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Therapy issues - issues in therapy

Discussion in 'LGBT Later in Life' started by Tightrope, Oct 22, 2020.

  1. Tightrope

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    I go to therapy. It helps. It's better to keep things on even keel than risk a meltdown if a meltdown was to come along.

    I like my therapist. He's married - also very urban and broad minded and secular. I liked my last therapist. He was single. The therapist before that was "questionable therapy" according to later therapists. He had been married several times and there were lots of messy marriages in his family.

    In a way, I wanted a married therapist because he wouldn't have any biases or agendas. Everything had been going well. It mostly still is. Right now the election is stressing everyone out and I sense that he had to give me his take on things, which differed from mine. But that's not really it. I get the feeling that he was closer to his mom and he doesn't have sons among his kids. This makes it hard to go through some issues about the rapport with some women I know or knew.

    We've had some good threads here on the forum where we discuss if our friends are same sex, opposite sex, or both, and how that has changed over the years. I have a woman friend I've known most of my life who is beautiful but has become harder and harder to deal with over the last few years. She has gone through a lot in her life and is a fighter. Now, I get the sense she is working on me - by projecting her issues and anger. I am considering distancing myself - as in "it's over." I have been thinking about it for a while. He seemed lukewarm to this months ago and the very last session was mostly about this friendship. He has a good handle on my sexual history. He was asking me about my dialogue with this friend, who does the reaching out, and what I think my part in this could have been. I get the feeling he is naturally more empathetic to women than he might be to men, even when you lay out all the facts for him. I am feeling a little stuck. Any ideas?
     
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  2. Chip

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    Your therapist offered an opinion on current political events??!! That's a HUGE no-no. Likewise, if your therapist is talking about his relationship with his mother and/or his kids, that (unless specifically disclosed for some valid therapeutic reason to benefit you, which I'd have a hard time justifying) is also not appropriate. And if you're sensing a bias in his empathy for women vs. men, this, too, is not a particularly good sign.

    By the way, therapists should not be telling you how many times they've been married, and (for a competent, effective therapist) whether s/he is married or single has (or should have) no bearing on the quality of the therapy.

    There are a lot of not-so-great therapists out there, and it can be challenging to find a good one. If you are raising all of the issues above, one question I would be asking myself is "Am I really progressing here, or is this more someone to talk to and bounce ideas off of." Good therapy is work. It's hard. It isn't a conversation, it certainly isn't the therapist talking about what's going on in his or her life. It is 100% focused on the client. Many clients will intentionally try to distract by asking personal questions of the therapist, by bringing up irrelevent or tangential things, and the like. A good therapist will skillfully deflect those questions and return the focus to the client.
     
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  3. HM03

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    How long have you being seeing this therapist? One thing I find kind of surprising is how much information you know about your therapist - the only I knew about mine was the he "couldn't personally relate to my [specific] situation". A therapist-client relationship is one of the very few relationships that should be basically entirely one-sided in that regard. Nothing in his life should matter, because his advice should strictly be about what may work best for you, not what did or didn't work for him.
     
    #3 HM03, Oct 22, 2020
    Last edited: Oct 22, 2020
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  4. LostInDaydreams

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    Similar to what @HM03 has said above, I don’t know much at all about my therapist, besides that she’s a certified therapist, etc. She does occasionally share anecdotes from her life, but with most of the details removed, and always explains at the end what point she’s trying to illustrate. So, it’s relevant and doesn’t tell me anything about her as such.
     
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  5. Tightrope

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    Now that it's Sunday night, I'm coming back to the thread about the comments that were brought up. My current therapist brings up these things as musings, as slight fill-ins after I make a comment. There haven't been many. The last one was after I made a comment that the election has been stressful for me and many people, and that who is on the Blue ticket works fine for me. He said something like it wasn't blue enough for him. I took that to mean he was for Bernie Sanders or someone else. Comments about family usually came up when holidays are around the bend and it's small talk. That's how I know about his immediate family.

