Deference to Authority and Therapists

[RainbowSearchParty]

Just curious to hear a read on this situation:

I just had a phone call with a potential therapist. It was broached to me as a consultation. I prepared a list of questions ahead of time, really basic stuff like "what is your working style" and "what modalities do you use" and "do you have experience working with clients who experience dissociation". Stuff that I always would want to ask someone and stuff I feel like I need to know before paying massive amounts of money to someone for a course of treatment that might not work.

She called me late -- just a couple minutes after our scheduled time, but still. Didn't introduce herself beyond her name and then launched into trying to get a full history from me. I interrupted to tell her that I had some questions, and wanted to learn a little more about her style before getting into the weeds of my own history. She answered my questions with one-word answers and literally could not carry on a conversation; I felt myself putting on my professional hat and trying to help her get through the questions. Then she launched into a tirade about how I was interrogating her and she couldn't work with me because I was too aggressive.

I was stunned. And offended -- I wasn't (at least to my standards) being aggressive in the least. And for her to make that judgment based on seven minutes of a phone conversation felt ... stunning. Judgmental. Self-centered on her part.

I posted about a similar experience a few months ago. I'm starting to realize that it might just be a fundamental cultural difference where, in the culture I'm in, therapists expect deference to their authority and for no demands to be made (because they are in charge and the expert). But I have trouble with that, both as an American used to a flatter hierarchy and more customer-service based model of therapy, and as a trauma survivor. To just defer, to make myself small, to not have needs .... that feels like it just repeats the original trauma where I had no voice.

Curious how it works for you all and how you feel about deference to authority/treating treatment as true collaboration that positions the client as an expert on themselves. I'm trying to sort out what is fundamental values for me versus cultural differences (and if I can ever bridge that gap).

 

[Midnightmoon]

Sounds, well, not very therapeutic to say the least.

Wondering out loud if the modalities these Ts are using has anything to do with it? As well as and on top of the cultural differences? You know I've had my fair share of assessments are there is a very clear difference to me from the Ts that are analytical or psychodynamic to the Ts that are CBT to then those that are relational, developmental or somatic.

Ts that are analytically registered here in my experience position themselves as the expert, you are a patient and they are there to treat you. The ones more humanistic leaning seem to be more about partnerships and working alongside rather than in front of you, if that makes any sense.

 

[arfie]

I'm trying to sort out what is fundamental values for me versus cultural differences (and if I can ever bridge that gap).

i was raised, "gypsy" in the good ol' us of a. the first cultural diff i tried to sort was, "townie versus roadie." by the time my road life made it to other continents/languages/cultures, i had to trash the cultural sorting and start keeping ^it^ strictly personal. if cultures CAN heal, the healing happens one citizen at a time. whatever the sociological debates, i attend psychotherapy for my strictly personal healing and every case is unique. insert tolstoy quote here. "All happy families are alike; each unhappy family is unhappy in its own way." ditto for the individuals which make up a family.

as a trauma survivor. To just defer, to make myself small, to not have needs .... that feels like it just repeats the original trauma where I had no voice.

this is where my psychotherapy focus moved to after i stopped looking for academic explanations. all personal power was stolen from me over the course of the traumas which led to my need for psychotherapy. the authority issues which had me over-critical of the therapists were about regaining my personal power. at least. . . that's my theory and i'm sticking to it until a better theory comes along.

 

[Calmdown]

I had similiar experiences. I don't think it has anything to do with culture but with bad therapists, and there are plenty. I didn't want to talk about trauma related stuff in detail on the first phone call (which here is just to make an appointment mostly) and the therapist berated me how therapy is supposed to work if I don't talk, it was ridiculous and condescending. Had another expierence like that a second time. This just shows that they don't understand people affected by trauma.
I wish you luck to find the right therapist for you, there are good ones but you need to filter out the bad ones.

