Seeking Therapy Stories

[rachelmanija]

For my own benefit, I am looking for stories of two types of therapy moments:

1. Things a therapist did right.

2. Things a therapist did wrong.

In both cases, I'm looking for things that weren't obvious.

For "wrong things," I'm not thinking of clearly, extremely terrible things that I would never do in a million years, like having sex with a client, telling a client their abuse was their own fault, telling a client not to be gay, etc. I'm looking for mistakes that were more subtle than that - things a well-meaning but inexperienced therapist might do. For example, it was not beneficial to me (as a client) to let me sit there and recount lengthy abuse stories, and then have the therapist immediately start delving deeper into the abuse. But that's not an obvious mistake on the level of "It was all your fault it happened."

For right things, also, I'm looking for moments that went beyond the obvious "She was very empathetic," "He told me it wasn't my fault," or "She helped me see the connections between my childhood and my adult relationships." I am particularly interested in any times in which a therapist managed to do a good job with identity issues (gender, culture, etc), whether or not the therapist had the same identity as the client.

I realize that everyone is different, and what's right for one person may be wrong for another. I'm not looking for a rule book, but rather for inspiration and food for thought.

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Comments

[dorothean]

Here's something that's important to me that was handled well and poorly in different occasions:

I like to have a sense that the space in which I'm doing therapy (group or individual) is very safe and somehow set apart from the rest of the world. The more emotionally fragile I'm feeling, the more I'm sensitive to this and the less able I am to coherently and calmly ask for any change to be made!

The best example I have is from my first sessions of group therapy (DBT). I knew from the beginning that everyone participating was carefully interviewed first to make sure they would be a good fit for the therapy. New people could only join the group at the beginning of each eight-week session, and on the first day we discussed the rules and were able to suggest our own (mine, very well received, was "no unsolicited advice"). Each meeting had the same structure, and we always began with a five-minute meditation. One of the most important rules was to try to discuss our emotions and urges without lengthy narrative -- explaining the details of our own situations could be done in the required individual therapy, but in the group we were to focus on applying the DBT methods.

When I went to these meetings I could trust that the people and structure would be consistent and that the meditation would quiet everyone down and help us feel respectful of our time together. I soon realized that a couple of the group members were in situations that were triggering to me -- but when the "avoid narrative" rule was working, I could still feel safe because the rule protected me from hearing about it.

Things that occasionally disrupted the safe space for me: (1) the "avoid narrative" rule failing to protect me from some triggers, which was probably inevitable at that time; (2) a group member smelling so strongly of cigarettes that I got a headache (there was a rule against strong scents but it's harder to apply that to smokers, I think); (3) a stranger coming into the therapy room to fix a computer.

I have also (depending on how much emotional distress I was in) been discomfited by my individual therapist greeting me with small talk as we walked from the waiting room to her office: "How have you been?" I know the appropriate small-talk answer to that is "Fine, and you?" but when I'm talking to my therapist and the only reason I'm seeing her is that I'm not at all fine, small talk doesn't really fit... I think this was always made worse by the question being asked before we got to her office. If we'd been in there already with the door shut, I could have answered literally and honestly, and that would have felt so much better. But we weren't there yet and I didn't feel safe enough to be honest in the middle of the hallway.

[kore]

There was one receptionist at the university outpatient psychiatry clinic I went to (sliding-scale) who persisted on asking me "And how are you doing today?" every time I went there. Every. Single. Time. And it was one of those genuine questions, not some kind of formality; he was clearly expecting an answer and would stop what he was doing and look up if he didn't get one. Once I finally snapped at him, "Pretty shitty, or else why would I be coming here every week?" He looked startled and didn't ask it for a while, but a couple of weeks later he was back to doing it again. sigh.

I seriously think everyone -- therapists, staff members, whoever -- working in a clinic or hospital setting should be told NOT TO ASK PSYCH PATIENTS HOW THEY ARE in a non-serious manner. Maybe I'm too easily bruised a flower but it was already really triggering to constantly run into that question at the bus stop, at work, at the lunch counter, on the way home &c &c and have to lie and fake some kind of happy BS and a smile while severely depressed. To have to keep doing that in the place where I was trying to get help was really excruciating.

(I also personally think "How are you doing today?" is a useless question to start a session with because it's much too global. "What's happened since our last session" or "Have you been thinking about what we talked about last time, or do you have something new you want to bring up" would be better.)

[dorothean]

Thank you for that comment -- it really helps to know I'm not alone in wanting not to be asked that question on my way in to therapy!

[sara]

Heh. C. came in the other day and asked me how I was doing and I reminded him that I am still literalminded, and also that I had just come out of the bathroom, and asked if he actually wanted an answer to that question.

He said no, perhaps not.

[dorothean]

Adding this: I think what really helps is to know that the therapist and I are more or less on the same page about the sanctity of the therapy space. For most of the DBT group sessions, I did trust that the group leaders wanted the room to be a safe space. But when my individual therapist makes small talk on the way in to her office, I don't feel that she has the same priorities I do about my therapy.