Communication difficulties with therapist
September 3, 2020 7:22 AM   Subscribe

I'm looking for some perspective on what seem to be regular communication difficulties between my therapist and me.

Two months into therapy I am, on the whole, positive that we're getting somewhere. I'm feeling disconcerted, awash with a whole range of intense emotions (about everything in general, but also about my therapist) and also excited. This is a good feeling. I think over the last decade or so I have poured an inordinate amount of energy into controlling everything about me, especially my feelings, so this feels like a very positive kind of upheaval. I also have the confidence that she can take whatever emotion I'm flinging at her, even if I tell her I'm angry at her, and do something useful with it, and that she won't mess up my emotions. She seems reassuringly competent in that way. I also like her sense of humour.

However, I feel like my therapist misunderstands the things I say, or what I am getting at, too often. I keep thinking that either I am bad at communicating or she is bad at listening, or I am just way too picky.

So I would like to know if this is just par for course, or whether there is something I should be doing about it, because it's honestly annoying and when it happens it makes me wonder if she knows what she's doing or if our session went awry.

Here are 3 examples.

Me, at the beginning of a session: Can I just start off by saying that today I'm feeling...vulnerable. (Except we are not talking English, so the equivalent word would be something like "hurtable".)
Her: Oh? How come?
(Session processes the usual way, At the end:)
Her: I was wondering at the beginning what you meant when you said you were feeling hurt.
Me: I didn't say I was feeling hurt, I said I was feeling vulnerable!

Or this one:
Me (at the start of therapy): And the last time I had therapy, as a teenager, I feel like in retrospect I wasn't open enough in what I was really feeling. I didn't address any of the things between me and my therapist. And I feel like I missed out on a lot that way. So I swore to myself before I came here I would handle it differently this time.
Therapist: You were just a teenager, though. There's no reason to blame yourself.
Me: I'm not blaming myself! This is just the way it turned out, and I regret the missed opportunity.
(2 months later)
Therapist: And I remember you saying that you regretted lying to your first therapist.
Me: I didn't lie to my therapist! I just wasn't entirely open with my feelings.
Therapist: Well, either way...

3rd example is part of a pattern in which we start a session by her looking at me expectantly and me wondering what the hell to say. I am used to filling silences with arbitrary patter and I'd rather not waste therapy time by talking about random stuff. I have tried not saying anything. I have tried asking her to take the conversational lead this week ("Of course we can do that, but why do you mean with that and why?"), I have tried updating her about how I did things differently last week. (She seemed encouraging but stressed that she didn't require an update.) Next, I tried firmly suggesting a subject. At the time, I was really finally looking forward to telling her something very specific and just kind of dumping it on her and sorting it out together later.
Me (unusally firm): I want to talk about writing with you today.
Therapist: We can talk about whatever you want, of course. (More sentences about therapy and what it's there for.) Why writing?
Me: ...because I want you to know how I feel about writing and because it is important to me and I feel like you should know about this.
Therapist: So you want to talk about this, and and you want me to handle it in a certain way?
Me (profoundly irritated): Well, you could start by listening to me.
Therapist (unpreturbed): Oh, sure.

I don't know if I just have too high expectations, or our communication styles are mismatched, or I need to express myself more clearly (I thought I was being very clear!). But this all makes for a somewhat difficult talking experience.

Any advice for me?
posted by Omnomnom to Human Relations (27 answers total) 3 users marked this as a favorite
 
Is the therapist a native speaker of this language?

Your third example doesn't sound like she wasn't listening to you, for what it's worth.

Do you have a pre-existing pattern of feeling unheard or misunderstood in your life? If so, the feelings from that pattern might be surfacing in this context.

Regardless of whether your expectations are reasonable or not, this is the kind of thing you can bring up with them. Tell them you feel unheard, misunderstood, that they twist your words, whatever it is. Therapists don't have perfect memory, so they may misremember something. If it happens most of the time that's a red flag but if it is an unusual event, then this might just be their imoerfect humanity coming through. Even if it's normal humanity, you are within your rights as a client (and perhaps even your responsibility) to bring this up and share how it is feeling to you to have these experiences.
posted by crunchy potato at 7:34 AM on September 3, 2020 [2 favorites]


Is the therapist a native speaker of this language?

