How can I set boundaries around therapy?
July 26, 2009 6:38 AM   Subscribe

I want to go into therapy but exclude certain important areas from discussion. How can I best approach this?

I'm slowly coming to the reluctant conclusion that I should seek therapy. I think it's going to be hard to do: I'm guarded, and reluctant to trust or to open up to others. I think I can get myself to do this, but it's going to be hard.

A thing that's going to make it harder is this. I'm pretty sure a therapist, upon understanding my situation, will advise me to take a particular action, let's call it X. I've been advised to do X by my friends. X is the common-sense thing to do in my situation. I'd advise a third party in the same situation to do X.

For reasons that are sufficient to me, I'm not going to do X. Furthermore, I don't want to be talked into doing X. I recognize that not-X has not worked so far, and may never work, but I have strong reasons to not want to do X.

I don't want an adversarial relationship with my therapist in which he/she tries to talk me into doing X or wanting to do X, for my own good. I'm willing to explain my reasons for not wanting to do X, but I don't want them challenged or otherwise attacked or circumvented. I don't want to have to be on-guard against attempts, subtle or overt, to change my mind on this point. I'm going to need all the psychic energy I can come up with just to get to the sessions; I can't spare any for that kind of self-defense.

I understand and accept that this may mean that I won't ever really solve my problems, or solve them as well as I might. I understand and accept that I may not have as much happiness in my life as I might have, were I willing to do X. I would, however, like as much happiness and well-being as I can find, within the constraint of not-doing-X, and I believe that therapy could help me get that.

Is it absurd to think that a therapeutic relationship could exist within this constraint? How can I best approach this with the therapist?
posted by anonymous to Health & Fitness (34 answers total) 6 users marked this as a favorite
 
It's not absurd at all. If you spell out these rules in your very first session and state it all explicitly then any therapist deserving of the title will respect your boundaries. Probably the closest he/she would ever come to "challenging" you on the subject would be to periodically ask you if your feelings about not doing X had changed. And when you say that no, you are still resolved, they will let it drop.

Just don't be surprised if, after working on other issues with a therapist and being guided through intense self-examination, you eventually do change your mind about X.
posted by philotes at 6:47 AM on July 26, 2009 [3 favorites]


A therapist is there for you, hired by you, and is, in a large part, directed by you. You've been very articulate about this issue here, and I'd recommend saying close to exactly the same thing to a therapist on your first visit. The first visit with any therapist is an interview, of sorts, for you and for him/her. If you feel that this therapist isn't a good fit, based on his/her reluctance to your wishes regarding X, or if your therapist thinks that s/he can't help you without addressing X, you both will know by the end of the first session, and you'll most likely get a recommendation for another therapist or further resources as to who can work with you in the way you want.
posted by xingcat at 6:56 AM on July 26, 2009 [1 favorite]


Is it my computer or did a comment get deleted? What was that about?

I don't know if a therapist would take you. Everything sounds reasonable enough except for I'm willing to explain my reasons for not wanting to do X, but I don't want them challenged. You would be asking your therapist not to do his/her job. Ultimately, your statements that you will accept no matter of subtle hinting or end-around strategies leads me to believe that therapy won't help you very much.

Just don't be surprised if, after working on other issues with a therapist and being guided through intense self-examination, you eventually do change your mind about X.

If that's the case, philotes, then you've given anonymous another reason not to go to therapy. That's explicitly what they don't want to happen.
posted by billysumday at 6:59 AM on July 26, 2009


Certain kinds of therapy are "directive" while others are "non-directive." A therapist of the latter type is not allowed to tell you to do x. One may want to discuss why it's out of the question in order to understand you, though. You could refuse to, though. I could imagine a dialogue something like:

Therapist: What's so awful about talking about X?

You: I just don't want to discuss it.

Therapist: I'm fine not discussing it, but is it because you hear the discussion as me wanting you to do it, even though I tell you that's not my goal?

You: Yes. I don't believe you.

