Massive backfire in therapy - don't know what to do

[Sideways]

It is not fair to put that on the client.

But he wasn’t putting it on the client. He was berating himself.

Trust between the therapist and their patient is critical for psychotherapy. And there was a lack of it, and that made the therapist feel bad.

Too me? All of that is…a pretty healthy conversation between a therapist and their patient about where they’re at.

 

[Weemie]

But he wasn’t putting it on the client. He was berating himself.

"You don't trust me after 10 months so you have to go away and do research on your own disorder" (if such a thing was said) is an incredibly loaded statement for any therapist to say to a client. The gist of it is that he got offended and took it personally that something completely unrelated to him, happened. It does indeed suggest to the client that their trust levels are insufficient, or that they've done something incorrect by researching their own disorder.

It has absolutely nothing to do with the client at all, and is something he should have worked out in supervision rather than voicing in the session. Him berating himself in front of his client puts an emotional expectation on the client, and would encourage them to soothe his distress, when that is not the role of a client in a therapeutic relationship at all. Especially because that response itself indicates he cannot be trusted with more intense work.

Sometimes these things happen, and it isn't always an indicator that a therapist is bad at their job. It happens, and there's room for humanity in therapy from both parties. But, he hasn't actually apologized for this or taken ownership for it if his clarification consists of literally doubling down on it. It was a poor reaction, he handled it poorly, and he appears to continue to be handling it poorly. I'm not offering any advice on what the OP should do about it, but their concern is absolutely not misplaced.

My actual advice would be for the OP to have a very frank conversation with him about whether or not he believes dissociative disorders are real - that is more crucial than this part of it, in my opinion. If he's still talking about the "evidence for dissociative identity disorder" then I don't think he is in a place where he can be an effective therapist to the OP. In the long-term, I imagine such a relationship will only result in a lot of wasted time and pain.

Even if the OP ends up not having a dissociative disorder, the skepticism can still cause harm, since there is still something happening symptomatically that is leading them to this conclusion in the first place. I was misdiagnosed with DDNOS, but there is no way I could have worked with a therapist that didn't believe DDNOS was real, while I thought I had it. Because I have experiences of structural fracture that are real, they just aren't due to DDNOS.

It would make me feel disbelieved, like a liar, etc - which as a trauma patient is incredibly damaging. So I would get that out of the way before anything else.

 

[tofubreadcoriander]

I saw this a while back and just want to share it with you, @beaneeboo

 

[beaneeboo]

I saw this a while back and just want to share it with you, @beaneeboo

Thank you @tofubreadcoriander but unfortunately the video doesn't work... I'm not sure why? Maybe one of the mods can help?

Also thank you @Weemie and @Sideways for your input over the last couple of days..Weemie I wrote loads and lost it ... I willhave to get myself together over the next few days as you have got me thinking about a few things and I wanted to reply.. Will just take longer than I wanted

 

[tofubreadcoriander]

Thank you @tofubreadcoriander but unfortunately the video doesn't work... I'm not sure why? Maybe one of the mods can help?

Uh, oh! I'll paste the link. In any case, it's probably something you already seen. Sorry if so.

https://youtu.be/A0kLjsY4JlU

 

[Friday]

Thank you @tofubreadcoriander but unfortunately the video doesn't work... I'm not sure why? Maybe one of the mods can help?

Many YouTube videos are country/region specific. Some only publish in one country, but most are simply linked differently; both to adhere to local/international laws, and to target ads.

It shows fine here in the US.

Uh, oh! I'll paste the link. In any case, it's probably something you already seen. Sorry if so.

https://youtu.be/A0kLjsY4JlU

If you can give the keywords / title / channel, that allows members in other regions to search fast & accurately.

 

[beaneeboo]

Had therapy on Monday - the first time since the session after the massive backfire... I think in that 3 week break I've cut off from alot of the emotions and thoughts of what happened in that awful session... about where it leaves me with decisions around moving forward with him... I think I'm attached to some degree because the thought of not having that support in my life is too much to bare... but on the other hand I'm aware that I haven't broached the subject with him about whether he really doesn't believe in dissociative disorders and if so where that leaves me... I need to be brave to bring it up... but I'm avoiding it because of the potential consequences...

