Therapist issue

January 8, 2010 7:53 AM

Was my therapist trying to manipulate me, or am I just being paranoid?

Last year I had some short-term counselling when I was diagnosed with moderate situational depression by my G.P. I had to visit a view therapists before finding someone I got on with and finally agreed on six sessions initially with a Gestalt practitioner in order to focus on a specific issue. Each session helped a great deal, but I saw it as a finite process.

During the last session we agreed it had been useful but that there were probably other issues I needed help with. He asked me about why I was quitting therapy at that time. I told him it was because I was worried about spending so much money on something that feels like a luxury (I'm trying to save to buy a house and £200 a month on therapy is a big deal for me) and also because I didn't want to become dependant on him - part of my problem is extreme introversion and I felt that I needed to work on developing stronger connections with family/friends rather than having my social energy focussed on someone I was paying to listen to me.

He persisted with the question saying that he still couldn't understand why I was ending things at that point. I was upset and felt that he was trying to strong-arm me into continuing the current arrangement. I asked why my explanation wasn't enough and he said that he thought it was a shame that I'd decided to stop there and that he was sad that the process was over. That felt weird to me - I didn't know if he genuinely found our work interesting, or just didn't want to lose a client. It may have been a bit of both, but regardless, should he have even told me that? It seemed a bit unprofessional. The session ended ok but I was unsettled.

However, I'm now thinking I was over-ambitious on the shoring-up-friendships-while-depressed front and would like to suck up the cost and continue therapy after all but I'm not sure how to proceed. Until that last session I really trusted the therapist, but then it went weird. I'm aware that my current state could be clouding my perspective but I'm feeling a bit fragile and don't want to have to deal with the therapist's feelings as well as my own. Should I ask to return to him and discuss this or just find someone else? Many thanks for any perspective.

posted by anonymous to human relations (18 answers total)

i would ABSOLUTELY find a new therapist if you want to continue. speaking from the experience of going through many therapists and being a psych major myself, a) the therapists behavior seems odd and b)even if it was with good intention, you are weirded out, and have specifically said you don't have a the same trust as before. the essential element of effective therapy is being totally comfortable and trusting with the practitioner. even if you think "hey, i can get over it, just a silly miscommunication" etc etc, it will still be a blip in your mind and will keep you from being totally honest, IMHO.

while it might be a pain to find a new one you trust, i heavily advise on doing so.
posted by assasinatdbeauty at 8:09 AM on January 8, 2010 [1 favorite]

I didn't know if he genuinely found our work interesting, or just didn't want to lose a client

If someone is trying to help you - to fix your car, cook you dinner, improve your physical health, or your state of inner well-being - and you formally decline their assistance, especially after they've started to try to help you, the helper may feel you are rejecting them and invalidating what they believe in and stand for.

I'm not trying to guilt you into going back and seeing this therapist, just pointing out that his reaction is not surprising.
posted by thermonuclear.jive.turkey at 8:09 AM on January 8, 2010

I've been to three separate therapists during my short lifespan. All three at the end of each session would ask if I wanted to schedule another session, which is the way I always thought it was best to do it.

A therapist can always suggest what they think would be a good step for you, but if you feel like you are being forced then it seems like that's a sign you aren't 100% comfortable with them. No one can make the decision for you because no one else can determine how you really feel, but trust is easy to lose and hard to gain back. If you don't trust your therapist how valuable will your sessions be? Even if your therapist was great before, if you can't be open the value of going decreases.
posted by semp at 8:11 AM on January 8, 2010

This sounds very similar to my interaction with a therapist recently, and I found myself asking the same thing. I came to the conclusion that I was being manipulated.

My insurance changed, and my therapist was no longer in-network, so I would have gone from no co-pay at all, to paying around $110 per session. I told my therapist that I would have to stop therapy or find someone in-network. She used a variety of weirdly manipulative tactics to try to get me to continue therapy with her. She even told me that not wanting to pay $110 a week to see her was a sign that I don't value myself.