Therapist: OK. Then we'll talk about what you want to talk about.
posted by Obscure Reference at 7:06 AM on July 26, 2009 [1 favorite]


One reason you go to therapy is to get counsel from someone trained to help others. If you are set against hearing whatever they have to say, you work against the therapy process. Maybe you should hold off on therapy until you can benefit from good advice, i.e., until you are ready for true change.
posted by RussHy at 7:19 AM on July 26, 2009 [4 favorites]


I think you're making more of this than it deserves. The therapist won't handcuff you when you arrive, and won't hold your puppy hostage to make sure you return. You will always have the opportunity to leave, at any time. Furthermore, therapy isn't about forcing you to do anything on anybody else's schedule. A therapist will know that you will not make progress if they push you so hard that you shut down and/or leave. They will want to help you, so it will be in their interest to work at a pace you can tolerate (albeit maybe not comfortably). They will have no interest in being adversarial.

You're worried about having to "defend" yourself, but nobody will be trying to hurt you. Constructive challenges and questions, in the context of therapy, are not forms of attack. You can certainly set boundaries about what subjects you're willing to address at any given time, but permanently ruling anything out is a bad idea. If you didn't need to be challenged, you wouldn't need therapy.
posted by jon1270 at 7:19 AM on July 26, 2009 [1 favorite]


I'm a therapist, although not your therapist. I have two comments:

1) You only need to talk about what you want to talk about in therapy. There is no contract whereby you agree to set aside all of your personal boundaries when you enter therapy. Your therapist works for you, as well as with you, and should take your direction regarding focus and direction. Good therapists are not, in general, in the business of "convincing" patients to do anything.

2) On the other hand, your protestations make a fairly convincing case that this issue is something that is likely to come up during the course of therapy. It's fine to not want to talk about it, and to redirect your therapist if they ask you about it, and to maintain your boundaries for as long as you want to do so. But I do think you should be prepared for, and open to, your therapist raising the issue with you during the course of your treatment. They may do this regularly given the impact you describe from this issue on your life. In my own view of what's useful in therapy I do not think it's a good idea to prevent your therapist from raising an issue, as long as they respond to your desire to talk about it or not once it's raised. In other words, it's one thing to maintain a boundary about not wanting to actually discuss something, and it's another thing to establish an embargo on even mentioning the issue. In the first case you're preserving your autonomy and desire, in the second you're obviating the perspective that you're hiring the therapist for in the first place.
posted by OmieWise at 7:40 AM on July 26, 2009 [8 favorites]


Is it absurd to think that a therapeutic relationship could exist within this constraint?

Not at all. You don't have to be no-holds-barred with a therapist to gain from the meetings you have with them. They can still help you with the issues you are willing to discuss, and it seems to me that any help you gain is just that, a gain. You'll be better off with some help than you will with none.

How can I best approach this with the therapist?

Say to the therapist that you're not ready to discuss X, Y or Z. They will honour this fact, and if they don't, then walk out of the office. They might ask you why you don't want to discuss X, Y or Z. If you're comfortable telling them why, then do so. If not, say that you don't want to discuss that either, or maybe that it's just too painful at the moment, or that you're simply not ready.

Trust is fundamental to a therapeutic relationship, and if you can't trust your therapist, then find another. Any therapist who backs you into a corner or tries to take you to places you don't want to go is not someone to trust. Therapy is all about you, and what you want to get out of it, and how you feel. If you're not getting something that you want, or getting something that you don't want, leave that therapist.
posted by Solomon at 7:40 AM on July 26, 2009


Trust is fundamental to a therapeutic relationship

That's true, and yet, you needn't trust your therapist. It's useful to trust him/her enough to be able to say so, though.
posted by Obscure Reference at 7:46 AM on July 26, 2009


Most of the therapists I've been to have specifically not told me to do this or that. No therapist wants to be responsible if something doesn't turn out well. And anyway, you're responsible for your own life.

However, I can practically guarantee you that if there is a big important thing in your life that you don't want to talk about, that's what's messing up your life.

On the other hand, maybe you're not ready to talk about it, and you can talk about other things until you're ready to talk about the thing you need to talk about.
posted by musofire at 7:46 AM on July 26, 2009


I'd advise a third party in the same situation to do X. ... I'm not going to do X.

