What Do You Want From Therapy?

[Pencil]

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.

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Hashi, wow, you are really clear on what you want, I'm impressed.

As for me, I have an attachment problem, which I was utterly unaware of until recently. Before that, it was impossible for me to say - 'I need to deal with my attachment problem'. That is why I need someone to be able to see what is going on. So yes, you are right, everyone is different.

Perhaps I also base my view on my training experiences. In my 'previous life' I used to be a professor, and later a corporate trainer. In South AFrica, racial tension is still very high, and corporations often request training in diversity management. Whereas one would ask delegates attending a course on negotiation skills, for example, what they want and need, in diversity it would make no sense, as those people with deeply held beliefs about other races could not give you a coherent answer. The trick then is to orchestrate the whole training intervention in such a way that people's deepest prejudices are challenged or shown to be wrong - but in the most positive way possible. But even in negotiating skills training, a good trainer will be able to spot those who need interpersonal skills or assertiveness training first in order to become effective at negotiations, something the delegate him/herself may be unaware of. The Johari Window and the Iceberg Model both come to mind - and I think these models are applicable to therapy as much as to training - or any other interaction for that matter. There is so much about us that we are simply not aware of. Sexual abuse is another example; some people show all the signs but have no conscious memory. A skilled therapist will lead the client there without ever mentioning it. I therefore see therapy as a way in which the unknown becomes known, more than a process that deals with the known. I think good therapy is often a mixture of both.

So yes, I think we all agree that we are all different and each situation requires a unique approach ;) .

 

[Abstract]

As for me, I have an attachment problem, which I was utterly unaware of until recently. Before that, it was impossible for me to say - 'I need to deal with my attachment problem'. That is why I need someone to be able to see what is going on. So yes, you are right, everyone is different.

Pencil,
I think all therapist should be able to realise that that is the case for you after working with you for a while and this type of thing is exactly the role of a T or what it should be. They should also know what to do about it and refer you on if they are not able. This would never be something a client could ask for unless someone has diagnosed at some point. What I do think is that conversations and questions such as Pirateladies T's can help them get to know us better more quickly and get to the point where they figure stuff like this out.

But I think what Hashi is saying if we really are on the same page is that even if there are three people with the same attachment disorder (lets say disorganised) each of those will have their own sensitive points and issues that both them and the t need to work around. That is what the process of T should be all about. It isnt something a T or you will know on the first meeting.

To me recognising and being able to deal with an attachment disorder comes down to knowledge, intuition/empathy and a good personality fit (the later being a random thing).

 

[Pencil]

Pencil,
I think all therapist should be able to realise that that is the case for you after working with you for a while and this type of thing is exactly the role of a T or what it should be.

Hi Abstract

All your points are maddeningly valid. I think this is an excellent thread as it challenges some beliefs I hold onto for dear life - and perhaps I will still hold onto some of them, but at least it gets me to analyse what they are, why I have them, why I hold onto them and whether they are valid or not.

One thing I am beginning to see is that perhaps most of the people who posted here have perhaps made a lot more progress than I have - perhaps I'm a bit of a novice after my first, and very positive experience with a T came to an abrupt end. I still have contact with her, I check in after every major event in my life and she is still an important person in my life. But we obviously never discuss anything heavy - I visit her at home and we very politely have tea :)

I guess I've never had the opportunity to work with one for long enough. I had a very, very, very bad experience with postural integration about 10 years ago, after which I wouldn't go near anything that even resembled therapy. I kind of slipped into counseling with T1 as I did not originally go to see her for counseling, and it started off as a 'chat' about things. But that only served to open the closet doors and everything I had so carefully locked down for so long came tumbling out. And now I seem to scare them off :eek:.

Thanks for your comments Abstract

 

[Abstract]

Pencil,

You are very welcome. I have a lot to say :rolleyes: lol so will come back when I can.

 

[Pencil]

I appreciate your input very much Abstract.

 

[Hashi]

conversations and questions such as Pirateladies T's can help them get to know us better more quickly and get to the point where they figure stuff like this out...

To me recognising and being able to deal with an attachment disorder comes down to knowledge, intuition/empathy and a good personality fit (the later being a random thing).

I agree. I would just say I think the good personality fit is individual, rather than random.

In general, too, talking about the therapy relationship and process helps our T's get to know us and work with us in the ways we need. I think it's good to do that from early on. I don't want to be trying to navigate how my T and I work together at the same time as working on trauma, I need to have the basis of that in place already.

Hashi...you are really clear on what you want .

I think it's called being a control freak. ;)

Seriously, being in control is a big thing for me. Which relates to how hard I find it to trust and open up to people. For the first few months seeing my current T, I'd only commit to going for one week at a time. Attachment is a problem for me but, as Abstract says, the way I react to that can be quite different from the way someone else does.

I feel for you losing your therapy with your first T, because I had to stop seeing a T who was really helping me and it took me some time to find another, including seeing someone who wasn't right along the way. The mistake I made seeing the not-right-for-me therapist was actually due to not paying enough attention to what I wanted from therapy. She was an experienced and capable T who I'm sure is helping her other clients very much. But I needed a more compassionate, holding approach and hadn't recognised how important that would be in order for me to make progress with a T, however skilled they were.

