Psycho-Babble Psychology Thread 1050295

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

Ideal Fit

Posted by Dinah on September 7, 2013, at 10:46:08

I talked about this, briefly, with my therapist. We tossed around some ideals, but in the end we agreed. There is no ideal client and no ideal therapist.

A therapist can be as technically skilled as possible in his own chosen approach, and be helpful to a large number of patients, and be not at all helpful to other patients.

Jeffrey Kottler, who writes great books on therapy, obviously would be a great therapist for many. But he likely wouldn't suit me. He moves around a great deal, and I think I remember that he has expectations of change faster than I would like. My rate of change is glacially slow, and any attempt to speed me up would more or less cause the opposite.

T3 was likely more technically skilled than my therapist. But I don't know that she managed any particular change in me, outside a shift in attitude towards my own therapist with that curse she placed on me. In the long run, her more "direct" style, however expertly it was delivered, wasn't right for me.

What makes for a great fit in therapy? Is it tangible or intangible? How much is it therapeutic technique and how much is it chemistry?

I often suspect that my therapist is partly a perfect fit for me because of who he is. A largish man who manages to combine a flexible exterior with a rigid backbone. And partly he's a perfect fit because he makes an effort to become a perfect fit. He's willing to work on the relationship to a far greater extent than most therapists would, and in turn the working on the relationship becomes part of the therapy that benefits me outside therapy.

 

Re: Ideal Fit

Posted by Poet on September 7, 2013, at 11:34:06

In reply to Ideal Fit, posted by Dinah on September 7, 2013, at 10:46:08

> I talked about this, briefly, with my therapist. We tossed around some ideals, but in the end we agreed. There is no ideal client and no ideal therapist.
>

I agree, I don't think any therapist or patient can be perfect. We're human and try as I might to be perfect it can't be done.

My therapist is a good fit because we have the same sense of humor and that we both like talking about movies from a psychological view point.

Poet

 

Re: Ideal Fit » Poet

Posted by Dinah on September 7, 2013, at 12:23:42

In reply to Re: Ideal Fit, posted by Poet on September 7, 2013, at 11:34:06

If sense of humor is important to you, it would definitely be important to "fit". How can you say you aren't ideal for her? :)

I know my therapist suppresses some parts of his personality with me. I wonder if humor is one of the parts? He doesn't much use it in session.

I have a great liking for his stories that have strong Buddhist overtones. They make a point without hammering me with it. I think he's run out of them, though...

 

Re: Ideal Fit » Dinah

Posted by Poet on September 7, 2013, at 14:32:50

In reply to Re: Ideal Fit » Poet, posted by Dinah on September 7, 2013, at 12:23:42

Hi Dinah,

I think I'd be a better fit if I didn't argue with her so much, but then again I think she likes that I'm standing up for myself.

My husband is Buddhist, I don't think your T will run out of stories.

Poet

 

Re: Ideal Fit

Posted by alexandra_k on September 7, 2013, at 17:54:56

In reply to Ideal Fit, posted by Dinah on September 7, 2013, at 10:46:08

> I talked about this, briefly, with my therapist. We tossed around some ideals, but in the end we agreed. There is no ideal client and no ideal therapist.

Like how... 'There is someone for everyone' doesn't imply that the very same someone is for everyone?

I was never very good at those...

I think that getting someone to think about what would be ideal or perfect for them... Says more about what it is that they think they need (or what it is that they think most people need) than anything else.

That is why I asked :-)

This idea of 'fit' or 'match' is puzzling to me... As is the idea of 'chemistry'...

 

Re: Ideal Fit » alexandra_k

Posted by Dinah on September 7, 2013, at 22:03:36

In reply to Re: Ideal Fit, posted by alexandra_k on September 7, 2013, at 17:54:56

Well, I suppose it could mean a lot of different things. Shared sense of humor was mentioned. I suppose a shared vocabulary would help, since someone is more likely to be influenced if they really get what someone is saying. Style would be another. A lot of people find "direct" helpful. I tend to find it rude and am *very* unlikely to change in response to it. Dr. Phil would see my back before the end of the first session.

