What Did My Therapist Mean....

[Hashi]

I think there are several different aspects being discussed here. I'm not sure we're all talking about the same one.

 

[scot]

Challenging our thoughts and responses, learning to trust appropriately - these are a huge part of the therapy process. If we don't challenge them we can't move forward.

This is one of the points of the therapeutic relationship, to provide a safe space for us to act out and heal our responses that we learnt long ago - through projection onto the therapist/situation, among other things.

I totally agree with that. However, the issue is, which might be a little bit off topic, but actually not:
: What to do if the therapist slips emotionally in the role of the abuser?

Well, if somebody else slips into this role, I know how to deal with it. Me, there are basically two options:
1. I quit the relationship if I think that there is actually a good reason for my reaction or I simply can't deal with it
2. I stay and "show" my "stupid" brain that everything is just fine, which is quite successful if I just do completely normal things with this person until it feels better, regardless of my inner totally confused and panicked state of mind (but certainly I do NOT discuss the issue with that person.....)

So, what do I do with the therapist? Do I ask him/her to join me going shopping, or maybe to discuss this awesome scientific paper? Or, maybe to join me for a movie night or a cook out in the park on the weekend? Do I bring cookies so we can have a little nice innocent snake time together?
I don't think that is an option...:)

Or do I do the therapy type of thing: "Hi, I would like to address this one issue today. I noticed that I treat you emotionally like you are my abuser.(Yap, and I had this type of conversations actually with my abuser....which didn't go too well...SOOOOO??? ) I add, but I have a problem with having these conversions with you because these types of conversations are actually exactly what I had with my abuser, which didn't go well because I should have rather left instead of doing this type of stupid thing.....and in a hurry things become actually quite ridiculous and possibly very unhealthy ....

I am sorry, I don't mean that offensive, I am actually quite amused by my own reactions by now and sort of joke about them, but its actually not funny.... So, I ask my therapist what I should do just in case that happens, and this I address possibly right away in our first session - just in case? Or, do I say nothing to anyone and just suffer in silence?

I don't expect an answer.

 

[joeylittle]

What to do if the therapist slips emotionally in the role of the abuser?

I have no answer - but wanted to share that something very like this happened to me in a recent session and it was so horribly strange, I don't think I could even describe what it felt like. I kept trying to "put it away", because I knew it wasn't on purpose, he's not them, etc. - but it would not go away. And then he shifted a little in his chair and I went into full on intrusive memory mode.

When that had been dealt with, I did tell him that he was the problem for me in the room. He said "I wondered if it was triggering for you when I was talking about x". I said, "you were talking the way he talked, and I think for the same reasons". He nodded. I don't know why I was hoping for an apology, but he is so mindfulness-based that things 95% of the population would apologize for (whether they ahould or shouldn't) - well, he won't apologize for those things. I'm still a little angry, truth be told.

 

[scot]

Well, with me its sort of a guaranteed type of thing. It always happened sooner or later and by now I am at the point that I am so afraid that it does happen again that it definitively will happen only because I am afraid of it - the famous catch 22. Actually, right now, I go without meds just because I am more afraid of me doing this type of thing again than not having my emergency anxiety meds around..... The reason why I actually came to this forum was to maybe find some magic strength to tackle that type of problem because it is really stupid of me not having my meds around because of THAT. Sorry for venting, that sort of didn't fit here....

 

[greenleaf]

This is definitely a complicated topic, and I think some of our various posts here have sort of been using different definitions of things...

... challenging but not dismissive....
I don't think you can "argue" someone into not re-experiencing a trauma. I do think you can challenge someone about working on their reactions and responses, however difficult. I believe - and it's my personal experience - that there's a lot we can do.

In particular, I think there can be a tendency to see trust and attachment issues as an insurmountable barrier to therapy, rather than something to use therapy to work on, one step at a time.

I think that many of us are incapable, at some points in time, of simply immediately changing either of these types of things through a simple cognitive decision:
re-experiencing, trust problems -- and I'll add in dissociation.

I'd like to posit that all of these things can be improved with work, so they all have that common thread. We cannot simply change the reactions that perhaps are coming from older evolutionary parts of our brains. What we can change often are our cognitive-level response, our behavioral response etc.

Some of the posts about trust here seem to be more about acting like you trust someone rather than the actual deep trust itself. The "real" trust I'm talking about actually seems to let old emotions come up more around some people, for me, for instance, which would have been very unsafe around my brother. I really can't force that. Some level beneath the "me" that can talk to people, imagine things, etc. makes those decisions...

I think early on I started putting myself in situations where I cognitively figured out my chances for safety were better, then the trust level eventually improved with good stuff being repeated; I was lucky that some of my efforts worked in that respect. I'm definitely not arguing with working on trust stuff!

But we can all have weird limits with PTSD that channel our abilities differently from "normal" people; there are infinite choices (unless maybe we're totally panicked or something?), but some things are just not available at some points in time. Our weird limits are often different from each others'.

I've sort of repeated the same idea several times here, but I'm hoping it makes more sense this way. I appreciate the conversation.

 

[greenleaf]

@scot, that is definitely a nasty loop. I wonder if therapists get any specific training to help with that sort of loop... I hope so! Sure many people have these issues.

Have you ever drawn the logic out with arrows and such, and taken that to a therapist? I find visualizing loopy things a more powerful mental way to get creative with them than just linear words.

