I want to adjust the style of therapy I'm receiving, but not sure how?
April 10, 2023 10:17 AM Subscribe
I've been with my current therapist for about a year, using my employer assistance program. I realized the current form of therapy I'm getting isn't really changing anything, so I want help in how to make it more effective and useful for me, because my insurance approved the referral finally (yay!), and I want to make this worthwhile.
My therapist is great. She's very kind, a good listener in general, and validates me. That's all good. However, I realized that she's mostly listening, and sometimes bounces my questions back on me (probably to help me reframe stuff).
What I'm really looking for is: 1) help with addressing my traumas, particularly the more deep-rooted ones, and really "untangling" them; 2) my mindset/processes challenged in meaningful ways that will actually stick, not just temporarily; and 3) being told what to do, without being told what to do.
The 3rd one is a bit tricky, because it's contradictory, but I noticed that I function better when I have a specific script, clear instructions, or a process to do. I don't do well when things are more "go with the flow", because I'm indecisive and often hesitate because I'm afraid of making the wrong decision (as you probably could tell in my previous Ask about my birthday weekend, and so many other Asks). I don't like being told what to do, but I do believe it might benefit me.
My therapist is Deaf, just like me. I'm not sure if she's trained specifically in the areas of trauma, but I really hope she is, because I've fought hard to get her services approved by my insurance. Kaiser is no fun to work with, so this was a highly sought referral, and I really want to make the most out of it, so that I can really move forward and be the best version of myself that I can be.
I know it might be as simple as explaining all this to her, but I'm not sure exactly how to parse it, or if my wants are completely clear, so figured I'd turn to the Green for advice/suggestions on how to word it better, if needed, or even the right word for the kind of therapy I am wanting. I'm also open to suggestions on my end how to get my desired therapy more effectively.
Thanks!
My therapist is great. She's very kind, a good listener in general, and validates me. That's all good. However, I realized that she's mostly listening, and sometimes bounces my questions back on me (probably to help me reframe stuff).
What I'm really looking for is: 1) help with addressing my traumas, particularly the more deep-rooted ones, and really "untangling" them; 2) my mindset/processes challenged in meaningful ways that will actually stick, not just temporarily; and 3) being told what to do, without being told what to do.
The 3rd one is a bit tricky, because it's contradictory, but I noticed that I function better when I have a specific script, clear instructions, or a process to do. I don't do well when things are more "go with the flow", because I'm indecisive and often hesitate because I'm afraid of making the wrong decision (as you probably could tell in my previous Ask about my birthday weekend, and so many other Asks). I don't like being told what to do, but I do believe it might benefit me.
My therapist is Deaf, just like me. I'm not sure if she's trained specifically in the areas of trauma, but I really hope she is, because I've fought hard to get her services approved by my insurance. Kaiser is no fun to work with, so this was a highly sought referral, and I really want to make the most out of it, so that I can really move forward and be the best version of myself that I can be.
I know it might be as simple as explaining all this to her, but I'm not sure exactly how to parse it, or if my wants are completely clear, so figured I'd turn to the Green for advice/suggestions on how to word it better, if needed, or even the right word for the kind of therapy I am wanting. I'm also open to suggestions on my end how to get my desired therapy more effectively.
Thanks!
Print this and take it to her? It's fine, and the two of you can discuss together anything that doesn't make sense. If you need to, take out the final two paragraphs and the mefi-related asides.
I would also suggest you do the same edit-and-print on these recent relationship-related Asks, too.
Tell her it's from your journal. Therapists love when you journal!
You have to say what you want. You have to tell a therapist that you're ready for a specific treatment plan and what you want that treatment for - most people don't know when they first get there, it takes time to get to that place especially if you are in crisis when you first start sessions, and people often get defensive when a therapist says what feels like "okay now let's work on your next major malfunction". It is normal to periodically come in saying "okay, Z is no longer looming so large in my world, can we take a harder look at X now?"
Something you can reframe in this discussion - just in your own mind - is that being "told what to do" is maybe different from "being led/educated in new techniques". Sometimes we have innate skills to pick up a language or woodworking or driving, and sometimes we need the structure and informed processes of pedagogy to onboard the skill successfully. If you can muster up some excitement about learning super-helpful new stuff rather than prickle like someone is trying to control you - as in the idea of teamwork versus opposition - you may find it's actually an enjoyable process.
