I Think I Need A New Therapist.

[sonderlust]

I went to therapy again today; originally I thought that this therapist and I worked well together, but today I ended session a few minutes early because she was frustrating me to no end.

I didn't come to therapy to change anything significant about myself, I came to therapy to talk it out and get things out in my own time, and if things any significant things change then they would, as times go by. I want to take things slow. But she keeps challenging and asking questions about things that I've already told her I don't wish to talk about (a traumatic experience at the hospital), or that I've already made my mind up about (my relationship with my mother). She doesn't seem to trust that I've already thought things through, and it doesn't help that half the questions she asks are things I can't answer.

I'm the kind of person who needs to think carefully about their answer, but she expects one within a few seconds of asking. (eg "What do you think forgiveness means") Before I walked out I told her that she hadn't built up the rapport with me yet to be challenging me like this and asking these questions. I've only seen her four times now, this time being the fourth. I thought we were going to gel nicely but to be honest now I'm just annoyed.

I originally went back to therapy because I was in a spiral, and I still am, but that doesn't mean that I want a therapist to patronize me with questions and push my limits that I've already set clear boundaries about. I'm also not the kind of person to change their mind one I've made it up. I know that she has a supervisor that is probably pushing her to push me, but I've just about had it. I didn't bother to make another session. (It also doesn't help that I can see what she's doing and why she's doing it; my own mother is a therapist). The last thing I ever wanted from therapy was to be re-traumatized by reliving bad experiences.

I do know that I desperately need a therapist, but I really don't think she's the one I need. I'm an online college student and she was helping me file for disability. I think I might need to drop out of classes again, but I'm afraid to do so because the last time I took medical leave my mother told me I couldn't come home and practically banished me from ever coming home at all. It took me breaking down and ending up in the hospital for my family to see that I needed help at all.

If I'm to be honest with myself I don't feel that I'm ready enough for college yet; I need to get out of this spiral first. It makes me uncomfortable that I have to rely on my uncle, who made my college fund, for the money to do this; I'd rather just get well, get my own apartment, get a job, and then slowly work to getting my degree. There's too much pressure involved right now for me to be able to succeed.

Now that I've successfully rambled to oblivion, I have a question. In your guys' experience, which type of paradigm did your therapists work out of, and which of those paradigms were successful in making you guys comfortable enough in session to talk? I didn't and still don't feel comfortable enough to talk to this girl, and her stepping over my boundaries is a clear reason why. In my experience CBT and DBT do not work for me, but regular talk therapy does because I can work at my own pace.

 

[Hashi]

Hi sonderlust,

I've had a slightly similar experience to you with a therapist I tried to see at the beginning of last year. I wanted to focus on coping and life skills, but she quickly began pressing me to talk about trauma. Her reasoning was that my need for the skills was because I hadn't processed the trauma. I found the situation impossible because at the time I was struggling so hard to get through the day, and had only been seeing her for a few weeks. Neither of those things made trauma work a good idea.

In my case I had to stop seeing her. I'm seeing a different therapist now, and it's completely different. She sometimes holds different views from me about what to work on and when, but she will only suggest her ideas and she respects my view if I disagree.

I think it can be valid for a therapist to question whether a client is avoiding what they need to address, and to encourage them to process trauma (safely, and not by reliving it) - but not as a challenge/confrontation and not at four weeks. As you say, there isn't enough rapport at that stage. You're only getting to know each other and finding ways to work together.

With regard to paradigms, there was a thread a little while ago that might be relevant, because it included a discussion about directive and non-directive therapy (ie whether the therapy style and pace etc is led more by the therapist or by the client). [DLMURL]https://www.ptsdforum.org/c/threads/no-i-did-not-violate-your-boundaries.30514/[/DLMURL]

For me, one thing that's important is to see an integrative therapist - someone who has trained in a number of different approaches, and uses the ones that are most appropriate to the client at that point. That's important not only because they can draw on different ways of working, but also because it indicates that they're willing to. They're not going to try to fit me into a process that isn't right for me.

My therapist now is integrative and her approaches include things that I personally find helpful, like art therapy and Jungian ideas. Other integrative therapists will have a different mix. Probably all of them do CBT but I make it clear I'm not interested in that because it's not for me, either.

For what it's worth, the person I see now is a transpersonal psychotherapist, which is a regular talk therapy and one where we can talk about spirituality and beliefs (mine, not hers) although that's completely up to me and she's happy to see clients without any interest in spiritual aspects. Something which is also part of transpersonal psychotherapy is compassion for the client and respect for the client's own healing process and wishes. They follow Carl Jung's view that the client is the one in charge of their own process, and the therapist is there to assist.

