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We Aren't Communicating

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Sandstone

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I've been struggling to understand what T is saying to me, and this is having a adverse effect on sessions. She seems irritated when I continually say either "What do you mean by that?" or "If you mean X by that then the answer is this, but I think you probably mean Y, in which case the answer is that"

I'm aware that my brain is very woolly, because of PTSD itself, plus lack of sleep, meds and withdrawal. Maybe that means it's all my problem. Or maybe I'm using it as a barrier?

I really like to know what others think.

A couple of examples
Talking about how little I do, T said "Maybe that is what you have needed" I replied "So you think it's time I began to push myself into action?"
She seemed shocked, and then when I explained that she had used a past tense, she told me that was irrelevant.

Two weeks ago she said "You have scatological thinking". I was surprised; I could have bought orally fixated, but the other didn't seem to fit. As she was in full flow, I tried to let it go, but had to come back and check. She insisted she was using it to mean something else. I even wrote it down and checked the spelling she was using. Further discussion showed she meant erratic, jumping thought patterns.

When I got home and looked it up, my understanding of the definition was confirmed:-


1. (Medicine / Pathology) the scientific study of excrement, esp in medicine for diagnostic purposes, and in palaeontology of fossilized excrement
2. obscenity or preoccupation with obscenity, esp in the form of references to excrement

Last week she used it again, and when I said "You can't use that word like that" she got quite cross and said "I can use whatever word I like."

But I'm flummoxed - how will I ever know what she means if she won't use words precisely?
 
I think she is a bit confused about the term, she probably means your thoughts are scattered??? but who knows. Perhaps you can print out the definition for her and ask her to clarify what she actually thinks it means. I don't blame you for being upset about it, but there probably is a simple explanation, she really doesn't know what the word means. I google 'scatterlogical' and didn't really come up with much, I think she has invented her own word and should clarify its meaning.

I am interested to learn the meaning as she sees it too.
 
Uhm, my thought is that no, you can't use any word and give it any meaning that you want when your entire profession (ie therapist) relies on your ability to communicate! That's like saying I can call you every dirty word in the book and its your fault that you don't know I'm really giving you compliments because I changed the meaning of the words!

This therapist sounds like a real piece of work! You know, the type that uses "big" words to sound smarter than he/she is. Maybe she was embarrassed that you called her out on her ignorance because you knew the meaning of the word and she didn't! It sounds like she heard the word in passing, assumed its meaning, and decided to use it herself, albeit incorrectly. I mean scatological SOUNDS like scattered, but its completely different in meaning.

Tbh, if you can find another therapist, maybe you should. Communication issues can be huge in therapy, and if you have a therapist who's unwilling to budge, the problems not on you, it's on her.
 
Scatty means scatterbrained or flighty, although the original meaning of scatological is as you said connected with excrement, the words scatological thinking are used to describe scatty thinking, you may find the up to date dictionary definition has expanded due to common usage. You may not find this definition from free online dictionaries.

I do however agree with Scared of Lonely that if your therapist is not working for you, consider changing therapist or at least re-challenge the therapist. Your therapist does sound a little narcissistic and less than person centered. I find this is more common in CBT therapists and less specialised, less experienced therapists. A good trauma therapist to me, is someone who is able to offer unconditional positive regard and congruence, after all these are part of the core conditions of person centered therapy. The therapist needs to be present and in the moment with the client, respecting to the clients view. If your therapist is not able to adjust their perspective in this instance, it may show that they are departing from the core conditions. I suggest checking that your therapist is working from a person centered perspective, reading up on the basics of this approach and then considering re-challenging them in more specific detail. In a healthy therapeutic relationship, such things can serve as an area of growth in the therapeutic alliance.

I also question why your therapist feels the need to put you down in describing your symptoms, after all being scatter brained and having difficulty in concentrating and retaining information is part of the symptoms of trauma. Therefore it may be considered un-ethical, to belittle a clients symptoms. There are instances where this is allowed, but that is dependent upon the therpist being in the moment and very congruent with the stage that the client is at.

My own long term regular therapist, has a great ability to make a joke about both my symptoms and my response to these. This response is however appropriate and congruent to the stage that I am at when she makes such remarks. Such jokes will often assist me in adapting and changing personality states and perspectives, especially when I am being too rigid. My therapist is well trained and adjusts to my needs in the moment, respecting the necessary boundaries in a stage specific manner. If the client is not in the mood for a joke or remark, it is the therapists job to adjust approach to suit the situation (this is a central part of congruence, especially with traumatised persons).

