Therapist as exposure therapy?

[FauxLiz]

I met with my P-doc yesterday and we discussed my struggles with finding a new therapist since I moved 6 months ago. For the second time he suggested that I consider trying to work with a female therapist. His thought is that a healthy therapeutic relationship may heal some of the issues I have resulting from what I call a "complicated relationship" with my mother. I understand the thinking but really can't see how this could possibly work. I have struggled my entire life relating to other women. I have never even been able to have female doctors, dentists, dental assistants, nurses etc. so how on earth could having a female therapist even work. I have a hard time trusting male therapists and I have always related better and worked better with men.

Probably the only thing that he said that I did agree with was that with my history I will probably benefit most from therapists that have completed doctoral level (Ph.D or Psy.D) as the additional training would be helpful in working with me/through things. I know that some women that have been traumatized by men as I have in the past that working with a man not something they are willing to do but for me I don't work well with women. My mother is dead so its not like I could ever fix that relationship so I guess my question is should I consider trying to work with a woman? It might make it possible to resolve some of the scheduling and location issues I have had finding a therapist since I moved but I am really reluctant to even consider it.

 

[Sideways]

3 questions:

Is your p-doc planning to work with your T as a therapeutic team? Or is he essentially handing over therapy to someone else?

Is he recommending this on the basis that working with a female T would be effective “exposure therapy”, or for some other reason (for example, because he has a particular therapist in mind to work with you, and they happen to be female)?

Is being able to work with females your priority at the moment, or are there more immediate issues that you feel need to be addressed (which might be anything from SI, to memory processing, to learning grounding techniques, etc etc)?

 

[FauxLiz]

@Sideways he would like to work with my T as a team if I let him (in the past I have always compartmentalized my care and not allowed communication between members of my care team). He has recommended two possible therapists one male, one female with the belief that the female would be a good fit for me if I was willing and also does teletherapy if I were to be interested in trying that again to alleviate some of the distance and scheduling challenges. Is working with a female a priority for me at the moment no, but good consistent therapy is and that right now seems to be a challenge. My therapy session was cancelled this week due to weather (I live in a state in the middle of the polar vortex and much of the state has been closed all week) and if I wasn't able to take personal time next week and accept a cancellation he had for next week we wouldn't have seen each other until the end of February a six week gap between sessions. I have gone from having sessions twice a week to being lucky to schedule sessions every two weeks. Other issues that need work more than working with a woman include SI, SH and memory processing.

I would like to potentially return to River Oaks in late 2019 to do more processing but until I have a stable outpatient team that won't be a possibility. I am really wondering if I did the right thing by accepting this job and making the move last summer.

 

[Sideways]

Ok. If he was prioritising exposure to working with women? I think you’d have good reason to toss that advice in the bin.

But you have some really strong reasons for trying out the female therapist. Absolutely it makes sense that consistency is a big deal, particularly if you need some support with SI & SH.

Long term it may end up being helpful to have worked with a female T. But in your position, that wouldn’t be one of my motivations for going with the female. Instead, I’s probably make that call based on your other (really quite serious) issues that you really deserve some more support with, and that happens to be the female option.

Inevitably, there will come a time in your life where getting with a female doctor/dentist/T is necessary, if for no other reason than your medical situation is urgent, and only a female practitioner is available. While you aren’t forced into that situation right now? This is an opportunity for you to choose to try and work through that, rather than being forced to at some point. Maybe that’s a plus.

Fwiw? I think the consistency issue is a big, big deal. Consistent support with the ongoing SI and SH, and working on coping strategies? May be the difference between being able to settle into this new job and it simply becoming too overwhelming.

If you’re up for it? I reckon you’ve got it in you to handle this better than you give yourself credit for. Instead of priortising “working with women”, prioritise the amount of support that you need right now, and the importance of that support being consistent and accessible...?

 

[Sandstone]

Why is the gender of your mother the characteristic that you carry through to other relationships? It could be something else - you could reject working with brunettes, or smokers, or denture wearers for instance. Or (like me) run from people who won't give a clear answer.

I have no idea of your history, so you may have very good reason for gender being the issue it is. Have you looked at why over 50% of the population aren't OK for you? Even if you end up narrowing the band of impossibility to something like "women over 40", that would give you more options to try.

I have a hard time trusting male therapists

but you have written about the efforts you've put into overcoming that, so there may be things you could carry across into trying a female therapist.

 

[FauxLiz]

@Sandstone i don’t know why it is gender for that matter as complicated as the relationship was I don’t know if I agree that was the cause of my issues relating to other women. I have had a long term trusted therapist and now my current P-doc suggest that working with a woman would be a restorative experience due to my challenges associated with my mother. It could easily be tied up with my mother, sisters, grandmother and a whole host of other women that were in my life as a child and into adulthood. I just don’t know.

 

[scout86]

I kind of share your feelings about female therapists, and females in positions of authority in general. I have female friends, but it's hard to imagine trusting them with anything serious. Probably because of a "complicated relationship" with my mom, growing up. Personally, my gut reaction to this suggestion is that it's nuts. But, like I said, I've got a similar tendency. The one thing I'd suggest is that if you DO decide to do this, you should have a discussion, up front, about how this therapeutic relationship is a version of exposure therapy. I think it would save a lot of time and increase the potential for things working out if the T knew going in that you have a hard time trusting women. (That sort of thing sounds like it's not all that unusual.)

 

[somerandomguy]

Sorry if I'm intruding ... my perp was female, and I have/had a LOT of issues about women. Having a female therapist (and even more so, one who was in the same age range that my perp was during my abuse) was extremely helpful to me. In a way it was kind of like a reset button, and it really helped me reorder my thinking and my generalizations about women.

I don't think it's for everyone, but this was my personal experience. I went into it fully aware that having that kind of therapist might be really scary for me.

 

[FauxLiz]

@somerandomguy you aren't intruding. The reset button is exactly how my P-doc described it. The thing is how would I choose a female therapist similar to my mother, she was a part of my life from birth until she died. I would also repeat what I mentioned earlier that my sisters, grandmother and other women in my life. Honestly, I am about to throw therapy out the window for a while because nothing seems to be working out for me right now and I would rather go it alone than continue down paths that aren't working.

 

[Justmehere]

I’ve seen a therapist with strong characteristics that reminded me of a central childhood abuser. It’s not actually an impediment to trauma therapy to see someone who triggers us, but can facilitate it. It is more than exposure therapy. It can lead to “corrective emotional experiences.” It’s sort of like if someone was abused by people wearing purple shirts, and has symptoms whenever they deal with people in purple shirts... it can be really healing to experience someone wearing a purple shirt being really super safe.

The problem isn’t the gender. It’s the abuse. The trauma. You have been classically conditioned by trauma and repeated crappy experiences to associate gender means xyz... and this therapist may be able to do more than any male therapist to help undo that association and reduce symptoms. Especially because I’m addition to her gender, it sounds like she has a style like someone you did connect with an trust - your lay solid therapist.

If you are going to give up on therapy entirely, maybe it would be worth it to try something new before you do. Then you will know you tried all the options available.

That being said, if you don’t want to do it, you are not ready, or you are otherwise unwilling, that’s ok. Totally your choice. I’ve taken wanted and unwanted vacations from treatment and done other work to stabilize and pull through. It’s not ideal, and it stinks that you are lacking in more options that are more accessible to you. It would be wonderful for both of us if there were better options out there.

 

[Abstract]

It may be worth doing one session before trying to make up your mind completely. I realise that alone may be scary. Remember that you have had good therapy and benefited from it before. Not reason why that can't happen again despite all the present obstacles.