This sounds like a really important internal conflict for you. It obviously has a very large effect on your life. A therapist isn't going to try to inflict a decision upon you or make you take some action you don't want to take. That being said (and plenty of others above said it too), you should not exclude X from discussion; you should talk about X and work with the therapist to help you become more at peace with your decision, your situation because of it, and the ways it affects your life. I can see how your relationship with friends might become adversarial in this situation (for instance, something like "DTMFA or else I don't want to hear about it anymore") but it won't be this way in therapy.
posted by fritley at 7:52 AM on July 26, 2009


IANAT, and IANYT, but I did just chat with one this morning over breakfast and here's a summary of what they said:

They should definitely share their boundaries with a therapist, at the very least because many therapists may decide on that basis to refer them elsewhere (perhaps to a 'non directive therapist' that Obscure Reference speaks about).

Basically, to badly misquote Toni Morrison, for (at least some) therapists, the point of therapy isn't happiness. The point of therapy is to work towards wholeness, maturity and wisdom.

.....

And the non therapist part of this message (that'd be me), adds that even if all that's true (and I don't know if it is), it sounds like the only way to really discover what will and won't happen, and if it is or isn't absurd, or if it ultimately therapy is or isn't good for you, is to go find a therapist, and see what happens.

Even deciding to explore therapy is very brave, and I don't know how many people walked in saying, 'yep, I've had problems with these 14 things, well, forever, and I'm equally willing to deal with each of them, right now. Bring it on!'. I think everyone has defense mechanisms, and blind spots, and fears, and so you go to therapy with all your baggage, and see what happens.

Best of luck to you.
posted by anitanita at 7:53 AM on July 26, 2009 [1 favorite]


You should see a therapist, and tell them your attitude about X. I went to a therapist years ago, telling here again and again that I was unwilling to do X. Never once did she tell me to do X. Funny thing, though, after talking to her for a long time, I ended up deciding to do X on my own accord. Life has never been better.
posted by TurkishGolds at 8:09 AM on July 26, 2009 [2 favorites]


You've very clearly articulated your reasons, and therapy is largely self-directed. Whatever you start to talk about at the beginning of each session, is going to be the focus for that session. If x comes up organically, and you still don't want to discuss it, you can just say your position about x has not changed and then steer the conversation away from x. I'm not saying your therapist will never ask you hard questions or give feedback you don't want to hear. S/he probably will, but that doesn't mean your boundaries around x can't or won't be respected.

This is completely anecdotal, but I have an excellent therapist who has helped me in many ways. That said there are some issues, big, important issues, that we do not see eye to eye on and never will. Basically, I have my own version of x, and though I am not following her recommendations about the situation, it is still a very valuable and helpful therapeutic relationship. Boundaries, differing opinions, and divergent solutions can exist simultaneously within an excellent counseling situation that also leads to growth, increased happiness, and health. Good luck!
posted by katemcd at 8:40 AM on July 26, 2009


A lot of people have things they don't want to talk about in therapy. Many only find this out later on and you're already clear on the subject. Therapy is about making your own decisions so no competent therapist is going to make them for you.
posted by Obscure Reference at 8:46 AM on July 26, 2009


I'm guarded, and reluctant to trust or to open up to others... I don't want an adversarial relationship with my therapist... I don't want to have to be on-guard...

For whatever reason, you have made a decision about your life. You sound logical and thoughtful, and ready to share those reasons with a therapist. You don't want to spend therapy time justifying this decision.

You're going to a therapist with a goal. A competent therapist will help you get to your goal, discover obstacles, and have better understanding of what's going on in your head. You're anticipating that the therapist will recommend X, but the therapist may surprise you. The critical component is to find a really good therapist. You should find a therapist you can respect, and your therapist should respect you. I think you should stay open to discussing X, but I'm sure you and the therapist will find other options. Good luck.
posted by theora55 at 8:51 AM on July 26, 2009


Okay, since I can't deal with the vagueness of "X" in my head while writing this out, I'm mentally substituting things like "refuse to try antidepressants" or "cut off abusive family member" in my head. Not because I am 100% sure this is your issue, but they seem like likely things to fit your situation and thus I can frame the question better.

In my experience, you can say no, repeatedly, and the therapist will probably be all "Hey, it's your choice, I can't force you, just remember that you are choosing to put up with this." (Especially if drugs are the issue and you are talking to someone who can't prescribe them.) However...if you talk about how you can't get out of bed a lot and called in sick 4 out of 5 days this week, or if the abusive family member keeps on treating you like crap, or whatever it is, all the time, they are periodically going to be all, "You DO realize that if you'd just take the drugs/cut off Aunt Sally, the problem would probably be solved a lot faster than we're doing right now at $150 a pop per week?" You can't really really 100% forbid them from EVER bringing it up and expecting it to stick, especially if you are going into therapy FOR dealing with X and it's obvious to every single person on the planet that you should be doing X because that's the #1 most efficient way to eliminate it. It IS their job to ask. They can't in all good conscience NEVER EVER ask.