    I feel he understands me and has my back. Most of the work is about issues other than relationships or sexual matters. A lot of it is about family of origin issues, work issues, and things that happen in between sessions that needs to be talked about. I think he works with this part well.

    I put the topic and thread up because this latest situation with a long-term friend has vexed me for a while, even in therapy. I pretty much decided that this friendship is on the way out. I've lost some long-term friends because I've learned we can't keep them for a lifetime. Some withered away when they got married and had kids. This friend has never married but has control issues and likes to yank the chains of men she has been involved with or is even just friends with. I've had enough. The therapist doesn't seem too content with my rationales. I've been able to keep other long-term friends.

    I only have one therapist. He has many clients. He may forget some of the things I've explained to him and that's understandable. I'll repeat them. This therapist doesn't write anything down. Some have written a lot and some have written essential things.

    My last therapist, over 4 years ago, was single and I didn't know anything personal about him. I knew that he had a mother, father, and several siblings, and that's about it. I don't ask personal questions. Like the thread we've had here about the mix of the gender of our friends, he seemed to support the idea of having more same gendered friends. He didn't seem as concerned when negative friendships and relationships ended.

    I need to reevaluate how much of it is a conversation and how much of it is work. It feels stressful, like the therapy that is considered work, because I walk away from some sessions frustrated BUT it's more because I sense something like the gender empathy bias, the different political spin, and all that. My last therapist, who was in another city, also used to bring in research because I would ask general questions about a situation or experiences. I liked hearing about the current research and what is happening with people. It told me others are going through the same thing or similar things. I would reflect on it and leave thinking about what I learned.

    The therapist prior to that, so before 2010, was a nightmare. He came from a rich family and his father's high visibility line of work had him trading in spouses for the latest and greatest. He followed suit. One time, during these evening appointments, when the office was dark and empty, there was a woman messing around with paperwork, quite a bit younger than him, in the front office. I only mentioned that there was someone there. He said that it was his fiancee and asked, "Why, does she seem officious to you?" More recent therapy has confirmed that that was really questionable therapy. There was a LOT more to it, and many other comments like that - a whole lot of countertransference.

    I have a session this week. I think I need to bring up the conversation versus progress. I need to be on safe ground and not shaky ground, but he can't expect me to be like him and I don't expect him to be like me. Another thing that came up a few months back, just talking about testing I did when I was younger, was my mentioning my personality profile ending in TJ. He reflected on that. He wanted me to try to feel and perceive more. I don't even know if that's possible or how helpful that would be. My personality profile is among the most common type. Can he not work within that framework? My stuff might be deep and prolonged but I don't think it would shock anyone. It might upset some people who aren't trained to deal with it.

    It has been between two and three years. Like I said above, the learning about family comes in when we either of us have to take a few sessions off or holidays are coming up. Personal views about politics came up recently because there's a lot of fighting about the election and it has affected people's relationships, friendships, and work and it's ending up in therapy for many people these days. I will mention it but not dwell on it. But I learned he has different political leanings than I do. I'm in therapy to talk about psychological matters.
     
    #5 Tightrope, Oct 25, 2020
    Last edited: Oct 25, 2020
  6. Chip

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    Yeah, that is *grossly* inappropriate for a therapist to share for the very reason you gave later in the post: Knowing the therapist's political orientation is different from yours creates separation in the therapeutic alliance.

    I had a client who went on and on about how Obama had completely ruined his life and made his business go bankrupt and so forth and so on. He never had the slightest clue I wasn't in complete agreement with him. And that's the way it should be.

    Again, unless there's something I am missing (the therapist has seen a consistent pattern where you are quick to dismiss friendships over seemingly minor things, for example) a therapist has no business second-guessing your decisions on friendhips. That's getting into the realm of giving advice, which is a huge no-no for therapists.

    Both strategies are common, and both are appropriate. There's a school of thought (I don't agree with it) that writing notes during the session can interfere with attunement between client and counselor. I have never found that to be the case, on either side of the transaction.

