Is not-great therapy better than no therapy?
October 13, 2019 11:51 PM Subscribe
Had my first appointment with a new therapist recently and to be honest she wasn’t great. A couple of small red flags, but my biggest objection was that we weren’t a personality fit. I’m unsure whether to continue.
She is reasonably affordable which is good as money is tight. She also does after hours, which I need. She seemed good at knowing when she was getting close to hitting a nerve, which was good. I do think she is trying to help.
However I didn’t like the sound of either of the approaches she wanted me to learn about, and I didn’t think her general personality suited me. We didn’t seem to have much in common, though I am not a therapist so maybe that is to be expected?
She said a couple of things which made me feel she didn’t have as much faith in me as I would have liked, she admitted to asking her friend how to say my name (it’s quite uncommon here in Australia) and she said her approach was to be honest and tell me what she thought I needed to hear (she did not ask me what I would prefer.) She also said I could contact her after hours and sent me a text once already to see how I was doing.
I am not having a crisis - therapy is for helping me maintain my progress and work on a couple of nice-to-have areas, and preventing future crises (if that’s possible).
I have booked another appointment with her just in case and to suss her out a bit further so I’m sure, but I was hoping to line up someone else as well. I’ve approached four other clinics with requests for trial appointments, but one the psychologist I wanted is on maternity leave, another the whole clinic has closed their books, a third has no after hours or weekend service except without a rebate, which doubles the price, and one I am waiting to hear back from still.
If the last option doesn’t turn out, should I keep going with the therapist I’ve got, just to do something, or is it not worth the money?
She is reasonably affordable which is good as money is tight. She also does after hours, which I need. She seemed good at knowing when she was getting close to hitting a nerve, which was good. I do think she is trying to help.
However I didn’t like the sound of either of the approaches she wanted me to learn about, and I didn’t think her general personality suited me. We didn’t seem to have much in common, though I am not a therapist so maybe that is to be expected?
She said a couple of things which made me feel she didn’t have as much faith in me as I would have liked, she admitted to asking her friend how to say my name (it’s quite uncommon here in Australia) and she said her approach was to be honest and tell me what she thought I needed to hear (she did not ask me what I would prefer.) She also said I could contact her after hours and sent me a text once already to see how I was doing.
I am not having a crisis - therapy is for helping me maintain my progress and work on a couple of nice-to-have areas, and preventing future crises (if that’s possible).
I have booked another appointment with her just in case and to suss her out a bit further so I’m sure, but I was hoping to line up someone else as well. I’ve approached four other clinics with requests for trial appointments, but one the psychologist I wanted is on maternity leave, another the whole clinic has closed their books, a third has no after hours or weekend service except without a rebate, which doubles the price, and one I am waiting to hear back from still.
If the last option doesn’t turn out, should I keep going with the therapist I’ve got, just to do something, or is it not worth the money?
She said a couple of things which made me feel she didn’t have as much faith in me as I would have liked, she admitted to asking her friend how to say my name (it’s quite uncommon here in Australia) and she said her approach was to be honest and tell me what she thought I needed to hear (she did not ask me what I would prefer.) She also said I could contact her after hours and sent me a text once already to see how I was doing.
Can you say more about why these things made you feel she did not have faith in you? To me, reading this, it sounds open clear and supportive. I realise everyone reads things differently, but it's difficult for me to see where you think the problem lies. I could imagine you saying "well, I appreciate you telling me how you work, but I need a different approach" but I have a hard time seeing these things as evidence of her not having faith.
My best therapists have all been very different than me. They aren't there to be my friend, just to help me work things through.
I can't say based on this whether you should continue or not.
posted by frumiousb at 3:27 AM on October 14, 2019 [8 favorites]
Can you say more about why these things made you feel she did not have faith in you? To me, reading this, it sounds open clear and supportive. I realise everyone reads things differently, but it's difficult for me to see where you think the problem lies. I could imagine you saying "well, I appreciate you telling me how you work, but I need a different approach" but I have a hard time seeing these things as evidence of her not having faith.
