I didn't realise being in therapy was a skill
February 27, 2009 10:39 AM Subscribe
I feel like the punchline of a joke: on top of everything else, apparently I suck at therapy. I've given it a while - a year and a half - and I still can't do it properly. Now I'm at a loss. Help.
I've been seeing my therapist since the August before last. He's the third one I've had. The first two I gave up on after a few months, as I couldn't talk to either of them properly - it was like talking a foreign language; I just couldn't use the appropriate vocabulary to convey what was going on inside me.
I've always found it difficult to talk about this stuff, but I know there's a difference between difficult and impossible. I thought with this guy if I kept going for long enough, I'd build up enough trust and mutual comprehension to have something approaching a productive therapeutic relationship. Basically, I need to be able, I think, to convey specifics of my emotional response to certain situations, and access those emotions in some way that's immediate enough to have a two-way conversation about it. I don't know how easy that's supposed to be, but I find that in many situations I'll just clam up, and it feels like I just don't have words to describe what's going on without unacceptable levels of distortion. I just sit there staring at the carpet, trying to imagine that there's no-one there so that I can actually feel something rather than trying to keep it as inaccessible as possible.
Towards the start of this year, I thought I was finally getting to a point where I could be relaxed enough to talk properly. I started, for example, talking about a relationship which caused me a large amount of emotional trouble, and for a while I seemed to be speaking with real fluency about things that had actually been important to me. But then I began to be aware that despite the appearance of fluency, he still wasn't understanding what it was I was trying to say. Even worse, I apparently couldn't trust him to respond to what I'd presented at all, let alone appropriately. I would begin to feel like I'd spent an hour effectively talking to myself about something I needed to ruminate about less, not more. Now it seems that the trust has gone or something, and I can't talk in sessions any more - it's worse than it's ever been. I don't know that he realises how much this isn't working for me. I can just spend the whole time deflecting with self-deprecating jokes and he'll laugh and there is an appearance of communication. Or I'll talk about some entirely peripheral issue. Or I'll try to talk about something and fail. I generally spend the first half hour not speaking at all.
I don't have any real hope any more that this will help me. It doesn't help that I don't earn much, and almost a quarter of my net income is going on this. I wonder whether I wouldn't feel better if I just donated that much money to charity. Thing is, this was my last hope that I might someday make my life properly livable. I can't face spending another eighteen months trying to build up enough trust in someone else to find out if they 'get' me or not. I can't believe I'm failing at therapy, for christ's sake.
I've been seeing my therapist since the August before last. He's the third one I've had. The first two I gave up on after a few months, as I couldn't talk to either of them properly - it was like talking a foreign language; I just couldn't use the appropriate vocabulary to convey what was going on inside me.
I've always found it difficult to talk about this stuff, but I know there's a difference between difficult and impossible. I thought with this guy if I kept going for long enough, I'd build up enough trust and mutual comprehension to have something approaching a productive therapeutic relationship. Basically, I need to be able, I think, to convey specifics of my emotional response to certain situations, and access those emotions in some way that's immediate enough to have a two-way conversation about it. I don't know how easy that's supposed to be, but I find that in many situations I'll just clam up, and it feels like I just don't have words to describe what's going on without unacceptable levels of distortion. I just sit there staring at the carpet, trying to imagine that there's no-one there so that I can actually feel something rather than trying to keep it as inaccessible as possible.
Towards the start of this year, I thought I was finally getting to a point where I could be relaxed enough to talk properly. I started, for example, talking about a relationship which caused me a large amount of emotional trouble, and for a while I seemed to be speaking with real fluency about things that had actually been important to me. But then I began to be aware that despite the appearance of fluency, he still wasn't understanding what it was I was trying to say. Even worse, I apparently couldn't trust him to respond to what I'd presented at all, let alone appropriately. I would begin to feel like I'd spent an hour effectively talking to myself about something I needed to ruminate about less, not more. Now it seems that the trust has gone or something, and I can't talk in sessions any more - it's worse than it's ever been. I don't know that he realises how much this isn't working for me. I can just spend the whole time deflecting with self-deprecating jokes and he'll laugh and there is an appearance of communication. Or I'll talk about some entirely peripheral issue. Or I'll try to talk about something and fail. I generally spend the first half hour not speaking at all.
I don't have any real hope any more that this will help me. It doesn't help that I don't earn much, and almost a quarter of my net income is going on this. I wonder whether I wouldn't feel better if I just donated that much money to charity. Thing is, this was my last hope that I might someday make my life properly livable. I can't face spending another eighteen months trying to build up enough trust in someone else to find out if they 'get' me or not. I can't believe I'm failing at therapy, for christ's sake.
