anonymous asked:

Last weekend I overdosed to, with meds and alcohol. I came in the hospital to and because it was not safe for me to let me go home they sended me in the night to a mental clinic, I stayed there for three days. I steel feel suicidal and thinking of other ways to do it. Got any tips for me to stay alive?

Always tell people how you’re feeling so they can help you

Just to clarify...
  • psychiatrist is a medical doctor (M.D.) who specializes in preventing, diagnosing, and treating mental illness. This is the person you would go to to get your prescription medication. 
  • psychologist has a doctoral degree (Ph.D., Psy.D., Ed.D.) in psychology. In the sense that most people think of psychologists, this is the person you would talk to in therapy; however, he or she does not prescribe mediation (except in a select few states). Psychologists hold a wide variety of other jobs though, including research positions, teaching positions, and working in hospital settings.
  • licensed mental health counselor has a master’s degree (M.A., M.S.) in psychology, counseling, or a related field. Many of these individuals provide counseling and psychotherapy. However, holding a master’s degree in psychology does not make one a psychologist. 
  • clinical social worker has at least a master’s degree (M.S.W.) in social work. They also can provide therapy, but also work in case management, advocacy, and hospital discharge planning. 
  • Further, there is a difference between counseling, which is typically provided by someone with a degree in counseling or social work, and psychotherapy, which is typically provided by someone with a degree in psychology, although the terms are commonly used interchangeably. 

Teen Wolf AU Trailer: Sleepwalking
Please, note: viewer discretion is advised

Stiles doesn’t remember waking up. It just happens to him at some point. He wanders through reality, goes to school, hangs out with Scott, but something just isn’t right. When he starts seeing things, he thinks he’s gone insane. In a mental clinic he meets a guy who doesn’t remember waking up either. Seems like they’re stuck in Bardo, the in-between state, but they can’t be dead. They have never died. Haven’t they?..

ps. For Simone, because of reasons.

Source:  Esterberg, M. L., & Compton, M. T. (2009). The psychosis continuum and categorical versus dimensional diagnostic approaches. Current psychiatry reports, 11(3), 179-184.

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10 Things I Wish Clients Knew Before Starting Therapy

I realized as I started to write this list that I could probably put way more than 10 things on it, so maybe there will be a part 2 eventually. Your suggestions/additions are very welcome! Of course, clients are very different from one another, but in general, here are some things I wish clients knew before they started therapy. (Credit to the anon who suggested doing this list!)

