Psycho-Babble Psychology Thread 420851

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Re: Babble Guide to Therapists: Do's and Don'ts

Posted by simcha on December 5, 2004, at 15:38:22

In reply to Re: Babble Guide to Therapists: Do's and Don'ts, posted by Susan47 on December 5, 2004, at 13:17:24

> And here I am, *wishing* that my therapist would've had sex with me, lol!

That is a very normal reaction in therapy. Perhaps he's the first man who has takent the time to really get to know you. Perhaps it's the first time you have felt safe enough to open yourself up completely to a man.

This is all part of the healing process. The hope is that you can find this out in the world as a result of the treatment with another man.

Also, it would not be a good idea for a therapist to share everything about a treatment plan or style. There is such a thing as transference...what the client feels or thinks and projects onto the therapist. This is very important and necessary for the therapeutic process. It would ruin the entire therapy to explain all of the transferences and counter transferences...

Therapy is the place to be bowled over like you've never been bowled over before. That way when it happens in the outter world (outside the office) the client has the ability to deal with the feelings in a more adaptive manner....

Simcha

 

Re: Babble Guide to Therapists: Do's and Don'ts simcha

Posted by cubic_me on December 5, 2004, at 16:44:19

In reply to Re: Babble Guide to Therapists: Do's and Don'ts, posted by simcha on December 5, 2004, at 15:38:22


>
> This is all part of the healing process. The hope is that you can find this out in the world as a result of the treatment with another man.
>
> s. It would ruin the entire therapy to explain all of the transferences and counter transferences...
>
> Therapy is the place to be bowled over like you've never been bowled over before.
>
>

Sometimes I want to know the whole story, then I can feel like I am part of my own treatment. Just because I know that a feeling is transference doesn't make it any less real. Also sometimes some of us don't want to be bowled over by transference, however much it may help. When I was deep in transference I wished I could just forget about it and get on with all the things I needed to do - but I couldn't, and my T wasn't there every second of the day to help me through it. So I guess I was dealing with transference 'in the real world', i didn't have any coping strategies and I felt completely alone...until I came here and found out what was happening when I was in the T's office.

 

Re: simcha

Posted by messadivoce on December 5, 2004, at 17:15:26

In reply to Re: Babble Guide to Therapists: Do's and Don'ts, posted by simcha on December 5, 2004, at 15:38:22

>>> Also, it would not be a good idea for a therapist to share everything about a treatment plan or style. There is such a thing as transference...what the client feels or thinks and projects onto the therapist. This is very important and necessary for the therapeutic process. It would ruin the entire therapy to explain all of the transferences and counter transferences...>>>

Hmm, I think knowing that such a thing was normal would have helped a lot. My T did not provide info fast enough for me, so I went out and did my own research, which took a long time and required me to wade through a lot of nonesense. I was relieved to discover that there was a name for what I was experiencing, and that it was pretty normal. If only he had told me what was happening and that it was normal (instead of my coming to that conclusion myself) I could have saved myself a lot of time, worry and pain. My point is, if your client has insatiable curiosity, we will try to find out what's going on, and the info we get might not be what you'd want us to hear (it may be erronious or unprofessional) so it's better if you tell us yourself what's going on (and you don't have to tell us everything, but a little enlightenment helps).

>>> Therapy is the place to be bowled over like you've never been bowled over before. That way when it happens in the outer world (outside the office) the client has the ability to deal with the feelings in a more adaptive manner....>>>

I sort of agree with this, but I think that only someone who has experienced the pain of transference and longing is truly qualified to make such a statement. Maybe you have experienced such a thing and it was beneficial to your treatment. To that effect, I was totally unprepared to deal with my immense feelings for him, and as cubic said, I had to deal with it myself most of the time...I look back on that period of my life and realize how much agony I was in because my T seemed to call forth such strong emotions that I then had to deal with myself until I saw him again. Yes, therapy is supposed to shake up your world, but after a certain point I think it can do more harm than good.

