Therapy

[Summertimesadness11]

I’m just about to qualify as a therapist and I’m wondering what people’s experiences of counselling/therapy has been? In particular, what you think makes a good therapist and what you think makes a bad therapist? I’m particularly looking for people who have actually been to therapy. Thanks in advance for anyone who answers 😊

Ignore my first post, just saw "counselling".

Are you medically qualified?
Do you have any history of your own mental health struggles what would allow you to closely relate and understand your clients rather than just assuming you know how they feel?

Good- authentic, listened intently, was very action focused so instead of being sent away with homework we did exercises (letter writing, reflections) in the sessions- this was great because with previous therapists I wouldn’t do the homework and would feel bad.

Patient, therapy triggers defensiveness more than I expected and I have worked with therapists who weren’t great at handling that, which ended up with me feeling guilty.

Positively focused- the best therapist kept bringing things back to what I wanted, or what might be different when a problem was dealt with. Basically what I have to look forward to.

Clear about what their approach is

Warm but professional

Present, with an air of authority on matters of the mind

Bad-
Focused on their part of the conversation, felt like they were dying to skip to the bit where they can tell me the answers. They may have even been right but it can be a bit difficult to learn your basic-bi*ch problems are predictable and easily solved

Bored of people -Not genuinely curious enough about me and my life. Didn’t ask enough about what I had tried before

Cut and paste- worked with a therapist who was nice but their examples, questions and advice felt very surface level and generic, the sort of thing that comes up at the top of of a Google search

but

you definitely don’t want someone who is improvising too much rather than following the approach they’re trained in.

hope that helps, make sure you take care of yourself, it’s great to help people and you will, but make sure all your training benefits your own life and relationships too

@Finnishflags thank you for your thoughtful response. It’s a great insight

Bad - told me about her own behaviours, showed me her semi colon tattoo, spent the entire session telling me about her own experiences of depression

Bad - told me I was a bit pathetic and no one would want to be my friend if I carried on behaving as I did

Bad - told me I had several (conflicting) personality disorders at once, told me I had an eating disorder, told me I wasn’t ill enough to need help, told me he wasn’t interested in discussing why I felt the way I did, encouraged me to spend the session lying flat with my eyes closed despite a history of complex abuse and trauma

Good - when I walked in I said, ‘I’ve had 20 years of this shit, I can’t live like this anymore, please please get rid of my anxiety.’ - her answer was, ‘only you can do that, we can give you the tools but you have to actually use them.’ She remained very blunt but kind during sessions and would actively call me out on stuff that was perpetuating the cycle, which worked wonders.

Good - unconditional positive regard and kindness, and showing empathy

I've had CBT and counselling. Neither useful. The CBT methods were not effective at all and the therapist was meek and softly spoken and gave me no faith in the process.

My counselling was also pretty useless I'm afraid. She asked me leading questions which were really obvious what she was trying to do and felt unprofessional - like someone who thinks they know stuff trying to prove a point e.g I was talking about seeing people in my hallucinations and her saying 'knowingly' - "and it's always men in the hallucinations, is it?"because she thought she'd cleverly identified some root cause of trauma. She was smug. (And wrong)

One of my many issues is that I'm a people pleaser and worry more about other people than myself - so in both the above situations when I had to do the questionnaire each week to see how depressed I was, I just changed it slightly each time so it looked like I was getting better, so the therapist didn't think they were bad at their job. But that's a weird and stupid trait of mine, not really the fault of the therapists 😂

I didn't like the soft therapy voice and the sympathetic bobbing head. I felt patronised by both therapists I've seen.

I'm still looking for a decent one but can't afford it these days! I read a lot of self help books 😂

I've been in and out of therapy since I was 14. I'm 52 now.

I've had wishy washy therapists, therapists who act like a mate, therapists which literally behave like they're reading from a text book.

My last one, highly qualified, quirky, intelligent, used DBT instead of the usual CBT crap. She actually diagnosed me (which was so incredibly helpful), gave me printed handouts to refer back to, did questionnaires with me every few months to monitor progress.

Please don't encourage them to blame other people for all their trauma. Somebody I know who has therapy has sat down with everyone they know and gone into great detail about how they individually have caused their trauma. They don't expect a resolution, just want to let me know that something I did/said 20 years ago caused them trauma. They are also enforcing therapy on everyone they know. It has caused huge problems and fractured relationships. They feel great though. Doesn't matter they have completely sideswiped 10+ family members and caused irreparable damage.

I've had a lot of therapy over the years.

The best therapists listened and secondly remembered. I've had therapists who couldn't remember what I'd said from one week to the next and I was constantly having to repeat myself and start again.

The good therapists not only listened but they saw patterns and challenged me. I sometimes felt uncomfortable and sometimes angry but they made me reflect on my behaviour and change it.

I am interested in your response, and curious to know how you would know your therapist's history and whether or not they have experienced mental health problems or not? I have never worked with a therapist and have had any idea of their history. I have had a sense of those who can really acknowledge my pain and not be thrown by it though, and my impression is that this is because they have been through some stuff themselves.

this is interesting because as you say yourself- they feel great. I have seen this before too, especially abusive men emboldened by therapists to use therapeutic language to bully their partners and mainly female relatives into thinking it’s all their fault after all.

That said, if someone’s role in a family and friend group is corrosive to their well being, for example they are always the basket case or the black sheep, giving themselves permission to stop spending time with people who make them feel bad can be a positive life-changing step. It’s hard for those they leave behind, but if someone is constantly painted as a loser or someone who can do no right it can be fair in the grand scheme of things, even if it feels like it’s coming out of nowhere.
If they think this kind of confrontation is more likely to improve relationships though they are sadly living on another planet.