Now it seems that the trust has gone or something, and I can't talk in sessions any more
I don't have answers for you, perhaps therapy is not for you, but for me, the only time I ever benefited from therapy was actually opening up to someone I didn't trust. Realizing that the person couldn't hurt me, realizing that keeping these secrets inside was the problem and not that the world could hurt me or misunderstand me, that was the benefit I got from therapy and with it came a lot of freedom. Instead of trying to create trust, try opening up to someone you don't trust. Just my two cents.
posted by milarepa at 10:54 AM on February 27, 2009 [1 favorite]
I don't have answers for you, perhaps therapy is not for you, but for me, the only time I ever benefited from therapy was actually opening up to someone I didn't trust. Realizing that the person couldn't hurt me, realizing that keeping these secrets inside was the problem and not that the world could hurt me or misunderstand me, that was the benefit I got from therapy and with it came a lot of freedom. Instead of trying to create trust, try opening up to someone you don't trust. Just my two cents.
posted by milarepa at 10:54 AM on February 27, 2009 [1 favorite]
Before you terminate this therapeutic relationship, why not print out what you've written above and take it to your next session?
posted by Carol Anne at 10:55 AM on February 27, 2009 [5 favorites]
posted by Carol Anne at 10:55 AM on February 27, 2009 [5 favorites]
I wouldn't necessarily say therapy doesn't work for you. There are many different types of therapy, one of which does involve mostly letting the patient/client/etc simply talk with little to no feedback. This however does not seem to be the type of therapy for you. Things like Cognitive Behavioral therapy are much more focused on giving you ways to stop doing things (like thinking about your relationship) or change how you think about things (again your relationship). This might be more like what you are looking for. It's hard to tell exactly what you want out of therapy from your post, and you may not be sure yet yourself.
What you should do is honestly sit down with yourself, think through exactly what you want to be getting out of therapy, be it someone to listen to you and give perspective, someone to give you active things to do, etc. You may not have it all correct in one go, and you may need to reassess later, but do this as a first step. Then go into your therapist and have a discussion with him about what you are really looking for, see if it is something he can provide, as you have already built up some trust with him. If he can't do it, see if he can refer you to someone who specializes more in what you are looking for.
Don't give up, you are not wrong and you don't fail at therapy, it is a learning process to figure out what you need and want and how to get it.
posted by katers890 at 11:02 AM on February 27, 2009
What you should do is honestly sit down with yourself, think through exactly what you want to be getting out of therapy, be it someone to listen to you and give perspective, someone to give you active things to do, etc. You may not have it all correct in one go, and you may need to reassess later, but do this as a first step. Then go into your therapist and have a discussion with him about what you are really looking for, see if it is something he can provide, as you have already built up some trust with him. If he can't do it, see if he can refer you to someone who specializes more in what you are looking for.
Don't give up, you are not wrong and you don't fail at therapy, it is a learning process to figure out what you need and want and how to get it.
posted by katers890 at 11:02 AM on February 27, 2009
You've had a really rough time, it sounds like. The money issue compounds it, too.
I would say two things: first, maybe therapy alone isn't enough for you. If you haven't seen your GP or a psychopharmacologist in a while, it might help. It doesn't sound like the treatment strategy you have in place right now is totally effective.
And second, it's easy to say this, but please don't give up. There are thousands of therapists out there, specialized in so many different fields. Maybe you need a psychiatrist if you haven't seen one, or a psychologist, or a social worker. Do some research to see who's in your area and what his or her area of expertise is--age group, condition, etc. And go to your GP for a referral.
I just got out of a "relationship" with a social worker. It didn't start out too well. We didn't really connect. Like you, I thought with time it would improve. No such luck. Therapy is an art as much as it is a science, so its success depends on an inter-personal connection. You're a thoughtful and eloquent person, so keep looking for that person around whom you can feel comfortable. It's worth the time, effort, and income.
posted by world b free at 11:03 AM on February 27, 2009
I would say two things: first, maybe therapy alone isn't enough for you. If you haven't seen your GP or a psychopharmacologist in a while, it might help. It doesn't sound like the treatment strategy you have in place right now is totally effective.
And second, it's easy to say this, but please don't give up. There are thousands of therapists out there, specialized in so many different fields. Maybe you need a psychiatrist if you haven't seen one, or a psychologist, or a social worker. Do some research to see who's in your area and what his or her area of expertise is--age group, condition, etc. And go to your GP for a referral.
I just got out of a "relationship" with a social worker. It didn't start out too well. We didn't really connect. Like you, I thought with time it would improve. No such luck. Therapy is an art as much as it is a science, so its success depends on an inter-personal connection. You're a thoughtful and eloquent person, so keep looking for that person around whom you can feel comfortable. It's worth the time, effort, and income.
posted by world b free at 11:03 AM on February 27, 2009
This is just my opinion. I think that it is important to realize that you get out of therapy as much as you put in. Unfortunately, it sounds like you haven't put much in. It sounds oversimplified to go in and tell the therapist what is bothering you. But, that's what you have to do. The therapist cannot help you if you just sit silently for a half hour. Therapists aren't mind readers.