My best therapists have all been very different than me. They aren't there to be my friend, just to help me work things through.
I can't say based on this whether you should continue or not.
posted by frumiousb at 3:27 AM on October 14, 2019 [8 favorites]
I just recently reached a point where I broke through my initial dislike/distrust of my therapist (I had been tallying red flags too). I first started seeing her in April. In my case it just wasn’t really an option to start over with a new person for reasons. I’m so glad I stuck with her. I’m really sharing more openly with her and I’m getting a lot of good feedback from her as a result. In my case it was a great example of how many trust issues I have and how that itself is something that I want/need to work on. Good luck!
posted by seemoorglass at 4:42 AM on October 14, 2019 [3 favorites]
posted by seemoorglass at 4:42 AM on October 14, 2019 [3 favorites]
I'd say it is too early to tell. Unless you've had a strong reaction against her and you know in your gut that she won't be right for you, have a few sessions before calling it quits to see how things pan out.
My best therapist was very different from me, and not at all who I thought might be helpful. It took me a few sessions to sink into things with him, which it will do if you have any reservations about a new therapist, but we found a way to work together that ended up being very beneficial to me. This meant steering clear of some elements of his usual practise that sat uncomfortably with me, such as dream analysis and musical therapy - the stuff that made me horribly embarrassed and unreceptive.
I decided to give him a pass for the few red flags that popped up initially (such as not remembering some details from one session to the next, which for *reasons* was very important to me) and raised the ones with him that bothered me, so he knew to alter his approach to fit my needs. So, bear in mind that your new therapist will quite likely be able to shift her approach depending on what works for you - but only if you mention these things during your sessions so that she is aware of them. If you feel like you can speak candidly with her and she will grasp what you are telling her, the rest can work itself out I think.
I've also had sessions with a few therapists who I knew pretty immediately would absolutely not be the right person for me (two clearly had no understanding of me as a person, and one funnily enough was a dead ringer for my mother, which again... *reasons*). One I kept going with for six weeks, partly because I didn't trust my judgement yet (it was my first attempt at therapy) and partly because I was at rock bottom and didn't have the capacity to look for anybody else. This was definitely money thrown into the aether (resentfully at that), but it at least helped me learn to distinguish between gut feelings and less definitive reservations. If you think in this case it's the latter, I'd say give it some more time, and work *with* her to figure out how this could work for you.
posted by FifteenShocks at 5:12 AM on October 14, 2019 [5 favorites]
My best therapist was very different from me, and not at all who I thought might be helpful. It took me a few sessions to sink into things with him, which it will do if you have any reservations about a new therapist, but we found a way to work together that ended up being very beneficial to me. This meant steering clear of some elements of his usual practise that sat uncomfortably with me, such as dream analysis and musical therapy - the stuff that made me horribly embarrassed and unreceptive.
I decided to give him a pass for the few red flags that popped up initially (such as not remembering some details from one session to the next, which for *reasons* was very important to me) and raised the ones with him that bothered me, so he knew to alter his approach to fit my needs. So, bear in mind that your new therapist will quite likely be able to shift her approach depending on what works for you - but only if you mention these things during your sessions so that she is aware of them. If you feel like you can speak candidly with her and she will grasp what you are telling her, the rest can work itself out I think.
I've also had sessions with a few therapists who I knew pretty immediately would absolutely not be the right person for me (two clearly had no understanding of me as a person, and one funnily enough was a dead ringer for my mother, which again... *reasons*). One I kept going with for six weeks, partly because I didn't trust my judgement yet (it was my first attempt at therapy) and partly because I was at rock bottom and didn't have the capacity to look for anybody else. This was definitely money thrown into the aether (resentfully at that), but it at least helped me learn to distinguish between gut feelings and less definitive reservations. If you think in this case it's the latter, I'd say give it some more time, and work *with* her to figure out how this could work for you.
posted by FifteenShocks at 5:12 AM on October 14, 2019 [5 favorites]
Sometimes I throw up "red flags" and reasons why not because internally, I'm afraid of something. I tend to reject before being rejected. I'm not saying that's what is happening here, but let's look at some of it.
