How far to push yourself in therapy

[Freddyt]

What’s more important to you, in a therapist?
- Someone who respects your no?
- Someone who calls you on your BS?

I got a unicorn....

I don't know that I push myself for more than answers. Those are the hard things to find. We know the what - just not the why its stuck in the now still.

 

[Friday]

Someone who can balance the two. Someone who sees and understands me enough to know when no means no and when no means please come at it from a different angle. Seems to me if a trauma therapist can’t do this then they aren’t in the right business.

Personality & trauma types reeeeally divide trauma therapists.

Not only is PTSD so 180degrees of “different” from each other, but the dozens of disorders & conditions resulting/exacerbated by trauma, & the hundreds of disorders/conditions effected by trauma… means it’s a reeeeally niche specialty. As therapists are people, too. And get on with / don’t relate at all with… niche things.

 

[Sideways]

Someone who sees and understands me enough to know when no means no and when no means please come at it from a different angle.

This comment really struck me.

My experience with both trauma therapists, and more generally therapists, is that No is a complete sentence. While they might be curious about why the answer is No, that’s as far as they go.

With complex trauma in particular, that is very often critical to making progress. Partly, that’s because of how essential it is for the patient to trust the T - and at a very fundamental level, that means No must be respected. The onus is on the patient to take responsibility for the fact that they said No, because the therapist is modelling a healthy relationship, where No means No. If they start mind-reading, or ignoring, when they hear ‘No’, that falls apart, trust gets lost, and the patient is being controlled rather than respected.

In addition, it’s also because psychodynamic therapy, and trauma-informed therapy, both begin from the premise that the patient needs to set the pace, and make their own choices about what is covered, when and how fast.

That can make the recovery process a shiteload longer. But fundamental to giving the patient back their agency, and retaining a sense of control in the space. Both those things circle back to relearning how to trust.

So…it isn’t necessarily the case that Ts need to understand the nuances of different types of ‘No’ that they hear from their patient. It may be the case that the patient could be exploring more effective communication skills, practice moving in grey spaces rather than the black/white of yes/no, or taking more responsibility for their own part in the recovery process (or, conversely, learning that they are the one in control, rather than relying on their T to exercise that control, and learning to normalise that, in place of the dynamics of an abusive relationship).

That all applies to psychotherapies with trauma. It doesn’t apply to many other forms of therapy, such as CBT, DBT or ACT.

Therapy for someone with complex trauma is often a very slow process. But allowing the patient to become comfortable with exercising control over the process, experience a relationship where they have agency rather than being abused/controlled, is very often fundamental to the long term success of the therapy. If therapy isn’t ‘moving quickly’, that’s okay. Learning how to normalise a non-abusive relationship, how to trust, how to navigate relationships when they aren’t abusive, is a core part of recovery.

There’s often no point in moving fast, because those core parts of recovery typically can’t be achieved unless the patient is the one in control. Often, the patient learning that, in a healthy relationship, No will be respected, is often way more important than continuing to probe whatever issue the particular conversation is about, because of all the different critical elements attached to the therapist respecting the fact that the patient has said No.

 

[deno]

That’s a really solid breakdown of the complexity of trauma therapy. It’s true—when dealing with trauma, the process isn’t just about unpacking events; it’s about reshaping how a person relates to control, agency, and trust.

I think that’s why finding the right therapist is so hard. There’s a fine line between respecting boundaries and gently challenging the walls we’ve built. And not every therapist knows how to walk that line well. Some lean too far into “No means No” without helping a person understand why they’re saying No. Others push too hard and end up feeling more like another force of control rather than a guide toward self-trust.

For people with complex trauma, therapy isn’t just about “talking through the hard stuff.” It’s about learning how to exist in a space where they have control over their own healing, often for the first time. And yeah, that can make things move slower than some people expect. But in the long run, building that trust in yourself—that you can say No, that you can set the pace, that you can decide what’s too much—is sometimes more important than the specific trauma details being discussed.

It’s frustrating, though. Because it means not every therapist is the right fit. And finding the right one can take forever. But when you do? That’s when the real work and the real healing begins.

 

[Charbella]

This comment really struck me.

My experience with both trauma therapists, and more generally therapists, is that No is a complete sentence. While they might be curious about why the answer is No, that’s as far as they go.

With complex trauma in particular, that is very often critical to making progress. Partly, that’s because of how essential it is for the patient to trust the T - and at a very fundamental level, that means No must be respected. The onus is on the patient to take responsibility for the fact that they said No, because the therapist is modelling a healthy relationship, where No means No. If they start mind-reading, or ignoring, when they hear ‘No’, that falls apart, trust gets lost, and the patient is being controlled rather than respected.

In addition, it’s also because psychodynamic therapy, and trauma-informed therapy, both begin from the premise that the patient needs to set the pace, and make their own choices about what is covered, when and how fast.

That can make the recovery process a shiteload longer. But fundamental to giving the patient back their agency, and retaining a sense of control in the space. Both those things circle back to relearning how to trust.

So…it isn’t necessarily the case that Ts need to understand the nuances of different types of ‘No’ that they hear from their patient. It may be the case that the patient could be exploring more effective communication skills, practice moving in grey spaces rather than the black/white of yes/no, or taking more responsibility for their own part in the recovery process (or, conversely, learning that they are the one in control, rather than relying on their T to exercise that control, and learning to normalise that, in place of the dynamics of an abusive relationship).

That all applies to psychotherapies with trauma. It doesn’t apply to many other forms of therapy, such as CBT, DBT or ACT.

Therapy for someone with complex trauma is often a very slow process. But allowing the patient to become comfortable with exercising control over the process, experience a relationship where they have agency rather than being abused/controlled, is very often fundamental to the long term success of the therapy. If therapy isn’t ‘moving quickly’, that’s okay. Learning how to normalise a non-abusive relationship, how to trust, how to navigate relationships when they aren’t abusive, is a core part of recovery.

There’s often no point in moving fast, because those core parts of recovery typically can’t be achieved unless the patient is the one in control. Often, the patient learning that, in a healthy relationship, No will be respected, is often way more important than continuing to probe whatever issue the particular conversation is about, because of all the different critical elements attached to the therapist respecting the fact that the patient has said No.

I guess I mean I want a T who knows that no doesn’t mean forever and I want it brought back up but that’s a careful balance because I agree no needs to mean no which is why I said from a different angle. I didn’t mean to imply at that moment, that would be a lot like the abusers who are trying to get you to do the thing they want. But most of us are pretty closed off to the hard stuff because it is so hard, if my T allowed me to always avoid the hard stuff there’d be no point in therapy for me. So I do want someone who will gently push me to try something I’m not going to want to always do. I also want someone who is going to respect no so I know that I can say no even if he does think it’s important.

 

[anthony]

it's not like any of this is ever going to be easy to talk about, so what am I even doing with it all

Well... you just sack up and do it. Once you get past the fear and do something, you will realise just how irrational your fear was to begin with.