Why Do Therapists Minimize?

[sun seeker]

I just came home from a therapy session that frustrated me by giving me the same sense I've had before with other therapists (and other people) which is that no matter how I try to express myself, I'm not succeeding in getting across how severe the problems I'm having really are.

This isn't what the conversation was about, but just as an example, suppose I am trying to convey that I have been in agony for the past ten years, and the therapist's reflection is something like, "oh, so you have been experiencing some depression lately." Arrgggh. It probably gets to me more than it might some people because of coming from a family that very blatantly doesn't listen to me and where I have to basically jump up and down waving neon signs before they notice that I exist at all. One thing I want in a therapist is for them to really hear just how bad it is, to be strong enough to sit with that. I already feel like a freak, like what I experience is too much for anyone to wrap their minds around, and I have to hide it. I really long for at least one place where I don't have to do that.

I've run into this so many times that I'm wondering what it's about. Is it the therapists' discomfort, in which case I still haven't found one who is right for me? Or is there some therapeutic reason why they do this? Are they taught in therapist training to minimize when they reflect what clients say to them?

I can see the point of helping clients to find what is positive in their lives and building that up to take the place of the distress. I can also see not wanting to go too deep towards the end of a session. But I've experienced this enough that it is really disturbing me and I don't think it is achieving whatever it is supposed to achieve, if indeed there is a plan behind it. Does anyone know if there is?

 

[katiekat]

I'm sorry you feel like you aren't being taken seriously and feel misunderstood. Why don't you just bring it up next session and ask if your therapist why it feels like the severity of your feelings are/have been minimized? Say you don't feel understood. Maybe the therapists you have seen really can't fathom how you feel? Maybe the reaction you're looking for won't ever come and maybe you can explore that idea in your next session?

Me personally, I can totally feel your angst and frustration just through your post and I too have felt like no one understands what it's like for me. I don't know your particular situation but I totally feel like this when it comes to certain sounds. I found out about something called misophonia and I have felt hopeless and completely misunderstood and crazy since it started and not until a year ago did I figure out that I actually have a legitimate problem. It's so hard for me sometimes that certain sounds canmake me feel like I'm going to lash out at wwhoever is making the sounds. It wasn't until my fiance and I went to couples therapy that a therapist validated what I experience to my fiance that he started to have compassion for me instead of feel like I hate him. You definitely need to have your feelings validated by someone and you should bring it up :)

 

[joeylittle]

I don't automatically think it's minimizing; it could just be making sure it's "real-sized". It's hard to find the common language that expresses inner pain. So, I've noticed (in group settings) when someone describes something as unbearable, debilitating, horror - the smart therapist will follow with "describe the sensation of that" to try and get at what that individual's definition of horror is. The less smart therapist will re-frame it into a clinical term. So, "experiencing depression" is a version of a translation of "unbearable" - but they should follow up with getting the client to talk about it more, to weigh out exactly how bad it is. And truly, it takes time also.

I always was afraid to tell a therapist how often I dealt with suicidal thinking, because really, it sounds like I'm exaggerating - and I didn't know how to express it using balanced, relatable language. I didn't want to be the client who cried wolf. Still, sometimes I'll say something that ends in "I don't know how to live with it anymore" and my therapist will respond with softer language- "do you mean you want to stop working towards (whatever, lately it's been job stuff) - and I'll have to clarify, that no, I mean it literally.

just came home from a therapy session that frustrated me by giving me the same sense I've had before with other therapists (and other people) which is that no matter how I try to express myself, I'm not succeeding in getting across how severe the problems I'm having really are.

I think this is a brilliant way to start your next session, because finding that common understanding between you and your therapist of what you mean when you talk about your pain is a really important thing.

 

[Deleted member 1860]

Are you seeing a trauma therapist?

One thought that I have is that these are "normal" people (you KWIM) so they may not truly "get it". They don't understand the true severity of our symptoms, and never really will. Most are only equipped to help people who have problems along the lines of "I don't like to get up for work on Monday mornings". So when someone like you or I come along, they're completely out of their league.

