Help Me Understand The Professional Mentality Of Therapists

[Bragado Jansing]

OK, so I've talked to nearly 20 therapists and met a handful of them.

I detailed them my life story, and they were basically, "uhuh, ok." Most of them said they couldn't help, and the other ones who offered to take me on as a client basically ignored everything I told them.

Now that I'm opening up to people about my childhood and my family, I've been getting responses such as "GET THE HELL AWAY FROM THESE PEOPLE, YOUR LIFE IS IN DANGER! PLEASE, PROTECT YOURSELF! IMMEDIATELY!" And they're right about it, as hard as it is to admit and wrap my head around.

What I don't get is, why aren't these therapists concerned at all about my life situation and the danger I've been facing by having a family of sick, creepy psychopaths screwing my life up? It's like all of the nightmarishly demented stuff I've been telling therapists just goes in one ear and out the other.

Is this part of their professional ethos or something? Because it seems really stupid. I've had doctors, even the worst among them, tell me to quit smoking in the first meeting because it was dangerous for my health. Yet these therapists haven't batted an eye when I've told them I have real-deal attempted murderers in my life who've been f*cking around in my personal life, leading to some seriously disastrous consequences.

Like, what good are these people then? I seriously do not get how therapists work. All I've heard is, "you just have to find the right fit" from people, but it's like ... how many after 20, of the same exact thing over and over again, is the right fit going to happen?

Because if this lack of concern/regard for clients is part of their professional ethos, and it has to be considering how I experienced it with 20 of them so far, yes, 20, then what good are they? They've just been making things worse with their lack of concern, not better. Even on the level of basic humanity it doesn't make any sense to me.

In fact, I had a few therapists who seemed to really enjoy the screwed up shit I was telling them, and a few of them got manipulative about it, like it was an avenue for them to work or something. This is a field that is in serious need of higher standards and regulations. As in... I've had therapists actually pose a threat more than provide an opportunity for aid. This industry needs a serious overhaul. God damn!

 

[expectingbetter]

I am of the opinion that therapists never should tell you what to do exactly, they certainly have their own opinion what they would do if they were in your shoes but it is simply not their job to telling you what to do. Their purpose is to by working with you make you to become physically and mentally capable to do exact things which would get you out of situations, circumstances, people that are threat for yourself.
They mustn't tell you what you should do. It must be yours and yours only decision.
They are here to support you and to be people you can talk to and discuss things with and to help you set your goals, make your own plan, go step by step according to your plan, but all of that - goals, plan, steps must come out of your mind only.
It would be really harmful if some of the professionals would try to take that role from you.

 

[Bragado Jansing]

If this is what the therapist's job is, then maybe the job of therapy needs to change. I'm sorry, but what I've experienced here is completely nonsensical, and in some instances downright dangerous for people.

And it makes sense why I've heard so many stories from people about incompetent therapists, dangerous therapists, abusive therapists. I haven't heard many stories of helpful therapists, other than, "it was helpful!" I never read any detailed explanations about what quite made it helpful. "It just was!" Like, what does that mean?

I've read CBT books and they're pretty helpful, but the material is only as valuable as the person administering it, and the system in which they're administering it in, within the culture it's all operating under.

To me the whole idea of the "therapeutic relationship" needs to be eliminated and replaced with something different. Or standards need to be raised to something equivalent to the professions, like law, medicine, dentistry, etc. But fixing it is complex.

I completely disagree that the status quo of psychotherapy is acceptable and just something I have to adapt to. I will not, because it's filled with too many problems and issues that stem from the people in the field, to the way the field is structured, to the educational standards, to the system, and to the culture it works in. I've seen way too much messed up, nonsensical, and sometimes dangerous stuff not just from myself, but others, too.

I'd have to beat myself in the head with a lead pipe to be able to ignore this stuff.

 

[joeylittle]

I'm wondering - can you give some examples of what you would like a therapist to say/do?

Like - your ideal first,second session: what would happen?

 

[Bragado Jansing]

Ideal therapist ... here's my personal vision for it.

