What is OK/not OK in therapy?
September 22, 2014 7:17 PM Subscribe
I've just started seeing a therapist for Cognitive Behavioural Therapy to treat my ongoing depression. I have a few concerns about his approach that are troubling me slightly and would appreciate input about normal expectations/practice
I'm female, 34, he is a mid 40s man. There are a few things niggling away at me for example
-I talked about not being treated seriously at the GP, maybe perhaps because (in the past) of being young and a woman (doctors telling me I can't be depressed because I'm wearing make up, telling me to stand on my head if I think my hair is falling out while laughing, telling me I need to be closer to my *abusive* parents and I wouldn't feel so sad, not treating my endometriosis for 7 years because 'it's normal pain'). He says I'm reading things into situations that maybe aren't there. I'm not unsure of these things at all and am not happy with pretending sexism at the doctor doesn't exist and I am imagining it.
-Last week he was asking about my husband and how I let him know I love him/appreciate him. I said 'I tell him' and my therapist pulled a face like he was going to be sick and actually had to look away from me for a bit to manage his reaction. I mean, OK I know it might come across cheesy and lovey-dovey but still.
This is the first time I've had proper therapy (everything before has been counselling, just really someone who'll listen to you without giving any input which didn't really help me). So I'm new to the dynamic of someone who reacts, gives feedback and challenges you. I'm really asking I suppose if this is normal for CBT as I don't know what to expect. Any input from those with experience of mental health treatment would be much appreciated, I've been struggling with depression now for 5 years and am willing to press through with this if it is meant to be uncomfortable but works. I don't want to feel like this all my life.
I'm female, 34, he is a mid 40s man. There are a few things niggling away at me for example
-I talked about not being treated seriously at the GP, maybe perhaps because (in the past) of being young and a woman (doctors telling me I can't be depressed because I'm wearing make up, telling me to stand on my head if I think my hair is falling out while laughing, telling me I need to be closer to my *abusive* parents and I wouldn't feel so sad, not treating my endometriosis for 7 years because 'it's normal pain'). He says I'm reading things into situations that maybe aren't there. I'm not unsure of these things at all and am not happy with pretending sexism at the doctor doesn't exist and I am imagining it.
-Last week he was asking about my husband and how I let him know I love him/appreciate him. I said 'I tell him' and my therapist pulled a face like he was going to be sick and actually had to look away from me for a bit to manage his reaction. I mean, OK I know it might come across cheesy and lovey-dovey but still.
This is the first time I've had proper therapy (everything before has been counselling, just really someone who'll listen to you without giving any input which didn't really help me). So I'm new to the dynamic of someone who reacts, gives feedback and challenges you. I'm really asking I suppose if this is normal for CBT as I don't know what to expect. Any input from those with experience of mental health treatment would be much appreciated, I've been struggling with depression now for 5 years and am willing to press through with this if it is meant to be uncomfortable but works. I don't want to feel like this all my life.
I wouldn't like this one bit and would find a new therapist.
posted by quince at 7:20 PM on September 22, 2014 [36 favorites]
posted by quince at 7:20 PM on September 22, 2014 [36 favorites]
Nope, this does not sound normal at all. The first thing your therapist should make you feel is safe. I would find someone else.
posted by xingcat at 7:21 PM on September 22, 2014 [26 favorites]
posted by xingcat at 7:21 PM on September 22, 2014 [26 favorites]
He sounds horrible. I wouldn't even be friends with this guy let alone entrust my mental health work to him.
posted by stoneandstar at 7:29 PM on September 22, 2014 [6 favorites]
posted by stoneandstar at 7:29 PM on September 22, 2014 [6 favorites]
New therapist, stat. Unprofessional louse deserves to lose his license. I am so sorry this was your first CBT experience. This is not how CBT works.
posted by Hermione Granger at 7:32 PM on September 22, 2014 [6 favorites]
posted by Hermione Granger at 7:32 PM on September 22, 2014 [6 favorites]
Disclaimer... I am a therapist, but I'm not your therapist...
"He says I'm reading things into situations that maybe aren't there." This is sort of standard language for someone using CBT. It's difficult, however, to determine from your brief description if it was an appropriate response.
"my therapist pulled a face like he was going to be sick and actually had to look away from me for a bit to manage his reaction" Hmmm... you're making some assumptions here that may or may not be accurate. It might be worth letting him know what your perception of that exchange is and see how he explains it.
Bottom line, however, is that you need to be comfortable and trust your therapist. Since you're early into this process it would make sense for you to shop around a bit and find someone that you feel better about.
posted by HuronBob at 7:32 PM on September 22, 2014 [19 favorites]
"He says I'm reading things into situations that maybe aren't there." This is sort of standard language for someone using CBT. It's difficult, however, to determine from your brief description if it was an appropriate response.
"my therapist pulled a face like he was going to be sick and actually had to look away from me for a bit to manage his reaction" Hmmm... you're making some assumptions here that may or may not be accurate. It might be worth letting him know what your perception of that exchange is and see how he explains it.
Bottom line, however, is that you need to be comfortable and trust your therapist. Since you're early into this process it would make sense for you to shop around a bit and find someone that you feel better about.
posted by HuronBob at 7:32 PM on September 22, 2014 [19 favorites]
This guy sucks, and this behavior has nothing to do with CBT.
I received CBT from a psychologist who managed to make me feel comfortable and taken seriously. Even though we were very different types of people who probably wouldn't have been friends outside of a clinical relationship. I'm sure he was able to do that because he was a professional and not an asswipe. But what you've got here, is an asswipe.
posted by Coatlicue at 7:35 PM on September 22, 2014 [4 favorites]
I received CBT from a psychologist who managed to make me feel comfortable and taken seriously. Even though we were very different types of people who probably wouldn't have been friends outside of a clinical relationship. I'm sure he was able to do that because he was a professional and not an asswipe. But what you've got here, is an asswipe.
posted by Coatlicue at 7:35 PM on September 22, 2014 [4 favorites]
He says I'm reading things into situations that maybe aren't there.
Here's the thing about that.