I had a second therapist for a while this year, she was a lot less experienced than my regular long term therapist. I found some of the similar stubbornness and narcissism that you describe. I stopped going back partly due to funds, partly due to her attitude, which was not that bad - but was not totally up to scratch. I would consider using her again, but only if my funds improve and only if she backs down a little. I would not consider having her as my long term regular therapist, as she is not a patch on my other therapist. I would not have gone near this therapist a few years ago, when my symptoms were much worse. Although I admit that I have some therapeutic training, so it may be easier for me to challenge a therapist on ethical and technical grounds.

I hope that this helps. Best wishes upon your journey of assisted self healing.
 
P.S. I think the therapists use of the term scatological is described/ classed as figurative, rather than literal n dictionary definition terms. But this further emphasizes why the therapist may be lacking in congruence in their approach. It may be an idea to ask her why she didn't justify this as a figurative from of speech, rather than saying "I can use whatever word I like". You could ask her to consult her supervisor over this, because all therapists are supposed to use therapeutic supervision and this is part of what it is there for.
 
if you can find another therapist, maybe you should

if your therapist is not working for you, consider changing therapist or at least re-challenge the therapist.
Unfortunately she is an NHS therapist, so I don't have lot of choice. She is also supposed to be the most experienced available and was recommended by the assessing Psych. as being suitable for me because my trauma is complex and my case complicated. That is why I wonder if it's a problem of language more than anything else.

I'm quite opposed to running away from this, I do a lot of running and hiding and it's time to stop. On the other hand, I was so unhappy after yesterday's session that I considered an overdose for the first time in months.

the words scatological thinking are used to describe scatty thinking, you may find the up to date dictionary definition has expanded due to common usage. You may not find this definition from free online dictionaries.
Can you point me to any resources on this? I originally used a paper copy of the OED, then looked online using all the spellings I could think of and found only one in "Urban Dictionary", which doesn't look like reliable source

I find this is more common in CBT therapists
Initially she was planning to use a DBT approach, but this seems to have faded away.


I have been challenging her almost every week since the third time I saw her, mainly over the lack of explanation and road mapping of where we are going. She says I'm trying to take control to protect myself, but she also says I'm trying to abdicate control to her whenever I say " I don't know about X, you're the professional so I expect you to lead".


I am interested to learn the meaning as she sees it too
When I pinned her down on this, she said that I jump from A to E without going through the logical steps of B, C and D. But I think it's just that they are obvious and don't need stating. I do agree though that my mind leaps erratically from subject to subject. when I had control of it it was useful for multi-tasking. Now it's just confusing.

why your therapist feels the need to put you down in describing your symptoms,
I genuinely don't believe that was her intent. I think she was just describing.
.
 
Hi stenni,

I think the part of what you describe that seems off to me is her defensiveness when you queried her use of the word. I better response would have been something such as, "ah it can mean what you say but it is also used for scattered thinking. I am sorry you perceived it that way and hoped it would be understood in the context I used it in."

I hope you don't mind me bringing up a couple of questions to see what is happening here for you. Is this your first lot of T or have you had more in the past? I don't know if I am imagining it but something about what you relate saying to her over all seems to me to be on the defensive. Do you think that is possible? That you may be going into this looking for fault as a way of distancing and protecting yourself and having some sense of control? Looking at details and judging her performance. Or do you just think there is a disconnect between you?

I think its great to ask for clarification when we need it but there is something more that comes across to me that I can't quite put into words.

Quote: "Talking about how little I do, T said "Maybe that is what you have needed" I replied "So you think it's time I began to push myself into action?"
She seemed shocked, and then when I explained that she had used a past tense, she told me that was irrelevant."
I would absolutely have understood this as her being understanding and saying to you that maybe it is ok to be kind to yourself and give yourself some slack and I would not have perceived it as a past tense issue. I can understand her shock but it does seem she is on the defensive as instead of just explaining what she meant she has gone into dismissive mode. However, if she were to say to you that she meant that you should be kinder with yourself and you still started dissecting the language and not accepting her explanation then I think you need to look at why you need to do that.

I know I have had a mother and others where there is always other things being said than it appears and that has made me distrustful of peoples intent. It seems possible that if you are going in defensive mode that she has picked it up and is responding in a similar vein. She needs to be able to manage that though and it seems the two of you are locked in this in a to'ing and fro'ing way.

DBT can be a bit tough love in that it points out the affects that our responses have on others so it is possible she is doing this on purpose but it is also possible she is doing it without realising it which is not ideal.

I hope that makes some sense and please ignore what isn't relevant.
 
Thanks for your thoughtful response.

