Felt Like T Was Out Of Her Depth

[Sandstone]

I've had several really bad days lately, and desperately didn't want to go to therapy yesterday. I didn't seem to have the resources to get through the hour and half journey and then focus.

She started briskly going through the proposed agenda, and after struggling to keep up, I broke in to say " I really don't want to be here, Can I go home?" Of course she wanted to talk about that, but it was so hard to take in what she was asking and compute an answer. I kept having to close my eyes to focus on being able to speak. She said I looked as if I was in pain as I tried to force my brain to function. In she kept me there for 90 minutes

I felt that she just didn't know what to do or say, which I haven't thought before. She said she was worried about me, but I told her that this isn't all that unusual for me, it just hadn't fallen on a therapy day. Inside I wasn't sure if this was real or I was faking for attention. It was only when I got home and was so tired I could barely pick up a cup of tea that I thought it was probably real.

I'm really thrown that she was surprised - I can't believe she thought my Apparent Normality in our sessions so far continued all the time. I feel less inclined to trust her now, because she didn't know what to do. Is that reasonable?

 

[Deleted member 12723]

Yes. I think you need to trust your gut instincts on this one. Mabe you could consider looking for another therapist. Therapists are human and have their limitations as well. A professional would tell you that the therapist would refer you to another therapist more qualified.

 

[Kefira]

Just my initial impression: Your reaction is not at all unreasonable but if you can, maybe talk to her about the fact that you felt like she didn't know what to do when faced with you being at less than your normal level of functioning. She might be out of her depth. She might just not know how best to support you in particular when you feel that way.

Maybe if you can figure out what would have made you feel supported and cultivated trust in that situation, you could communicate that to her and she would be able to provide that in the future. I feel like sometimes the 'default' setting that therapists operate in isn't necessarily the best for trauma sufferers, or for a particular individual. That's sort of to be expected- they're dealing with so many clients who have so many very different needs based on their personalities and histories.

If you can't resolve it, then absolutely look elsewhere. And I also empathize with how difficult it can be to feel trapped or unsupported in therapy or to doubt your therapist. I hope you can be gentle with yourself and gradually process what you'd like out of this situation. Best of luck.

 

[Sandstone]

if you can, maybe talk to her about the fact that you felt like she didn't know what to do when faced with you being at less than your normal level of functioning

I half thought I'd do this, as she said she would phone on Monday to check I was OK. But I don't want her to perceive me as being negative or critical. I'm so aware that I have been critical of others in the organisation , because they have been catastrophically bad. I thought maybe I'd just apologise for easting a session.

As this is provided through the NHS, i don't have the option to look elsewhere - it has taken me so long to get this, and overall she seems t have a good understanding of how to go about treating trauma/PTSD. But I'm left wondering how much of it is theoretical rather than applied.

if you can figure out what would have made you feel supported and cultivated trust in that situation, you could communicate that to her and she would be able to provide that in the future.

Thats a big question. I don't think I have any idea - I'm not used to being supported, I'm used to doing it myself, and i think that is why I wanted to go home and wait for it to pass.

 

[Kefira]

I'm not used to being supported, I'm used to doing it myself, and i think that is why I wanted to go home and wait for it to pass.

I totally understand that.

So take it or leave it, but maybe you can take a middle ground of "here's how I felt. I'm not sure whether it's partly because of the fact that I'm so used to being on my own and I was so focused on doing what feels safe to me, which is to isolate. Maybe we could work on how I can feel safe in session when I'm struggling." Or something along those lines.

But I don't want her to perceive me as being negative or critical.

Her opinion of you is not your problem. As long as you aren't rude, and you're explaining what your internal process and emotions were, that's your job. If she doesn't know how you're feeling about the way she handled it she can't possibly fix it.

It sounds like neither of you were right or wrong, you just weren't syncing up in a way that was working. And even if you don't have a option to go elsewhere, she still is there to serve your needs. I also think it's okay not to know exactly what those are and that maybe that would be a productive thing to explore.

 

[Friday]

I'm curious is you asked her if you can go home to be polite, or because you actually thought you needed her permission? Or something else?

 

[Jane.l]

To me it feels like you were not sure what was going on during the session and your T was not sure either - she told you she was concerned, perhaps you were not able to understand or verbalise everything at that point, but if this is the first time she has seen you like this, it maybe a learning curve - she can only see and process what she is given - I would go back and talk it through next session.

 

[desiderata310]

Heh.. Wow. If I had turned to my therapist (and I have done this) and said 'I don't want to be here, can I go' he would have immediately shut the session down and rescheduled via text or phone later. If that's where you are, you're right to voice it and leave. Therapy is as much about support as it is about the work. Some days aren't good for either. If you can't do it then you can't. It's about self care at that point.

 

[seedling]

She started briskly going through the proposed agenda,

Maybe this was part of the problem. The first focus could have been on where you were at, then see what might get done with the session.

If she's willing to work on it with you I think it could be a relationship builder to figure out a way to handle these kind of days. After a while my therapist started to joke with me "I know, just shut up and listen" when he was trying to inject too much theory and structure in to our sessions when all I needed to do was talk and be listened to.

 

[SeaQuel]

Are you sure you weren't dissociated? It kinda sounds like that (I've had similar experiences in terms the eyes closing/being unable to speak). Regardless, it's her job to actually get you back into the "present." Maybe she felt you were incapable of getting home safely so she kept you there? Just playing devil's advocate here.

 

[SeaQuel]

The first focus could have been on where you were at, then see what might get done with the session.

Yes, I agree with this. My therapist is usually pretty good about checking in with me at the beginning, while also providing enough structure that we don't spin our wheels every week. Occasionally, though, she's already got something in her head that she wants to launch into right away and it really, really throws me off. I've called her on it a few times, and wish I had the other times.

 

[Sandstone]

The first focus could have been on where you were at,

She asked how I was, and I did the I'm OK, in an equivocal voice. I usually feel doubtful and hesitant at the start, but can usually push myself into gear. She did ask why I hadn't cancelled, and I said that would be cowardice. I can't rely on what I feel like as a predictor of how well I'll be able to function

Her opinion of you is not your problem

I'm curious is you asked her if you can go home to be polite, or because you actually thought you needed her permission? Or something else?

Because my best T to date explained that most NHS staff perceive running away as an act of anger/aggression, not, as I see it , as exactly the same thing as crying. That made sense of some of their reactions in the past. Since I'm aware I'm getting treated as a concession, I need to keep things as acceptable as possible.