Confused about a confrontation in therapy
January 5, 2012 9:54 AM   Subscribe

In my last session, my therapist kind of forced a confrontation with me and I feel weird about it. How do I handle this?

TL;DR: I feel like my therapist misread my body language in a way that made about ten minutes of our session about him and not about me. How should I handle this next week?

Long version: I've been seeing a therapist for about five months now: first for acute depression and panic (which has subsided) and now we're working on ways for me to live in a more self-aware, positive way with my own natural emotional responses to life. It's been generally good, although this is my first time in therapy so my ability to assess it is limited.

Yesterday, we were talking about my tendency to defeat myself by adopting a hopeless posture toward life in general. (e.g., thoughs like "yes, I have a job now, but I owe so much in student loans that I'm going to be paying them for the rest of my life so it doesn't matter"). My therapist is big on this idea that we absorb "energetic patterns of behavior" from those around us, especially as children, and that one of the patterns I've absorbed gets a lot of pleasure in cutting me off at the knees whenever it seems like I'm starting to stand up.

So at some point I said something like, "what I'd like out of this is some kind of method or understanding or process where I can stop defeating myself when I feel that part of me taking hold."

I kind of smiled as I said it, which I intended to mean "I understand that this is kind of a tall and specific order and that therapy doesn't work like a fast food drive-thru."

(Side note: my therapist also seems to believe that inadvertent smiling can come from a place of patronizing and self-victimizing -- he often reads smiles as meaning something like "here, let me help you: you'll never succeed at anything and that's just the way it is. Sorry.")

So: when I said what I'd like, he kind of turned it around onto himself. He said (and I'm paraphrasing here) "then stop defeating yourself. I don't have the answers for you. Do you see how you just put me into a bind? Only you have the power to defeat yourself or stop defeating yourself, so if I give you something to do and it doesn't work (and you're in control of it not working), then your need to defeat yourself extends to me."

He continued, "It's like you came in here tired and defeated, but you had a searchlight out for positive energy and self-confidence. So you latched on to me -- here's a successful therapist: let's see if I can defeat him, too -- and tried to put me into a bind where you can control whether I succeed or fail."

This felt kind of confrontational and uncomfortable but I was trying to process what he was saying. We continued to talk about self-defeat and he pointed out that when I was "trying to defeat him" my physical posture changed and I became more awake and upright and that this is because a part of me enjoys the power of trying to defeat people and that's why I keep undermining myself.

I feel like his hypothesis might be true, but I also feel like this was a kind of weird and possibly shitty was to bring this to my attention. I also feel like he made the confrontation about himself, which seems odd to me. I'm not sold on his theory about smiling and I've found myself thinking "don't smile" when I'm in sessions -- which I worry is me trying to game the
therapist-patient relationship. I also suspect that my posture changed because I was sensing potential danger (in the form of this confrontation) from him, rather than because I wanted to undermine his self-confidence.

Is this sort of thing par for the course in therapy? Should I expect these sorts of confrontations? How do I know whether I'm uncomfortable because I'm being challenged in the right ways, and when I'm uncomfortable because it's not a good fit? Should I bring it up with him next session?
posted by anonymous to Health & Fitness (33 answers total) 8 users marked this as a favorite
Print out your question and take it to your next session.
posted by Carol Anne at 10:00 AM on January 5, 2012 [2 favorites]

I agree with Carol Anne. This is a nice summary. You could edit it a little bit, but all the details that are important to you are here, stuff that might get lost in a free-form conversation.
posted by zeek321 at 10:06 AM on January 5, 2012

You should absolutely bring it up in the next session. You should voice your doubts and concerns, and you should be prepared to discuss them. No one here will really know what happened between you, so it will be hard for anyone to say whether what your therapist said was right or wrong, but regardless, the ability to discuss it and come to terms with it is the most important thing. Seriously, it matters much less whether this interpretation was incorrect than it does whether you're able to work through figuring out what's going on here.