[EDIT - added after reading Bloom's reply to your post, below - I do talk in therapy and I work hard through issues including processing trauma. I don't avoid, and my therapist is a therapist and not a friend. I just do better when I lead the pace and content myself. I can be trusted to do that, and don't respond well to being pushed or challenged although other people might. I think it differs from person to person.]

I think what has made me comfortable talking is a mixture of her approaches being compatible with my views, her proving herself over time to be understanding, professional and reliable, and her as an individual - we're a good match. Bear in mind that it always depends on the individual therapist as much as the type of therapy.

It's also important to me to see a therapist with good experience and understanding of trauma, who's willing to also work on other issues. My personal experience is that a therapist like this can understand better than a general therapist how important it is for a client to go at their own pace and not be pushed to do trauma work.

I'm sorry that you've had this experience, but if it's not fixable and you look for someone else then I hope at least it will give you some questions to ask other potential therapists to help find a better fit.

 

[BloomInWinter]

Hi sonderlust,

Wow, do I remember feeling like that for a long time!

It doesn't sound like your therapist is doing anything 'wrong' by the definition of counseling, but rather trying to do her job according to the standards of practice. It would be unethical for a therapist to just sit and listen to only what a patient wants to say without trying to get the details necessary to establish treatment goals. It is a therapist's job to use socratic questioning to find out our thinking and relational style.

By giving a measured response rather than off the top of my head, that allowed me to hide my secrets and prevent my counselor from having the correct information necessary to guide my treatment. I wasted several months of his and my time, and my money, trying to hide the details I was too afraid to deal with.

I learned the hard, expensive way that having someone to just sit and listen to only what I wanted to talk about, and be nice to me, is friendship. It's not therapy. Questions are part of the process, not patronizing. They are an opportunity for me to share what I think with my therapist so we don't waste our time on things which aren't a problem. They aren't mind readers so can only go on what I tell them.

Once I started to push against my trust, and at least try to answer the questions, I began to get relief from my symptoms. It's essential for my T's to elicit details so they can identify my cognitive distortions I picked up during my traumas which hamper my functioning today.

I also learned I couldn't think myself out of PTSD. I needed a competent, caring guide to introduce new information into my brain so I wasn't just digging in the grooves further.

It's a good sign if you're getting annoyed, as it gives you a good opportunity to identify the reasoning behind your annoyance. That shows you're aware of your feelings.

I didn't feel confident sharing for over 2 years. But I kept forcing myself out of my comfort zone because everything I face in therapy, I conquer in the outside world, too.

Can I ask how long you stuck with DBT skills before deciding it didn't work for you? It took me a year and 1/2 in DBT group to finally gain enough distress tolerance skills where I could safely cover the rough stuff in therapy.

Our boundaries tend to be overgeneralized and too firm to allow even good info in. The only way to fix this is by identifying them in the therapy room, and talking it out with our therapist.

It's not completely my therapist's job to make me feel comfortable. Comfortable kept me stuck in my misery. It is my job and my therapist's to work on building a strong alliance where the safe healing can begin.

It's perfectly ok to decide to not accept any of our therapist's efforts. We do have a choice. But it's expensive and does feed into the cognitive distortions such as "Nobody can help me" or "My therapist doesn't know what s/he's talking about." Though, that's far easier than admitting "I need help. This nice, competent person is telling me I need to change something. That makes me feel uncomfortable."

I know, because this was me. These years later, wow, am I glad I stuck with it. All the discomfort has been worth it because I am much better and far more comfortable in my own skin.

You're not alone. This stuff is very difficult. It takes real strength and courage to go back to therapy. The fact you are questioning what you want out of it is great! Tell her what you feel. If she's worth your time, she'll be able to handle it.

 

[sonderlust]

Thank you for your input, BloomInWinter, but no. It is not as simple as that. I've already terminated, and she was not worth my time, or my money.

 

[BloomInWinter]

I wish you well and hope you find a therapist you can work with.

 

[Abstract]

he hadn't built up the rapport with me yet to be challenging me like this and asking these questions.

Hi Sonderlust. I think this sounds key to the issue. I think if you were saying you never wanted to discuss certain things in therapy then any good therapist would discuss that with you no matter what their approach. If they are more directive then in a more direct and challenging manner and if they have a non directive approach then as questions to help you discuss the issue and guide you to the better choice. I also think its reasonable to expect to explain the why and how of your thinking but it seems you have done that already with her.

