Blog Articles and Resources
The following article was found on GoodTherapy.org. This article talks about a client’s perspective of things they wish their felt confident in saying to their therapist. Have any of you felt this way when working with a therapist, or maybe had other thoughts you wish you therapist knew?
7 Things I Want to Tell My Therapist
February 15, 2015 • By Share Your Story contribution by G. H. Francis
Diagnosed with a mental health issues 15 years ago, first with bipolar and finally with schizoaffective disorder of the bipolar type, I’ve been in therapy off and on for that same amount of time. I’ve cycled through many therapists, some with a great grasp of what it’s like to have a mental illness, and others who didn’t have a clue. Therapists go to school for years, but how can anyone possibly understand mental illness without actually having a mental illness? Isn’t that like learning to swim without any water?
As someone in therapy, I’ve always wanted to say these things to therapists in order to help them understand me, and to let them know how I feel about them:
1. You’ve Experienced a Lot of What I’ve Experienced
Everyone has good days and bad days; everyone gets manic, depressed, or paranoid at times. I didn’t always have a mental illness; it was first brought on by drug use and the stress of 9/11, so I know that even before the initial onset of my mental health issues, I still experienced emotional shifts. We all get in a good mood when we get a raise, or depressed when a family member dies, and sometimes we’re paranoid that someone doesn’t like us. Take those experiences and use them to understand my mental illness, realizing that those with mental health issues experience these same emotions—except that theirs often come without reason, or for irrational reasons.
2. I Want Your Guidance, Not Your Advice
In his article The Best Advice a Therapist Could Get? Stop Giving Advice, Justin Lioi, LCSW discusses the importance of not giving advice to people in therapy. As a client I can tell you that most of the time I want therapists to just come out and tell me what to do, and a lot of other people want the same; however, as a therapist you don’t always know the full story—only what we want to tell you. So it’s best to leave direct advice up to close friends and family of the person in therapy. That being said, I consider the ability to provide guidance a key element for a great therapist. Guidance isn’t about giving answers; it’s about guiding people to come up with their own answers. Just asking questions is often enough to help us see things from a different perspective, and to come to our own conclusions.
3. I’m Human. You Should Be, Too
There’s nothing worse than talking to a therapist who doesn’t seem to care: their answers are halfhearted; they seem disinterested; and half the time it feels like I should be giving them advice. Mental Health Workers May Not Recognize Their Own Burnout, by Zawn Villines, explores the emotional and mental exhaustion health workers face as a result of their jobs. I imagine it’s not easy listening to other people’s problems, which can weigh heavy on the heart and mind and can wear on a therapist or cause compassion fatigue.
You need to understand that no matter how hard you try to cover up your burnout, it carries over into your work. People see it during their therapy sessions, and it affects them. Therapists have important jobs, and I know from first-hand experience that they can change lives. You’re as human as I am, and despite the pride that may come with being a mental health worker, sometimes you may need to work on improving your own mental well-being, too.
4. I Want to Get to Know You
I’m not really sure what therapists are taught in school about maintaining distance between themselves and their clients, but I don’t want therapy to feel like a one-sided relationship. Sometimes I feel a little selfish talking about myself for 45 minutes straight, and it’d be great to hear a little about your life to break up the monotony of my own voice. It doesn’t have to be personal—just a little back and forth that feels like a real conversation. If I know you, I can more easily trust you, and trust is the foundation to successful therapy.
5. You’re the Expert, but I’m the One with First-Hand Experience
As discussed in Justin Lioi’s article, empowering people is important during therapy sessions. Because I’ve been through a lot—that’s why I’m seeing you—I want to feel like I can teach you something, and I want to get the impression that you’re eager to learn from and about me. Simple questions about how my experiences felt give me a sense of knowing something you don’t, and that helps me open up and also helps build our relationship.
6. This Stuff’s Embarrassing … and Kind of Funny
When I started going to therapy I was mortified to talk about the things I thought when I was depressed and the things I’d done when I was manic. After all, who wants to admit that they were once certain they were the Son of God, and also the devil, and also the reincarnation of Jim Morrison, and also a rat? Not me! The thing is, though, with a little perspective these things are actually kind of funny. If I genuinely laugh at them, don’t be scared to break a smile (but don’t ROFL!); that confirms that these memories are harmless and not really that serious in the long run.
