Should I keep seeing this therapist?
April 26, 2013 9:00 AM   Subscribe

I felt invalidated by my therapist two sessions ago and can't seem to get over it, even after bringing it up with her. There also has been a lot of awkward silence lately and I feel like I'm just saying the same things over and over again.

A brief history: I started seeing a therapist and psychiatrist last June when I was in a very bad spot. I am in a much better place now, but unsure if I want to keep going to therapy.

For the first five months or so, the therapy was very helpful and cathartic. But since December, I've felt like I'm just repeating myself over and over and that I have nothing new to say. I've brought this up with her, and she always says the same thing: "You may feel like you're saying the same thing over and over, but every time you approach it from a slightly different angle and learn something new." Well, I don't feel that way. It's gotten to the point where I can predict everything she's going to say.

I also have told her that I feel like I'm not making progress and I often feel stuck/at a loss for words, and she says, "Therapy does not fix things overnight. You experienced 25 years of trauma, and you aren't going to resolve this in only one year."

What is really bothering me, though, is that two sessions ago, I was explaining how I once — way back in the day — saw a student therapist, and I mentioned that the student therapist's eyes got wide and she didn't know what to say when I was discussing my past (presumably because she was shocked). My current therapist sort of chuckled and said, "I've heard much, much worse" (in reference to my trauma). Generally, she is supportive, but this comment really hurt me. I told her it did, and she apologized, but I just can't get over it. Now, every time I go in, I feel like I don't deserve to be there; that my problems must not be that bad and I just need to get over them.

My concerns with ditching this therapist are:

-I've done good work with her in the past, and wonder if I keep going if I'll have some sort of "breakthrough" moment or get back on track. But it's been four months of "meh" therapy.

-I have a history of making pretty rash decisions that I later regret, especially in regards to pushing people away.

-I am terrified of hurting her feelings and don't want to have to explain that it's not working.

-Perhaps the therapy still is helpful and I just don't know it.

After nearly a year of working with her, would it be shitty to just call and cancel all of my outstanding appointments? Should I see her in person for one last appointment and explain why? Based on your experience, should I keep giving it a go for a while?
posted by shiggins to Human Relations (24 answers total) 4 users marked this as a favorite
 
No, it's not shitty. If you feel that there's no benefit at this point, then you may have reached the limits of what you can accomplish with her.

You can either call or email and say something like, "I appreciate the work we've done together, and I think it's time for me to move onto a different therapist. Thank you and I'd like to cancel my remaining appointments." No reason to do this in person and pay for another session. It's a waste of time and money.

You've expressed your concerns with her, you've told her when she's crossed lines with you, and there's no reason to belabor it.

Therapy is just like any other relationship. Sometimes it's magical, sometimes it's mundane, sometimes it accomplishes a goal, but then it peters out.

Also, don't wait for a "breakthrough" moment, those rarely happen. A good therapist will make you feel heard and validated. This lady doesn't and that's as good a reason as any to more on.
posted by Ruthless Bunny at 9:08 AM on April 26, 2013 [3 favorites]


It might not be a bad idea to continue therapy with someone else if you feel like you could still benefit from therapy in general, but it seems clear that therapy with this particular person isn't benefitting you, and in fact it's probably only going to exacerbate trust issues if you feel like you can't fully trust your therapist or you feel that your therapist is judging you. Therapy itself shouldn't end up being another source of turmoil in your life, so it definitely sounds like you need to stop seeing this particular therapist despite your long history together. I think an e-mail is sufficient since I'm sure this is fairly common.

I also think that a new therapist might actually help you reach some new conclusions in the sense that you will have another person hear your story and maybe help you think about it from a new perspective. It doesn't sound like that's something that will suddenly happen with this current therapist based on how things have been going.
posted by OnTheWing at 9:17 AM on April 26, 2013 [2 favorites]


It's clear that your therapist was chuckling at the student therapist's reaction and trying to reassure you that she won't have that reaction.

She's a psychologist - presumably she's seen a lot of trauma? Like the way a doctor has seen a lot of sick people. You might want to talk to her about how you feel you don't deserve sympathy unless you believe you are one of her worst cases.
posted by AlsoMike at 9:18 AM on April 26, 2013 [27 favorites]


My current therapist sort of chuckled and said, "I've heard much, much worse" (in reference to my trauma).

I would suggest that perhaps she was chuckling at the student therapist's naiveté rather than dismissing your experiences.