Chemistry is more ephemeral. I suspect I felt safer with my therapist because he is large and has a deep voice. That probably evoked feelings of safety from my childhood. People who had negative experiences with a large person may well have had the opposite reaction. I am comfortable with his... oh, for want of a better word, "aura". It's relaxing, and not terribly high energy. I think I wouldn't like a high energy person as a therapist.

But I suppose when I think "ideal" therapist, I tend to think more of skills and reactions. Not what's ideal for me, precisely.

 

Re: Ideal Fit » Poet

Posted by Dinah on September 7, 2013, at 22:06:25

In reply to Re: Ideal Fit » Dinah, posted by Poet on September 7, 2013, at 14:32:50

If she really disliked your arguing with you, you'd probably know it. I think you're probably right.

I ought to give him a book to expand his repertoire. Or have him talk to your husband. :)

 

Re: Ideal Fit

Posted by alexandra_k on September 11, 2013, at 2:08:09

In reply to Re: Ideal Fit, posted by alexandra_k on September 7, 2013, at 17:54:56

I don't have much time for Dr Phil, either. I suspect it is because his priority is to make sensationalist TV rather than to actually do what is in the best interests of his 'clients'.

I think I do get some of the 'chemistry' thing. Something about presence. Timing. Stuff like that. Reactivity. Etc.

 

Re: Ideal Fit

Posted by pegasus on September 19, 2013, at 12:56:44

In reply to Ideal Fit, posted by Dinah on September 7, 2013, at 10:46:08

I have had Ts that I felt a lot of chemistry with, and Ts that I didn't. I'm not actually convinced that it's necessary, or even always desirable. With my latest T I did not feel all that much of a "click", but I think that made him feel safer. I started with him some time after losing a T with whom I felt a lot more chemistry and attachment. I think the logic was something like: If I lose this one, it won't be as bad, because there's not as much friendship within our therapy relationship.

Although, it's still a big loss, as it turns out. But, not as big, for sure.

I've also noticed that no matter what T I'm working with, I find important things wrong with the fit. I've never been in therapy and not wondered whether I should really find another T that would be better in some way. I suspect that there is no ideal for me. Maybe one of the things I need to work out in therapy is related to never feeling sufficiently attuned.

- peg

 

Re: Ideal Fit » pegasus

Posted by alexandra_k on September 20, 2013, at 23:57:53

In reply to Re: Ideal Fit, posted by pegasus on September 19, 2013, at 12:56:44

I have always found important things wrong with the fit, too. Even with the therapists who (in hindsight) really helped me a great deal. I remember that when I was working with them I had reservations about them. Thought that there would be therapists out there who would be better for me / better suited to working with me.

Even my last therapist. Who I probably idealize now since he's gone... I remember packing a right wobbly that he wasn't there for me when I got back from the US - even though he said he would be before I left and I let him know at least 1 month in advance of my return date (as soon as I'd booked the flights). Then I got back and... He said he didn't even know that I wanted to see him! And I was like 'why did you think I told you when I'd booked my flights for!' And I just couldn't believe...

And I never trusted him again. Not that I trusted him particularly before that... Sniff... Whatever.

What you say about things feeling safer because of the lack of chemistry... I think I understand that. Yeah.

> Maybe one of the things I need to work out in therapy is related to never feeling sufficiently attuned.

Maybe.

How would you know you were sufficiently attuned. / What do you think a therapist would have to do / be like to have you feel sufficiently attuned?


 

Re: Ideal Fit

Posted by pegasus on September 23, 2013, at 13:54:10

In reply to Re: Ideal Fit » pegasus, posted by alexandra_k on September 20, 2013, at 23:57:53

I imagine that a T would have to be really warm, and forthcoming with really specific, connecting statements about how much they like me and care about me, etc. Coupled with a feeling that they really get what I'm saying, appreciate my sense of humor, etc. But . . . I had that with one of my Ts, and it actually didn't help. So, I can't imagine anything else that would.

