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The mechanisms in the mental health treatment system will work better for us when we grease its wheels with assertiveness. This is where, in a manner considered appropriate, we strongly ask for what we want, and ask effectively that we don't get what we don't want. This can pertain to almost anything.

In recent years I've pushed them for empathy-based therapy rather than analytic therapy. Analytic therapy, to me, resembles an unwelcome individual getting under the hood and tampering with the settings. The problem seems to stem from how therapists often receive their training. They are taught how they should perceive "clients", and this includes presuppositions that could be far from accurate. When I've worked repeatedly with intern therapists who have fresh doctorates, it seems that they all ascribe to the same playbook. And this playbook isn't any good. Therapists, with few exceptions, will behave toward "clients" in ways defined by how they are trained. Therapists don't see their clients as human beings; they see us as objects of their work. 

Mental health is not a one-size-fits-all thing. For the therapist to do a good job, they must comprehend what they are looking at and must not be looking at a set of assumptions that they've generated from what they've learned in school. My experience with older therapists is they tend to be much better than the young ones. When they have decades under their belt of working with my population, it is likely that more firsthand observation has filtered in. 

When I've spoken to therapists who can't think, they do not absorb any of the things I say. Yet, if I push them a bit harder, I can often get them to listen and to consider what I need. I've stated to them in recent times that I'd like empathy-based therapy and not analytic based. The technique of pressing a therapist, in a manner that is appropriate and not abusive, will work about half the time. 

Therapists or other individuals who are not up to the task of giving me what I openly request will often fade out of the picture. They may have requested reassignment to other clients. 

Psychiatrists, who are medical doctors (as opposed to psychologists) seem to be at a better level. Medical school probably teaches students to observe. Doctors are trained to observe and to function in a scientific, reality-based manner. When someone is trained in physical science, we'd hope that they won't ignore facts. In the past ten to fifteen years, it has been easier for me to get along with psychiatrists as opposed to psychotherapists. 

We can also push psychiatrists to give us what we want. This is within limits. They may be hesitant about prescribing a controlled substance. And this is a good thing. Pressing a prescriber for a controlled substance is not appropriate. Also, asking a treatment provider out on a date is not appropriate. My advice is applicable only within the accepted norms of treatment. You can ask for the treatment you need and/or ask not to be given the treatment you don't need, but you can't ask to see a therapist or psychiatrist to be your friend outside of the therapy venue. 

When a particular medication doesn't work for us (or so we think and feel) we can certainly ask assertively that we be switched to something else. This is a better idea than trying to be our own doctor. 

If we want to do more with our lives than just be a mental health consumer, we can make our efforts within programs offered by the "system" or we can go outside of it. If we are looking at applying for programs tailored to help mentally ill people work or do something else that we find valuable, we should put our best foot forward. If there are obstructions, or therapists who seem to intentionally create obstructions, we need to give some pushback, and ask that such therapist be taken off our case. If we want to do something outside of the system, we must tell those in the system to bug off if they are creating interference. 

Furthermore, our lives are our property. If we have an ambition in life, there is no need to tell everyone about it too soon. Doing so will leave us open to being psychologically manipulated or otherwise obstructed, such that our ambitions are shot down before we gain momentum. (This doesn't apply in all situations.) 

If you fail to ask for what you want and to ask not to be given what you don't want, how is anyone to know? People can't read your mind, and they do not have any manner of knowing your preferences unless you express them directly.