Now, every time I go in, I feel like I don't deserve to be there; that my problems must not be that bad and I just need to get over them.

FWIW this is a really common feeling in therapy.
posted by DarlingBri at 9:20 AM on April 26, 2013 [4 favorites]


The "much, much worse" comment really sounds more like she was trying to reassure you: she is not shocked speechless by your story, she has experience helping people with serious trauma, she's a pro rather than a student, you don't need to be self-conscious, etc.

She has told you that she thinks your problems are bad and that you should be there.

Maybe you could show her this post? Especially if you think this might be a rash reaction to feeling slighted, this might be an opportunity to talk about why you feel terrified of hurting her feelings, why it hurts you so much to hear that you are not her most traumatized patient ever, etc.
posted by steinwald at 9:20 AM on April 26, 2013 [13 favorites]


Therapists are human and make mistakes, say the wrong thing. To me your therapist's mistake seems fairly minor and she apologized. (Your experience of her mistake might be something to talk about with her or with another therapist.) If you are dealing with 25 years of trauma, then therapy seems appropriate. So, if you decide to leave this therapist, it's probably to find another therapist, yes? And start a new therapeutic relationship, which takes time. The next therapist will also be human and make mistakes. He or she may be a better fit. All things to weigh.
posted by ClaudiaCenter at 9:23 AM on April 26, 2013


Here's what I think are NOT good reasons to abruptly quit: 1) the comment your therapist made two sessions ago; 2) being terrified of hurting her feelings if you say therapy isn't working. Four months of "meh" therapy is POSSIBLY a good reason to quit.

But in any case, before you quit I think it would be a really good idea to discuss all three of these things with her. The hurtful comment you've discussed some but I think there's more to process there, and it sounds like you haven't said the second two things yet. You should absolutely tell her you're afraid of hurting her feelings. It's 99% certain she'll tell you she can handle anything you have to say, which again, you might need some time to grapple with-- you may not believe her, or may feel hurt by that, too. If you haven't said the last four months in particular have felt "meh," that's worth saying.

Regarding her comment about having heard much worse, there are multiple ways to interpret her comment. One way is to worry that your problems aren't very important and you don't deserve to be there. Again, it's 99% certain she didn't mean it this way. Another interpretation is that she wanted to reassure you that, unlike the student therapist, she's experienced enough that she won't be overwhelmed or at a loss for words to hear about your past. All therapists sometimes say things that are unintentionally hurtful. Good ones are flexible enough to learn how their words come across and adapt themselves to the way your particular brain works, so that the message you receive is the message they intended to send more often than not.
posted by Dixon Ticonderoga at 9:32 AM on April 26, 2013 [2 favorites]


Now, every time I go in, I feel like I don't deserve to be there; that my problems must not be that bad and I just need to get over them.

I get why you're feeling this, but remember that the existence of problems worse than yours does not invalidate your own.


That said, I'm not sure you need to keep going to the same person to help you cover the same ground repeatedly. A second point of view can offer a different perspective, literally enough. Or -- grain of salt on this next bit, as I don't know your situation -- I'm not sure talk therapy necessarily always has to be continuous: taking some weeks (or months) to turn things over and absorb at home has been its own kind of therapy for me at times.

It is never a shitty thing to break up with a therapist: they are doing a job, you are a customer. You do not need to factor her feelings into your decision.
posted by ook at 9:32 AM on April 26, 2013 [1 favorite]


Have you seen this heavily-favorited comment from Omiewise about how to get the most out of therapy, and tools that patients should be using to get the most out of it?

Personally, I would be less likely to consider dropping the therapist because of the stupid comment, but I would be seriously considering dropping her--or maybe therapy in general--if I realized I didn't have any specific outcomes I was trying to work towards, or felt like I wasn't getting anywhere with the goals I had with this specific therapist.

I guess this gets to your therapist's comment that "You experienced 25 years of trauma, and you aren't going to resolve this in only one year." Do you agree that there is something to resolve in your present life related to that trauma, or are you in therapy to process it with no particular goal other than feeling like you should be processing because what happened to you was bad? Even if you stay with your therapist, I imagine you'll feel it's more productive to focus your time and energy on resolving whatever problems you think exist in your life or currently hold you back. Conveniently, this should also give you a nice yardstick against which to measure your therapist's performance and make a decision about whether to keep going.
posted by iminurmefi at 9:35 AM on April 26, 2013 [1 favorite]


In my work in therapy (IANAT), I have heard utter horror stories, and all sorts of assorted trauma. I understand that the student therapist may not have been quite equipped to handle that yet, and the pro-therapist was't (probably, if shes the slightest bit decent) trying to dismiss or minimize your trauma... just that she can, in fact handle it. Because, yeah, we've heard worse. (Scary, isn't it?) but... we want to help, and you are there and need help.