Adult strong me ended up in the session. We talked about alot of things to do with my family that I couldn't before. It was easy talk and I felt good being able to share more detail.

It was odd because I felt good being the strong one and able to have open conversations about stuff I know I would have found hard a few months back. That's progress. And it was good to hear T being super complimentary about how strong he thinks I am and have been. He thinks I should be telling my story so others can hear it. Unfortunately though despite on one level feeling something positive about having that feedback (it's very odd and new for me), it also drives other parts of me further away from him. Because I feel I have to keep up that strong part of me. I don't want to disappoint him or embarrass myself with the more vulnerable parts which come out... and my younger parts have defo gone quiet for a while now...

So I guess this is me still not knowing where I stand in this relationship. And yes I need to step up and have that convo with him and tell him what I'm thinking and feeling. It's so hard. I can't say what I think/ feel.

 

[Sideways]

I'm aware that I haven't broached the subject with him about whether he really doesn't believe in dissociative disorders

This is a very ‘all or nothing’ way to approach the topic. Perhaps you could simply ask for his opinion about dissociative disorders? That leaves you perhaps a bit more opinion to whatever that opinion is.

IME, it’s very often not a ‘believing’ issue, but a slightly more complicated ‘diagnosis and treatment’ issue.

 

[beaneeboo]

This is a very ‘all or nothing’ way to approach the topic.

I hadn't thought about it like this.

Perhaps you could simply ask for his opinion about dissociative disorders? That leaves you perhaps a bit more opinion to whatever that opinion is.

I like this idea. I guess in my head it HAS boiled down to 'Do you believe me or not?' Which of course is very difficult to say face to face in the room for me. And I know he will say he believes my experience / my states no matter what we call it. So I think you hit the nail on the head when you said:

IME, it’s very often not a ‘believing’ issue, but a slightly more complicated ‘diagnosis and treatment’ issue.

I guess I'd like to go ahead with us both assuming I have a DD, as diagnosed 7 years ago (given that I've tried 7 years of ignoring the diagnosis). So we both need to be on board if he is to 'treat' me because otherwise I feel we're not aligned and I'm not understood. And I think other parts of me would feel they aren't welcome, even though he's said they are.

 

[scout86]

otherwise I feel we're not aligned and I'm not understood

This might not pertain to your current situation, but.... When you said that, I couldn't help but think that it's possible for 2 people not to be aligned on something and yet one might understand the other perfectly well and they might be able to work together towards a goal too. When it comes right down to it, one of the most useful things I got from my therapist was that he often pointed out to me where I was wrong about stuff. When he did it, it wasn't criticism and it wasn't an attack, and those are things I often associate with being told I'm "wrong". It was an attempt to help me see things more accurately. It was valuable to learn that people can disagree with you and mean that they disagree with your conclusion, not that you yourself are somehow flawed and "wrong". I'm not at all sure it's helpful to be working with someone who totally agrees with your world view. Respects it? Absolutely, but that's a different thing.

When I first started seeing my T, we were talking about DID one day & he said that he didn't think it was a real thing. Didn't really matter to me, because that wasn't my issue anyway. By the time he retired, he was excitedly telling me that they now had fMRI evidence that DID actually DOES exist. His ability and willingness to do stuff like that was one of the things I really liked about him. He was open minded and willing to learn. I think, when it comes to what we call "mental illnesses", we often go too far with labels. It's not like a physical illness where you can culture the bacteria that's causing it and be sure what you're dealing with. There are patterns and ways of thinking, but there aren't always clear bright lines between "disorders". I think the labels probably matter more to insurance companies than they do to real world experiences.

Where I live, good therapists are few and far between. There were a few times when I was tempted to quit, but the choice kind of came down to the guy I was working with or no one. It worked out fine, even though there were messy stretches. If there had been other choices, I can see where it might have been tempting to spend my time searching for "perfect" and never accomplishing anything as a result. Don't let "perfect" be the enemy of "good",

 

[beaneeboo]

This might not pertain to your current situation, but.... When you said that, I couldn't help but think that it's possible for 2 people not to be aligned on something and yet one might understand the other perfectly well and they might be able to work together towards a goal too.

this is a really good point and is getting me thinking in a more flexible way about it all...

