Therapy dynamics - or, how does therapy actually work? (Goals, disagreements, etc.)

[scout86]

I had a conversation, early on, with my T, about what I wanted out of therapy, why was i there, etc. I had no idea. I was there because the alternative seemed to be suicide. (I finally told him that, which lead to a whole different conversation.) When I couldn't answer his "How can I help you?" questions (and i really couldn't) he said that was ok, lots people couldn't answer those questions, don't worry about it.

I think that was a good answer on his part. If he'd insisted I answer the questions, I'd have quit. I'd have told myself I didn't need or deserve to be there, and I was wasting his time because i didn't have the answers, and I'd have quit. And I figure it's about 50/50 I'd be dead by now.

As it is, I've learned a lot. One of the things I've learned is that I'd have to trust him a whole lot more than I did (or do?) to answer those questions. I'd also have to have a much better idea of what's possible, and what's "normal" than I did, or do. I could give him better answers today, and have, on occasion, but I'm really glad he didn't insist i have answers then. I just didn't have them and I needed to hear that was ok.

 

[siniang]

Thank you @Sideways as always super hyper mega helpful :hug:

I hear the frustration. I really do. But before you leap into ditching this one for a new T?

I don't actually want to ditch my T. I actually really like(d) her. Just somehow a few sessions ago things seemed to steer in a direction that just doesn't feel "right". And I want to make sure to get it on the for-me-right track again. Basically bringing myself and T back on the same page, because right now it feels like we're not only reading different pages, we're reading entirely different books.

Hence me wondering if I had the "wrong" approach/expectations from therapy. Hence me wondering what my "part" in therapy is. Hence me wondering if it's actually ok to tell her all that, including actually disagreeing with her. Because right now? The last session? Wasn't actually helpful, at all. Just mega upsetting.

More later, after I've figured out whether to reply here or in my diary, as to not make this thread about absolute specifics.

 

[Mach123]

Resistance for me is really big too. This has covered a lot so far and I agree with everything that's been said. For me it's a process. I spent a lot of time not just resisting and disagreeing with her but probably actually attacking her. I hope I've improved and calmed down a lot. She knew why I was like that. I tried hard to make her hate me she knew why I was like that too.

I had to put her through all that. I had to know I was going to be able to trust her with what I was going to tell her.

Now I've told her. I'm resisting her still I know this but I hope I'm more aware. It's very deep water when you trust someone that much.

That's all processing. Going through that over and over. Opening up and retreating over and over. It's trust and boundaries and it takes a long time.

Then I'd get mad and say she was doing everything wrong and wasting time. Feeling abusive towards her and how she's not helping me enough. Then I'd apologize.

Then I'd see she Led me into something and she knew me and saw it and I didn't. And she was being careful and trying to judge how much I could take.

So mostly I'm glad I've had someone to put up with all that? IDK how she does it.

 

[Sideways]

Hence me wondering if I had the "wrong" approach/expectations from therapy

There are so many times in life where exacting, black/white, right/wrong thinking? Is a totally awesome skillset.

This ain't one of them.

You can't fail therapy. Can't. Doesn't happen. So ease up on yourself. It's only been 5 months, and you've actually achieved a lot in that time (remember when you hadn't "really" suffered a genuine trauma and it couldn't be ptsd because criteria A specifies...?). You're achieving more than you give yourself credit for.

 

[siniang]

Thank you :hug::hug:

I guess I was just really dysregulated and triggered from a ton of different stuff and it just didn't help her telling me in my face that she didn't think I actually love what I do and actually want to do my PhD and that it's perfectly ok to quit. That was so incredibly invalidating and kind of triggery in itself, because it's almost along the lines of what part of my family keeps trying to convince me of, against my own better judgment.

It was also extremely invalidating when I spent quite some time thinking about root-causes for my anxiety and actually drew a diagram that I brought with me to my session and wanted to discuss, and she didn't even want to take a look at it or talk about any specifics and dismissed it all as "nah, this is all just prime anxiety/depression". It was like it didn't matter that in that moment that was something that was important to me.

I don't think she realized it (or maybe she did?). I think I really need to stand up more for myself and be a better advocate for myself. Yeah....fear of burning bridges....because been there, done that. Hence my insecurity when I don't know how something is supposed to be, or not even that because there are no set rules, no set expectation, no, as you said, black/white approach. Always the potential of thinking you'd do something wrong - it's good to know that those thoughts are completely unjustified. Reassuring.

 

[theshadowoftheliving]

It probably is cultural that people in the US drive their own therapy. I’ve been reflecting lots on this. Our medical system is so disconnected (because of private insurance, we are all constantly switching doctors) and we become the only ones that have the whole story. To assume that our doctors know better is actually total bogus. We know better. Our doctors may not really know at all.

I don’t know if other cultures are the same. But I think, out of necessity, US clients are the driving force of therapy, and the idea of the doctor as expert is definitely upended.

I also know that many of us on this site are American ....