You sound articulate about this, and it sounds like you've found this guy helpful in the past.
posted by OmieWise at 10:14 AM on January 5, 2012 [3 favorites]

My therapist would be a lot harsher with you than this, and he'd be right. Life's too short to be a victim. Like everyone's saying, this sounds like great grist for the next session. Maybe try yelling at him about it, if you're mad! (Seriously. It's your session, go nuts.) Good luck! Sounds like you're doing totally great, actually. Yay to your progress.
posted by RJ Reynolds at 10:17 AM on January 5, 2012 [4 favorites]

You should definitely bring it up with him in the next session.

I'm not sure if this exact sort of thing is par for the course, because every therapist is different and every therapist-client relationship is unique. But, like any type of relationship, there's going to be rough patches, awkward moments, misunderstandings and conflicts. Also like any relationship, it's not the fact that you sometimes misunderstand each other or disagree that makes it a bad fit--it's how you deal with those difficult moments that matters.

On to what your therapist specifically said. It does seem a little more aggressive than I would expect. I think a lot of therapists communicate in softer ways, and might say, "Well, I wonder if you might be trying to blah blah blah". "Have you considered...?" "I don't think I can give you that answer. Here's why..."

I guess part of what seems aggressive to me about it is that your therapist seems so certain that he's right and also pretty attached to a specific narrative about what you're doing and why. I don't think that would work for me, but I can imagine it working for some people, especially at some points in their lives.

Can you imagine it working for you?

Have you ever said to your therapist, "hey, what you're saying doesn't make sense to me. This is what I think is going on."? If so, how did he respond? Is he willing to do some give and take with you? Does he seem to respect your right and need to define and interpret your own experiences?

That said, it doesn't seem to me that what he said was really making it about him. It seems more like he was trying to talk about the dynamic that exists between the two of you. He didn't talk about how he was feeling or what he needed or wanted--he talked about your pattern of self-defeat and how that might be playing out in your relationship with him. Which is I think an important and valid thing to talk about in therapy.

It's also important and valid that you feel safe in therapy, and that you feel like--even when your therapist is bringing up things that might be uncomfortable for you--that he's doing so in a way that is ultimately helpful for you.

I think you can only really find out whether or not that's the case by talking this through with your therapist. Good luck!
posted by overglow at 10:20 AM on January 5, 2012 [3 favorites]

Agree with the other posters that discussing this with your therapist is the best approach. I just wanted to add that one of the most beneficial therapy sessions I ever had was going into a couples counseling session with a very angry letter from me to our therapist, having her read it, and discussing it/working through it with her.

I've come to think that disagreements and conflicts are a normal part of any human relationship and that includes therapist-client relationships -- learning how to resolve those effectively (versus sweeping the issue under the rug which is my instinct) is a very powerful skill to have.
posted by elmay at 10:35 AM on January 5, 2012 [2 favorites]

OMFG, are you me? I love you and I HATE your therapist.

You're smarter than this guy, and less hostile. You could be doing his job. I think he knows this and is threatened by you. I hate drama-addicted therapists. This guy sounds like one to me!

Where on earth does this nasty-ass crap come from that these so-called helpers start in with? I don't care if his cover story is that he's telling like it is because it's good for you - getting in your face because you need to know this stuff, etc. etc. Some people respond well to "tough love." Others don't. There is absolutely NOTHING wrong with you if that approach doesn't work for you, and if it doesn't, he needs to know and to adjust his tactics.

I don't know if your therapist has a pattern of hostility, or if this was an isolated circumstance. All I know is that your therapist should not be attacking you, even as a therapeutic strategy, if you're not comfortable with being attacked.

You're in a place with this person where you're walking on eggshells - trying to anticipate how he's going to react to anything you do, from words you say to the micro-expressions on your face - so you can head it off before he bites YOUR head off. This looks to me like he has a pattern of attacking you. He needs to stop doing this, whether he's out of control emotionally - feeling irritated or threatened by you personally - or whether he goes home every night and calmly chooses a new way to niggle you from a range of strategies on a spreadsheet. As his client you shouldn't be afraid of his responses, and to my mind he's created an environment of fear in the one place in your life where you're supposed to feel safe.