My termination was somewhat problematic due to his inconsistancy with post-termination communication. I wonder if the promises he made to me had more to do with counter-transference than inexperience. I'll never know, because though he shared that he experienced countertransference, he never went into detail (this was at the end of my treatment). So I'm left to put the pieces together myself, and there's a lot missing.

That having been said, in defense of my T, he handled my feelings skillfully even if he didn't always clue me in. And yes, I did learn that there was at least one trustworthy man in the world, and my experience with him has colored my feelings about other people, for the better. I owe him a lot of my happiness. I feel a great deal of love and affection for him that I know goes around and through transference.

 

Re: simcha

Posted by Susan47 on December 5, 2004, at 22:06:26

In reply to Re: simcha, posted by messadivoce on December 5, 2004, at 17:15:26

I agree with the last poster that it would've helped me to know what was going on in therapy. As people, we are *not* all the same and there are many many ways of thinking and approaching things, also many ways of interpreting and living through feeling.
I disagree with the theory, used in therapy as discussed above, that it's in the patient's best interest to hide disclosure of psychodynamic dynamics (Heeheehee, Susan you're a nut....

 

Re: simcha

Posted by simcha on December 5, 2004, at 23:46:41

In reply to Re: simcha, posted by Susan47 on December 5, 2004, at 22:06:26

Yes,

And consider this... When you go in for surgery (and the analogy is apt for therapy for those of us who have walked the path) the surgeon explains what they are going to do and what you might expect. Yet, in the end, each person is different and the effects in recovery vary greatly. They can't predict it. Neither can therapists.

Some things must be held by the therapist until the client's ego structure has grown enough to be able to handle what is actually happening.

Like denial: It is not my job to pop someone's denial. It is my job to explore all of the detrimental debris of the tornado that is really in the room that the client can't see. It is a lack of respect for the client for me to point at the tornado and tell them that that is the monster that they MUST deal with to get better. It's much better and it honors the client's own ability to heal to hold certain things.

Those of you who have gone on-line and investigated are brilliant. That is precisely what the therapist is looking for. You find your way to wellness. We are guides. Guides on quests do not reveal the goal and the place where the querant is going. That would be arrogant. The guide may be wrong in their own judgments.

I honor my clients' abilities to heal themselves and walk their paths with them. I might point out a stone or a tree or a bramble along the way, but it is not my job to blow away coping techniques that have allowed many clients to cope most of their lives just fine without me.

The coping mechanisms have become maladaptive. It is up to the client to see that and to develop the new more adaptive mechanisms with the therapist's guidance.

We walk on a knife's edge in the room with clients. And yes, we make mistakes. I do in every session. And I point them out to the client. That way they can see that I am human too and I'm not some guru with all the answers coming from an infallible theory.

I never know the way therapy will turn out. If I did know, I would be arrogant and a terrible therapist.

Just my 2 cents....

I hope I have not offended anyone.

I've been in the client chair for ten years. Now that I'm on the other side and I've had almost three years of grad-school I can see why my therapists did not point out certain things to me at certain times. There were times I was not ready to let go of a coping mechanism. I was surviving using that maladaptive coping mechanism. If the therapist were to make me aware of it and take it away from me too soon without helping me find a new coping mechanism I don't know that I'd be writing these sentences....

So, I hope that I have not come across as some "know it all." After all, I've been at this only three-ish years. It takes at least a decade to become more sophisticated. And the good therapists I know tell me that they still have doubts about their abilities.

Simcha

 

Re: simcha

Posted by messadivoce on December 6, 2004, at 0:16:37

In reply to Re: simcha, posted by simcha on December 5, 2004, at 23:46:41

Hi Simcha,

I liked your reply. However, I'm not sure all T's like it when clients research on the internet. I know that I did a bunch of internet research and when I told my T, he rolled his eyes (because he was afraid of all the wacky info I might find). I found his response kind of annoying b/c I felt like he had put me in the position of ignorance and I had to fend for myself.