I wouldn't worry about if your therapist will "get you" or not. Just put yourself out there. Tell the therapist, in plain language, what is bothering you. Don't assume that they get it or don't get it. They should tell you, either way. If you don't actually talk to them, they can't help you. You have nothing to lose.
posted by bolognius maximus at 11:04 AM on February 27, 2009
I wouldn't worry about if your therapist will "get you" or not. Just put yourself out there. Tell the therapist, in plain language, what is bothering you. Don't assume that they get it or don't get it. They should tell you, either way. If you don't actually talk to them, they can't help you. You have nothing to lose.
posted by bolognius maximus at 11:04 AM on February 27, 2009
Have you read If You Meet The Buddha On The Road, Kill Him: The Pilgrimage of Psychotherapy Patients? It won't solve all your problems in a flash but might make useful reading.
posted by game warden to the events rhino at 11:16 AM on February 27, 2009
posted by game warden to the events rhino at 11:16 AM on February 27, 2009
Also, for your case, I would say one of three things is happening with your therapist:
1) He or she uses a very hands-off approach that doesn't try to steer you back towards an issue when you skirt, and doesn't offer solutions; that's an unhelpful approach for you
2) He or she is incompetent and doesn't understand when you ARE skirting around an issue, even after having known you for eighteen months
3) He or she knows full well you're not being as free as you want to be, and doesn't care.
In any of the three, I'd say it's time to move on. Remember, it's been a year and a half with little progress.
posted by world b free at 11:18 AM on February 27, 2009 [2 favorites]
1) He or she uses a very hands-off approach that doesn't try to steer you back towards an issue when you skirt, and doesn't offer solutions; that's an unhelpful approach for you
2) He or she is incompetent and doesn't understand when you ARE skirting around an issue, even after having known you for eighteen months
3) He or she knows full well you're not being as free as you want to be, and doesn't care.
In any of the three, I'd say it's time to move on. Remember, it's been a year and a half with little progress.
posted by world b free at 11:18 AM on February 27, 2009 [2 favorites]
Believe it or not, all these experiences make you more likely, not less likely, to hit it off with a different therapist, because you've explored a wider range of what works for you and doesn't, and you've gotten better at articulating these things (and this thread is a good example of that). Start the hunt again. Bring this post with you for inspiration when you meet with your new therapist.
posted by hermitosis at 11:32 AM on February 27, 2009 [2 favorites]
posted by hermitosis at 11:32 AM on February 27, 2009 [2 favorites]
I don't think you're "failing" at therapy. It sounds like you're trying different things and learning, even if you have not yet found a way to get where you want to end up. So, maybe you're not done, but you're doing it right.
posted by salvia at 11:36 AM on February 27, 2009
posted by salvia at 11:36 AM on February 27, 2009
I had the exact same problem when I was in therapy. My first therapist was a total loser and had no idea what I was talking about. This was also a difficult and very emotional period where it seemed like nobody I knew understood what i was trying to say and that is so incredibly frustrating.
What worked for me was finding someone else, and then explaining to the second therapist that I had a hard time using words to express things. I compared it to a translation problem. The way I explained it was that I had feelings in one department of my brain and I couldn't move them over into the part of my brain that articulates things. With this in mind I just tried to go really slowly and carefully and made sure that he was following me. It's important that the therapist is aware that it's a problem and that you make sure he's following you. Take your time and don't rush through things. Eventually it gets easier with practice.
This therapist was a Cognitive Behavioral therapist which I think you should look for if you don't have one already. My therapist also had sort of a specialization or academic interest in Buddhist philosophy, which I found reassuring because I figured he would have kind of an open mind and might be more receptive or understanding to how I might need to get things out and if I wanted to reference something I had read in that field he would already be knowledgable of it. Not that you MUST be interested in Buddhism to have an open mind, but it was something that I found reassuring in regards to being understood.
Also, there are tons of questions on Askme about therapists and finding the right one, and you will see that many many people have a hard time finding a good one so please don't think you're "failing". Therapy is not an easy to thing to.
I understand that it's a financial hardship. If you feel that you really can't make it work with this guy then there's no harm in finding another one. But before you give up I would give it one more shot armed with all of the advise in this thread.
posted by amethysts at 11:44 AM on February 27, 2009
What worked for me was finding someone else, and then explaining to the second therapist that I had a hard time using words to express things. I compared it to a translation problem. The way I explained it was that I had feelings in one department of my brain and I couldn't move them over into the part of my brain that articulates things. With this in mind I just tried to go really slowly and carefully and made sure that he was following me. It's important that the therapist is aware that it's a problem and that you make sure he's following you. Take your time and don't rush through things. Eventually it gets easier with practice.
This therapist was a Cognitive Behavioral therapist which I think you should look for if you don't have one already. My therapist also had sort of a specialization or academic interest in Buddhist philosophy, which I found reassuring because I figured he would have kind of an open mind and might be more receptive or understanding to how I might need to get things out and if I wanted to reference something I had read in that field he would already be knowledgable of it. Not that you MUST be interested in Buddhism to have an open mind, but it was something that I found reassuring in regards to being understood.
Also, there are tons of questions on Askme about therapists and finding the right one, and you will see that many many people have a hard time finding a good one so please don't think you're "failing". Therapy is not an easy to thing to.
I understand that it's a financial hardship. If you feel that you really can't make it work with this guy then there's no harm in finding another one. But before you give up I would give it one more shot armed with all of the advise in this thread.
posted by amethysts at 11:44 AM on February 27, 2009
many situations I'll just clam up, and it feels like I just don't have words to describe what's going on without unacceptable levels of distortion.
I find that writing or journaling is very helpful in figuring out my feelings. It slows the brain down enough to sort things out so they make sense.