Let HER figure out what kind of therapy is right for you. She got a degree for this, you don't need to do all the heavy lifting here, just the introspection.
posted by Lyn Never at 10:30 AM on April 10, 2023 [2 favorites]
I would also suggest you do the same edit-and-print on these recent relationship-related Asks, too.
Tell her it's from your journal. Therapists love when you journal!
You have to say what you want. You have to tell a therapist that you're ready for a specific treatment plan and what you want that treatment for - most people don't know when they first get there, it takes time to get to that place especially if you are in crisis when you first start sessions, and people often get defensive when a therapist says what feels like "okay now let's work on your next major malfunction". It is normal to periodically come in saying "okay, Z is no longer looming so large in my world, can we take a harder look at X now?"
Something you can reframe in this discussion - just in your own mind - is that being "told what to do" is maybe different from "being led/educated in new techniques". Sometimes we have innate skills to pick up a language or woodworking or driving, and sometimes we need the structure and informed processes of pedagogy to onboard the skill successfully. If you can muster up some excitement about learning super-helpful new stuff rather than prickle like someone is trying to control you - as in the idea of teamwork versus opposition - you may find it's actually an enjoyable process.
Let HER figure out what kind of therapy is right for you. She got a degree for this, you don't need to do all the heavy lifting here, just the introspection.
posted by Lyn Never at 10:30 AM on April 10, 2023 [2 favorites]
For #3, what might work is to tell her that you would like to work together so that after each session you have a clear plan for what you can do between sessions to help with your progress. The idea would be for her to help you figure out what the homework assignment for the week should be. She can help you figure out what might be useful but it would only be things that you wanted to be doing. The idea is that you are telling you what to do, the therapist is just an advisor. Also, if you make a plan and don't do it, that can be good to talk about too.
Even a therapist who doesn't normally give homework should be open to working with you to set some specific goals for your week.
posted by metahawk at 10:32 AM on April 10, 2023 [1 favorite]
Even a therapist who doesn't normally give homework should be open to working with you to set some specific goals for your week.
posted by metahawk at 10:32 AM on April 10, 2023 [1 favorite]
#2 - if you are getting meaningful insight but it isn't sticking, that is really normal. It takes a lot of repetition before the new way of thinking is able to pop up and take control when you need it. Portia Nelson's Autobiography in Five Chapters is very popular in recovery circles for good reason.
posted by metahawk at 10:38 AM on April 10, 2023 [1 favorite]
posted by metahawk at 10:38 AM on April 10, 2023 [1 favorite]
Have you considered Cognitive Behavioral Therapy?
posted by falsedmitri at 10:49 AM on April 10, 2023
posted by falsedmitri at 10:49 AM on April 10, 2023
Definitely talk to your therapist about this- I'm a therapist, and this is the kind of conversation we expect and that is useful. She may not be trained in a specific trauma modality like EMDR or IFS, but she can definitely dig in to past incidences and connect them to present reactions more with you, if you feel that the sessions are too focused on "present stuff".
Also, I'd say that a year is not that long in therapy to see "big changes". However, it sounds like you have specific things in mind to work on. Your therapist can help you set and keep track of goals. I don't do a lot of worksheets with clients personally, but some people like them. I do keep track of what clients talk about, and check in with it, and also try to connect it to childhood and past events and worldviews that developed from that. Some people find worksheets to be useful and CBT does a lot of this- your therapist should definitely at least have a passing familiarity with CBT. It's pretty directive and structured, which may be what you're interested in, at least initially.
posted by bearette at 12:03 PM on April 10, 2023 [1 favorite]
Also, I'd say that a year is not that long in therapy to see "big changes". However, it sounds like you have specific things in mind to work on. Your therapist can help you set and keep track of goals. I don't do a lot of worksheets with clients personally, but some people like them. I do keep track of what clients talk about, and check in with it, and also try to connect it to childhood and past events and worldviews that developed from that. Some people find worksheets to be useful and CBT does a lot of this- your therapist should definitely at least have a passing familiarity with CBT. It's pretty directive and structured, which may be what you're interested in, at least initially.
posted by bearette at 12:03 PM on April 10, 2023 [1 favorite]
Hey! I’m so happy for you because you’re awesome. We all deserve the support but you definitely deserve it even more because you have been working so hard to be your best and have faced a lot of adversity. I totally second the suggestion of printing this question and also more from your Ask history. You express yourself very well here and it could be an excellent starting point.