I know that I had a bunch of maladaptive coping mechanisms, and when my T pointed some of them out, it was really rough. But I was glad he did so...it helped jolt me out of the mediocrity I was in. But that's just me, I know that a lot of people handle things differently.

Honestly, I've always been a huge advocate for consumer's rights, so that's kind of where I'm coming from. I guess I figure if I'm thoughtful enough to want true, deep answers about my treatment, I should get them. But again, I admit that may not be right for everyone in their treatment situations.

It's interesting to hear someone's point of view who is a T. And I liked what you said about the discipline being in adolesence. I had never thought of that.

 

do's and don'ts

Posted by dawnfawn on December 6, 2004, at 6:36:30

In reply to Re: simcha, posted by messadivoce on December 6, 2004, at 0:16:37

I have been following this thread and I would like to say just a few words: Let's look at mental illness the way all the Ts currently say we should. It is an illness not something to be ashamed of but something to work out with medicine or talk therapy. Ok, everyone, got it. It is not like in the dark early days a secret only attended to by shaman like people who hold the solution to secrets in their own brains and methods. Well now if that is true---why should any of us as clients, patients, etc. have to undergo arcane approaches that further generate fear and misunderstanding? Put another way would you consistently wait and wait for a dentist (or any other type of doctor)? Would you wait while the doctor went over notes for ten or fifteen minutes to see what he/she was doing. Would you undergo a procedure that you were told nothing about to clean your teeth? Better yet would you not even know that you were having your teeth cleaned? Would you take medication without knowing its true effects or if it even worked? There are further analogies here but we all get the picture. The day of the mystical all-knowing father figure (Freud, Jung, etc)are long gone. Some of the stranger elements in therapy really need revision and patient input. Unless the patient has no grip on reality (psychotic) then input into treatment and methodology should really be taking place.

 

Re: simcha messadivoce

Posted by littleone on December 6, 2004, at 14:13:16

In reply to Re: simcha, posted by messadivoce on December 6, 2004, at 0:16:37

> I know that I had a bunch of maladaptive coping mechanisms, and when my T pointed some of them out, it was really rough. But I was glad he did so...it helped jolt me out of the mediocrity I was in.

This may be true, but I think part of what you're missing in simcha's message is that timing is everything. It's possible that your T identified these maladaptive coping mechanisms very early on in the piece. But it is unlikely that he pointed them out to you in the first session. I bet he waited until you got to a stage where you were ready to be jolted. You may not have been consciously aware of this readiness, but he would pick it up from things you said/did.

If this is the case, then this is like one of the stones or trees that simcha's pointing out along the away.

Thanks for your message simcha. You articulate yourself so well.

 

Re: simcha

Posted by Susan47 on December 6, 2004, at 17:41:40

In reply to Re: simcha, posted by simcha on December 5, 2004, at 23:46:41

I got as far as a therapist holding, and can't read any longer. Shite. Okay, I hurt and have to say that, don't care if I'm vilified.

 

Re: simcha

Posted by Dinah on December 6, 2004, at 19:28:05

In reply to Re: simcha, posted by simcha on December 5, 2004, at 23:46:41

I think a wise therapist should probably judge disclosure on a case by case basis. My therapist could have probably saved us both a bit of grief by demystifying things a bit. He didn't respond to my tentative questions, and I was too embarassed to go further until I did tons of research. Now mind you, I probably would have done the research anyway because I don't like the idea of someone mucking about in my brain without my knowing how. :) But I picked up a lot in my internet research that still causes me shame. If my therapist had been a bit more open, perhaps some of that stuff wouldn't have found such a foothold.

I think he regrets that now. He's way more open now than he was, and he still gets irritated when I quote the anti-whatever sites.