Though this might not be related to your situation, I've read that clamming up and fumbling for the right words can be a trait associated with introversion. I'm very much an introvert and find no amount of comfort will change how my brain works, which means I'm often at a loss for the right words.
posted by ljesse at 11:45 AM on February 27, 2009
I find that writing or journaling is very helpful in figuring out my feelings. It slows the brain down enough to sort things out so they make sense.
Though this might not be related to your situation, I've read that clamming up and fumbling for the right words can be a trait associated with introversion. I'm very much an introvert and find no amount of comfort will change how my brain works, which means I'm often at a loss for the right words.
posted by ljesse at 11:45 AM on February 27, 2009
he still wasn't understanding what it was I was trying to say. Even worse, I apparently couldn't trust him to respond to what I'd presented at all, let alone appropriately. I would begin to feel like I'd spent an hour effectively talking to myself about something I needed to ruminate about less, not more. Now it seems that the trust has gone or something, and I can't talk in sessions any more - it's worse than it's ever been. I don't know that he realises how much this isn't working for me.
Why would you say after this that YOU are failing at therapy? It sounds like it is your THERAPIST who isn't getting it and it is clear to me that your current therapist is not the right fit for you. A good therapist will help you make progress and make progress pretty rapidly. If you are making no detectable progress and you can't even trust or COMMUNICATE with your therapist, you need to get a new therapist. This is very, very common. It is just a necessary fact that you will need to "try out" a few different therapists until you find one that you feel comfortable with and you feel is helping you make progress. It is a pain in the butt, but when you find a good therapist, your whole life will change profoundly for the better and it doesn't have to take a long time! The ones who just sit with you and run out the clock and don't help you make any progress are the ones who are sadly just after your money. Also, please stay away from any therapist who encourages pharmaceutical drugs! Go to the ones who DISCOURAGE pharmaceuticals except only in rare situations. Please also pay attention to hermitosis excellent comment. Good luck!
posted by synchronicity1 at 11:51 AM on February 27, 2009
Why would you say after this that YOU are failing at therapy? It sounds like it is your THERAPIST who isn't getting it and it is clear to me that your current therapist is not the right fit for you. A good therapist will help you make progress and make progress pretty rapidly. If you are making no detectable progress and you can't even trust or COMMUNICATE with your therapist, you need to get a new therapist. This is very, very common. It is just a necessary fact that you will need to "try out" a few different therapists until you find one that you feel comfortable with and you feel is helping you make progress. It is a pain in the butt, but when you find a good therapist, your whole life will change profoundly for the better and it doesn't have to take a long time! The ones who just sit with you and run out the clock and don't help you make any progress are the ones who are sadly just after your money. Also, please stay away from any therapist who encourages pharmaceutical drugs! Go to the ones who DISCOURAGE pharmaceuticals except only in rare situations. Please also pay attention to hermitosis excellent comment. Good luck!
posted by synchronicity1 at 11:51 AM on February 27, 2009
as others have said, it sounds like your therapist isn't very good. Another thing to consider is that maybe you aren't comfortable with the face-to-face style of therapy. You seem to be able to express yourself well in written form, maybe you could try online therapy. Some therapists also do phone sessions - it may be easier for you to open up if you can do it comfortably at home. There may also be a cost advantage to these methods as well, but I'm really not sure. worth looking in to though...
posted by 5_13_23_42_69_666 at 12:13 PM on February 27, 2009
posted by 5_13_23_42_69_666 at 12:13 PM on February 27, 2009
Can you talk to yourself about it? I don't mean talk in the literal sense of saying words, but can you clearly and concisely work out exactly what the problems are when you're alone?
If you can do that, could you create some kind of bullet point list that you could give to your therapist, so you could get the ball rolling?
posted by Solomon at 12:38 PM on February 27, 2009
If you can do that, could you create some kind of bullet point list that you could give to your therapist, so you could get the ball rolling?
posted by Solomon at 12:38 PM on February 27, 2009
Here, try this: just say what you're thinking to him. You don't have to grapple with your psyche to divulge your innermost feelings; just say what you're thinking. See, when you're staring at the carpet the way you say you do, just say: "Well, Doc, this might sound weird, but right now I'm just staring at the carpet, trying to imagine that there's no-one here so that I can actually feel something rather than trying to keep it as inaccessible as possible." When you "become aware" that he's not really getting what you're trying to lay out for him, say "Doc, I have a feeling you don't exactly understand what I'm saying." When you feel like you're just talking to yourself about things that you should think less about, not more, say "Doc, I feel sometimes like I'm just talking to myself about things that I should think less about, not more."