We are both native speakers.
posted by Omnomnom at 7:37 AM on September 3, 2020


To me, these do not sound like particularly bad examples of a therapist not paying attention. This sounds about average for therapists I've worked with honestly. To me a fed flag is when the therapist isn't even trying to listen/respect me, in your examples it sounds like they are trying and just falling a bit behind or losing context. One thing to remember is that therapists do see a lot of different patients, and may be thinking about different aspects of your case than your explicit requests

I think the key question is "is this therapist helping me, and is it worth the financial, time, and emotional cost of going to sessions?" if you think the answer is no, and you think that you could maybe find a better one, I would move on. There's nothing wrong either way
posted by JZig at 8:21 AM on September 3, 2020


None of these instances sound to me like someone not listening or even misunderstanding you. They sound like someone actively trying to reflect back what you said, using slightly different words (so they aren't just parroting you). But you feel keenly the different nuances in words or phrases that others might consider near-synonyms. That's a good thing to know about yourself, and a good thing to tell her. It probably makes you a great writer, too, by the way!
posted by Ausamor at 8:21 AM on September 3, 2020 [9 favorites]


Based solely off the exchanges as you relayed them, it seems like you firmly want to be treated in very specific ways, and expect her to have total recall of a lot of information, even months later. You seem to take any failure on that front as her not listening to you. It comes off like you consider her to be subordinate to you.

I've had serious issues with feeling like people weren't listening to me. I'd get angry and eventually started interpreting a wide variety of behaviors to indicate that I literally didn't matter to the other party. Things have improved some (through therapy, and meditation), and I feel like I overreacted to a lot of that stuff. But that might not be true in your case.

I think it's reasonable to want to be treated in certain ways, generally and also specifically by a therapist. What you've described here seems prescriptive to the point where she's not sure how to talk to you, as per her line near the end of the third interaction. If how she treats you bothers you, there are of course many other therapists, but I'm not sure how much luck you'll have finding one who always says the right thing. On the other hand, if it's really bothering you, might be better to go try and find one.
posted by troywestfield at 8:27 AM on September 3, 2020 [5 favorites]


Just to clarify, I wasn't intending to look for a new therapist just based on that. My question is rather if I should do anything different in talking to my current one.
posted by Omnomnom at 8:33 AM on September 3, 2020 [3 favorites]


Is she a lot older than you? If your communications styles are mismatched, why not discuss how that makes you feel.
posted by Obscure Reference at 8:54 AM on September 3, 2020


I think you are probably seeing your desire for control come out in a different shape.

Looking at the way you describe what you wanted in the third example, you had a very precise vision of exactly what you wanted the conversation to be. Like you want either her to be in control (starting off the conversation with specific topics, etc) or you want yourself to be in control (I will dump this entire story without interruption or question and then we will sort through it).

And it's fine for you to come with something specific that you want to talk about or especially if there was an incident you don't understand and you want to sort through, to be clear. Just the conversation that actually unfolds will be an interplay between you and if the therapy is working for you then it may be helpful to have a little more trust. Maybe a specific question won't be right or will be based on a misunderstanding, but overall as a process the therapist is probably looking for different patterns and information than you, and that is specifically the expertise that you have them for.
posted by Lady Li at 9:13 AM on September 3, 2020 [7 favorites]


Basically your therapist has to probe a lot of different possibilities and interpretations of what you say, because most people leave things out without even realizing it. So she may not be right about the specific things, but the act of probing and trying to get more info is good.
posted by Lady Li at 9:19 AM on September 3, 2020 [1 favorite]


The consensus seems to be "insanely picky". I appreciate the feedback and it's somewhat a relief that it's so unanimous.

I think you are probably seeing your desire for control come out in a different shape.

That's possible.

Anyway, thank you, and I will think about how to address this.
posted by Omnomnom at 9:21 AM on September 3, 2020 [1 favorite]


In two of your examples, time elapses between what you said and when your therapist repeated it back to you. One was a fairly significant amount of time. Is it possible that your therapist's memory just isn't as clear? Like, you said "hurtable", and she remembered that you said something hurt-ish, and guessed the wrong word? Likewise, for the lying-to-therapist example, is it possible that she just vaguely remembered less-than-whole-truth and guessed that you lied? As the patient, your memory would probably be clearer, and as a writer, you would probably be especially attuned to word usage. So I don't want to blame you for being insanely picky, but yeah, it does seem like there's a difference in verbal specificity.
posted by kevinbelt at 9:37 AM on September 3, 2020 [2 favorites]


I think the first two examples are different than the third, and that one does seem possibly controlling on your part. But I don't think you're being insanely picky about the others; I've been in similar interactions and it's frustrating to be misunderstood like that, particularly in a context where the other person is actively building a model of you that informs their approach to treatment. You want that model to be based on accurate understandings, right?