But yes, you do have to jump up and down wearing a neon sign before you get any real help. I hate to say this, but yes, you have to exaggerate the F*CK out of your symptoms. I am NOT saying this so that people can fake a PTSD diagnosis, but in the psychological world, the most severe cases get the best care. It was when I was at my worst (near death) that I got my best care (hospitalization). If I just sat there and told people my symptoms and such, they wouldn't believe how bad it is. I think we're better at hiding things than we realized, coupled with "BAD" for normal people being "oh no I spilled my coffee on the way to work this morning".

 

[Intrepid]

I don't think that it's minimizing all of the time. Sometimes even a well educated or experienced therapist just doesn't directly relate. My therapist, as far as I can tell, has not suffered from PTSD, flashbacks or depression. She's lived a full life, but doesn't quite understand what it's like to be me. That's okay. What's really important is that I understand what it's like to be me. She gives me the space to do that, sometimes. But more important, I make the space for myself.

 

[Friday]

Reframing... For sure.

I'm in the other side of this boat. My therapists have almost universally been trying to get me to put more weight behind XYZ activity or event. Vexing. Yeesh. It's hard enough without wailing about it. But while I completely blew off the first couple... When it became a trend? When everyone was like "Friday. Stop that." I had to take a long hard look at whether or not they were right.

And came to an uncomfortable conclusion : Yep. I do that.

Why doesn't really matter. <grin> Although I've debated it! Too long in the UK as a kid, maybe? I know I have described a monsoon as a bit damp & windy out. Too much time in the military? Where you only bitch about the little shit that doesn't matter? Shrug. Dunno. Why is less important than that I don't see things as a big deal, that apparently, I might should.

I suspect there's some sort of median we're both being nudged toward.
The fair & accurate representation median.

 

[Seasounds]

I'm sorry that you aren't getting what you want in therapy. And I absolutely love you intelligence, and what it implies. So many professionals don't know how to really be with another person.

Is it the therapists' discomfort, in which case I still haven't found one who is right for me?

From my experience, it could be, very true.

Or is there some therapeutic reason why they do this?

It could be their personal discomfort, their training, or their session plan-what they want to focus on.

Are they taught in therapist training to minimize when they reflect what clients say to them?

From what i have learned, after speaking to therapists, "Yes." Depending on the T personal point of view, or their training, or their discomfort, Ts may be unable to fully relate to your suffering.

I have had better luck with, believe it or not, psychoanalysts, since they are trained to listen, and not change the subject. But still, the T really has to be willing to "hold", "be empathetically with me", for the session to be satisfying. Their personality and their own experience of working through deep trauma, play a huge role.

You are absolutely on track; that there is someone out there for you, who will work better. I think that I get an excellent feel and demonstration for the mutual rapport, (i.e. how they relate to me, overall), in the first two sessions. Good luck, the search is worth it!

 

[Chava]

For me it would depend on tone, context (like is the therapist mostly helpful, etc). I understand how that sounds minimizing (or at least your example). But the time thing is also a meltdown thing for me...I get stuck in "it's always been like this and it's always going to be like this" and I feel pain and flooded...all time happening at once. I feel trapped easily and I think my therapist recognizes my references to time as being a cue that I'm losing ground. In those places, my therapist tries to help me notice the present and what is real right now. It annoys me in the moment, because it feels worse than I think she is understanding, but in hindsight I always realize she was just doing her job pretty well.

The past matters though. We can talk about the past a lot, we work with it pretty directly, but for me not in the timeless, everything-globbed-together sense...or the I'm trapped and will never get out sense. Sorry if that doesn't relate. But sort of stuff of context and how you understand the connection you have with your therapist (which takes a long time for me). If not, if it is continual minimization or that they clearly don't get it...well, I'd sense that pretty quickly and move on. It's too painful to feel like a freak. If you feel like you can't talk about your past, that would seem pretty uncomfortable and confusing. I do think some therapists want to "fix" stuff or change thoughts somehow instantly or very easily, and somehow they symptoms will go away. It doesn't usually work like that, but I've personally only experienced that type of minimizing in CBT (just wasn't my thing but I maybe didn't find the right therapist).

