Therapy Issues - Relationship To Depression

[Hashi]

I'm currently taking a short break from therapy and wondering if I should make it a longer one. I'm seriously questioning how helpful it would be to go back to therapy right now, or even at all. I honestly don't know.

We keep having issues that aren't the sort of constructive ones that ultimately lead to a better therapy relationship. They're just her slipping up, saying things without enough care and me getting upset as a result. In one sense they aren't huge. They aren't unprofessional or triggering. In another sense, they're a big problem. The comments themselves make me question whether we can work together effectively. Plus I feel angry that she has done this more than once. Not only saying similar careless things, but once saying the same careless thing again. When that happened, I had to question how sincere her previous apology was, and what had been the point of us discussing it all.

Unfortunately, the repeat of the same careless comment as previously was just before the current break started. We had one session to discuss it, but it doesn't feel resolved to me.

I don't want to talk about the issues themselves, and I don't know how much I want to talk about whether I'm right to be upset or over-reacting. I'm not sure I'm giving enough detail for that anyway. It's more that I can't judge my own reaction. One reason for that is that I don't know how this inter-relates with depression.

I'm noticing that the issues have happened and my depression has been worse at the same time. But I don't know if the issues have caused the depression to get worse, or the depression was already getting worse and that made me react more strongly to the issues.

I wonder if the depression, and the effect on me, had an effect on our interactions that partly contributed to her being careless with what she said. (Although I would have hoped that if anything it would make her more careful,)

In another way, I think it doesn't really matter what caused what. If my depression's worse then therapy isn't useful (it isn't - I don't benefit from general support, I need to work through trauma or other major issues, and I don't benefit from trying to work on depression itself, that makes me much worse.) If my depression seems to be worse much of the time, I might as well stop going - but I can't know if it's going to get worse or better.

I realise that an obvious response would be to question whether this is avoidance. Again, I can't tell. I feel like I might equally be avoiding a decision I need to take - that maybe she isn't the right therapist for me going forward.

Another obvious thing to consider is a much longer break, but I don't trust myself with that. I think I'd lose the momentum to go to therapy and not get it back, at all. I think it would become leaving without admitting I was doing that.

I'm not someone to go through repeated dramas of leaving and returning to therapy. I go through little scenarios in my head almost every week, where I want to leave because it's too hard, but that works it out of my system. I don't work out things like that by enacting them. This is different.

I feel like I can't keep going to my therapist with this happening. I'm losing my faith in the value of talking to her about it. That makes me lose my faith in the value of talking to her about anything. This is serious and I need to consider it seriously. But in order to think about, I feel I need to understand the relationship to depression, and I don't understand that.

Has anyone considered this for themselves? Any thoughts.

 

[Leah123]

Hi, Hashi, I'm sorry you're struggling and sounds like you're feeling confused as to the best course of action but also as to whether you are clear on exactly what's going on with you in terms of cause and effect and whether you're trusting your perceptions/judgement, which makes it harder to figure out the best course of action. I hate when I am stuck in a muddle like that, have been there lately.

Without knowing the details, my only suggestion is to consider if you might benefit from seeing a new therapist for just a couple sessions to work through where you are right now and see if therapy, just not your current therapist, might be helpful. I have occasionally booked a session with a therapist online to work such things out and found it very helpful and soothing when I was in a difficult place.

In the meantime, I'm glad you're posting here and hope you are taking good care of yourself.

 

[scout86]

I guess it would bother me, her making the comments twice, if she has already agreed that it wasn't something she should have said or would say again. I'd have to wonder what that meant, why it happened, etc. I can see where you'd question continuing to work with her.

At the same time, I can really relate to the struggle to sort out what's related to what, what causes what, what's reasonable, what's not.... It's really confusing. It's the reason I decided to see a therapist last spring. For all that I DON'T like about it, I don't know how else you sort this stuff out. I know my own perspective is messed up, I just don't always know HOW, much less what to do with it. I don't know how a person would find their way through all that without some kind of outside, objective, help. You can't really expect that from family or friends. They probably don't have the resources, even if they have the willingness.

All I can say, I guess, is good luck, but I totally get what you're talking about. It's not just you!