I'd talk with her about it. I'm also someone who tends to remember things loosely, and would guess it's probably just a cognitive thing on her part rather than lack of interest or attention. But you could talk about those examples and why they worry you, and ask whether you could come up together with mitigating strategies to make sure you feel (and are) understood. Maybe she could do more reflecting statements on your information in the moment, making sure she understands things as you're telling them to her before trying to process them.

But I'd also pay attention to whether these lapses really do affect her work adversely, or whether they're just frustrating in the moment. Like in the second example, has she on other occasions treated you as someone who lies? Does her misunderstanding seem to have informed her general perception of you? Or does it seem to just be a blip that doesn't really go any deeper?
posted by trig at 10:06 AM on September 3, 2020 [1 favorite]


It sounds like.. you really value your therapist & want to be really seen as who you actually are, and might be getting a little frustrated when you feel like they're a bit off.

I think you should actively bring it up. For example, I might say: "I feel like you're misunderstanding me, or not correctly understanding me, and this frustrates me". I think this feeling in of itself is a good thing to work though in a therapy context, and a really good thing to follow.
posted by suedehead at 10:30 AM on September 3, 2020


I think your second example is a real miss on her part.
posted by gt2 at 10:35 AM on September 3, 2020 [1 favorite]


Hey I am a super-tight-laced person too, and I think people are picking up on the fact that this way of managing human interactions is fine, but it may not be normative. And your therapist my be a little less exacting with their language and you pick up on this and fuss with it. Which is fine! But it may be pointing out something about you that might be useful to spend some time on (maybe with the therapist, maybe on your own). To me this exchange is telling

Therapist: And I remember you saying that you regretted lying to your first therapist.
Me: I didn't lie to my therapist! I just wasn't entirely open with my feelings.
Therapist: Well, either way...


Like, when I have discussions like this with my partner we'll occasionally talk like this (minor incidents, these are not huge dramatic fights)

Me: Hey you lied to me about a thing.
Him: I didn't LIE, I just didn't fully tell you the story.

And we'll talk it out. But to him, being told he was lying makes him really upset, whereas to me, saying he was lying is nearly the same as what wound up happening as a result of what he said. And I've had a lot of people I trusted lie to me in this way that was NOT ok (think: parents) and so I'm touchy about it. We work it out and no harm no foul, but it seems like you have an "AHA, you're not listening" response that is very strong and maybe comes from somewhere?
posted by jessamyn at 11:08 AM on September 3, 2020


I'll go against the grain and say: I would be quite put off by what you describe. And I do think this is enough of a pattern to consider switching to a new therapist.

It's not the initial miscommunication/forgetting/misunderstanding/whatever that's the problem, it's how she handles the aftermath. From what you describe, she's repeatedly (and deliberately) avoiding your obvious anger when she ought to become immediately curious about it and help you probe it.

You are clearly expressing irritation and anger within a therapy session. And your therapist's response is .... to sidestep it, refuse to acknowledge it, duck and weave and avoid mentioning it? That's a pretty stonking huge failure of therapy. If I had to guess, I'd say she's reacting defensively, as if she feels blamed by you. She's telling herself, "Oops, I forgot/misunderstood/misstepped, but hey, I'm human, it's no big deal, let me model to my patient how to healthily move on from these minor misunderstandings that always will happen between people." Notice how this is 100% focused on herself: her mistake, her humanity, her need to move past it, her desire to impart a life lesson to you the patient.

The thing is, even if you're being unfair to your therapist and even if she does feel unfairly blamed by you, it's her whole job to explore this interaction rather than react defensively to it. Her entire job description is to help you become aware of your emotional patterns, but instead she's brushing aside your emotion? Treating your anger like it's "resistance" (which is a polite word therapists use for unco-operative behavior from patients, i.e. "bad doggie") and "rolling with it" (i.e. treating you like a parent treats a toddler's tantrum - killing the tantrum by refusing to pay any attention to you)? This is not cool, yo. It's a major misstep on her part.