In fact, when I looked for the next T, I think I unconsciously chose someone that didn't feel all that warm. Because after warm-T abandoned me, it was devastating. So warmth no longer felt safe.

peg

 

Re: Ideal Fit » pegasus

Posted by Partlycloudy on September 23, 2013, at 17:43:54

In reply to Re: Ideal Fit, posted by pegasus on September 23, 2013, at 13:54:10

> I imagine that a T would have to be really warm, and forthcoming with really specific, connecting statements about how much they like me and care about me, etc. Coupled with a feeling that they really get what I'm saying, appreciate my sense of humor, etc. But . . . I had that with one of my Ts, and it actually didn't help. So, I can't imagine anything else that would.
>
> In fact, when I looked for the next T, I think I unconsciously chose someone that didn't feel all that warm. Because after warm-T abandoned me, it was devastating. So warmth no longer felt safe.
>
> peg

(((Pegasus))) It's one of the few places I feel safe. But I must be careful, because I have to carry that feeling beyond the session and internalize it. I am not there, not when I am in crisis.

 

Re: Ideal Fit » pegasus

Posted by Dinah on September 23, 2013, at 19:01:14

In reply to Re: Ideal Fit, posted by pegasus on September 19, 2013, at 12:56:44

I'm not sure I meant *that* much chemistry. That much chemistry is not something I have or want with my therapist. Personally we don't click at all. Even professionally, I sometimes wonder if he can possibly understand me, because in fundamental ways we are very different.

I think what I meant was more....

I couldn't mesh well with a gung-ho very positive therapist. It would make me react in a knee-jerk negative way. I wouldn't deal well with even the most skilled "direct" therapist. I'd consider it rude. I couldn't even deal well with a very supportive or empathetic therapist. It would make me want to draw back.

I always say that I like my therapist because he stays in his chair, by which I mean his energy doesn't pop out at one. He can be receptive, but he's never squishy. The way he speaks and the energy he exudes, he does in a way that I can accept and appreciate. I'd say that as much as anything else, it's a question of energy and how it's expressed, with me. How comfortable I feel with someone has a whole lot to do with that, though I'm not particularly able to explain it well.

For me, that's very important. I don't know how important it would be for others.

 

Re: Ideal Fit

Posted by baseball55 on September 23, 2013, at 19:54:57

In reply to Re: Ideal Fit » pegasus, posted by Dinah on September 23, 2013, at 19:01:14

Thinking back on it all, I would say that the most important thing in a therapist-client relationship is trust and that that is the basis of a good fit. You have to trust that s/he will listen carefully and want to be empathic and helpful rather than judgmental and dismissive. You have to trust that you can be honest (or as honest as you are capable of understanding yourself at the time) and they will listen empathically and without negative judgment. Or for that matter, without excessive sympathy or advice or trying to fix everything and make you feel good.

Studies show over and over again that the most important benefit of therapy is the relationship between the therapist and client. It barely matters what kind of therapy they do -- dynamic, CBT, DBT, Whatever. If there's a poor relationship, the therapy won't work. But nobody can say what a good relationship consists of because everyone is different and responds differently in such an intimate setting.

I have been lucky in finding two therapists (dynamic and DBT) for whom I have high regard and whom I trust completely. I don't know if it's me or them or the combination that has made the fit good.

When I first tried to get help, I went to a social worker whom I hated. I had no confidence whatsoever in her. I stopped after a few weeks.

 

Re: Ideal Fit

Posted by pegasus on October 1, 2013, at 10:02:16

In reply to Re: Ideal Fit, posted by baseball55 on September 23, 2013, at 19:54:57

Yeah, I think trust is an essential ingredient. Although it's not the kind of thing you can find when you're shopping around for a therapist. At least not me. I don't trust anyone until I've worked with them for a long time. I've had a number of Ts that I eventually came to trust, though. In various ways, but never completely. I trust my most recent T to try to be empathetic etc., and to be very professional. I don't trust him to actually care about me much. He has too many other clients, and I can't imagine how a person could have enough energy to actively care about 40 or so people, in addition to family etc.

I trusted my old, warm T to care about me, and also to be professional, and to know how to help me. And I trusted him to continue to be there for me, which turned out to be a mistake.

- peg


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