Are shrink couches only on TV?

[roadman65]

I was noticing that real life situations involving a trip to a head shrinker are not anywhere near what you see on television.  For example you complain to a doctor you can't sleep lately, where on TV a doc would put you on a couch and ask you what you have been doing and eating lately.  Then figure out if you are stressed from it and then take action to treat.  In real life, you sit in a chair facing the shrink's desk and instead of him probing into your recent actions, he just writes out a prescription and tells you to go to your pharmacy and take the pill before you go to bed at night. Guaranteed it will put you to sleep.  Heck with the source, or trying to rid the problem.  Just treat the symptoms.

Then go to a mental health center and you not only get to see a real doctor, but one that is fresh out of college who is an intern.  Then get the one I got back in 1988, who I confided in that I had anger feelings and was scared that I may eventually act out in rage! Instead of being concerned at all for my own safety (or those around me) he said to me in a voice that was similar to your dad after you ask him a stupid question " Just do exercise!  Just so you know your rage comes from not doing push ups or jogging!" He even tried to make me feel bad for not knowing that exercise relieves emotions like anger.

Top it off I told him I got extremely depressed about a girl I asked out rejecting me.  I even told him I was worried which was why I went to the place ( a clinic in Perth Amboy, NJ) as I hardly knew this girl and I still got real sad despite me deep down knowing that this sadness was not my own doing.  So I thought a shrink could annalize what is causing me to be depressed, as I had no idea that your own primary doctor could do the same thing at the time. I found the place by word of mouth, and applied for it as you paid upon income.  Anyway, this guy would not let me explain the situation but made me feel ashamed for the fact that I was sad over the problem!  He said I needed to forget about it (that I created the problem by not moving on) despite that it was an uncontrollable sadness and I was there to seek a treatment option or to find out at the time if I was having a breakdown or serious disorder.  He never even asked for details nor asked about my past leading up to the event! Nor did he try to annalize me in anyway to see if I did something or even if there was more to it (which later I did find out on my own without this dick's help) like depression or possible Autism or Asperger's or any kind of spectrum.  In my case it was simple doubt as I felt that I was not coming out right to this girl, but could not finger it meaning I had a lack of empathy that was not my doing.  I never knew the word empathy nor knew how to describe the symptoms, but you would figure a PHD would be able to read between the lines, but no thanks to this quack I ended up getting more depressed and ended up having to move to Florida as my family departed New Jersey in 1990.  I really did not want to go as my life was good up there, but could not afford to live solo and had no place to find a roomie to board with, so I was emotionally impaired.

Anyway, is the couch thing on TV just like the swinging kitchen doors where its only on TV as in real life our kitchen door is an open passageway?  Or has the establishment changed where couch therapy is no longer due to shit like Prozac, Welbutrin, and other drugs out there?

[MisterSG1]

Nope, can't say I have.

That being said, the role of psychiatrists is to drug you up, and use your body like a metaphorical dartboard until they hit the bullseye of the correct meds that work on you. Even if there are scary side effects.

A psychologist on the other hand to my knowledge cannot write prescriptions and they will often  behave as a counselor/therapist.

[NE2]

A couch is just an obese chair.

[Scott5114]

You got a shitty therapist. The good ones don't act like that.

I've never personally needed therapy, but my wife and some of my close friends have, and it's important to find a therapist that works well with you. Some people go through several until they find one they really gel with that can improve matters.

I don't think the stereotypical couch thing is actually something anyone uses. I went to one of my wife's therapy sessions at her request and they just had a couple of regular office chairs to sit in. "Shrink couches on TV" seem like an infomercial product–just apply heat and the couch can easily be stored in the closet!

[qguy]

The psychiatrist's couch is a Freudian construct. (He used it to encourage reveries for dream interpretation purposes.) And since pretty much everything Freud did has now been recognized at complete nonsense or worse (much worse), the couch has nearly vanished.

[abefroman329]

I've never seen a couch in a therapist's office. Most notably, Dr. Melfi in The Sopranos did not have one.

I've also noticed that film and television don't do a great job of explaining the distinction between a psychologist and a psychiatrist.

[US71]

Psychiatrists can prescribe meds.

Psychologists can't.

Psychologists generally help people try to find workable solutions. Psychiatrists generally keep people addicted to drugs.

[wxfree]

It sounds like you got a bad therapist.  Not everyone is cut out for that line of work.

As I understand it, the psychiatrist's couch is something Freud came up with.  I've never seen one other than on television.  Maybe if you saw a Freudian psychiatrist he'd have one.