I also agree that, while she may not be trained in a specific modality for treating trauma, she can do a lot to help. If a time comes that someone else might be a better fit, you can work together on that shift but it sounds like you’ll gain a lot! Could you give yourself, say, six more months of full commitment to her strategies — with you as the guide, perhaps going through one AskMeFi a session — before reevaluating. Of course, you can always exit if you feel any red flags earlier or simply a bad match but it sounds good. One thing she’ll understand is how being Deaf and part of the Deaf community in the society we live can affect us, and that’s really valuable. I’m so excited for you!
posted by smorgasbord at 1:23 PM on April 10, 2023 [3 favorites]
I also agree that, while she may not be trained in a specific modality for treating trauma, she can do a lot to help. If a time comes that someone else might be a better fit, you can work together on that shift but it sounds like you’ll gain a lot! Could you give yourself, say, six more months of full commitment to her strategies — with you as the guide, perhaps going through one AskMeFi a session — before reevaluating. Of course, you can always exit if you feel any red flags earlier or simply a bad match but it sounds good. One thing she’ll understand is how being Deaf and part of the Deaf community in the society we live can affect us, and that’s really valuable. I’m so excited for you!
posted by smorgasbord at 1:23 PM on April 10, 2023 [3 favorites]
All of that said, I first wanted a queer therapist who would understand that part of my life because I hadn’t felt validated or understood in therapy like that before. She was great and I made important progress! But after a year, I realized I needed a different approach and switched to a trauma-focused therapist who happened to be an older straight white woman and it was life changing. Just to validate that therapy wish of yours too!
posted by smorgasbord at 1:27 PM on April 10, 2023
posted by smorgasbord at 1:27 PM on April 10, 2023
Another therapist saying: tell your therapist what you need. I think there's a feeling of prohibition people have sometimes, a feeling that if they say any form of "what we're doing right now is not working" that it'll cause a rift or just plain hurt the therapist. This is not a thing to worry about, and in fact talking about why you hesitated to say anything could be a productive side-conversation in itself, if you're interested.
There are a lot of ways to look at how to address deep seated trauma. For me, talking is all there is. Others will tell you somatic therapies (that your current therapist may or may not be versed in) are the only way to address that stuff. It may involve some trial and error, but again, tell your therapist there's stuff you want to get at that it hasn't felt like you've been getting at.
Being told what to do is another thing where you may be able to ask for it or your therapist may be trained in a way where she'll want to frustrate and explore the feeling of wanted to be told what to do. Some of this may get put back on you, and then it's up to you to decide if that's something you can use.
posted by less-of-course at 1:42 PM on April 10, 2023
There are a lot of ways to look at how to address deep seated trauma. For me, talking is all there is. Others will tell you somatic therapies (that your current therapist may or may not be versed in) are the only way to address that stuff. It may involve some trial and error, but again, tell your therapist there's stuff you want to get at that it hasn't felt like you've been getting at.
Being told what to do is another thing where you may be able to ask for it or your therapist may be trained in a way where she'll want to frustrate and explore the feeling of wanted to be told what to do. Some of this may get put back on you, and then it's up to you to decide if that's something you can use.
posted by less-of-course at 1:42 PM on April 10, 2023
I would share your wishlist with her and ask her about specific modalities meant to help heal trauma, like EMDR and IFS (and others she may know about). You can absolutely tell her that you’re hoping for treatment to directly address trauma - you don’t have to be coy about it. These treatments can be substantially different than typical talk therapy or Cognitive Behvioral Therapy, and they can be very very helpful with the type of long-term trauma healing you’re hoping for. Hopefully she can help suggest some good options for your situation!
posted by ourobouros at 2:17 PM on April 10, 2023
posted by ourobouros at 2:17 PM on April 10, 2023
Googled therapists in your area who take your insurance and found this list.
posted by mermaidcafe at 6:52 PM on April 12, 2023
posted by mermaidcafe at 6:52 PM on April 12, 2023
This thread is closed to new comments.
Share this question with her. You've parsed it perfectly.
Sharing your question history could be helpful as well, so she can discern patterns, the ways you've grown, and where you feel stuck.
posted by headnsouth at 10:29 AM on April 10, 2023 [7 favorites]