You have my sympathies because uh, I don't want to do my own X either and I have had these conversations myself. I'm just saying that an absolute conversational ban is probably not going to work with most therapists (or friends or anyone who hears the situation, though). If you really want to go into therapy, I'm just saying that periodically they are going to ask, "Are you still 100% sure you don't want to do it?"
posted by jenfullmoon at 8:53 AM on July 26, 2009 [1 favorite]


I was in a similar situation and for the purposes of this comment will use x also as a specific element of my situation that, while in my control, for my own reasons I decided also not to act upon.

I still went to therapy for may of the reasons you stated above. I was fortunate to find a compatible therapist and while I was open to discussion of x as it related to the rest of my life I was not looking for someone to tell me you must change x in order to make any other changes.

My therapist did not in any way try to change my mind on x, and I do still have to deal with some difficult issues because at this point I am not willing to make that specific change. Having said that, I was able to work through other issues and have greatly improved things in my own head-space and in my day to day life.

My experience with therapy was a positive one and just to reference anitanita..
Basically, to badly misquote Toni Morrison, for (at least some) therapists, the point of therapy isn't happiness. The point of therapy is to work towards wholeness, maturity and wisdom. .. I would say it did help me do that.

Best of luck to you..
posted by Weaslegirl at 9:08 AM on July 26, 2009 [1 favorite]


So, there's this old joke: what do you call a doctor who finishes last in their class? "A doctor"

Half of professionals are below-average. And, therapists, in my experience, have been much worse. A lot of people go into therapy for the wrong reasons or because they couldn't do their option #1. In fact, there are a LOT of lazy, bad therapists out there. I've yet to hear of anyone who's gone to a therapist and had extremely positive, life-changing results.

There's a really good chance that a randomly chosen therapist will recommend X. Or, worse, they may impose their own biases on you and get you into a worse situation. Seriously.

Unless you're suicidal, or you're at risk of harming someone else, I can only recommend to go slow. Make sure you ask around. Do not go to a therapist without having at least two positive recommendations. And, do not randomly select one from the phone book. Even then, be skeptical of their advice and approach until you've become extremely comfortable and trusting of them.

Remember, they're people.
posted by TheOtherSide at 9:16 AM on July 26, 2009 [2 favorites]


The question is whether you are asking your therapist to compromise his/her integrity as a person.

To use an extreme example, if you are abusing a child but don't want to discuss it, a good therapist will say: "I cannot pretend that you are not abusing a child. Continuing therapy would be an implicit endorsement of your child abuse, and I can't do that. Find another therapist."

I assume that X is not at that level of seriousness and doesn't present an ethical dilemma to your future therapist. Let's assume, instead, that, I don't know, you drink a lot of alcohol.

Let's suppose that you drink so heavily that it probably does cause a lot of your problems. Do you want your therapist to lie and say it doesn't? Or say that a lot of other things cause your problems when it's really the drinking?

The best outcome, given your constraints, would be that your therapist says: "I suspect that many of your problems are tied to X, and the surest way of solving those problems would be changing X. If you want to pay me to deal with peripheral issues, though, I can do that. There may be times, however, where we bump up against the margins of what we can't deal with by dealing with X. When we do, I'll have to let you know that's happening."

If you flip out or become agitated when X comes up, it's part of your therapist's responsibility to observe that, and perhaps ask that you observe it as well. If you can deal with that, then great and therapy may be possible.

If, on the other hand, you go in with the stipulation that your therapist must pretend that X does not exist, you are asking him/her to lie. A good therapist will politely refuse.

By the way, TheOtherSide: I went to a therapist and had extremely positive, life-changing results. There. Now you've heard of me.
posted by argybarg at 9:34 AM on July 26, 2009 [4 favorites]


By the way, TheOtherSide: I went to a therapist and had extremely positive, life-changing results. There. Now you've heard of me.
Awesome, I'm very glad; and, now I have an anecdotal 1/20+ success ratio.

I didn't say it couldn't happen. I just suspected that it was rare.

