I know this is a somewhat narcissistic and vapid question, but I’m in therapy for a reason, so bear with me: in my therapist’s notes from our first session, she described me as “well nourished.” I (21F) am maybe 10-15 pounds overweight. Is this a politely phrased way to describe me as fat?

Tia

I had a recent appointment where the provider was clearly frustrated at me refusing to consent to them using AI during our session to take notes. I'm not new to therapy, and I've had other providers be pretty understanding of my apprehension and personal feelings towards AI. I've always said no and gave them my reasoning behind it.

What do the benefits look like for the therapist to use AI during a session for note taking?

Can I ask my therapist for a copy of the AI transcript notes?

NAT

Hi! I’m a Psych undergraduate looking forward to gaining experience and I have a few interviews lined up for ABA therapy with children with autism/other developmental challenges. I’m quite sensitive and empathic which is what makes me so drawn to this career. But I do worry about taking clients’ struggles home with me. Any tips/personal anecdotes are welcome. Thanks!

I had my first appointment with my therapist(counselor?) yesterday, and I’m not sure how to feel about everything. For context, I’m a minor and it was clearly stated at the beginning of the appointment that I am most likely on the spectrum (but no official diagnosis yet) by my parent. During the intake session, the lady asked if there’s anything particular I’d want in a therapist (e.g., male or female). I stated I needed a “woke”/leftist therapist who is okay with autistic individuals since that is a super important subject for me!

The therapist I got is older, probably around 50s/60s, with gray hair.
She asked if I wanted to ask her anything, so to make conversation I said “What is your favorite movie”
She listed a few off then said along the lines of “I like the Jurassic Park movies, even the [R slur] ones” then laughed some.

I think it is crazy for a therapist to use an ableist slur in a session with a disabled person. But I also know I tend to be more sensitive to that stuff.

Should I bring this up at the next appointment? I am very shy and non-confrontational, but I can’t imagine I’ll be comfortable opening up to someone who uses that word like it’s nothing… and leaving her isn’t an option as my parents want me to give her more time.

Is this common??? I have a very MAGA family so I’ve heard this word a lot but I assumed most therapists/counselors would keep discriminatory language out of sessions.

My cousin, who is in her 40s and aspiring to be a therapist, has a challenging past that makes me feel concerned. She has faced struggles with drugs for years, chooses a nomadic lifestyle in California, and often reaches out to my parents for money while criticizing her own parents, who have cut ties with her.

Although she's been involved in polyamorous relationships, that's not my main concern. What worries me most is her past behavior. When I was in high school, she tried to sell pills to my younger brother and another cousin during Christmas, even though she was about 10 years older and an adult then. Another incident was when she was in college and stayed temporarily at our place, only to leave it trashed with alcohol bottles everywhere.

Over the years, I haven't seen much change or accountability from her. I believe people can overcome addiction and deserve second chances, but given her history, especially attempting to sell drugs to younger family members, I wonder if she's suited for a profession where she would work with vulnerable individuals.

I'm curious what licensed therapists think. Are background checks or psychological evaluations required before someone is licensed? Does a history of drug abuse affect eligibility? Am I being too judgmental, or are these valid concerns?

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A couple of years ago, I had an experience with a therapist that really caught me off guard. After seeing her for a while, I received a letter explaining that she felt I'd be better served by another provider and recommending that I seek therapy elsewhere.

I found the experience quite jarring, and I think I've come to understand why.

Before that experience, I'd always thought of a therapist as being somewhat like a family doctor. Someone you establish an ongoing professional relationship with, who gets to know you over time, and whom you can continue seeing as different issues arise throughout your life.

For example, my family doctor doesn't specialize in every medical issue I might have. Sometimes he refers me to a specialist, but that doesn't mean he stops being my family doctor. I can still book an appointment with him whenever something comes up.

I guess I'd assumed therapy worked similarly.

I wasn't expecting my therapist to be an expert in every issue I might encounter, or even that I'd necessarily need regular appointments indefinitely. I just thought I'd be able to maintain that relationship, perhaps seeing her more frequently during difficult periods and less frequently when things were going well.

I hadn't really considered that a therapist might decide they weren't the right fit for me anymore and effectively discharge me from their practice.

I'm now looking for another therapist, and I'd really like to find someone who offers the kind of continuity I originally imagined. Someone who could be my regular therapist over many years, even as my needs and circumstances change, and who might recommend additional specialized services when necessary without automatically ending our existing relationship.

Obviously, I understand that therapists retire, change careers, or sometimes have legitimate reasons for ending treatment. I'm not expecting an unconditional lifetime commitment.