Oh, and good call on noticing that something is wrong when the therapist makes the issue at hand about him. Yes, that shouldn't be happening. Therapists are human and they have all kind of counter-transference reactions to their clients. They get annoyed, they feel threatened, they get angry, they sometimes feel lost and confused, they sometimes question their own competence. But all of this has to be opaque to the client, or the experience is no longer therapy. It's something else - in short, a big frickin' mess, which is what you already deal with outside.

I have strong feelings about this because I had a very similar experience recently with a hostile and incompetent therapist. Look, there's no such thing as a harmless bad therapist. A therapist who is dispensing bad therapy is not just not helping you, but he's actively hurting you. I'd confront him with your feelings just as you presented them so effectively here, and see what he says. If he reacts with more attacks, just walk out. You don't need this crap!

Anyway, loved your post ! Good luck! :)
posted by cartoonella at 10:40 AM on January 5, 2012 [24 favorites]

You could ask him about it. That would show a great deal of strength and resilience on your part, and you could learn a great deal, as other posters say.

But I'm going to go against the grain here and give you full permission to fire this fuck and never go to another session with him again.

"What I'd like out of this is some kind of method or understanding or process where I can stop defeating myself when I feel that part of me taking hold." is a perfectly reasonable question and very appropirate one to ask your therapist.

His bullshitty doubletalk answer and chimpanzee-society smile-theory smacks of victim-blaming to me. Even if you were whiniest, most self-indulgent manipulative individual in the history of mankind? You're there asking for the tools to change, not to get called out on shitty behavior with no recommendations of practical steps to move forward with.

There are therapists working in pragmatic modalities. Cognative behavioral therapy gets mentioned here alot; maybe check out the workbook to see if something like this is what you envisioned as a process to help you with self-defeating thoughts.

You are doing great work for yourself. You sound like you are enough of an adult, that, were you to get started on a practical modality like CBT, that you would not blame the fact that it's hard and takes time on your therapist. You are not a horrific energy vampire, despite what that guy would have you believe. Best wishes in your forward journey.
posted by Rube R. Nekker at 10:46 AM on January 5, 2012 [19 favorites]

I said something like, "what I'd like out of this is some kind of method or understanding or process where I can stop defeating myself when I feel that part of me taking hold." I kind of smiled as I said it, which I intended to mean "I understand that this is kind of a tall and specific order and that therapy doesn't work like a fast food drive-thru."[...]

[He said] "then stop defeating yourself. I don't have the answers for you. Do you see how you just put me into a bind? Only you have the power to defeat yourself or stop defeating yourself, so if I give you something to do and it doesn't work (and you're in control of it not working), then your need to defeat yourself extends to me."

Think about what you intended. I could imagine your intent was to affirm your friendly rapport with the therapist; "we're in this together and I know these goals will be tough to achieve, so I don't mean to be setting unrealistic goals for you".

But I can see his point as well -- with this comment you're relying on him agreeing that those goals are tough to achieve, and maybe agreeing with a general view that life is full of goals we can't reach etc. So you are sort of pulling him into your view, which could be seen as a defeatist view, or a view that focuses on limitations rather than possibilities etc.

I tend to have the same view you do, often -- assuming that "human limitations suck, but we're all in it together" is a friendly kind of attitude. But in a way, he's right - it's not obviously such a friendly attitude.

We can accept that there are many limitations in life, but we can still focus our thinking on possibilities, ways to overcome limitations and get around obstacles etc. Maybe try to take something useful from his reaction -- you see your mindset as inevitable, but it isn't, for example here's a person who doesn't think "life is full of frustrated ambitions" is a proper baseline for all friendly conversation... maybe that can be a useful jolt for you?
posted by LobsterMitten at 10:49 AM on January 5, 2012 [3 favorites]

(Not saying that your therapist was right to snap at you. Just saying there might be something useful in there despite nastiness.)
posted by LobsterMitten at 10:50 AM on January 5, 2012 [1 favorite]

Hmm. Does he believe you literally absorb energies?