Personally, I've had much more success reading David Burns' Feeling Good book over three months than I'd had from seeing four therapists. But, I'm still not cured (of anxiety).
posted by TheOtherSide at 9:50 AM on July 26, 2009


I also had an X that I refused to do. My therapist, who I randomly selected from the phone book, recognized that I was unwilling to do X even though it would have really helped improve other areas of my life. In this case, it was ending an unhealthy relationship. So, we worked on improving other areas of my life. Its not like I couldn't do better professionally because I was in a bad relationship (it wasn't abusive just unhealthy). Periodically, when it was related, she would bring up X and we would talk about it. Or I should say why I wasn't ready to do X. The most important thing that you take away from therapy are your reasons for not doing X. I didn't tell her X was off limits for discussion just that there was no way I was going to do it. I was open to talking about my reasoning. Having clarity and peace with your decision is more important than taking one action that, while it might make sense, is not right for you now or ever. Making an informed decision for yourself, with full knowledge of your motivations, and having that decision affirmed is really valuable.

For what its worth, I spent 3 years examining my reasons for not doing x, ended therapy because the rest of my life improved and then, I was ready to do X on my own. I ended the relationship and went back into therapy to deal with it! And a short while later, I was back in balance. I gained a lot of insight into my behaviors that I use daily to keep things moving in the right direction.
Good luck!
posted by rachums at 10:21 AM on July 26, 2009


This issue comes up repeatedly in addictions treatment. If the X you don't want to do is quitting drinking or drugs, see someone who specializes in "harm reduction" or "motivational interviewing." The idea in both of those is to "meet the person where he's at"-- so, if you don't want to stop injecting, they will recommend needle exchange, not detox. If your drinking is causing problems but you don't want abstinence, they will work with you on moderation or on reducing those problems (ie, not driving drunk rather than not getting drunk).

It will often occur that people who want to moderate discover that, in fact, it is easier to abstain entirely-- but no one who works in either of those methods will, if doing their jobs, push abstinence on you. However, you might discover that abstinence is what you want, and then they will help.

But their whole goal is to help you attain *your* goals, not theirs. And they are extremely nonjudgmental and empathetic if they are any good.
posted by Maias at 10:30 AM on July 26, 2009


follow-up from the OP: "Thanks to all for the advice. It'll probably be helpful if I make clear that X is approximately "DTMFA" rather than anything more dire."
posted by jessamyn at 10:40 AM on July 26, 2009


When I started therapy I had an X.
In my second or third session, I said to my therapist, somewhat despairingly: "I just feel like everyone in the world wants me to do X!"
My therapist said: "I don't. I don't care whether you do X or not."

For about two years, I thought she had to be lying, because EVERYONE thought I should do X. Slowly, I began to believe her. Eventually it turned out, it was pretty much just my mother who was so very keen for me to do X ;-).

I still haven't done X. I might do it someday. What therapy has done for me is to take this issue that felt so huge I couldn't see around it and shrink it down into something very manageable. The world is not all about X, for any value of X.

My advice: find a good therapist who you feel you 'click' with and whose intelligence and skills you respect. No good therapist is going to 'instruct' you to do anything, and you might find that the very expectation that they will is really just part of what you're there to sort out.
posted by acalthla at 1:48 PM on July 26, 2009


I do therapy. I like it - I find it interesting. That said, I find it difficult to talk knowledgably about the process. My therapist never sat me down and said "let me tell you how this really works." I find that a bit disconcerting, sometimes, and am annoyed by the idea there are secret methods in play that I don't understand. But perhaps like magic, if I could identify every linguistic sleight-of-hand, I'd never relax enough to open up. So instead, I ramble on about my life, and occasionally she asks an interesting question or makes an insightful observation about my rationales or choice of phrase. Like, "hey, that metaphor you just used to describe your holiday is the same one you've used before to describe your job..." And I'm all: "a-ha! It's all connected, isn't it?" And she's all: "Do you think it is?" Cumulatively, I feel like it's helpful.

To deal with your most obvious objection, my therapist has never made a concrete recommendation or offered an opinion about anything, least of all my choices outside the therapy session. I couldn't even hazard a guess as to what she really thinks about me or the things I do. They're trained to be that way. It's very effective, if occasionally weird to dwell on. But she'd never say "hey, the obvious thing to do is to just do X!" Any Joe Sixpack can have an opinion on what you ought to do, but it's a therapists job to help you get to where you want to be.