 

Re: But of course

Posted by Dinah on December 6, 2004, at 19:30:34

In reply to Re: simcha, posted by Dinah on December 6, 2004, at 19:28:05

I kept my research my biggest darkest secret of all. It was somehow way more embarassing to admit than anything in my personal life or history.

 

Oooh, that leads to a DO

Posted by Dinah on December 6, 2004, at 19:32:34

In reply to Re: But of course, posted by Dinah on December 6, 2004, at 19:30:34

It might be a good idea for a therapist to put out feelers every once in a while to gently inquire about outside research. I'm sure I'm not the only one embarassed that my psych libary is probably bigger than my therapist's or that I subscribe to professional magazines. (He STILL doesn't know that!)

 

Dinah, I agree with everything you said 100% (nm)

Posted by messadivoce on December 6, 2004, at 20:33:56

In reply to Oooh, that leads to a DO, posted by Dinah on December 6, 2004, at 19:32:34

 

Re: simcha messadivoce

Posted by simcha on December 6, 2004, at 23:32:33

In reply to Re: simcha, posted by messadivoce on December 6, 2004, at 0:16:37

Thanks for your thoughtful reply.

I actually love an educated client. When a client is searching out answers I know that they are getting better.

I think that some therapists are insecure about their expertise and think that therapy should be some sort of secret. I don't like that. Then again I come from a Holistic perspective. I'm kind of a radical in my field.

Also, seeing how some clients look up information and apply it to their own situations is very diagnostic. Hypochondriacs are easier to spot this way. Sometimes a client may diagnose themselves improperly. I tend to err on the side of client education. When I was starting therapy ten years ago I read everything I could about what I was experiencing. This helped me and my therapy.

I've had many a psychiatrist roll their eyes when I give them information about medication that they would rather that I don't know about.

Also, there are some pretty crappy sites out there about psychiatry and psychology. Generally these are infiltrated by scientologists who hate psychiatry and psychology. They call it quackery.

So, this site is actually very excellent as a source for reliable information. WebMD is another good source. NIMH has a great site too. Be careful out there. Not all that is written anywhere is true.

Also, I'm humble enough to know that I can be wrong too. So, I do make mistakes with clients and I acknowledge them. There are limits to what we know about psychology and I acknowledge this with clients. Sometimes when I don't know the therapy is about sitting in the "I don't know."

Simcha

 

Re: simcha Susan47

Posted by simcha on December 6, 2004, at 23:39:48

In reply to Re: simcha, posted by Susan47 on December 6, 2004, at 17:41:40

Susan,

I'm so sorry you are hurting. I hope that I'm not offending you. I'm just trying to tell you my experience.

I'm more than willing to be wrong. I'm a trainee. I hope I never lose the willingness to be wrong. A little humility is a great therapeutic tool and a sign of a good human being, in my humble opinion.

So, please hang in there.

Also there are a lot of very bad therapists out there unfortunately. They make it more difficult for the profession to really advance. Unacknowledged mistakes fester and give us no chance to really make the profession better.

I'm sorry if I'm no comfort to you here.

Blessings,
Simcha

 

Re: Oooh, that leads to a DO Dinah

Posted by simcha on December 6, 2004, at 23:46:55

In reply to Oooh, that leads to a DO, posted by Dinah on December 6, 2004, at 19:32:34

Dinah,

All I say is go! Read, watch, and learn. Many of us who are becoming therapists started in the client's chair. I truly believe that those of us who have walked through fire and know what it is like and have made progress make the best therapists.

Who knows? Maybe you might be starting an MA degree in the near future. I say, go for it! We need educated consumers in this field. Heck, doctors try to educate people about their physical syndroms. It only makes sense that we therapists should expect that our clients educate themselves.

I know that some therapists find an educated client a threat. That shows me that the therapist has some work to do on him or herself, in my humble opinion.