  1. Your therapist is not your friend. You and your therapist should have an important, close relationship, but it’s the not the same as a friendship. This is a good thing! (See #7). You want your therapist to be able to see you and your treatment as objectively as possible while being caring and empathetic about you as a person. This will help you two work successfully together. It’s okay if it takes time to figure out how your particular relationship will work, and if it is different from one therapeutic relationship to the next. 
  2. Start and work through treatment with the end in mind. Ideally, therapy should not last forever- you should begin with a goal or goals (see #3) and you and your therapist should figure out how to achieve those goals so that you no longer need treatment. Your therapist will probably check in about how close you are getting to these goals, and may set a timeline at the beginning of therapy or partway in. This is normal. We like our clients, we want to continue seeing them, but treatment is successful when they don’t have to see us anymore. 
  3. Goals are essential to successful treatment. Some clients would like to come in and do a “weekly review” sort of thing, or a “crisis of the week” sort of thing. The problem with this is that it doesn’t help them achieve a goal or improve their lives, it mostly just passes the time and maybe provides some social support. We’re not really doing our jobs when this is all that happens. That’s why goals- short and/or long-term- are essential. 
  4. There are infinite worthy goals. There are lots of things that are worthy of being a therapy goal. I usually group them into three categories: goals related to decreasing your distress (for example: decreasing anxiety), goals related to increasing your functioning (for example: having better social skills), and goals related to increasing meaningfulness (for example: pursuing hobbies, existential questions).  
  5. Structure is also essential. If a client has great goals, but they continue to come in with a crisis of the week, or are constantly distracted throughout session, it’s often hard to get things accomplished. Although it isn’t necessary to only discuss the therapy goal(s) 100% of the time (and sometimes it’s necessary to halt things due to crisis), it is important to have some kind of structure of make sure that treatment is progressing. Lots of different kinds of structures can be used (from almost nothing, to agendas, to manuals) depending on your needs. 
  6. Your therapist is not being mean to you when they enforce boundaries. Boundaries are necessary, to uphold professional ethics, protect the therapist and their family/loved ones, protect the mental health field, protect the agency the therapist works for, protect other clients, and most importantly, to protect you. It isn’t random, and it isn’t a punishment. We do our very best to be both professional and have a sincere relationship with you.  
  7. Your therapist is not judging you. Here’s the thing- you really are a special and unique person, with your own backstory. But as therapists, we have heard some weird and terrible things (it’s unlikely you’re going to top the list, for better or worse). It is our job to listen to those things and not judge. Since we’re not our client’s friend, we’re not thinking about judgement, we’re thinking about how to help, or how impressed we are that you trusted us enough to share, and so on. We’re in your corner. 
  8. The therapeutic relationship is important- and not off-limits to discuss. I always make such a big deal about the therapeutic relationship, and it is because it matters so much to client outcome. So pay attention to it. It’s okay to care about how things are in the interaction and relationship with your therapist. And if you are confused, or upset, or concerned, or pissed off, talk about it with your therapist. You are not doing anything wrong- this is key to the success of your treatment. 
  9. It’s okay to question and disagree with your therapist. Clients sometimes think that therapists are untouchable– sort of all knowing experts. It’s true that therapists are trained in specific things, and hopefully know how to do the things they need to do to help you accomplish what you want to in therapy. But this does not mean they know everything about you or will not mess up (we don’t and we will). So ask questions. Get more information. If you disagree, speak up. A good therapist is comfortable discussing the process and being wrong. 
  10. It’s okay to find a new therapist, but make sure you think about why you are doing it. If you do not like your therapist, it is okay to look for a new one. But- “therapist shopping” is sometimes frowned upon because we worry that you are looking for a therapist who will tell you what you want to hear about something, and a good therapist is willing to challenge their clients- which means their clients will sometimes be pissed off and uncomfortable. This means a good therapist is sometimes not the one who makes you feel warm and fuzzy all the time. So, find a new therapist if you do not like yours, but think carefully about why you are doing it. Make sure you work with someone who helps you reach your goals. (That’s why you’re there, right?) 

There are five main categories of delusions that are commonly found in individuals who are experiencing psychosis or schizophrenia. They include the following:

  1. Delusions of persecution. These are delusions in which the individual believes he or she is being persecuted, spied upon, or is in danger (usually as the result of a conspiracy of some kind).
  2. Delusions of grandeur. Delusions in which the individual believes he or she is someone with fame or power (e.g. Jesus christ or a famous music star).
  3. Delusions of control. Delusions where the person believes that his or her thoughts, feelings or actions are being controlled by external forces (e.g. extraterrestrials or supernatural forces).
  4. Delusions of reference. Delusions where the individual believes that independent external events are making specific references to him or her.
  5. Nihilistic Delusions. Delusions where individuals believe that some aspect of either the world or themselves has ceased to exist (e.g. the person may believe that they are in fact dead).

Friendly reminder that 1 in 84 or 3.2 million people in the USA suffer from Agoraphobia.

This includes but is not limited to fear of:
Using public transportation
Being in open spaces
Being enclosed in spaces
Standing in line or being in a crowd
Being outside of the home alone

So be nice to your friends who might ask you for help in one of these areas, don’t make fun of them for not wanting to go into Target alone or anything like that. Just be a bad ass safety buddy and help them get through fear/anxiety inducing situations, that’s what friends are for right?


“Look, Doctor, I-I think the doc was in over his head on this one ‘cause my brother’s, uh…
[pauses, then spins his finger around his ear and makes the "cuckoo” whistle]“

Dr. Aaron Fuller: "Okay, fine. Thank you, That- that’s really not necessary.
[to Sam] Why don’t *you* tell me how you’re feeling, Alex.”

Sam Winchester: “I’m fine. [scoffs] I mean, okay, a little depressed, I guess.”

Dr. Aaron Fuller: “All right. Any idea why?”

Sam Winchester: “Probably because I started the apocalypse. [taken aback] "The apocalypse”?“

Sam Winchester: "Yeah, that’s right.”

Dr. Aaron Fuller: [the Doctor looks at Dean, who smirks, then back to Sam] “And you started it.”

Sam Winchester: “Well, yeah, I… [sighs] I killed this demon, Lilith, and I accidentally freed Lucifer from Hell, so now he’s topside and we’re tryin’ to stop him.”