When it comes right down to it, one of the most useful things I got from my therapist was that he often pointed out to me where I was wrong about stuff. When he did it, it wasn't criticism and it wasn't an attack, and those are things I often associate with being told I'm "wrong".

It was an attempt to help me see things more accurately.

I guess this is what it's partly all about isn't it?

It was valuable to learn that people can disagree with you and mean that they disagree with your conclusion, not that you yourself are somehow flawed and "wrong".

I think I'm really struggling with this alot and I'm only just realising it... it's like when I feel people are criticising me they can see the me that feels i am inherently bad... that they (young part) are stupid and lesser etc etc. I know that's a child like view but that's how it feels...I think when guilt is mixed in with it (which is how I perceived T to be during that inflammatory session) then it activates my threat system.. brings on shut down...I guess criticism is linked with that somehow... slides along a spectrum...

I'm not at all sure it's helpful to be working with someone who totally agrees with your world view. Respects it? Absolutely, but that's a different thing.

I agree with this. I definitely don't expect T to agree with my world view. I do expect him to be open enough to listen to my world view and learn about it in a way which may be different to his own understanding, and be open to learn more about it.

The reason why I came to him about the DD information to begin with is because there were areas in the therapy i was struggling with which he just wasn't hearing. And I think those issues were DD - specific. I felt like if I could show him these issues exist for others too- I.e it's an actual thing not just me , then he would get it more. Take it more seriously? For example, not being able to communicate difficult states (and what they wanted to communicate) i was experiencing between sessions, because of amnesia and not feeling confident bringing what I wrote to speak about it between sessions - because I couldn't relate to what I'd written. I needed him to address this with me but he consistently didn't. And that's prob because he couldn't, because of having less understanding/ training about what's helpful for someone with a DD in therapy. So it was less about my world view and more about 'let's learn some different therapy strategies that are offered out there and help others with DDs'. If you are stuck on not 'believing ' in a diagnosis, you're not going to be open to trying strategies to address issues which come hand in hand with that diagnosis. That's all I wanted him to do. Be open to trying something which appeared to be good suggestions.

When I first started seeing my T, we were talking about DID one day & he said that he didn't think it was a real thing. Didn't really matter to me, because that wasn't my issue anyway. By the time he retired, he was excitedly telling me that they now had fMRI evidence that DID actually DOES exist. His ability and willingness to do stuff like that was one of the things I really liked about him. He was open minded and willing to learn. I think, when it comes to what we call "mental illnesses", we often go too far with labels. It's not like a physical illness where you can culture the bacteria that's causing it and be sure what you're dealing with. There are patterns and ways of thinking, but there aren't always clear bright lines between "disorders". I think the labels probably matter more to insurance companies than they do to real world experiences.

I love what you've said here. I think my T and yours are on the same page. And I think it's a healthy approach in thinking in therapy. My T perhaps is still learning to be even more open with considering things he doesn't know about/necessarily agree with. We'll see how that goes...

Where I live, good therapists are few and far between. There were a few times when I was tempted to quit, but the choice kind of came down to the guy I was working with or no one. It worked out fine, even though there were messy stretches. If there had been other choices, I can see where it might have been tempting to spend my time searching for "perfect" and never accomplishing anything as a result. Don't let "perfect" be the enemy of "good"

I hear you. And thank you for your input

 

[No More]

Would it help to be able to separate out disagreement and criticism?

Disagreement is great. Without it there would be no progress, nobody would step out and push forward, there’s no debate, no change. I see disagreement as a hugely positive thing, shows someone can hold their own view and not just soften to mine/those around them.

So your disagreement with your therapist shows you know yourself, you have your view, you use your voice. Just because he doesn’t agree, or he has a different personal experience - that’s not a criticism. It’s just a difference. Maybe you can assess his views and take a little of his, maybe he can take a little of yours.