    That is seriously problematic. One thing that we are learning about the value of therapy: much more of the long-term effect has to do with the level and quality of therapeutic attunement than anything else. The particular approach, therapeutic modality, theoretical perspective... none of those matter as much as the level of attunement. So anything that gets in the way of that is going to interfere with therapy. And that's why the therapist has no business mentioning his political beliefs and should mention as little as possible about the rest of his or her life, nor offer judgments... because those can interfere with attunement. If you are feeling frustrated, and feel like the therapist has biases, then you are seeing the biases, and that is a problem. No therapist is neutral; that isn't possible. But what is possible is for the therapist or counselor to do such a good job with his or her interaction that the client has no idea. I'd been working with a particular group of clients (doing group work) at a treatment center for drug/alcohol disorders, and there was some circumstance where something came up about sexual orientation. In that setting, it was therapeutically appropriate to disclose I was gay. I did so, and apparently several clients were shocked, as they had no idea... including two clients who were gay and surprised/disappointed that I had not disclosed. I simply said that it wasn't relevant at the time to treatment, which they were able to understand.

    Talking about research can be really useful to clients who understand and appreciate how theory applies to practical work. It gives some clients a sense of security.

    All of that, from his coming from a rich family, the fact he had multiple spouses, that he mentioned his fiance and asked for your opinion... grossly inappropriate. And, sadly, not that uncommon.

    That should be super obvious, and if he's a decent therapist, he'll appreciate your bringing it to his attention. Especially after a couple of years, boundaries can get sloppy, and sometimes, it just takes the client pointing things out for the therapist to reset the boundaries.

    That's a tough call. I could see myself suggesting something like that to a client, but not in such a direct way. One can't really change personality type, and simply telling someone "you should try to perceive more" isn't helpful. But what one can do is explore whether the client feels any desire to perceive or feel more, and if so, explore what might be getting in the way of experiencing or exploring that.

    Certainly he can, or should be able to, but it is also possible he is looking at things that he perceives might be holding you back. That would be a good thing to discuss.
     
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  7. Tightrope

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    I see a lot of the points here. I don't dismiss friendships that easily. Not long-term ones, anyway. He seems a little perplexed that I don't admit some new ones in. That's because I can get a good idea of new acquaintances that he can't and decide they're not for me, or good for me. The one under the microscope in therapy that I've talked about in the first post is a long-term one. The drop in the quality of the friendship has been brewing for several years. I've sort of decided that I want out and I don't see a change in my view. She has made zero new friends in the new town she has lived in for years and seems to get into spats with many of her neighbors. I don't believe I need to know about her intimacy issues all that much because we've been friends for so long and it didn't matter as long as we got along. But when she has brought up men that she's been interested in, they are usually a lot younger than she is and they don't reciprocate her interest. There's more but I won't go on. When the therapist asked me what my contribution was to the situation, I had to think about it. I've been the same with her over the years. She just needs a new project to fight with because she's done with the other ones.

    The attunement with the therapist seemed good for a couple of years. Good word for me to consider about therapy. It's lately that I see some cracks. That's the sloppiness. The idea of bringing up that I don't feel as attuned could be good to reset boundaries or it can bring about all sorts of revelations. I have to do it but am a little anxious about what it might bring about - in a negative way.

    The therapist from the mid-2000s with the fiancee made a few wise cracks like that. I had signs that I should have walked. He was incredibly smart and there were some things in our backgrounds in common. That really wasn't enough. I was in an overwhelming work environment and didn't want to start over. He was grossly inappropriate.

    Since the sessions are now on-line, does the therapist have the option to record a session without my knowing? I like the on-line sessions because I don't have to drive over there but I feel a little uneasy about this way of doing it because the office visits felt more private. I saw the same clients in the waiting room and we were all familiar faces to each other. The office personnel were very supportive.
     
    #7 Tightrope, Oct 27, 2020
    Last edited: Oct 27, 2020
  8. Chip

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    This, from what you describe, sounds like a very one-way friendship. One of the things that is common in folks working through worthiness issues is they tend to attract friendships that aren't balanced. She sounds like she's got a lot going on, and isn't makign any major steps to change. If the relationship isn't working for you, it doesn't sound like there's much reason to continue it, and you don't owe anyone any explanations or justifications for that.