If you want my honest opinion, you're 'failing' at therapy because you're not giving it, and your therapists, a chance. In therapy, as in life, when somebody doesn't understand, or when you feel as though there's a lack of communication, you have to say something about it; that's the only way. What's keeping you from that is, I think, this notion you have that you have to carefully compose your words to avoid "unacceptable levels of distortion." Trust me - unless you're a paranoid schizophrenic, he will piece together the words that come out of your mouth; and that's his job. You don't have to utter some philosophical treatise about how you're feeling; "I feel funny 'cuz I think you are not gettin' what I'm sayin'" should be enough for him to work with, so give it a chance.
posted by koeselitz at 12:56 PM on February 27, 2009 [2 favorites]
If you want my honest opinion, you're 'failing' at therapy because you're not giving it, and your therapists, a chance. In therapy, as in life, when somebody doesn't understand, or when you feel as though there's a lack of communication, you have to say something about it; that's the only way. What's keeping you from that is, I think, this notion you have that you have to carefully compose your words to avoid "unacceptable levels of distortion." Trust me - unless you're a paranoid schizophrenic, he will piece together the words that come out of your mouth; and that's his job. You don't have to utter some philosophical treatise about how you're feeling; "I feel funny 'cuz I think you are not gettin' what I'm sayin'" should be enough for him to work with, so give it a chance.
posted by koeselitz at 12:56 PM on February 27, 2009 [2 favorites]
As a future therapist myself, I believe that the most important qualities in any therapist are kindness, warmth, being supportive, being inviting and creating a safe environment. These are absolutely necessary for a succesful therapuetic experience. You need to feel that the counselor likes and respects you. I'm not sure what is getting in the way of communication between you and your therapist. However, if the above qualities are not present, it would be very hard to make much progress and/or solve a communication barrier about the progress. Keep looking for the counselor who will make you feel safe!
posted by rglass at 1:12 PM on February 27, 2009
posted by rglass at 1:12 PM on February 27, 2009
I would begin to feel like I'd spent an hour effectively talking to myself about something I needed to ruminate about less, not more.
Well, there's part of your answer. If you don't have anything to talk about, maybe your therapy arc is done.
Or at least this topic is. Instead of what's still stewing in you after all this time, what about what's going on at work, or with your family? Is any of that day-to-day stuff relevant to what's holding you up and keeping you still thinking you need something?
One thing you haven't tried, and may want to consider, is group therapy. At a certain point the "inner monologue" engagement is just masturbation whereas a peer group approach can ground you in reality.
posted by dhartung at 1:19 PM on February 27, 2009
Well, there's part of your answer. If you don't have anything to talk about, maybe your therapy arc is done.
Or at least this topic is. Instead of what's still stewing in you after all this time, what about what's going on at work, or with your family? Is any of that day-to-day stuff relevant to what's holding you up and keeping you still thinking you need something?
One thing you haven't tried, and may want to consider, is group therapy. At a certain point the "inner monologue" engagement is just masturbation whereas a peer group approach can ground you in reality.
posted by dhartung at 1:19 PM on February 27, 2009
Trust is super-important. I absolutely believe that if trust is lacking, real therapy can't happen. But if youhave a therapist that you generally feel comfortable with, the less than perfect parts of the relationship can be dealt with -- though broaching them can be hard. A good therapist will react without defensiveness, and will thank you for bringing up a problem between the two of you.
I've experienced this: I explain and describe important thoughts and emotions about a particular thing, and the therapist doesn't seem to know what I'm talking about -- even after a few tries. For me, it seems to happen when I'm feeling a lot of anxiety or depression. It feels very frustrating and discouraging, and also very strange, in a way I won't even try to decribe right now :-\ My shrink is excellent, but it still happens sometimes.
In my case, it might be largely cognitive. In the moment, I'm certain that the therapist just can't get it. At other times I remember that when I'm at emotional extremes, I'm less clear -- whether I'm speaking or listening. I also try to express subtle shades of meaning, because when I'm feeling especially bad, their importance is magnified in my mind. Explaining subtleties that only I can sense is just impossible when I'm in a bad way emotionally.
Only recently, I've been able to make myself say, "I feel like you're not understanding me." My doctor is very professional and I trust him a lot, but still it's not easy to make that statement. But when I do say it, I feel significantly better right away -- about the communication issue, that is.
What if you really can't express yourself at the level you'd like to? That may actually be the case. Let the therapist work with you on getting the important things understood.
posted by wryly at 1:47 PM on February 27, 2009
I've experienced this: I explain and describe important thoughts and emotions about a particular thing, and the therapist doesn't seem to know what I'm talking about -- even after a few tries. For me, it seems to happen when I'm feeling a lot of anxiety or depression. It feels very frustrating and discouraging, and also very strange, in a way I won't even try to decribe right now :-\ My shrink is excellent, but it still happens sometimes.
In my case, it might be largely cognitive. In the moment, I'm certain that the therapist just can't get it. At other times I remember that when I'm at emotional extremes, I'm less clear -- whether I'm speaking or listening. I also try to express subtle shades of meaning, because when I'm feeling especially bad, their importance is magnified in my mind. Explaining subtleties that only I can sense is just impossible when I'm in a bad way emotionally.
Only recently, I've been able to make myself say, "I feel like you're not understanding me." My doctor is very professional and I trust him a lot, but still it's not easy to make that statement. But when I do say it, I feel significantly better right away -- about the communication issue, that is.
What if you really can't express yourself at the level you'd like to? That may actually be the case. Let the therapist work with you on getting the important things understood.
posted by wryly at 1:47 PM on February 27, 2009
I don't think you have to keep "trying" with one therapist when there are so many of them out there. I've been to three, one of whom I went back to after several years. If you can't open up to him, than he's not the right therapist for you. It doesn't mean that you're failing or that he is either. It's a weird almost relationship that is probably one of the most intimate you'll ever have because of the things you share with them. As much as it's about trust, it's also finding a common line of communication. Also, every therapist goes at things a different way, which should be encouraging to you. It means that there is someone who WILL understand you or help you open up. I say, keep looking and don't get discouraged. As a side note: I don't make a lot of money and my insurance doesn't cover mental health care. Out of pocket, I pay $80 a session (which is a discount from $120). So that's a whopping $320 a month...well worth it, though. And not to get all preachy or anything, but if you're looking to give back in some way, time is just as valuable as money, so maybe volunteering would be something you could look into.
