Help. My therapist won’t let me go.

[Lizzbear]

This is a bit tongue-in-cheek, but also a bit worrying. I’ve been seeing a psychodynamic therapist on the NHS therapies fir 5 weeks, once a week.
I’ve been suffering with intrusive thoughts and anxiety.
After a couple of sessions I decided we weren’t a good fit, Im not sure it’s forms.
I’ve told him on 3 occasions but he keeps saying I’m giving up on myself and that he’ll see me next week. I then feel bad and turn up the following week, and have the same conversation.
He’s quite hard to read, and it’s not his fault I’m looking for more direction.
The thing is it’s an unusual therapy which is based on the relationship between the therapist and the patient.
its called dynamic interpersonal therapy and Im finding it hard to navigate. I think I’ll stick with it now, but has anyone else had this therapy?
How did you find it?

Through my doc after CBT didn’t help. Waited 4 months.

Try a different therapist!

you are a grown up and you get to decide if you click with someone or don’t.

however; therapy requires trust with your therapist so if you can’t build a relationship with them (cause you feel you haven’t clicked) there won’t be trust and makes the whole thing much harder. Try another provider

I've had psychodynamic psychotherapy and it was exactly like this.

After 3 years I couldn't have told you the first thing about my therapist except her name.

The technique was as you describe - she would ask me about something I said, make some comments, we would disagree, then talk about why I was disagreeing... it was really hard work as it challenged everything about my relationships and interactions with other people. If I thought something she said was weird or upsetting, I'd bring it up in the next session and get 'interesting, can you explain why you thought that?'

As you say, it was bloody hard work.

Mine was also NHS so no concept of whether the therapist was a good fit, I was just grateful to be having it. Ultimately it was one of the best things I've ever done and I'm eternally grateful for having it.

I've seen a psychodynamic therapist privately for years. I'm also ironically a mental health nurse! The modality is a bit 'blank slate' because it's all about playing out patterns in your relationships by projecting on to your therapist. The aim is to recognise your unconscious beliefs/thought patterns and how these relate to our past and continue to impact us in the present.

This kind of therapy is challenging and uncomfortable at times. I have an excellent relationship with my therapist, but I've known her like 8 years now, and we've definitely had a lot of ruptured and repairs (due to my own transferance). I've felt all kinds of feelings towards her: anger, love, a longing to be mothered, indifference. It's been hard, but it's the best therapy I've ever had. My therapist also holds absolute unconditional compassion towards whatever crap I tell her, and that's been more healing than I can say. It will make you truly do a deep dive into why you are the way you are. It might be that that feels unsettling right now, so really do some soul searching and ask yourself if deep down you're actually feeling frightened and question whether you have some defenses up. He may genuinely not be a good fit for you, but I'm not sure you could know after 3 sessions.

And in all honesty I'd tell him how you feel. If he's a good therapist, he will openly have that chat, as that's what this kind of therapy is all about. I've told my therapist before when I've felt mad at her, or if something isn't working, or I can't read her, and we've talked it though. If you think he looks confused, ask him. If you say you don't feel you're a good fit, tell him. You will definitely be met with a lot of 'it's interesting that you're seeing my face as blank right now, I wonder why you might think that', but that's okay.

It's a very open ended and client led therapy. It ultimately might not be for you, but my advice would be to stick with it for now. I know it feels weird to tell a professional you think they look blank or confused or whatever, but I promise you that in this form of therapy it's very welcome.

You do not have to bond with a therapist for therapy to work, quite the opposite for many clients. Some people often have a desire for their therapist to like them and get confused between a therapist accepting them and a therapist being a friend to them and when not getting any signs that they can find this frustrating, hurtful and often get angry towards their therapist but that is not a bad thing and it can lead to some very positive changes in their relationships.

no one on here can made the decision for you if you really are not wanting to return don’t. Therapy is a rollercoaster it’s always worth reading up on how a particular therapy is practiced before

He has challenged you already yet you still have returned isn’t there something in that ?

