Therapy: am I doing it wrong?

April 10, 2012 11:40 AM

Therapy is going okay so far...but should it really just be me rambling for an hour every week?

I started seeing a therapist two weeks ago who was recommended by a friend. She (the therapist) seems like a very nice person, and I have no problem talking to her, but so far the two sessions I've had have seemed very disjointed. Like, I just talk about my anxiety and she listens and asks me about my family and my spirituality, which are totally not what I want to talk about. But I'm not sure what I do want to talk about or if I should be focusing or something.

I started seeing her because of general anxiety disorder and OCD--mostly intrusive, obsessive thoughts. Also because I am generally irritable and out of sorts and I can't even focus on what my actual problems are right now. So far we've talked about my family (a lot) and about my fear of death (generally). She keeps asking about things that I think are kind of irrelevant, and aside from offering to teach me yoga breathing, hasn't offered much more than a sympathetic ear. I kind of don't want to pay for that.

So, okay, my question is, should I have more of an agenda going into therapy? What am I supposed to be doing in there? What is she supposed to be doing? I don't really know specifically what her counseling focus is, but I'm worried it might be a little more touchy-feely than I like. If I don't know what I want from therapy, should I just stop going (which is kind of my inclination right now)? Mefites. I know you all know from therapy. Am I doing it wrong?

posted by devotion+doubt to health & fitness (19 answers total)

It's been two sessions. She's probably still trying to get a read on you. If she's any good at her job, she'll start imposing some focus on things here in a bit. And just because you think something is irrelevant doesn't mean that it is.

Of course, it's also possible that she isn't any good at her job, but two sessions isn't generally enough time to tell unless she's done something outrageously bad. Doesn't sound like she has.

Give it time. If you're still not getting any love after another session or two, talk to your therapist. It may be that one or the other of you has unexpressed or inappropriate expectations, but the only way to find out is to bring it up. Then see if things improve. If they don't, maybe then it's time to start looking elsewhere.
posted by valkyryn at 11:44 AM on April 10, 2012 [2 favorites]

Two weeks in, you're still in the "getting to know you" process. The therapist has to know who you are and what your issues are, more than just the Cliff Notes version, before any real work can begin.

That said, talk directly with your therapist about what her approach is. If you want something more directed and focusing on a certain difficulty, speak up. A decent therapist will accommodate your needs or direct you to someone who can.
posted by xingcat at 11:44 AM on April 10, 2012 [2 favorites]

No. I spent the first two years just letting all my emotions out and purging before my therapist and I started a game plan to work on bigger issues. This stuff takes time, and this is only your 2nd session.
posted by These Birds of a Feather at 11:47 AM on April 10, 2012 [1 favorite]

I wouldn't recommend having an agenda just yet. I am also in therapy and we are taking things very slowly even though I have had several sessions now.

Jumping too quickly into the pain can make things worse for the client rather than better. At least, that's what my psychiatrist said although YMMV.

Regardless, two sessions is not enough time for you to develop trust for your therapist or for her to truly be able to help you. You both need to take your time getting to know each other. You need to develop trust and she needs to understand more of your background in order to help you in the present moment.

In the mean time, this getting to know you process can be helpful even though it's slow. It helps you develop a safe space to cry in front of someone else. It also helps you learn that it's okay to share feelings that you may have bottled up for far too long.
posted by livinglearning at 11:51 AM on April 10, 2012

Nthing that it just takes some time. Your therapist is trying to get a sense of a narrative from you -- your main issues, your supporting cast (friends, family, coworkers), etc. You know all of this, but she doesn't. She needs to have a good sense of all of this in order to work with you effectively.
posted by scody at 11:51 AM on April 10, 2012

No, you aren't doing it wrong.

Early on, the therapist should be getting to know you and you should be getting comfortable with them. That's all good.

I would, however, bring up this concern with your therapist. Go in and say, "ok, before we start today, I need to know where this is going. What's the plan? What should I expect? When do I start to feel better? What are your thoughts/views on how therapy should go?"

Now, expect some or all of those questions to be turned back on you. "What is your plan? What do you expect? What do you want out of this?" But it's okay to push back if you feel you aren't getting your questions answered. "OK, this is what I was looking for, but I need to know we are on the same page, what are your thoughts?". Therapists can get stuck on "well how does that make you FEEL" mode, and it's perfectly fine to snap them out of it from time to time so that you don't get lost in wishy-washy-therapy land.