Dr. Aaron Fuller: “W-who is?”

Sam Winchester: “Me. And him. And, uh, this one angel.”

Dr. Aaron Fuller: “Oh, you mean like a- like an angel on your shoulder.”

Sam Winchester: [matter-of-factly] “No, no. His name is Castiel. He wears a trench coat.”

Dean Winchester: “See what I mean, doc? I mean, the kid’s been beating himself up over this thing for months. The apocalypse wasn’t his fault.”

Dr. Aaron Fuller: [again taken aback] “It’s not?”

Dean Winchester: “No. There was this other demon, Ruby. She got him addicted to demon blood. I mean, near the end, he was practically chugging the stuff. My brother’s not evil. He’s was just… high. Yeah? So could you fix him up so we can get back to traveling around the country and hunting monsters?”

Problems with the Clinical Psychology Field

1. There is a massive number of terrible programs in clinical psychology- both PhD and PsyD programs (and really, master’s programs) –and these programs admit huge numbers of students every year (like, 100 students compared to 5-15 in high quality schools). These schools are predatory, expensive, and low quality. They take advantage of students by delivering a poorer education with poor outcomes (like lower graduation and licensure rates) and a huge price tag, and they negatively impact the discipline and our clients by creating a subset of psychologists with poorer skills. 

2. Mostly because of these terrible programs, there are too many psychology graduate students entering the field, and not enough internships or jobs for the graduate students to go into. As a result, a number of students get trapped at the internship match process- which is pre-graduation –and either don’t graduate or graduate far later than intended, potentially after attending a lesser quality, unaccredited internship, which will impact their ability to get licensed or work in desired jobs (for example, the federal government will not hire psychologists who did not go to an accredited internship). This is called the “internship bottleneck” and people are trying to fix it by increasing internships, which is a nice thought- but there are still too few jobs and too many graduate students (which again, many of whom are coming from terrible programs). So the better answer would be to get rid of the terrible programs and increase admissions standards. 

3. APA accepts funding from several of the terrible programs I have mentioned, and shockingly, and has been slow to make necessary changes to improve things in the field- like, for example, increasing graduate school and internship standards (wonder why?). 

4. APA and other groups have not done enough (or as much as other disciplines) to protect and advocate for the clinical psychology discipline. This leads to difficulty billing for things like assessment, or receiving the same amount of money as a doctoral level psychologist as a master’s level clinician, and receiving questions like, “So like, what does a psychologist do that a [insert other clinician here] can’t do?” This happens within mental health but also within science in general. We have not clearly advocated for clinical psychology as an essential scientific discipline, or medical discipline, and then it’s surprising when it gets cast aside by STEM or by the medical field (or called a “soft science” or put under the psychiatry umbrella). 

5. Psychologists not only do a shitty job of advocating- we also constantly undercut our own skills in some settings (i.e., when interacting with MDs with years less experience in research) while being stupidly elitist in others (i.e., interacting with case managers who know their community far better than anyone else). This does not help us create our own niche, make it clear what our strengths are, and become a respected as a discipline and as individuals.

6. There is a massive underutilization of evidence based practice in typical clinical settings. Although we know that EBP works, and that the model can be adapted for different people and different settings, a huge number of psychologists report being “eclectic” and “integrative” and “holistic” and all kinds of words that might be something reasonable and evidence-based, and but also often mean “I just do what I feel like with no attention to what actually works.” And when we look at the data- that’s what we find, that therapists are often not using EBP even in situations where they would be relevant and effective. 

7. That underutilization of evidence based practice in clinical work is partly due to a lack of communication and connection between science and practice. An average clinician is in a very different place- literally, they work in completely different places most of the time –than an average researcher. Most clinicians are not spending much of their time reading journals or going to conferences, and most researchers don’t spend much time practicing clinical work or talking to clinicians, particularly in typical clinical settings (rather than academic medical settings). That can all lead to a lack of trust and infighting between scientists and practitioners, causing rifts within clinical psychology and within mental health. 

8. There is a huge amount of underfunding of key areas of clinical psychology research, particularly in applied areas like treatment and prevention. Most of the big money goes towards neuroscience, genetics, etc., right now- which isn’t a bad or unimportant area at all –but many of the big funders are not as interested in psychosocial or treatment questions which have the potential to have a more immediate impact on people in need.