She said a couple of things which made me feel she didn’t have as much faith in me as I would have liked, she admitted to asking her friend how to say my name (it’s quite uncommon here in Australia) and she said her approach was to be honest and tell me what she thought I needed to hear (she did not ask me what I would prefer.) She also said I could contact her after hours and sent me a text once already to see how I was doing.
These are open-ended questions to consider (no need to answer here, I recommend journaling):
1.) What did you feel in the moment about her asking a friend how to say your uncommon name?
1.b) What do you feel now?
2.) What does your ideal therapist look like?
2.b) Do they (or should they) have the capability to surprise or challenge you?
3.) Articulate to yourself how you felt at the moment when she described her process.
3.b) Do you feel the same way about the process she described now?
4.) How did you feel about the text as you received it?
4.b) How do you feel about the text now?
Therapy is very hard for lots of reasons. Generally, I think it is important to look at how we feel in the moment and how we feel when we're out of the moment when we're considering an urge to reject something quickly that is tied up in how we're coping or looking to change. Wanting these other opportunities for therapy that were denied you could bias you against the one you did get, especially if some tiny part of your brain is afraid of what you're doing.
We can convince ourselves of anything. If you want to convince yourself a therapist is great, you will do so. If you want to convince yourself a therapist is not great, you will also do so. If you don't want to convince yourself of anything but just write down and ponder actions and how they made you feel, you might have a better idea what to do and feel confident in the judgement.
edit: I have had a therapist who threw up so many red flags. I actually gave her a second visit because she hadn't charged me for the first one. Turns out she'd … forgot? … and tried to charge me then. I even made a post here about it, if you want to read it. Anyway, I have an amazing, all-time-best therapist now who I love dearly. It took me many months to get up the willpower to find her though after that first failed one. I'm glad I didn't stick with it though.
posted by OnTheLastCastle at 8:01 AM on October 14, 2019 [1 favorite]
She said a couple of things which made me feel she didn’t have as much faith in me as I would have liked, she admitted to asking her friend how to say my name (it’s quite uncommon here in Australia) and she said her approach was to be honest and tell me what she thought I needed to hear (she did not ask me what I would prefer.) She also said I could contact her after hours and sent me a text once already to see how I was doing.
These are open-ended questions to consider (no need to answer here, I recommend journaling):
1.) What did you feel in the moment about her asking a friend how to say your uncommon name?
1.b) What do you feel now?
2.) What does your ideal therapist look like?
2.b) Do they (or should they) have the capability to surprise or challenge you?
3.) Articulate to yourself how you felt at the moment when she described her process.
3.b) Do you feel the same way about the process she described now?
4.) How did you feel about the text as you received it?
4.b) How do you feel about the text now?
Therapy is very hard for lots of reasons. Generally, I think it is important to look at how we feel in the moment and how we feel when we're out of the moment when we're considering an urge to reject something quickly that is tied up in how we're coping or looking to change. Wanting these other opportunities for therapy that were denied you could bias you against the one you did get, especially if some tiny part of your brain is afraid of what you're doing.
We can convince ourselves of anything. If you want to convince yourself a therapist is great, you will do so. If you want to convince yourself a therapist is not great, you will also do so. If you don't want to convince yourself of anything but just write down and ponder actions and how they made you feel, you might have a better idea what to do and feel confident in the judgement.
edit: I have had a therapist who threw up so many red flags. I actually gave her a second visit because she hadn't charged me for the first one. Turns out she'd … forgot? … and tried to charge me then. I even made a post here about it, if you want to read it. Anyway, I have an amazing, all-time-best therapist now who I love dearly. It took me many months to get up the willpower to find her though after that first failed one. I'm glad I didn't stick with it though.
posted by OnTheLastCastle at 8:01 AM on October 14, 2019 [1 favorite]
What can be frustrating to process is that all your red flags COULD be red flags or they could be that, as a human being, you don't like not being in control and it makes us cranky and defensive to be told what to do, even when that telling is backed up by education, training, and professional certification.
