Have you ever sat across from a doctor, nodded along to everything they said, and walked out feeling more confused than when you walked in? I have been there. It is incredibly easy to hand over all your power to someone with a degree, expecting them to have a magic formula to fix your brain. However, figuring out what to do when therapy isn’t working is a critical part of your own personal accountability. Your mental health treatment should be a collaboration, not a dictatorship.

My guest today is here to challenge the traditional care paradigm. Mark Michaels is a fantastic writer, a conceptual artist, and a self-described punk savant who came of age in the 1970s New York punk scene. We are talking all about taking back control of your own care and decentralizing authority. Be sure to check out his incredible forthcoming preprint titled “Binaries, Multitudes and Beyond” at https://markamichaels.com/.

Also, a quick shoutout to our season sponsor, Sucreabeille. We teamed up to create my signature gender-neutral scent, “Why Did I Walk Into This Room”, which is an absolute love letter to the ADHD community.

Decentralizing Authority in Mental Health Treatment

When I was diagnosed with ADHD at 34, I initially handed all of my trust over to medical experts. I learned the hard way that while therapy and medication are vital tools to help our brains function, I am ultimately responsible for my own progress. Mark approaches his care by intentionally decentralizing authority and returning power to himself. Reclaiming your mind does not require blind submission to an external paradigm. According to the American Psychological Association, a collaborative therapeutic alliance is actually one of the strongest predictors of treatment success. You must be an active participant.

Working Through Bad Therapy Experiences

A lot of us carry the weight of bad therapy experiences. Maybe a clinician did not listen, or maybe a treatment plan felt forced. Mark emphasizes that maintaining a punk rock ethos means questioning assumptions and challenging authority, even in a clinical setting. He told me word for word: “If something’s not feeling right in therapy, it’s almost certainly an interpersonal and dynamic problem, not just you. And if a therapist is telling you that it’s just you, run away.”

Setting Your Own Therapeutic Boundaries

Taking control means you get to dictate what works for your biology. Executive dysfunction and burnout are biological realities. They are not moral failings, and they are definitely not laziness. If a specific approach is burning you out, you have the right to set firm therapeutic boundaries. Speak up when a method does not fit how your brain naturally operates.

People Also Ask

Q: What to do when therapy isn’t working? A: The first step is to communicate your concerns directly with your clinician. If they are dismissive or tell you the problem is entirely your fault, it is time to find a new provider. You are always allowed to seek a second opinion.

Q: How do you establish therapeutic boundaries as a patient? A: Start by clearly defining your goals and limitations before a session begins. Be honest about what you have the mental energy to handle, and do not be afraid to say no to exercises or treatment styles that feel harmful to your well-being.

Actionable Steps for Your Next Session

Try this simple exercise. Before your next appointment, write down three specific things you want to get out of the session. If the conversation veers completely off track, use that list to guide it back. Take control of your care.

Disclaimer: I am not a licensed mental health professional. I am just a guy sharing my story. Please seek professional help if you are struggling.

Much love. Good vibes. – Ky