 

[Sideways]

actually drew a diagram that I brought with me to my session and wanted to discuss,

I have no idea what the diagram was about. But if that's helpful to you to working through issues in your mind, or one's brought up in therapy? Remember that. Use that tool again. So incredibly helpful if you think that way, because it makes it easier (often with help) to see where there's fault lines occurring, like cognitive distortions or inaccurate assumptions or missed opportunities.

she didn't even want to take a look at it or talk about any specifics and dismissed it all as "nah, this is all just prime anxiety/depression"

Still anxiety and depression seem to register as "meh" issues to you.

Maybe consider attending a workshop or similar specifically for people suffering depression and a seperate one for anxiety (or join any quality forums like this one for those conditions).

Anxiety is probably something that shows up in your daily lived experience. But depression? You have depressive thoughts in spades when you journal sometimes.

I've had the benefit (hawhaw) of having spent a lot of time in psych hospitals. So, I've come to know a lot of people with anxiety, or depression, and no other diagnosis.

I don't doubt for a second that you feel really invalidated whenever something is explained away as being part of your depression or your anxiety. What floors me is that you perceive this as invalidating.

Having seen first hand what those conditions do to people? And having lost a few of them along the way to those illnesses, if my T was to say to me "That's depression talking", for example - that would be a great big red flag for me that my T is basically saying "This is a big friggin deal and you are really not okay right now".

You don't seem to hear it that way...? Observation - may not be accurate, but if it is kinda accurate, maybe worth exploring whether being invalidated is a cognitive distortion, or even a core belief.

Like, an overlap of the schemas of feeling a bit alien to everyone else, and the belief that others can't/won't be able to meet your emotional needs.

Your T seems to be offering you validation for your suffering, and that seems to be really uncomfortable for you, and bringing up feelings of frustration, anger (at her), and thoughts about "I'm a failure".

People validating our feelings can be really confronting (man, do I ever get that!!). Is that perhaps distressing you? Making you feel like you wanna run from therapy? Idk...

 

[grit]

I am sorry that I am very harsh in my comments. I had similar resistance documented here. I really care about you and wish you speedy recovery. I will refrain from posting in your posts because I am not helping and actually probably harming unintentionally.

If a moderator kindly can delete my post above...I would much appreciate it.
I am again sorry for my unconscious posts.

 

[HealingMama]

Hence me wondering if I had the "wrong" approach/expectations from therapy. Hence me wondering what my "part" in therapy is. Hence me wondering if it's actually ok to tell her all that, including actually disagreeing with her. Because right now? The last session? Wasn't actually helpful, at all. Just mega upsetting.

I just want to add that sometimes the mega upsetting stuff means you're having a breakthrough, or if you tell your T that it's mega upsetting in session the session can lead to a breakthrough. I would encourage you not to assume things are taking the wrong direction simply because it is painful but definitely share those thoughts with your T to see what they have to say.

 

[siniang]

I am sorry that I am very harsh in my comments. I had similar resistance documented here. I really care about you and wish you speedy recovery. I will refrain from posting in your posts because I am not helping and actually probably harming unintentionally.

If a moderator kindly can delete my post above...I would much appreciate it.
I am again sorry for my unconscious posts.

I absolutely value your input, but you kept banging on over multiple different threads about suppressed early childhood trauma that I repeatedly told you isn't there and your last assumptions about my mom were just plain out of line. Just a shit ton of projection and assumptions.

All good. Keep posting. :)

 

[Teasel]

Just to say that the kinds of difficulties/expectations you are having with therapy I can relate to.

I hoped therapy would be going to someone who knows about this stuff, can help me figure out which parts of that are a problem for me and teach me useful stuff for dealing with it. And using specific kinds of therapy on particular issues. Be someone to be able to get stuff off my chest with. That sort of thing.

In the kinds of counselling I've had I've not not tended to find it helpful. The sort that feels like you're not really achieving anything, where there seems to be years of not talking about much. If anything this kind of therapy for me seems to make me far less able to talk about anything with them than I could have done in the first session.

Can't explain myself very well as I don't especially know that I understand what and why it doesn't seem to help me.

With things like CBT, ACT, PTSD education and symptom management, Equine therapy, it's like putting on 7 league boots. They help me enormously.

Anyways enough about me. Hope you figure out a way go make this work for you or else find something else that does.nust wanted to say I relate to the difficulties you describe.

 

[pam4him]

What I've found in my time in therapy was it is kind of like any other relationship where each person has to do some give and take. What I mean is if it felt to platonic, or just dealing with the same stuff, I'd ask about working on something deeper. It's not so much about push back, as it is realizing you are probably ready for harder work. It is okay to discuss this with T as they may be waiting to see if you are ready. It's hard to know that if, for instance, the session starts with T asking how it's going and we reply with "this or that happened and it (stressed, depressed, etc.) me." T may see that as we still need to work on some coping skills. But if you are feeling solid on dealing with such small stressors, perhaps answer that question with, "This happened, but I was able to work through it." That is a sign to the T you are ready to move into deeper issues. Prayers for wisdom and guidance as you continue to move forward.