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Long post. Not sure whether counsellor/psychologist is a good fit, after several months - how to tell.

8 replies

fryday · 12/02/2021 21:02

I wondered what others' experiences of a good psychologist are, and whether it sounds like I am in the right hands.

I've been seeing a psychologist via zoom for over six months, weekly, for an hour and a half each time. It's the first time I've seen a counsellor or anything like that since about three sessions at uni many years ago.

He is well qualified etc and has worked on the NHS too in the past. I see him privately and the fee is quite high.

He is very much of the internal/mindful approach. I was listening to some psychologist podcasts recently and realised a common approach is to spot client's patterns and point them out to them. He never does this though I've asked a few times: he says his approach is that I get in touch with how I am feeling about things rather than lost in thought, which I suppose I tend to do, so that I can spot my own patterns, rather than have him point them out to me.

I've had quite an unusual life with large periods of isolation, having no friends for very long stretches, not working for long periods, virtually no relationships (romantically). I also have some history with being obsessive/ruminative about things. He doesn't seem concerned about any of this; how a session will go is he will listen to me talk about what is going on with me, then try and zone in on how it feels in my body and what the feeling needs. When I feel I have specific logistical things that are holding me back, I will talk about it for a long while, then eventually he will zone in on how I am feeling. I repeatedly say that I feel I waste up to an hour of each session just explaining things and all the somatic work is rushed at the end, but it keeps happening, for instance in the last session and in the last few, every ten or twenty minutes I would express that it felt I was just talking again and nothing useful was happening, yet they all followed the same pattern.

Last year I was in quite an emotional crisis and called three emergency helplines, unfortunately couldn't get through on any of them as I was abroad, but managed to calm myself in the end. I told the psychologist and he didn't make too much of it; I told my friend later that week about the helplines, and he was concerned that the psychologist hadn't made more of it. Similarly re the ruminative thoughts, my friend advised me to buy a book to give me some tools to address them since the psychologist wasn't really addressing it; at that point 90% of my waking thoughts were preoccupied with one thing. It passed eventually after a few months but I think that was more because my circumstances changed.

He is a very nice person and very well qualified. I feel quite distressed and confused about it, because I am not sure what I am entitled to expect. It may be a theme that I don't know what my needs are, nor how to ask for them, nor to realise that if they are being ignored that's not simply what I deserve. So I feel I lack the insight that could let me see whether this is working for me or not. Alternatively it could be exactly the right type of therapy, but I'm used to a results-based paradigm of thinking whereas this is much more gentle? I have no idea, I'm just confused at this point. I have discussed all this with him, but he has a style where he sort of echoes back to me what I am saying, and then we go into the feeling stuff again. I've even discussed that his style seems to be just paraphrasing things back to me, but we tend to end up at a similar point.

Maybe psychology is a very long process, and this is all I can expect at this point.

I am having a difficult time right at this moment, and it is hard to see where I go from here (I mean more logistically/physically in terms of my life choices). It could be that I am trapped by a lot of my old patterns of thinking. But I can't seem to get the insight into them that I crave, in order to perhaps accelerate the process of moving forward, or making different choices on more sound bases.

A simple example in the most recent session is a situation has re-arisen which has hugely stressed me out and I have a short time to make a decision about. I said at the start and several times in the first hour I wanted to get back to doing emotional work about it, but he kept encouraging me to talk about my longer-term plans, so it ended up again being jammed into the end of the session. When I pushed the point, he said it was because the longer term plans had a relationship with this and other situations, which might be right, but didn't provide much relief from the immediate distress, nor any additional clue how to move forward over the next few days.

On the other hand, my family and my friend tell me that I have come a long way in the past six months: able to talk more, about more things, less likely to run away/abandon, less likely to misinterpret neutral things as personal, and so forth. I have been doing a lot of other work to support this, such as meditation, and cultivating one or two friendships.