Whether your therapist thinks you read more into a situation, personally, professionally, it's his job to be supportive of you.
When I was in therapy, I would carp about X or Y bad thing that happened in my life. Many of them, I'm sure, were tedious, and shit, I was probably not entirely justified in my accounts of those situations. Maybe my mom didn't actually say what I remember her saying, circa age 9. Maybe my boss was impatient with me because she was stressed out. Maybe this is all being filtered through a heavy layer of anxiety on my own part.
But every single time, my therapist took my side and validated my feelings. Even if a person could read the situation another way.
The whole point of therapy is that you feel safe and understood. If you don't feel that way, whether it's ethically right of your therapist or not, get a new therapist.
posted by Sara C. at 7:48 PM on September 22, 2014 [6 favorites]
Here's the thing about that.
Whether your therapist thinks you read more into a situation, personally, professionally, it's his job to be supportive of you.
When I was in therapy, I would carp about X or Y bad thing that happened in my life. Many of them, I'm sure, were tedious, and shit, I was probably not entirely justified in my accounts of those situations. Maybe my mom didn't actually say what I remember her saying, circa age 9. Maybe my boss was impatient with me because she was stressed out. Maybe this is all being filtered through a heavy layer of anxiety on my own part.
But every single time, my therapist took my side and validated my feelings. Even if a person could read the situation another way.
The whole point of therapy is that you feel safe and understood. If you don't feel that way, whether it's ethically right of your therapist or not, get a new therapist.
posted by Sara C. at 7:48 PM on September 22, 2014 [6 favorites]
i did cbt with someone who is very different from me in terms of demographic/perspective. she is much older, a parent, conservative and religious, married very young and stayed married, an immigrant. i am none of those things. but she never "pulled a face" about something i said or made me feel uncomfortable. if you don't feel comfortable and safe being honest about your life and your past, you won't make progress with this guy. find another therapist - maybe a woman! - whom you feel more relaxed around. the people above are right, it's his job to make you comfortable and make it easy as possible to have difficult conversations with him, that's the whole point.
posted by zdravo at 7:51 PM on September 22, 2014 [7 favorites]
posted by zdravo at 7:51 PM on September 22, 2014 [7 favorites]
CBT is therapy where you learn relaxation/self-soothing techniques and healthy coping mechanisms, strategies for managing emotions you find overwhelming; or it was for me, once I found the right therapist. There's nothing in it about making weird faces.
posted by Juliet Banana at 8:04 PM on September 22, 2014 [5 favorites]
posted by Juliet Banana at 8:04 PM on September 22, 2014 [5 favorites]
I did CBT with a guy who was in a lot of ways an unabashed asshole and I definitely never had any negative feelings brushed aside. Just the opposite: he had me confront them regardless of how much I tried to play them off as "stupid" or "nothing serious" and he never gave me shit about positive communication with my partner. Again, it was just the opposite: he encouraged me to show love and appreciation in whatever heathy way that worked for us.
CBT is tough, but not at all for the reasons you describe.
posted by griphus at 8:22 PM on September 22, 2014 [7 favorites]
CBT is tough, but not at all for the reasons you describe.
posted by griphus at 8:22 PM on September 22, 2014 [7 favorites]
I had symptoms of endometriosis dismissed by 6 or 7 doctors over 4 years in my 20's, they were all men --- you were saying?
Oh, yes. Of course you should get a new therapist!
posted by jbenben at 8:26 PM on September 22, 2014 [4 favorites]
Oh, yes. Of course you should get a new therapist!
posted by jbenben at 8:26 PM on September 22, 2014 [4 favorites]
Just a note: the guy was an asshole but it was in the same way a drill sergeant or gym trainer is. That was good for me because I respond best to that sort of attitude.
The personality of your therapist should be the one you are most comfortable with. Therapy is hard enough; you shouldn't have to constantly compensate for your therapist's personality.
posted by griphus at 8:27 PM on September 22, 2014 [6 favorites]
The personality of your therapist should be the one you are most comfortable with. Therapy is hard enough; you shouldn't have to constantly compensate for your therapist's personality.
posted by griphus at 8:27 PM on September 22, 2014 [6 favorites]
Oh fuck no. This guy is an unprofessional jackass, and he needs to kept as far away from patients as possible.
My therapist is pretty damned different from me. Quite frankly, I'm sure some of the things I tell her make her raise her eyebrows. She has never shown it on her face, nor has she allowed that to affect the quality of care she gives me.
And I'm sure I've told her about several small, trivial things- things that upon reflection were completely blown-out-of-proportion reactions to normal shit (yay anxiety!) Not once, in over a year of therapy, did she ever belittle my concerns, tell me I was reading into things, none of it. She validated my feelings even when they were ridiculous, and then helped me unpack and deal with them. That's what a good therapist does.
You need a different therapist, stat.
posted by Tamanna at 8:28 PM on September 22, 2014 [3 favorites]
My therapist is pretty damned different from me. Quite frankly, I'm sure some of the things I tell her make her raise her eyebrows. She has never shown it on her face, nor has she allowed that to affect the quality of care she gives me.
And I'm sure I've told her about several small, trivial things- things that upon reflection were completely blown-out-of-proportion reactions to normal shit (yay anxiety!) Not once, in over a year of therapy, did she ever belittle my concerns, tell me I was reading into things, none of it. She validated my feelings even when they were ridiculous, and then helped me unpack and deal with them. That's what a good therapist does.
You need a different therapist, stat.
posted by Tamanna at 8:28 PM on September 22, 2014 [3 favorites]
One thing I've learned about therapy is that you need to trust your gut. If you don't feel comfortable with the person, you don't need to come up with endless justifications as to why you're not going to see them again. Just call or email them, tell them that you "don't think it's a good fit" and find someone new.
Now as someone with anxiety/depression I know it feels like "ugh, I have to try to find someone *again* it's so hard." I get it. Just please try to pick yourself up and find another therapist. There are good ones out there!
posted by radioamy at 8:30 PM on September 22, 2014 [4 favorites]
Now as someone with anxiety/depression I know it feels like "ugh, I have to try to find someone *again* it's so hard." I get it. Just please try to pick yourself up and find another therapist. There are good ones out there!
posted by radioamy at 8:30 PM on September 22, 2014 [4 favorites]
Mostly, I agree with everyone here who says you should find someone you are comfortable with.