Thank you FinnishFlags for giving me a different perspective to look at it. That has really made me think.

Patient centred and adaptable. Different patients need very different things, depending on their capacity and issues. Don't get lazy and be the same therapist for everybody.

I have seen about five therapists at different points- some very briefly (because they weren't useful), others for lengthy periods. Overall, for me at least, I greatly appreciate:

1. A therapist who truly listens, is able to offer a safe, authentic, caring space uninhibited and undistorted by the therapist's own ego and issues.

1. But also intervenes powerfully- not by giving advice or judging or coming in with their opinions, or their own stories but by observing and questioning the underlying beliefs or 'norms' that the patient may live with but not be aware of.

1. Has clear, firm, but compassionately expressed boundaries. That's everything from how fees and cancellations/scheduling is dealt with, through the limited communication between sessions, to maintaining a consistent level of withholding v support / subjectivity v blank slate etc....

These to me are the three biggest things,

When I see it most often go wrong:

1. The underactive Therapist: who has got lazy, lost their curiosity and passion, and is basically just offering you a highly priced chat/ listening ear. Sometimes this can be useful if the patient literally has no outside support, but it's mostly a waste of time for real change.
2. The overactive therapist: who jumps in too soon, shares their opinions, their own stories, their wisdoms (eg has gone into benign parent mode or is constantly diagnosing / defaulting to their frameworks, rather than seeing the full unique human)
3. The shoddy boundaries therapist. All manner of minor to massive evils here.

I just want to thank you all for your very thought provoking responses. I’m taking note and I’ve got my listening ears on

I think be a good listener, validate their feelings and experiences and then ask them what they want from coming. And why now? Keep their goal in mind.

I stopped seeing a therapist who was training because she was so late and flaky it made me very anxious. So timeliness and commitment are important to me.

I’m really sorry for those of you who have bad experiences with therapy.

There are some bad experiences that are just a waste of time and money (this is serious of course). But the really bad stuff is when you are reinjured by a therapist who you have allowed yourself to be vulnerable with. This happened to me, and took a couple of years to recover. Sounds pathetic, but he was a psychoanalyst, and there was very deep transference. Generally, he'd been extremely skilful. But one day, he lost his orientation, and it completely messed me up. It is hard to explain, but analysts in particular can end up doing emotional open heart surgery, and one slip of the knife, and you are in a very bad place.

@financialcareerstuff this doesn’t sound pathetic at all. It sounds deeply wounding. If you feel comfortable, are you able to explain a bit more about him losing is orientation and what that looked like? No worries if not.

It's really hard to articulate in a way that would make obvious sense. He was a very strict, classic blank slate analyst- zero self disclosure. Ie never so much as said he liked or appreciated anything about me, always called me by my second name, and I knew absolutely nothing about him. I was 'on the couch' for three years. Incredible 'archeological dig' for me, unearthing all kinds of suppressed childhood fears and also sexual reawakening. Deeply intimate and intense, and I am not a sharer normally! So massive leaps of allowing someone to see my inner self and reaching the point of feeling accepted and cared about, despite the lack of any explicit affirmation from him.

One day, after all that time, I guess he was unsettled/ pissed off/ maybe with me or with the world, and he suddenly self disclosed in a way that felt deeply rejecting. It wasn't this, but something like saying 'Oh, I wouldn't ever want to know you in real life'. I was totally blindsided- wasn't like I was attacking him or anything, so I still don't know what set him off. It landed in my regressed/injured parts as a total disowning, profound rejection from this 'reparative parental figure' etc.... which was a repetition of original trauma.... I also felt profoundly humiliated, having shared so much and exposed myself so much, to someone who apparently didn't even like me. (I think he did well enough, and was just in a defensive whirlwind of some kind, but emotionally that's how it landed) Then worse than this, he went back to being the classic analyst- not apologising, acknowledging that he'd broken his own rules or explaining where the hell that had come from. That felt gaslighting and cruel to me, and hypocritical- as he'd self disclosed in a moment of defensiveness- greatly hurting me, but wasn't willing to self disclose in order to help heal it. I struggled on for a few months with him, trying to feel better, but it was a major severing.... and I left in the end without any resolution or understanding.

After struggling to get over it on my own for some time, I went to a different kind of therapy (IFS), and that hugely helped to heal it in just four sessions. There were two major 'injured parts' (if you know about IFS) - a four year old, who felt shunned and disowned, and a teen girl, who felt she'd been stripped bare and humiliated. They are both much better now!

I think psychoanalysis can be immensely powerful - but for good and bad. Any model that is so reliant on the therapist getting it perfectly right is high risk. IFS, I prefer for this reason - it focuses on helping the patient build a better relationship with themselves... the therapist is the facilitator, but should not become the object of repair. (Ie they are not the reparative parent,,,, the patient finds their own inner core self/ reparative presence instead).

Anyway, hope all that makes sense and is useful.

@financialcareerstuff thank you so much for this. It’s such a powerful exploration of what happened to you. I’m truly stunned that he acted that way. How truly awful for you to have to process all of that without his humanness in the aftermath of the rupture.
I am fascinated by IFS … I’m really pleased you had a reparative experience there. It’s something I’m considering training in but for now I will concentrate on building my experience.
Can’t thank you enough for your sharing here 😊

Pleasure. I'm also trained in IFS (as a 'practitioner' as I'm not a therapist, but a coach.) It's an incredible model in my opinion! Xx