• Throw out the "therapeutic relationship" aspect of it. This is a red herring that provides no help or benefit to people because it requires a two-sided delusion that goes beyond the usual roles people play in life, because the therapist, at the heart of it, is merely a service provider and can never actually provide what the relationship entails. It sets up an inherent failure of goals in and of itself, and can result in people staying in therapy for 2+ years, which is way too long and unhealthy for people, IMO. Nobody should be in therapy for that long. It may help some people in an unhealthy way, but this should not be allowed at all, because it harms clients who actually do want to get healthy just by existing.
• As far as a session goes, the therapist takes a catalog of the client's background, symptoms, circumstances, situation, and other relevant information, and this is matched up with the latest evidence-based research and treatments related to the situation. Then the therapist develops a treatment plan and timeline regarding these issues. There is no standard here that requires or promotes timely, effective, evidence-based treatment, and this should be mandatory; like you'll lose your license if you don't do something like this that you can explain to a high standard. If someone is in a dangerous situation, like me for example, then it requires an immediate proactive response from the therapist to help get the client out of danger. Which I don't think would be hard because all it requires is using the accepted standards of society and human conduct, which exists, and is real, so it takes the element of uhhh ... "therapeutic creativity" out of the equation. Which I think is important because a lot of therapists want to treat their job like their own personal art, which is an egotistical and self-serving standard that isn't always in the client's best interests, and can be harmful for the client. It might be boring for the therapist, but that's irrelevant to the job at hand.
• The therapist should have maybe one or two specialties and should be held to a professional ethical standard towards those specialties, such as with law. In law you can't hold yourself out as an expert on a subject matter unless you have specified education, training, and experience in it that meets a certain standard, and if you end up not being as experienced in the subject as you hold out, then you can lose your license. In therapy you can say you're a trauma expert with absolutely nothing to back it up. This means if you're a trauma therapist focusing on child abuse recovery, then you have a demonstrated expertise and track record of effectiveness in all aspects of trauma recovery, which includes things like symptom reduction, assertiveness and relationship skills, normalizing standards, etc., basically covering all of the common elements I've seen in trauma studies and in my own recovery. There's a lot of material out there that already exists that a therapist can use; assertiveness and relationship skills have been studied and refined in business fields, normalizing beliefs and standards has been studied and refined endlessly in fields like sociology, but psychology takes no heed of any of these developments, which is nonsensical to me. Once again, therapist and subject matter ego gets in the way of professionalism.
• Therapist has access to an established network of resources to help the client recover that are held to an evidence-based, professionally regulated set of standards. This is more of a utopian vision of things, though.

... so on and so forth, I don't have the time right now to detail all of my thoughts on it, but those are a few. Our culture is part of the problem, though, in that mental and social health is placed very, very low in priorities compared to other areas of life, despite the fact that these issues have wide-reaching consequences for personal health, social stability, and the economy. So it's a really complex issue, but I don't think it's wise to just accept the status quo and think that the client needs to conform, because the status quo isn't working very well, and can be very unhealthy for people.

Say

 

[Lotis]

Now that I'm opening up to people about my childhood and my family, I've been getting responses such as "GET THE HELL AWAY FROM THESE PEOPLE, YOUR LIFE IS IN DANGER! PLEASE, PROTECT YOURSELF! IMMEDIATELY!" And they're right about it, as hard as it is to admit and wrap my head around.

What I don't get is, why aren't these therapists concerned at all about my life situation and the danger I've been facing by having a family of sick, creepy psychopaths screwing my life up? It's like all of the nightmarishly demented stuff I've been telling therapists just goes in one ear and out the other.

I guess I am confused. In the first statement you said that now that you are opening up to people (who I assume are therapists you've seen?) are concerned about your well-being. They are telling you to get away etc... But then in the second paragraph you wonder why they aren't concerned? Maybe I am not reading it correctly. Could you explain?

