What Do You Want From Therapy?

[Abstract]

Thinking about all of this, and all the f*ups in the past - canceled the follow-up appointment with T4.

Pencil,

Please don't give up. Once we know better we can make sure it goes better or at least self protect (being a total hypocrite as am running scared myself). I think starting a thread about the exact things you are afraid of may help.

 

[Deleted member 12723]

What do I want from therapy? I want to find out what the reason I have so much anxiety and have that anxiety go away. I would be very happy with that.

 

[Lionheart]

I want to thoroughly understand how various abuse events / traumas affected my childhood development in order to have adult control over those things in the present. I want to be free of limitations imposed by those traumas, to totally minimize their affect on me.

I want to be able to identify and process my emotions easily and effectively, in an adult manner. I want to be free of the distorted cognitions and unhappy feelings I grew up with. I want to be free of feelings of inferiority and the resultant beliefs that keep me from being successful and happy.

I want to develop healthy relationships. I don't want to live in fear or repeat the mistakes of my parents or of my past and I believe therapy can help me to achieve this.

 

[piratelady]

Then the other stuff seems to me that she would be person centred or possibly psychodynamic. These approaches are not structured in the way that CBT would be as they emphasise letting the client feel empowered and feeling they are taking the lead and also work a lot with relationship itself and how that can heal other parts of our lives.

That sounds like what I am doing in therapy. My first therapist, he never asked me what I wanted or if I felt we were going in the right direction and we weren't. He would just listen to me talk and ask no questions. This new therapist, he asks questions and directs the conversation some. I like the feeling of being in control, but still having the conversation directed some since I don't know where to go.

"My approach is xyz, which is not the best for un-recovered or un-recalled trauma, and therefore what you need is someone whose approach is abc and will do mno with you."

I agree that they should do that. They should be able to tell when it is not a good fit and maybe refer you out.

The more I have thought about this, the more I see other benefits in him asking me. It does make me feel sort of in control, which is something I need. Over the course of the time I've been seeing him he will occasionally stop to ask my permission before we talk about a particular subject or if what we are talking about is ok, because we can change it. That feeling that I can control where things go makes me feel much more comfortable telling him some things I was afraid to before.

I have made it clear to her before, on a couple of occasions, that I'm ready to talk about it, but nothing so far.

Maybe try that right away when you go in and see what happens? Instead of starting off the appointment talking about your life since the previous one, just say, "Today I want to talk about my trauma." See where that takes you? Or maybe it is time to move on to someone who can find a better balance of pushing you and letting you drive, so to speak.

Thinking about all of this, and all the f*ups in the past - canceled the follow-up appointment with T4. Just can't do it anymore.

Just because of past mistakes doesn't mean this one will be a mistake. It took me three therapists to find one who was helpful and insightful. It was worth it though.

Sorry that my replies are so out of order. My brain is a jumbled mess.

 

[JustBe]

When I first saw this thread, I didn't know how to respond. Therapy is still new to me. I had about 5 weeks with my 1st T and then she moved to another state. I've had a month break and now have had two sessions with the new T.

Yesterday I was thinking that it might be a waste of time, but today I'm glad I went. Now I think that what I want out of Therapy is to be kept on track. I self sabotage and need someone with no emotional investment in me to reflect back my insights and misinterpretations.

I need to do the hard work myself. It is solitary work, but I need my T to give honest and emotionless feedback while forcing me to look at the things I'm dancing around.

So far, so good.

I also like that she is present. She doesn't take notes or seem to be thinking ahead. It feels like she is present and listening to what I am saying (or trying to say). I appreciate that.

 

[Pencil]

Pencil,

Please don't give up. I think starting a thread about the exact things you are afraid of may help.

Thanks Abstract, but she accepted the cancellation so there is no turning back. She said she'd send me an e-mail next week after having thought about it all. And yes, perhaps I'll start a thread about that, thanks for that. And thank you for your support.

 

[Hashi]

And this is exactly why I think that Ts should be more 'in charge', so I reiterate my point made earlier about hairdressers - of all things. I think the T should be able to say: "My approach is xyz, which is not the best for un-recovered or un-recalled trauma, and therefore what you need is someone whose approach is abc and will do mno with you."...

...Why is the END-RESULT not the answer to give the T?? Why would a T ask you for a road map? And so, when a T diagnoses me with complex trauma, yet asks: What do you want from therapy?, I will scream. Loudly.

Pencil, I'm sorry you have had such unhelpful experiences with T, and that your first T stopped practising.

I think everyone's different, and your hairdresser analogy illustrates that for me. When I go to the hairdresser, I know exactly what I want and I take a picture with me to show them.

I wouldn't trust a T to decide how to approach and structure therapy because it's not just about the best approach for the type of trauma I've experienced, but the best approach for me. For example, having tried CBT exposure therapy I know that's not right for me, but it's generally considered the gold standard for trauma treatment. So however good a T is, letting them decide for me doesn't/wouldn't help me. Not just on that point, but on all points.