This is wonderful and made me tear up. I feel exactly the same. After 3 years I understood why the therapeutic relationship is so important. Its been incredibly healing in a way I have no words to describe.

Lots of great advice but, lots of posters seem to ignore that OP has this therapy through the NHS. I am absolutely not saying that because it is triaged and then prescribed it it the right thing for OP. However, assuming, like for many people paying privately is not an option then just walking away means she has basically self-discharged from a service with a very long waiting list. Just stopping going will mean OP is discharged, that she will be contacted and offered an alternative. I have not worked for the NHS for over 20 years now (jumped out from the frying pan to work in Child Protection) but even in the 1990s, mental health services were chronically underfunded and ignored.

I disagree with most here. The most important part about counselling is the therapeutic relationship and if you do not fit then I don't think it will work. You have a gut instinct for a reason.

I once had CBT with a guy who would laugh at me (when I was describing intrusive thoughts). I found him patronising and told him so, and I asked for a different therapist.

I had therapy for CBT and felt uncomfortable with the guy. He was into body building and wore tight T-shirts and it just made me feel like I was back at school being pathetic in front of the cool kids.

I kept going a few weeks and in the time we talked about my aversion to germs, dirt etc. It’s been 10+ years and I often get thoughts about how he put his hands inside the waste paper bin the room and wiped them all over his face. It still makes me feel sick.

That therapy did more damage than good, and it’s been lasting. Please request someone else if you don’t feel it’s a good match for you.

I personally disagree with the theory behind this approach (Freudian, what a surprise!), and having met two such practitioners I found them both to be very manipulative people (didnt meet them professionally, and not connected to each other, pure coincidence).

So perhaps it really is him and not you!

I disagree @Allthesmallthings182 it's probably extremely common to reach a point where you feel your psychodynamic therapist doesn't like you do to the nature of their responses.

This then gives you the opportunity to explore why your gut instinct is telling you they are horrible as if you found relationships easy, you wouldn't be doing psychodynamic therapy. My gut instinct turned out to be seriously misfiring and not reliable at all.

Hello, therapist here ✋🏻

The relationship is the most important part of therapy in my opinion. This is a tricky spot to be in as I’m guessing if you had to pay for this you’d probably leave. But you’ve been given the opportunity for this on the nhs and you don’t want to pass up the offer. If this was me I’d give myself a time limit, maybe 8 sessions and see how I feel. Your therapist sounds like he challenges you which is fine when clients have a strong rapport with their therapist as they trust them. But not so easy when you don’t know that person at all. It could need a bit of time or he could not be the right match for you. Personally for me I’d be using a compassionate approach to those intrusive thoughts. I would see how you feel over the next few sessions and go from there. As other posters have said I would absolutely call it out in the room with him, he should be able to handle that professionally x

That sounds really good! I wish I’d had that.

I mean, the thing to do, surely is to tell him all this.

The whole point of therapy is to feel that you gel and that it is working. The very fact he is forcing you to stick with something that makes you uncomfortable should set slarm bells ringing. There's being gently challenged and there is feeling uncomfortable. They are not the same thing. Leave. You dont have to justify your decision to him. He is showing more interest in you sticking it so that he keeps his job than he is in your feelings and welfare.

He keeps saying you are making progress, he keeps getting paid.
Should you feel you are not making progress, particularly if the NHS funding stops just stop going.

The quality of the connection between therapist and client is the most significant predictor of successful outcomes regardless of the modality.

The therapeutic connection is built on acceptance. I agree that this connection is different to a friendship or feeling liked as such but I disagree on virtually everything else.

I didn’t gel with my psychologist at all, I wouldn’t want her as a friend etc, she was still excellent and helped me out significantly.

Many years ago I saw a private therapist for 2 years. He was absolutely shite but just kept going back and paying out my money. I just question myself now wondering why did I keep going back.