Based on weird behavior I have seen in other therapists, I'm guessing this kind of thing is not as rare as I would hope.
posted by Yesterday at 8:14 AM on January 8, 2010

It's legitimate for any professional to ask why you decline to continue working with him/her. Once you give a firm response, however, it's inappropriate to badger you in an attempt to keep your business. Because he was your therapist and not your plumber, it might have been appropriate for him to say something along the lines of "I think you've been making great progress and could continue to do so if you chose to come back to therapy. Give me a call if and when you're interested." His actual choice of words seems inappropriate given the power imbalance and supposed trust between the two of you.
posted by Meg_Murry at 8:27 AM on January 8, 2010

Are you female? Because the interaction I see described seems intense. It isn't what's being said, it is the way it is being said. I'd look around and find another therapist.
posted by Ironmouth at 8:41 AM on January 8, 2010

I quit therapy abruptly after three years of going twice a week.

My therapist, being human, was a little taken aback but she did not badger me or try to browbeat me into continuing. She accepted my decision and left the door open for me to return, which I appreciated. She took the respectful approach.

Yeah, your therapist's comments were not that professional. I'm not sure if I would characterize them as manipulative but that's neither here nor there; his behavior made you uncomfortable and ruptured the therapeutic alliance.
posted by jason's_planet at 8:52 AM on January 8, 2010

He thought it was a shame and he was sad...?  A professional knows those are loaded emotional words to put on a patient's actions.  And to use both of those together?  No wonder you have misgivings and feel coerced.  Look elsewhere.
posted by Hardcore Poser at 8:54 AM on January 8, 2010

That sounds like a crazy person. Even though a lot of AskMe advice is basically encouraging someone to go to a counselor or therapists, I've heard that some therapists and counselors are messed up people who pursue the study of counselling and therapy so they can cover up their own problems.

Plus, he should have offered to lower the cost to something more feasible if he was really sad. What a weird person.
posted by anniecat at 8:57 AM on January 8, 2010

Even though a lot of AskMe advice is basically encouraging someone to go to a counselor or therapists, I've heard that some therapists and counselors are messed up people who pursue the study of counselling and therapy so they can cover up their own problems.

Not every doctor knows what they're doing. Not every therapist knows what they're doing. Not every auto mechanic knows what they're doing.

Advising someone to go to therapy isn't exposing them to the danger of incompetence or fraud any more than advising them to go to an auto mechanic is.

That said, this therapist doesn't know what the fuck he is doing. Never go back to him again.

The correct thing to say when one feels a client is terminating therapy too soon is not "Oh, no, that will make me sad" but "I feel you could benefit from more work, either with me or with another therapist."
posted by Sidhedevil at 9:00 AM on January 8, 2010

I was in therapy for twenty months and it took five sessions to disengage. My therapist did not make me feel like she was strong-arming me to get me to stay, but often people use excuses like money or busy-ness to avoid talking about something that's uncomfortable. My therapist explained this, and said she'd like us to keep working together for a few more sessions to make sure that I felt like I was really ready to leave and we ended up making a LOT of strides in those last sessions, wrapping up a lot of loose ends. My last session felt very much like a lot of closure over the time we'd spent together and I have a very positive feeling regarding how my therapy ended and I'm fully prepared and comfortable to go back in if I need to.

I say all this to point out that your therapist may truly have your best interests in mind in encouraging you not to stop therapy very suddenly. Your therapist should not view therapy is an infinite process, but should want to make sure that you're ready to go out on your own. Rather than thinking that your therapist is enjoying your time together so much, consider that he really might have a vested interest in you continuing simply because he truly feels you're not ready to leave.

I found this book very helpful. It covers good reasons for leaving therapy, bad reasons for leaving therapy, how to handle the money issue, and how to handle a therapist who has bad reasons for wanting you to stay in therapy.
posted by peanut_mcgillicuty at 9:08 AM on January 8, 2010

Forgive me for asking, but did he actually say he was sad that the process was over, or did you perhaps just interpret his words that way? The only reason I ask is because I'm a longtime therapygoer, and sometimes I've heard my therapist say something when the therapist actually said something else, and I just interpreted it a certain way through my mental/emotional filter. Certain words and phrases can have charged meanings for us that they might not have for other people.

