Not picking up on empathy in therapy

[Ronin]

Soo... how & where do you look for a therapist that *gets* you are *both* profoundly insightful & challenged in other ways, and turns the insight into something worked with practically to lessen pain?

Bc I doubt that is a combination that just cannot be found. These people can be found. Just were not YET.

Also maybe switch from communicating generics of issues to concretes posing problem.

Like, I'll take my Cannot self care with injuries / talk it part as an example - it's not really true I wholely can't with informing others what's up. Crack a joke or five my way, ask me if I can answer at all, ask me if it's as pooch screw and fun as X year action, tell me what to do in a way that sounds as just f*cking around ((... Okay Ro but you got to clean it up first and not skip that one. Or I'll have to do an amputation when you get all gangrenous. What, :eek:, you don't like that thought? Told ya mate, just simple correct order of actions now :D))... and I catch up fine.

Helplessness & childhood messing in & inability to brain moving aside, back to Bitch please, but I know this & got this.

But people need to know that bit, to not start questioning me ad nausea or demanding who caused that injury or any other stupid BS that true, is normal etiology, but no, doesn't work with how I learn anything and shuts me down deeper.

//

So what are your catches & turn arounds to I got this :smug: when it comes to therapy?

What makes therapist invasive / violating vs supportive?

As a fine line it may be, it can be balanced out.

 

[Kintsugi]

Therapists frankly seem enamored at first with all my "insight" and ability to communicate - they praise it - that I think they overlook the "THIS IS A REAL THING." It's like a learning disabled kid who is super bright too. (Which I also have personal experience with on a cognitive level.) Those kids have the hardest time getting real help for the disability. They are told try harder much longer than the kid who is globally disabled.

Man, I feel this so hard, JMH. I really do. It’s why it took me around three long years to find a T I even considered qualified to meet my needs. Well, it was an amalgamation ofc (religious based? No. Warm and fuzzy profile/bio? F*ck no. Education short of a doctorate? Probably no.), but one thing I was super sick of was all the praise for how “verbal” I am (geewhodathunkthat given my background, not to mention yours, you composition rockstar you :inlove:) and h-

(Prematurely posted—whoops)
Eta

How many coping skills I had in my toolbox and how accomplished I was and and and

I don’t wanna pay someone to pat me on the f*cking head because well golly I’m seeking therapy to get better and, y’know, not kill myself, so how’s about we work on me improving instead of talking up what I already worked tooth and nail to achieve on this shitastic journey?

Okay, I know, I’m talking about me here and maybe projecting overmuch...

I just, I think I get what you’re getting at.

But for clarification, can you give me some exposition re: the pattern you see yourself stuck in and expound on what exactly these Ts are surprised by? Because I’m trying to see this clearly through your eyes, as much as me projecting is great for angry rambling.

So like—one last “Hey I think I feel you here but this is all fairly tangential/digressive”

There’s a song by The Dresden Dolls, “Perfect Fit,” about this very issue, so here’s a short snippet you made me think of:

“I used to be the bright one/Smart as a whip/Funny how you slip so far/When teachers don’t keep track of it!”

 

[Friday]

Essentially, I think that's part of what is happening. I have some strengths therapists like, and yet those don't overcome the real battle they overlook as yes being THAT bad and that real. Then when they get it, they tell me it surprises them.

You might try looking for therapists who work with first responders.

For 2 reasons.

The first? They’re USED to their clients being super capable, and still needing help. As opposed to what seems like the majority of therapists I’ve interviewed who... we don’t need to go there. It’s gross -to me, personally- but it seems to be what many if not most people need/want out of therapy.

The second? They may not have experience dealing with victims of horrific crimes (although they also may; it depends on how closely they worked inside of a department. Many never set foot inside, many others spend a few years working with both law enforcement and victims)... but they will have heard about the horrific things people do to one another from the other side of the street (the cops and docs working with horrific crimes). So that first wall of disbelief you run into from therapists whose client base is suburbia? Despite all the actual evidence you’ve brought in for a few of the twats? Just won’t be there. <<< aIf you have a local FBI field office? I’d consider hitting them up for a referral, first. Local first responders often work big cases, but the FBI deal with big cases day in and day out. The therapists who work wih agents and their families are going to have a lot higher bar as their baseline.