It seems that what you are saying is that this is not the time or space for trauma work and you do not yet have enough of a trust base with this therapist to go "there" there either. That you need to work on stability at present. I think your reasoning is very legitimate.

I know that she has a supervisor that is probably pushing her to push me

I think this is likely too. And so it makes it even more important that the approach match what you need as if they are CBT then supervision will be very focused on the so called results. For the majority of people that go to therapy that is sure to be fine and work well for them of course but not for all.

which type of paradigm did your therapists work out of, and which of those paradigms were successful in making you guys comfortable enough in session to talk? I

I like Hashi would prefer an integrative therapist that uses more than one approach. I am however open to someone specialising in one approach if I think it is likely to suit me. I will definitely be looking for non directive therapy as it suits me better. The only way I would consider psychodynamic again is if they were Ok with adapting it and combining it with a more person centred focus. In other words be willing to be a little more reassuring and speak a little more.

The main things I will be looking for are 1/ if the person truly specialises in trauma and understand dissociation; 2/ If they have enough experience; 3/ If they sound CBT focussed I am out of there. 4/ If they seem to be able to understand me; 5/ if they seem intuitive 6/ If they have good and appropriate boundaries for me; 7/ if I can somehow afford them!

Oh and it would help greatly if they use a sandbox and crayons and paper. I struggle terribly with being able to speak.

DBT do not work for me

I did just want to ask about this briefly if it is OK. Can you define what it was about DBT that was problematic? I am certainly not saying this is the case for you but the other thing to consider is that it isn't healthy for us to want the therapist to fix us without taking the steps to help ourselves too and practice coping skills. Sometimes if someone doesn't like DBT it is because of this so I thought it was worth checking.

I also think that regardless of the approach we need to be willing to ask questions about motivation when we are upset by something; to check in with the therapist when we are upset by something they say and to explain how we feel. As these are all very important skills to practice in relationships and can give the therapist the information to be able to better suit the therapy to what we need. Regardless of the approach noone is a mindreader.

I hope you find what someone suitable! :)

 

[piratelady]

I think, in therapy, it is a fine line. Yes, it is important for the therapist to push someone to make progress in therapy. That progress doesn't necessarily have to mean talking about trauma. As Hashi says, first you need to be stable and have coping skills. If you do not have those skills, then the therapist should be pushing you gently in that direction. Once the skills are there, then they do need to push you to process the trauma.

The point is that the client needs to be pushed, it is in what direction that is important. I'm like Goldilocks. My first therapist didn't push me at all. I didn't learn coping skills, talk about trauma. We just talked about whatever popped out of my mouth. The second guy pushed me way too hard and it was not good (big understatement there). The third one, is just right. He has pushed me, but towards the things I need to work on at that time.

I hope you can find someone who can help you to get to where you need to be and who you can have a good rapport/relationship with. It takes time, but is worth the effort.

 

[Abstract]

that the client needs to be pushed

I sort of agree with most of this. How I would put it though is that the therapist needs to be engaged with helping us help ourselves move forward in the way that is most appropriate for us and our situation. I am not keen on the word "pushing".

A bad therapist no matter what approach will not be thinking about what is happening for their client and what direction they are heading in. They may also speak randomly about irrelevant things too much. Or behave as a friend and chat about their own lives too much; or worse start telling the client about their problems and cross boundaries. A therapist that behaves as a friend and crosses boundaries can be very dangerous to our wellbeing!

Whatever the approach the therapist needs to be able to be engaged in the process of therapy and work with the client to make things change. Whether that be by listening and gently guiding or by challenging and teaching.

To me that is a totally different issue to the approach the therapist works with.

 

[Abstract]

Goldilocks

And then it was just right.... :tup:

 

[Hashi]

The point is that the client needs to be pushed

I can see that this is true for some people. I can't agree that it's therefore true for everyone.

I think all clients are different. Some may need to be pushed. Some may need to be guided. Some may need to be given space to follow their own direction, with just a gentle suggestion every now and then.

For some clients - like me - it's healing to lead the direction of their own therapy, after having little control over their lives generally and in trauma in particular. It can be an important way to build trust, confidence and awareness in ourselves. Depending on the client, the therapist trusting them to set their own pace doesn't mean they won't do any work. Also, the therapist can always ask questions or make suggestions, mine does. She has a lot of insight and wisdom. And she recognises that I might have some too.