Psycho-Babble Psychology Thread 961726

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can you tell when your therapist

Posted by tetrix on September 8, 2010, at 20:02:59

can you tell when your therapist using a technique aimed to disarm/relax/reassure/provoke etc?

 

Re: can you tell when your therapist

Posted by violette on September 8, 2010, at 21:06:21

In reply to can you tell when your therapist, posted by tetrix on September 8, 2010, at 20:02:59

Yes, there's a pattern. Usually it's in the tone, pitch in voice and rate/speed of speech.

I know when he confronts/disarms a defense i'm using when his voice gets louder, and he acts surprised, sorta makes a big deal of something i said or did...Though it's not frequent when he does this, i go home feeling exhausted and usually sleep 10+ hours. Then go into some intense affect state, followed by new insights, transference changes, etc.

Not too much 'relaxing' going on...when he did comfort me before, about my first transient hallucination i told him about, his voice and mannerisms were very protective.I only remember that once and have craved it ever since...but since that time, those affect states don't scare me or bother me much.

Reassuring is usualy a higher-pitched voice. Not much reassurance anymore...It's really interesting how every thing and how it is said affects us. I doubt if a stranger said the same thing, it would have anywhere near the same affect. it's really interesting how this works.

You worried about something your T said?

 

Re: can you tell when your therapist tetrix

Posted by obsidian on September 8, 2010, at 23:07:29

In reply to can you tell when your therapist, posted by tetrix on September 8, 2010, at 20:02:59

sometimes, other times I get it after the fact :-)

 

Re: can you tell when your therapist

Posted by sigismund on September 9, 2010, at 2:26:28

In reply to Re: can you tell when your therapist, posted by violette on September 8, 2010, at 21:06:21

I'm somewhat uncomfortable with the idea of technique. (Why?)

I always felt my T meant what she said. In fact it was critical to me that she did.

But perhaps I have missed the point.

Perhaps it has something to do with using instruments?

 

Re: can you tell when your therapist

Posted by violette on September 9, 2010, at 8:09:12

In reply to Re: can you tell when your therapist, posted by sigismund on September 9, 2010, at 2:26:28

words are instruments in therapy.

but i don't see how it would work otherwise...maybe you didn't have as many 'issues' as I?

then again, i've always been hypersensitive to stimuli and might notice more 'voice' things..like even though his office is cluttery, i notice the blue pen that was on the left corner of his desk was moved the next week..or his chair just 2 inches...a 1/2 inch piece of straw paper that was near the garbage can the week before..lol

If my T was supportive and never challenging, i'd probably stay the same..better for me to not stay too 'comfortable'...or i'd be wasting my time and money.

 

Re: can you tell when your therapist

Posted by Dinah on September 9, 2010, at 8:52:29

In reply to can you tell when your therapist, posted by tetrix on September 8, 2010, at 20:02:59

On the occasions he uses them, I suppose I can. Sometimes I approve. Other times, I consider it sheer laziness on his part, and ask him to please quit acting like a shrink. I guess I figure that if he applies himself, he doesn't have to rely on technique to do any of those things.

 

Re: can you tell when your therapist

Posted by tetrix on September 9, 2010, at 8:58:03

In reply to can you tell when your therapist, posted by tetrix on September 8, 2010, at 20:02:59

yes.. I suspect that last time my T deliberately made a mistake in order to show me that it is OK to make mistakes.. but it was so trivial that it left me feeling uncomfortable, as if I am a child.. I am sure her intentions were good but the examples she chooses are not always successful.

mine doesnt raise her voice, the opposite actually, when she tries to make me feel good or create an emotional charge she lowers her voice..

perhaps the word technique isnt the best choice but I don't know what to use instead..

well we are affected by what T's say or do because we trust that they "know and understand" what is going on with us and of course because they know a lot of intimate details that we wouldnt share with just anyone. There is also an element of respect of their opinion as opposed to a friend who doesnt have training in the field and is biased and subjective.

I was curious if people are attuned to their therapist's manipulations... I think that I always see what mine is trying to do..

 

Re: can you tell when your therapist tetrix

Posted by Dinah on September 9, 2010, at 11:21:09

In reply to Re: can you tell when your therapist, posted by tetrix on September 9, 2010, at 8:58:03

I used to be certain that my therapist understood all about me and was trying to manipulate my feelings with his vast amount of knowledge and experience.

I'm not sure if I was relieved or disappointed to find out he was an ordinary mortal without any extraordinary ability to understand or manipulate me. To some extent, he was a fellow traveler on my path to wellness, who was just hopefully a bit more clear sighted and aware of where the destination might be.

