How To Tell If Your Therapist Is Working For You.

[AlmostFellForIt]

Hi,

Wondering if anyone has advice on this?

I've done over ten sessions with my therapist and I have this feeling we haven't even started yet...also when I've asked what type of therapy my T has in store for me, he doesn't define what were going to try out...... or methods or the type of approach is discussed..."trust the process" you know.."we'll get there".

There's also been some comments that for what ever reason haven't sat well with me, also, no matter what I try, it just seems that my efforts are in vain..that is, most of my self help is cited as 'trying to control' the situation...It makes me feel like I'm wrong but then I'm not told why or what the alternative 'should' be....again...."trust the process" you know.."we'll get there".

Finally, and this is a big one, I'm not even confident the diagnosis of PTSD that he made was accurate.

I guess what I'm asking is, should I know what type of therapy I'm actually involved here..the approach? I have no idea what the bigger picture is.

Thoughts?

 

[Ronin]

I go by if it lets me move with some aspect of my life I was stuck with, or how many aspects of said life.

If it doesn't, I'm out. If it spins me back to unhelpful behaviors and style of thinking, I'm out faster.

 

[AlmostFellForIt]

I go by if it lets me move with some aspect of my life I was stuck with, or how many aspects of said life....

Very simple but a hell of alot behind what you just said..thanks, makes alot of sense.

 

[Suzetig]

Your therapist sounds like he might be Rogerian/person centred, which means that the relationship is the vehicle for healing - the "trust the process" thing is very person centred, although they don't tend to rely on diagnosis much.

It depends on what you want from therapy. My therapist is trained in person centred therapy and, while its been a long, slow process she works at my pace and is respectful of what I can cope with in terms of processing trauma. I do see significant changes in me, both in decisions I've made about my life and how I cope with being triggered - it's been hard work but I'm glad I chose to work this way. I have a very complex trauma history so things like EMDR wouldn't have been good for me and I've done CBT, which kept me functional but never got near the root of my difficulties.

This course of therapy has been like resetting a broken bone, very sore, but things feel stronger at my core and more straight. In saying that, it's not for everyone, if you want homework, directive input/advice, you may need to look for a different therapist.

 

[JEKBreatheandBelieve]

My therapist does a mixture of types of therapy. It works for me. I know that my therapy works with her because I am comfortable around her (that doesn't mean we always agree or that I can always say what I want without fear), but I know that she has my best interests at heart. I also know that my therapy is working because I am making progress in my life. Some things were too big for her to deal with and I did seek in-patient support, but she worked with them and now thing are even better (not all rosy mind you, but better). I have been with my therapist for 2 and a half years and when I think in the moment, I wonder why I haven't made any progress (as in I'm nearly normal again), but then I look back and see how much has changed for me and realize that this is a long process not a short one.

My advice for you would be to think about whether or not you are gaining anything helpful by working with professional. Do you feel like when you look back in another 10 sessions, you will be able to see some progress that's been made? If you desire to know the specific model of treatment, then I would encourage you to outright state that that is a need you have even if he answers with he doesn't just use one method, press for examples he does use. Also, if you are questioning his diagnosis of PTSD, ask him to explain it (even if he's done so already and even if you think you heard him before) because it is a complex diagnosis and I know I had to have my therapist go over it several times with me. And if in the end, you don't feel comfortable in the relationship, satisfied with his answers, or like you're making progress, then I would recommend starting a search for a different therapist.

 

[Kintsugi]

Damn. I started a lengthy response to this and lost it.

But actually, that's not so bad, because as I was responding I realized the heart of what I was getting at. I think a good question to pose to yourself in thinking about this is to determine if you know what your therapeutic needs are in therapy.

I personally would be unwilling to work with someone who seemed to evade my inquiries about the type of treatment methods they employ. I know I need a T who respects me without being intimidated by me, who pushes and stretches my boundaries, who is quick on their toes, who is reasonably experienced in dealing with complex trauma, and who is willing to be as constellational in their thinking and perceptions as I am (which is to say, I guess, holistically minded) rather than being very linear in their approach.

I would feel extremely patronized and dismissed by the responses it seems your T has given you, but how I feel doesn't matter. I'll summon the old tongue-in-cheek cliché about therapists: how does that make you feel? ;)

Addendum: progress in my case with my T, whom I've been seeing for almost a year (!) now, was initially somewhat difficult to gauge, but it is easy for me to see now how far she has helped me along in my journey to find myself amidst the trauma and to root out the core of my issues. The insight she has assisted me in gaining has brought me a much greater appreciation for the depth of my continuing problematic behaviors, beliefs, and coping within relationships (chief among them, the relationship I have with my self).