 

[PamelaS]

I had similiar experiences. I don't think it has anything to do with culture but with bad therapists, and there are plenty. I didn't want to talk about trauma related stuff in detail on the first phone call (which here is just to make an appointment mostly) and the therapist berated me how therapy is supposed to work if I don't talk, it was ridiculous and condescending. Had another expierence like that a second time. This just shows that they don't understand people affected by trauma.
I wish you luck to find the right therapist for you, there are good ones but you need to filter out the bad ones.

I agree. It depends on the person/personality of the therapist as well as on their training. I was in a facility that did not even have PTSD listed as a possible diagnosis. I will never allow that to happen to me again. I fired my last therapist. I have been without a therapist for over a year because I couldn’t trust anyone. Yesterday I had my first appointment with my new “trauma informed therapist” and it was a perfect fit! Wondering if there might be an international way to find a therapist who would be a good fit for you, since the culture where you are might not work. Sorry for your struggle. Glad that you had the ability to sort it out and not just get sucked up into their method of treatment. Some therapists create more problems than you already have. Some are simply not effective. And some are patient centered, collaborative and lead to healing rather than just treatment. Hoping that you are able to find a therapist who is a good fit for you and who leads you to healing.

 

[Friday]

Curious how it works for you all and how you feel about deference to authority/treating treatment as true collaboration that positions the client as an expert on themselves. I'm trying to sort out what is fundamental values for me versus cultural differences (and if I can ever bridge that gap)

I have a degree in psych. There is ZERO deference for anyone who has chosen a career of it.

I cannot fix a car for shite. There is also ZERO deference. Curiosity, sure. Waiting to see what they can do (or not). But I’m not bowing before the car-lords. What they do is sacrosanct, or some other BS? I should simply submit to their wisdom? Simply because I don’t grok it? f*ck off. Either they’re good, and honest, or not.

Either someone knows what the hell they’re doing, and is good at their job, or they don’t.

Why the f*ck the faaaawn?

You’re interviewing someone to do a job.

You will have shit candidates who apply for it. As well as good/interesting candidates. It is still YOU that are potentially hiring them. If you don’t get on? Kick them to the curb.

 

[PamelaS]

I have a degree in psych. There is ZERO deference for anyone who has chosen a career of it.

I cannot fix a car for shite. There is also ZERO deference. Curiosity, sure. Waiting to see what they can do (or not). But I’m not bowing before the car-lords. What they do is sacrosanct, or some other BS? I should simply submit to their wisdom? Simply because I don’t grok it? f*ck off. Either they’re good, and honest, or not.

Either someone knows what the hell they’re doing, and is good at their job, or they don’t.

Why the f*ck the faaaawn?

You’re interviewing someone to do a job.

You will have shit candidates who apply for it. As well as good/interesting candidates. It is still YOU that are potentially hiring them. If you don’t get on? Kick them to the curb.

I agree with Friday 100%. We do not have to take it. Even if the system is broken, we do not have to submit to it. It is our body and it is our mind that is broken. We are the only ones who know how it got that way. Those professionals who come alongside us, are there to help us not to harm us. It’s our job to decide whether a professional is hurting us or helping us to heal. And it is our responsibility to fire those people and seek out the ones who will come alongside us and support us in moving forward towards healing instead of backwards with more and more trauma. I learned something about the kangaroo. Kangaroos have a big old tail behind them. Because of that big old tail, they cannot move backwards. So let’s all be like kangaroos. Let’s encourage one another to always move forward. Not get stuck in the muck. Not moving backwards into more and more trauma. But moving forward toward healing and a better life. I love you all. I am so extremely thankful that this forum came to me. I don’t even remember how I got connected with it. But it has been a tremendous help for me. And I completely respect every single one of you here. Thank you for coming alongside me in my healing journey. Thank you for sharing. Thank you for caring. Take good care of yourselves. We are the only ones who can do that. Those professionals are there to help us, but they cannot heal us. We are the ones who have to do the work it takes to get to our healing. Be careful who you choose to come alongside you. Don’t be afraid to fire them if they bring more harm. We are in charge. Not them. Have a good night. See you all tomorrow.