 

[Promicarus]

I'm curious as to how exactly the specifics of this played out--the "repeated disreepectful comment", that is.

The reason I ask?

She may feel as though you're attempting to establish dominance/authority, by insisting she apologize. Or even if she doesn't believe that this is your conscious strategy, she may feel that it effectively tips the balance of power against her as holding the position of authoritative role in your mutual therapeutic alliance, nonetheless.

The reason this is an issue: therapeutic protocol dictates that in order for the client/patient to hope to benefit from therapy, the therapist must retain authority in the relationship. Therefore, her mention of the comment again may well have been a direct attempt to broach your unbalancing of her necessary authority--especially if you demanded an apology (it's difficult to have an apology demanded from you, to apologize accordingly, yet still retain a sense of dominance in the relationship)

This was a real problem in my earlier attempts at therapy--even though I have no accent, or difference in coloration, I'm of a cultural background which associates rigid assertion of authority as taken for granted as necessary to maintain basic self-respect. If I'd had the accent to put this approach in context, it wouldn't have been seen as antisocial or attempt at domination--just a cultural characteristic. But in my generation of Americans, presenting with authority has become relatively antisocial, instead--so they thought they was dealing with an--at the least inappropriate--and likely dominating young American male, rather than simply someone acting consistently with his cultural background.

The result? I was regularly shouted from tdocs offices, without having any idea why. Only after piecing all of this together some 20 years later, do I realize that they were in effect drawing the line in the sand---their protocol dictates that if they don't maintain authority, you might as well not be there at all, as the therapeutic dyad will be ineffective, and the client/patient none the better for it. Therefore a "my way or the highway" outlook institutionalized as protocol.

I'm not arguing for or against validity of the theory, here. Just trying to point out possible underlying dynamics at play.

Of course I could be wrong entirely, I realize. Might have been an innocent slip due to carelessness and/or inattention.

But I do have to include my opinion that in all likelihood, most therapists would find being forced to formally apologize to be objectionable as running contrary to their training.

Just my two cents

 

[arfie]

I would be guilty of the drama leaving and returning to therapy, though I don't see it as high drama. I see recovery as a long and mysterious journey. My therapists are not buddies, nor companions on my healing journey. They are professional contractors to be used and/or let go as needed. Strictly nothing personal. Professional detachment defines the entire relationship.

My support groups are where I go for the personal touches in my healing journey.

 

[Promicarus]

If I'd already had that sort of bad taste placed in my mouth regarding a therapist, it would likely no longer be possible for me to progress with them. That's just me.

 

[franciemarnie]

I would not be able to continue with this person. An aspect of my years of early trauma was a denial of my reality. I was not listened to, not "seen" as I was by respected (and loved) authority figures. It was as if I didn't exist or as if what I said or did in response to crisis didn't matter.

So if my T and I had discussed a comment and it's deleterious effect on me, and the T repeated the comment as if it never happened, it would be over with my history. Because the T would be triggering me now. And I wouldn't be able to relax with her again.

I would trust your gut instinct to take a break. I wouldn't think about any forever decisions about therapy. I would give myself a break and if I had new information as time went by that convinced me to return to some kind of therapy, I would reconsider it then.

But that's just me. And Im so sorry this happened to you.

 

[Promicarus]

I'm so sorry that happened to you franciemarnie. Same here. What better way to convey to a child their lack of worth on an ongoing basis than to simply ignore them? Have you found any specific methods of addressing it, therapeutic approaches, useful techniques or practices, etc.? It's something I need to deal with.

Thanks

 

[ms spock]

Hello Hashi,

Can you test drive some other psychologists with a list of what you want from therapy?

You can keep going with your therapy but perhaps need to find another therapist or clarify the issues with your therapist.

As someone who stayed with abusive therapists I don't have much to add except you are brave to look at this stuff from balanced perspective.

 

[Seasounds]

I'm sorry that you are encountering this.

I agree with Franciemarnie. Your depression and indecision may, understandably, be from your therapist not integrating your feedback; she is being disrespectful, and she is not 'good enough'.