Mental therapy is always a challenge, because we don't know that much about how the brain works.  We pretty much know what happens if you take aspirin, or insulin, or if you have a heart valve replacement, but the outcome from psychotherapy or psychiatric drugs is unpredictable.  It can take time to find a good match.  For me, psychotherapy (group therapy and sessions with a counselor and psychologist) never did me any good.  They gave me an antidepressant and antipsychotic (which is sometimes combined with an antidepressant in the case of very severe depression) and the drugs simply fixed me.  I didn't want to take mystery drugs, but they made the whole world better and without them I was unable to function and was going crazy from the sadness.  It seems like the source of my problem was physical, something in the brain, more than psychological.  Like taking insulin for diabetes, the drugs didn't fix the source but they took care of the trouble it caused.  I have no expertise in the field, but I suspect that the majority, perhaps vast majority, of people with similar difficulty have psychological problems and would benefit from therapy at that level.  It's easier to give a pill, however.  Psychiatric drugs get a bad reputation because we don't really know how they work and sometimes get bad outcomes, and because they may be used in place of a better psychological treatment, but the right combination given to the right patient can be very effective.

[NE2]

I have had several who had couches instead of chairs. It was the same setup though, me facing him/her, just with a comfy couch.

[US71]

I have had several who had couches instead of chairs. It was the same setup though, me facing him/her, just with a comfy couch.

Fetch the comfy chair!

[jon daly]

I saw this thread and thought it would be about furniture.

From what I understand, the psychiatrist (or APRN) teams with a therapist and mainly prescribes drugs and follows up however often is needed a runs through a list of questions to determine if the meds are working or if a change is needed,

The therapist is the one who does the heavy lifting and thinks that an hour is 45-50 minutes. And there's no lying down involved; just sitting.

[Brandon]

I have had several who had couches instead of chairs. It was the same setup though, me facing him/her, just with a comfy couch.

Fetch the comfy chair!

Not the <gasp> comfy chair!

[RobbieL2415]

Psychiatrists can prescribe meds.

Psychologists can't.

Psychologists generally help people try to find workable solutions. Psychiatrists generally keep people addicted to drugs.

Psychologists/counselors/therapists are concerned with your cognition

Psychiatrists/APRNs with psychiatry backgrounds use your cognitive state to recommend (or not) medication that IN CONJUNCTION with therapy can help you become mentally healthy.

[abefroman329]

Psychiatrists can prescribe meds.

Psychologists can't.

Psychologists generally help people try to find workable solutions. Psychiatrists generally keep people addicted to drugs.

Yes, and damn those oncologists who keep patients addicted to chemotherapy rather than trying to find workable solutions to their cancer.

[roadman65]

I saw this thread and thought it would be about furniture.

From what I understand, the psychiatrist (or APRN) teams with a therapist and mainly prescribes drugs and follows up however often is needed a runs through a list of questions to determine if the meds are working or if a change is needed,

The therapist is the one who does the heavy lifting and thinks that an hour is 45-50 minutes. And there's no lying down involved; just sitting.

Yup.  They have you in their office for a couple minutes and you tell them the nature of your problem and instead of having you talk about things about you and try to get the doc to understand you and your behavior they just say "Try this drug out, and I will see you back in 2 weeks." 

I think its trial and error.  They keep trying many meds until one works for.  If you do not allow the pills two weeks to work as most of these drugs take weeks to kick in, so that adds to it all.  It could take years to find the right drug that works.  Plus what if it is an event that sets you off.  We all have experiences that traumatize us all. While these docs are trying to figure out a med that works on you (if one actually does) they could be probing your mind to find the shattering experience you wish not to face and then make you deal with it.

Sounds to me like there should be one kind of therapist.  One who prescribes and one who annylizes you.  Two docs in one and not two for two.

Yes that idiot in Raritan Bay was not a good man.  To not allow the trauma to be brought to the surface, but instead make me suppress it and have it in my subconcience causing me to not make the rational decision we all humans need to make due to fear was not professional to say the least.  It was 30 years of hell!  Let me also say I am beginning to think I know why we have people like Timothy McVae out there, cause if Don Stagler was his therapist  (that is if Timothy was the type to see a shrink) his  "Oh do push ups or exercise" would have been said the moment McVae told him he was angry and wanted to blow up the Federal Building.   Yes, I had rage in me, and this guy Stagler quickly answered me and showed no concern that I could go out and act out on it.  Just that quick answer,

To complete, I was feeling depressed and I did not know why, as it was just a simple no from a woman I asked out.  I have had bigger rejections in my life previously.  This also was not just simple sadness but painful one.  So you could imagine why I needed to see a doctor!  I went to Raritan Bay in Perth Amboy as they were the local free clinic (as free meaning price of visit depends on one's personal income) and they specialized in mental health and treatment of illnesses.   I told them everything.  I even told them that I prepared myself for rejection as in the past my ego used to boost me to almost certainty that women would always say yes or feel the same way as I do toward them.  However, I got hurt, but not like this one and the fact that I prepared myself for the worst made me worry a lot more as it should have been less painful and not so much to effect my daily life.  Plus I hardly ever knew this girl other than being the typical blonde co-worker that I talked plenty too.

