My ongoing therapy dilemma

[gooblax]

I kind of do need to deal with all of them because it's all a flow on from the first point, explaining why I don't know the best way to discuss it.

Why it made me sad - I dunno.
What made me sad - thinking about how my therapist said he cares about me less than some other clients, and extrapolating it to mean that my stuff, feelings and I are less important/worthy of help /caring about.

 

[David Baxter PhD]

What made me sad - thinking about how my therapist said he cares about me less than some other clients, and extrapolating it to mean that my stuff, feelings and I are less important/worthy of help /caring about.

He actually said that? What was the context?

 

[gooblax]

OK, full explanation time...

I'd written an email saying how I have trouble with the idea that I think people don't care about me, that I don't deserve to be cared about, that I know some people do care about me but it doesn't feel right although I'm not sure why, and that I want my therapist to care about me but that's disgusting and pathetic and should be unnecessary etc.
While discussing it in session it became a bit of a monologue and while telling me that he does care about me he came out with the unfortunate and unnecessary line "I care about you as much as some clients, not as much as others."
Next session I told him that the line sucked hard (and was part of the reason I was sad for like 2 weeks), so he explained that I don't really allow him to care because I sort of block him... Which is a fair assessment.
I told him that after discussing it maybe I'd be able to let the line go, but I haven't been able to particularly because of the extrapolation potential.

 

[David Baxter PhD]

Wow. Quite frankly, I would say that is an incredibly thoughtless and insensitive comment for any therapist to make to a client. I am astounded.

Even if it is true, why say it? And then to defend the comment when you brought it up later? That's even more unforgivable.

He already knows that you have an issue with wanting people to care about you but also feeling that you don't deserve to be cared about. Making a comment like that is just poking a wound.

I am honestly appalled.

And I think you need a new therapist.

 

[Daniel E.]

Of course, I agree. Randomly pick any other therapist, and you will be doing much better.

 

[gooblax]

Sometimes I think he just starts talking and doesn't know when to stop, which meshes poorly with my tendency to become silent and accepting of anything that's being said. (I've since told him that the monologues don't work for me and I think we've been reducing them.) So yes I'll agree with it being a thoughtless comment. He did admit that he probably shouldn't have brought up other clients as part of the discussion.

This is where I've been torn between trying to use it as a thing to stand up for myself and try to continue with him, or whether the real "standing up for myself" thing to do would be to not settle for a therapist who thinks I should be ok with knowing that I'm cared about less than some other clients .

I can put it out of my mind when we're having a session about stuff that's not emotional eg. how to talk to my bf about relationship stuff. Those sessions go well and my therapist has useful tips to share. But the "caring about" session was 4 sessions ago and other than the recap/aftermath discussion, we haven't really spoken about any stuff I'd consider to be emotional stuff and I don't know if I can. Or if I should, given that he likely doesn't care how I feel as much as some other clients.
It also contributed to the slow email replies being so hard for me.

So that's why there's so many dot points... Because if I'm going to bring up anything that might be emotional, I have to have this discussion with him again first to decide if it will be OK.
Or alternatively I just keep it to surface level strategy stuff until that outgrows its usefulness.

 

[David Baxter PhD]

the real "standing up for myself" thing to do would be to not settle for a therapist who thinks I should be ok with knowing that I'm cared about less than some other clients .

^^^ This.

 

[Daniel E.]

How Do I Know if My Therapist is Effective? | NAMI: National Alliance on Mental Illness


The most effective therapists make you feel accepted and validated, showing understanding and sympathy/empathy for whatever you’re going through. They will approach you with compassion and kindness, and build enough trust for you to share your darkest thoughts and memories with them.


Therapy is one of the few parts of life that is all about you. Therapists are not there to express their own needs--they are there to help you reach your goals. Like any other worthwhile endeavor, the benefits of therapy don't happen overnight, but over time you should feel like your therapeutic relationship is nothing but beneficial to your well-being.

 

[Daniel E.]

Next session I told him that the line sucked hard (and was part of the reason I was sad for like 2 weeks), so he explained that I don't really allow him to care because I sort of block him... Which is a fair assessment.

No, not a fair assessment.

e.g.

All I can say is thank God my therapist did not have an ‘ideal client’ criteria to filter me through.

Discuss Private Practice

 

[gooblax]

Problem with that is that the thought of never seeing him again hurts more than the thought of him not caring.

 

[David Baxter PhD]

 

[Daniel E.]

Maybe if you just try a session with a new therapist, it will help you decide or adjust?

For online therapy, there are so many options now, including internationally.

I know some people stick with the same therapist for years, but I am not one of those people. I like different perspectives. Every therapist brings something different.

 

[Daniel E.]

In other words, we are geared towards "loss aversion" but transitions can be less difficult by having something else to look forward to or just focusing on the present. Even positive transitions though can be stressful.

 

[gooblax]

I'm nervous about my session tomorrow and am worried that it's not going to go well. Or even if it does go well, some part of it won't.

I haven't told my parents what time I'll get to their place because I'm not telling them about the session. I couldn't lie about the flight time because there's no flight with that airline that lines up with the session time, even accounting for delays (and I can't lie about the airline because I booked a return flight with the same airline so it would be too much effort to maintain a lie about what airline or whether I booked two one-way flights with different airlines).

