to think therapy/counselling isn't always the answer to MH conditions?

[sittinonthetopofthebay]

Two family members have tried it and have had no joy, as have I, years ago now thankfully.

Yet it is often bandied about as the one definitive answer to all MH problems: I am not being unreasonable, or am I, in thinking this is misleading and inappropriate?

There is lots of evidence to suggest that talking therapies are indeed useful even when dealing with psychosis. I know that when I was at my worst and hearing voices etc, just having someone else around who I could explain things to worked wonders (this was in a different country with a different attitude to treatment). Now it seems that the NHS is finally catching up with such attitudes, largely because of the work that groups like the Hearing Voices Network has done. Simply telling people that the voices aren't there doesn't help, ime, but having someone engage with me even when I was talking shite helped me come down.

Mental health is as wide as physical health. For many psychiatric disorders medication is the best way forward. Sometimes the problem is neurological rather than social.

There are different types of councelling and sometimes learning practical strageries (ie. CBT) is more useful than (woe is me!) person centred councelling.

you are right really tired mental health shouldnt be lumped together as one thing

^However, this is a very specific group of people for whom the antipsychotics are either not working or are causing such severe side effects that the cure is worse than the disease.^

There are lots of people that antipsychotics don't work for though - isn't the statistic that only something like a third of people diagnosed with schizophrenia find drugs successful? It's something pretty abysmal like that, anyway.

YY re income.

When there are big stories about 'X therapy effective for mild to moderate depression' I do think, what about the severe and enduring end?

Having said that, my dh has found meditation and sometimes mindfulness to be genuinely helpful, but only when provided by a wooey new age person, not when provided by someone employed by mental health services! And only when on a socking great cocktail of drugs as well, which control the psychosis to the point where he can actually take things in.

Group therapy and psychotherapy haven't helped at all.

There is no one-size-fits-all answer, because there is no one-size-fits-all MH condition.

TBH, a lot of current treatment for many MH conditions is guesswork anyway; knowledge of the various MH illnesses is wildly incomplete.

I think that group therapy is utterly crap and a waste of everyone's time. Competitive "Woe is me" does nothing to lift someone's mood. When I tried it I felt worse at the end than I did at the start as I had to hear everyone else's problems/ moaning.

Things that have really helped me was a protected behaviours course and a course for women run by Mind. I found that practical strageries much more useful than moaning. Protective behaviours is great for learning to manage anxiety.

With one to one councelling there is a danger of excessive dependence. Its almost like a drug. Transference can end up being a bigger problem than what the client started off with. Sometimes the only course of action that a therpist has is to reject the client as the transference is getting in the way. This rejection can be extremely hurtful to the client who doesn't understand. (Especially if the therapist is too much of a coward to explain why)

I miss my health visitor horribly and part of me wants to curl up on her lap like a small child rather than learning to face the nasty world like an adult. The health visitor who I had with dd was very good at managing the boundaries of a professional relationship and preventing emotional dependence. I did become excessively dependent on the health visitor with my son.

"counselling made no difference, medication had me sorted within weeks."

Here is your problem - something like depression doesn't just 'go away'. I had therapy for 5 years, I am now able to deal with life and what it throws at me, but I still have moments where it all feels a bit much.

If you expected counselling/therapy to fix you in 3 months, it will not.

I found that ADs only worked for me when I stopped taking SSRIs like Citalopram and Sertraline and started taking high dose Venlafaxine which is an SNRI (it works on both the Serotonin and the Noradrenaline in the brain).

Similarly I tried one Anti-Psychotic (Risperidone) and just got the side effects but it didn't get rid of the paranoia.
Aripiprazole is great compared to that because it's got rid of the paranoia and irrational thoughts I had.

Dependency can be a problem. But any decent counsellor expects it and knows how to deal with it. I always plan and stagger my endings (even when I am just seeing a client for six sessions). I'm sorry your HV wasn't trained to see the signs of it Really.

In my experience most therapists are crap. I have been to a number and they range from actively make things worse to nice person but ineffective. They often just don't know what to say I have found. I have been to one brilliant therapist who was able to cut through all my built up head crap and who just had a lot of common sense. But finding someone like that is hard.
But of course therapy isn't the solution for everyone. Depends on the issues and the person.

I was lucky enough to find a fantastic therapist. But I was in a position to want change. The patient/ client needs to want to get better otherwise it won't work. My DM has seen countless therapists, and has been on lots of different forms of medication, but when it comes down to it all she wants is to be told that she's right, and for someone to come in and act as a surrogate all-loving parent who will never find fault. Therapy has never worked for her.

Sadly many people can want desperately to get better but therapy still doesn't work.

I've known several people to have no obvious improvement from various talking therapies.

I finally went to therapy a few years back because people kept suggesting it to me, mainly due to my general anxiety. At the end of the first session the counsellor said to me, I don't think you need therapy, I think you need an SSRI to chill you out a bit as I think your anxiety is borderline OCD. Convinced my lovely GP to start me on one and it worked wonders, it just lifted me out of the anxious murky state I was in. Maybe counselling would have done the same eventually, but I respected the counsellor for suggesting that in my case, his approach probably wasn't best for me.

Agree with joanofarchitrave. Even if the patient/client puts all their effort in and very much wants to be better, it may still not work. And that isn't the client's fault. Sometimes there seems to be a suggestion that if therapy doesn't work, then the client obviously didn't want to get better or was too lazy to "make the effort". And that's inaccurate and hurtful.

Unpredictability in therapist competence is part of many people's frustrations with talking therapies.... Part of the problem lies in how the proffesions are regulated. There is a big difference between seeing a counselor and a registered psychologist. Anyone can call themselves a counselor, so it can be hit and miss.... It is very dependent on finding the right approach and the right person.

I've been through loads of different types of therapy : group, CBT, psychotherapy, sectioned etc as I've been 'lucky' enough to have persistent depression,eating disorder, PTSD, psychosis and suicide attempts. So I've seen quite a big range of Mental Health care.

Unfortunately I've found it all to be quite ineffective longer term. Id say being sectioned was the least effective because it just made me pissed off AND depressed. I feel better after say a years intervention but about every 5 years I go through another 2 years of shite.

I think a large amount of mh issues are cyclical and a whole life care plan would be beneficial and would stop the 'sticking plaster' thing. I also think it would be more cost effective. I'm on high dose 60mg fluoxetine at the moment and I still get suicidal thoughts. I've accepted that my mh is part of me and I think not fighting it & asking for help when I need it is the most effective treatment.

I,m a mental health nurse whilst CBT certainly can help I think sometimes there needs to be a combination of medication and talking therapies for example I work on a PICU a psychiatiac intensive care unit wevhave people that are acutely psychotic or very mood disordered sometimes we have to use medication to help,people get to a point where talking therapies may work I suppose I do work with people who are very extreme but I think both medication and talking therapies can be invaluable.

In amongst the waffle ^^ the point is if I can be responsible for and accept my mental health this is more effective than talking therapies IME.

To be fair though latara whilst risperdone did not work for you and arprizole does with other people bit may be the opposite there is still so much unknown about mental illness and why somevdrugs work for some people and also you will find that certain consultant psychiatrists will prescribe their medication of choice or whatever medication is thought to be the best right now.