Is this your first lot of T or have you had more in the past?
. 25 years ago I saw Marriage Guidance after the end of my first marriage. 20 years ago I did 6 months group therapy for Abuse Survivors with the Rape Crisis Centre. 10 years ago I saw a T privately, but pushed to go faster into trauma stuff and then ran way when we did.

This time I saw a Clinical Psychologist for 9 months, but only intermittently (his choice). He wanted to use EMDR, but after initially promising results it went badly. I found him much easier to relate to, partly because I already knew him in another professional context, but mainly because his pattern of speech was more like mine. He said more than once " I'm considering every word I say".


dissecting the language

I strive for clarity and precision in what I say to T, because there is no point in me telling her something that's not exactly what I mean. So she might ask "You found that event exciting?" and I'd respond "no..oo.. maybe stimulating and interesting, but it lacked the element of joy I'd expect in excitement"

This is a family trait. I once asked my brother if he could give me a really accurate definition of the word pedantic, and he was 30 seconds into thought about it before he got the joke.


something about what you relate saying to her over all seems to me to be on the defensive

Or maybe I'm using it as a barrier?

Yes I'm alert to the likelihood. But rather than developing trust we seem to be going the other way. A few weeks ago I wanted to be able to tell her details of trauma and even posted on here asking for support to "hold my nose and jump in". Now I feel so unsafe that all I want is a road map programme so I can see where we are going and what, if anything, I can tick off. I can't see how I can build trust with someone who can't "hear" what I'm saying.

I know I'm on the defensive now, because this matters too much to take risks with,
But yet again when I tried to explain it, she heard something that wasn't what I said.
I told her "If I walk away, you'll have someone else sitting here next week, but I'll be back to weighing up whether suicide is the best way ahead". She took this as being an accusation that she didn't care about me, which was a million miles from what I was trying to communicate - that the importance, weight, value consequences for me were much greater than for her.

She got very hurt and offended, and still doesn't seem to understand, no matter how I try to phrase it that I'm not bothered whether she cares. I just want her to do her job competently and professionally. I have a husband and children to care about me, and if I get better I'll be able to see my friends who care about me.


know I have had a mother and others where there is always other things being said than it appears and that has made me distrustful of peoples intent. It seems possible that if you are going in defensive mode that she has picked it up and is responding in a similar vein

I've twice told T about this very pattern . My mother expected us to play guessing games about what she wanted and what she was 'upset' about. Getting it wrong resulted in withdrawal of all affection or interest.

But with this, and other issues, having already told T that I know this is a problem, I then want to be told how I can go about righting it. I want to DO something, and then be able to come back next week, and discuss whether the approach went well or whether it needs tweaking. Knowing can't be enough to change a life times patterns, surely action must be necessary too?


it is possible she is doing this on purpose

I have wondered if this could be the case. I told her in our very first session that anger was the only acceptable emotion in my birth family, but that even that had been suppressed in me of late. So maybe T is wanting to provoke that anger? If so, she's succeeding!

Or maybe she wants to make me so fed up that'll just go way and get on with living?

I'm sorry this has been so lengthy a post. These thoughts occupy so much of the time when I should be sleeping.
 
Mate, I had to go to only god knows how many psychologists/psychiatrists over so bloody long before I actually found one that I could communicate with, effectively and with whom I could develop a relationship that allowed me to respond to therapy. Not all therapists or doctors are created equal, some have interpersonal skills so much worse than their patients it is somewhat scary. In this situation I would strongly advise you to look around, find someone who specialises in PTSD (it took me ages to get around to that) and try that. Spending all of your time trying to work out the communication between you and the therapist means you cannot make any progress or benefit from therapy.
 
Hi Stenni

It seems that you have both reached the time where you cannot comminicate anymore. It is no good her trying to use similies or metaphores if they do not make sense to the listener. She is being very harsh and if she makes you feel that she is being irritable towards you she needs to know that.

I cannot say I have ever heard of scatological thinking. Sounds like something she has plucked up to try and describe something based on a metaphore she may have thought about it, but totally got the meaning wrong. No wonder you are confused. It does not sound like a term worth using and if anything will just cause more confusion and lose of understanding between you.

It is not unnormal for people to 'outgrow' their therapists or for there to suddenly be this communication block as things begin to change.

If you feel that she is irritated, you coul to tell her that and explain that if she continues to use obscure language or fleeting metaphores ect then you will have to consider finding another therapist, which is a shame as you seem to have come this far.

She might even deny it in which she is also devaluing your correct judgement of the situation. It should not be a battle between you and her.

I hope you find a solution to this.

best wishes
Saffy :)
 
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