-I am terrified of hurting her feelings and don't want to have to explain that it's not working.

Don't be. She provides a service you pay for. If the pizza guy gives you the wrong pizza, you don't pay for that. Its ok to quit, to change therapists, to keep going, to request a change.

-Perhaps the therapy still is helpful and I just don't know it.

In my experience (on both side of the couch) things bubble up when you are ready to deal with them. So, it might be time to take a break, and as soon as the next issue/bad time/etc pops up, schedule and bring in stuff to work on.
posted by Jacen at 9:40 AM on April 26, 2013 [1 favorite]


You can conclude therapy with this person if you want; it's okay. I agree with everyone else that her response was probably much more "I am worried that shiggins thinks I am horrified by her problems and perhaps that I see her mostly as a Walking Terrible Problem; I will respond by assuring her that I have seen worse".

Therapists make mistakes in session, even good therapists. I think it's easy to assume that a therapist's lightest word is Very Authoritative and infallible. I therefore also agree with everyone else that you should think about why you are getting stuck on this point. (maybe it's just because you want to leave therapy, maybe it's something else.)

Here is what I have found: I have been in therapy about as long as you (ask me about my fantastic Twin Cities based therapists' office!) I've hit a couple of potential "stopping points"; I'm in one now. Each time, I felt like I had done some significant work and was at a loss for where to go next. I felt an urge to say I was "finished" with therapy, because the therapeutic process had made so many things so much better that each time I was feeling far better than I had when I came in. At the same time, I didn't feel like I as a person was quite where I wanted to be - even though I had cleared away a lot of painful stuff, I felt that it was like...hm....maybe like taking wallpaper off, or something. You take off the top layers so that you can get at what is underneath and make underlying changes.

I have found that several things are needed to get past these points. One has been just talking and seeing what emerges, although this generally hasn't taken four months. Another is doing some writing and focused reflection on what I want the next phase of therapy to be about - what do I want from it? I have also noticed that I am now moving into the parts where I have to do things - I can't just make mental changes or unburden myself of secrets - and that is harder for me, so I feel more reluctant.
posted by Frowner at 9:48 AM on April 26, 2013 [1 favorite]


But in any case, before you quit I think it would be a really good idea to discuss all three of these things with her.

Exactly.
posted by shivohum at 9:48 AM on April 26, 2013


When she's saying the same thing over & over, are you thinking "yeah yeah yeah I know already!" silently in your head? I don't know your situation, but maybe you know it in your head, but she's not seeing that your actions reflect what you know. So ask yourself honestly whether you're really doing what she's saying. (My personal example: I was upset last year because I was still single, and my friends were telling me I just needed to learn how to be ok on my own. I said "I am ok on my own!" and they gently laughed and said "Baby, if you were ok on your own, you won't be crying at a party!" That's when my mind went "bing" and I realized I needed to do the work, not just think I had it mastered.)
posted by St. Peepsburg at 10:10 AM on April 26, 2013 [5 favorites]


Frowner, my fav therapist uses 'peeling an onion' as his metaphor of choice :) And, the deeper layers are usually progressively harder and more damaging to our psyche. I very much think most hardcore, fix ALL THE THINGS! psychology takes a long time, spread out over time. You get in, you work on the surface stuff. You heal a little, live a little, and then #2 pops up, when you are ready. And then 3, 4, 5... and so on. Facing the big gaping holes in our development and needs and strengths/weaknesses is very, very hard. Its kinda like killing the bad us we've lived with for so long to get to the good we deserve. (and yes, 99.999% of people deserve good!)
posted by Jacen at 10:41 AM on April 26, 2013 [1 favorite]


My current therapist sort of chuckled and said, "I've heard much, much worse" ... Now, every time I go in, I feel like I don't deserve to be there; that my problems must not be that bad and I just need to get over them.

The fact that your doctor has seen people with their legs blown off does not make your appendicitis any less worthy of treatment.
posted by flabdablet at 11:00 AM on April 26, 2013 [5 favorites]


I would echo the suggestions to process this post with your therapist.