That said, I want to point out one little thing. You write: "He says I'm reading things into situations that maybe aren't there."
My understanding is that that's kinda part of CBT. The assumption in CBT is that part of what goes on in the minds of people who are depressed is that they engage in distorted thinking, and filter the world in a negative way. According to CBT, everyone who is depressed reads things into situations that maybe aren't there, and becoming aware of that is part of how you get better.
You do want to feel supported. But I think any CBT therapist is going to ask you to challenge some of what you read into situations.
I'd encourage you to at least try talking a bit to this therapist about your discomfort.
posted by ManInSuit at 8:37 PM on September 22, 2014 [9 favorites]
That said, I want to point out one little thing. You write: "He says I'm reading things into situations that maybe aren't there."
My understanding is that that's kinda part of CBT. The assumption in CBT is that part of what goes on in the minds of people who are depressed is that they engage in distorted thinking, and filter the world in a negative way. According to CBT, everyone who is depressed reads things into situations that maybe aren't there, and becoming aware of that is part of how you get better.
You do want to feel supported. But I think any CBT therapist is going to ask you to challenge some of what you read into situations.
I'd encourage you to at least try talking a bit to this therapist about your discomfort.
posted by ManInSuit at 8:37 PM on September 22, 2014 [9 favorites]
Best answer: Nope. Move on. I've sought all kinds of therapy for depression over the last 24 years and I have encountered all kinds of therapists, good and bad. I would never, ever go back for a second session with a therapist who didn't believe that sexism happens in doctors offices or who pulled a face for any reason. Trust yourself, trust your instincts, and drop this (at best) ineffective therapist.
In my experience CBT ,when done effectively, guides you (with the therapist acting as a guide) as you learn to question your own beliefs. It's not necessarily overtly confrontational and it doesn't leave you feeling exasperated or like you're not being listened to by the person who's supposed to be helping you.
(Incidentally--and I'm sure this won't be a very popular opinion, but it might mean something to you--I've never had a male therapist and I never will, simply because I don't want to have to use a single second of my time in therapy to explain to a male therapist, himself replete with male privilege, how sexism and misogyny can exacerbate depression.)
posted by GoLikeHellMachine at 8:53 PM on September 22, 2014 [25 favorites]
In my experience CBT ,when done effectively, guides you (with the therapist acting as a guide) as you learn to question your own beliefs. It's not necessarily overtly confrontational and it doesn't leave you feeling exasperated or like you're not being listened to by the person who's supposed to be helping you.
(Incidentally--and I'm sure this won't be a very popular opinion, but it might mean something to you--I've never had a male therapist and I never will, simply because I don't want to have to use a single second of my time in therapy to explain to a male therapist, himself replete with male privilege, how sexism and misogyny can exacerbate depression.)
posted by GoLikeHellMachine at 8:53 PM on September 22, 2014 [25 favorites]
Best answer: Ditch any therapist, male or female, who doubts and casts mockery on your claims of being a woman who is not being taken seriously by her other doctors. The things you are describing are not you overreacting to harmless things, they are you reacting properly to insulting and demeaning behavior from people who are supposed to be taking care of you.
posted by poffin boffin at 9:06 PM on September 22, 2014 [15 favorites]
posted by poffin boffin at 9:06 PM on September 22, 2014 [15 favorites]
I kinda think HuronBob is onto something...to his first point...
>>"He says I'm reading things into situations that maybe aren't there." This is sort of standard language for someone using CBT. It's difficult, however, to determine from your brief description if it was an appropriate response.
Given a set of facts, there are a lot of narratives that 'fit'. It seems your therapist was emphatic and precise enough to use the word 'maybe' and have it stick in your mind. If - on the other hand - he was straight up telling you you got it wrong, that would be suspect to me.
This is only my simplistic POV as a CBT patient, but...I don't think the role of the therapist is to *confirm* your world view. To me, the only confirmation you would need is from your inner self.
to his third point
>>Bottom line, however, is that you need to be comfortable and trust your therapist. Since you're early into this process it would make sense for you to shop around a bit and find someone that you feel better about.
there really is no downside to shopping around a bit.
posted by j_curiouser at 9:20 PM on September 22, 2014 [1 favorite]
>>"He says I'm reading things into situations that maybe aren't there." This is sort of standard language for someone using CBT. It's difficult, however, to determine from your brief description if it was an appropriate response.
Given a set of facts, there are a lot of narratives that 'fit'. It seems your therapist was emphatic and precise enough to use the word 'maybe' and have it stick in your mind. If - on the other hand - he was straight up telling you you got it wrong, that would be suspect to me.
This is only my simplistic POV as a CBT patient, but...I don't think the role of the therapist is to *confirm* your world view. To me, the only confirmation you would need is from your inner self.
to his third point
>>Bottom line, however, is that you need to be comfortable and trust your therapist. Since you're early into this process it would make sense for you to shop around a bit and find someone that you feel better about.
there really is no downside to shopping around a bit.
posted by j_curiouser at 9:20 PM on September 22, 2014 [1 favorite]
I say you stick with him for a few more sessions.
Why?
(1) He may not have meant to make any face, or did not make a face.
(2) You may have been projecting a lot onto your GP.
Explanation: CBT is based on the idea that we adopt internal verbal coping strategies in response to past negative situations.
One of those coping strategies involves thinking negatively about yourself and sometimes projecting negative thoughts into the actions of others. Examples would be thinking others don't like you or misinterpreting what others say or do.
I belive there might be a chance you are doing that. I know I do. And it may be that your therapist also thinks that's the case.
What I think you ought to do: I think you should go back. I think you should tell him exacty how you feel about the last session. Mention the GP thing and the face. Be firm in your response to him. Those are the interactions which therapists are the most interested in, because they gauge where you are in relation to treatment. In addition, they give you a chance to gague the therapist.
