Our journey with therapists

I’ve seen 4 therapists in the last 5 years.  That seems a high number.  M was told by Liz that we have very high expectations of therapists, maybe they are too high?  Here’s a brief run-down of what happened with each –

Debra seen for 6-8 months.
Worked part-time from home.  Her methods were based on Mindfulness and Cognitive Behavioural Therapy.  She was intelligent and studying towards her masters.  Reason why we stopped seeing her was because of boundary issues and she was stopping therapy work to concentrate on her masters.

Carol seen for 2.5 years.
Worked part-time from offices.  Her methods were based on Cognitive Behavioural Therapy with some influence from other methodologies including Dialectical Behavioural Therapy. Reason why we stopped seeing her was because of boundary issues and her fascination with our dissociation. She loved playing with Aimee. She wasn’t helping us move forward in any meaningful way and we’d started to become convinced that she had planted the whole idea of DID in our head.

Bob seen for 6-8 months.
Worked full-time from her extremely busy offices. She came highly recommended and we saw her to try and find out if we were making this dissociation thing up. She had extensive experience with abused teens and children. Things went a bit haywire with Bob when she was trying to force an integration of personality states to counter what she described as a “fragile personality structure”. We stopped seeing her when the short term contract was up with ACC.

Liz seen for about 6 months.
Works part-time from offices. She was the only therapist willing to take on a client that came with warnings about dissociative issues. She has other dissociative clients and came recommended from another therapist. We don’t know if we can go back to see her.

Earlier this week we posted a rant that was fairly quickly deleted.  It covered the issues we’d had when seeing Liz on Monday and problems we’d seen throughout the time we’d been seeing her.  Some of these include:

  • Turning her cell phone volume down during sessions.  It has rung during session, so you get the noise of a vibrating cell phone dancing across the desk as you’re trying to talk about something important.  She has also looked at the cell phone to see who is calling while in session.
  • She has a habit of clearing her throat when being asked something difficult or is faced with challenging ones within the system.  Mickie is generally silent during sessions when fronting, which prompted much throat clearing and a conversation about us living alone meaning that we don’t know how to socialise and make conversation.
  • On Monday there was a discussion about our night-time photography trips and the reason why we’re doing them – to get hurt.  Liz suggested that the reason why we hadn’t been hurt was because of someone or something looking out for us.  She was meaning a higher power of some sort.  Any talk of religion is a huge trigger for us.  It felt more like the focus of the discussion had moved from helping us, to preaching to us.
  • She is unable to remember our basic biographical information – we’re the youngest of four, get on alright with the oldest brother and have minimal contact with the entire family.  This is the sort of information that she has asked several times, including constructing a sociogram with us.  If the information was important enough to ask several times, it’s important enough for her to remember or to write on the front page of our file for easy reference.

Monday’s session was particularly bad.  The religion trigger set off a negative reaction with W.  M came forward to protect W when she realised what was going on, but it was too late.  This meant that M came forward annoyed that Liz was talking religion without checking out who was present and their beliefs about the subject.

It was after Liz again asked M about our basic biographical information that things got particularly tense.  M asked why Liz had to keep asking about this information, Liz responded that she might get a different answer one day.  M pointed out that we would always be the youngest of four children and unless something major happened, we’d still feel the same about the family as we do now.  Liz said our expectation that she would manage this information was too high, M asked what a reasonable expectation would be…

To be fair, M was defensive as Liz had challenged one of the young ones she protects.  But Liz was helpless to find us all a way through that defensive mechanism.  We left without making a further appointment.  If this has been a one off bad session we would have had a cool-off period and made another appointment.  But it isn’t, it’s the latest in a series of unusual sessions.

Now we’re stuck.  We don’t trust Liz and don’t know if we can go back to see her.  But if we don’t, are we doing so because our expectations are too high?  Are we being unreasonable with our expectations that a therapist will manage basic information, silence their cell phone and not talk about sensitive issues without checking who is present?  Maybe our reaction is off the scale because of our dysfunctional thinking and reactions?

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21 thoughts on “Our journey with therapists

  1. Hi,

    It is not high expectations to expect a therapist to remember basic facts about your life, or to refer to them at the front of the file before starting session. It is not expecting to much to expect a therapist to have good boundaries, to not push integration, to not talk about religion, and to not abuse the system. It sounds as though you were right to leave each of them. Some of them don’t help and the worst ones hurt the system or the healing process. It is okay to ask for what yous need. No one needs to be preached to, that is not therapy, that is s person with a personal agenda and that is not usually helpful or healing.

