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Schizoaffective Disorder and Therapy

Achieving real change is a lengthy process. Find out how therapy helps and how to find the right therapist.

Achieving real change is a lengthy process. Find out how therapy helps and how to find the right therapist.

Q: How many psychologists does it take to change a light bulb?
A: Just one, but the light bulb has to want to change.

Early on, in the year before my diagnosis and for awhile afterwards, I saw a number of psychologists. (I had also seen one for awhile when I got really depressed in eighth grade, and had also seen a couple of school psychologists in elementary and junior high school, but didn't feel any of them helped much because I was such an unwilling patient.) I would typically seek a therapist out because I felt really bad, but after a few months I would feel better and stop going. Early on, I really disliked having anything to do with psychologists and wouldn't see one any more than I absolutely had to.

That's a pretty common phenomenon for therapy patients. It seems that many of the people who seek out therapists are not in a position to get better in any substantial way because they have no commitment to making any real change in their lives.

Achieving real change is a lengthy process and it is often painful. Seeing a therapist just until you feel better for awhile is not likely to effect meaningful change. And, in fact, for a bipolar person it's not likely that the therapist will have made any difference in such a short time - you could consult a brick wall for your depression for a few months and after awhile the inevitable bipolar cycle while make you feel better.

Time for Meaningful Change

There came a point, I think it was around the Spring of 1987, that I noticed that I always kept falling into the same hole and that I was not having any success in making my situation any better. I was on medication for much of the time since I was diagnosed and although it provided some relief, I did not feel that it did much to make my life substantially better either. The symptoms weren't so bad with the medication but I still experienced them and life just plain sucked in general.

I made a really important decision then. It's the sort of decision everyone needs to make if they're going to get anything out of therapy and is one of the more significant turning points in my life. I decided I was going to see a psychotherapist and stick with it and no matter what happened that I was going to keep going even if I felt better. I was going to keep going until I was able to effect meaningful, positive, lasting change in my life.

(Simply deciding to see a therapist for a long time is not enough. You have to decide that you're really going to change and face up to the work it will require and face the fear that it will arouse. Lots of people see therapists for years, even decades, and never get anything out of it beside a little temporary comfort. I know some people like this and I find them incredibly vexing. These people don't want to change and quite possibly will never change. They may even feel that they're good little therapy patients because they attend regular therapy for so long. However, they must be very frustrating to their therapists who spend years trying to get their patients to face themselves only to have every effort deftly deflected.)

Finding a Good Therapist

It's important to pick out a good therapist that you can work with effectively. I don't think nearly all therapists are all that enlightened - I'm sure almost all learn a lot of important theory in graduate school, but I don't think any amount of theory is going to make anyone an insightful human being.

Even if you find a therapist that's good in general, you may not personally be able to work with them. For that reason, it's best to shop around. And that's why it's best not to wait until you really need help to find a therapist - if you feel, as I did at first, that psychologists are only for crazy people, then likely you're not going to see one until you are crazy. When that happens it's hard to take the time to shop around and it's also much harder to pick up the pieces. If you think you're ever going to need to see a therapist, it's best to start when you're in a strong enough position emotionally to see one on your own terms.

At the time I made my fateful decision, I was getting by OK. I was desperately unhappy, but life was manageable. It was not like when I first saw a psychiatrist at Caltech, when I was ready to climb out of my own skin.

I got a very poor impression of the first therapist I saw. Her primary concern was whether I had the financial means to pay for her sessions. She was really quite shrill about the money and kept emphasizing that she did not offer a sliding scale. I had a good job at the time and would have had no problem paying her fee, but in the end decided she was just not someone I cared to be around.

The second therapist I saw was someone I rather liked. I'd responded to her ad in The Good Times offering New Age therapy. (Santa Cruz is a pretty New Age kind of place, one reason I decided to stay there after living in the urban Hell of Southern California.) She seemed like a pretty happy and enlightened woman and was quite pleasant to talk to. She seemed to like me at first too.

But when I explained my history to her - mania, depression, hallucinations, hospitalization and finally my diagnosis, she said she wasn't competent to deal with someone as troubled as I. She said I should consult with someone who specialized in challenging cases. I was really disappointed.

She gave me the names of several other psychologists. One of them was someone I'd seen at the County Mental Health department who I thought was competent enough but I didn't want to see anymore because I did not feel that she cared for me as a person. The next one on the list was the therapist I ended up sticking with.


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Last Updated: 14 July 2016
Reviewed by Harry Croft, MD

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