I agree with OmieWise in large part because of some larger theories and research about the therapeutic alliance but something about this guy seems off to me in a "might actually be damaging" way.

I don't know. Good luck.
posted by the young rope-rider at 11:00 AM on January 5, 2012 [3 favorites]

I agree with those advising you to consider seeking a new therapist.

It seems like this guy is spending most of his time analyzing body language and diagnosing you with certain "energetic thought patterns" and inappropriate smiling, and not enough time giving you practical tools that will help you address some issues that you have defined pretty clearly. It seems odd to me that you have to think so carefully about how you say what you say in therapy, or whether you smile or sit a certain way. Sure, body language can be revealing, but you should also feel comfortable and relaxed when you're in a therapist's office -- not as though you're under a microscope.

I think the question you asked him was completely appropriate, and deserving of a helpful answer. His response almost suggests to me that he didn't really have any tools to provide. I think you can find a therapist who does.
posted by mingodingo at 11:03 AM on January 5, 2012 [8 favorites]

I have never been to a therapist. Probably should! But never have. With that said, it sounds to me like you were asking for tools to help you understand and modify the negative patterns (destructive thoughts, emotions, and actions) in your life. That's like, the point of therapy, isn't it? Why would the therapist not have a good, helpful response for a request like that? Why didn't he instigate that conversation by your second or third session if it hadn't already come up?

I am completely inexperienced with therapy, but if I ever go, one of the first things I will ask will be for some kind of method or understanding or process where I can stop [some negative pattern of behavior/thought from repeating itself].

Maybe you shouldn't ditch the therapist, but definitely hash out what happened, what you expected and wanted from him, and why he responded the way he did. Don't just let it drop.
posted by jsturgill at 11:07 AM on January 5, 2012 [1 favorite]

It could simply be that your therapist made the wrong call in this case. That happens.

If it's part of a larger pattern of behavior then it sounds like a poor fit and you should move on.

With regard to confrontations... I had a therapist for three years who was not shy at all about using our conversations as reference points and I found it very helpful. A live example of how I was interacting was a great thing even though it often lead to defensiveness (more grist for the mill) on my part.

So confrontation can be part of therapy for some people. Not so much for others.

I do agree about printing out this question and bringing it into therapy with you. There is a tremendous amount to discuss here.
posted by Tell Me No Lies at 11:08 AM on January 5, 2012

I said something like, "what I'd like out of this is some kind of method or understanding or process where I can stop defeating myself when I feel that part of me taking hold."

This seems like a pretty reasonable request actually, in fact CBT is basically all about a process to stop defeating yourself. I'd fire this therapist and find one who wants to give you some useful tools.

His reaction appears very unprofessional to me, but maybe it would work for some people.
posted by rainydayfilms at 11:09 AM on January 5, 2012 [2 favorites]

I'm a simpleton here. And there are lots of other signs in your question that indicates this therapist might not be a good fit.

But isn't he just saying that neither he nor anyone else can tell you something which will magically change your self defeating behavior and that it needs to come from you. If anyone gave you a solution, if you are self defeating, you could ensure the solution failed and by extension the person giving you the solution will also be defeated.

Perhaps this is crystal clear to everyone else and I'm just missing the point, but in cases like this (unless you have other information or history) it's usually best to try to find the interpretation which both makes sense and would be a result of the therapist acting in your best interest - even if they said it in a ham handed manner.
posted by NoDef at 11:16 AM on January 5, 2012 [1 favorite]

Agree with what was said above: you're smarter than him. This is not good. You need a new therapist, BUT, give him another chance. Print out your question and take it to him next time.
posted by spicynuts at 11:17 AM on January 5, 2012

Agreeing with Mingodingo, what the therapist did was not helpful to you. I have similar issues with being self-defeating. If I were you, what he said would make me feel worse and even more self-defeating and self-hating, and I could not bear to have someone like that watching me and telling me what he thought my smiling, not smiling, or posture meant. As others have said, this might work for some people, but would not work for me, and maybe not for you either. You asked for tools, and this guy told you that you were in some way contaminating him with your attitude. Hey, you are paying him to help you, not to further knock you down. If you knew on your own how to change your attitude and thought patterns, you would not be there.

