Rida M.

Part-time therapist, full-time cat mom.

[Jonathan Shedler @JonathanShedler]

Depression is most helpfully understood as the psychic equivalent of fever.

Fever is a NON-SPECIFIC physiological response to near-infinite range of underlying conditions from the common cold to Ebola.

Likewise, depression is a non-specific psychological response to a near-infinite range of underlying causes which may be psychological, social, biological, or a complex interaction between them.

Blanket statements about where depression “comes from” are necessarily wrong. But they sure make for great PR.

[Jonathan Shedler @JonathanShedler]

AI “therapy” promoters assume 24/7 availability is good

Maybe good—if goal is to help patients relate to machines, and bolster fantasy that instant gratification is always available

Maybe not good—if goal is to have relationships with humans and function in the world of humans

[Jonathan Shedler @JonathanShedler]

“Therapy should never begin before the therapist knows what it is for or why it is being undertaken” *
—Otto Kernberg

Knowing what therapy “is for” isn’t as simple at it sounds

If you ask therapists the purpose of therapy with a particular patient or client, most will tell you a symptom or diagnosis (“depression”), or something about the patient’s history (“they were abused by their mother”), or a desired life outcome (“better relationships”)

None of these things is a what psychotherapy is for. None of these things gives therapy a direction and purpose

The purpose of psychotherapy is to help the patient change something *about themselves*

More specifically, the purpose is to help the person change something about themselves that is
1) causing difficulties or limitation, 2) that they desire to change about themselves, and 3) that psychotherapy can realistically help them to change about themselves

In other words, the purpose is not “depression,” but understanding and helping change something in the person’s psychology that makes them vulnerable to depression

The purpose is not “childhood abuse,” but how their past continues to affect them in the present, and continues to play out in their lives in ways that cause difficulties

It’s not “better relationships,” but to understand and help change something about the person that has been getting in the way of having the relationships they desire

In every case, the purpose of psychotherapy sis to change something about oneself

That is, in fact, the only thing a patient and therapist working together can hope to change

The treatment purpose therefore comes from a clinical case formulation. A case formulation (or case conceptualization) is an understanding of the person’s underlying psychological makeup, and what about it is giving rise to the difficulties that brought them to treatment

This is what is missing when therapist and patient jump into “doing therapy” before they both understand and agree what, exactly, they are setting out to do and why

This is why treatments get stuck, reach an impasse, or become aimless and directionless

“Therapy should never begin before the therapist knows what it is for or why it is being undertaken”
—Otto Kernberg

(*consolidating and expanding a previous thread)

[Paul J. Gilbert -Psychotherapist. @pauljgilbert_]

@ZekiyeK7 I find group therapy so useful in this way. - I am stretched in different ways to individual therapy. I know that the therapist will always have my back in individual. So many more different dynamics in group and pushes our window of tolerance.

[Rida M. @RidaMCouns]

For women who have never experienced anxiety or distress in extremes, the first introduction to these states come in the form of the (toxic) rishta or arranged marriage culture. Its justifiably experienced as a massive threat to one’s individuality and sense of security.

[Marina Harris, PhD, HSP-P, CMPC @DrMarinaHarris]

Are you a helping professional who knows how important it is to label feelings? Have you, like me, been dissatisfied with the feeling wheels out there?

Look no further 🤩

🧵

[Rida M. @RidaMCouns]

@jeanine_connor @Therapists_C Not currently writing, but hoping (not working) to get over my anxieties about being an underwhelming writer 😛

[Rida M. @RidaMCouns]

@winnicotthead It made me feel terribly uncomfortable to watch that as a trainee. I watched that recently again and was moved by how he brings the hidden to foreground. The principles of Gestalt were demonstrated harshly but clearly.

[Paul J. Gilbert -Psychotherapist. @pauljgilbert_]

The sessions when the client starts with
"Well I really don't have anything to talk about this week"
Are frequently the most profound ones of self discovery in them. I find the unconscious often emerges into the room in these moments.

[Rida M. @RidaMCouns]

@aleenakhanpk @PMDC_org @drmariyam_ I do feel that this is troll account meant to incite anger. Anyone who is a mental health practitioner and sits across despair, pain, and trauma every day has at least a speck of empathy or evidence of being impacted. Pretty sure this is a new, fake account.

[Rida M. @RidaMCouns]

@drmariyam_ @stup1dfkndin0 I have been practicing since a few years and I, too, have taken regular therapy. Before that I projected a lot of my anger externally. If you deal with vulnerable patients and something blocks your empathy currently, please take a break and see what’s happening for you.

[Rida M. @RidaMCouns]

@drmariyam_ @stup1dfkndin0 Hi Mariyam. I am not sure if you are a troll/fake account, but if its really you and you are in the mental health field, I am really curious about how you came to this point. It looks like you are burnt out

[Rida M. @RidaMCouns]

@etihad @ammaralijan Same has happened with me. Never taking @etihad again.

[Ben Behnen 🌲 @BecomingaThera]

What podcasts have you found helpful to your growth as a therapist?

(Feel free to drop your own below 👇)

[@Mollys_ADHD_mayhem @Mollys_ADHD]

🧵//: ADHD shutdown

#adhd #Neurodiversity

[Rida M. @RidaMCouns]

Grateful for the micro moments of happiness and peace in an overall bad day/week.

[Rida M. @RidaMCouns]

Need some recommendations for interesting articles/books on PMS and PMDD please 🙏 #TherapistTwitter #TherapistsConnect

[Rida M. @RidaMCouns]

Trauma is not what happened. Trauma is the effect of what happened.

[Rida M. @RidaMCouns]

Snowy places make me feel at home. Tb to Gabala in winter, right out of a Bob Ross painting.

[Jonathan Shedler @JonathanShedler]

1/ We do not experience others as they are; our experience of others is saturated by our experiences of past relationships, going back to our earliest attachments. The saturation of the present by the past imbues the present with feeling & meaning. This is called 'transference.'