In other words, perhaps your therapist didn't use the phrase "I'm sad," but you interpreted his words to mean that he was sad.

Or, I could be totally wrong and you might have heard him accurately.

Another point is that if you are ever uncomfortable in a therapeutic situation, especially if you are uncomfortable about something involving the therapist, it is really important to tell this to the therapist, because examining your relationship with your therapist is actually a really important part of therapy.

(This does not apply to things like sexual activity or emotional abuse from your therapist, of course.)

But ultimately, you need to be with a therapist who makes you comfortable -- not so comfortable that you won't experience growth and change, but comfortable enough so that you feel you can tell your therapist anything and you know that your therapist is there for you, not for himself or herself.
posted by Tin Man at 9:08 AM on January 8, 2010

Did he mention anything at all about changing the fee so that you could stay? Adjusting the frequency of sessions? It seems really, really odd to me that he would not try to do either one (it would be part of a standard, good-practice approach to a client who was terminating therapy early)--so either he is oblivious to good ethical/interpersonal practices (in which case you should probably check out a new therapist), or there were some details that aren't present in your initial retelling (which would make it difficult to judge what the situation really is).
posted by so_gracefully at 9:56 AM on January 8, 2010

I didn't know if he genuinely found our work interesting, or just didn't want to lose a client.

It seems to me that his most likely legitimate concern would be that you were in the middle of some kind of progress and he was concerned that you were ceasing therapy too early, which is entirely legitimate (and if this was the case, frankly it sounds like he was right).

He may have expressed it poorly but then again maybe your fear of being manipulated, pushed around or made dependent led you to the least charitable interpretation of what he actually said. In my opinion there is nothing wrong with a therapist counseling against terminating therapy.

Good relationships in counseling can be tough to find: maybe you should call him and lay out the situation and your feelings about your final session and see if he can provide a response that restores your trust in him.
posted by nanojath at 12:15 PM on January 8, 2010

I can't be sure that you've represented the interaction 100% objectively, and I say this having been in the situation myself. My inclination would be to give him the benefit of the doubt and assume that he was concerned about your progress. I know that when I ran out of insurance for my one-on-one I was urged to continue using less-expensive group therapy and I declined, something I now regret.

In any case, therapist-client relationships can be tricky -- there's a business aspect as well as a human and therapeutic aspect -- and it isn't always something that clicks for people or necessarily objectively works. It's very common to shop around and try different styles of therapy as well. If you back off to the abstract question of whether you should continue therapy itself, it may be easier to think about.
posted by dhartung at 1:00 PM on January 8, 2010

No matter what the "real" interpretation of the interaction is, the simple thing is that right now, this person makes you uncomfortable. No matter what kind of post-mortem thinking you do, the discomfort is now bundled into your relationship with them.
You can't do effective therapy with someone who ooks you out; find a new therapist and start fresh.
posted by Billegible at 3:50 PM on January 8, 2010 [1 favorite]

Repairing a breech in a good therapeutic alliance is a good indicator for therapeutic success. If you go back to him and talk to him about your decision and tell him that you felt manipulated, you two might be able to repair the situation. That will do wonders for your assessment of your own social competence. One part of learning how to make friends is learning how to keep them when they mess up, or you feel like they messed up. Another part of friendship is knowing that you tried your best and then walking away with confidence that you made the right decision in terminating the relationship. Depression leads us to look at things negatively--this person did this, we can never repair it, I don't know how to fix this--and our default becomes to abandon a situation without really resolving it.

Good luck.
posted by kathrineg at 9:27 PM on January 10, 2010

By the way, you might want to read up on gestalt therapy and the concept of deflection. This may have informed your therapist's reaction to your decision, and your therapist's direct and honest response to you.
posted by kathrineg at 9:31 PM on January 10, 2010