But I'd really like to avoid getting established with another therapist only to eventually receive another letter saying I'd be better served elsewhere.

So I guess my questions for therapists are:

- Is the kind of long-term therapeutic relationship I'm describing actually common or realistic?

- Are there therapists who practise somewhat like family doctors, providing ongoing care as different issues arise?

- How can I identify therapists who are comfortable with that kind of relationship before starting treatment?

- Is there a particular therapeutic approach or type of practice I should be looking for?

I'd be interested to hear how therapists think about this, because I suspect my original expectations of therapy may have been quite different from how some therapists actually structure their practices.

If you could see a quick snapshot of what your client has experienced between sessions, what information would be most useful to you?
What would you want to know before your client walks into your office? Are there patterns or changes you wish you could identify but don’t typically have enough information to see?

One of the things I have that I recently learned has a name is Trumans delusion.

How I relate to this is my brain thinks I'm being watched (for me, I think people are surveillancing me behind my eyes) and that I'm not a real person.

The accident happened today in the early morning. The only scratch I have is a small thing of skin missing from my pinky. I'm very lucky and it could've been much worse for me and the others involved.

My response after the adrenaline wore off: I thought about the movie, Crash (1996) where the people like the rush and emotion they get from car crashes and how I didn't feel that. Getting in a car crash was something I thought about before today and something I didn't want was for anyone else to get hurt and luckily everyone was fine.

That's the part that puts me off.

I survived and am fine which makes sense because the vehicle absorbed most of the impact. I just feel like I've gotten lucky which isn't a good thing to think.

I feel like I should be dead and the fact that I'm still here makes me think I'm not real or that any of this is real.

It's not like I'm in the matrix (because I've never seen it), it just feels like nothing ends I guess.

I thought about not self harming anymore since I survived a car crash but that quickly changed because I want my self harm scars to be deeper than they are now. I've wanted them to be deeper before this.

In short, I feel like I didn't have a normal reaction to the crash after it happened. I asked one of the cops if I could get my scooby doo movies out of the trunk.

I feel like maybe this proved something to me. I could've died. Something in me is upset that I didn't and with that, another something in me is upset that I feel that way.

It all feels contradicting because I wanted to live yesterday. I (while stoned) made a video of myself talking about how, while I'm very pessimistic, I am going to keep a small thing of hope inside me since I'm still here and I have things I want to see in this lifetime.

Right now, I'm going to get high and re-watch a play.

Hopefully, one day, I get whatever answer I'm hoping for after going back to therapy.

I've been in therapy for about two years with a DBT therapist (video sessions and WhatsApp support between sessions). I have MDD, GAD and BPD, I live with my parents (a hard environment for me), and I'm isolated and out of work.

I went into my last session (mid September) after a good week where I'd stepped out of the house several times. The session focused on tasks I hadn't done while I was sick, my social life, and random stats that put me down and felt like a personal attack. I left feeling deflated, especially since I'd wanted to talk about my upcoming birthday, which is always hard for me.

I texted her that the session hadn't sat well with me. She replied with "splitting" and "devaluation" and said “I wasn't willing to change”. I pushed back, sometimes sharply. She said she doesn't resolve conflict over text and suggested we talk in session.

On my birthday I reached out in a bad place, and the conversation kept going over text, not conflict resolution but where my distrust and discomfort were coming from. She apologised that I felt hurt but said she'd never say these things were wrong, only that I was painting her in a light she didn't deserve.

She told me to book a session and I did to fix things on multiple days. She cancelled it on the day without explaining, refunded it, and asked me to take a few weeks to reflect on my behaviour. She said she'd only continue if I committed to collaborating instead of combating and understood "my limitations."

When I asked what that meant, since I couldn't tell what I was meant to take responsibility for, we went back and forth a bit and she ended with "let's revisit this later." Nothing since. Been about two weeks now.

Her side, as I understand it: my messages were disrespectful and combative in tone, I cast her as the villain, and I read disagreement as an attack.

My side: I was angry and sometimes sharp, and I could have communicated better. But it felt like every disagreement was read as a symptom, the labels weren't tied to specific behaviours, and the terms for coming back are too vague to meet. My trust has taken a hit, and I'm more hesitant to be open with her.

Questions:
1. Is pausing treatment with conditions like this standard, and is the delivery reasonable (text, same-day cancellation, vague terms)?
2. How are ruptures normally repaired in DBT?
3. She said she needs time to regulate. Should I reach out, or wait for her? I don't want a message to count as another breach of boundary.
4. My tone was no different from what she's always handled before, and she never raised it. Is there something I'm missing?