I think simply saying the end result that I want wouldn't necessarily get me there, partly because the route the therapist has in mind might be one that's not right for me, and partly because the end result can be achieved by other things as well, with only some input from therapy.

Suppose I have a fear of cats. If I want the end result of therapy to be feeling safe with cats, I might want only listening and support from the therapist while I work on that by myself, or I might want the therapist to run the whole process, or somewhere inbetween. I might want the therapist to challenge and push me because I know I tend to avoid things, or I might want the therapist to be supportive and compassionate while I go at my own pace and have control of the process.

I think if someone wants structure then that's one answer to the question, and gives an opportunity to talk about what that might look like. I think the question of what you want's a good thing to discuss, to make sure both therapist and client are working together and being realistic about what to expect from each other.

Personally, what I want from therapy is support, guidance, understanding, compassion, perspective, reflection and a safe place for me to work on healing. I like advice and suggestions, and am very guided by my therapist's insights, but it's always me who decides what we do, how and how fast. Which might be quite different from what other people want, even though the end results we have in mind could be exactly the same.

 

[Abstract]

Hi Piratelady,

I actually think its a great question as it opens communication.

He would just listen to me talk and ask no questions. This new therapist, he asks questions and directs the conversation some. I like the feeling of being in control, but still having the conversation directed some since I don't know where to go.

I actually think you have some good insight. I don't think a T that just listens and does not guide the process is very good no matter what the approach is. They are at the least a sounding board or should be. And I think you express very well the benefits of person centred and psychoanalytic approaches! And yes it does sound like your T uses one of those approaches. CBT does not fit well for me. Maybe if I had a different T I would feel differently but there it is. I too want to feel like I have some say and some control or power.

The T can actually be strongly guiding the process and be quite challenging and still do it in a way where you are leading it. At the end of very teaching orientating T one often feels very impressed with the knowledge of the t. At the end of less led approaches one oftens very impressed with oneself and empowered. In my experience that has been the case. But I have definitely needed and benefited from learning skills, CBT and especially BDT. I like the sound of your T!

If I was asked this question this is what I would answer:
I would like a safe place where I can feel understood, cared for and guided. I want an environment that is healing of trust and allows me to be able to process trauma safely. I want to be able to rely on both honesty and openness as well as relevant knowledge and expertise. Mostly I want a space and guidance to help me heal myself.

 

[Abstract]

I wouldn't trust a T to decide how to approach and structure therapy because it's not just about the best approach for the type of trauma I've experienced, but the best approach for me. .

I agree with so much that Hashi said and relate a lot.

And I will say that, Pencil, the biggest problem is that a lot of what makes T work for us is the T getting to know us so that the two together can find something that fits and works. It was quite a revelation for me when I realised how truly differently human beings can respond to the same thing. We are all wonderfully unique. It can be easy to judge people as being hopeless when in fact what they are saying may have worked very well for someone else.

I am now at a point where I am starting to have an idea of things I do not want in a T for me:
The first is lack of knowledge in trauma and dissociation. That is a deal breaker.
The second is a T that happens to not be able to understand me (this makes me crazy and I loose all trust and ability to stay present).
The third is someone who does not ask me about my feelings or perspective on things and assumes they know me better than me.
The forth is someone invalidating or are judging (again I implode).
The fifth is Someone who is not present and guiding the process and willing to be tough if needed.
The last is bad boundaries.

I am sure there a hundred more if I let myself have them! ;)

 

[Abstract]

And Piratelady, I hope you don't feel your thread is being taken over by all the other stuff on here. Feel free to say.

 

[piratelady]

The T can actually be strongly guiding the process and be quite challenging and still do it in a way where you are leading it.

Mine does seem to have this down to an art form. I think, with abuse, where your control was taken away, the feeling of being in control adds to the feeling of safety in therapy. He is the first therapist to nudge me to talk about something, but still ask my permission. Granted, we haven't actually talked about any of it...that is frustrating.

I like the sound of your T!

Me too! I am thankful for having found him. Despite my sudden downturn last night, I have made more progress in the last few months than I did in a whole year with the other therapist.

And I am okay with the direction the thread is going. I am enjoying the discussion and learning a lot :)

 

[Abstract]

So however good a T is, letting them decide for me doesn't/wouldn't help me. Not just on that point, but on all points.

I think simply saying the end result that I want wouldn't necessarily get me there, partly because the route the therapist has in mind might be one that's not right for me, .

.

I just had to come back and quote this as I agree with so much of it. Personally I too find the route very important as it has to fit unique me. Yes, of course the end result I would like is a, b and c. But actually trying to look at it that way isnt helpful to me. It makes me feel despondent and overwhelmed. I like to concentrate on putting 110 % into getting better. How fast and how much that happens I will find out when I get there. I dont believe the T can "make" anything happen either.

The main idea is to process the trauma but for me to be able to do safely both me and the T have to wrangle our way through a mass of distrust, self hatred, transference, dissociation and previous bad T experiences. Having something that helps me do all those as easily and painlessly as possible allows me to get to the trauma - the goal.