Best of luck.
posted by patientpatient at 2:03 PM on February 27, 2009
Best of luck.
posted by patientpatient at 2:03 PM on February 27, 2009
Mod note: This is a comment from an anonymous contributor.
You must feel horribly frustrated and defeated. I think about might have Attention Deficit Disorder.
You seem to feel like a failure at everything, it is a classic sign. As is the difficulty communicating with a therapist, feeling like you're really off track, having nothing to say, feeling like your therapy is missing the point.
A lot of children/adults are not diagnosed with ADD because they're not bouncing off the walls, or it's mistaken for another problem (depression, laziness, problems with authority, fear of failure). This is especially true for women.
Read Driven to Distraction, it talks about this problem. You can also bring ADD up with your therapist.
Keep trying to get help for yourself and don't give up. You are worth it and we're pulling for you.
posted by cortex (staff) at 3:15 PM on February 27, 2009
You must feel horribly frustrated and defeated. I think about might have Attention Deficit Disorder.
You seem to feel like a failure at everything, it is a classic sign. As is the difficulty communicating with a therapist, feeling like you're really off track, having nothing to say, feeling like your therapy is missing the point.
A lot of children/adults are not diagnosed with ADD because they're not bouncing off the walls, or it's mistaken for another problem (depression, laziness, problems with authority, fear of failure). This is especially true for women.
Read Driven to Distraction, it talks about this problem. You can also bring ADD up with your therapist.
Keep trying to get help for yourself and don't give up. You are worth it and we're pulling for you.
posted by cortex (staff) at 3:15 PM on February 27, 2009
follow-up from the OP
I'm getting people telling me to try harder. I probably didn't make it clear enough what the experience of 'clamming up' is like for me. I can't speak. I try to talk, and no words come. It's frightening. I can't say anything. I try to say one word at a time, and it comes out making no sense - it's not ungrammatical, but I don't complete sentences and often I can't think of any nouns at all, so I just put generic replacements in there. And unfortunately, it doesn't seem to be the kind of thing that gets easier - it doesn't work just to force myself to talk garbage until something comes out. It gets harder; I start thinking of the person as someone I'll never make myself understood to, and the strength to force out words just drains away. I really get that therapy requires work. I've been working and working, but it feels as hard as a physical impossibility - there are certain weights I just can't lift, and certain things I can't, in the moment, talk about. That quite often includes what's bothering me right now, or what's going through my head right now.posted by jessamyn at 3:42 PM on February 27, 2009
I had no second thoughts about ditching the last two therapists. But I'd be worried about gambling on getting better than this guy, because the gap between him and the other two is very large. He's not working, but he's been a lot better. I have found it difficult to find friends, etc whom I could actually talk to about important things in such a way that they'd understand what I was saying, so I think that maybe I just find it difficult to find people who are on the same wavelength, in general. It doesn't help that my inarticulacy is accompanied by a secondary framework that's quite heavily theorised. I think my book-larnin is disguising the fact that emotionally, I am dumb as a brick; at the same time, a lot of the time the only handle I have on what's going on is said book-larnin, so it really helps having someone who has a chart for some of the semaphore I use to communicate with. (A nice example of this going wrong: therapist #1 suggesting, without irony, that I should esteem myself more highly because "you're obviously very intelligent. I mean, most of the time I have absolutely no idea what you are talking about.") Just finding people with the appropriate decoder charts is surprisingly hard.
I don't think it's the therapist's fault that I'm unclear, and though I'd like to feel disappointed that he can't see through me sometimes, I don't know that it's fair to expect him to do so.
I don't know that my style is quite conveying how distraught I am about this right now. The entirely understandable suggestions that I should put some back into it are making me like even more of a fuck-up. Thanks for the volunteering suggestion but I've tried it pretty extensively and I was a crappy volunteer.
Dear OP:
Perhaps what might work for you is to do therapy at a distance, rather than in person. Since your ability to write coherently is obviously not compromised, it might be worthwhile to try an approach where you write down what you're thinking, and when you're satisfied that you have said what you needed to say, you send it to your therapist. Hell, do a couple of drafts if you feel you need to. It is not uncommon for therapists to do work over email. If necessary, you may want to start a relationship with a new therapist who you've never met in person in order to make it more like talking to random people on MeFi, as you're doing now.
Intelligent people are often bad at emotional things; they spend a lot of their time analyzing instead of feeling, and they're far better at rationalizing than the average person.
Best wishes!
posted by '' at 4:16 PM on February 27, 2009
Perhaps what might work for you is to do therapy at a distance, rather than in person. Since your ability to write coherently is obviously not compromised, it might be worthwhile to try an approach where you write down what you're thinking, and when you're satisfied that you have said what you needed to say, you send it to your therapist. Hell, do a couple of drafts if you feel you need to. It is not uncommon for therapists to do work over email. If necessary, you may want to start a relationship with a new therapist who you've never met in person in order to make it more like talking to random people on MeFi, as you're doing now.