    Good and healing thoughts to you.

    Kate

  2. Don’t think that’s to high either.
    My therapist constantly amazes me at what she remembers about my history she must be taking awesome notes and doing a huge amount of review or something. I know she has quite a few clients too, plus she does a ton of conferences it seems.
    Checking her phone and letting it be a distraction, unacceptable. My therapists phone went off once. I think she turned beet red, kept apologizing, quickly found it and shut it off.
    If the religion trigger has been brought up to her then yeah, I agree she needs to either not say anything or check who is about and if it would be ok to say.
    I’m sorry about the comments implying that you aren’t socialized…geez!! That’s pretty bad! I’ve had a lot of people say a lot of things to me about being silent but…*shakes head* How about the line “Can you tell me what your feeling or what is going on in your head right now?” instead!
    Sorry it’s such a struggle where your at to find a good therapist. Hope the right thing comes along for you soon

  3. a therapist should not have a phone during consult and they most definitely should either recall easily or have inside the front of your front basic details about you.
    my psychiatrist could easily re-tell my life story complete with names of major players & places without notes or prompting – but i have been seeing him for seven years so that makes a difference.

    ask yourself : what do i want out of therapy ?

    because it sounds like you have learnt a lot of coping skills already – CBT & DBT etc etc.

    maybe therapy is not the right thing for you.
    maybe you need a support group instead [ for example ]. maybe you can put the CBT & DBT to more use in your day to day life.

    there comes a point when therapy is not of use anymore, other than for a chit-chat and emotional support. that is when the patient needs to stand alone and use the teachings learnt. that will be very hard – acknowledging that no-one other than you can actually help you anymore .

    i don’t know where you are with things or what you want from therapy but i would suggest that, although each of the counsellors have had their own particular problems, the common denominator is you and it may just be that you don’t need the therapy that they are offering you – either now or maybe at all.

    i am saying that you are the common denominator not as a derogatory thing – please don’t take it the wrong way – but as a simple observation.

    may i ask please, what boundary issues were there ?

    xxx gracie et al.

  4. I don’t think asking your therapist to remember the most basic biographical information is a high expectation at all. I would have thought this was basic human decency. I also don’t think it’s too high an expectation not to be triggered in session, or to have your therapist turn her damned phone off. Grrr…

    That said, if, overall, you feel that a therapist is helping you, then based on my recent rupturous experience, it’s worth going back to try to sort it out. On the other hand, if your overall sense is that Liz can’t help you… the it’s time to move on. Only you can make this decision, but whatever decision you make, it will be the right one for you.

    Kerro
    xoxo

  5. Hi everyone,

    I’d like to thank you for your support and comments. Just to add as a note, this post is of course from our rather skewed perspective. I’m sure Liz has a totally different idea of what happened. This is part of the problem, how much of an influence is my dissociative and dysfunctional thinking playing a role in my view of this all. Surely four therapists can’t be that bad?

    As an additional complication, most of that 5 years of therapy has been geared at helping us survive the abusive marriage. It hasn’t been looking at working on the dissociative issues and how to cope with them, but rather how to make it from week to week. Bob said that we needed intense assistance in order to heal. We’ve been told several times in various ways that we are hard work, both as a human being and as a therapy client. I’m still unsure of what I am going to do. M was waiting during the session for Carrie to come forward to assess the situation, but that didn’t happen.

    We’re still not sure what to do… Time to assess…
    Take care…

  6. I’d just like to reiterate that your expectations don’t seem too high to me either. I’d be horrified if my T stopped to look at her phone in a session, or forgot the basics when I’d told her several times. I’d expect her to want me to be angry with her about it also, not to get defensive. I’m also shocked at your previous therapists boundary issues – particularly breaking confidentiality – that sounds awful.

    I hear that Liz may have a different perspective. Is it possible that you can discuss this with her along with several of your different alters, to get a broader perspective?

    If it is any consolation I’ve seen four therapists too, and I’m not particularly ‘difficult’ as a client in the way you are using the word. (I am stubborn, and very controlled, but I don’t have any major diagnoses or dissociated parts). It’s important to find one that you can work with, or who you are comfortable challenging when they screw up (and they all will).

