How to resolve issue of communication with a therapist

littleoc

Sponsor
I really like my therapist. She’s perfect for me right now because her area of expertise is in gender and sexuality, two things that have been much more on my mind recently than previously.

However, she always tackles each problem exactly the same way. If I bring up an issue, she’ll begin by asking me to list out all my negative, self defeating thoughts. Then she’ll have us write down how they make me feel. Then, we challenge those thoughts and try to see if my anxiety or helplessness or whatever else has lessened.

It feels... worse? while in quarantine. She’s very supportive. But there have been some issues. Times when I’ve assumed she was telling me secret messages about my behavior being wrong, which led to a dangerous interaction — totally my fault, but if therapy over the dangerous person hadn’t taken that turn, I would have cut them off instead of assuming that wasn’t allowed because the other person happened to be another patient of hers. (She didn’t tell me that, she literally had nothing to do with what happened besides me misinterpreting something, don’t worry.)

She just does this same therapy tactic over and over, especially if she seems in a loss for what to say, which might be in my head, for all I know. But, sometimes I’d like some validation. Or just to vent? But I understand this isn’t “real” therapy? That this is something I should be using friends for, so I need to work past my inability to discuss negative personal matters with friends.

Maybe it’s because it feels like she’s asking me to be over certain issues in a forty-minute window?

For example, I discussed with her frustration about not being able to do work on my computer because of anxiety, TBI, EFD, etc — doesn’t matter fully whats behind this for this post. She asked me to list all my negative thoughts keeping me from working. Which was helpful to an extent. It didn’t fix my issues, though.

This seems to be mainly an issue with me. I am not communicating. She is a good therapist. I’m aware neither of us are “at fault” for this issue. It’s not black and white. So how do I breach it?

Apologies if this post is unclear. I have a massive headache and haven’t slept yet. If you’ve had this problem, how did you resolve it?

Thank you :)
 

scout86

MyPTSD Pro
Maybe it’s because it feels like she’s asking me to be over certain issues in a forty-minute window?
Would it be worth mentioning that to her? That's probably NOT what she's asking, but I can see you it would feel that way. It might be worth asking her to clarify what her point is.
Which was helpful to an extent. It didn’t fix my issues, though.
Do you have an idea what WOULD fix your issues? That might be worth talking about too.
 

littleoc

Sponsor
Do you have an idea what WOULD fix your issues? That might be worth talking about too.
Only vaguely. I feel that instead of trying to discover what was causing the issues, she immediately asked me what negative thoughts I had, which I think has gotten in my way. I think I could try to figure this out on my own, and then get back to her. But then I end up asking myself why I need a therapist if I could just do that, and that... doesn’t seem right?

You’re right, I should mention the first thing you said with her. I feel incredibly uncomfortable doing so. I suppose I need to get over that, but that’ll take some work.

I can’t quite tell if I’m being too hard on myself, putting too much into what I need to do, or if I’m being too passive, or what. And I feel I can’t talk to any therapist about this, due to previous problems. Past therapist, my parents, teachers, just all in the past either expected me to never ask for help, which has made it very difficult to communicate now because I feel I should just be doing everything myself; or I worry I’m going to get taken advantage of.

It makes it hard to communicate. But I understand at the same time that not communicating with a therapist will hold me back from learning to communicate. And yet I can’t picture what I need or how to have a therapist help if I could work through something myself? It’s frustrating.

I think I’ve made the issue in this post more muddled. It’s really hard to concentrate on what the issues are surrounding the communication problem. I really appreciate your feedback though, thank you.
 

grit

MyPTSD Pro
Hey Littledoc,
Actually your two posts make real sense and are very clear AND NORMAL.

IMHO, therapy is precisely what you are doing thinking about what the other person says, feels, wants/needs and WHAT YOU want, need, feel and say.

It is a relationship. It is like mini ecosystem of relationships so you can learn who you are in relationships and where are the gaps. So you cannot do wrong therapy especially when you like the therapist. Every feeling is worthy and normal just like life.