Intelligent people are often bad at emotional things; they spend a lot of their time analyzing instead of feeling, and they're far better at rationalizing than the average person.
Best wishes!
posted by '' at 4:16 PM on February 27, 2009
Hey again. I'm really sorry you're feeling distraught. I like the idea of printing out what you've said on here, taking it to your therapist or GP, explaining that you have trouble communicating verbally, and that what you've written should point both of you in the right direction. I feel like, having read what you've written, that I have a pretty good sense of what's going on. I'm nowhere near qualified to tell you what that is or how to fix it, but the written-communication skills are there.
I know it's frustrating. You're definitely not a fuck-up.
posted by world b free at 4:22 PM on February 27, 2009
I know it's frustrating. You're definitely not a fuck-up.
posted by world b free at 4:22 PM on February 27, 2009
When the "therapeutic relationship" becomes something for you to think about, it means your therapist is screwing up.
If your therapist can't feel out how you grasp the world in the first twenty or thirty minutes and blend into it, and then, in the twenty minutes after that, proceed to take a wrench to the rustier bolts holding together your world-view-- he or she is not very competent.
And there are many, many semi-competent therapists out there.
A good therapist should be able to piece together your thought patterns based on your nonverbal behavior, shifts in your voice, and how you talk-- or decline to talk-- about your presenting issues... help you pin down exactly what's going on... and then give you specific techniques for changing your feelings, behavior, and results. You shouldn't expect to be "fixed" immediately-- but you should have a definite pathway toward progress already marked out, and specific tools for getting there.
This should happen in the first session.
If not, dump him/her and move on.
Based on what you've written, I'd go with a) bodywork or b) NLP. NLP would probably take fewer sessions and be much less expensive...
posted by darth_tedious at 7:18 PM on February 27, 2009
If your therapist can't feel out how you grasp the world in the first twenty or thirty minutes and blend into it, and then, in the twenty minutes after that, proceed to take a wrench to the rustier bolts holding together your world-view-- he or she is not very competent.
And there are many, many semi-competent therapists out there.
A good therapist should be able to piece together your thought patterns based on your nonverbal behavior, shifts in your voice, and how you talk-- or decline to talk-- about your presenting issues... help you pin down exactly what's going on... and then give you specific techniques for changing your feelings, behavior, and results. You shouldn't expect to be "fixed" immediately-- but you should have a definite pathway toward progress already marked out, and specific tools for getting there.
This should happen in the first session.
If not, dump him/her and move on.
Based on what you've written, I'd go with a) bodywork or b) NLP. NLP would probably take fewer sessions and be much less expensive...
posted by darth_tedious at 7:18 PM on February 27, 2009
I spent 2 1/2 years in therapy and until maybe the final month of it, I didn't feel like I was making any progress at all. Perhaps you'd do better with a different therapist, but you may need longer term therapy, especially if your therapist can only see you every 3 weeks like mine did.
posted by IndigoRain at 7:21 PM on February 27, 2009
posted by IndigoRain at 7:21 PM on February 27, 2009
This is kind of random, but have you considered doing group therapy or something similar for a while? For myself, it took about a whole year of listening to other people talk before I even began to get a idea of what vocabulary worked and how the whole thing worked.
posted by small_ruminant at 11:20 PM on February 27, 2009
posted by small_ruminant at 11:20 PM on February 27, 2009
Your post and follow up post here are very articulate.
Why don't you write everything down and bring it to your therapist?
posted by JFitzpatrick at 9:28 AM on February 28, 2009
Why don't you write everything down and bring it to your therapist?
posted by JFitzpatrick at 9:28 AM on February 28, 2009
Thoughts:
a) group therapy / support group. Pros: cheap/donation basis, you feel *less* emotionally vulnerable, because everyone else is too)
b) progress at 6 sessions tends to predict long term success in counselling - wish I could find the link, and see other comments for counter examples (sudden progress at 1, 2 years etc)
c) The last... 6 counsellors of various stripes I saw before my current one, were entirely unhelpful matches. Current one, who I incidentally found through a low-income support group (bonus!), is great. Clicked from first session. It may just take awhile.
d) you sound like you are experiencing severe anxiety when you try and open up (inability to talk, "it's frightening", ungrammatical/gibberish words). You may not be aware that what you are experiencing is anxiety. I thought I was feeling 'nothing', that I just couldn't talk/do anything/I kept freezing up or my thoughts were skittering about. I kept looking up 'procrastination' online, trying to figure out what was wrong with me - it, well, it was that too, but mostly it was anxiety.
Mine, was partly set off by a phobia of being 'crazy'. So, talking to a Dr, a help-line, a therapist, or taking pills when I was say, a little depressed, caused spiralling anxiety and panic - a feedback loop. I was emotionally unaware enough to not realise what was wrong, or what was setting it off (other than that doing the things I was 'supposed to do' was making me feel worse). Yours may be centered around verbally opening up to people or something like that - and is therefore being set off by the therapy. If you can figure out what it is, or relates too, then it may diminish alot right there - and be sure and tell your therapist.