I think it's fine to lay it down straight: "look, I'm not coming here to change my mind about doing X. I'm very committed to it." But, not-doing-X is a part of your life, and surely causes you some concern, so it would be bad to not talk about at all. Hopefully, you'll find a way to feel more at peace with your decision. For instance, among friends you may not want to acknowledge the residual appeal of X, lest it encourage their persuasive efforts all the more. But with a therapist, you could say "admittedly sometimes, I feel kind of weird about not doing X" and they won't weaponize your words to use against you. You don't have to worry about sounding ingrateful, or arrogant, or melodramatic, or any of those things. So aside from the more complex stuff going on, therapy is also a good, safe place to acknowledge your own complicated feelings about stuff. That's helpful in itself.

The way you put it, "X/not-X" seems like this big, dramatic thing. And I'm guessing it is. But I think a lot of people have equivalent areas. One of the weirder aspects of therapy, in my experience, is that there isn't a bright line between "the good stuff" you want to keep and "the bad stuff" that you want to get rid of. Take something like "ambition." Lots of people (in therapy!) like being ambitious. They're invested in it, proud of it, and have all sorts of goals that they don't want to give up on. Even if it's making them really unhappy! Achievement is that important to them. But their therapists don't just say, "Look, trying to advance your career by working these crazy hours is making you miserable! You should leave Wall Street and go live the simple life of a gardener." If they did, the clients would throw up their hands and go "Oh, you do not understand me AT ALL." Instead, there is lots of other stuff to explore. Is it true to say some things are more important than happiness? Probably, but how can you make sense of that? What personal stuff does "achievement" fulfil? How do you think you'd feel if your priorities cahnged? And the aim is not to secretly trick you into giving up on your aspirations, but to get you to develop a more healthy relationship to them.

And I think that does mean not being paranoid about the therapist trying to "circumvent" your reasons for not-doing-X. To the extent that you talk about it at all, you have to at least explore the reasons, because the reasons are interesting. And it does entail a slight risk that you'll modify your stance on X, but that's all part of it. If you're so set against doing X, then maybe just considering it makes you feel kind of appalled. So, one outcome could be: you're somewhat less dead-set against X, but when you idly flirt with the idea of doing it, you feel less anxious and guilty. Or, you stay dead-set against doing X, but you have a really good sense of why that's the right decision for you and is true to your values. Or, you stay really opposed to doing it, admit it's a bit crazy, but instead look at other aspects of your life where this thinking might also have crept in. And so on.

But mostly your therapist will be pretty accommodating about what you want to talk about. Sometimes something will happen that I feel I ought to mention, but don't really want to discuss because I don't have any comment on it, and that's fine. Sometimes my therapist makes an observation that doesn't really resonate with me, and we might chew it over for curiosity's sake, but I can say "nice theory, but nah" and move on. Or we might even touch on something that is genuinely problematic, but I can say "yeah, I'd like to get a grip on that... someday" and move on to something that I'd rather be dealing with.

Finally, the question of "the right therapist." All I had to go on was, did they seem nice, reasonable and smart? This was only the second person I saw, but because of that, I don't know if really there is a way better level of therapy out there! I gave the first therapist I met a top-line summary of my life in our first session, and she said "Clearly, ziss sing is because of ziss uther sing." And I said "maybe, but I don't really see it that way. Don't you think it might be coincidence?" And she said "In psychoserapee, zair are no coincidences!" Which was so annoying, I left. For all I know my current therapist thinks the same, but at least she has the patience to let me feel like I'm figuring things out for myself!

Good luck, I'm sure it will all be cool.

*Finally: I don't do CBT, I do some other kind of therapy. Um, the wishy-washy kind? I feel like CBT is best for dealing with fairly specific behaviour in a practical, rational way, quickly finding the craziness, showing you it's crazy and getting you to change. What I do is a bit more philosophical although rather less practical. I chose it because things were all a bit stressy and meh, but wasn't really sure why.
posted by so_necessary at 1:52 PM on July 26, 2009


And, to TheOtherSide, I too have had extremely positive, life-changing results from therapy. It took a while - longer than I would have felt comfortable contemplating when I first stepped into a therapist's office.