Also, don't dismiss talking about family, etc. as unimportant and unrelated to your problems just yet. I pushed back hard when my first therapist wanted to talk about my family---I didn't want to be the stereotypical psych patient laying on the couch discussing my mommy issues---but she persisted and it turned out to be a good thing. We ended up discussing patterns of how I relate to other people and things that make me anxious that DO have their origins in how I relate to my parents. You don't have to come from a horrible abusive home to have settled into unhealthy patterns. I didn't want to get into the blame game, but as it turned out, neither did my therapist. She just wanted to understand how I relate to others, and discussing my most long-standing relationships was the best way to do that.
posted by keelyellenmarie at 11:53 AM on April 10, 2012 [5 favorites]

(That said, if you feel you're not inclined to the talky side of talk therapy in general, I have found that therapists working with CBT are much more strategy-oriented early on. So maybe that's a style you might prefer? Nevertheless, I would give this some more time to see if you can find a groove with her. Getting the style and practitioner right in therapy can be a bit of a trial and error process; it doesn't mean that there's something wrong with you.)
posted by scody at 11:55 AM on April 10, 2012 [2 favorites]

You're allowed to bring an agenda. You're allowed to talk about setting an agenda. You're allowed to talk about whatever you want to talk about.

Agree with everyone who's saying "Right now, the therapist is getting to know you" but you can talk about making even these introductory sessions more focused if that's what you want to do.
posted by Sidhedevil at 11:55 AM on April 10, 2012 [1 favorite]

First, you have to acknowledge that therapy isn't a quick fix - it will take time. Getting to know you and your history can be an important part of that.

There are many different approaches to talk therapy, so it's possible that her method is to take the long road, so to speak, in finding out more about you before focusing on any specific issues. She could also be from the school of thought that letting you somewhat free-associate with general topics could reveal a hidden or subconscious thought pattern that contributes to your issues.

Therapy isn't like watching a magic show - that is, knowing how it works doesn't ruin it. Basically, you shouldn't be afraid to ask your therapist exactly how she plans to approach your treatment. Any competent therapist should feel comfortable explaining their approach and letting you know how/why her method thus far helps reach your end goals.

You can say "I know that this can be a long process and I'm not looking for a quick fix, but can you lay out for me, at least generally, how we will address the specific issues that compelled me to seek treatment?"
posted by trivia genius at 11:56 AM on April 10, 2012

I agree with folks that it can take time, and I know that I was pretty resistant early on and frequently thought of quitting if we didn't do something Tangible soon. But I also know that the first therapist I saw (CBT) was Not a good match, and I knew that and never went back.

So no, you're not doing it wrong, but it could be that your therapist isn't a good match for you. If you're looking for very CBT-esque quick solutions, that's very different from trying to explore your patterns and reasons for doing things in order to feel better. Ask your therapist to help you figure out what you're looking for.
posted by ldthomps at 12:00 PM on April 10, 2012 [1 favorite]

I just want to point to someone else's comment as a reference point:

I spent the first two years just letting all my emotions out and purging before my therapist and I started a game plan to work on bigger issues.

Some people are content to just talk out their problems over long periods of time and that sort of approach is the kind you'll see most often on TV and in movies and the kind that dominates the construct of "therapy" people have in their heads. But it's not the only approach, and it's not an approach that works for everyone. I had a few therapists like the one you and that comment describe and it was a complete waste of time for me. My current guy is brutally honest, vulgar, borderline abrasive and has absolutely no problem telling me that I am fucking up (and how and why) and gives me what practically amounts to brain-homework between sessions.

That sort of approach works for me, because I know what sort of personality I respond to with regard to getting something done. It would be straight-up detrimental to someone with a different personality and different problems. It sounds like the kind if therapy you're interested in is the kind where you get something done. I'll agree with everyone who says it's too early to tell after two sessions, but once you get your head around her approach and you still feel like nothing is happening, find someone else. Preferably someone specializing in Cognitive Behavioral Therapy, which is "get shit done" branch of the profession.
posted by griphus at 12:10 PM on April 10, 2012 [2 favorites]

Er, by "content" I mean they find themselves actively helped by that sort of therapy.
posted by griphus at 12:11 PM on April 10, 2012

You could talk about yourself in any way at all, and have it be therapeutic. Talking about positive things is really useful, too. The things you enjoy, or enjoyed as a child, can lead you to finding more pleasures in life, even if they're small pleasures. Talk about a movie you saw, or about some decision you want/need to make.