7. We Can Get Through This
Over the years my therapists and I have been through a lot: depression, mania, anxiety, suicidal thoughts, confusion, anger, hopelessness, etc. While at times our sessions seemed like nothing more than spinning car wheels in mud, over time I learned the coping mechanisms needed to manage my mental illness, thanks to the help of my therapists. Once despondent, depressed, feeling hopeless after three manic episodes resulting in hospitalizations, and living at my parents’ house at the age of 30, I now own two businesses, manage over a dozen people, and have written numerous books. It may take time, but we can get through this.
To access the original article and many other informative articles on the GoodTherapy.org website please click the following link: http://www.goodtherapy.org/blog/7-things-i-want-to-tell-my-therapist-021515
Francis, G. H. "7 Things I Want to Tell My Therapist." GoodTherapy.org. GoodTherapy.org, 15 Feb. 2015. Web. 28 June 2016.
The following article was found on the GoodTherapy.org webpage. It was written by Dr. Maury Joseph and talks about different issues that can keep people stuck in therapy. Good Therapy.org is an excellent resource for articles on a variety of topics and offers a database of therapists to conveniently help people find the therapist right for them.
3 More Patterns That Could Be Keeping Your Therapy Stuck
March 16, 2016 • By Maury Joseph, PsyD, GoodTherapy.org Topic Expert Contributor
According to one fairly comprehensive review (Lambert, 2013), approximately 50% of people in psychotherapy can be expected to experience “recovery” within 20 sessions. While I am pleased to see this evidence for the effectiveness of psychotherapy, the data also gives me pause: What about the other 50% of help-seekers? What about the therapies that get stuck before significant benefits are achieved?
This article, as a follow-up to my previous post on “stuck-ness” in therapy, will examine three more factors that can cause a therapy to get stuck, leading to sub-optimal results. It is my hope that my discussion of these potentially therapy-stalling ways of thinking, feeling, and behaving will lead to increased awareness of the factors that can lead a therapy to get stuck, and, ideally, to improved therapy outcomes. Read to the end for more information about my interest in “stuck-ness,” and for some of my thoughts about overcoming it.
Would you give a good thing to someone you hate? Would you work hard on their behalf so they can achieve their goals? If you truly hate them, I’m guessing you would not. This is why self-hate, especially when it goes unaddressed, can keep your therapy stuck. If your self-hate persists, how likely are you to let yourself get a satisfying result from therapy?
Bottom of Form
Many people enter therapy with some variant of self-hate operating in their lives. A sense of worthlessness, hopelessness, or a certain comfort with suffering often becomes evident in the first moments of treatment through statements like, “I’m not worth trying for,” “Therapy won’t work for a (insert expletive) like me,” or, “I deserve these symptoms.” As a therapist in those moments, I must ask myself, “Can healing occur under such conditions?” And I must ask of the person in therapy, “Are you going to let yourself have a good experience here if you think you’re not worth trying for?”
I have even heard people insist these qualities are not changeable. I think this is where the stuck-ness truly occurs: The person in therapy and the therapist become convinced the self-hate cannot change. They try to achieve a self-loving result to the therapy, but the saboteur of self-hate lingers in the background.
Self-hate can change. I have seen it happen in as little as one therapy session. However, if you are not focusing on your self-hate with your therapist, trying to “do therapy” while a part of you tries to withhold from or devalue you, how likely are you to succeed? If you’re feeling stuck in therapy, and you’re aware self-hate may be keeping you there, please bring that up to your therapist and see if you can do something together to create and sustain some thoughts and feelings about yourself that might allow you more benefit from the therapy.
A sense of disconnectedness and detachment from friends and loved ones often brings people to therapy. They have relationships, but these relationships lack the emotional intensity that makes interpersonal life vital and satisfying. This can lead to a sense of loneliness, even when you’re not alone, and can contribute to depression.
When we detach in our therapy and detach from our therapists, the emotional intensity of the work is all but lost in a haze of thoughts and words. The lyrics are there, but the music is missing. We have insights, but they do not get inside.