And I totally agree with you that picking someone at random from the phonebook is a terrible way to find a good therapist. Personal recommendations are great. Failing that, try a Referral Service - most big therapeutic organisations offer them. They'll give you a two-hour interview with one of their most experienced therapists, who'll then recommend someone they think would work for you. This is how I found my therapist, and I've recommended this method to others with, again, many positive, life-changing results.
posted by acalthla at 1:57 PM on July 26, 2009 [1 favorite]


You need to consider what your "X" is. There are certainly some "X" which an ethical therapist simply cannot ignore, insofar as "X" is so harmful that they would simply be enabling you to damage yourself more efficiently, rather than helping you on a net basis.

(To take it to an extreme, if you came to therapy session bleeding profusely from the nose and said "Doc, forget about my bleeding, I really need to talk about my mother" he could not accommodate you.)
posted by MattD at 4:09 PM on July 26, 2009


MattD, Jessamyn already provided an update from the OP that X is approximately "DTMFA" and he/she does not want to DTMFA.
posted by IndigoRain at 4:34 PM on July 26, 2009


OP,

I've been in a situation similar to yours. (Therapy, where one significant issue was dealing with a romantic relationship I was unwilling to end).

I don't think a therapist is going to put you in a situation where they say "you need to end this relationship." They don't tell you what to do: it's not their job to make life decisions for you. That's your job. Therapists are there in an advisory role; trying to help you make sense of your own feelings and your own emotions.

So no, a good therapist won't insist you DTMFA. But you have to be prepared to discuss this relationship with the therapist. A good therapist will help you identify the various issues in your relationship, and give you strategies to deal with them. They may ask you to question your values and deeply-held beliefs surrounding this relationship, but also relationships generally. And, from my experience, this questioning is important for you to participate in. It helps you understand your own decision making process within the relationship in question. But at the end of the day, any therapist worth his salt certainly shouldn't be telling you to DTMFA, as that's simply not their place.

I think therapy can be helpful for you in the type of situation you are describing. It was helpful for me. Please feel free to memail me.

Feel free to memail me.
posted by HabeasCorpus at 7:01 PM on July 26, 2009


Tell the therapist that you'd like to find ways to make things better for yourself without doing X. He or she might want you to talk for a while about X, to explore your reasoning and feelings. But if your aim is to find another solution, they will most likely work with you to try to do that. Emphasize that you're looking to find other solutions. It's perfectly reasonable on your part.
posted by wryly at 7:19 PM on July 26, 2009


If you are saying that you want to get your life more organized without dumping TMFA, I would think a therapist could help. Surely therapist see people who aren't going to DTMFA because of religions reasons and whathaveyou.
posted by Lesser Shrew at 7:54 PM on July 26, 2009


I completely understand the reluctance to follow other people's advice in a situation like this. When well-meaning friends continually provide what they see as the "obvious" solution -- which you don't want to take -- it can feel like they're looking down on you and your choices. That's a crappy feeling.

But I would chime in to echo those who have said that many of the difficulties you likely face with, say, the other person or people involved in X are probably difficulties you face in other areas of your life. If X is your relationship with a family member, which is not so easy to get out of (especially if you live in the same town... oy), we're talking about decades of learned behavior and reactions behind just the identifiable issues alone.

I hope that you are able to simply say, "X exists and this is just how it is," and work from there, instead of just ignoring it completely. There are bound to be some deep commonalities. If X is your relationship with your dad, for example, let's say that a big part of it is not trusting yourself because he never let you make mistakes and you can't deal with failing. That likely spills over to work and other relationships. The problem is not necessarily your dad and your relationship with your dad but the feelings that you felt when you dealt with him: it's a trust issue that gets played out with your dad, not a dad issue that includes trust. Your therapist, then, can help you talk about trust in a way that might benefit both situations instead of just harping on the dad stuff and hoping that it will spill over to work. Does that make sense?

I haven't made any progress without facing the things that scared me. The best thing therapy has done for me is to help me be more internally consistent with myself and more consistent with how I present my internal feelings externally. THAT is a wonderful feeling.
posted by Madamina at 8:36 AM on July 27, 2009


Really good therapists don't give advice. They help you think about things until you decide for yourself a good way to deal with them.
posted by y6t5r4e3w2q1 at 7:07 PM on January 5, 2010


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