My ongoing therapy dilemma

[David Baxter PhD]

That's what makes me angry.

You are NOT the problem. HE is the problem.

 

[gooblax]

Do you think it's worth escalating to text message or voice message (assuming his mobile takes voice messages, I dunno), or is that just asking for more disappointment? Him not replying always seems to become a bigger deal than the original thing to begin with.

 

[David Baxter PhD]

If you do that, do it with the expectation he won’t respond.

But it’s worth a try I guess.

 

[gooblax]

I don't think I can. I'll still be hoping for a response.

 

[David Baxter PhD]

Yeah. Will it make it worse if he doesn’t reply to voicemail or text?

 

[gooblax]

Not sure if that was an either /or question. Regardless of how I ask, it will feel worse if I ask again and he doesn't respond. I think voice would be the worst, because it would be the more anxiety provoking way to contact him.

 

[David Baxter PhD]

No it wasn't either/or, just either one.

 

[gooblax]

I just wish I could tone down the anxious/upsetness enough to get some work done.
I've got the EAP session after work today so I'll see how that goes.

 

[Daniel E.]

Was the first session promising (a thumbs-up experience)?

 

[gooblax]

Yeah it actually went pretty well. I was quite nervous and had written a page of notes for myself but only had to refer to the bottom 2 which were about what I was hoping to get out of the session. The rest was just useful stuff to have thought about in advance for when she inevitably asked (i.e. what I think is going wrong in my sessions, what I think might address it, what has been helpful).

I was upfront about not being sure if it was a good fit with my current therapist and wondering if it was doing more harm than good, but that I also really wanted to be able to work things out to keep working with him because of how "attached" I am. So she helped me think through some ways to try and fix the main things I identified as going wrong:

1. He starts the sessions asking about my week then asks a bunch of questions on follow-on topics that aren't really the ones I want to talk about, and that takes up almost the whole session while I'm waiting for him to pause so I can bring up my topics, and in the meantime I get increasingly upset but he usually can't tell because I'm going along with it and/or am blank-face-ing: a) I'm going to raise this point with him and mention that I have trouble being assertive about the points that I want to talk about. b) Then I'll suggest that we start each session with reading through my list of bullet point topics and if there's anything particular he was thinking he'd work on with me that session then he can suggest adding it but I'll be able to veto if it doesn't seem helpful or other stuff is more pressing. c) And I'll suggest a 30 minute checkin (or probably a 15 minute checkin to start with) to make sure the conversation is continuing to be helpful for me and we haven't gone off track.
2. I feel emotionally rejected when he focuses on behaviour stuff: a) Again, mention it like I was already going to. b) The strategy for number 1 should help with number 2, because at the checkins I'll be able to identify that something isn't feeling right about the conversation even if I can't articulate what's wrong about it (which is a typical problem for me, hence why I've only recently come up with this concise description of the problem).
3. I have emotional freak-outs when he doesn't reply to emails: We didn't really discuss how I was going to address this (aside from the fact that if the session doesn't end with me being upset, there's significantly less of a chance I'll try to contact him between sessions) but I figure I can mention it again and check that I've adequately articulated how much of a problem this is for me, and that I 100% need it to go differently next time. If he's been on holiday I'm going to suggest he put on an out-of-office reply because that is the bare minimum he could do.

We briefly discussed what I'd do if I decided it wasn't a good fit, but I get way too emotional trying to have any sort of proper discussion about it. I figure I'll try this stuff, see how it goes, then if it doesn't work I might need to come up with a bunch of performance metrics and targets for us to hit and a data-driven trigger point for the decision. I probably have to take emotions out of the decision process because I don't feel capable of making the decision. Not sure yet if I'll mention this part to him.

I also asked for some strategies for dealing with the not-replying-to-email emotions in the meantime and she didn't have much for that (just accepting I am feeling X about X, then "anchoring myself" in the present with a 5 things I see, feel, hear exercise). As of last night those emotions seem to have temporarily settled into a blob of psychosomatic ache in my chest/back but that's preferable if only temporary. Not sure how I'm going to go with this next week, given that there were no indications that he wouldn't be available next week (after all, I'm the one who couldn't do next Thursday because of a work trip) but I'll figure that out as it comes I guess. Hopefully the work trip is so distracting that I won't have much time to think about it.

I haven't booked another session with her yet because I figure I need to have the convo with my therapist first. She did say that I was articulating the problem well with her - I'd kind of hoped so, given my preparation... it's when I'm unprepared or have only partially understood the problem that I think my articulation adds to the problem. I noticed less of a tendency to blank-face (I started it at the start of the session but forced myself out of it to be socially acceptable, and I didn't have it come up again). It's not a fair comparison because I've really acknowledged and self-validated the problem with my therapist as being something that's a real, valid problem that it's ok for me to be upset about and need help with. That is definitely not the case with a lot of my other "problems" that have put me in therapy in the first place. So I could talk about this one and accept support for it in a way that doesn't work so much for other stuff.

 

[David Baxter PhD]

Excellent, @gooblax! Well done indeed!

 

[Daniel E.]

asks a bunch of questions on follow-on topics that aren't really the ones I want to talk about, and that takes up almost the whole session while I'm waiting for him to pause so I can bring up my topics

Pathetic!!!!

 

[gooblax]

Last time I brought this up he said it was to "get me talking." As an extrovert it's probably a bit difficult to tolerate the limited information that I tend to offer up in conversation. But if I have a list I'm already prepared to talk.

 

[Daniel E.]

As an extrovert

I always had a bad feeling about him

But, seriously, a number of therapists are not as good at active listening as they think. It is hard not to go with one's view of the world and one's recipes for success and put that all aside to provide a way for clients to unload and process and be truly heard, often for the first time.

(That's why Dr. Phil is more entertainment than therapy since all that matters is what Dr. Phil thinks. In contrast, Carl Rogers cared more about the client's views than psychology itself since the client is doing the healing, not the therapist and not applications of theories. That's part of the reason Rogers used the terms clients and counseling rather than patients and psychotherapy.)

Person Centred Therapy - Core Conditions | Simply Psychology

"Carl Rogers proposed that therapy could be simpler, warmer and more optimistic than that carried out by behavioral or psychodynamic psychologists."

 

[gooblax]

I know that other times when he hasn't replied have been pretty tough too, but this one feels like the worst. Not sure if it's just me not remembering correctly or what. I'd have hoped that the feelings would've faded away properly by now.

 

[David Baxter PhD]

It’s been 8 days since you emailed him

That’s beyond unacceptable. That’s when I would start to think he better be in intensive care or being held hostage because I can’t think of any other excuse for such rudeness.

 

[gooblax]

Based on previous times, that won't be the case. I'm still running with my holiday theory but that theory kind of runs out tomorrow. I'll be on a work trip the next few days so even though I would still want to talk on the phone it's impossible to know when would be a good time.

 

[Daniel E.]

Have you considered calling his secretary? I know she doesn't do the video scheduling, but she could at least confirm that he is alive and not in the hospital.

 

[gooblax]

Nah I'd rather not call her. The practice website has disappeared, and redirects (after being an http not https so you get a security error in the browser) to a website for one of the other psych's that used to operate out of the same location. It's possible that due to COVID they decided to close the joint practice. I still got my billing receipt from the practice manager's email address last week, but who knows if she's still going to be managing it now.

Skype was showing "seen 6 days ago" on one of his accounts (when we were doing Skype sessions he ended up with 2 accounts because Skype can be a pain in the ass) so that's fine.

 

[gooblax]

Can't believe I've still been hoping that he might respond this week to explain. I need a bullet through the back of my head.