If he is otherwise helpful you might try one more session and discuss this, but if he throws it all back on you, look for another therapist with a style more compatible with yours. Good luck with this, I know how hard it is. Not all therapists are helpful or really qualified, and many bring their own serious issues into how they deal with clients.
posted by mermayd at 11:25 AM on January 5, 2012 [1 favorite]

You should maybe when you talk to your therapist next ask him more about his modality, his training, his mentors, his influences. You might find that you're mismatched in style. I have met some analysts in New York who might pull this kind of shit, and I think it's ... questionable, at the very least. Sometimes these folks will say things that are helpful in retrospect but at the moment just feel incredibly unkind. I find it's best to encounter those sorts of practitioners in very small doses. So, time for a new therapist, I'd say.

You might search for someone who practices CBT or DBT. These therapies are about helping you find ways of doing exactly this: "some kind of method or understanding or process where I can stop defeating myself when I feel that part of me taking hold." Worksheets, my friend. Charts. Writing assignments. Homework! All on practicing coping skills or thought restructuring or mindfulness of negative thoughts ... this is not an unreasonable request you're making. This is something that exists and is done and you needn't be ashamed for asking for it.

If you can get your current therapist to be civil with you in your next meeting, you might ask if he knows any CBT or DBT practitioners to whom he could refer you. If you're in NYC, feel free to MeFiMail me for some names and numbers.
posted by brina at 11:26 AM on January 5, 2012

I don't really get how you thing he made it about himself. He was using himself as an example of how the way you interact with people might affect them. It doesn't sound like he meant it personally -- he's just using the handiest example available. Whether you agree with him or not is another story, and that's something to bring up in a session.
posted by hermitosis at 11:36 AM on January 5, 2012

Has your therapist repeatedly given you unsuccessful suggestions to stop self-defeating behavior? That's the first way I can think of to make sense of his reaction. If I were a therapist and I'd been trying to unsuccessfully help a client, and then the client smiled while they asked for yet another suggestion, I might be become frustrated and try a new tactic. A tactic like, "Do you see how you are a powerful person, then?" or something like what he said.

Can you use that reaction to your benefit? Do you think it's really unprofessional and unhelpful? Or is it challenging and exciting to you? Or some combination? If you don't see possibilities at all, then I'd say it's not a good challenge for you. If you do, then it's probably a good thing to latch onto the growth opportunity.
posted by Elizabeth907 at 11:36 AM on January 5, 2012

Um, this seems like a really inappropriate action on your therapist's part. You expressed a perfectly reasonable goal for therapy, and he responded as if you were asking him to move mountains.

It also sounds like because you are this worked up about the way it went down (much more than the content of what he said), that his style is clearly not working for you. You have to be able to trust your therapist, and I wouldn't be able to trust mine after an incident like that.
posted by Betty's Table at 11:51 AM on January 5, 2012

This sounds like a failure of what psychotherapists call timing, dosage, and tact, which is to say, offering interpretations has to be done very carefully--at a time, in an amount, and in a way that the client can take in. I think it's that, rather than the interpretation (which doesn't sound completely off-base to me, knowing what I know about therapy), that's the problem.