Once in therapy, someone with a detachment may have no problem sharing and talking with the therapist. They can clearly describe their problems. They can label emotions. The words of the therapy sessions sound just right. So why do people get stuck in therapy because of detachment?
When we detach in our therapy and detach from our therapists, the emotional intensity of the work is all but lost in a haze of thoughts and words. The lyrics are there, but the music is missing. We have insights, but they do not get inside. Through the veil of detachment, we talk about our feelings, but we do not feel our feelings; this prevents us from learning new ways of managing those feelings in therapy. We end up in the same detached, emotionless pattern with the therapist that keeps us stuck with our friends or partners. If we are detached, we cannot learn new ways to attach, and our growth process may stall.
If it feels like you’re thinking hard and saying all the right words in therapy, but you’re not feeling the emotional impact and benefits of your sharing, detachment may be keeping you stuck. If you are noticing this in yourself and your therapist is not, try to bring it to the therapist’s attention. If they can’t help you with this thorny problem, find someone who will.
3. ‘It’s Just the Way I Am’
Say I came to you and told you my house was on fire. Say you asked me if I wanted help with that and I blandly replied, “Meh, that’s just how my house is.” You’d be worried about my house, and you’d probably wonder why I seem so comfortable with the fire destroying it.
Some people are comfortable with suffering, usually as a result of developmental experiences that required them to accept a certain degree of suffering as normal. Some people even become identified with their suffering: “This is just the way I am. I am a suffering person.” When suffering becomes a piece of a person’s identity, a thread in the fabric of their character they cannot imagine parting with, therapy can get stuck. Why?
To achieve optimal results in therapy, we have to be willing to let go of the thoughts, behaviors, and relationship patterns that hurt us. Liking or even loving the very things that hurt us can make recovery impossible.
To whatever degree we remain married to our destructive thoughts, feelings, and behaviors, we may be unable or unwilling to let them go. If you are aware that a part of you is clinging to your suffering or identified with it, make sure to bring this to your therapist’s awareness. See if they can help you face the complicated feelings that have kept you clinging to a self-defeating pattern. If they can’t, consider finding a therapist who can.
Why I’m Stuck on This ‘Stuck-ness’ Soapbox
All too often, I find myself working with people who belong to the other 50%, who ended up stuck in multiple previous therapies over the course of multiple years. Stuck-ness prolonged their suffering, and I am aware that whatever kept them stuck with their previous therapists could sabotage our therapy, too. As a survivor of sub-optimal therapy in my own past, I am all too familiar with the pain and continued burden this can cause, so I strive to be vigilant, and to assist the people who come to me for therapy to do the same.
In intensive short-term dynamic psychotherapy (ISTDP), the model of psychoanalytic therapy that I practice and teach, we have an elegant, evidence-based system of interventions (Abbass, 2015) that helps us address the self-defeating and treatment-defeating emotional factors that can keep people stuck in life, love, and therapy. Empirical research is beginning to show that ISTDP has unique efficacy for “complex, treatment-resistant conditions” in which the stuck-ness mechanisms are often a factor (Solbakken and Abbass, 2014, 2015; Abbass, 2006). Other psychodynamic approaches are also beginning to demonstrate efficacy for treatment resistance (Fonagy, et al., 2015).
Again, if you’re feeling stuck in therapy, the first person who needs to hear about that is your therapist. However, if you’re finding your therapist is failing to help you get unstuck, consider finding a therapist with training in ISTDP or another psychodynamic approach. We are trained to work effectively with self-hate, detachment, and all the other stuck-ness mechanisms I’ve described. Perhaps you will find it worthwhile to offer yourself a new, different treatment experience that offers the support you need.
To read this article on the GoodTherapy.org website, click the following link: http://www.goodtherapy.org/blog/3-more-patterns-that-could-be-keeping-your-therapy-stuck-0316164
Joseph, Maury. "3 More Patterns That Could Be Keeping Your Therapy Stuck." GoodTherapy.org Therapy Blog. GoodTherapy.org, 16 Mar. 2016. Web. 28 June 2016.
I write articles based on my experience as a therapist or a training or conference attendee. Many of these articles are written by others who are experts in their field and I share their information as resources for others.