I'd also suggest keeping a diary of everytime you think someone is thinking negatively of you and what you saw and heard. Then you can judge how much you are projecting onto others. We all do it, the only question is whether or not you are doing it at a higher rate than is healthy and how to fix it if so.
I would say it is always good to resist early inpulses to ditch treatment or a particular therapist. Note them, but give it some time because generally we react to defend any coping style we have, because we think it protects us. Usually we defend by pushing away the therapist or the treatment.
So I say engage him. Let him know what you percived and that you felt upset. Show him this thread. See how he reacts. It will be a good exercise for your self-esteem because you deserve to be stuck up for by you.
posted by Ironmouth at 9:23 PM on September 22, 2014 [4 favorites]
Why?
(1) He may not have meant to make any face, or did not make a face.
(2) You may have been projecting a lot onto your GP.
Explanation: CBT is based on the idea that we adopt internal verbal coping strategies in response to past negative situations.
One of those coping strategies involves thinking negatively about yourself and sometimes projecting negative thoughts into the actions of others. Examples would be thinking others don't like you or misinterpreting what others say or do.
I belive there might be a chance you are doing that. I know I do. And it may be that your therapist also thinks that's the case.
What I think you ought to do: I think you should go back. I think you should tell him exacty how you feel about the last session. Mention the GP thing and the face. Be firm in your response to him. Those are the interactions which therapists are the most interested in, because they gauge where you are in relation to treatment. In addition, they give you a chance to gague the therapist.
I'd also suggest keeping a diary of everytime you think someone is thinking negatively of you and what you saw and heard. Then you can judge how much you are projecting onto others. We all do it, the only question is whether or not you are doing it at a higher rate than is healthy and how to fix it if so.
I would say it is always good to resist early inpulses to ditch treatment or a particular therapist. Note them, but give it some time because generally we react to defend any coping style we have, because we think it protects us. Usually we defend by pushing away the therapist or the treatment.
So I say engage him. Let him know what you percived and that you felt upset. Show him this thread. See how he reacts. It will be a good exercise for your self-esteem because you deserve to be stuck up for by you.
posted by Ironmouth at 9:23 PM on September 22, 2014 [4 favorites]
Response by poster: To be clear going forward: I am not interested in the opinion of men telling me that sexism is all in my head, I'm projecting, I've misinterpreted my own experiences, blah blah blah. Just. Not. Interested.
posted by everydayanewday at 9:33 PM on September 22, 2014 [37 favorites]
posted by everydayanewday at 9:33 PM on September 22, 2014 [37 favorites]
I think that the most important thing to consider is the fact that seeing him was not comfortable. If it doesn't feel right, it's not.
posted by DeltaForce at 9:42 PM on September 22, 2014 [4 favorites]
posted by DeltaForce at 9:42 PM on September 22, 2014 [4 favorites]
Yeah I would dump this guy for sexism.
(That said, I am surprised by the people here saying they expect empathy or validation from their therapists. I have had therapists like that, and I dumped them as useless. You need to feel safe in therapy, but you also need to be challenged.)
posted by Susan PG at 10:05 PM on September 22, 2014 [6 favorites]
(That said, I am surprised by the people here saying they expect empathy or validation from their therapists. I have had therapists like that, and I dumped them as useless. You need to feel safe in therapy, but you also need to be challenged.)
posted by Susan PG at 10:05 PM on September 22, 2014 [6 favorites]
The research (according to my therapist) says that a key determinant of therapy's success is the relationship between the patient and the therapist. So I don't care if this guy is 100% "right" or "the top ranked therapist in your city," if you are having this reaction to him, it will negatively impact your therapy. There must be other therapists in your area, no? Ship around a bit. Find someone who makes you comfortable and then really dig into work with them.
posted by salvia at 10:31 PM on September 22, 2014 [3 favorites]
posted by salvia at 10:31 PM on September 22, 2014 [3 favorites]
He's just lucky you're not there for anger management.
Forget him, he's ignorant and rude (at best). There are better therapists out there, you don't deserve to be chained to this one.
For what it's worth, I've tried out CBT, and liked it specifically because (at least in my experience) it was super impersonal and basically involved following directions/scripts. It didn't involve being belittled or the therapist making faces or anything like that. We didn't even talk much about personal experiences, other than in terms of defining exactly what I wanted help with and how things were progressing. The therapist's input could generally be boiled down to, "in situation X, do Y." And it's true that the therapist's directions could be very explicit (which was something I liked about it, the therapist would just tell you what to do and you could sort of take it or leave it), which could come off as harsh or cold. The therapist could sometimes seem intractable, too, because he was going to go through with the CBT ~program~ whether you liked it or not. But no therapist is supposed to ever be *rude* like this guy was being, including a therapist doing CBT.
Honestly, if you think that your therapist is just straight up being disrespectful and rude to you, there's probably never going to be a valid professional explanation for it. That's not part of any school of therapy I've ever heard of.
posted by rue72 at 10:33 PM on September 22, 2014 [3 favorites]
Forget him, he's ignorant and rude (at best). There are better therapists out there, you don't deserve to be chained to this one.
For what it's worth, I've tried out CBT, and liked it specifically because (at least in my experience) it was super impersonal and basically involved following directions/scripts. It didn't involve being belittled or the therapist making faces or anything like that. We didn't even talk much about personal experiences, other than in terms of defining exactly what I wanted help with and how things were progressing. The therapist's input could generally be boiled down to, "in situation X, do Y." And it's true that the therapist's directions could be very explicit (which was something I liked about it, the therapist would just tell you what to do and you could sort of take it or leave it), which could come off as harsh or cold. The therapist could sometimes seem intractable, too, because he was going to go through with the CBT ~program~ whether you liked it or not. But no therapist is supposed to ever be *rude* like this guy was being, including a therapist doing CBT.
Honestly, if you think that your therapist is just straight up being disrespectful and rude to you, there's probably never going to be a valid professional explanation for it. That's not part of any school of therapy I've ever heard of.
posted by rue72 at 10:33 PM on September 22, 2014 [3 favorites]
(That said, I am surprised by the people here saying they expect empathy or validation from their therapists. I have had therapists like that, and I dumped them as useless. You need to feel safe in therapy, but you also need to be challenged.)