  7. It seems to me that your expectations are too low, causing you to spend months or years with therapists who have not been entirely helpful. If you had higher expectations you could dismiss a therapist more quickly — ideally after the first session. Only 4 therapists in 5 years is too few.

    Of course the goal is not to get through as many therapists as possible, but to find a therapist who can really help. Suppose (for the sake of argument) only 1 in 20 therapists can really help. You might have to try many therapists in order to find one who can help.

    It might also be useful to imagine you are a therapist for a moment. Suppose you are a CBT therapist and you are highly successful in using CBT. Why would you bother to learn some other technique like mindfulness or DBT? You wouldn’t! You would stick to what works. So when therapists mix therapies, it is a warning sign that they might not be highly skilled at any particular therapy.

  8. I think your expectations are very valid. My therapist does things which I write off as being a novice. They don’t bother me much. But I can see how they would bother others.

    On the flip side of all of this are the times when Liz has been incredibly helpful. So, consider it all as you think about this.

    And it wouldn’t hurt to bring a printout of your expectations. This will help set boundaries and safety.

    Paul

  9. I agree with what everyone else is saying so I won’t repeat it. I do have one thing to add and it is that my T has told me that most therapists/psychologists understand their clients so well because they have issues or where traumatized/abused as children, too.

    If that’s the case, I can see why one would spend time just playing with Aimee and one would not be able to continue with you if you were suicidal too long – some of those things possibly trigger their own issues.

    In any case, be careful, and if a therapist is worth having, stick in there and state your desires clearly, such as “I will not be integrated and I don’t want you to expect it or force it.” Remember, the therapist is there to work for you in your best interest, not the other way around.

    I wish you the best of luck and I’ll be thinking of you.

  10. This is a bizarre question, but — do you know for sure that Liz meant a higher power when she made the remark about someone or something looking out for you? The reason I ask is that I wonder whether she might have meant that you had a strong helper part looking out for you, and she might have been trying to direct you toward greater knowledge of a part that has wisdom or self-preservation as its agenda. I assume you do have reason to know that she meant it in a religious sense, but I was curious.

    I don’t think you’ve dropped any previous therapists for inappropriate reasons. I also think that therapists are rarely perfect. To provide some perspective … Debbie’s phone goes off almost every damned time I’m in session with her; my appointment is right after her lunch hour, and she is really forgetful about turning her phone back off. In the bigger picture of how helpful she is, though, it doesn’t tip the scale. I think whether an expectation is reasonable or whatever really depends on how it fits into the bigger picture of the relationship, and also what the other party’s motivation is. Is it simple forgetfulness, or deliberate carelessness? Sometimes, I realize, it’s hard to tell where someone is really coming from.

    I think if it were me, I’d consider taking to Liz exactly what Carrie said, and seeing what her response is. It should give you some useful information about what Liz’s agenda is. If she’s defensive, that’s a bad sign.

  11. Hi David,

    Yes, it was definitely a religious based question. W said “We don’t believe in God” and Liz asked if we believed in angels, to which W also said “No”. There was a fairly extensive conversation about religion and at no point did Liz say that she was meaning an internal protector instead. Admittedly W’s reaction may have driven the conversation, but Liz could have reigned it in by clarifying that she was meaning something else. She also raised the concept of man’s free will.

    I know that people forget to put their cell phones on silent mode, or turn them off. But Liz deliberately turns the volume down, she intends it to be left on. So it vibrates away like a mad thing, which has happened every session so far – I see her first thing on a Monday morning. To us, it fits the bigger picture of her not really being present in the room during session. But I know she is as she has noticed when we’ve totally closed her off.

    I’ve contacted Liz, so will see what her reaction is…

    Take care…

  12. Sounds like the basic necessities for providing therapy are not being observed. speaking as a therapist I not only turn off my mobile phone but any other sources of potential distraction prior to conducting therapy. Also it is essential to prepare for the session and a very good idea to maintain professional boundaries, respect culture & belief etc and never attempt to impose one’s own ideals on others- the main idea of therapy/counselling etc is to empower or enable the client(s) to find their own way and not to tell them what to do nor tell them what is right or wrong
    I would (in your shoes) take my time and find a therapist whom is prepared to respect you as a person and to endeavour to offer you the therapy (not advice) that you may need.
    Good luck!

  13. Pingback: Losing myself… over and over « Scattered pieces…

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