 

[Lucycat]

However, the issue is, which might be a little bit off topic, but actually not:
: What to do if the therapist slips emotionally in the role of the abuser?

Yes, totally off topic! I assume you mean that the client perceives the therapist as the abuser? This is called transference and is discussed in great depth in many threads on here.

So, here we have different types of PTSD, different cultures, genders, genetics, and this could go on and on..

Although I appreciate that this is the PTSD forum,therapy is accessed by many people for many other conditions. I would suggest that for every one of them the relationship with the therapist is the key to therapy being effective. I am not suggesting it is possible for everyone to find the perfect therapist, or even if you do find a good one that it will automatically develop into a good relationship. We are all humans and every one of us is different. We all have different lives and different experiences. But the bottom line - I believe - is that if you want therapy to be effective then you must engage. It is like there is an unwritten contract, and that means learning to say 'sorry I don't understand you' to your therapist. Of course it can be tough in the beginning, but it is worth the effort.

thinking that's not helpful !

I know I have taken this out of context. But I read it as; 'thinking- that's not helpful' and sometimes that is so true. The glorious 'we' as in the PTSD community do seem to have a tendency to overthink. We make the simple complicated. Sometimes we should stop thinking and just 'do'. Easier said than done I know, but rather than ruminating on that comment from the therapist, a simple 'what did you mean?' can save an awful lot of time and effort. I recall thinking my T had 'sacked' me, because I did not immediately ask what he meant. He was shocked I had so totally misunderstood him, and I only found out by sending a pathetic message asking 'why?' .

My apologies, it's not my intention to be judgmental of others,

One of the problems is that we are all judgmental, and it is easier to justify it when we cannot see the faces of those we judge. I note an especially harsh judging of therapists on here - perhaps because they are unable to defend their stance, or because we are less concerned that they might read the comments posted.

I just appreciate that not everyone is always immediately ready to be so direct all the time.

I don't think you have to be direct all the time. It is not always about challenging a comment that you disagree with it is about asking for clarification of meaning, just as you might if a technical term is used. I do get that people are often feeling at a disadvantage within the therapeutic relationship, due to their own trauma and relationship histories, but that cannot be used as an excuse. If you don't understand your therapist it is unlikely that you are gaining any benefit.

I think, more and more, that trust isn't some ephemeral thing. It's not a feeling I'm going to have.

Trust is important, sure. But I don't need to trust you to ask you what you mean. I don't need to trust my T to ask him what he means. Of course I do need to trust him to share my story, but that is not the issue here.

Maybe with PTSD one of the issues might be what kind of triggers there are.

I am not sure I understand you here. We all have triggers and part of the therapeutic process is learning to recognise them, avoid them and deal with the fall out. It is likely that discussing difficult problems will bring up traumatic memories, but in the process of a discussion about such things I would still ask for clarification if I did not understand what T was telling me. No advice in the world will help me deal with triggers if I don't understand the advice. Nobody on this forum can tell me what my T meant when he gave me that advice. Even by repeating it on here I am distorting it by putting it into my words, rather than what T said verbatim as we don't remember like that. We remember what we think we hear.

I don't believe in being dismissive, but I do believe in a certain amount of challenge - however tough that is. That's where I'm coming from.

I fully agree with you here. Effective therapy will always be challenging - that is what makes it such fun :wtf:

 

[Tinyflame]

I'm not sure about T's specifically, but I agree one can only ask. For me the problem is, sometimes I don't have the words or courage or energy to ask, or the thought/ question comes to me later. And sometimes (lots of times) even asking seems like being a burden.

I do think also you have to be able to trust the response will be the truth.

I think asking for feedback here is to see if others come to the same initial conclusion/ feelings, or see if our feelings/ reactions/ thoughts are valid. But, then again, so much detail is left out.

I guess most logically the very best is to ask, provided there is trust & honesty. And I guess if there is trust & honesty you can also say, "I'm afraid when you said.." or "do you mean.." or "does that infer,.." etc. Explain 'why' you're thinking 'what' you're (we're) thinking or worried about.

 

[Tinyflame]

Oops, I missed a page of posts! I really like @greenleaf 's post #28.

 

[rainbow1]

I have/had (not so much now) a great fear of asking T what he meant by a certain comment or whatever. I worry the response will be negative and that my fears will be realised. That he did mean to be angry with me, or doesn't want to see me or whatever. Writing it down here is helpful because not only can people respond with encouragement but also it makes me think about it more logically once i've written it out.

 

[Tinyflame]

I think much comes down to fear, fear for ourselves, or fear for the other person's well-being, or fear to ask, or fear of consequences or reaction. Well, for me at least.

 

[Hashi]

I think that many of us are incapable, at some points in time, of simply immediately changing either of these types of things through a simple cognitive decision:
re-experiencing, trust problems -- and I'll add in dissociation.
I'd like to posit that all of these things can be improved with work, so they all have that common thread. We cannot simply change the reactions...

I agree.

I didn't say change, I said challenge. And I didn't say immediately.

In general I'm no fan of cognitive behavioural approaches. In general, I'm against them, although I think in some limited situations they have their uses. Not sure what the reference to cognitive decision has to do with what I said. I don't think it's a cognitive decision and I haven't said anything about cognition.