Dear Cary,
I am seeing a psychiatrist for depression. Although I am successful at work and in most things I do, I only get on with people on a politeness and superficially social level. I have entered my 50s without any close friends (I moved countries, got divorced, became a workaholic and had some bad general attitudes and behaviors), and I am afraid to get close to anyone other than my dogs. I live a very solitary existence. Most weekends I don't see anyone except other dog walkers. I have joined groups and I have taken part in dozens of evening classes and weekend workshops, but I don't seem to be able to connect with other people. I haven't always had this problem, but it has gotten worse in the last couple of years.
I have been seeing this doctor for about a year. Initially he put me on antidepressants, which did cheer me up and we do talk for an hour each week. I respect him and understand he is expert at his job. He is about 70. He is very thoughtful and he has won recognition for his writing. I didn't choose him -- he came as a referral from my G.P.
I am writing because I am not sure how this therapy thing works. We talk about politics (on which we agree). We talk about books. We talk about investment strategies (I'm in finance). He talks about his life and his family. I try very hard to bring up issues that are affecting my life: people problems I have, my feelings, my observations about myself in relation to others, basically anything that will help me deal with my closed attitude. But I never seem to progress with these. He changes the subject and gets on to something factual like politics.
He says he finds my talk interesting, which is great but I do have to pay him to listen to me. Apart from having these enjoyable chats I am wondering if it is doing me any good. Is he really teaching me how to be a friend?
What do you think? Do I have the wrong attitude to therapy?
Isolated Down Under
Dear Isolated Down Under,
I don't understand why this doctor keeps changing the subject when you bring up issues that are affecting your life. Why don't you ask him why he's doing that? That's exactly the kind of conversation you should be having with him. That's what he's trained for -- that's why you're paying him.
While you're at it, tell him you want to review with him the goals of your therapy. If you spelled out your goals when you first started seeing him, then revisit those initial conversations and discuss whether those goals have been met, whether they are still relevant, and how they may have changed. Then talk about your current goals. If one of your goals is to understand your relations with other people better so that you can improve your friendships and connectedness, then tell him that's what you want to talk about. Ask him how he sees you getting there. Tell him that you don't see the connection between discussing politics and finances and the real issues that brought you into therapy in the first place.
See if you get anywhere with that. Listen to his answers and ask yourself: Does what he's saying make sense? Do you trust him to help you understand your life better? Or do you feel you're being taken advantage of, that he's not really listening to you or helping you? And ask yourself: Have you learned anything from that conversation?
If you really don't trust him, then how can he possibly help you? I think you need to feel that he knows what he's doing and has your best interests at heart. If not, you may find yourself cutting corners to protect yourself. For instance, if there is something painful you need to talk about, but you're afraid if you start talking about it he's going to change the subject, that's no good! You need to know that he's there for you. That's the whole idea. You need to know that he is willing to regard your problems and ideas as seriously as you do -- or even more seriously!
So have this conversation with him. Tell him how you feel when he changes the subject. If, after your conversation, you don't have a strong feeling of renewed confidence in him, then start looking for another doctor.
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