Therapy is supposed to chafe a little. You're not necessarily supposed to "like the sound of" the approaches she's presenting to you (within reason, obviously - if you think they are unsafe or have been discredited or never even credited as a proper therapeutic approach obviously you should protest or walk away). Assuming her suggestions are reasonable, that's not a lack of personality fit, it's that this is hard and it's going to be hard. You're not auditioning a new friend, you're asking someone to fuck you up a little bit and it's a good sign that they have Approaches and Methodologies rather than just a passion for messing people up.
I just think you should sit down and break out the post you wrote here into bullet points and consider each one again. Your narrative sounds exactly like me talking myself out of something I don't want to do because it's hard and scary.
Big red flags with a therapist are generally related to professional boundaries, questionable business/privacy/billing practices, not paying attention, not taking your concerns seriously (which is not the same as just doing everything your way) when you bring them up. Since you're not in crisis, what you're doing really is hiring a teacher to work with you on good life skills, so you don't need shared interests and you don't really need a personality fit so long as any personality mismatches are navigable - which many are, and that navigation is a useful skill you can strengthen in therapy.
You've only had one session, which is basically intake and introduction, and you've already decided this is not-great therapy? It's worth digging a little harder into why you think that and interrogate your reasons for asking here and what answers you were imagining you'd get - probably you had an idea in your mind that everyone was either going to say "run" or "this is fine", and there's stuff to unpack in those expectations too.
posted by Lyn Never at 8:49 AM on October 14, 2019 [7 favorites]
Therapy is supposed to chafe a little. You're not necessarily supposed to "like the sound of" the approaches she's presenting to you (within reason, obviously - if you think they are unsafe or have been discredited or never even credited as a proper therapeutic approach obviously you should protest or walk away). Assuming her suggestions are reasonable, that's not a lack of personality fit, it's that this is hard and it's going to be hard. You're not auditioning a new friend, you're asking someone to fuck you up a little bit and it's a good sign that they have Approaches and Methodologies rather than just a passion for messing people up.
I just think you should sit down and break out the post you wrote here into bullet points and consider each one again. Your narrative sounds exactly like me talking myself out of something I don't want to do because it's hard and scary.
Big red flags with a therapist are generally related to professional boundaries, questionable business/privacy/billing practices, not paying attention, not taking your concerns seriously (which is not the same as just doing everything your way) when you bring them up. Since you're not in crisis, what you're doing really is hiring a teacher to work with you on good life skills, so you don't need shared interests and you don't really need a personality fit so long as any personality mismatches are navigable - which many are, and that navigation is a useful skill you can strengthen in therapy.
You've only had one session, which is basically intake and introduction, and you've already decided this is not-great therapy? It's worth digging a little harder into why you think that and interrogate your reasons for asking here and what answers you were imagining you'd get - probably you had an idea in your mind that everyone was either going to say "run" or "this is fine", and there's stuff to unpack in those expectations too.
posted by Lyn Never at 8:49 AM on October 14, 2019 [7 favorites]
I started therapy this year, for the first time in my life, at age 38. I'd previously held some dubious distrust of therapy, which is to say that I came to it in crisis. I had no idea where to begin, so I had consultations with the first two therapists I'd contacted who had the room in their schedule to take me on. I went to both, weekly, for four weeks. At the end of that period, I, too, felt quite confident that I wanted to continue work with one and not the other. Both had what seemed like personality quirks that might not mix well with my personality but, what do you know, after a few interactions I more or less got comfortable with both of them (although I got much more comfortable with one of them). When I let the one therapist know I wouldn't be continuing to work with him but that I'd appreciated and gotten value from our four sessions (he was very academic and evidence-based, but also very, very expensive), he very helpfully gave me a ton of references to books and supportive material so I could keep working on the practices he'd introduced me to.