You said something about if I can fix it why do I need therapist? That is great way to explore you vs others. It is not different than saying well I am so happy in everything in my life why do I need my husband for? because we do. Therapy is a relationship that may end someday but so any other relationships divorce, termination or death...so exactly the same.

Since you asked for help, imho, I think you are hard on yourself and you are passive both. Which is not a bad thing but I think you are on the verge of maybe (and I could be wrong) having or wanting to challenge your therapist...your little autonomous side is getting strong (hence saying why do I need therapist)...you are gaining some strength in places maybe you were weak before and you want to challenge her but for some reason (again I hope I am not spilling my things here), you are afraid she may not like you if you challenge her and say...let us try something different than the way we always work together. And you are not alone to feel this way.

My therapist said one time, I hide well (hide my trauma that is). I said I think that is judgement and went silent. I am not angry about it as she is a human and obviously something spilled there but my standing up and challenging without taking it too personal - even though it is personal but it showed me her more than me.

You like your therapist. You trust her. You are the only the other person in the room to say I respect you for this but I have different idea or way of doing this and do you want to see? A good therapist, would jump for a joy cause that means her work is working and you are flexing some muscles of yourself that were weak before - standing up to a trusted person and it is OK!

Not sure if this gives you some feedback...but there it is.
 

Freida

Sponsor
You’re right, I should mention the first thing you said with her. I feel incredibly uncomfortable doing so. I suppose I need to get over that, but that’ll take some work.
This ^^^ I have a hard time with this too - but found out pretty quickly that if I tell her what I'm thinking she can easily make changes to her process. As she said -- I can't fix something if I don't know it's not working for you. so ya - it's ok to tell her. It won't upset her or insult her. It tells her you want to be an active part of your therapy.
 

scout86

MyPTSD Pro
I think I’ve made the issue in this post more muddled.
I'm not sure that you have. I think, maybe, it's just that this particular issue is big, complicated, and muddled. Which means it's also probably important.

I don't think you're SUPPOSED to have this all figured out right now. That's part of what the therapy is about and part of why a therapist can be helpful. I can really relate to your situation. What has worked with my T is throwing something out there that's in the general direction of what I'm trying to say. Something that at least gives him a heads up that there's an issue and a clue about where to look. It ends up being a process of successive approximation, where the conversation gradually gets closer and closer to where it needs to go. Seems kind of inefficient, but if I had it all figured out, I probably really WOULDN'T need a T. I guess one of the most valuable things I'm learning through all this is that sometimes, communication, even if it's messy, can also be safe and helpful.
 

whiteraven

MyPTSD Pro
But, sometimes I’d like some validation. Or just to vent? But I understand this isn’t “real” therapy? That this is something I should be using friends for, so I need to work past my inability to discuss negative personal matters with friends.

Hm...if this is true, I've been wasting a ton of time and money on therapy.

How can it not be "real" therapy? And what does that mean? I don't have friends (seriously), so if I didn't vent (and, incidentally, get feedback on how I'm managing those things I have to vent about) in therapy, I'd have to keep it all in and to myself.

The friends I've had in the past would never have tolerated the degree of negativity I hold. Occasional venting, of course, but not to the depth that I needed. If you need to vent, there are things that bother you and that is something you can/should talk about in therapy.

I think I know what you mean. You are talking about accepted therapies - like CBT, DBT, etc...? I don't see any reason you can't mix the accepted therapies with whatever else you need.
 

Allie D.

MyPTSD Pro
@littleoc, I don't know if you tried this already but maybe you could tell your therapist that you'd like to change things up since you've been in quarantine. You can always go back to whatever old way. But it does sound like you're progressing, at least in fits and starts. You sound pretty positive despite hardships.
.if this is true, I've been wasting a ton of time and money on therapy.