In fact, I had a few therapists who seemed to really enjoy the screwed up shit I was telling them, and a few of them got manipulative about it, like it was an avenue for them to work or something. This is a field that is in serious need of higher standards and regulations. As in... I've had therapists actually pose a threat more than provide an opportunity for aid. This industry needs a serious overhaul. God damn!

You bring up some close to home issues for me.

Unfortunately, and this is just from my experience, I have had more bad or incompetent therapists then good ones. In the US everyone knows the state of our mental health system; it is awful. Therapists are grossly underpaid by insurance companies and the good ones charge WAY too much money for an average person to afford. How often do we hear in the news that people who have committed atrocities were either in IN treatment or previously in treatment. Well if they were in treatment how the hell did a guy go on a murdering rampage? The system is broken and underfunded, does not identify problems or intervene early to prevent later tragedy, and too many responsible are wedded to old ways of doing business. I have had one absolutely horrid and abusive therapist who I should have reported but I was just a kid and I did not have an adult in my life to say "hey this is really screwed up". By the time I was told by another professional that everything the previous therapist did was completely unethical, the statute of limitations was up. Not to mention the bad therapist moved out of state and disappeared. I regret not taking action. I have also heard stories of careless Psychiatrists prescribing medications that should not be prescribed (example xanax to an addict or an antidepressant to someone who is manic etc.)
On the flip side you can also say the same thing about a medical doctor. They miss diagnoses, they under-treat patients, they ignore symptoms etc. Primary care docs should be able to refer their patients out to receive mental health treatment and yet not many do. There are problems within the model of treatment people receive. When one model fails the negative impact trickles down. Look at the drug problem we are dealing with in America because Doctor's prescribe pain killers like candy!

Use your own judgement when it comes to your treatment. It is a fact that there are bad people everywhere, including professionals. Just because someone has a license or a degree doesn't make them qualified. I do not think you or any of us should be OK with bad treatment or the way that the mental health system functions. Sadly, I do not have the answers because something major needs to change within the mental health platform in order for change to happen.

Unfortunately, I am in the same boat as you in regards to trying to find someone competent who I can afford and who is willing to work with me. I am disheartened and discouraged right now. I want to be well but I also do not want to be damaged any further by the irresponsible professionals within this area of health care.

I am sorry you are having such a difficult time finding a good therapist. Believe me when I say I know it is not easy.
L

 

[Bragado Jansing]

I guess I am confused. In the first statement you said that now that you are opening up to people (who I assume are therapists you've seen?) are concerned about your well-being. They are telling you to get away etc... But then in the second paragraph you wonder why they aren't concerned? Maybe I am not reading it correctly. Could you explain?

Sure. Say a doctor is concerned that you're smoking and says it's bad for your health and you should stop. He's not doing it because of a "relationship", but because it's his job as a medical professional to say that. That's what I'm saying. I'm not talking about "opening up" in some mewling love love kind-of way, but in a way that helps people live a safer, healthier life.

 

[Lotis]

Sure. Say a doctor is concerned that you're smoking and says it's bad for your health and you s...

Ok. Take someone who self injures. They tell their therapist. The therapists responds with you shouldn't harm yourself you could do irreparable damage. I don't think that has anything to do with the relationship. It comes down to the professionalism and the training of the therapist right?

 

[Bragado Jansing]

Ok. Take someone who self injures. They tell their therapist. The therapists responds with you shouldn't harm yourself you could do irreparable damage. I don't think that has anything to do with the relationship. It comes down to the professionalism and the training of the therapist right?

Sure. If a person wants to harm themselves, that's their right, and if they lack the desire to change that, then that's also their right and choice. A person outside the individual can't do much about that other than provide treatment. This makes me realize there's an entirely different side of this than I realized. I'm talking about what I personally would want, and I don't have any of these issues ... I'm willing and able to do whatever it takes to get better, and I don't have problems like this, so my own ideas aren't exactly comprehensive.

 

[Lotis]

Sure. If a person wants to harm themselves, that's their right, and if they lack the desire to...