Talk with your therapist about your impressions about your meetings with her -- especially if you're reluctant to bring it up. You don't need to have your own suggestions of how you want to proceed. See how she handles it, whether constructively or not. It takes time to develop trust, and there's no one right way to do that.
posted by wryly at 12:12 PM on April 10, 2012

Nope, not doing it wrong. It took me a couple months of just sort of talking to my therapist before she understood me well enough to make concrete progress.

I'd talk to her about your concerns though - it's a good sign if she responds well, offers her thoughts, and is not defensive. Ideally, she would explain her treatment philosophy, tell you what you can expect in the future, and you would mutually decide on a future course of action. If she is defensive and takes your thoughts as a personal insult, it is a Very Bad Sign.
posted by insectosaurus at 12:34 PM on April 10, 2012

FWIW, I was getting something done when I was just talking -- and what I forgot to mention is that the first time I met with my therapist, I sat down and told her that my primary objective for being there was to become a better person so my boyfriend at the time would want me back. As we got to know each other, and as I talked through years worth of junk, that daily objective became, "I just want to be me, and be happy and proud of that." The way that objective is met now varies day to day, but it doesn't have to be some kind of official thing. I don't think it's a good idea to view your therapist as a personal trainer, but YMMV.

Obviously, therapy is definitely a very personal thing. If you genuinely think this lady isn't a good match for you, fine. But from your initial post it doesn't sound like you believe therapy is going to work for you and that you feel like this therapist isn't qualified to work with you. If that's the case, you're really working against yourself. I wonder if you would start to see gradual progress if you were to stop thinking that the questions your therapist is asking you are irrelevant and just start having a real dialogue with her. If having an agenda will help you, fine. Go in, let her know you want to talk about X, and then talk about X. Let her ask her follow up questions. She needs to get to know you. She's establishing a baseline. That doesn't happen in one session, or even 20 sessions. I feel like maybe you're trying way too hard to control the sessions, though, and I think in the long run that will end up not getting you to where you need to be.
posted by These Birds of a Feather at 1:50 PM on April 10, 2012

What kind of therapy is it? I would start out with asking her that. I am not a therapist, but it seems to me that talk therapy wouldn't be as good as CBT or DBT for OCD. If it releases some of your anxiety, your OCD symptoms should lessen, but I don't think it is the best direct route to work with OCD.

Personally, all the talk therapists I have had have pretty much been useless to me. I share my feelings all the time with friends, so it was just rehashing the same thing over and over. It would have been nice to have one that actually did something or inspired me to do something, but I guess I just had back luck with them.
posted by Vaike at 2:32 PM on April 10, 2012

I was pretty rambly for the first month (4 sessions) or so. One thing that I've found out that helps is to ask questions of the therapist about where they are, what they suggest you think about until the next session, how you're doing so far, etc. Invest yo' ass in yo' therapy, have goals, and ask if you're getting any closer to accomplishing them (or getting to where you can start accomplishing them).
posted by rhizome at 3:44 PM on April 10, 2012

You are doing it RIGHT! It's great that you're asking questions, and honestly, I think you should ask her these questions. There is nothing at all wrong with her guiding you through sessions and there are definitely are very specific nameable things that you will be doing together. Intake, analysis, discovery blah etc. Sorry, I'm just a patient and don't know all the terminology.

I don't advise quitting. Get a handle on what her approach is going to be. It may very well get touchy-feely in the sense that you might end up digging pretty deeply into your psychology while discovering root causes and triggers and things like that.

I would stick with it and just ask some questions so that you don't feel like you're floundering or wasting your time. I have to say from experience that having a good therapist can be very liberating and life changing.

Good luck and keep trying.
posted by snsranch at 3:53 PM on April 10, 2012

I'd give it another session or two, and the advice to bring up some of these questions with her is great (especially the 'what is your treatment philosophy' type), but as someone who has been in and out of therapy for something like six years now, take it from me when I say if you have given her a fair shot and your gut feeling is that she isn't a great fit for you, then find someone else.

For comparison's sake, I have seen my newest therapist for 5 sessions, so three more than you, but by the third session she had already given me concrete things that I could do when I start to feel anxious to help me feel less anxious. We do a lot of talking, yes, but she also challenges my disordered thinking and makes me think through what is going on in my head. I have found this to be immensely helpful, but of course, YMMV.

The bottom line is, this is your therapy and your treatment and if it doesn't feel right, you should find someone who you feel comfortable with so that you can do the work you want to do.

Also - figuring out what you want from therapy is a totally legit question to hash out with your therapist!
posted by rosethorn at 6:32 PM on April 10, 2012