Aaaaaaand circling back around ;) to 1.5) If you can’t find a therapist who specializes in first responders / disaster response/ NGO workers, etc.? Find one who specializes in vets. Same ethos of dealing with competence+problems. The FIELD is very different, even though combat is where I cut my teeth I’ve found NGO/First response therapists to be more... versatile? But the ethos, of “Yes. You’re capable. Now let’s sort the shit that’s f*cking you up.” is still the same.

 

[Justmehere]

The worst moment though with this whole issue? Sitting there completely confused and saying, "I do not understand." and "I do not know what you mean." or "I do not know what you want of me".... etc...
And then being told, "Yes you do" with forcefulness. Or being laughed at or etc to my saying I don't understand. Or being threatened with ending unless I do it or told to just do what I am doing. I'm not looking for someone to tell me what to do exactly, but this crap just is pointless.

I was that learning disabled kid beaten when I got the wrong answer. "You are smart enough to add this right. Do it again." I could do the calculus and screw up the addition. Therapy became a repeat. Not the same, but similar. Pastoral shit is the same. I do. not. get. it. I will be genuinely baffled and they will go off about the greek of my refusal of something I do not even understand. Of course then there is all the religious crap there added on top. Whole other thing...

It's not a learning disability in therapy but a straight up this-is-the-battle thing. I am an adult now and I won't do this whole thing as an adult. It was remarkable when I figured out the learning disability. Life changed. Dunno the equivalent of it for therapy. I have been able to get past it but it takes the therapists that can see capable plus mess at the same time. Both. And understand half of the "capable" is some way I am coping with the mess....

And now? I'm pissed, exhausted, walled up, at the end of myself, anxious, with a pile of bad experience under my belt.

but one thing I was super sick of was all the praise for how “verbal” I am (geewhodathunkthat given my background, not to mention yours, you composition rockstar you :inlove:) and h-

(Prematurely posted—whoops)
Eta

How many coping skills I had in my toolbox and how accomplished I was and and and

I don’t wanna pay someone to pat me on the f*cking head because well golly I’m seeking therapy to get better and, y’know, not kill myself, so how’s about we work on me improving instead of talking up what I already worked tooth and nail to achieve on this shitastic journey?

All this. Yes. Exactly. OMG if another therapist praises insight and capacity to understand while I sit there suicidal and telling them over and over things are not ok...

You might try looking for therapists who work with first responders.

This is a really good idea. I made some calls and did some digging... All the first responder therapists I have found are booked out unlike ever before because of the pandemic and the world burning down. BUT, I have leads to other therapists they suggested that might get it. :) The one good thing about the pandemic is that it is opening up many possibilities of therapists willing to see people with my insurance on telehealth. Options I have never had before.

Find one who specializes in vets. Same ethos of dealing with competence+problems. The FIELD is very different, even though combat is where I cut my teeth I’ve found NGO/First response therapists to be more... versatile? But the ethos, of “Yes. You’re capable. Now let’s sort the shit that’s f*cking you up.” is still the same.

Yeah, exactly.

It will be some time before I can darken the doorway of a therapist's office - or show up on the telehealth screen.

The whole empathy thing... even if they are, I'm super shut down to it. Why connect with it when it's about to come with a bunch of crap?

What hasn't worked:

One therapist was complimenting my insight and they would not let it go. Kept challenging me to see myself as an amazing client/person because I had all this insight. It was an annoying discussion where once again I was trying to convince someone I was struggling at all. I replied, "F*ck insight. I can describe how to swim in great detail, but still drown when I get into the water unless someone is with me coaching me how to learn to swim. I can describe the kinetic physics of riding a bike BUT actually learning how to sail down the street on two wheels are two VERY different things." This therapist would purposefully trigger me and then basically tell me to deal with it myself. "Go on, go regulate." Which like wtf. That's just life. And it would play out with two more after them in stunningly similar way. "Do whatever you do to cope." If that was working, why the f would I be in therapy? There was no anything... no teaching tools, nothing... Reporting, not processing, trauma happened and that's about it. The more I asked for actual therapy basics here, the more frustrated they got... next therapist... same... I found myself sitting through 20 minutes of praise and "everything is great with your recovery" while I was battling suicidal thoughts and telling her point blank I was in need of serious help and things are very not ok. I became so frustrated. I gave up. Too much trying to convince them I had a problem.