You should talk to him about it. It's entirely possible that he knows he did it poorly and has been thinking about it, too. Therapists make mistakes sometimes. It's whether they can acknowledge those mistakes that matters.
posted by liketitanic at 11:59 AM on January 5, 2012 [1 favorite]

The fact you do not understand what what your therapist said needs to be discussed with your therapist. Seems clear to me, but why you don't understand what he meant needs to be discussed, as well as why you were uncomfortable.
A good therapist should challenge you. If all you want is supportive therapy, maybe you should seek other types of counseling.
posted by provoliminal at 12:02 PM on January 5, 2012

I am not a therapist but I have been in therapy for a long time and unless my therapist and I had previously agreed that it was okay for them to say this kind of thing I would never go back. Because if I'm seeing a therapist for self-defeating (which often includes self-critical) behavior, why would I want them to attack me in the tone of my inner critic? I can do that on my own time.

Nthing the suggestion that you find someone who does CBT/DBT. One of the things I love about my (CBT) therapist is that she challenges me but at the same time I know that she's on my side. This type of therapy works for me (and I've tried others). That's why there are different modalities, after all.
posted by camyram at 12:11 PM on January 5, 2012 [1 favorite]

I have been to a few different therapists in my lifetime and how you want to proceed is totally up to you but normally I like to be challenged by my problems and not my therapist. I do prefer to work with someone that helps me to confront myself but I need to feel safe and like I can trust the person, wondering if I am saying the right things or making the right movements would not be conducive for me. I understand we are hearing about one incident from one side and maybe you want to give this person more of a chance, but in my gut I usually know if its going to work after about 2 sessions. Learning to trust myself was a big hurdle as well after I had to move on from a therapist. It is not always a personal thing, you are in this to help yourself and if its not working, you don't have time to waste. In some cases therapy can be to save our lives. A good therapist will hopefully wish you well and be understanding. Best of luck :)
posted by heatherly at 12:16 PM on January 5, 2012 [1 favorite]

His interpretations behind the meaning of smiles makes this unworkable. What a nut job! He probably has other good ideas, but the smiling thing? Oy!

Find a new therapist. Talk this incident over with them. There's nothing left to process directly between you and this fellow. Good luck.
posted by jbenben at 12:30 PM on January 5, 2012 [1 favorite]

I think the people who are saying DTMFTherapist are really really jumping the gun quite a bit, to be honest. From what you describe, this therapist helped you through an acute depression and--possibly--helped you to remit your panic disorder? While that doesn't necessitate the therapist being great right now, it sounds like you did some rather valuable work together in the not-so-distant past. I wasn't there in the room with you both, but it's not at all clear from what you've written that this necessitates trashing your compact with him.

I believe what he did is called a transference interpretation, and it's pretty par for the course in some styles of therapy--it's the therapist dealing with the one relationship that he can directly observe, your intense particular therapeutic relationship, to try to gain insight about you and your relational styles. The fact that he's making such an interpretation in and of itself isn't particularly weird.

Bluntly, I have no idea who you are, so it's a nonstarter for me whether or not anything he said could be true about you. It's possible there is a grain of truth to what he's saying. It's also possible he made a bad interpretation, either in accuracy, delivery, or both. Regardless, I think this could be an important moment. I think you need to have an open dialogue about how this moment has made you feel, and how similar moments (e.g. if you've never talked about feeling on-edge about smiling) have made you feel, because while the average therapist may (hopefully) be an above-average empath, no therapist is a total mind-reader.

In my own therapy, my therapist's biggest mistake ended up being our single most therapeutic moment--essentially implying that he was growing bored of hearing about my (harmful, complicated) romantic infatuation with a particular individual. And it hurt! And it sucked! And I said it! And this in itself was pretty abnormal to me to confront someone for having hurt me. And therapy ended up being a great space to try that out; my therapist and I worked through what was going on, and we patched things up. In a weird sense, I'm almost glad he screwed up: otherwise, I would never have been challenged to act. But, importantly, my therapist was willing to recognize the implication of our interaction, the earnestness of my feelings, and where he might have errered.

