Why do I dread therapy?
April 11, 2013 11:22 AM Subscribe
I've been seeing a new therapist for about two months. I dread going to him every week. The conversation feels forced, and I can't open up to him. Is it too soon to decide he's not for me?
I was seeing a different therapist for a year or two before this one. She was great for what I needed at the time (support, understanding, a little bit of coddling) but after awhile I got sick of being so comfortable in my victim mentality and found that she really didn't try to get me out of my comfort zone. Basically, she was a "teddy bear" therapist.
My new therapist is the polar opposite of my old one. He's pretty cynical, no-BS, but not very intuitive. I told him at my first session that I wanted goal-oriented CBT, that I didn't want to vent for weeks about problems of my past-- I know what most of my problems are, but I want to know what to do about them. He was thrilled that this was the type of therapy I wanted, and I thought it was good match.
Fast-forward two months, and I am feeling totally stuck. I absolutely dread going to him every week. He seems bored by my problems (as evidenced by his yawning and glancing at the clock every 10 minutes or so). He also focuses way too much on the behavioral aspects of therapy, without ever really considering the cognitive. He believes that beneficial behaviors come first, then self-esteem will follow.
For example, I have a debilitating fear of intimacy. At age 22, I've never had a serious relationship; this is not because I don't want one (because I do, badly), but because I push people away, have low self-esteem, etc. I would think that I need to get to the root of my backwards thinking and build up my confidence and self-worth. He thinks I just need to go on eHarmony and go on more dates. But when I have gone on dates with nice, normal guys, I've been plagued by the notion that they would never like me if they really knew me, that they wouldn't want to deal with my emotional baggage, etc. How can I form healthy relationships when my THINKING is so irrational? So, I don't see how simply changing behaviors is sufficient.
Last week there was another episode like this that really pissed me off. I mentioned feeling social anxiety around my co-workers and feeling like I was on the outside looking in. His solution? "Be nicer."
Basically, I don't know if it's him or me that's the problem. I've only been seeing him for two months, and maybe I'm just not used to this more practical approach to therapy. I was very comfortable talking to my old therapist, but again, I felt like I just kept digging deeper into my past and my problems, without ever formulating an action plan. Is it crazy if I ask him (my current therapist) to give me homework assignments? I just still don't feel like I'm doing anything to reach my goals. I also feel like he doesn't really get me as a person, but is this something that will happen over time?
My psychiatrist (who referred me to both therapists) suggested I tell him I want to focus more on cognitive development. He also said to give it more time before jumping ship.
What do you guys suggest? Have you had a no-nonsense therapist that just took some getting used to? Is the discomfort I'm feeling a sign of growth, or does it mean I need a better therapist more suited to my needs? How can I present my feelings to him in a productive way?
Thanks in advance!
I was seeing a different therapist for a year or two before this one. She was great for what I needed at the time (support, understanding, a little bit of coddling) but after awhile I got sick of being so comfortable in my victim mentality and found that she really didn't try to get me out of my comfort zone. Basically, she was a "teddy bear" therapist.
My new therapist is the polar opposite of my old one. He's pretty cynical, no-BS, but not very intuitive. I told him at my first session that I wanted goal-oriented CBT, that I didn't want to vent for weeks about problems of my past-- I know what most of my problems are, but I want to know what to do about them. He was thrilled that this was the type of therapy I wanted, and I thought it was good match.
Fast-forward two months, and I am feeling totally stuck. I absolutely dread going to him every week. He seems bored by my problems (as evidenced by his yawning and glancing at the clock every 10 minutes or so). He also focuses way too much on the behavioral aspects of therapy, without ever really considering the cognitive. He believes that beneficial behaviors come first, then self-esteem will follow.
For example, I have a debilitating fear of intimacy. At age 22, I've never had a serious relationship; this is not because I don't want one (because I do, badly), but because I push people away, have low self-esteem, etc. I would think that I need to get to the root of my backwards thinking and build up my confidence and self-worth. He thinks I just need to go on eHarmony and go on more dates. But when I have gone on dates with nice, normal guys, I've been plagued by the notion that they would never like me if they really knew me, that they wouldn't want to deal with my emotional baggage, etc. How can I form healthy relationships when my THINKING is so irrational? So, I don't see how simply changing behaviors is sufficient.