 

[UnKnown-Self]

An excellent question and something I am struggling with as well.

There's also been some comments that for what ever reason haven't sat well with me,

This is a developing relationship. An important one. Just like any other relationship, those "moments" are red flags. You not only have the right but the obligation to yourself to question anything not feeling quite right.

no matter what I try, it just seems that my efforts are in vain..that is, most of my self help is cited as 'trying to control' the situation...It makes me feel like I'm wrong

Of course you are trying to control the situation. It's your situation. I think you should have control. Your therapist's role is to keep you on the right track. They guide you with objectivity and wisdom gained through their experience in the field while you do the work.

but then I'm not told why or what the alternative 'should' be....again...."trust the process" you know.."we'll get there"

Okay, I would find a statement like this from my T very offensive and condescending. Has your therapist suggested any books for you to read? What kind of homework, if any, are you assigned? Once the relationship has developed a mutual trust, there will be times you should follow the advice of your T and in the process of doing so, the reason becomes clear. You can't and shouldn't "trust the process" without first trusting your therapist.

Finally, and this is a big one, I'm not even confident the diagnosis of PTSD that he made was accurate.

Getting the proper diagnosis is important in case you need to change therapists/psychiatrists for whatever reason, your previous records can serve as a starting point. It has the power to assist with getting the right help from your medical insurance and legally protect you in your workplace. It is also used as scale to determine what medications to prescribe. This makes the diagnosis, in my opinion, a cog in the wheel of moving through the current mental health medical system. A diagnosis helps get the assistance to do the work.
PTSD is an umbrella diagnosis indicating unresolved trauma(s) that have a negative impact on functioning in one's life. That is my own simple understanding and definition for PTSD which is anything but simple.
While it is complex and varies with each individual there are some common elements besides the trauma(s).

One's need for control of what is happening in regards to self, trust and validation are three that come to mind immediately.

You not only should, but need to have control of your treatment. The words "trust the process" without first trusting the individual is not my understanding of how the "process" should work. When you get feedback and it makes you feel "wrong", your thoughts and feelings are not being validated.

Make the time to research and educate yourself. Read books and other sources of information that strikes a chord inside you. Read, take notes and journal. Develop grounding skills and backup plans that work for you in case you hit a nerve and trigger yourself during the process.
IMHO, these are the things you should be discussing with your T.

If anything I wrote here does not feel as if it applies to you, please disregard it :)

I appreciate the question and the opportunity to write my thoughts.

I have to go now so I can make some calls and start my search for a new therapist who "fits" me.


Best wishes on your journey,

Alice

 

[Crow]

Is this person trauma trained? I work with a person centered therapist.....she uses whatever modality is helpful at the moment and we've never had a set course - just let it work organically. But better damn believe if I ask her a specific question about her work, why we're doing something, or whatever, she gives a concrete almost clinical answer. Ptsd f*cks with trust. Telling a client to trust the process is like having killer clowns in a bedroom waiting for a person to wake up from a nightmare about killer clowns. (I don't like clowns obviously :) )

 

[JEKBreatheandBelieve]

Ptsd f*cks with trust. Telling a client to trust the process is like having killer clowns in a bedroom waiting for a person to wake up from a nightmare about killer clowns. (I don't like clowns obviously :) )

Although this is a completely true statement and sums the trust issue of PTSD up, it had me laughing because of it seeming so perfect of a description.

 

[JackRJN]

Where I live a therapist has a couple of sessions for intake, and then he has to come up with a diagnosis and a treatment plan, which I would ask for if I were you. And if you're aaking this question here you're obviously not trusting the process, so I would discuss that with your therapist. Therapy is not some sort of magic that depends on the client not knowing what's going on.

 

[AlmostFellForIt]

Thank you to everyone who has replied, it has been eye opening, I didn't even know about the Rogerian /person centred style.

This sounds alot like the style my therapist uses. In your opinion, if this is his style, should he have made me aware of this? I just feel like we talk and do nothing, however if this is the reason it may make more sense.

 

[Kintsugi]

I continue to feel like your T should have answered you like an adult no matter what the process he uses is, but that's sort of who I am as a patient. I place a lot of value in being informed and spoken to as a capable adult who can understand therapeutic methods.

My T lists all of the styles she uses on her website, but she has also been happy to expound on those methods for me in person. :)