Are you sure her actions are so premeditated? As opposed to an attempt to communicate with you? I must admit that I don't think my therapist ever tries to make me feel good. And while he does have certain tones of voice and postures he uses when he's trying to bring an emotional charge to the space between us, I always got the feeling it was as much to put himself on task as it was to make me respond in any given way.

 

Re: can you tell when your therapist tetrix

Posted by violette on September 9, 2010, at 11:21:39

In reply to Re: can you tell when your therapist, posted by tetrix on September 9, 2010, at 8:58:03

> yes.. I suspect that last time my T deliberately made a mistake in order to show me that it is OK to make mistakes.. but it was so trivial that it left me feeling uncomfortable, as if I am a child..

Oh I see..that would seriously annoy me! My T doesn't do things like that..he is too genuine...Well i'd like to think my T manipulates words and their expression rather than 'me'...carefully and subtly (to provoke, challenge, whatever). And when you read psychoanlytic case studies, that seems to be how it's done...but I can't see that i've ever veiwed it as fake or untruthful...like the example you've given.

> perhaps the word technique isnt the best choice but I don't know what to use instead..

Could always refer to it as the mechanics of therapy...or Ts 'position'...i mean the therapy is a range from supportive to expressive...words are used as tools-otherwise, there would be no therapy taking place-it would be just two people talking.

> well we are affected by what T's say or do because we trust that they "know and understand" what is going on with us and of course because they know a lot of intimate details that we wouldnt share with just anyone. There is also an element of respect of their opinion as opposed to a friend who doesnt have training in the field and is biased and subjective.

I can relate though for me, it's mostly child-parent transference feelings...so every verbal and non-verbal communication is more intense..and has an effect on me-much like how a child would feel around his parent.

> I was curious if people are attuned to their therapist's manipulations... I think that I always see what mine is trying to do..

Hmm. I can only think of one time where i thought T manipulated me...he said something that i could not rationalize; i kept thinking of all the why's he said it..then later, felt anger...then thought maybe he said something to outsmart me, to get me to quit rationalizing..it worked...i liked the affect, so i no longer cared 'why' he said it...and i now that i think of it-i rarely try to rationalize why he says things anymore; instead, i feel the emotional affect. That he did this makes me feel he cares for me to come up with a creative way to address this maladaptive trait. i still don't know for sure if that's why he said it, as it became irrelvent and turned out to be very therapeutic.

Sometimes when i feel provoked in some way by T, i evaluate myself first to see if i'm using projection... sometimes it's difficult to tell.

Are you going to ask her if she deliberately made a mistake? I would definitely address that..and am curious as to what she would say.

 

Re: can you tell when your therapist

Posted by emmanuel98 on September 9, 2010, at 20:08:08

In reply to Re: can you tell when your therapist tetrix, posted by violette on September 9, 2010, at 11:21:39

I have never felt that my T manipulated me or tried to manipulate the therapy session. He is very directive at times, asking me questions to move the discussion to something other that what I had planned on. But I have learned not to plan on much with him, because he's so directive and straightforward with me, that I find myself being more honest and straightforward than I might have planned on being. I also have had intense and painful parent-child transference issues with him and I have talked about them constantly because they trouble me and they sometimes trouble him (because of the intensity of my feelings and reactions to him). But I never feel he deliberately lowers or raises his voice to achieve and effect. His technique is vitually invisible.

 

Re: can you tell when your therapist

Posted by pegasus on September 10, 2010, at 9:07:23

In reply to can you tell when your therapist, posted by tetrix on September 8, 2010, at 20:02:59

I had a T once who used some techniques in a really transparent and fun way. One thing he would do is, if I claimed to not know what to talk about, and wanted him to pick something, he'd start talking about Thomas Jefferson. So, it became a kind of joke, but also he was making a point.

He also did this thing that I totally hated. He'd ask me what I thought about something, and then I'd honestly answer. When I was done, he'd give me *his* thoughts, which were clearly already fully formed independent of what I had to say. I'd always realize that he hadn't really wanted to hear what *I* thought, it was just a way to move the conversation to what *he* thought. I always felt duped, and really annoyed, by that.

Sometimes he'd repeat something he'd said before, too. Then I'd realize that it was something he probably said to a lot of people. A sort of canned response. Usually about something that must come up a lot in his work, such as running into him outside the office, or whether we could hug, or that type of thing. I hated that, too.

