mental-clinic

In case it’s not obvious, I am losing my damn mind. I can’t watch TV. I can’t read. I can’t play games. I can’t do puzzles. I can’t have conversations.I was super-excited about Dishonored 2 and I’ve made it through two missions because I just can’t.

I keep thinking of how I want my mental health clinic to go out of business while Screaming Lady and the landlord go to prison. Or, like, I get to encase them in a tomb with BOB and an endless supply of Steel Reserve and several bed bug colonies with no treatment.
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. 
youtube

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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5

“State violence is more than just police shootings. It is the police and prison systems themselves. It is the criminalizing of sex work, of the survivors of abuse. It is a legal order which treats Black, trans and cis women who defend their lives as insolent, in need of punishment. It is homelessness. It is the calculated impoverishing of Black communities. It is the closing of public schools and mental health clinics, the slashing of HIV prevention and other healthcare services, while militarization devours the lion’s share of public funds. It is gentrification. It is the poisoning of natural resources. It is all the structures—including the police and prison systems—which uphold and depend on violent masculinity, reinforcing the disposability of women and femmes, of trans and gnc communities, of the earth itself.”

– #TURNUP4TT: A Public Statement from the Organizers for TT Saffore | Radfag Wordpress

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?

10

“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?”