Dependency - could use some advice.

My brother, who is now in his early 20s has had depression for a few years now. There's always ups and downs; it used to be completely debilitating. It's still pretty bad, but I don't really want to discuss his depression in too much detail; it's not what I'm posting this about.

For over a year now he has been visiting a psychologist. He's been to both a different one before and a psychiatrist but said they weren't helping him. This guy, on the other hand, is different. He seems to really help him and my brother looks forward to visiting him weekly. He has, however, seemed to have changed little. He still has terrible mood swings where he becomes bitter and hateful towards us, his family, but especially towards himself. It's been over a year now and while there's temporary reprieves, there appears to be little long term improvement.

I'm not going to pretend to know anything about psychology, and I have no idea how long it would take to separate my brother from his depression, if it's even at all possible, but what truly worries me is the communication. The psychologist has never contacted us once. If asked if the psychologist is helping, my brother explains that he is but "there's a lot to go through". Recently, my mother (who has been cracking under stress about this) contacted the psychologist, without letting my brother know of course. When asked about virtually any aspect of his depression, however, he seemed to have just brushed her off and told her that "progress is slow".

The visits to the psychologist are, of course, expensive. I've heard of psychologists manipulating patients into becoming dependent without actually helping them although, again, I know nothing about if this actually happens. I really don't know who to turn to for advice about this so I wanted to ask here if
1) This total lack of communication with the family is common.
2) Whether this manipulation actually happens or not.
I'd appreciate any advice you guys could spare. Thanks for reading.

Arden wrote:The visits to the psychologist are, of course, expensive. I've heard of psychologists manipulating patients into becoming dependent without actually helping them although, again, I know nothing about if this actually happens. I really don't know who to turn to for advice about this so I wanted to ask here if
1) This total lack of communication with the family is common.
2) Whether this manipulation actually happens or not.

1) You said your brother is in his early 20's. Being an adult, a psychologist would have to maintain confidentiality. So total lack of communication to the family is his a requirement of his job. The psychologist should never contact anyone else to discuss your brother's situation unless your brother had specifically consented to him doing so. It would be different in the case of a minor who's parents were their legal guardian. But the psychologist did 100% the right thing by the law/professional guidelines in not sharing any information with your mother when she contacted him. The fact that your parents might pay for the sessions is between them and your brother. The psychologist still can't share anything without your brother's consent.

2) It's always possible, but I think it's rare. I believe most people who study long and hard enough to become a qualified psychologist do so because they truly want to help people. Not because they are manipulating people to become permanent, easy income, clients. I'd imagine the satisfaction they get from their work (in addition to income) is seeing people change and improve their lives. There must be bad eggs, like in any profession, but the majority would not manipulate people like that.

I think sometimes a psychologist maybe isn't helping an individual, but it can be hard to identify that at times. It's not deliberate manipulation, but it can be hard for them to make the call and say that they don't believe their client is improving with them and maybe they should see someone else. A good working relationship is valuable in getting better in and of itself.

Depression can be a long process to work. The only person you can talk to about this is your brother directly and hope that he is willing to share. There is nothing worse than feeling pressured by others for progress. He may well be making some. Those temporary reprieves are progress. It won't necessarily be a case of "all better now, it's smooth sailing forever". It may go up and down. Two steps forward, one step back.

If money is an issue for your parents, then they need to bring it up with your brother. It's not a good idea to go behind his back and push the psychologist for answers. First, because you won't get any. Second, because if you want to relate your brother better and encourage openness, an action like that just creates distrust.

Hope that helps.

You're right of course about confidentiality; I've spent so long listening to my brother's concerns that it didn't even occur to me that the family is included in regards to this policy. In retrospect, I'm glad that his response was kept vague.

As for the second issue, I had not expected much to come from it; it did sound like the kind of shock material used to draw attention. These things just have a way of gnawing at you and I wanted to hear another opinion on the matter.

Thanks for the detailed response. It's good to read the opinion of someone outside the situation; helps put things in perspective.