Having not previewed, IME the "challenging you" comes later, after they've taken the time to understand you and you've developed some trust and respect. But every person's preferences are different, and every therapist is different. Find one whose style works well for you.
posted by salvia at 10:35 PM on September 22, 2014 [4 favorites]
Having not previewed, IME the "challenging you" comes later, after they've taken the time to understand you and you've developed some trust and respect. But every person's preferences are different, and every therapist is different. Find one whose style works well for you.
posted by salvia at 10:35 PM on September 22, 2014 [4 favorites]
To be clear going forward: I am not interested in the opinion of men telling me that sexism is all in my head, I'm projecting, I've misinterpreted my own experiences, blah blah blah. Just. Not. Interested.
I wouldn't be either, but the whole theory of CBT is that you are unhappy because WHATEVER is hurting you is all in your head, you're projecting, you are misinterpreting your own experiences, etc. So CBT is not for you.
OF COURSE sexism is real. OF COURSE. But from a CBT standpoint, anything, anything at all bad that happens to you is just you framing things negatively. Can you tell how much I hate CBT?
posted by Violet Hour at 10:37 PM on September 22, 2014 [12 favorites]
I wouldn't be either, but the whole theory of CBT is that you are unhappy because WHATEVER is hurting you is all in your head, you're projecting, you are misinterpreting your own experiences, etc. So CBT is not for you.
OF COURSE sexism is real. OF COURSE. But from a CBT standpoint, anything, anything at all bad that happens to you is just you framing things negatively. Can you tell how much I hate CBT?
posted by Violet Hour at 10:37 PM on September 22, 2014 [12 favorites]
I am not interested in the opinion of men telling me that [...] I've misinterpreted my own experiences
Isn't this kind of the point of CBT? Someone to help you explore when you might be misinterpreting your experiences and then help you explore new ways of interpreting that would be healthier and/or less troubling?
Clearly if that's what this guy was trying to do, he didn't introduce it very effectively with you. You could talk with him about that, or you could decide to look for another practitioner. But if you're really not interesting in finding out that you might have misinterpreted some things, I think you should look for someone who uses a different modality than CBT.
FWIW, I can't imagine any therapist making a face when you describe clearly communicating your feelings to your partner. Pulling a face and looking away says, to me anyway, "dude had to burp." Which is not the height of professionalism, but it's also not a reaction you, either.
Is there any chance that your previous experiences being written off by men in medical specialties could have made you extra sensitive to any hint of it happening again? I know I am a lot more defensive/on-the-alert in some situations that resemble past experiences when I was disrespected. And I know when my first reaction to someone's feedback is, "NO, YOU'RE WRONG," it often means there's a kernel of truth hiding in there, one that I don't want to face. Just a thought.
Whatever you decide, good luck!
posted by vytae at 11:06 PM on September 22, 2014 [2 favorites]
Isn't this kind of the point of CBT? Someone to help you explore when you might be misinterpreting your experiences and then help you explore new ways of interpreting that would be healthier and/or less troubling?
Clearly if that's what this guy was trying to do, he didn't introduce it very effectively with you. You could talk with him about that, or you could decide to look for another practitioner. But if you're really not interesting in finding out that you might have misinterpreted some things, I think you should look for someone who uses a different modality than CBT.
FWIW, I can't imagine any therapist making a face when you describe clearly communicating your feelings to your partner. Pulling a face and looking away says, to me anyway, "dude had to burp." Which is not the height of professionalism, but it's also not a reaction you, either.
Is there any chance that your previous experiences being written off by men in medical specialties could have made you extra sensitive to any hint of it happening again? I know I am a lot more defensive/on-the-alert in some situations that resemble past experiences when I was disrespected. And I know when my first reaction to someone's feedback is, "NO, YOU'RE WRONG," it often means there's a kernel of truth hiding in there, one that I don't want to face. Just a thought.
Whatever you decide, good luck!
posted by vytae at 11:06 PM on September 22, 2014 [2 favorites]
But from a CBT standpoint, anything, anything at all bad that happens to you is just you framing things negatively.
That's not in line with my experience of CBT, albeit maybe because I got CBT for help with a really concrete issue. I had the impression that CBT was meant to be about pain management.
It's not going to be able to actually take away any pain, but it's a set of techniques you can use to make your pain easier to handle. So like, if you have an injury and the pain from that injury is keeping you from sleeping, you can use CBT techniques to keep from freaking out about the pain/sleeplessness, and your therapist will probably give you a checklist of things you can do to lessen the pain/sleeplessness -- but of course there aren't going to be any CBT techniques that literally take away the pain or sleeplessness directly.
I think that CBT is kind of limited, since it is just a bunch of techniques to help you cope with situations that you find difficult but that come up again and again -- but if you *do* have a situation that you find difficult but that comes up again and again, I think it can be really helpful. CBT will at least gives you a go-to "healthy response" to the situation that you can use as a kind of script for dealing with it. It won't necessarily make the situation better, but at least you'll have a guide to follow to get through it with the least possible upset.
Though maybe I was also supposed to be changing all kinds of thought patterns and I just never realized it! I figure that going through the motions was good enough. And that has been helpful, and has basically resolved the issue that I got CBT for. I dunno, if you're going to try therapy, I do think that it's a good first step, because it's targeted/goal-oriented and practical and you see results pretty fast. So I wouldn't throw the baby out with the bathwater if you're still interested in seeing if CBT can be helpful for you in meeting certain goals.
Isn't this kind of the point of CBT? Someone to help you explore when you might be misinterpreting your experiences and then help you explore new ways of interpreting that would be healthier and/or less troubling?
I disagree that challenging your sense of reality is the point of therapy. I mean, maybe if you have issues w/r/t psychosis or delusions, but not if you have a pretty firm grasp on reality and just tend to over-focus on the worst-case scenario.