I go to therapy every week. I take my meds. I will never stop going to therapy so long as I see clients. My clients are like mirrors sometimes showing me parts of my psyche that I did not know needed work. I think that a therapist who is not willing to do self work is not a very good therapist. There would be too much projective identification in the room if I did not sort things out with my therapists and collaborate with other professionals.

Blessings,
Simcha

 

I've just experienced a do simcha

Posted by Dinah on December 8, 2004, at 11:52:38

In reply to Re: Oooh, that leads to a DO Dinah, posted by simcha on December 6, 2004, at 23:46:55

My son's new play therapist has a great opening handout that, among other things, discusses the therapeutic relationship.

It explains that therapy feels like an intimate personal relationship but that it is a professional one confined to the hours that she is paid to be there. That contact should be confined to that time and that clients shouldn't try to contact her in extratherapeutic ways through inviting her to personal events or giving her gifts or a few other examples.

It was clear, yet nicely worded, and given at the beginning of the therapeutic relationship when no attachment had been formed.

I liked that.

Of course, on the other hand, my therapist may have given me something similar nearly ten years ago and I blew it off. :))

 

Whoops. That was a general response. (nm)

Posted by Dinah on December 8, 2004, at 11:53:05

In reply to I've just experienced a do simcha, posted by Dinah on December 8, 2004, at 11:52:38

 

Re: I've just experienced a do

Posted by Daisym on December 8, 2004, at 12:29:50

In reply to I've just experienced a do simcha, posted by Dinah on December 8, 2004, at 11:52:38

hmmm...I just sort of shivered reading those words.

I like the way she was straight up about gifts, ect. but I think the "confined to the hours I work" would give me pause. It would reinforce my "don't bother anyone" sensibilities. And I'm pretty sure that if I read something like that at the beginnning I would have simply thought, "well sure, of course." But having been "bowled over" (someone else's phrase) by therapy feelings in a way I never expected, that piece of paper would stand in conflict with what I was being told (call me).

*sigh* I guess I want my cake and to eat it too.

 

Re: I've just experienced a do Daisym

Posted by simcha on December 8, 2004, at 17:26:48

In reply to Re: I've just experienced a do, posted by Daisym on December 8, 2004, at 12:29:50

Here is my policy:

I let my clients know that I check my phone messages 4-6 times per day. I can get back to them within a couple of hours usually. Or if it's late at night, the next morning.

I will talk to them for 5 minutes if it is not an emergency. If it's an emergency we talk for 10 minutes. If the emergency cannot be resolved in 10 minutes over the phone we schedule an extra appointment hopefully within 24 hours...

I have been taught to remain available to my clients and to keep boundaries professional. It's kind of like being a willow bending in the wind as opposed to an oak that will snap in a nasty gail.

Simcha

 

Re: I've just experienced a do simcha

Posted by pinkeye on December 8, 2004, at 17:50:34

In reply to Re: I've just experienced a do Daisym, posted by simcha on December 8, 2004, at 17:26:48

Simcha,
this is a general question. What do you feel about clients who need you too much or become emotionally dependant on you and want to contact you a lot ? Do you feel they are a nuisance? Also do you respect them or think they are a nuisance? Do you like your clients?
Pinkeye
> Here is my policy:
>
> I let my clients know that I check my phone messages 4-6 times per day. I can get back to them within a couple of hours usually. Or if it's late at night, the next morning.
>
> I will talk to them for 5 minutes if it is not an emergency. If it's an emergency we talk for 10 minutes. If the emergency cannot be resolved in 10 minutes over the phone we schedule an extra appointment hopefully within 24 hours...
>
> I have been taught to remain available to my clients and to keep boundaries professional. It's kind of like being a willow bending in the wind as opposed to an oak that will snap in a nasty gail.
>
> Simcha

 

Re: I've just experienced a do Daisym

Posted by Dinah on December 8, 2004, at 19:21:09

In reply to Re: I've just experienced a do, posted by Daisym on December 8, 2004, at 12:29:50

Hmmm. I think I worded that wrong. There was a separate session about phone contact. She does make herself available, but says that if it's an emergency she can't promise to always be available and to go to an ER.