She OUGHT to be saying to herself, "Oh, the patient feels misunderstood. It's making the patient snap at me. Notice that tone of voice. Notice that forward lean. Why does my patient react this way when they feel unheard or misunderstood? What's going on here? Let me ask about it."Notice how this is about you, not about herself.

You can bring this up with her directly: "I notice that whenever I express irritation or anger at something you forgot or misunderstood, you avoid my emotion and quickly move on. This makes me feel even more unheard than whatever it was you misunderstood or misremembered in the first place. I would like you to please acknowledge my anger and irritation rather than brush it aside. And I would really like to explore why feeling unheard makes me angry."

If she reacts in a defensive way, or if she shuts you down, or if she pretends like this is no big deal... if she tries to brush this off with a "Sure, sure, we can do that!" without becoming curious about what prompted your complaint .... that's a bad sign. You can and should find a different therapist: someone who focuses on YOU during a therapy session.
posted by MiraK at 2:58 PM on September 3, 2020 [6 favorites]


It also sounds like your therapist isn't taking particularly good notes, but is relying on the notes heavily. Like, you say "I'm feeling hurtable" she writes "hurt" assuming that she will remember the whole sentence from just that cue. When she returns to it, she is missing the information that you feel is key to understanding you. I'm not sure how you could address this, but it may be something to look for.
posted by 5_13_23_42_69_666 at 3:12 PM on September 3, 2020 [1 favorite]


I notice no one said "insanely picky" except you. Neither did I get a sense of that being implied by others, but that's my take and yours is clearly, and that's interesting.

It seems that accuracy is important to you, as well as being perceived correctly. Do I have that correct? Where else in your life does the kind of dynamic you report happen? Do you have a history of not being seen clearly for who you are to yourself, or even invalidated by others/someone else?
posted by dancing leaves at 5:54 PM on September 3, 2020 [2 favorites]


I'm going to go slightly against the grain here and suggest that your therapist is... a really good therapist. Your first paragraph describes all the things you like about her, and also the ways that she has pushed and challenged you, and your examples are consistent with feeling pushed and challenged. I actually think your therapist may be intentionally paraphrasing or interpreting your words to try to tease out some of the subtext. She says "hurt" and "lying" and those are different than the words you used but they are similar in theme, and - more importantly - those words triggered a lot of emotion for you. Uncomfortable emotion, but valuable territory if you're willing to explore it. I have had a therapist like this, and sometimes I would feel really offended by something she said in session and immediately have an urge to clarify or defend myself or explain how she was misunderstanding me, but later came to see that she had hit on a truth about me and my feelings and interactions with others, and working through that discomfort in the safe space of a therapy session helped me then be able to actually change how I interacted with people and reacted to things outside of therapy. I echo others who have said this is worth bringing up with your therapist, but I also think it's worth sticking with this therapist because it sounds like there's a lot of good growth potential. And no, you're not unusually picky, you're just in therapy... which is often uncomfortable. If you can trust that discomfort is where the growth happens, I think you'll reap a lot of rewards from sticking this out, and should be proud of yourself for doing so.
posted by sleepingwithcats at 6:03 PM on September 3, 2020 [3 favorites]


Me (at the start of therapy): And the last time I had therapy, as a teenager, I feel like in retrospect I wasn't open enough in what I was really feeling. I didn't address any of the things between me and my therapist. And I feel like I missed out on a lot that way. So I swore to myself before I came here I would handle it differently this time....
Therapist: And I remember you saying that you regretted lying to your first therapist.
Me: I didn't lie to my therapist! I just wasn't entirely open with my feelings.


You didn't say that you lied, but you did say that you didn't talk about your true feelings. I see that you felt a bit defensive when she raised this possibility, but, with some time and distance, did she get at something deeper? If you weren't being completely honest with your therapist, was that a kind of lie? I don't know if your therapist misspoke or if she was probing, but your strong reaction suggests something. It may be related to control -- you want to control the narrative of your own life--but it might be worth thinking about what happens if, instead of reacting negatively to this moment when your therapist says something that feels a bit off, you instead pause and reflect for a moment and she if maybe she has some useful insight.

"I didn't lie to my boss! I just didn't tell him I didn't go to that meeting he asked me to go to."
posted by bluedaisy at 6:37 PM on September 3, 2020 [2 favorites]


All of your examples would also make me nuts. I agree with MiraK that your therapist's sidestepping is really off-putting and not really conducive to building trust.
posted by desuetude at 11:50 PM on September 3, 2020 [4 favorites]


I want to jump and say "I do that too" and my therapist helped me realize that I do when there are things about myself that I really want to be seen and understood but there is something fragile about it so I need to make sure it really right. So, I get very picky about the exact right word.