Also, you have to agree that something is a problem before the therapist leaps to help you "solve" it. If the OP had been like like, "I WANT TO TRUST MY TRUSTWORTHY DOCTORS PLZ HELP," then I think the therapist would have been well-served to ask her to think about different ways to interpret her interactions with her doctors. But it sounds like the OP was just giving background and expressing founded-in-reality frustration with her doctors, and the therapist weirdly decided to explicitly side with the doctors against the OP (though nobody asked him to take a side?).
Cognitive distortions are probably real, but that doesn't meant that every subjective judgment is the result of a cognitive distortion.
posted by rue72 at 11:19 PM on September 22, 2014 [6 favorites]
That's not in line with my experience of CBT, albeit maybe because I got CBT for help with a really concrete issue. I had the impression that CBT was meant to be about pain management.
It's not going to be able to actually take away any pain, but it's a set of techniques you can use to make your pain easier to handle. So like, if you have an injury and the pain from that injury is keeping you from sleeping, you can use CBT techniques to keep from freaking out about the pain/sleeplessness, and your therapist will probably give you a checklist of things you can do to lessen the pain/sleeplessness -- but of course there aren't going to be any CBT techniques that literally take away the pain or sleeplessness directly.
I think that CBT is kind of limited, since it is just a bunch of techniques to help you cope with situations that you find difficult but that come up again and again -- but if you *do* have a situation that you find difficult but that comes up again and again, I think it can be really helpful. CBT will at least gives you a go-to "healthy response" to the situation that you can use as a kind of script for dealing with it. It won't necessarily make the situation better, but at least you'll have a guide to follow to get through it with the least possible upset.
Though maybe I was also supposed to be changing all kinds of thought patterns and I just never realized it! I figure that going through the motions was good enough. And that has been helpful, and has basically resolved the issue that I got CBT for. I dunno, if you're going to try therapy, I do think that it's a good first step, because it's targeted/goal-oriented and practical and you see results pretty fast. So I wouldn't throw the baby out with the bathwater if you're still interested in seeing if CBT can be helpful for you in meeting certain goals.
Isn't this kind of the point of CBT? Someone to help you explore when you might be misinterpreting your experiences and then help you explore new ways of interpreting that would be healthier and/or less troubling?
I disagree that challenging your sense of reality is the point of therapy. I mean, maybe if you have issues w/r/t psychosis or delusions, but not if you have a pretty firm grasp on reality and just tend to over-focus on the worst-case scenario.
Also, you have to agree that something is a problem before the therapist leaps to help you "solve" it. If the OP had been like like, "I WANT TO TRUST MY TRUSTWORTHY DOCTORS PLZ HELP," then I think the therapist would have been well-served to ask her to think about different ways to interpret her interactions with her doctors. But it sounds like the OP was just giving background and expressing founded-in-reality frustration with her doctors, and the therapist weirdly decided to explicitly side with the doctors against the OP (though nobody asked him to take a side?).
Cognitive distortions are probably real, but that doesn't meant that every subjective judgment is the result of a cognitive distortion.
posted by rue72 at 11:19 PM on September 22, 2014 [6 favorites]
Mod note: Some comments removed, take metacommentary to the contact form or Metatalk and please keep stuff in here constructive.
posted by cortex (staff) at 11:27 PM on September 22, 2014 [1 favorite]
posted by cortex (staff) at 11:27 PM on September 22, 2014 [1 favorite]
I've gone back to therapists who didn't make me feel comfortable to give them the benefit of the doubt - I found it never felt better with those ones and that my gut had known it wasn't right.
posted by tanktop at 12:37 AM on September 23, 2014 [4 favorites]
posted by tanktop at 12:37 AM on September 23, 2014 [4 favorites]
Best answer: Dump and move on. Therapists have always been like relationships for me - when it's right, you won't have doubts about the care you're getting.
You talk about being dismissed by healthcare providers for gender reasons (yep, been there, it sucks) - women also get conditioned to ignore their gut instincts and suck up all kinds of crap in the name of being nice and agreeable. Trust what your instincts and doubts are telling you.
And ditch this guy.
posted by terretu at 12:54 AM on September 23, 2014 [4 favorites]
You talk about being dismissed by healthcare providers for gender reasons (yep, been there, it sucks) - women also get conditioned to ignore their gut instincts and suck up all kinds of crap in the name of being nice and agreeable. Trust what your instincts and doubts are telling you.
And ditch this guy.
posted by terretu at 12:54 AM on September 23, 2014 [4 favorites]
"I wouldn't be either, but the whole theory of CBT is that you are unhappy because WHATEVER is hurting you is all in your head, you're projecting, you are misinterpreting your own experiences, etc. So CBT is not for you."
Let me speak to that last point, directly.
I grew up profoundly emotionally abused, but because I did tons of therapy and self-work, and because I am now "old" and have life-experience... I have something in my "tool box" called Boundaries.
There is a Boundary between "This is in your head," VS. "This did not happen."
I'm going to focus on the aspect of this AskMe I have the most direct experience with - the OP's experience with Endometriosis. This diagnosis involves hormones, so the symptoms of depression and "feeling off" go along with the condition ...
The OP's GP, among others, should
not have discounted her symptoms. As described, there are the clinical and recognizable symptoms of Endometriosis. Including depression or fatigue (often mistaken for each other.)
I don't want to go off the rails with this.
There's nothing the OP describes that does not rise to level of boundary crossing in this particular professional capacity, and the strong whiff of misogyny is palpable...
OP, move on! This is not what you intended when you began this particular process.
posted by jbenben at 12:56 AM on September 23, 2014 [3 favorites]
Let me speak to that last point, directly.
I grew up profoundly emotionally abused, but because I did tons of therapy and self-work, and because I am now "old" and have life-experience... I have something in my "tool box" called Boundaries.
There is a Boundary between "This is in your head," VS. "This did not happen."
I'm going to focus on the aspect of this AskMe I have the most direct experience with - the OP's experience with Endometriosis. This diagnosis involves hormones, so the symptoms of depression and "feeling off" go along with the condition ...
The OP's GP, among others, should
not have discounted her symptoms. As described, there are the clinical and recognizable symptoms of Endometriosis. Including depression or fatigue (often mistaken for each other.)