One of the healthiest exchanges I had with a therapist was when I wrote her a letter indicating that I thought she had unfairly portrayed me as an abusive partner (this was in a couple's counseling context). I had never really worked through a conflict with a person I was very mad at before. [In my family, we just stopped talking to each other, sometimes for years at a time.] Standing up for myself and resolving the issue with this person was huge for me.

If you tend to be an avoider of conflict, I encourage you to try talking this out with your therapist -- having it written down like this can help you make sure you cover all the points that are bothering you. You may still end up leaving this therapist, but maybe you will gain something in the process.
posted by elmay at 11:46 AM on April 26, 2013 [1 favorite]


Use this as part of your therapy. It's often easy to get into the same patterns in a therapeutic relationship, just like any relationship. The "work" of therapy, IME, is being able to go one step deeper. It's an active process, and most of the "active" part is on you. Sometimes there is a lull in the relationship, and it exposes deeper flaws and desires. You have an opportunity to deal with these things head-on. I can't tell you if you should leave or not, but I definitely agree with the people above who said you should try to work on these issues before you leave.
posted by Katine at 12:50 PM on April 26, 2013


Maybe this is a sign you don't need therapy any more at this time. A good thing.
posted by zadcat at 2:10 PM on April 26, 2013


I think it's perfectly fine to put it on hold for a while. Let her know that you want to fly solo for a bit, do so, and then decide if you want to return to her or seek someone new. Time and perspective will help sort out these questions for you. As for a final appointment? I see no point, especially given that it costs money. If you're in a relatively stable phase, there's nothing wrong with quitting, switching or doing whatever you please. Screw her feelings, she works for you (or she used to!). Best of luck.
posted by cior at 3:17 PM on April 26, 2013


I've hear the description of therapy as an onion before. For me, though, therapy was like a spiral staircase. I kept coming around to the same things, but I frequently had a slightly different perspective on them next time around. I found that to be a feature, not a bug.

When I did leave my therapist, we left the door open: "I'll check back in if I'm not doing so well in six months."
posted by instamatic at 4:37 PM on April 26, 2013 [1 favorite]


I'm not sure what your diagnosis is, but if you've experienced years of trauma you may benefit by techniques such as EMDR and CBT, or even DBT.

I did talk therapy for several years before I was able to talk about trauma I experienced as a child. It never occurred to me that it could be contributing to my problems, but it finally was triggered. EMDR works well for me, but everyone's different - at this point my therapy is mostly EMDR and some talk therapy in between, because the focus is about healing trauma on an emotional level and not so much about trying to analyze what happened in the past.

If you're already talking about it with someone with a history of treating trauma that's a good place to be, even if it seems like you're not getting anywhere at the moment. From the amount of time you've been in treatment compared to 25 years of exposure, I don't think you're done yet, but that's up to you to say. If it's affecting you and you don't have good coping mechanisms, then it's worth doing what you need to heal, whether it means sticking it out with this person or seeking help with another therapist. But if you're doing OK in your life and don't see much need for it right now, it's OK to put it aside for now and come back later if you need to.
posted by krinklyfig at 6:32 PM on April 26, 2013


No matter what else you decide to do, since you've seen her for an extended amount of time already, I think you ought to end in person rather than phone or email. You might get something out of having an intentional goodbye rather than just abruptly stopping.
posted by tacoma1 at 7:56 PM on April 26, 2013


Almost everything in life follows this course. Lots of progress and then a "why am I still doing this" moment. If it is honest, and not avoiding something, then that should be a sign to try something new. It doesn't mean therapy doesn't work, or that this therapist is bad. It just means you are past needing what she has to offer. Roll on your own for a while, and then self-assess in a week or a month, and see if you feel like you need to see someone new.
posted by gjc at 8:54 PM on April 26, 2013


Best answer: Please make the decision you need for yourself and don't worry about hurting your therapist's feelings. I'm a trainee therapist and even I would not take your decision to quit therapy personally.

In fact I often think a break in therapy and even a change of therapist can be beneficial parts of the process. My experience so far is that although people often feel that therapy is moving slowly they are in fact experiencing fairly seismic shifts in quite a short period of time. Four months of 'meh' therapy suggests to me that you could actually do with some time away from your therapist to absorb what you have learnt.

If you want to do more work later you can either start up with her again or find someone new. She honestly won't mind. As your therapist she wants what I best for you. This is not about her.

Well done on the work you've done so far and good luck for the future. So many people carry trauma their whole lives and never make the progress that you already have.
posted by Dorothia at 7:49 AM on April 27, 2013


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