 

[RainbowSearchParty]

Ts that are analytically registered here in my experience position themselves as the expert, you are a patient and they are there to treat you. The ones more humanistic leaning seem to be more about partnerships and working alongside rather than in front of you, if that makes any sense.

This does make sense. I couldn't really really tell what her approach was, and that was part of what I wanted to ask. But I couldn't find out ....

Why the f*ck the faaaawn?

You’re interviewing someone to do a job.

It's not a fawn. I am just trying to work out what I can handle, where I can accommodate and where I cannot. I'm just overwhelmed because I feel like my cultural values mean I can't actually access therapy in this country. In the US? Yes, an interview. But that doesn't work in this country, for better or for worse.

 

[Friday]

In the US? Yes, an interview.

When you’re paying someone $200-$750 an hour? (Or insurance $500-$2,000 per month, plus an added $20-$100 per hour) damn skippy!

I know Commonwealth countries, with universal healthcare, most people expect to pay nada. I’ve LIVED in universal healthcare nations, with nationality (I’m half Canadian, half American, and married an Italian, so I had US/CA duo citizenship, and then married into the EU for the no holds barred). And 92% of the time the wait in queue is less than I’d have to wait to save up to pay out of pocket. Because waiting a year for a 60k surgery, is a decade less than it would take for me to save up for it, even if I could have it tomorrow with badass insurance.

Logistics? Is a damn important thing.

What’s the free option?
What’s the partial pay option?
What’s the out of pocket option?

If the free option sucks? Time to look for other ways/means.

But just because it’s free? Doesn’t mean you don’t interview. Because pouring sugar in your gas tank doesn’t give your engine more power / a sweet ride. It blows your engine. INTERVIEW. Your mechanics, doctors, therapists, anyone/everyone you entrust… WITH ANYTHING that is important to you.

 

[sidptitala]

Curious how it works for you all and how you feel about deference to authority/treating treatment as true collaboration that positions the client as an expert on themselves. I'm trying to sort out what is fundamental values for me versus cultural differences (and if I can ever bridge that gap).

I feel you on this one.

I come from a culture that defers automatically to therapists or other authority figures regardless of modality. I've always seen it as a hangover from the colonial era and the scary years after it - everyone understands that people in authority can f*ck your life up and there is nothing you can do about it. That understanding permeates the whole society because it historically has been always true.

I hate this. I've been raised with that knowledge, but as a trauma survivor I can't stand it and it goes against my own personal values.

I have also lived elsewhere. Where as you say there is a more 'customer service' attitude towards professionals. And I hate that even more. Genuinely, the idea that 'you are here to serve me and I will fire you' makes me recoil with disgust. I think it's both very anti the culture I come from and anti my own values. I don't believe anyone is ever here to serve anyone else.

There are ways that I am not as deferential in my own country as I am expected to be, because I have lived elsewhere. But also, there is a core of communication and humility in my country of birth that I deeply admire.

Balancing those two things has been a real project. I think it's possible but it requires a lot of adaption from us.

I also sometimes have to accept that the standard of mental healthcare in my own country is not very good. That what's normal there is wildly bad in comparison to some other places- but that despite that I am not going to give up on myself. I'm determined to get something from what's available - which sometimes means accepting when you need a cast you may get a band-aid, but it's better than an open wound. There's something about not giving up and trying to adapt and help ourselves that I think is better than nothing.

I don't know if yours is similar, but in my context what is assertiveness in other places is read as aggression. So I know the rules of this and make sure that when I am looking for information, I follow them. It gives me a lot more leeway to find the information I need without seeming aggressive, and I don't see it as deference. (I also get this wrong a lot, because both living away and I don't personally value authority or deference). I don't know if this is helpful for you, but in my context it's like this:

In your situation of trying to make first contact with a therapist, I would let the therapist lead the conversation. The 'consultation' probably means they ask you the questions? And you explain your personal situation. They decide if they can help you - and whether to offer to. And then you decide whether you like the way the therapist is talking to you and about your situation- do you feel understood or respected? If yes, agree a time. If no, say you will get back to them later and then never do that.