    An effective therapist won't respond negatively to anything you bring up about what isn't working for you. S/he will listen and respond and take steps to modify the approach. If you get pushback, or a desire to analyze why you're bringing these things up, that's the therapist's own boundaries or worthiness issues, and points to an issue with the therapist. I think every client who has cultivated a reasonable connection with the therapist probalby worries about damaging the relationship, but the thing to remember is that the relationship is not a friendship. The therapist is there to help you do the work you want to do. So it isn't a reciprocal arrangement. You get to dump on them, you get to tell them what you want, you get to ask for what you need, and they should not expect anything (other than being paid) in return. That's a hard concept for some folks (including, unfortunately, some therapists) to get, but it is crucial to good therapy.

    Absolutely not, and if the therapist is using proper software that is HIPAA compliant, it would not permit recordings to be made at all.

    There are advantages and disadvantages to telehealth. I think most people prefer in-person, it just isn't safe at the moment. The limited data we have actually shows it is just as effective, provided the therapist is skilled and understands the differences between telehealth and in-person therapy.
     
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  9. Tightrope

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    The relationship was better about 5 years ago and prior to that. She has typically been in therapy. I never knew this when we were younger. I have some very thoughtful gifts in my place that she has given me and are sitting on my furniture. Just like I've stayed with therapy, her absence from it, in my opinion, has been too long for what has gone on in her past.

    I dug up another friend I had known since college. He is married and has no kids. The friendship is fine, but his wife doesn't seem to like any of his friends. He doesn't have any male friends, or female friends, he hangs around with. This was also one boisterous guy and he is the bread winner. I woke up this friendship - later in life - through social media. It's probably not a relevant friendship anymore and we live hundreds of miles apart. Yet the therapist is also challenging me on why I want to exit from this friendship too.

    Is there some sort of significance when people are purging friends that might worry a therapist?

    The therapist has brought up that the people with more things going for them - and even better mental health - are harder to find or hang on to as the years go by. They are either in relationships or their circle of family and friends is well established and functioning. To me, that says that some of these friends might not be such quality people and losing them is not a big deal, because of how they interact. It's better to fly solo, I think, than have lopsided friendships.
     
  10. Tightrope

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    I brought up my issues with his comments on how I look at things a while back. Things got better for a while, to use a much used phrase - it gets better. I brought up that I didn't want to be shrunk wrapped into his way of thinking or perceiving the world based on his social and political perspectives. I didn't say it that way. I was more polite than that. I'm me. And he's who he is.

    During the last session, I got a slight bit of exasperation about the same thing. I will bring it up again at the beginning of this week's session.

    I think he is genuinely concerned with my well being. He's just putting it through his lenses. I go for maintenance. I don't want to fall off my steady course in a way that would then make for a possible emergency. I started therapy with this psychologist when things were okay, but not great, so there was no emergency need for him to get brought up to speed real fast.

    I am thinking of closing out therapy this year, as a resolution. I have friends who, after being in therapy for long periods of time, have stopped and they seem to be doing fine.
     
  11. Lyman

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    I've read your story and the replies to it. All of them very informative!

    Can I ask you why you have made this resolution? I'm curious because I'm myself trying to figure out how to determine the threshold between needing therapy and not. How do you know a meltdown is not to come along and that you need no more maintenance?
     
    #11 Lyman, Mar 19, 2021
    Last edited: Mar 19, 2021
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  12. brainwashed

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    I do this to my long term friends and it pisses me off about me. For the most part I've stopped doing it.

    Follow up: The trouble is, I was not aware I was doing this. I was hurting and wanted sympathy and connection.
     
    #12 brainwashed, Mar 23, 2021
    Last edited: Mar 23, 2021
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  13. brainwashed

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    I like this material. You know it's not like friends come with an "owners manual" so one has to flail a bit in real time.
     