I think, especially for longer therapies, there are always going to be moments like these of therapeutic tension that threaten to rupture the therapeutic alliance. What matters most is: Do you think you could still work with him if you could deal with the fallout from this moment in a collaborative, constructive manner? There is your answer, then. Not just DTMFTherapist.
posted by Keter at 12:48 PM on January 5, 2012 [7 favorites]

The way you have framed this is all a bit begging the question in my opinion. You've stated what your therapist believes, which may or may not be as accurate as you think. You've also stated how your innocuous actions tapped that belief and prompted a reaction. On the surface it leads one to think the reaction was out of line or at the least that the two of you are not a good fit.

Here's the thing. A majority of face to face communication is non-verbal. My experience is that most of us communicate different things non-verbally than we think we are. So what if you re-examine the exchange in this way:

"I thought I was making a light and somewhat silly comment, but something caused my therapist to interpret it as a deeper seated re-emergence of the exact symptom I'm trying to break out of. Further, it put someone who is my ally into a defensive mode. Why did that happen? Is it something I can view and be aware of?"

To be clear. I'm not putting this on you. But, I am not comfortable just putting it onto your therapist either. It is something that happened in the communication between you. There may be something of value to find there.
posted by meinvt at 1:08 PM on January 5, 2012 [1 favorite]

Yeah, the responses here condemning the therapist are too assured by about 80%. However, this is a pattern in these types of questions, and some of the same people come into these threads to suggest that the therapist is at best a dolt and at worst a cult leader, and that the OP is heroic for trying to separate themselves from the therapist's pernicious influence.

Here we have half of a story about ten minutes (10!) of a session that did not go well, according to the OP, in a months long episode of therapy. The rest of the therapy is described as "generally good," and there is indication from the OP that they have seen improvement where they wanted to see improvement. The explicit question is how to handle this issue of the messed up ten minutes.

Many of the answers here have almost nothing to do with answering that question. Instead, people are offering ill-informed and unfounded suggestions for different treatment modalities, are practically diagnosing the therapist, and are telling the OP in no uncertain terms that their therapist deserves to be fired. These responses do not respect the OP. The tone verges on hectoring and condescending (Can't you see this therapist is a dangerous piece of crap?!?). They don't account for our one-sided view, or for the OP's explicit acknowledgement that they have been helped in this therapy.

I don't know what the OP should do. I don't really know what the therapist did. But I do respect the OP enough to give them the benefit of the doubt that they can figure it out. The way to do that is to discuss it with the therapist. If the therapist is a jerk during the conversation, then the OP has more information; if the therapist handles it well, then the OP has more information. What the OP does not need is a bunch of knee-jerk responses based on half-readings of the question and (presumably) scarring experiences in personal therapy. I'm not sure why the people thinking the therapist was out of line for trying to insist on his misreading with a "vulnerable" patient think that their own over-inflated sense of righteousness is more acceptably deployed with the same "vulnerable" patient.

(I am, by the way, a therapist. I believe you should fire bad therapists quickly, but I don't think anyone (including the OP) knows enough about this situation yet to draw a conclusion.)
posted by OmieWise at 1:37 PM on January 5, 2012 [13 favorites]

Interesting. I've been told that the most effective therapy is the most awkward and challenging because that means new psychological ground is being broken. Things actually sound like they are proceeding well and you are confronting aspects of yourself you would rather not confront, but which are noticable by your therapist. Keter's answer was excellent, especially regarding transference. But, eh, what do I know?

Anyways, it sounds like you are on your way to "defeating" this therapist, beginning with an question to get internet permission to dump your therapist or otherwise withdraw from therapy.
posted by fuq at 1:53 PM on January 5, 2012 [1 favorite]

I've been told that the most effective therapy is the most awkward and challenging because that means new psychological ground is being broken.

Good therapy can often be awkward and challenging. Awkward and challenging therapy is not always good though.
posted by Tell Me No Lies at 2:55 PM on January 5, 2012 [2 favorites]

I defer to the professionals on the thread, yet I question the smiling thing. The OP's description of that sounded like an accurate recounting of the therapist's belief on the matter. I'm not sure how much more the OP can get from a therapist that makes them so self conscious they have to censor themselves in session. No?
posted by jbenben at 9:00 PM on January 5, 2012 [2 favorites]

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