Not to mention I had other issues I wanted to finally deal with!  So in essence I wanted to get not only treated or examined for this issue but other issues as I have always lived with much fear and anger and even was willing to accept being evaluated to the point where serious doctors would examine me.  Instead I get sent to this moron and not being helped at all.

Sorry about this rant, but this experience was a violation of me!  And for all these years had to live with more problems and the lack of treatment now that I believe may be of more serious nature.  I feel that I have either a spectrum or bipolar and, of course, if that clinic in NJ did their job right and looked at me, I think that would have been discovered or at least something.  I have for a long time had problems allowing myself to be happy as I the last time I really was happened before the incident with my female co-worker.  Though I have had to deal with Molly treating me like crap and hurting me in 2013, I still feel somehow that if I become happy again something like the experience I have had over 30 years ago would reoccur!  As I was happy just before that downfall, I feel somehow not destined to be a happy person that I was born to be miserable and that event was because of my previous happy times.

[ce929wax]

I want to preface what I am about to say with the fact that I am VERY LUCKY and my experiences aren't typical.

I suffer from severe mental health issues (autism, bipolar, intermittent explosive disorder, etc, etc, etc.).  I have had an excellent psychiatrist who has taken the time to get to know me and my problems and hasn't over prescribed me on medications.  She ordered a genetic test several years ago that showed what types of medications I am compatible with and which ones I am not.  I have had some issues with my last couple of counselors (one I became co-dependent on and the other won't shut his mouth and let me talk sometimes), however I am about to do Dialetical Behavior Therapy, which is a year commitment, which I hope will help me clear some of my hurdles.     

[roadman65]

I spoke to one coworker of mine who admitted he has Aspergers and is on meds that help some, but he admits about some therapists out there he has seen and many do not shut up and do not let you talk.  You are cut off right as you want to explain he asserts.

Many therapists, I feel are like non docs who think that because your spectrum makes you talk about things that others usually do not talk about, get bored and are just too damn lazy to want to take the time and figure out what it all means. 

However I am glad you found one that listens and does not assume that you have typical mental health issues.  To me assuming is just like you going into the doctor to have a pain treated like a tummy, but instead of doing tests he automatically assumes its food related and says it will just go away later.  Most physicians will ask you when the pain came, and how it feels followed by questions of what you ate, where, and when, before typical gas is determined. I had one physchiatrist already prescribe me sleep pills after I complained about not sleeping right on a regular basis.  He did not even want to know if I was stressed or even had issues with anything in particular that could cause restlessness in bed.  For all he knew, I could be a college student having exam anxiety, which does deprave sleep.

Bottom line is the fact that a patient would walk into your office and want to talk about something that is not right should want the therapist to annylize the situation and not shame the patient into not talking about it cause its not normal!

[texaskdog]

I always sat on a couch but never laid on one.  One shrink I joked about it so I sat in the chair for two weeks and she sat on the couch.

[roadman65]

What really tells things wrong is Fraiser (the former NBC sitcom spinoff of Cheers).  They show him doing the work of a psychologist and doing that kind of thing where he listens (last season when he went back into practice) instead of just saying "Here is the prescription."

Then again Fraiser in real life would be more patient material than doctor material as his odd obsessive behavior and always raged makes him the candidate for a shrink himself.  Sitcoms are not real hence Gomer Pyle being a Marine when in real life a goofball like him would not pass entry into the Corps.  Also no police force could ever hire a bumbling cop like Barney Fife in Andy Griffith, but being its Hollywood, its fictional.  So is Fraiser.

Also in real life a doctor treating a mentally ill patient can go to jail if he dates her or him.  Remember how Kelsey Grammar first appeared on Cheers as Fraiser?  He was Dianne's doctor when she was in the nut house, and they fell in love and came back only cause Coach begged Dianne to sober up Sam as he was drinking to cope with his and hers breakup at the end of Season 2.  That is a big no no and a doctor could not only lose his license to practice but go to jail if he ever gets romantically involved with a patient!

[texaskdog]

I'm sure every shrink has a shrink of their own

[Scott5114]

Also no police force could ever hire a bumbling cop like Barney Fife in Andy Griffith, but being its Hollywood, its fictional.

I dunno, in a small town it could happen. New Rome, Ohio, for example.

[abefroman329]

I'm sure every shrink has a shrink of their own

Dr. Melfi did.

I saw a licensed therapist in DC who worked at prisons during the day, listening to first-world problems in the evening was his way of unwinding.

[roadman]

Also no police force could ever hire a bumbling cop like Barney Fife in Andy Griffith, but being its Hollywood, its fictional.

I dunno, in a small town it could happen. New Rome, Ohio, for example.

Also consider the nepotism factor.  Barney Fife was Andy Taylor's cousin.  This was mentioned only once during the show's run, in the first episode The New Housekeeper.

[US71]

I wonder if Dr Phil has a casting couch?