This is all a long-winded way to suggest that being a little more flexible than you feel in the moment can be a good thing when it comes to finding a therapist. See where it goes with the one you've got, even as you continue looking for another, because even if you switch in the future you're still getting value out of talking and listening and learning now.
posted by late afternoon dreaming hotel at 10:46 AM on October 14, 2019 [2 favorites]
This is all a long-winded way to suggest that being a little more flexible than you feel in the moment can be a good thing when it comes to finding a therapist. See where it goes with the one you've got, even as you continue looking for another, because even if you switch in the future you're still getting value out of talking and listening and learning now.
posted by late afternoon dreaming hotel at 10:46 AM on October 14, 2019 [2 favorites]
Good therapy is a bit uncomfortable. Good therapists will let you know this.
posted by argybarg at 11:19 AM on October 14, 2019 [1 favorite]
posted by argybarg at 11:19 AM on October 14, 2019 [1 favorite]
Response by poster: Frumiousb - just to clarify, those are not reasons why I felt she had no faith in me, they are problems additional to the fact she displayed at one point that she had no faith in me.
posted by EatMyHat at 1:07 PM on October 14, 2019 [1 favorite]
posted by EatMyHat at 1:07 PM on October 14, 2019 [1 favorite]
Best answer: To answer the headline question, "is not great therapy better than no therapy," I would say if you're not in crisis, and the therapist is legitimately not-great, there are potential negative consequences to sticking it out with a therapist you don't like. I did ~2 years with a therapist who was a poor fit for me, and there's a number of perfectly valid therapeutic tools that now have strong negative associations because of how they were handled by that therapist (because she tended to give up on them, and me, very easily when I expressed any mild difficulty or discomfort with them) and will be much harder for me to make productive use of in the future.
A therapist is given a position of authority and trust to help you define what feelings and behaviors are positive and represent "progress" and which are counterproductive. A therapist making weird calls in these areas, telling you your victories are fails, and vice versa, can really scramble your brain.
I think "doesn't seem to have faith in me" sounds like a big red flag that this person won't know when and how to encourage you.
posted by space snail at 3:14 PM on October 14, 2019 [1 favorite]
A therapist is given a position of authority and trust to help you define what feelings and behaviors are positive and represent "progress" and which are counterproductive. A therapist making weird calls in these areas, telling you your victories are fails, and vice versa, can really scramble your brain.
I think "doesn't seem to have faith in me" sounds like a big red flag that this person won't know when and how to encourage you.
posted by space snail at 3:14 PM on October 14, 2019 [1 favorite]
However I didn’t like the sound of either of the approaches she wanted me to learn about
There are some that are legitimately fishy to me, but it's really hard to tell from just this if this is reasonable or if this is just you having a general feeling of nothing seeming to quite fit yet that could resolve over time and some more exploring of this. I would not have thought that much of the therapy that really helped me if I'd just heard the initial elevator pitch for it and then tried to make a decision about whether I thought it was going to be good for me.
There's some things that bill themselves as "therapy" that are basically just versions of alternative medicine and not evidence-based. But a lot of the stuff I've done that helped either started out sounding silly or tedious and sometimes was both of those things in the moment, so... I'd put a lot of weight here on whether she's recommending stuff that actually has research backing behind it or not.
posted by Sequence at 5:21 PM on October 14, 2019
There are some that are legitimately fishy to me, but it's really hard to tell from just this if this is reasonable or if this is just you having a general feeling of nothing seeming to quite fit yet that could resolve over time and some more exploring of this. I would not have thought that much of the therapy that really helped me if I'd just heard the initial elevator pitch for it and then tried to make a decision about whether I thought it was going to be good for me.