How can it not be "real" therapy? And what does that mean? I don't have friends (seriously), so if I didn't vent (and, incidentally, get feedback on how I'm managing those things I have to vent about) in therapy, I'd have to keep it all in and to myself.
Thank you for this. That not everyone has that, because that is exactly what was running through my mind when I read the OP. and I'm finding it very painful right now. The idea of having a "paid friend" sounds awful to me but maybe it's not so bad.
Amongst disaster, teletherapy is covered for me, now means I can take the luxury of having 2 people to talk to each week. And leave alone everyone else who is busy taking care of others.

A plain old vent session might do a person good even in the most careful behavioral therapy. That's what I'm thinking now. Supportive plain talk therapy, and then I hope to go back to a little more ptsd/trauma work and only slowly.

The friends I've had in the past would never have tolerated the degree of negativity I hold. Occasional venting, of course, but not to the depth that I needed. If you. need to vent, there are things that bother you and that is something you can/should talk about in therapy.

I personally need this kind of support to make my daily life bearable and I think a lot of people feel the same way. There are things I wouldn't want to put on a friend even if I had one to listen. My 'best friend from college,' I haven't spoken to in years. She's a physician and I know she has a toddler and lives and works in Manhattan and I'm terrified to even reach out but when I do gather the courage I won't slam her with all the stuff I've accumulated over this time! I am not THAT far from the city but I might as well be on the moon. I'm an introvert but I haven't left the house since February and it is taking its toll like on everyone else, even though I'm borderline agoraphobic and logically should be very happy to stay home. But I'm not.!

Anyway. I guess the point is, some of us need a variety of therapies and no one therapy should be above another. If venting makes you feel better, then a therapist is a very good person to vent to.
Forgive me if I've derailed the thread. I'm out of practice/
 

littleoc

Sponsor
Yeah, you are right about the venting. Come to think of it, a lot that I want to vent about are things that I wouldn't ever be comfortable venting about with a friend, no matter how close... or maybe I just really want a professional opinion on that's an unbiased third party.

(Don't worry, @Allie D., you haven't derailed anything)
 

Harmonics

Learning
I really like my therapist. She’s perfect for me right now because her area of expertise is in gender and sexuality, two things that have been much more on my mind recently than previously.

She just does this same therapy tactic over and over, especially if she seems in a loss for what to say, which might be in my head, for all I know. But, sometimes I’d like some validation. Or just to vent? But I understand this isn’t “real” therapy? That this is something I should be using friends for, so I need to work past my inability to discuss negative personal matters with friends.

For example, I discussed with her frustration about not being able to do work on my computer because of anxiety, TBI, EFD, etc — doesn’t matter fully whats behind this for this post. She asked me to list all my negative thoughts keeping me from working. Which was helpful to an extent. It didn’t fix my issues, though.

Thank you :)
It sounds like your therapist may be using one treatment theory to treat everything you bring to therapy. When you started with this therapist, did she explain her training and what her preferred treatment modalities are? If not, you can always ask. Your therapist should be comfortable sharing what she is doing and what methods she is trained and competent in using with clients.

Some therapists are drawn to manualized therapy where they respond in the same way to everything a client brings in. In many ways, it is easier for the therapist because they don't have to think abstractly to understand what they client is trying to communicate beyond their words. While some clients like this type of therapy, it doesn't tend to work as well in long-term therapy or with clients who have complex trauma issues that stem from childhood.

Interestingly enough, in one of my classes right now, there is a PhD psychologist who is learning psychodynamic theory because after years of strictly doing CBT, he realized there were many things he could not help his clients with. So, he is getting additional training to enable him to do a different type of work with his clients. Sometimes when therapists find out that what they are doing is not meeting the needs of their clients, they are motivated to learn additional treatment modalities. That's yet another reason to have an open conversation about what you are feeling. It could help you and other future clients.
 

littleoc

Sponsor
That's helpful, thank you. When we're in person again maybe I'll be able to. I've been having some problems with fearing being overheard through these video calls.
 
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