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  14. Chip

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    That's a super difficult question to answer, and I think it's different for everyone. I've posed it over time to several different therapists I've had, and I've also discussed it clinically with other counselors and therapists. There's no wide consensus.

    But some factors that come into play:

    -- If you find that nothing new is coming up, and no real insights or "aha" moments are happening after a period of time (say a month or two of weekly sessions)
    -- If you don't find yourself coming away with things to think about or process or contemplate after your session(s).
    -- if there are multiple sessions in a row where not much is really happening and the conversation is either rehashing old stuff or new stuff that isn't particularly profound

    All of those would be indicative that it may be time to take a break. And that might not be necessarily a break from therapy, but just a time to try a new therapist.

    Now... if there are , as you put it, "meltdowns" that are happening on a fairly regular basis either inside or outside of the therapy room, that's a cause for concern. It could mean that there's still a whole lot more to be uncovered, explored, processed... or it could mean that the therapist is ineffective in teaching effective coping skills and strategies, or helping the client to incorporate the taught strategies in a real-world environment. A client shouldn't be relying on a therapist long-term as a crutch or someone to go to for venting; that's fine when a lot is coming up and being processed, but over time, the therapist's role should be teaching the client how to live his or her life and how to cope with the typical things that come up.
     
  15. brainwashed

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    Great info in this post. The line I highlighted is most notable. I have a friend who has been going to the same therapist for a long time. I've heard some of the subject matter of sessions (when I have coffee with said friend) and I'v said to myself, hum it seems this material is a rerun.
     
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  16. Lyman

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    I hope Tightrope will forgive me for hijacking a little bit his thread, but I cannot not reply to a couple of points made by Chip. :slight_smile:
    I'm not going to focus on the answer to the question I asked last time, which is great, but on its toppings

    So... The first interesting thing I notice is that Chip, who clearly has his act together better than I do and clearly knows what therapy is for, has sought the advice of therapists more than once.

    And this has made me see the idea of therapy from a completely different angle.

    I could pretend that I'm AFAF, but as EC is anonymous who cares...

    So over the last year I'm having from time to time attacks of "very strong unhappiness" (now I'm having two a week) and my basal level of mental wellbeing has been just mediocre (whereas precovid, it was super duper great 99 % of the time).

    I've been reading on the topic of worthiness (which was suggested to me before) and it appears to correlate with the kind of feelings I'm dealing with, but it might me confirmation bias or something. I've also been feeling like absolute crap since I joined a dating app recently, which would align with the "diagnosis". And most of my "friends" are actually acquaintances with whom I can socialise only on the event of them not having anything else to do, which is the kind of "friendship" people with low self-esteem/worthiness tend to attract, if I'm not mistaken.

    So on the one hand I have that plausible issue, and also the fact that I've been in the closet for a quarter of a century (which per se would tend to indicate other issues, right?), and also the fact that my relationship with my mum is spiralling out of control, and also the fact that I feel that loneliness is slowly killing me (covid plus shitty "friends" means I can easily spend periods of 15 days without seeing people), and also the fact of the recent abusive relationship and breakup (the one of the previously linked thread). All this to say that I basically feel that I'm not able to cope with my own life.

    On the other hand, I also tend to think that it's normal that the combination of coming out, a virus-induced apocalypse, crazy mom, *lots* of online rejection, an unhealthy lack of non-abusive human interactions, not sleeping well, etc. affects anyone. So one part of me tends to think that I should deal with it by myself, instead of with therapy.

    What would a reasonable and sensible person do in my shoes?

    Is this a standard on something?
    Money is something I care about, and it's not the same paying 12× 1-hour sessions per month than 4× 45-minute sessions per month.
     
    #16 Lyman, Mar 27, 2021
    Last edited: Mar 27, 2021
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  17. Tightrope

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    I saw your post and question a while back. I was constantly getting signed out by the site. I wrote a long answer and the site asked me to sign it again. I think I have a handle on how to do this now!
     
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  18. Tightrope

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    I'm continuing the post since it worked.

    I need the support, so I keep going. I feel that it's more for maintenance right now. I may move. If I do, I will need to find another therapist anyway. And I will do that.

