by freddy » Mon Apr 21, 2014 3:29 am
Bobbin- I appreciate the response. You raise some valid inquires and concerns. I actually do welcome them because it challenges and questions the whole ordeal and my introspection/defending my knowledge on the spot.
I have explicitly mentioned in the in-take screening with the non-doctoral research coordinator (iirc) that there might be potential conflicts considering my psychodynamic interests, but I was still open to the idea of embracing CBT (or at least short-term, which is what they actually specialize/designed it to be) –– realizing that it may help specifically for the anxiety that came into my realization. I walked-in trying to vie and inquire more information but she was trained to go on the modulated/structured regimen being that they are evidence-based research-heavy. She semi-acknowledged that as well, and did not reject me based on that alone. If anything they're happy to get folks in, especially Asian folks whom are low in their demographics, for clinical experience I suppose.
The research coordinator had somewhat of a familiarity with my presenting concern, but I suppose just put me through the hoops in deference until I had a full evaluation with the phd candidate to see if I was a good fit for the actual CBT treatment. So nothing really went wrong, but I had suspicions that it may not have been right, but I never got a final "no" even as we went further along the interview. If things went perfect, then they wouldn't have an outlier/differentiated clinical experience aside from peddling folks through their assessment/treatment framework forever without change.
However, it seemed they insisted and come the actual comprehensive evaluation, the clinical doctoral psychologist candidate as I suspect apparently did not make the connection with the coordinator prior–it might have went over her head considering my psychodynamic responses and my case history. We both knew there was a disconnect during the initial in-take screening; however, much of my theory is theory-oriented and I was trying to solicit empirical proof to test these internalized theories. She offered the stop early-on with the interview realizing my stance once I brought up my "psychodynamic" and my reasoning for favoring it. I question about this and she acknowledged that there should have been better communication/handling early on so we would have not went as far for the evaluation. I was trying to seek out information but the way they have things organized it slipstreamed into seeing the "CBT" interviewer because I reckon they put her on the front-lines for training.
After discussing with my therapist, I don't deny that it wasn't really a kosher thing to do, especially since I was still within bounds and relations with sessions with him. She did not hurt me at all, I never met her prior/don't know her - I will acknowledge my disdain is toward CBT and I wanted to understand it a bit more directly/intimately. In fact, conversely, I think I felt that I may have bruised some of her ego. I fuck around what can I say? However, my therapist did pick-up with ease that I went out to prove/disprove understanding my own research. I used the "CBT" situation as a two-for-one deal here.
I should have been more clear: the program and center was very vague and minimally-descript and was not a full-fledged "outpatient clinic" at all . It seemed that the master clinicians and actual directors/licensed folks were tied up with research/directing their doctoral program/etc. – a sorta all-in-once-place – and I never got any face-time an actual APA professional. The actual evaluation done by the lady also entails referral service to elsewhere if their place is not a good fit, which as a result of our fragmented evaluation that we quickly came to realize that it was likely not. In the end she gave me a referral to somewhere else and wanted me to follow-up, so despite the CBT screening not being a good fit for me; I suppose it was proper protocol to refer me to somewhere else.
It's not that I don't fit their criteria for whatnot anxiety nor is my anxiety is wrong, it's just that their treatment modality consist of a specific CBT paradigm, which may not work for all folks. If their referral to another place that seems to be actually full-fledged as an "outpatient clinic" then from my cursory glance at their program objectives, will too offer CBT – perhaps a variation.
I suppose my overly aroused excitement and perceived "belittling" is that I have made aware/conscious of a vulnerability with their psuedo-team/"case manager" coordination at the preemptive training-level, that during our interview, I forgot to add the detail that the interview came a bit confident about running through the gamut with her CBT module, until my psychodynamic responses proved otherwise and the limitations. I'm basically a bit validated because I think I got her to realize, probably a first, as a doctoral student in training, that her CBT framework lead by her master clinicians will not always work –– and in the process, I also enlightened her with research theories to underwriting/correlating my responses, which informs her much more deeply as an academic/training clinician, than say for example a patient for not being able to express or recall their memories to make responses because of PTSD/trauma, which may be without much to analyze and would not be a good fit. Now, she may have experienced this with prior evaluations, but I'm willing to bet (as arrogantly as I can sound her) that it may not have been as in depth and intellectual as she may have anticipated.
Essentially, I gave her the "yes" and "no" but also more importantly the "why". More so, I correlated my case history/background regarding family relational dynamics of BPD/Narcissism through an insecure disorganized attachment relationship that underwrote a lot of my anxieties. It is because of this psychodynamic exposition where I have clear structural explanations that it make too much sense that my my response are "yes, i'm anxious for X" but it just won't work because of my aforementioned response explaining why. it is because of my understanding of my background prior in clinical jargon that I also helped the clinical psychologist in training to understand how CBT has its limitations here in a conceptual way – rather than a point-blank; yes/no response.
Lastly, she is a clinical psychologist in training under supervision by a master clinician, so while I did have your same exact sentiments and feelings empathy for the interview about the potentiality of this unraveling, I also realized that she as a "clinician" would have to deal with "shit-hitting-the-fan" because there will always be a different thing turned upside down with each, new prospective client -- nonetheless each new session and folk's problems/interviewing style. As Freud said, there is no such thing as a "normal" personality, only normative. I anticipating that I would have benefit only on the proving/validating of my psychodynamic theories, though her asking these structured questions where my own respective therapy is more psychodynamic-inclined with some CBT. (her program's framework is highly-structured CBT, which may not be for everyone even if they like CBT because of the intensity of it)
So as much as it seemed that I fucked with her interview, lets realize I came in with full disclosure, despite already foreshadowing that I would have likely destabilize/de-orient the interview because I was theoretically confident in my psychodynamic theories. I think for the fact that my responses did not comply to what she anticipated or within the paradigm of the CBT module, was a new, if not a terrific, experience-builder for her -- despite it not working out. Hopefully, she realize in turn that the analytic technique/unconscious mind does triumph behaviorism. I earnestly think she will be a better clinician because of our session as much wrongdoing it may seem. I like to believe I disenchanted her a bit literally.
Unfortunately, I am only theoretically psuedo-aware of my learnings because I have self-studied whatnot psychoanalytic literature individually, though again, it is merely pure internalized conceptualization in my mind, until it is proved via experience/testing – where it can be actualized instead. I didn't outright slander her, and let's realize there are tons of clients/patients that unconsciously direct their rage/trolling at whatnot mental health professional. Rather, I turned a CBT/behavioral analysis interview that was suppose to be her directed at me, into a reversed psychoanalytic one where my psychodynamic responses resulted in her to make unconscious/enlightened realizations alongside with mine. We both benefited if you can decipher my jargon/phraseology/terminology.
I understand you may not be able to endure sifting through my stream of consciousness (if you've made it far.. lol), but as I've mentioned earlier in my posts, I suppose it's one of the things that I am unraveling where I am going against the grain with faucets of the mental health complex. I'm simply being a rebel here. I hope to do good with embarking and outlying this vignette in the future. I'm happy that you've been clamored in Bobbin, you will realize it later – just you wait.