Also, there have been a few sessions where we have done exercises which have led to some insights about my underlying feelings about myself, or pieces of my past; I would say about three or four have stood out. But I don't know that there have been any long term effects.

I suppose the sessions feel scarily vague a lot of the time, but it could just be my interpretation of it.

Anyway I would appreciate any thoughts, as I mentioned at the start of my post, as to how you knew your psychologist was working/the right one for you, and whether mine sounds like a good fit, or what an alternative suggestion might be; either how to approach him, or another approach altogether.

OP posts:
noego · 12/02/2021 21:51

Let go of all your thoughts about the psychologist, the sessions and the structure of those sessions and accept the way he is going about the therapy.
It is these thoughts that are stopping you from moving on. Therapy is not a quick fix.
Relax into it, take your time.

ricericebabydududuhdiddleuhduh · 12/02/2021 22:00

As you've said, there are many types of therapy. 6 months at 90min a pop is a fair amount of time - you've given it a good go.

In your position I'd probably tell him you're taking a break and try a few sessions with somebody of a different modality (maybe look for someone with a psychodynamic approach if you want them to offer some more interpretation etc) and see how you feel.

Digestive28 · 12/02/2021 22:00

The fact you’ve given feedback and it hasn’t significantly changed doesn’t suggest it’s helpful. Just because he is super qualified doesn’t mean he is right for you. You’ve given it six months and still struggling. If you see someone else and the pattern continues then it maybe you. It doesn’t sound like it’s working for you and the fact you don’t feel comfortable saying says the relationship doesn’t feel right

hastingsandchips · 12/02/2021 22:47

Have you ever tried CBT OP? It helped me a lot with controlling unwanted thoughts.

It sounds like you maybe need someone with more empathy than this guy? Why not interview some others

RedPaperLantern · 12/02/2021 23:17

If it’s not working for your and he’s not responsive to feedback, time to think about moving on.

Thank he thing I find a bit worrying is that his has ignored your previous crisis and that he swept aside your need to address a distressing situation during the current time.

Yes, it’s good to spend at least 70% of your time on long term work, but everyone needs a bit of help with fire-fighting at times.

Even just the empathy of someone willing to help can make a big difference about those kind of times .

That for me, would impede a proper, trusting therapeutic relationship and without that everything is a bit like pushing water uphill.

It sounds like you’re a bit of an academic exercise to him, rather than a person. People have varying needs and if he doesn’t have some flexibility to respond to changing needs that can be damaging.

You’ve given it a decent length of time and you’re making other efforts.

So, yes, take a break. It’s often interesting to see someone’s reaction when you set that kind of boundary, can tell you a lot. Use that time to see if you can find a different approach helpful.

MajesticWhine · 12/02/2021 23:27

I think a break might be a good idea. Not all therapists / psychologists are flexible enough to to change their approach although some are. You might have got all you can from him. If you change your mind you can always go back. He probably won't turn down your money.
If you want to spot things like destructive patterns or relationship problems and work on the deeper underlying meanings then psychodynamic therapy might be more useful.
But a psychodynamic therapist probably won't give you active solutions to tackle rumination, for that, try a therapist trained in CBT / 3rd wave therapies.

Stompythedinosaur · 13/02/2021 01:12

It sounds like you need a more structured therapy model - CBT is probably easiest to access, but I wonder whether CAT would be helpful too.

My guess is your current therapist is part of the psychodynamics family, it isn't a style that would suit me either.

partyatthepalace · 13/02/2021 01:57

It sounds to me like you may not be a good fit. Just because he’s well qualified doesn’t mean he’s right for you, different approaches work for different people.

You’ve given him a good go, so why not take a break from him. Do a bit of reading around approaches on UKCP, and then book initial sessions with say 3-5 people and see who feels right.

As a PP said you could try a course of CBT, it’s not often all that helpful for deeper issues, but if you want to give rumination a blast it can be really good.

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