    There are some times when he forgets things I've talked about or facts that I feel are important and specific to me. I repeat them. I give him all the background. He doesn't think I'll ever fully recover from MDD and PSTD, which I agree with. He feels that I should aim to maintain, stay safe, and slowly get better. A complete cleaning of the slate of everything I've been through is not possible. The therapist and I both acknowledge that ruminations are a problem for me.

    Like Chip said, there is venting going on. In some sessions, I get new insight about it and sometimes I don't. It can be same old, same old. I'm hanging in there for now because we're going into another chapter for me because of one or two major stressful things happening now or in the near future.

    What scrapes we have is about politics and interactions with both genders as friends, coworkers, and stuff like that. My last therapist - several years ago - handled this more empathetically. Life changes meant a new therapist, and I was okay with that. My current therapist has taught me about as gaslighting, trauma, family of origin baggage, trust issues, and more. I feel that with his politics and different dynamics than I would have across genders, I am being judged or, maybe, I don't feel that he can even see how I feel the way I do about things. He does not have sons. Only daughters. I have a feeling we have completely different Myers-Briggs profiles. I belong to the most common M-B group, so I don't think the way I process is all that odd.

    The last session was difficult. It was because I didn't feel I was being understood. But the few sessions before that were fine. I laid stuff out on the table and we worked on it. I don't hold back on how I feel about people, relationships, sex, and sexuality. I can handle the difficult sessions where I feel I am being understood, even part of the way. I have trouble with the ones where he can't see where I'm coming from. This is general stuff that I may run by friends and acquaintances that isn't about therapy, but about life viewpoints, and even some of them validate me.

    I meant to answer sooner. I kept getting signed out! Therapy is hard and has been hard for many members here.
     
  19. Tightrope

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    I had a rough session this afternoon. I went home, to bed, and laid down. I called a friend I have had from when I was in school. He talked me through my angst and calmed me down.

    I've mentioned some of the weird dynamics I have with this therapist. When I mention recurring patterns I come across, he will say, "I don't see that." He may not see them in his life or in his work, but I've seen certain things, my friends (intelligent, educated) discuss things they see, and some of his clients may see things. It's not validating.

    I feel it can be helpful to know if others are experiencing certain things in life. You feel less alone. He says that it shouldn't matter. My last therapist would tell me if what I saw and perceived was seen by others, similar to what others see, or unique to me.

    My current therapist has helped me understand family of origin issues, has given me good advice, and I'm going through some big changes soon, so I need a therapist at this time. I am concerned about changing therapists. Today, my friend told me that I can stay with this therapist if I don't think it would be too, too long before some life changes or change to a different therapist to get a different perspective in the meantime. It has happened that I have tried some therapists for a short while because I did not get a good feeling from the initial visits. I got neutral feelings from my initial sessions with this therapist, so I stuck with it.
     
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  20. Chip

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    I'll again say, this sounds like a shitty therapist. A competent therapist wouldn't just contradict his client. It's one of the most basic things one gets in the first class on counseling skills. It breaks attunement, damages empathy, and screws up the therapeutic alliance with the client.

    Now... in cases where the therapist sees things differently, a more appropriate response would be along the lines of "Tell me more about that so I can better understand." And then, if there are obvious cognitive distortions on the part of the client, it might be appropriate to follow up with "Hmmm. Is there another way you might interpret what you're experiencing" and encourage the client to look and see if what they are perceiving could be interpreted in a different way. But to just say "I don't see that" serves no therapeutic purpose. It essentially creates a therapeutic dead end, something the therapist never wants.

    My personal feelings: Therapy is expensive. So you should be getting high quality, attuned engagement for your $. With the problems you are describing, if this were my therapist, I would not have lasted nearly as long as you have. I would have given it maybe 3 or 4 sessions and then looked for someone else. There are a lot of really shitty therapists out there, so it can take some time to find a really good one, but when you do, it's well worth it, as they will help you do the hard work necessary to work through your issues.
     
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