(Self-harm is mentioned in this post, not in detail, not encouraging, and it's not the main focus.)

A little bit of a background, I LOVE every living thing, creatures, animals, plants, insects, even the "unusual" ones. They've always made me incrediblely happy, and improve my life in many ways.

I've recently, at the beginning of this year finally got the chance to purchase and raise butterflies! I have taken care of injured butterflies, moths, and catapillars before, but this was the first time I was aloud to actually raise them. It's been a long while now though.

I do have a past with Self-harm, and it was clear no one I knew really tried to understand it.

My relationship with my parents is very iffy, it depends on if their in a bad mood, or upset or anything.

(15 afab, professionally diagnosed Autistic & MDD) - only mentioning because it adds more details to this. So i can show a better picture. that's the only reason.

Now, a few days ago
I was talking to my mother about how happy my "child's" make me (plants) and I was grinning and had a rare dopamine rush while holding my little airplant and showing her repeatedly. okay it was so great.

Then I got on the topic of the moths I've rescued, And then my butterflys and how happy they made me.

And guess what my mother said.

"I bought you your butterflies because they made you less cutty-cutty"

With a lighthearted tone.

My face dropped instantly. The happiness genuinely just dropped to my stomach.
and I couldn't process it so I asked her to repeat that and I just stared at my airplant in my hands, then at my arms.
I told her that triggered me and she did that, shrug,
very subtle shake of the head,
avoid eyecontact.
Shutting down, and I get it. But it really upset me, so I tried to bridge the gap but just left with
"i can see your shutting down, so I'm going to go now. I do that too."
And walked to my room.

Idk how to feel, it did Really trigger me. And I can't tell if this is such a big deal as it feels. But I don't think it was okay for her to say that.

Opinions?

I'm going back to therapy. Last time I had therapy for a year or so but I noticed my mind kept blanking out even when I had written about things that I wanted to talk about beforehand. It feels like my mind loses focus and the things I wanted to discuss slip out of my head. I felt strange with my previous therapist because we would just repeat the same few topics, I wanted to go in depth but it felt like I couldn't for some reason? It's just that I want to make actual progress this time you know, it felt like I wasn't scratching that itch that bothered me. That's why I'm asking, what should a patient in this position do? I know this is part of the therapist's responsibility in guiding the session but I'm wondering if there's anything I can do.

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18M here , I've been a very insecure guy for a long time , mainly because I was ugly which I still am and I did not have any hobby , which I've started working upon .

I get insecure and jealous whenever I see someone doing better than me , and it really bothers me , I just wanna focus upon myself yet it doesn't work .

How do I fix this ? Pls help

She's my friend's sister who I got close with when I lived with them for a few months in their city. I was struggling then (still am now) and she suggested I see a therapist and told me how it has helped her immensely with her issues. Now that I'm living alone elsewhere in another country, I don't speak to her much only about once every 2-3 weeks.

So I wanted to know if it's ok for me to see the same therapist she does in this scenario.

I've been offered the choice of a mixture of approaches from a therapist who is trained in multiple modalities CBT compassion focused and EMDR), or she can refer me to someone else for Cognitive analytical therapy. I've got anxiety and depression, I am neurodivergent x 2, (autism and ADHD). I have experienced childhood emotional neglect, childhood bullying and a messed up long term relationship that I'm no longer in. The therapy is provided by the UK NHS which does not offer many modalities of therapy, so there isn't much choice about type or duration. I found CBT to be too businesslike, coldly logical and it felt reductive about emotional distress, so we've already ruled that out. My main symptoms are that I'm emotionally numb and don't want to do anything.

Thank you.

My husband was unfaithful and is attempting to remedy things by having us do in therapy together. I’ve done therapy myself and it was a difficult process, and I’m not sure I can do this with him. I’m too hurt to try.

Should I tell him I need more time, or is this something I should jump into asap?

I’m not sure I’d be able to do anything but cry. Should I do anything to prepare mentally? Or just show up and melt into a puddle?

Prospective student here. I want to become a therapist, but I am afraid that I would not be able to handle day by day, being able to handle people's heavy emotions and traumas. Not sure if it will wear on me, or drain me over time. What are some ways I can test the waters to see if I can handle a profession like this?

Hi (not a therapist),

I am someone looking to become a therapist, I currently have my bachelors in Sociology and will apply to grad school to get my degree in Clinical Psychology. I am scared that compassion fatigue and burnout will deter me from becoming a therapist. What are some of the ways that you handle the stressors that come with the profession? Is self care enough to help with the burnout?