Short term vs long term therapy opinions and experiences

[Deleted member 28942]

Based on my not so good experience with my former therapist and now working with an excellent therapists who gets to the heart of the matter within the first session and another thread here where @barefoot was brave enough to take an assertive stand and call me out on some projecting, I decided to create this thread where people can debate and share their opinions and experiences regarding therapy.

Here is one article:
Opinion | In Therapy Forever? Enough Already

Also, check out This is How by Augustine Burroughs. There is an essay "How to be a Good Mental Patient".

I worked with a therapist for about 2 years. Some of the work we did together was useful others not so. I am certain she was making some decisions in her financial interests. I don't think she was fully money grubbing heartless bitch but I do believe her financial needs clouded her ethical judgement.

I work now with two therapists one EMDR one CBT and DBT. Both are Psychologists with PhDs private practices and high success rates. Both of them immediately got to the core issues quickly instead of going with tiny details. Both of them from the first session pointed out that I have a lot of repressed rage that I sometimes spill onto other people. I was not aware of this until I sent a harsh email at my former therapists and some member her pointed out the rage towards my mother. I think my former therapist was either not trained well enough with this, has her own unresolved issues, was dragging things to keep a client for financial resource or a mix.

What has been your experience with therapy? Long term vs short-term? Are the therapists that get directly to the heart of the matter more efficient and more successful or do you benefit more from long-term therapy? Do you think or do you have experience where you felt a therapists was dragging you in therapy for long time because of her financial needs or other unresolved codependency issues?

Feel free to share and discuss.

 

[Deleted member 28942]

Another useful link about the inherent power differential in therapeutic relationships:
The Power Differential and Why It Matters So Much in Therapy

and another link that is closely related:
Link Removed

 

[Abigail7]

I don't think it's so simple as short term therapists get to the matter right away and long term therapists drag their feet. It sounds like you just had a therapist who didn't really know what they were doing in terms of trauma and that's why therapy dragged on forever. I think short term versus long term therapy has more to do with the severity of the client than anything else. That is, length of time needed in therapy depends on severity and responsiveness of the client. It sounds like your old therapist was a talk therapist and your new therapists are not as they focus on EMDR, CBT, and DBT. These are very different modalities. If you know the basics of traditional DBT, it's not exactly a short-term therapy as traditional DBT requires twice a week sessions (individual + group), and a year long commitment (enough to go through the training twice). This is a major deterrent for people considering traditional DBT training as it's very time intensive.

 

[mrsmegan]

I have been with my therapist for just over 2 years. I would say, for me, it has not been the most "efficient", but it was what I have needed in this process. I needed to take a lot of time to build up trust and feel ready to open up. So - it has been me and what I need that has really driven how that looks.

 

[Deleted member 28942]

@Abigail7 my former therapist was Hakomi and EMDR therapists. She said she is a holistic body work therapists. She was on the wishy-washy or vague side. The current therapist that is CBT and DBT uses I believe only CBT with me. I don't think we use DBT though I am not sure.

I agree that the severity of client condition is a factor however most clients are not sever case. I consider sever cases bipolar, schizophrenia, DID, chronic addiction and suicidal tendencies/attempts, self harm, etc. I don't have any of these.

It sounds like you just had a therapist who didn't really know what they were doing in terms of trauma and that's why therapy dragged on forever.

This yes. She was supposed to have knowledge but I guess being certified in EMDR or Hakomi does not make someone a good therapists.

 

[Nessa7]

I think our timeline of changing therapists is pretty similar. I saw a long term therapist for about two years. I stopped seeing her at the end of April, and I began seeing a new therapist for short-term therapy at the beginning of this month. I'm doing great with the new therapist and want to dig into my trauma.

The tricky thing with a direct comparison is that you need to be stable for short-term therapies with a focus on trauma to be successful. When I started seeing my old therapist, I had almost been hospitalized a few weeks before. I was self-harming and still in the middle of a bout of depression. I had no PTSD diagnosis. My new therapist might have got me to this point about a month faster, but it's not a big enough difference that it would be concerning for me.

I did feel like my previous therapist took me leaving harder than I took leaving her, but I thought that was understandable. She was leaving a lot of patients, and I thought that would reasonably be difficult. All of the mental health professionals that I have seen always had plenty of patients. They could easily have had someone else take my appointment times.

 

[Suzetig]

I consider sever cases bipolar, schizophrenia, DID, chronic addiction and suicidal tendencies/attempts, self harm, etc. I don't have any of these.

I don't have any of these either but I do have a history of severe neglect, physical abuse, sexual exploitation, childhood domestic violence and assorted other adult trauma. I've also held responsible, senior level posts in national organisations, have always sustained employment, have three university level qualifications and am working on a fourth.

So according to you, I wouldn't be a "severe" case.

I've done both short term and long term therapy. Short term kept me functional and served a purpose but it didn't deal with the underlying trauma. Nearly all my trauma has been relational, relationships have been deadly terrifying things for me. Not just intimate partner relationships, family relationships, friendships, professional relationships - anything that involved any measure of closeness or interaction was intolerable for me. I managed to hide that well for a very long time but eventually I stopped coping.

The only thing that has helped me has been a long term, close, private, therapeutic relationship with someone who practices good old fashioned talking therapy. It has literally changed my life. I'm glad you think I've been wasting my time and have been lining my therapists pockets for no reason.