Further to that:
e) medication. Are you on any? See above about anxiety. If you end up talking to a dr, & if you end up getting any anxiety medication, and it is short-term acting - try taking some at a therapy session, to see if it is any different. It might at least let you realise whether it is anxiety, and what is 'you'.
f) An exercise my current counsellor has me doing, is identifying emotion. You've got to start at the very beginning - feel the body, and identify sensations, then work your way up to emotions. So, you're sitting there - can't say anything. Start describing physical sensations. The back of my neck is sore, and I keep tensing up between the eyes, I have a tight feeling in the middle front of my neck...
Once you work your way through that (work progressively through the body if you're really having trouble), you can start 'guessing' as to what emotions that might be... (some are easy - I keep wrinkling my nose a little when I think/say that, hey - is that disgust?).
g) breathe. And just talk slowly. I talk fast to cover up emotions - because I think I'm trying to keep up with my thoughts. Talking really slowly, allowing pauses, the emotion I don't realise I am feeling starts to leak out. Might be different for you (more than likely), but you might find your own way.
h) My counsellor has started me on mostly stress-reducing techniques. Even Time management stuff, because that would be most effective (ie not running late to everything versus breathing exercises when I'm panicking because I have). When I feel ok, more comfortable feeling, I'm not walling off as much because of stress/anxiety.
posted by Elysum at 5:25 PM on March 1, 2009
a) group therapy / support group. Pros: cheap/donation basis, you feel *less* emotionally vulnerable, because everyone else is too)
b) progress at 6 sessions tends to predict long term success in counselling - wish I could find the link, and see other comments for counter examples (sudden progress at 1, 2 years etc)
c) The last... 6 counsellors of various stripes I saw before my current one, were entirely unhelpful matches. Current one, who I incidentally found through a low-income support group (bonus!), is great. Clicked from first session. It may just take awhile.
d) you sound like you are experiencing severe anxiety when you try and open up (inability to talk, "it's frightening", ungrammatical/gibberish words). You may not be aware that what you are experiencing is anxiety. I thought I was feeling 'nothing', that I just couldn't talk/do anything/I kept freezing up or my thoughts were skittering about. I kept looking up 'procrastination' online, trying to figure out what was wrong with me - it, well, it was that too, but mostly it was anxiety.
Mine, was partly set off by a phobia of being 'crazy'. So, talking to a Dr, a help-line, a therapist, or taking pills when I was say, a little depressed, caused spiralling anxiety and panic - a feedback loop. I was emotionally unaware enough to not realise what was wrong, or what was setting it off (other than that doing the things I was 'supposed to do' was making me feel worse). Yours may be centered around verbally opening up to people or something like that - and is therefore being set off by the therapy. If you can figure out what it is, or relates too, then it may diminish alot right there - and be sure and tell your therapist.
Further to that:
e) medication. Are you on any? See above about anxiety. If you end up talking to a dr, & if you end up getting any anxiety medication, and it is short-term acting - try taking some at a therapy session, to see if it is any different. It might at least let you realise whether it is anxiety, and what is 'you'.
f) An exercise my current counsellor has me doing, is identifying emotion. You've got to start at the very beginning - feel the body, and identify sensations, then work your way up to emotions. So, you're sitting there - can't say anything. Start describing physical sensations. The back of my neck is sore, and I keep tensing up between the eyes, I have a tight feeling in the middle front of my neck...
Once you work your way through that (work progressively through the body if you're really having trouble), you can start 'guessing' as to what emotions that might be... (some are easy - I keep wrinkling my nose a little when I think/say that, hey - is that disgust?).
g) breathe. And just talk slowly. I talk fast to cover up emotions - because I think I'm trying to keep up with my thoughts. Talking really slowly, allowing pauses, the emotion I don't realise I am feeling starts to leak out. Might be different for you (more than likely), but you might find your own way.
h) My counsellor has started me on mostly stress-reducing techniques. Even Time management stuff, because that would be most effective (ie not running late to everything versus breathing exercises when I'm panicking because I have). When I feel ok, more comfortable feeling, I'm not walling off as much because of stress/anxiety.
posted by Elysum at 5:25 PM on March 1, 2009
follow-up from the OP
I just wanted to come back, just over a month later, to say how glad I am that I went to Metafilter about this. It genuinely did help me to get some kind of a handle on what I was going through, and to identify ways of working that suited me rather than holding myself to a 'standard' way of going about things. Per, in a slightly modified way, some suggestions here, I'm now supplementing the talk session with a weekly 1000 word written piece which I email to my therapist and which we discuss during the session. I feel like I'm back at university having supervisions again, but it actually seems to be working. I've been able to 'work' much more effectively at therapy when I'm not thrown by having another person in the room; the follow-up conversation then helps me to connect these insights to my more immediate, in-the-moment experiences. It feels as if the therapy has become more effective by several orders of magnitude, and we're definitely talking about much meatier things and in a more coherent way, making some real connections. I feel a lot less hopeless and a lot less powerless. Thank-yo u all very much.posted by jessamyn at 7:57 PM on April 4, 2009 [2 favorites]
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posted by 2oh1 at 10:52 AM on February 27, 2009