You are a self-empowered client to realize the problem. When you want, you can move on, to a new therapist whose issues do not interfere with your therapy. Your depression may lift and your confidence may return.

Thank you for you post. I have been through a similar situation. After thinking I was making a big deal out of nothing, I realized the opposite. My therapist, by not integrating my feedback, was connecting me to some of my primary loss issues.

 

[Promicarus]

My previous trauma therapist--EMDR--actually took advantage of me at my lowest point, and promoted a sexual relationship which she then used to essentially emotionally strong-arm me into moving into her home with her, and beginning wedding plans...all this during a period when I could hardly put my pants on straight, much less access any critical thinking skills. And yes, I'm male. Unusual, I know. But it does happen. After getting to truly know her, and meeting her other therapist friends....I've become deeply mistrustful of therapists, in general.

I've known lots of nearly professional grade screw-ups black sheep and the fundamentally and colorfully imbalanced...
but I've never met anyone as frighteningly disturbed as she turned out to be. Her therapist friends weren't much better.
They sat around and drank wine, ridiculing their client/patients, laughing uproariously. I couldn't believe it was actually happening.

So there's that. Doesn't make it easier to trust the next time, needless to say.

But something good came out of it, I now realize. I've felt newly empowered to view therapists as very potentially having feet of clay, and less likely either to tolerate an incompetent one in the future, or to have feelings of guilt about speaking my mind about just that, should I feel the need to.

It also helped me view lots of negative experiences with tdocs in the past as not a matter of my simply being fundamentally unhelpable (as was insinuated at the time) but to realize that it was actually them, not me, in most instances.

I see making progress in my treatment as no less than a war, at this point. Not in a negative, oppositional sense, with therapists as the enemy. But against my symptoms and PTSD in general. And in a war, you've got to be determined, and not get tripped up when trying to stumble across obstacles standing in your way. I now view potentially negative reactions by therapists as opportunities to learn resilience, and not allowing others to 'steal my joy' whoever it might be.

If I stumble into the therapeutic equivalent of a mine, or dead body....they're out there...just keep marching forward.

 

[Hashi]

Thank you for your responses. I realise I haven't given the whole picture, and feel a bit bad about that, I just didn't want to write an endless post. She is a very good therapist in other ways, and works with me in the way I want to work, which is highly unusual.

Promicarus, I completely agree with what you say about therapists and authority. I'm feeling guilty that I didn't explain this aspect. I've been through the sorts of things you talk about in your first post here - therapists/psychiatrists not wanting to be questioned etc - and I know what that feels like. It's because of that that I see my current therapist. She is a transpersonal therapist, which is person centred and gives respect and authority to the client. Transpersonal therapists see the client as an alchemist (making changes and transformation) and the therapist as their assistant.

The problem is actually that she has full psychotherapy training, and accredited trauma training, and is caught between professional good practice and me... I'm strong willed and have my own views, and most of what's considered professional good practice doesn't come into it. So she wants to work the way I want to work, and she wants to be professional and ethical, and that causes a conflict.

I'm really sorry if wanting not to write pages and pages means I haven't given enough information.

It was cathartic to write what I did. I felt much better for facing it. I think what I'm taking from that feeling and the responses here is that the way things have been need to change. If they can't, then there isn't any point in continuing with her as my therapist. My particular reference to depression is related to this. I might not be communicating enough, hearing enough, and being able to judge this situation well enough, due to depression.

I do feel that somehow I need to give my therapist a fair hearing, taking into account that depression (and past trauma) can make me highly reactive and negative. It's this that I'm trying to navigate my way through.

In one sense, I feel like a very reasonable person who can say - I do this and that, my therapist does this and that - what's the outcome? In another sense, I know - however much I don't want to - that I'm very affected by my history and the resulting depression, I'm only going to put forward my own view of things, and my view of things might not be all that reliable. That's kind of what I'm trying to work through.

Having said that, I agree that her carelessness over what she says isn't acceptable. Before I posted this I was confused about that. I'm grateful for replies that make me feel this isn't all me. I think she does need to stand up and deal with that whole area better, and if she can't then that's an issue. So thank you for giving me a reality check on that.