It is absolutely fine for you to say it's not what you find helpful, it's bullshit to extrapolate that to a whole treatment process and client group because it serves your purpose. Long term therapy doesn't suit you and isn't what you want, that doesn't mean it's wrong or unhelpful for others.

 

[anthony]

Therapy is a business, and its exploited more than ever nowadays with service competition. I see psychology offices open and close locally, everyone vying for work. Unfortunately, the client suffers. You get a therapist that does little other than listen, giving little helpful advice or teaching tools so the client gets better. Instead, they say "see you next week" and believe they've done their job.

There are good therapists out there. This is also why therapy models have timelines. The average case should work within the 12 week therapy model, then not return.

I will agree though, that severe childhood trauma can take years. I would put a cap on it though, 3 - 5 years of therapy. If you aren't going it alone by then, either you're lazy, you're therapist is lazy, or both. In that time frame, you should have tackled the major points, you should have been doing a lot of self-help work between sessions, you should be capable of your own journey without the need for therapy.

For those in the USA, this is different, as the culture is based upon a therapy model. Everyone goes to therapy to talk about their feelings. It's a lifestyle culture of being American -- that is some of the problem.

Long-term therapy isn't good for anyone IMHO. Get in, work hard, get out, start working it out. If you don't walk alone you can't really put to use what you have learnt, you can't learn new things, you can't become independent in your recovery -- instead you mimic a pattern of reliance, which is another aspect for many's trauma history. One that should have been dealt with in that time frame.

Therapy should be capped IMHO. You can attend for x months, then you must have the same months away from therapy -- to actually learn and grow. Then return if you need help with other areas. Repeat.

Society is pathologized more than ever -- its getting ridiculous -- and then the therapists who want lifelong clients. Argh!

So much broken...

 

[Deleted member 28942]

I'm glad you think I've been wasting my time and have been lining my therapists pockets for no reason.

It is absolutely fine for you to say it's not what you find helpful, it's bullshit to extrapolate that to a whole treatment process and client group because it serves your purpose. Long term therapy doesn't suit you and isn't what you want, that doesn't mean it's wrong or unhelpful for others.

@Suzetig you are drawing that conclusion from my post but I never said that. I started the post because I wanted to hear other people's opinions and experiences and as I already acknowledged I was projecting part of my frustration with my former therapist on here. You are taking it too personally when it has nothing to do with you.

 

[Deleted member 28942]

If you don't walk alone you can't really put to use what you have learnt, you can't learn new things, you can't become independent in your recovery -- instead you mimic a pattern of reliance, which is another aspect for many's trauma history. One that should have been dealt with in that time frame.

The pattern of reliance or codependent relying was what was happening with my former therapist. I don't know if she was blind to see it or if she was intentionally encouraging it. There were times when I felt initialized like her telling me what is good for me in therapy. With the two therapist I am working now I don't get that feeling. I am seeing both only for the summer so it will be 12-13 sessions each. I will see what will happen in that time frame.

ROFL:

For those in the USA, this is different, as the culture is based upon a therapy model. Everyone goes to therapy to talk about their feelings. It's a lifestyle culture of being American -- that is some of the problem.

I am in the USA this summer living in Canada. Yes that happens in the USA I guess and therapists encourage it. "How do you feel?" and the excessive validation of clients experiences and needs is what causes the codependency.

The first article I linked contains this paragraph:
""If a patient comes to me and tells me she’s been unhappy with her boyfriend for the past year, I don’t ask, as some might, “How do you feel about that?” I already know how she feels about that. She just told me. She’s unhappy. When she asks me what I think she should do, I don’t respond with a return interrogatory, “What do you think you should do?” If she knew, she wouldn’t ask me for my thoughts."

I think what will start helping is more online reviews of therapists. It is a service like any other service and anonymous reviews should be available. That is how I found my current therapists.

 

[Suzetig]

I will agree though, that severe childhood trauma can take years. I would put a cap on it though, 3 - 5 years of therapy. If you aren't going it alone by then, either you're lazy, you're therapist is lazy, or both.

I agree, or the Client is overly attached/dependent on the therapist. And yes, therapists who create clients for life are appalling in my view.

I'm coming up on 3.5 years sometimes seeing her fortnightly/monthly and sometimes weekly for a short spell if I'm actively triggered by something. I don't see me being there for much longer all things being equal.

@UniversalBeing you gave a definition of "severe case" which in every way excluded me. I live with the almost reverse stigma of not being disordered enough for the experience I had, not being "damaged" enough to need long term support. I even had s therapist tell me that if my life thus far had been that bad I would be a dead prostitute, not have a successful career. So, when someone says a severe case looks like significant disorder yes, I do take it personally because support and treatment has been denied me on exactly that basis.

 

[Deleted member 28942]

@Suzetig you missed the "etc." part there. You know your experience best and you know what works for you. The thread is exactly about that people sharing their experiences and opinions. What I am getting from your post you did have sever childhood abuse and that had a strong impact on you and that is why you want/need long term therapy.

I had a severe childhood abuse but I am also very resourceful and I've also had people that have loved and love and people that have protected me. This aspect of protective factors/figures during childhood are also important. Same with nurturing figures. In addition the individuals unique gifts and talents.