Last week there was another episode like this that really pissed me off. I mentioned feeling social anxiety around my co-workers and feeling like I was on the outside looking in. His solution? "Be nicer."
Basically, I don't know if it's him or me that's the problem. I've only been seeing him for two months, and maybe I'm just not used to this more practical approach to therapy. I was very comfortable talking to my old therapist, but again, I felt like I just kept digging deeper into my past and my problems, without ever formulating an action plan. Is it crazy if I ask him (my current therapist) to give me homework assignments? I just still don't feel like I'm doing anything to reach my goals. I also feel like he doesn't really get me as a person, but is this something that will happen over time?
My psychiatrist (who referred me to both therapists) suggested I tell him I want to focus more on cognitive development. He also said to give it more time before jumping ship.
What do you guys suggest? Have you had a no-nonsense therapist that just took some getting used to? Is the discomfort I'm feeling a sign of growth, or does it mean I need a better therapist more suited to my needs? How can I present my feelings to him in a productive way?
Thanks in advance!
I mentioned feeling social anxiety around my co-workers and feeling like I was on the outside looking in. His solution? "Be nicer."
I... think this is a bad fit. That's not advice, that's a platitude. Between that, and the evident signs of boredom (which I would probably consider calling him on - not angrily, just "hey, I noticed you've looked at the clock three times this session, what's up with that? Because it's kind of stressing me out.") and the lack of any actual CBT stuff, I don't think you're going to get what you want from him.
I do think you should go see him one more time and tell him that you're looking for cognitive strategies, like you told him up front, and you feel like you haven't gotten any of those, and if he can't shift the focus to that then you need to find someone who will. Maybe he can actually do that stuff, maybe he will change his strategy. But mostly I think it's just useful to have a clean break with this sort of thing and be able to walk away feeling like you put your needs on the table and prioritized them.
posted by restless_nomad at 11:33 AM on April 11, 2013 [3 favorites]
I... think this is a bad fit. That's not advice, that's a platitude. Between that, and the evident signs of boredom (which I would probably consider calling him on - not angrily, just "hey, I noticed you've looked at the clock three times this session, what's up with that? Because it's kind of stressing me out.") and the lack of any actual CBT stuff, I don't think you're going to get what you want from him.
I do think you should go see him one more time and tell him that you're looking for cognitive strategies, like you told him up front, and you feel like you haven't gotten any of those, and if he can't shift the focus to that then you need to find someone who will. Maybe he can actually do that stuff, maybe he will change his strategy. But mostly I think it's just useful to have a clean break with this sort of thing and be able to walk away feeling like you put your needs on the table and prioritized them.
posted by restless_nomad at 11:33 AM on April 11, 2013 [3 favorites]
Sounds like this isn't the therapist for you. I had a real hardass CBT guy, and a lot of the things you mention -- checking the clock, advice like "be nicer," etc. -- don't really jive as inherent downsides of picking such a therapist.
posted by griphus at 11:37 AM on April 11, 2013
posted by griphus at 11:37 AM on April 11, 2013
Best answer: "Be nicer?" This guy is not even making an effort. If someone you're paying a good deal of money who's job is to listen to what you have to say, is seeming bored and checking the clock, then yeah, it's way past time to find someone new. He's not even trying, and you're paying for it and getting nowhere. It's not even inner turmoil you're describing because he's challenging you to change, which would be more understandable.
Really if you're feeling that way towards anyone, it's time to cut ties. Listen to your inner dread and find someone new.
posted by readygo at 11:42 AM on April 11, 2013 [3 favorites]
Really if you're feeling that way towards anyone, it's time to cut ties. Listen to your inner dread and find someone new.
posted by readygo at 11:42 AM on April 11, 2013 [3 favorites]
Sounds like it is time to move on.
posted by michellenoel at 11:43 AM on April 11, 2013
posted by michellenoel at 11:43 AM on April 11, 2013
As long as you're being honest with yourself about the friction between you and your therapist, I think it's fair to start investigating other options.
posted by blue t-shirt at 11:44 AM on April 11, 2013 [1 favorite]
posted by blue t-shirt at 11:44 AM on April 11, 2013 [1 favorite]
Best answer: It sounds to me like this therapist isn't able to emphathize, which, I would think even in goal-oriented CBT, is necessary. I think you need to feel heard and understood before you can start investigating solutions.
posted by Asparagus at 11:50 AM on April 11, 2013 [1 favorite]
posted by Asparagus at 11:50 AM on April 11, 2013 [1 favorite]
I do think you should go see him one more time and tell him ...