I think the question of what we want, having to think about it ourselves and talking about it with our therapists, is the basis of making progress in therapy. I really hope that if you decide to continue, you're able to go back and negotiate what you need with your current/most recent T or find someone else who's a good fit. My experience is that it's worth persevering, and not settling for someone who seems competent or going with an accepted approach, if it doesn't exactly feel right for you.

I think, with abuse, where your control was taken away, the feeling of being in control adds to the feeling of safety in therapy.

Completely agree. The amount of structure and direction we want from the therapist is individual, and might change over time. Essentially, though, I think it's important that it's a partnership rather than the T being 100% in charge.

I think it's also healing for us to be thinking about what we need. It helps us to reconnect with ourselves, and start trusting ourselves and our own judgement.

piratelady, thank you for starting this thread and not minding it's meanderings. I'm finding it very useful. My T and I are looking at going back to trauma work after a break from this, and how to keep things safe. This thread is helping me to think about that.

 

[Pencil]

I guess my annoyance with Ts and my insistence on them being more directive stems from the fact that for many years my brief attempts at therapy were not successful and have led to different diagnoses that I felt did not address my issues. This, I learnt, is par for the course for ptsd - a 'history of therapy failure'. Perhaps this is why I am so damn adamant that I want a T to be capable of asking me the right questions to get the right answers. From this thread I have come to realise that I have an almost bolshy challenging attude. Mmmm.

 

[Pencil]

But I needed a more compassionate, holding approach and hadn't recognised how important that would be in order for me to make progress with a T, however skilled they were.

I really hope that if you decide to continue, you're able to go back and negotiate what you need with your current/most recent T or find someone else who's a good fit.
t.

Hashi

When you refer to the compassionate, holding approach, did you find the right person or did you spell that out to the therapist as part of 'this is what I want from therapy'?

And thanks, yes, I know I need therapy as I've been just holding on for many years and constantly feel that if I let go of my grip I'll fall down a deep well.

 

[piratelady]

I think it's also healing for us to be thinking about what we need. It helps us to reconnect with ourselves, and start trusting ourselves and our own judgement.

I agree. For me though, he has also pointed out things I have missed completely. When I started seeing him, I told him I need to learn coping skills and to be assertive. He has since pointed out ways in which I am assertive quite often. Most of my issues seem to stem from my lack of self-esteem - not assertiveness. So now our path will meander a bit and we will work on that.

Perhaps this is why I am so damn adamant that I want a T to be capable of asking me the right questions to get the right answers.

What I have learned is that sometimes the "wrong" question can spark a conversation and take you down a road that leads to the right answer. I used to just answer questions with very short yes, no, or just a few word answers. As I started to talk more and the discussion would continue, I would find myself in very different territory and both therapist and I would learn a lot about me and what I need. Sometimes...I still think it's magic, jk.

When you refer to the compassionate, holding approach, did you find the right person or did you spell that out to the therapist as part of 'this is what I want from therapy'?

I know you asked Hashi, but I really wanted to give my two cents, I hope that's ok. I have spent a fair amount of time with three therapists. The second one was very direct, two the point - no compassion, holding, etc. It was not working at all and at one point I think he even did some damage. It was only when I found my third therapist that I realized he had a good combination of compassion and pushing. I didn't even realize that is what I needed until I found it. If for any reason I am unable to continue with him at some point, I will know what I need going forward.

 

[Hashi]

When you refer to the compassionate, holding approach, did you find the right person or did you spell that out to the therapist as part of 'this is what I want from therapy'?

Now I understand that myself, it's something I'd look for and discuss from the outset. It still means negotiating and agreeing how you work together as you go along, and the therapist could still turn out to be not the right fit. But it gives a much, much better chance of finding someone you can work with. It's about having a shared understanding about the things that are most important to you, and a willingness to find the best ways to work together, rather than finding a perfectly formed T who'll fit like a glove.

With my current T, her website profile mentioned the things I was looking for, but I still asked her about them. I got a very good feeling from the initial phone call and after that it was a case of seeing her, discussing it more and seeing how things went.

I think the initial contact can tell you "no", "possible" or "seems very hopeful". I didn't follow up on the "no's" or "possibles". I don't think you can really feel "yes" until you've seen the person for a while.

Also, you might be able to find what you need with someone you didn't talk to about it at the outset. With the T I loved but had to stop seeing, I didn't realise what I needed until we were working together, but she was able to work in that way with me.

 

[Hashi]

... he has also pointed out things I have missed completely.

Yes, absolutely. I might not have been very clear. I look to my T a lot for insights, guidance, asking questions and showing me a different perspective. Just not for how the sessions or the therapy overall is structured.

 

[Hashi]

This, I learnt, is par for the course for ptsd - a 'history of therapy failure'. Perhaps this is why I am so damn adamant that I want a T to be capable of asking me the right questions to get the right answers. .

Before T-that-I-loved-but-had-to-stop-seeing, yes: textbook history of therapy failure, wrong diagnoses and ineffective or even damaging treatment.

I do understand what you're saying. It's difficult enough to have trust in therapy, let alone with a background of poor therapy experiences. I'm sorry you've been failed by people who should have either helped you or known that they couldn't.

When you get the right therapy, though, it can make a world of difference.