I agree with those that say that your therapist is paying attention and getting about as right as most people would. So, don't blame her for the mistakes. However, you also shouldn't blame yourself for being too picky. I see the process that happens when you stop to correct her seems like it could be really good therapy.

Think about it this way:
- You are making an effort to be more open than you have before (yay!)
- You like your therapist and trust her enough that you want to be really seen and understood (yay)
- She gets it wrong (at least somewhat wrong) - she isn't really seeing you fully (ouch!)
- You tell her
- She want to know that she got it wrong. She's curious to understand what she missed. (she cares about the connection and wants to see you - yay)
- Bonus: you get to experience having some get it wrong, you speak up and the two of you repair. That's a great skill and possibly a healing experience.

Bottom line: Keep on being picky as long as it feels important. Nobody is messing up here.
posted by metahawk at 1:32 PM on September 4, 2020


- She want to know that she got it wrong. She's curious to understand what she missed. ...
- Bonus: ... and the two of you repair.


These two steps are crucial to good therapy but they do seem to be conspicuously absent from the scenarios as described. Did you just leave it out, Omnom? Or are these steps truly missing?
posted by MiraK at 4:46 PM on September 4, 2020


Or are these steps truly missing?

You're right about that. Mostly, the response I got was a flicker of puzzlement across her face and then a return to the subject at hand. It does make me feel rather...like I'm yelling at cotton wool.
I think part of it is that we've been talking about external subject X or subject Y, but increasingly I've been trying to address Our Relationship (as per what I said in the 2nd example, lol). And she may not be entirely picking up on what I felt are obvious pleas, but clearly aren't. It makes me feel confused.

Everything else is true at the same time, though, which makes the responses here both enlightening and confusing. I do have control issues, she may be touching a nerve, I want very much to be understood AND I am very particular about word choice in all situations, but particularly about feelings.

Thank you!
posted by Omnomnom at 12:54 AM on September 5, 2020 [2 favorites]


To clarify: clearly aren't obvious. (Missing word, sorry).

I don't ever tell people I'm feeling vulnerable. This was a big deal to me and I have mentioned more than once that that kind of disclosure is a big deal. But then I realise 40 minutes in that she didn't actually hear what I said. (And I still think "hurt" and "vulnerable" are two different things requiring different responses.)

That's why I reacted with more heat than might seem reasonable.
posted by Omnomnom at 2:47 AM on September 5, 2020 [1 favorite]


Omnomnom, even if you did react due to control issues or having a nerve touched or whatever else, that's not wrong or inappropriate or unreasonable in the therapy room. You're SUPPOSED to react in honest ways in therapy. That's your whole job. Like, trust me, I spent my entire first year of therapy hiding behind a perfect, unflappable, totally "together", smooth-as-glass public persona instead of being honest about my emotional responses in the moment and revealing who I was underneath - you don't want to aspire to that!

It's really, really great if your messy emotional responses are getting evoked in therapy. I just wish your therapist would stop letting all that gold slip through your fingers! I hope you can accept that whatever you are feeling IS the therapy, and directly ask your therapist to stop avoiding your emotions. Fingers crossed, she steps up and fixes this.

PS: Could this be a modality-based problem? If your therapist is oriented to CBT/DBT/other behavioral therapies, she might not consider it important to examine or understand the source of your emotions at all. You might try looking for a psychodynamic therapist if this is the case.
posted by MiraK at 9:01 AM on September 5, 2020 [1 favorite]


Hi, I wanted to report back that I addressed the issue in our next session using some of the framing from this thread, and I am very happy with the result.

For one thing, somewhat at odds with my complaint, she instantly understood exactly what I was talking about, such that I suspect that maybe she'd been mulling these things over, herself. She went straight to the core of what this is about, but she did it in a way that made me feel very listened to. (She apologized, too, though that wasn't the important part, for me.)

So that conversation unearthed three more sessions' worth of emotional baggage. The result is that I feel a lot more on solid ground with my therapist and I think I wouldn't be bothered anymore by the occasional human misunderstanding.

Anyway, thank you, your answers were very helpful.
posted by Omnomnom at 11:30 AM on October 2, 2020 [5 favorites]


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