I wouldn't. I'd call him and break up with him. You don't need to spend more of your money one someone you don't click with. If he gives you any static, HE'S unprofessional.
posted by small_ruminant at 11:51 AM on April 11, 2013 [1 favorite]
I wouldn't. I'd call him and break up with him. You don't need to spend more of your money one someone you don't click with. If he gives you any static, HE'S unprofessional.
posted by small_ruminant at 11:51 AM on April 11, 2013 [1 favorite]
You don't need to spend more of your money one someone you don't click with.
That's a good point. Certainly a phone break-up would be totally fine - my point was more that it's better to state your case than to just cancel and never reschedule without ever saying why.
posted by restless_nomad at 11:56 AM on April 11, 2013
That's a good point. Certainly a phone break-up would be totally fine - my point was more that it's better to state your case than to just cancel and never reschedule without ever saying why.
posted by restless_nomad at 11:56 AM on April 11, 2013
Lots of glancing at the clock is unprofessional, regardless of the profession. Look, I've never been to therapy, so take this for what it's worth. But it sounds to me that you're protecting yourself against change by finding problems with these two therapists' approaches. You said the first one didn't direct you to action, but helped you figure out what your problems were. Meanwhile, the problem with this one is that he's all action. Do you want to change? Really? Because to me it sounds like you don't want to do the work he gives you (going on more dates, for example) and instead find reasons it can't work. But those reasons sound like a way for you to continue to talk rather than act. At some point, you have to stop talking about how you'd like to change and just do it.
posted by smorange at 12:01 PM on April 11, 2013
posted by smorange at 12:01 PM on April 11, 2013
Best answer: Dump your therapist and find one on your own.
Because you describe your first therapist as a "teddy bear" therapist and you were just treading water... and the CBT people might be more matter of fact... I suggest you seek out a transpersonal or spiritual psychologist.
The focus isn't on your past and what you need to take apart from way back when... it's about what's happening now and what you are going to do next. You figure out what you're really working with and start building from there.
Guess what? It makes going to therapy something you look forward to.
posted by bobdow at 12:06 PM on April 11, 2013 [2 favorites]
Because you describe your first therapist as a "teddy bear" therapist and you were just treading water... and the CBT people might be more matter of fact... I suggest you seek out a transpersonal or spiritual psychologist.
The focus isn't on your past and what you need to take apart from way back when... it's about what's happening now and what you are going to do next. You figure out what you're really working with and start building from there.
Guess what? It makes going to therapy something you look forward to.
posted by bobdow at 12:06 PM on April 11, 2013 [2 favorites]
Best answer: Because to me it sounds like you don't want to do the work he gives you (going on more dates, for example) and instead find reasons it can't work. But those reasons sound like a way for you to continue to talk rather than act.
The problem most people have is getting from A to B. In between are the thoughts, beliefs, feelings etc that CBT is one tool used to get at, and poking at those is the therapist's expertise (if not this particular therapist's). The point is to examine and challenge specific scripts that block desired outcomes, not throw out glib advice that might occur to your teenage cousin.
posted by nelljie at 12:18 PM on April 11, 2013 [1 favorite]
The problem most people have is getting from A to B. In between are the thoughts, beliefs, feelings etc that CBT is one tool used to get at, and poking at those is the therapist's expertise (if not this particular therapist's). The point is to examine and challenge specific scripts that block desired outcomes, not throw out glib advice that might occur to your teenage cousin.
posted by nelljie at 12:18 PM on April 11, 2013 [1 favorite]
If it was two sessions, I'd say, yeah, give it another couple of times. But after two months? Totally OK to move on. Trust your gut.
posted by scody at 12:37 PM on April 11, 2013 [1 favorite]
posted by scody at 12:37 PM on April 11, 2013 [1 favorite]
Best answer: I'm inclined to agree with those saying this doesn't seem like a good fit.