The best therapists:

1.) Two at an inpatient PTSD program (that wasn't the good part) that worked with "executives," active military, and also handled human trafficking victims, war refuges, veterans, etc. They could see capability, mess, and they also were pretty unshakable in any trauma I told them. (Many therapists, I even start to describe the trauma and it's like *gasp.* I don't even get to the bad stuff before I'm watching them go over the top with the "that's so horrible." I mean... come on that was breakfast. I didn't even get to the trauma...)

2.) A therapist's therapist. It didn't work out in the end because she projected her crap on to me but until that weird point, which I did notice before she noticed, it worked. It changed me. I could do the whole empathy thing with her and it helped with others. It just worked. She understood all the verbal insight the world didn't mean much if my life was burning down.

This really has been the thing with doctors and pastoral types too. I can go so far on the intellectual stuff, then it will hit some space where I just do not get it or am falling apart... and I'm realizing how many times I have said "I do not even know what you want me to do" to get a...
"oh yes you do."

They never said. It was just assumed. Because you are smart enough afterall... clearly...

But then if they get that I really don't get it, I really am struggling, it's always a surprise and by then I'm so broken by the process... I don't shake it off well. I get stuck.

It's now left me fairly walled up and pissed. Ultimately, it will be on me to try to walk in and not be ready to verbally torch the place at the get go or set up jovial intellectualized walls of safety 57 feet thick because I am so afraid of being humiliated, cut down, and generally stuck again. It's cheaper to do stuck on my own anyhow. Don't need to pay for it in therapy.

At least there are more possible options right now for whenever I'm ready.

 

[Kintsugi]

Find one who specializes in vets.

This is anecdotal, as I have a sample size of exactly one, but damn this is good advice from where I'm standing, because the best damn therapist I had (and I fear she will always be the best I'll ever find) worked full time at one of the supposedly top VAs in the country. She was tough as nails, had a PsyD, and when I said "I don't know what you want from me?" She gave me an answer I found frustrating at the time, but in retrospect, I think it was the only right answer? "I don't want anything from you. Why do you think I want something from you?"

Sigh... nostalgia... leaving her office calling her a f*cking bitch and simultaneously feeling so grateful that she was competent and not at all dazzled by my eloquence. Although admittedly she still called me "The most verbal person I have ever met in my life." :roflmao:

 

[mylunareclipse]

Maybe you are going for the wrong kind of therapy? Like the directive type. Once I had a therapist ask me to name five things I liked about myself and I begged her to stop and she wouldn’t. I quit the day after. It was making me too suicidal for her to push me like that.
For me the non directive type of therapy works beet, when I kind of bring up what’s on my mind and we explore my patterns ie more psychodynamic therapy.
Lastly, have you ever explored the world or parts in therapy? Ie something like janina fishers book on fragmented parts? It seems to me like you might have some form of fragmentation, parts of you that know and parts of you that don’t, and shifting rapidly between them makes things confusing. Starting to use part language, though it seems counterintuitive can help. Ie part of me understands what you are telling me, but part of me doesn’t know what going on etc. you might want to look for a therapist that understands this kind of dynamic so that they can hold the multiple views at once with you.

 

[Ronin]

Or, without really going into any more derealizing & unstomachable weirdness of parts (just remembering JMH had shitty experience there, every time I see her user name ;) ) -

JMH, do you know *what* concretely with empathy, or more like empathy gap and they not getting your suffering, is unstomachable?

Since you say there were patterns, in styles & expressions and across social interactions, triggery to multiple types of trauma.

Maybe if you'd nail down more what concretely is the set off that rolls badly everything else, you could communicate the need for them to avoid stepping on it.

Maybe they can put demands in a way that isn't pressure and benefits you / turns it more support, less demanding.

 

[Justmehere]

Did a consult of 20 minutes today. I was curious to see what happened if I explained I am high functioning and severely mentally ill - straight up like that. The therapist had good training, decent therapeutic tools, and had worked with a mental health center seeing severe cases... I worried she wouldn't be able to hold the high functioning space. But hey, it was a free consult with someone qualified.