I don't want to go off the rails with this.
There's nothing the OP describes that does not rise to level of boundary crossing in this particular professional capacity, and the strong whiff of misogyny is palpable...
OP, move on! This is not what you intended when you began this particular process.
posted by jbenben at 12:56 AM on September 23, 2014 [3 favorites]
Best answer: I've been struggling with depression now for 5 years and am willing to press through with this if it is meant to be uncomfortable but works. I don't want to feel like this all my life.
I just wanted to encourage you keep advocating for yourself. You are already doing great by pushing back against the mistreatment you've experienced in your previous medical care, and in questioning your therapist's treatment of you. There is someone out there who can truly help you. They will help you so you won't have to feel bad all your life. Keep seeking that person.
Firing this therapist could be an empowering act -- it is you saying you refuse to settle for less-than treatment. (I'm a woman who is working with a guy therapist who incorporates CBT into our process, and he is respectful and nuanced in how he does so, and is highly sensitive to issues of sexism. I had to fire a few duds before I found him, but it was worth the effort. And the process of firing those duds helped reinforce my sense of self and self-worth.)
posted by nacho fries at 1:36 AM on September 23, 2014 [4 favorites]
I just wanted to encourage you keep advocating for yourself. You are already doing great by pushing back against the mistreatment you've experienced in your previous medical care, and in questioning your therapist's treatment of you. There is someone out there who can truly help you. They will help you so you won't have to feel bad all your life. Keep seeking that person.
Firing this therapist could be an empowering act -- it is you saying you refuse to settle for less-than treatment. (I'm a woman who is working with a guy therapist who incorporates CBT into our process, and he is respectful and nuanced in how he does so, and is highly sensitive to issues of sexism. I had to fire a few duds before I found him, but it was worth the effort. And the process of firing those duds helped reinforce my sense of self and self-worth.)
posted by nacho fries at 1:36 AM on September 23, 2014 [4 favorites]
Best answer: Ugh! Get rid of this guy. And tell him (or his practice) why you're getting rid of him, if you can. His bullshit is unhelpful at best and harmful at worst.
For what it's worth, I am socially read as female and have also had abdominal pain dismissed by a male doctor. I have been told by a male doctor that my symptoms (which turned out to be stress related) were caused by pregnancy, despite the fact that I hadn't had sex in 6 months (he made me take a test anyway). I have been looked over my male doctors and shrugged at and told that "it's just life". I can also think of at least three separate friends who have had similar experiences. You are not alone.
posted by fight or flight at 3:15 AM on September 23, 2014 [3 favorites]
For what it's worth, I am socially read as female and have also had abdominal pain dismissed by a male doctor. I have been told by a male doctor that my symptoms (which turned out to be stress related) were caused by pregnancy, despite the fact that I hadn't had sex in 6 months (he made me take a test anyway). I have been looked over my male doctors and shrugged at and told that "it's just life". I can also think of at least three separate friends who have had similar experiences. You are not alone.
posted by fight or flight at 3:15 AM on September 23, 2014 [3 favorites]
Best answer: Trust your gut. I had a similar experience in a very different setting. I went to a yoga class and the instructor made me feel so uncomfortable. I blamed myself and thought it was due to my issues with personal space so signed up for a full course. He continued to make me feel unsafe and uncomfortable to the point where I pushed myself and injured my shoulder. I should have trusted my instincts.
I've also had a lot of therapy and don't get on well with CBT. Luckily my CBT therapist was a nice guy, but I got so much more out of my female Cognitive Analytic Therapist. Sometimes, I really do think it can be better to have a therapist of your own gender, especially for discussing your experiences of sexism.
Adding to 'you're not alone' - I am so sick of having symptoms ignored becaused I am an anxious woman. It does happen and it shouldn't be made light of.
posted by Dorothea_in_Rome at 3:40 AM on September 23, 2014 [5 favorites]
I've also had a lot of therapy and don't get on well with CBT. Luckily my CBT therapist was a nice guy, but I got so much more out of my female Cognitive Analytic Therapist. Sometimes, I really do think it can be better to have a therapist of your own gender, especially for discussing your experiences of sexism.
Adding to 'you're not alone' - I am so sick of having symptoms ignored becaused I am an anxious woman. It does happen and it shouldn't be made light of.
posted by Dorothea_in_Rome at 3:40 AM on September 23, 2014 [5 favorites]
He could have phrased it a lot better, but a big part of CBT is looking at how your own thoughts about situations are influencing your emotional state. Which may have been what he was trying to get at with the "you're reading into it" comment.
In my own experience, sometimes it can be a very unpleasant process and you will feel the urge to combat it because obviously whatever is going on in your mind is very true and real to you while the therapist is saying "No maybe it isn't how you think it is." Personally I never got on well with stuff like CBT completely, I found it more helpful to learn what I felt was useful from it and kind of forget the rest.
As for the "pulling a face thing" this is another moment that's very open to debate and kind of hard for the internet masses to comment on because we only have your interpretation of it. Obviously you interpreted it in a very negative way, but for all we know maybe you cracked him up with your blunt response and he was struggling to maintain composure.
I any case, regardless of whether or not your therapist is "right" here or not it doesn't sound like you trust him at all. Which means you should probably find a new therapist because you're just going to continue questioning every little thing this one does.
posted by Kimmalah at 5:09 AM on September 23, 2014 [2 favorites]
In my own experience, sometimes it can be a very unpleasant process and you will feel the urge to combat it because obviously whatever is going on in your mind is very true and real to you while the therapist is saying "No maybe it isn't how you think it is." Personally I never got on well with stuff like CBT completely, I found it more helpful to learn what I felt was useful from it and kind of forget the rest.
As for the "pulling a face thing" this is another moment that's very open to debate and kind of hard for the internet masses to comment on because we only have your interpretation of it. Obviously you interpreted it in a very negative way, but for all we know maybe you cracked him up with your blunt response and he was struggling to maintain composure.