It may be best to seek out someone trained in CBT if you're sure that's what you want. If you haven't considered Schema Therapy, you may want to broaden your search, but either way I suggest making sure the therapist has formal training in the kind of therapy you hope to receive.
It is perfectly fair to "interview" several therapists briefly over the phone before making an appointment--just let them know you have a few questions and leave a way for them to get back to you when they have a few minutes. Have your questions written down and also try to put into a couple or few sentences what you hope to achieve.
The time spent doing this can be very telling and save you the time, money and effort of shopping around in person, but don't throw out your research until you've established that you do "click" with someone after a few visits.
What smorange says makes sense. I've been in therapy enough to know that the "Be nicer" type is too common, and I don't doubt that's what happened. But given your own description of your low self esteem and tendency to pull away from relationships, I also wonder if that comment was meant more as a suggestion to reach out to co-workers and possibly reap the benefit of finding yourself less of an outsider than you feel you are. That's just something to consider, because anyone assisting you in changing behaviors might say things you find hurtful. An ideal therapist might suggest specific practices that can't be taken personally but still help you change patterns, but ideal therapists are hard to come by, so if you find someone with methods you believe are effective and not insulting, you could be very happy.
I still think you should move on--there's already a bad vibe going there--and I wish you all the very best.
posted by whoiam at 12:47 PM on April 11, 2013
It may be best to seek out someone trained in CBT if you're sure that's what you want. If you haven't considered Schema Therapy, you may want to broaden your search, but either way I suggest making sure the therapist has formal training in the kind of therapy you hope to receive.
It is perfectly fair to "interview" several therapists briefly over the phone before making an appointment--just let them know you have a few questions and leave a way for them to get back to you when they have a few minutes. Have your questions written down and also try to put into a couple or few sentences what you hope to achieve.
The time spent doing this can be very telling and save you the time, money and effort of shopping around in person, but don't throw out your research until you've established that you do "click" with someone after a few visits.
What smorange says makes sense. I've been in therapy enough to know that the "Be nicer" type is too common, and I don't doubt that's what happened. But given your own description of your low self esteem and tendency to pull away from relationships, I also wonder if that comment was meant more as a suggestion to reach out to co-workers and possibly reap the benefit of finding yourself less of an outsider than you feel you are. That's just something to consider, because anyone assisting you in changing behaviors might say things you find hurtful. An ideal therapist might suggest specific practices that can't be taken personally but still help you change patterns, but ideal therapists are hard to come by, so if you find someone with methods you believe are effective and not insulting, you could be very happy.
I still think you should move on--there's already a bad vibe going there--and I wish you all the very best.
posted by whoiam at 12:47 PM on April 11, 2013
I personally believe that problems that arise in therapy should only be dealt with in therapy. Otherwise you are putting your hard-earned therapy energy outside of the system that can propel your change. But I will try to point something out to you in a hope that it strikes a cord and you'll feel like bringing it into the session.
This is your first male therapist. This is what you wrote about your interpersonal problems and your issues with him:
I have a debilitating fear of intimacy and I dread going to him every week
He seems bored by my problems and they wouldn't want to deal with my emotional baggage
As you read these sentences, do you think these feelings and beliefs are related? If you do, could you let him know how it feels for you to be in his office, to come to the session? I think it may make all the difference in the world. In my eyes, this man clearly activates some very important schema for you. If he is a good therapist he can help you work on these issues while they are active in the moment. Just something to consider before you jump the ship.
posted by Shusha at 12:57 PM on April 11, 2013 [3 favorites]
This is your first male therapist. This is what you wrote about your interpersonal problems and your issues with him:
I have a debilitating fear of intimacy and I dread going to him every week
He seems bored by my problems and they wouldn't want to deal with my emotional baggage
As you read these sentences, do you think these feelings and beliefs are related? If you do, could you let him know how it feels for you to be in his office, to come to the session? I think it may make all the difference in the world. In my eyes, this man clearly activates some very important schema for you. If he is a good therapist he can help you work on these issues while they are active in the moment. Just something to consider before you jump the ship.
posted by Shusha at 12:57 PM on April 11, 2013 [3 favorites]
I ditched a therapist I didn't click with after two sessions. You've gone much longer than that, move on!
posted by radioamy at 1:01 PM on April 11, 2013
posted by radioamy at 1:01 PM on April 11, 2013
Best answer: Two months is long enough to know if he's a "good fit" for you or not, just like two months in a dating scenario is long enough to know if you want to keep dating or not. The two examples you provide of his advice, "just go on eHarmony," and "be nicer," both sound crappy to me, not because they're bad things to do, but because he didn't break those things down into small enough pieces to find exactly where you're cognitively stuck. If that's typical of his advice, then working with him will be an uphill battle for you.