There's some things that bill themselves as "therapy" that are basically just versions of alternative medicine and not evidence-based. But a lot of the stuff I've done that helped either started out sounding silly or tedious and sometimes was both of those things in the moment, so... I'd put a lot of weight here on whether she's recommending stuff that actually has research backing behind it or not.
posted by Sequence at 5:21 PM on October 14, 2019
Best answer: I think not great therapy with a bad fitting therapist can be damaging. It was in my case. One I saw for about six months who really made me feel worse, for many reasons. And this was not because I was being challenged by her and pushed out of my comfort zone. It was because she and I were a horrible match. Therapy is a relationship and if you don’t feel like you are comfortable with the relationship then I think that is enough.
Maybe do give her a few sessions to try, just to feel it out. But if you still come away uneasy with HER, not therapy, then find someone else.
I’ve had four therapists over the course of 25 years. Only one has been worth a damn. She has quite literally saved my life and made it possible for me to get married, have a family etc.
Find the right one for you.
posted by ChristineSings at 6:43 PM on October 14, 2019 [2 favorites]
Maybe do give her a few sessions to try, just to feel it out. But if you still come away uneasy with HER, not therapy, then find someone else.
I’ve had four therapists over the course of 25 years. Only one has been worth a damn. She has quite literally saved my life and made it possible for me to get married, have a family etc.
Find the right one for you.
posted by ChristineSings at 6:43 PM on October 14, 2019 [2 favorites]
In stead of evaluating this therapist, tell her exactly what bothers you about her. Tell her what she said that made you feel she lacked faith in you. If you don't like her two "approaches" tell her what you don't like about them. Whenever something feels wrong, speak up. If you don't feel comfortable telling her what you want, at least tell her that you don't feel comfortable telling her. If she can't or won't explore your objections to her, or gets defensive, then is it time to find someone else.
posted by Obscure Reference at 6:42 AM on October 15, 2019
posted by Obscure Reference at 6:42 AM on October 15, 2019
It really would help if you would be more specific. Like, if someone says, "I feel like my SO is being unreasonable about how we spend our money, should I break up?" then there is no way to answer without knowing exactly what the money disagreement consists of. Right?
In the end, it's up to you what you will do in your situation. But if you want people on this forum to weigh in on your dilemma in any meaningful way, you need to give us meaningful specifics.
1. What exactly made you think she has no faith in you?
2. What exactly are the modalities which you don't think will work for you?
3. Do things like her needing help to pronounce your name, or her encouraging contact outside of session, bother you to a significant extent? Why? (I ask not to invalidate you but to understand your concerns better. On the face of it, it seems to ME that you could simply let her know you don't want contact outside of sessions, and interpret the name issue as her being willing to educate herself independently when she falls short... but you obviously have some concern that I'm missing.)
posted by MiraK at 9:57 AM on October 15, 2019
In the end, it's up to you what you will do in your situation. But if you want people on this forum to weigh in on your dilemma in any meaningful way, you need to give us meaningful specifics.
1. What exactly made you think she has no faith in you?
2. What exactly are the modalities which you don't think will work for you?
3. Do things like her needing help to pronounce your name, or her encouraging contact outside of session, bother you to a significant extent? Why? (I ask not to invalidate you but to understand your concerns better. On the face of it, it seems to ME that you could simply let her know you don't want contact outside of sessions, and interpret the name issue as her being willing to educate herself independently when she falls short... but you obviously have some concern that I'm missing.)
posted by MiraK at 9:57 AM on October 15, 2019
This thread is closed to new comments.
If it's just that you don't want to be her close personal friend, that's fine. But think of if you had a personal trainer for fitness. You don't have to want to get coffee with them or hang out on your own time. They may suggest exercises that are new to you or you've never tried before. But if they have goals that don't make sense for you, or if they ignore things you say (say you're trying to rehab an injury and they're focused on increasing your max bench press), or if they intimidate you so that you can't tell them if you're in pain, that matters. Same for a therapist.
posted by Lady Li at 12:25 AM on October 14, 2019