There are so many different types of therapists out there. It sounds like you want someone who will treat you, not dive into the "emotional" portion, follow a checklist and "fix" things like a doctor would by prescribing meds or a treatment plan. I do not know your background or what you are going through. Sounds like you want to skip the personal stuff and get right to fixing your issues. Most therapists do not work that way. I have heard life coaches are into fixing not so much into the relationship.
L

 

[Bragado Jansing]

There are so many different types of therapists out there. It sounds like you want someone who will treat you, not dive into the "emotional" portion, follow a checklist and "fix" things like a doctor would by prescribing meds or a treatment plan. I do not know your background or what you are going through. Sounds like you want to skip the personal stuff and get right to fixing your issues. Most therapists do not work that way. I have heard life coaches are into fixing not so much into the relationship.
L

I wouldn't mind working on the emotional issues, but I'm not sure how many people can relate to the emotion of Lovecraftian horror. You know? I've induced temporary madness in people just by sharing a little bit of what I've experienced. How I'm still standing and functioning I have no idea.

But the emotional stuff requires even more expertise, training, and skill than just treating people in a clinical manner. This isn't an easy situation. I wish we'd focus more time on things like this than on making a comfier car. But money talks, so.....

 

[BloomInWinter]

The very basic building block of any healing environment is establishing safety.

It is a therapist's job to help patient's come to awareness as to any ongoing threats to their emotional, physical, and spiritual health and safety so they can begin taking actions to mitigate the harms. It would be unethical for any trauma therapist to even being unpacking traumas when a patient's life is not fully stable with safe social support and routines which bolster resilience.

One of the very first things my very first therapist did with me was to help me understand that my family was dysfunctional and filled with people who were too sick for me to seek any help or support from. I was put into outpatient therapy for "Adult Children of Alcoholics" at the local hospital, and I believe that group literally saved my life. It helped me become completely independent from those in my family who were and continued to harm me every chance they got. I learned to stop allowing them into my life and that has made all the difference.

I fully believe I would be dead like my step-brother or most of my cousins if I had tried to stay a part of that family. I'm so grateful for that first therapist and the ones following who helped me build my own life for myself. But it began with them telling me what they thought, letting me know that there were so many other options out there that I didn't know about, and supporting me in whichever ones I chose based upon that new information.

It is an option to completely remove ourselves from blood relatives who simply are not capable of providing us with love, compassion, friendship, safety, and peace. It doesn't matter who it is, if they aren't healthy for us, it is OK to leave them behind to save ourselves, even if only for a while.

If you don't care for what 20 therapists haven't told you, perhaps you might consider that it might not be all of them. It may just be that you aren't yet at a place to begin separating yourself from the harmful people in your life to begin the hard work of processing therapy, and that is ok. But I do think it's important to at some point look at who were are surrounding ourselves with, and decide if that is the life we wish to continue living or if we're willing to try something different.

Healthy people will not tolerate unkind or unsafe people around them. Any therapist who would encourage a patient to keep trying to make a relationship with harmful people work would be unethical. Any who would say it's possible to become healthy in an unhealthy environment would be unethical.

I didn't know what a peaceful life looked like. I couldn't even imagine a life without constant chaos from my family members. But thankfully my therapists could, and did see the worst of the dangers in my life that I had become acclimated to and were invisible to me because my abused brain had learned to ignore the warnings since it wasn't ever ok to get to a place of safety away from them.

Our trauma related self-defeating behaviors stick out to therapists like a big bright red clown nose. It's their job to point those out to us so that we may now do something about them if we wish to. We can't heal what we don't acknowledge.

My trauma processing really starting happening when I finally decided that the therapists had more knowledge about trauma and healing than I did, and I decided to trust them when they pointed out suggestions. I tried out several suggestions and the results brought so much relief that I kept trying on more and more, and after a few years, nobody in my life has been able to hurt me. Those people have been replaced by much healthier, more supportive people. My healing has been profound, though I still have a way to go.

It's all on us to decide what messages from our therapists we are willing to listen to and try out. They're only suggestions. I've never regretted any I've been given and the act of trying them has built a strong confidence in my own ability to make my life safe and healthy.