I also think he's dead wrong that behavior always has to happen first in CBT-- if you have a cognition stopping you from trying a behavior, then some cognitive work needs to happen first, basically whatever it takes for you to finally agree to try the behavior. And THEN you get to the part he's talking about, where you can take the feedback from trying the behavior and revise your thinking accordingly. (I've learned from painful experience that if I ever decide my therapist is dead wrong about a major aspect of how to do therapy, our work is eventually doomed. I regret having spent way too much time trying to persuade several past therapists that their approach was wrong-- two years in one case-- and it never really succeeded.)
posted by Dixon Ticonderoga at 1:07 PM on April 11, 2013 [3 favorites]
I also think he's dead wrong that behavior always has to happen first in CBT-- if you have a cognition stopping you from trying a behavior, then some cognitive work needs to happen first, basically whatever it takes for you to finally agree to try the behavior. And THEN you get to the part he's talking about, where you can take the feedback from trying the behavior and revise your thinking accordingly. (I've learned from painful experience that if I ever decide my therapist is dead wrong about a major aspect of how to do therapy, our work is eventually doomed. I regret having spent way too much time trying to persuade several past therapists that their approach was wrong-- two years in one case-- and it never really succeeded.)
posted by Dixon Ticonderoga at 1:07 PM on April 11, 2013 [3 favorites]
Not only should you find another therapist immediately, but I strongly object to the phrasing being used in this thread of "breaking up" with your therapist.
Your therapist is NOT your friend, lover, nor romantic partner. He or she is a mental health expert you hired to help you with a problem. It's a business relationship. You don't have to break up with your mechanic, your favorite pizza delivery store, nor your high school teachers when you graduate or change schools; you don't break up with a therapist. You hire a new one, and cancel any planned appointments with the previous one.
"I'm working with a new therapist" is ALL the explanation needed, and then only if they ask. It's your health we're talking about here; guilt due to you looking for a better path to it is entirely counterproductive.
posted by IAmBroom at 6:53 PM on April 11, 2013 [3 favorites]
Your therapist is NOT your friend, lover, nor romantic partner. He or she is a mental health expert you hired to help you with a problem. It's a business relationship. You don't have to break up with your mechanic, your favorite pizza delivery store, nor your high school teachers when you graduate or change schools; you don't break up with a therapist. You hire a new one, and cancel any planned appointments with the previous one.
"I'm working with a new therapist" is ALL the explanation needed, and then only if they ask. It's your health we're talking about here; guilt due to you looking for a better path to it is entirely counterproductive.
posted by IAmBroom at 6:53 PM on April 11, 2013 [3 favorites]
I don't think the problem is the CBT here, it's the therapist who's not really doing his job.
You can confront him on that or you can find someone else.
posted by heyjude at 7:23 PM on April 11, 2013
You can confront him on that or you can find someone else.
posted by heyjude at 7:23 PM on April 11, 2013
FWIW IAmABroom's approach is only one way of looking at it. Others of us don't see it that way at all and indeed see therapy as an intensely personal relationship (if one sided.) You're allowed to have angst about how to change therapists, though it sounds like you've done this once before so you should be good to go.
And I too think it sounds like this is not a good match for your current needs and that you need to see a CBT specialist.
posted by DarlingBri at 9:33 PM on April 11, 2013
And I too think it sounds like this is not a good match for your current needs and that you need to see a CBT specialist.
posted by DarlingBri at 9:33 PM on April 11, 2013
It's time to move on. You don't need to go for another session to warn him. It's just throwing good money (or benefits) after bad. I need to reiterate what others have said regarding the commingling of the phrase "breaking up" with ending your business relationship with your therapist. It's not the same thing.