I had a few NHS sessions with someone I really liked but knew immediately I would never progress with - she was a real mum type and I was grieving the loss of my own mum so it was too painful, a Rape crisis service which was ok but then I ended up finding an absolute gem who was worth his weight in gold and changed everything. I never looked back.

The supportive relationship is so important with a therapist, if they cannot generate that then I do not see how therapy will work. There is so much evidence showing that healing happens in “community” so your therapist needs to be part but really the pinnacle of that community. However if you feel that the community might come from the group sessions well that is something to think about too. There are many poor quality therapists out there so it needs to be right.

That is not true in some forms of therapy the work really is in the uncomfortable moments, it’s not for everyone but that the op isn’t sticking to the boundaries she is trying to set I would expect to be explored

Psychodynamic forms of therapy are not for everyone and for some it’s too intense, the therapist being present but emotionally blank can feel cold and for some it can feel like rejection this of course can lead to the question why

that’s not to say the op should stay or leave but she is being challenged and it’s raising questions for her

Thats also how cult leaders operate and therapy is historically littered with abusive practice. You have to be careful. I have heard very expwrienced, well recognised practitioners say the same thing, so I'm not sure you are correct. There are a huge number of third rate practitionets operating and it's not talked about enough.

You definitely can't 'get a different therapist' on the NHS. You possibly should be able to but you can't.

OP therapy is hard when it's working. That doesn't mean it definitely is working if it's hard but it is interesting that you describe insecure attachment in yourself and then you're trying to extricate yourself from this particular relationship... In which the therapist is obliged to be there and therefore isn't going anywhere. And can't be horrible to you either.

If he has 'made you think', and it is 'much harder' than you expected, it sounds like you are being productively challenged and you should stick with it.

If the relationship feels bad in some way, then work with that. That is part of the meat-and-drink of psychodynamic therapy. For example, you could work on why you keep coming back despite feeling he is a bad fit. Is it people pleasing? What does that remind you of in other relationships? Everything that seems like an obstacle in the therapy is in fact part of its raw material, something to make you stop and dissect.

The way I think of it, NHS psychodynamic therapy is gold dust, soooo hard to access. Much better to use up all the sessions and find they haven't helped than to throw away the chance. At the end you are bound to have some extra knowledge that will help you make use of the group therapy.

(In writing this I'm assuming that you can't simply ask to switch to another therapist. It isn't usually too easy to do that, I think.)

We shall have to agree to disagree

by bonding I did mean liking or feel they trust their therapist which for some clients just feels impossible to accept

but some clients won’t like their therapist, they will at times feel anger or even indifference but something is compelling them to return. What that might be may never be explored (time limits or client ends the therapy) or acknowledged but work can still or had been be done in that space

I absolutely agree there should be far better regulation of the industry and more stringent training

when I was training (degree and post degree) within a few months of my placement I was working with bereaved parents, this is appalling I was in no way experienced enough and I feel they were let down and I was too

person centred gentle form of therapy can be damaging and manipulative too. Too many therapists enjoy the adoration of their clients.

I have spoken to many people who have put their therapist on a pedestal (very common) but this hasn’t been explored and I often wonder why or they will repeat what their therapist has said as gospel, this may be explored in future sessions (or maybe it has already). But I have sat in enough supervision session to be aware how many therapists get caught up in this (and I have myself at some point it’s part of the learning)

I agree with a lot of the previous posters that this type of therapy is difficult, especially if you are accustomed to reading people's body language and reactions for how to behave but now you can't read your therapist so it's frustrating you.

If you feel challenged it shows that it's triggering something within you (a sense of rejection, not being able to 'charm' your way out of avoiding difficult conversations, having to stand by your expressed feelings without capitulating etc)

Obviously there are bad therapists out there, and not all therapeutic methods suit every situation, but in this case it seems like it is working.

Also, you are getting it for free on the NHS so what's the harm in continuing? Worst case scenario nothing changes in your life. Best case scenario this therapy cracks open something inside you that has been resistant to other forms of therapy.

Good luck on your therapy journey! My therapy was completely life changing, I wish the same for you.