It does sound like reframing, which can be a helpful tool but also invalidating if not done carefully. Can you talk to your therapist about it, especially if it feels like it's getting in the way or creating too many negative feelings about the process?

 

[sun seeker]

Wow, this must be a topic close to many people's hearts. Seven replies in an hour! I am seeing that the answer could be "any or all of the above."

You know... soon before starting with this therapist I posted a thread asking if anyone had a name for the feeling I get when I go into an emotional flashback, because I really wanted to be able to describe it to my therapist so she would have a sense of what I am dealing with. Because avoiding situations that make me feel that way takes up a lot of my life. The thread went on for some time but I found even here, I wasn't really able to convey what I meant. With someone who has never had PTSD I guess it is even harder. I need to keep working at it though, it's important.

I get the point that she might be trying to make statements more accurate. Statements like "it's always been this way and always will be" don't leave much room for things getting better. I also know that when people are depressed they tend to globalize, and a therapist could be trying to get a more balanced picture. What I notice about this though, is - likely because of repeated experience not being taken seriously - it backfires when people either don't hear me or try to talk me out of it being as bad as I am saying it is. It makes me feel my needs are being minimized in a way that retraumatizes me. Even trying to find words to write about it, I'm at a loss because it's so painful and probably preverbal. It's sort of like I'm being denied the right to exist.

When I am fully allowed to express how bad it is, after that I am more able to find the positive.

I don't automatically think it's minimizing; it could just be making sure it's "real-sized".

Yes, I wondered that. The trouble is I've never had anyone try to make sure it's real-sized in the other direction (as in @FridayJones's example). Always the other way around. When I reflect in a more neutral mood on how accurate I am in therapy sessions, I think I may actually under-report my symptoms. Maybe I need to do as @Solara suggests, and exaggerate and see where that gets me. (I don't mean lie, I mean it seems sometimes like language strong enough to describe what many of us go through hasn't been invented yet and maybe it takes expressing ourselves forcefully to get the point across.) When I look at what I was writing in my journals ten or fifteen years ago, the pain I describe then hasn't changed much. It really has been, maybe not forever, but an awfully long time.

From what i have learned, after speaking to therapists, "Yes." Depending on the T personal point of view, or their training, or their discomfort, Ts may be unable to fully relate to your suffering.

@change, I'd like to hear more about this if you don't mind sharing. Have therapists actually told you that they are taught to minimize?

I always was afraid to tell a therapist how often I dealt with suicidal thinking, because really, it sounds like I'm exaggerating - and I didn't know how to express it using balanced, relatable language. I didn't want to be the client who cried wolf. Still, sometimes I'll say something that ends in "I don't know how to live with it anymore" and my therapist will respond with softer language- "do you mean you want to stop working towards (whatever, lately it's been job stuff) - and I'll have to clarify, that no, I mean it literally.

I believe you, for what it's worth. Have you come up with a solution? (To how to describe it, I mean, not to the thoughts.)

They don't understand the true severity of our symptoms, and never really will. Most are only equipped to help people who have problems along the lines of "I don't like to get up for work on Monday mornings". So when someone like you or I come along, they're completely out of their league.

Yes, I've sensed that this may be the problem. So I'll have to work some more at expressing what it's really like. Sigh. I'm TIRED of trying to describe what it's really like.

Trauma therapist - sort of. Her job title is women's therapist and she specializes in art therapy, which I don't particularly want to try again, but has a little training in somatic experiencing and is willing to learn about the Neuroaffective Relational Model that I am eager to try. That really is as close as it's going to get for what I can afford in this rural, under-funded area, and getting in to see her took four months and a lot of advocating for myself, so I am really feeling the need to make it work somehow.

I think on reflection, what I will do next session is talk about how important it feels to be heard, and work on describing what I actually go through. I have three weeks to work on finding words.:) I was also thinking about developing a scale, like doctors use to ask how bad your pain is, so we'd have a shorthand to talk about it in the future. But first, I have to define what is on that scale. That's the hard part.