I'm sure most Ts use things they've learned, during our sessions. I don't know when it becomes "technique" versus just skillful therapy. I guess when it seems canned? Not genuine? For example, I've had Ts use obvious "therapy techniques" such as sitting forward, changing tone of voice, asking particular questions, etc. and it felt totally natural and good.

Peg

 

psychodynamic therapy techniques

Posted by violette on September 10, 2010, at 11:56:18

In reply to can you tell when your therapist, posted by tetrix on September 8, 2010, at 20:02:59

Tetrix, you got me interested in this...and wondering since my T recently changed his approach....From how i understand it, the range of psychodynamic therapy goes:

supportive > neutral/expressive

Supportive
1. more interactive with *real-life* relationship with T
2. more T self-disclosure
3. limiting confrontation/interpretations
4. can be used when establishing alliance/trust
5. supporting adaptive defenses rather than challenging maladaptive defenses
6. can be used when patient has less ego strength, to build ego strength
7. overall less focus on insight

Supportive Techniques =
- praise/encouragement
- reassurance
- advice/instruction/guidance/persuasion
- directive
- clarification
- less unconscious material
- inexact interpretations**

Neutral:

- clarification + interpretation

Expressive:

1. interactive with *transference* relationship with T
2. less T self-disclosure
3. more focus on insight
4. trust/alliance has been established
5. challenging maladaptive defenses
6. used when patient has more ego strength
7. avoid supportive techniques (frustrates wishes)
8. increase transference > more exploring unconscious

Expressive Techniques =
-confrontation
-exploratory/interpretation
-challenging

Tetrix, wondering if this is more your Ts style-maybe she is not attuned to yur needs or she's not clarifying enough to be attuned:

**inexact interpretations

Might include (?):

- Working with the client's perceptions of reality rather than arguing
- Asking questions
- Sidestepping rather than confronting defenses
- Demonstrating the denial defense while interacting with the client to show her how it works

http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hssamhsatip&part=A59852

most of this stuff is in books, so i didn't have a good link; but here's one (i didn't read it but it looks like a good explanation after scanning through):

http://levylab.psych.psu.edu/PDFs/Chapters/Levy%20-%20Psychodynamic%20and%20Psychoanalytic%20Psychotherapy%20(2009).pdf

 

Re: can you tell when your therapist

Posted by tetrix on September 11, 2010, at 9:45:56

In reply to can you tell when your therapist, posted by tetrix on September 8, 2010, at 20:02:59

thank you all for sharing, it was very interesting to hear what you had to say and compare my experiences to yours.

Yes..my T's actions are premeditated and her intentions are so obvious to me that sometimes I feel awkward.. she can't be subtle. Her voice raises very artificially and some of her phrases are so cliche, her intentions are transparent and I never confronted her about it. If I will, I will let you know what she says, but I can say with certainty that it will be a denial.

violette thanks so much for the link I am very curious about the subject as well. I am not really sure what my T is usuing as approach as she is very inconsistent, maybe I am dealing with an unexperienced person, maybe I am a difficult client so she tries different approaches.. I don't know enough about the subject to draw quick conclusions.. it is quite a process, that's for sure.

 

Re: can you tell when your therapist

Posted by violette on September 12, 2010, at 10:47:36

In reply to Re: can you tell when your therapist, posted by tetrix on September 11, 2010, at 9:45:56

Hey Tetrix,

Glad to hear comparing notes helped you out.

One thing i don't think i mentioned, and with which i've both experienced and read about - denial is one thing that seems to be addressed a bit differently....while a T can bring a patient's defenses to awareness in conjunction with interpretations, that doesn't always work with denial, where the T might have to come up with diffferent ways to provoke in dismantling this defense...same with other maladaptive behaviors or defenses that may go unchanged despite a therapist addressing them, perhaps repeatedly...

I should probably mention my T has over 3 decades of experience, so that may be one reason why he doesn't seem 'artificial' - he likely developed techniques natural to his personality over the years..and of course, individualized to the patient. He is very sure of himself.

During our initial session where we met for the first time, i knew he was the right therapist for me; his genuineness/lack of fakeness was a huge influence as i have relevant mother issues related to childhood trauma. I could not deal with the issues you mention here-such as canned responses...I understand having those feelings..

You didn't mention how long you were seeing this therapist, maybe she just doesn't yet know you well or is a bit misattuned for other reasons. But i bet the 2 of you will figure it out after discussions..

Whatever it is, i hope talking about this with your therapist leads to positive changes, a stronger alliance, and overall progress with your therapy.

Take care


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