This takes way way longer than the other way. But when that's the norm - even therapists who hate authority and deference (and there will be some) are going to operate this way. And they'll perceive the directness you're describing as you trying to assert authority over them.

As I'm writing this I realise that I'm describing a cultural norm of appearing deferential - it's not actually deferring, just looking like you are.

 

[deno]

I’ve learned the hard way that the right therapist can be life-changing, but the wrong one can make things worse...sometimes much worse. I used to think that any therapy was better than none, but that’s not true. Some therapists—whether due to arrogance, incompetence, or an unwillingness to truly listen...can actually retraumatize a person instead of helping them heal.

For me, the biggest shift came when I stopped seeing therapy as a place where I had to defer to an ‘expert’ and started seeing it as a collaboration. I’m the one who has lived my life. I’m the one who understands my story. A therapist’s role is to help me navigate it—not rewrite it for me, not dismiss it, and certainly not demand blind obedience.

There are great therapists out there, but finding the right one takes work, and sometimes, trial and error. The important thing is to remember that you have the right to walk away from anyone who makes you feel unheard, minimized, or judged.

 

[PamelaS]

I feel you on this one.

I come from a culture that defers automatically to therapists or other authority figures regardless of modality. I've always seen it as a hangover from the colonial era and the scary years after it - everyone understands that people in authority can f*ck your life up and there is nothing you can do about it. That understanding permeates the whole society because it historically has been always true.

I hate this. I've been raised with that knowledge, but as a trauma survivor I can't stand it and it goes against my own personal values.

I have also lived elsewhere. Where as you say there is a more 'customer service' attitude towards professionals. And I hate that even more. Genuinely, the idea that 'you are here to serve me and I will fire you' makes me recoil with disgust. I think it's both very anti the culture I come from and anti my own values. I don't believe anyone is ever here to serve anyone else.

There are ways that I am not as deferential in my own country as I am expected to be, because I have lived elsewhere. But also, there is a core of communication and humility in my country of birth that I deeply admire.

Balancing those two things has been a real project. I think it's possible but it requires a lot of adaption from us.

I also sometimes have to accept that the standard of mental healthcare in my own country is not very good. That what's normal there is wildly bad in comparison to some other places- but that despite that I am not going to give up on myself. I'm determined to get something from what's available - which sometimes means accepting when you need a cast you may get a band-aid, but it's better than an open wound. There's something about not giving up and trying to adapt and help ourselves that I think is better than nothing.

I don't know if yours is similar, but in my context what is assertiveness in other places is read as aggression. So I know the rules of this and make sure that when I am looking for information, I follow them. It gives me a lot more leeway to find the information I need without seeming aggressive, and I don't see it as deference. (I also get this wrong a lot, because both living away and I don't personally value authority or deference). I don't know if this is helpful for you, but in my context it's like this:

In your situation of trying to make first contact with a therapist, I would let the therapist lead the conversation. The 'consultation' probably means they ask you the questions? And you explain your personal situation. They decide if they can help you - and whether to offer to. And then you decide whether you like the way the therapist is talking to you and about your situation- do you feel understood or respected? If yes, agree a time. If no, say you will get back to them later and then never do that.

This takes way way longer than the other way. But when that's the norm - even therapists who hate authority and deference (and there will be some) are going to operate this way. And they'll perceive the directness you're describing as you trying to assert authority over them.

As I'm writing this I realise that I'm describing a cultural norm of appearing deferential - it's not actually deferring, just looking like you are.

I would like to apologize if my comments have appeared aggressive. I have been abused by my last therapist and in a facility. And that’s on top of 21 years of my current husband’s abuse that ended me up in the facility in the first place. I don’t have a very good attitude about it right now. But it is what it is. We’re all a work in progress, right?
I am absolutely ecstatic that I have now been matched up with a trauma informed therapist whom I align with completely, and can trust. I am looking forward to finally starting to work on my healing rather than continue to build more and more trauma on top of what I already had .