The way it works around here is there is free counseling through community service societies, and if someone is more symptomatic than they can deal with, they refer them to the mental health system, which is funded by the provincial government. There is a parallel private system which I can't afford. I am certainly symptomatic enough to qualify for the mental health system, and there is a very good SE practitioner there, but I have already ascertained that I can't see her because I live outside of her catchment area and they have a huge backlog. I asked if there was any room for exceptions and they refused me. They insist I see the mental health worker assigned to the town I live in, which I feel would be a waste of time as she doesn't have the skills I am looking for and I have found her to be not a particularly compassionate person. I saw the women's counselor in this town for long enough to decide she couldn't help me either. So I don't know how much more shopping around I can do at this point.

Anyway, thanks everyone for the advice and support. Sorry if I missed responding to anything important. Wow, this is getting long, I'll stop now...

 

[Seasounds]

@sunseeker:

@change, I'd like to hear more about this if you don't mind sharing. Have therapists actually told you that they are taught to minimize?

It often looks like something other than what it is. By minimizing, I mean that they are taught to reduce the time and depth of a patient's reporting, through their behavior, by either discounting (not trusting the memory as real), or interrupting-in various ways, My learnings on this topic have been from asking therapists to tell me, directly. Responses I received:

1. They were diverting me from (so called) childhood memories that couldn't be proven, so that they wouldn't be liable in court for supporting false memories.
2. They thought their job was to help me think 'reframe' of my life in more positive terms.
3. They were taught to not let the client be the primary directive influence, in a session.
4. They were taught that PTSD increases if clients re-tell their experiences.

Minimizing--any way therapists avoided hearing my story.
Certainly, this is not withstanding, that there is a skill, in being a client, who learns how to tell their story, feel the feelings, and let themselves transform into new, healthier patterns.
I think the only way this process can begin to happen, is if a person is heard.

 

[Beachlife09]

I think the only way this process can begin to happen, is if a person is heard.

Amen to that. We need someone to actually listen in order to start healing.
Especially like in cases like mine where my tormentors told me that no one would believe me. It's of even more importance and value to be told that someone believes you.
@sun seeker I really don't understand why therapists/counselors minimize our pain. Telling us to move on or get over it will not help. It just hurts more. My prayers are with you, and I hope you are able to straighten things out with your T.

 

[StellaBlue]

For me it would depend on tone, context (like is the therapist mostly helpful, etc). I understand how that sounds minimizing (or at least your example). But the time thing is also a meltdown thing for me...I get stuck in "it's always been like this and it's always going to be like this" and I feel pain and flooded...all time happening at once. I feel trapped easily and I think my therapist recognizes my references to time as being a cue that I'm losing ground. In those places, my therapist tries to help me notice the present and what is real right now. It annoys me in the moment, because it feels worse than I think she is understanding, but in hindsight I always realize she was just doing her job pretty well.

This really resonates for me. While I definitely have a "it isn't/wasn't that bad" side like @FridayJones, I can also get sucked into the flooded/trapped/it's always going to be this way vortex as well. (and part of the vortex is me trying to convince myself that "it isn't / wasn't that bad"). And sometimes these occur simultaneously - as in I feel desperate and suicidal inside but have this calm exterior -"nothing wrong here" - so when I use extreme words to describe how I'm feeling, I think it comes across as exaggerating. I have, in the past, left therapy sessions where the therapist thinks everything is fine and calm and I think I've expressed how distraught I am and I've ended up in the hospital with both of us confused about what exactly happened.

I think it takes an especially skilled therapist to walk the middle path here - validate that things really are that bad, but also truly believe and be able to express that they might not always be that way or that there are different perspectives to consider...and to not get sucked down the rabbit hole. It doesn't do any good for both of you to be stuck in the mire.

I do think it is essential that you feel your therapist is really hearing what you're saying. I think discussing this with your therapist as openly and honestly as you can could be amazingly healing (risky, but if she's worth her license, she would be able to hear and validate you, which would be an amazing thing).