When I was trying to find the right therapist, I went for hardcore CBT therapists, and I also felt like I needed homework and didn't get any. I ended up finding my current therapist who I love through a friend's recommendation. I had to try several different therapists until I found the right one. It's important to find one with whom you feel comfortable working.
You gave it a fair shot with the past two therapists. Keep looking. You'll find the right one. One question: are you pleased with your psychiatrist?
posted by msladygrey at 9:51 PM on April 11, 2013
When I was trying to find the right therapist, I went for hardcore CBT therapists, and I also felt like I needed homework and didn't get any. I ended up finding my current therapist who I love through a friend's recommendation. I had to try several different therapists until I found the right one. It's important to find one with whom you feel comfortable working.
You gave it a fair shot with the past two therapists. Keep looking. You'll find the right one. One question: are you pleased with your psychiatrist?
posted by msladygrey at 9:51 PM on April 11, 2013
DarlingBri: FWIW IAmABroom's approach is only one way of looking at it. Others of us don't see it that way at all and indeed see therapy as an intensely personal relationship (if one sided.) You're allowed to have angst about how to change therapists, though it sounds like you've done this once before so you should be good to go.For the record, I don't view any of my previous therapists with dispassionate detachment. I simpy don't think it's productive to worry even a little bit about their feelings in opting for a different therapist. If it's better for me, it's better, period.
And I too think it sounds like this is not a good match for your current needs and that you need to see a CBT specialist.
We may be closer in approach than you think.
posted by IAmBroom at 11:55 AM on April 12, 2013
Is it crazy if I ask him (my current therapist) to give me homework assignments?
Not at all. At least, I do this all the time, and no one has ever diagnosed me with 'homework psychosis'.
posted by feral_goldfish at 12:34 PM on April 12, 2013 [1 favorite]
Not at all. At least, I do this all the time, and no one has ever diagnosed me with 'homework psychosis'.
posted by feral_goldfish at 12:34 PM on April 12, 2013 [1 favorite]
you may end up finding that in fact your therapist is not a good fit for you, but i think it is important to consider that you did tell him this is what you wanted:
I told him at my first session that I wanted goal-oriented CBT, that I didn't want to vent for weeks about problems of my past-- I know what most of my problems are, but I want to know what to *do* about them.
then you are not happy when:
He also focuses way too much on the behavioral aspects of therapy, without ever really considering the cognitive. He believes that beneficial behaviors come first, then self-esteem will follow.
he may just be doing what you requested of him at the beginning of your therapy. if you've found this doesn't work then just go ahead and let him know this. you can tell him that you probably need a combination of the more humanistic and behavioral approaches after all rather than one or the other. also, that you'd like to focus more on the cognitive aspects and would welcome homework.
it's quite possible he'll be able to make this change with no problem and things could then progress. i'd at least give that a shot first before moving on. a lot of therapy is learning to share these sorts of uncomfortable thoughts and feelings.
posted by wildflower at 12:11 AM on April 13, 2013 [1 favorite]
I told him at my first session that I wanted goal-oriented CBT, that I didn't want to vent for weeks about problems of my past-- I know what most of my problems are, but I want to know what to *do* about them.
then you are not happy when:
He also focuses way too much on the behavioral aspects of therapy, without ever really considering the cognitive. He believes that beneficial behaviors come first, then self-esteem will follow.
he may just be doing what you requested of him at the beginning of your therapy. if you've found this doesn't work then just go ahead and let him know this. you can tell him that you probably need a combination of the more humanistic and behavioral approaches after all rather than one or the other. also, that you'd like to focus more on the cognitive aspects and would welcome homework.
it's quite possible he'll be able to make this change with no problem and things could then progress. i'd at least give that a shot first before moving on. a lot of therapy is learning to share these sorts of uncomfortable thoughts and feelings.
posted by wildflower at 12:11 AM on April 13, 2013 [1 favorite]
Response by poster: Thanks everyone! I've decided to ditch my therapist. My search for a good shrink continues.
posted by DayTripper at 10:44 AM on April 16, 2013
posted by DayTripper at 10:44 AM on April 16, 2013
This thread is closed to new comments.
Life's too short.
posted by Ruthless Bunny at 11:29 AM on April 11, 2013 [8 favorites]