This was in a separate sessions, and she means nonprofessional contact. Inviting her to parties or weddings, going out to coffee, stuff like that I think.

 

Re: I've just experienced a do

Posted by simcha on December 8, 2004, at 23:31:46

In reply to Re: I've just experienced a do simcha, posted by pinkeye on December 8, 2004, at 17:50:34

So far I like all my clients.

If a client insisted on daily contact, it would have to be an emergency. Then if it could not be resolved over the phone in 10 minutes I would let them know that we need to meet 2-4 times per week for sessions if they need that much support. When the crisis is over we could cut back on sessions.

With Borderline PD clients this is an issue. Firm therapeutic boundaries are part of the treatment. I really like working with BPD clients. Most therapists don't I like the energy, the challenge, and I can meet the energy. Some therapists get overwhelmed with that much work on a client. I welcome it. I try to do whatever the client actually needs to get better. Sometimes people who insist on daily contact really need more than one session a week. I have to keep that boundary for their own treatment plan. I would let them know that it's a boundary and explain the parameters in a compassionate manner.

Simcha

 

Re: I've just experienced a do Dinah

Posted by simcha on December 8, 2004, at 23:34:33

In reply to Re: I've just experienced a do Daisym, posted by Dinah on December 8, 2004, at 19:21:09

Sometimes a therapist must refer a client to 911. Personally I like my Ethics and The Law teacher's way of dealing with such a situation. She tries to get the client to come to the office and they call 911 together. The police come and make a determination whether or not the client needs to go to the hospital.

Of course, clients are always welcome to call 911 or go to the ER and admit themselves. In that case I would want them to call me so I could visit them.

Simcha

 

Re: I've just experienced a do simcha

Posted by daisym on December 8, 2004, at 23:35:38

In reply to Re: I've just experienced a do Daisym, posted by simcha on December 8, 2004, at 17:26:48

I don't want to come across as challenging, Simka, but I don't know if you have that willow thing down yet.

I think if you've already set a time limit for things, 5 minutes, 10 minutes, etc. you've already limited your flexibility. I know the basic idea is to offer support over the phone and do therapy during sessions. But sometime clients need more than 5 minutes of support.

I am a competent, well-educated 40-something woman who works in human services. When I finally started talking to my therapist about the abuse that happened in my childhood, I was shocked at how absolutely overwhelmed and suicidal I felt. I remember the first time I called after a session. I think it was a couple of hours later and I said something like, "I don't know what is happening to me. I can't stop crying and I hurt so bad I can't function." It wasn't an emergency - I wasn't planning on hurting myself - but I NEEDED to have someone normalize the pain for me and just be there. He said all the right things and let me cry on the phone until I was calm. It probably took 15 minutes. If he had cut me off after 5 minutes, I probably would not have continued on this immensely hard road trying to heal. Since then, we have lots of phone contact. Much of this includes loosely scheduled phone check ins (like "let's touch base Friday afternoon") if I'm going through a rough patch. I worry a lot that I'm that "pain in the a**" client that made all the rules necessary. My therapist tells me that he wants me to reach out to him as much as I need to. I believe he means this. If you've read any of my posts you will notice that I swing wildly about accepting this attachment and fighting it.

I think I read in one of your other posts (forgive me if I'm wrong) that "most" people in therapy have boundary issues. I would argue that it is just as likely for you to have a client who won't want to bother you AT ALL as it is to have one bother you too much. That would have been me if my therapist wasn't so proactive in encouraging me to use him for support.

By the way, I do pay for phone calls. We agreed that this would help me get past my reluctance of bothering him.

Lastly, I think you will encounter clients who can't afford extra sessions, can't take the time off work, etc. etc. In these cases, longer phone calls might be just the answer.

I should admit to being sensitive about this subject tonight. I'm trying to add a perspective, not lecture.


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