For me, it's not the type of therapy. (I have tried almost every form of trauma work out there.) I would be ok with dealing with the trauma as something that happened in the past that may relate to now... but not to process the trauma itself. Not right now. Even then, my trauma often either shakes up the therapist or gets romanticized. YUCK. I can talk about it with safe friends and be fairly not triggered talking about it. It bothers me but doesn't undo me. It echoes in my life as to what does undo me. But going over it again and again and again with so many trauma therapies...

A therapist who wants to process it? I have a physical reaction to that. It stresses me out to even think of doing that. I do not see the therapist as empathetic when they suggest that. I get that they might be actually empathetic. I am fine enough with the trauma, but I am not fine with processing it to bits therapy right now. Today I said, "The world is on fire, my job is burning down, people I love are moving out to live on the street, I nearly died a few weeks ago from possible covid 19, my health was a mess before that, and on and on... I think 2020 is HARD ENOUGH right now to not go over and over past events that have been processed many times. I need to address the slightly traumatic happening right now. Today."

The therapist asked my goals, symptoms. I was very honest. Blunt. I did not mice words. I gave examples of clinical symptoms F*CKING up my life massively. I even told her I struggle with suicidal thoughts. She suggested that because I don't want to do EMDR or trauma processing for trauma processing sake, I should do life coaching. Not even bother with a clinical professional.

What?!?

NEXT. I can't even afford life coaching... nor would that even work... NO. I tried a professional who was like a life coach and it was a mess and I quit fast. I need a clinical approach to not drowning because of what is happening here and now. Not just 10 years ago.

I'm way too irritable to get far.

 

[mylunareclipse]

Wishing you luck. Keep looking! They exist. Like I said I have had therapists who were pushing me too much even on other occasions and made me suicidal but they thought it was their job to push me ?.
It must have been that like you said I seemed “fine”.
A non directive type of therapy gives you the wheel. You go with it where you wanna go with it. You wanna talk about day to day or past depending on the day you choose. These are best explored in psychodynamic or person centered or something like that.
Of course the transference is hard to heal with sometimes. But I believe these type of therapists would be best trained to handle any situations that might arise.

 

[joeylittle]

The therapist asked my goals, symptoms. I was very honest. Blunt. I did not mice words. I gave examples of clinical symptoms F*CKING up my life massively. I even told her I struggle with suicidal thoughts. She suggested that because I don't want to do EMDR or trauma processing for trauma processing sake, I should do life coaching. Not even bother with a clinical professional.

Well, here's the good news: it's excellent that you were completely clear, and she was completely honest. Now, I disagree with her belief that you can't work on contemporaneous shit without clearing out the trauma...that's a very narrow way to look at what a therapist can do. But if that's her view - it's great you know that now, rather than finding it out later.

And really - it sounds like you did a great job in that assessment of being clear and direct about what you wanted to work on. So while its disappointing that she's not going to meet your needs - I'd say the exchange is a major win, including the bit where she didn't try and trick you into trauma therapy.

You're not asking for something that's unreasonable. And sometimes, we need to go through a lot of shit to get to our own clarity about what we actually want. That's also not great, and you've definitely had (more than) your share of medical-professional-shit-wading. I'm sincerely hoping that you'll catch a break and connect with the right person. I think the law of averages is on your side.

 

[Justmehere]

The paid staff of religious orgs are the same thing in my brain. Put the religious issues aside, which I know are their own ball of mess, but they pose as helpers with authority. They are the LAST people I ever see as kind or caring. I am considering going to a class online at a place where the leadership seems very not leader-ish. So maybe I could handle it? I have two written messages. almost the same word for one. One not from a leader. One from paid staff. The message from paid staff? I'm angry about it. The other, not at all. They are pretty much the same. One I read kindess the other... it's like in my head, "Ok here we go. Just leave me alone before you hurt me." I legit still think the 1 message genuine and the other that is from the authority/helper/"professional" as here we go they are going to try to do xyz that would be harmful to me. Not far from how I respond to therapists. I can not find cause to believe it's not true.

 

[Ronin]

Ok what about, if 'They will hurt me' is a baseline and throws you badly symptomatic, instead of trying to alter that experience-belief, work with it?

As in even if counting you will be hurt, isn't there a way to persuade yourself you got the upper hand and are not at helpless / vulnerable to them position?

As they are separate things, harm or expected harm, and vulnerability, and own reactions to each. They're not automatically linked.