So my mum's assuming she'll pick me up from the train station at some point in the afternoon, but that's definitely not happening (by that point it'll be easier for me to get a bus and bypass the train altogether) and I have to figure out a way to tell her tomorrow. I have told part of the truth about what I'll be doing tomorrow (the part before the session) but now need a lie to explain why I still won't be arriving for that bit of extra time past when some things will be closed (and so my "what I'm really doing before the session" will be closed by the time it gets to "during the session and taking so long to get to their place").

But all that is less of a concern than the actual session. Or even being in the reception waiting area.

 

[gooblax]

The therapy session went ok. Once I got to the office I wasn't as nervous as I'd expected to be. Talking to him (or to the wall beside him at least 50% of the time) was similar to on video, which was >9000% better than 10-11 years ago. I'd mentioned beforehand that I wanted to keep it fairly light to avoid going into the holidays feeling bad, so we discussed some stuff about work, relationships and the holidays and about how we'd been communicating.

Next session won't be until early Feb. He said I could email/text/call if I'm struggling but I reminded him that his reply timeframe transforms my original problem into something worse so I wouldn't be doing that. He didn't offer up any alternate solutions so I guess I'll keep it as a last resort.

I do find it hard between sessions, mostly I think because of how strong my feelings are about him. It'll be about 8 weeks total (he's having 4 weeks off but is working next week, then when he asked me what I wanted to do next year I didn't want to be pathetic and ask for a session straight after he comes back to work so I said Feb). I wish I could just not care about it but I'm making myself upset now just writing about how much time it's going to be.

 

[gooblax]

This weekend I have really been noticing where I felt let down by my therapist in 2008/9. The cause wasn't just him but I now understand (on the inside, not just intellectually and dismissing it) that it wasn't just me either. I still have a lot of hurt feelings around this stuff and I'm not sure what I need to be able to resolve it.

 

[David Baxter PhD]

Sounds like something you should bring up with your current therapist... can't remember whether you've already done that.

Two questions:

1. how (in what sense) were you let down by that therapist?

2. in what ways do you think it was your fault?

 

[gooblax]

I've done it a little about 2 things where they related to current things but not properly. Current therapist is the 2008/9 therapist. Yeah, I've got 5 weeks to figure it out.

1. The time he "tested" me instead of responding, when it was the first time I'd told him any substantial detail thoughts about anything (he didn't reply to an email because he wanted to see if I valued myself enough to follow up, which is not the sort of test that I needed when I'd been upset with myself for even trying to tell him anything because clearly it didn't matter and wasn't serious and <usual gooblax stuff>). The time he came across as judgemental/dismissive of my interest in gaming, as I tried to tell him that I'd lost interest in things, which also shut down my communication a bit more than normal. The time he responded to my mention of doing a suicide-plan walkthrough as "testing boundaries", and later (after having to clarify that he didn't mean it was "fake crap that wasn't worth mentioning" because that's how I interpreted it) just randomly assumed that I had stopped having the thoughts without us ever properly addressing that or the self harm (because I hadn't mentioned them in awhile? Dunno why he assumed that). The time he was supposed to send a thing to my GP but it hadn't arrived by the time I had my doctor's appointment. How he seemed to focus on things that were bothering me less than the things I wanted help with.

2. Not communicating well - I couldn't find a way to say what I needed, what I felt, tell him where he was getting things wrong or not being helpful, or ask for clarification on stuff... because I was so caught up in the "doesn't matter, not worth taking about, I shouldn't have feelings at all etc". I didn't even realise that part of what I was experiencing counted as anxiety so I couldn't even be clear about that. Anything I did tell him was drenched in excess verbiage to try and obscure the fact that I was "pathetically" asking for help for emotional suffering that I "should have been able to handle on my own" - I may have ditched the verbiage now but it's harder to ditch the belief.
I also didn't try to find a way around having my mum book and pay for the sessions (I didn't think there was a way around that, but with hindsight maybe there could have been), so I always had the extra administrative barrier to having regular seasons, and I didn't explain to my therapist how much of an issue that was causing in my seeing him with any regularity (I explained it a bit but not fully)... And so even when I would bring up something that went wrong in the therapy, I'd be stuck handling it myself (and whining about it on this forum) for weeks before being able to discuss it with him, allowing the hurt to fester.

 

[David Baxter PhD]

Oh okay. I thought you were talking about one in your teens.

I've already expressed my opinion about him. I would have fired him a long time ago.

I don't fault you at all for being upset with him. I wouldn't tolerate even "friends" who behaved that casually about my feelings, let alone someone I was paying to help me.

 

[Daniel E.]

Also, David Burns believes many therapists fall short:

The website of David D. Burns, MD | Error #5: Failure to Set the Agenda | Feeling Good

Skillful empathy requires discipline and training. Most therapists believe they are reasonably empathic and have good listening skills. In many cases, this is not actually true. I have developed an Empathy Scale that my colleagues and I require all of our patients to complete in the waiting room at the end of every session. The score will show how your patient actually experiences you. Most therapists get failing grades initially from most of their patients. This can be upsetting, and a shock to the system. However, with practice, [therapist] scores can improve significantly, or even dramatically.