clear with her/him and tell the truth as that''s the only way the therapist could help you. Of course if you don't feel OK with her/him you should for another therapist that you might like more.

 

[k75]

UPDATE:

I went to see the mind-reading witch that gave me magic beans today.
Well, I mostly failed at bullshitting my way through. Nothing went as I planned and she asked a lot of open questions I had to half-heartedly answer and felt like a failure the whole time. I didn't bring up a lot of things I felt would keep me there for longer. I couldn't open up and talk to her with ease and it felt like interrogation. She gave me a prescription for escitalopram and scheduled another appointment a month from now. I got the pills from the pharmacy downstairs and am on my way home.

I know and understand why you're reluctant to open up and talk. But I still believe the more you tell her, the better. That's the only way she'll know what medication is most appropriate for you. Otherwise you're likely to fall into the trap where you get meds that don't work and have to keep trying or just give up.

 

[Wren]

@randomz and @k75
Thanks for the feedback.
I don't think I'm going back except for the second appointment. It was a waste of time and I'd rather keep up the façade than put effort into exercises in futility. I showed up, and both my gf and psychiatrist know I've done something for my mental health. I placated two people who care and that's it. If the meds don't work I'll drop them, if they do I might keep taking them.

 

[HelensNepenthe]

@randomz and @k75
Thanks for the feedback.
I don't think I'm going back except for the second appointment. It was a waste of time and I'd rather keep up the façade than put effort into exercises in futility. I showed up, and both my gf and psychiatrist know I've done something for my mental health. I placated two people who care and that's it. If the meds don't work I'll drop them, if they do I might keep taking them.

@randomz and @k75
Thanks for the feedback.
I don't think I'm going back except for the second appointment. It was a waste of time and I'd rather keep up the façade than put effort into exercises in futility. I showed up, and both my gf and psychiatrist know I've done something for my mental health. I placated two people who care and that's it. If the meds don't work I'll drop them, if they do I might keep taking them.

It's hard to find doctors who click with you. It takes a lot of effort (and many places know this, yet lack the ability to help people who chronically need of). Therapists are not all one stop shops to help, unfortunately.

 

[k75]

@randomz and @k75
Thanks for the feedback.
I don't think I'm going back except for the second appointment. It was a waste of time and I'd rather keep up the façade than put effort into exercises in futility. I showed up, and both my gf and psychiatrist know I've done something for my mental health. I placated two people who care and that's it. If the meds don't work I'll drop them, if they do I might keep taking them.

Fair enough. The totally respect that. I'm sorry if I've annoyed you with anything I'm saying. I really do hope it does work for you and wasn't just a waste of time. I've found sometimes meds make a lot more difference than you realized would happen.

Just a thought, though: you might find with good meds you don't need a facade.

 

[Wren]

Fair enough. The totally respect that. I'm sorry if I've annoyed you with anything I'm saying. I really do hope it does work for you and wasn't just a waste of time. I've found sometimes meds make a lot more difference than you realized would happen.

Just a thought, though: you might find with good meds you don't need a facade.

Oh no, you didn't annoy me at all. Sorry if I came off as offensive, that's not it whatsoever. On the contrary I'm glad you even bothered by commenting on this thread.
I'm just angry at myself for tanking the appointment. I'll see how the meds work out and will consider my next move in months to come.

 

[k75]

Oh no, you didn't annoy me at all. Sorry if I came off as offensive, that's not it whatsoever. On the contrary I'm glad you even bothered by commenting on this thread.
I'm just angry at myself for tanking the appointment. I'll see how the meds work out and will consider my next move in months to come.

Don't worry, you're fine. I just didn't want you to think I was like badgering you or anything. I don't think it sounds like you tanked the appointment. I mean, it didn't go like you had planned but honestly, you couldn't just say nothing or you would not have gotten your medication because they would not have had a single clue what to do with you. And if you'd flat-out lied, you probably would have gotten nothing or something super inappropriate. So I really wouldn't beat yourself up over it. I feel like if you're going to bother to do the thing anyway, why halfass it? And you proved you're getting help and got your pills, so really it was a success.

Also, judging by my own experiences, the next should be better. It's no longer a get to know you kind of thing, and the questions will probably be more about the medication she gave you. Like did you have any side effects, do you feel it's helping, how did it make you feel, that kind of thing. The goal is just to follow up and make sure it's not harming you or anything like that.

 

[Wren]

@k75
Thank you for the encouragement. I haven't considered the next appointment as a second chance. What a fatalist I am. I suppose I just expected different approach and questions so my preparation was in vain.
You are right, I didn't do as bad as I've convinced myself this morning.

 

[k75]

@k75
Thank you for the encouragement. I haven't considered the next appointment as a second chance. What a fatalist I am. I suppose I just expected different approach and questions so my preparation was in vain.
You are right, I didn't do as bad as I've convinced myself this morning.

I really think you did fine and you will do fine! Bonus is the next should be a much shorter appointment too. My psychiatrist visits are usually 10 to 15 minutes once we're established.

 

[Quarky00]

Psychiatrists are very aggressive and do an interrogation. That's not my personal opinion but what my physician , SW , and other professionals in the healthcare system told me, off the record. I always memorialize my lines. I have recorded some and filed ethic complaints.

a lot of open questions I had to half-heartedly answer

- "I'm sorry could you rephrase that question? It's vague"

Another great one for changing the subject to what you want:
- "That does not really speak to me, but I'd like to note that <whatever you want to bring up>".

it felt like interrogation

- "I'm sorry but I'm a bit stressed, could we take it down a notch, more calmly?"
- "Could you please hold for a moment? You are asking a lot. I need to think for a second."

I couldn't open up and talk to her with ease

You don't really need to open up because they are not your therapist and wouldn't listen to your pain -- they are just 'doctors' treating illness - so just list your symptoms.


I actually have these replies written down, and memorialized before psychiatric assessments . My favorite is: "That sounds like a general statement, could you please rephrase that in a form of a question that addresses me personally?"


#HackingTheSystem