I any case, regardless of whether or not your therapist is "right" here or not it doesn't sound like you trust him at all. Which means you should probably find a new therapist because you're just going to continue questioning every little thing this one does.
posted by Kimmalah at 5:09 AM on September 23, 2014 [2 favorites]
Best answer: I've gone back to therapists who didn't make me feel comfortable to give them the benefit of the doubt - I found it never felt better with those ones and that my gut had known it wasn't right.
Yes, precisely. Once you feel like you can't trust this person with your ugly painful thoughts then how are you going to take away anything beneficial? It's not validation as much as it is really basic human respect.
posted by poffin boffin at 8:01 AM on September 23, 2014 [4 favorites]
Yes, precisely. Once you feel like you can't trust this person with your ugly painful thoughts then how are you going to take away anything beneficial? It's not validation as much as it is really basic human respect.
posted by poffin boffin at 8:01 AM on September 23, 2014 [4 favorites]
Best answer: Not everyone with a licence to practice therapy is a good therapist, and not every "good" therapist is a good match for every client. Although I do think therapy can and should be CHALLENGING, it definitely should not involve a therapist telling you that sexism is "all in your head." No, it's not. Now, how you process and deal with sexism in ways that are more or less healthy for you might be something to talk about with a therapist if YOU think that's something you want to work on -- for example, talking through scenarios about how to confront a doctor who is dismissing your concerns due to your gender in a way that makes you feel empowered. I know with my former therapist we talked a lot about the sexism inherent in my field of work and how I could stay in that work environment (which I wanted to and still want to do) and still stay sane. But she NEVER questioned that in fact the sexism EXISTED (hello...it does!).
There is nothing wrong with YOU if this one particular therapist turns out to be either bad in general or bad for you in particular. It can take a while to find the right person. I strongly recommend looking for a female therapist -- I know it really changed my experience. (This is not to say male therapists can't deal with these issues sensitively, but...on average, I think a female therapist may be a better bet.)
posted by rainbowbrite at 8:17 AM on September 23, 2014 [5 favorites]
There is nothing wrong with YOU if this one particular therapist turns out to be either bad in general or bad for you in particular. It can take a while to find the right person. I strongly recommend looking for a female therapist -- I know it really changed my experience. (This is not to say male therapists can't deal with these issues sensitively, but...on average, I think a female therapist may be a better bet.)
posted by rainbowbrite at 8:17 AM on September 23, 2014 [5 favorites]
I think the reality is a bit in-betweeny here. I am super feminist, but therapy that was closer to CBT was much more successful for me than talk therapy because, during talk therapy, I'd just be complaining and complaining (and I already complain a lot) and falling down into a hole of misery.
I was finally successful in therapy because I found a therapist who gentle challenged my perceptions of different interactions. However, the key word was gently. One of my largest anxieties is around authority figures telling me I'm bad or wrong, and my therapist and I had chemistry that was sort of like your favorite tough love friend, who can point out exactly how you are influencing your own interactions negatively without making you hate them. And I was finally able to start to pull myself out of my misery and be proactive in changing my life. It was awesome.
Maybe this guy's approach isn't right for you. Based on the problems you're having, I'd suggest either a queer-friendly male or female therapist. But I would not seek out a therapist who is solely there to confirm or validate you if you want to make real changes in your life. It's okay if you don't want to make those changes, but then you're back to talk therapy, and it sounds like that wasn't really effective for you, either.
posted by PhoBWanKenobi at 9:24 AM on September 23, 2014 [3 favorites]
I was finally successful in therapy because I found a therapist who gentle challenged my perceptions of different interactions. However, the key word was gently. One of my largest anxieties is around authority figures telling me I'm bad or wrong, and my therapist and I had chemistry that was sort of like your favorite tough love friend, who can point out exactly how you are influencing your own interactions negatively without making you hate them. And I was finally able to start to pull myself out of my misery and be proactive in changing my life. It was awesome.
Maybe this guy's approach isn't right for you. Based on the problems you're having, I'd suggest either a queer-friendly male or female therapist. But I would not seek out a therapist who is solely there to confirm or validate you if you want to make real changes in your life. It's okay if you don't want to make those changes, but then you're back to talk therapy, and it sounds like that wasn't really effective for you, either.
posted by PhoBWanKenobi at 9:24 AM on September 23, 2014 [3 favorites]
Response by poster: To address the reason I go to therapy, my depression is not caused by sexist reactions I've experienced (though I'm sure those don't help me either) and I'm definitely NOT looking for a man to tell me whether or not an interaction is truly sexist or not (LOL). My problems are more to do with motivation, energy, numbness. He is directing the conversation at the moment, as we're only 2 sessions in, which is why any of this even came up. I think perhaps a female therapist might be the way forward as I'm not going to be receptive to a man asking ` but are you suuuuure that was sexist` about the most basic of things every time I reference normal life. Thank you for your input PhoBWanKenobi, no talk therapy isn't great for me either, but I'm going to keep looking for something that works.
posted by everydayanewday at 9:57 AM on September 23, 2014 [3 favorites]
posted by everydayanewday at 9:57 AM on September 23, 2014 [3 favorites]
Even the therapists I've had that have had me confront uncomfortable thoughts or feelings did so without pulling a face. That is beyond unprofessional, and I would not only dump him, but I'd send a letter to his office telling him exactly WHY I dumped him. But I'm pissy that way.
posted by sarcasticah at 3:09 PM on September 23, 2014 [3 favorites]
posted by sarcasticah at 3:09 PM on September 23, 2014 [3 favorites]
Yeah... I'd look for a new therapist, because therapy aint cheap and I'm there to get help for my mental health, not educate some clueless (I'm guessing straight, white) dude about whether women/POC/differently abled/LGBT people ever reeeeeaaaaaalllyyyy experience discrimination, maaaan. This is really a very low bar. There are plenty of men who get it, but this one doesn't sound like he will anytime soon so try to find a female therapist.
posted by abbagoochie at 6:36 PM on September 23, 2014 [2 favorites]
posted by abbagoochie at 6:36 PM on September 23, 2014 [2 favorites]
This thread is closed to new comments.
posted by everydayanewday at 7:19 PM on September 22, 2014