Problems with therapist

[therapistquestion]

I'm having psychodynamic therapy and an having problems with my therapist.

I'm not sure what to do, she keeps coming out with things that I find upsetting. I bring them up with her and the she says something else. We started off on the wrong foot because her style of therapy is to say hello and then remain silent for the whole session while I talk.

I told her that although I appreciate that's her process, I need at least some feedback to show I'm being heard. She seems to have taken that on board but the feedback she's giving doesn't make me feel heard at all, just misunderstood.

One of our biggest problems is incongruence. I've suffered a lot of trauma both as a child and an adult and find it difficult to be vulnerable with someone I barely know and to show them that vulnerability. She keeps telling me that it sound as though I'm telling her stories. I'm not sure how to interpret that. The week before she told me that it was like I had an agenda because I wanted to talk about issues raised in the last session.

I find talking about these incidents upsetting and traumatic and feel as though that trauma is not being empathised with but misinterpreted. I am bringing these problems back into every therapy session but then something happens again that I'm finding upsetting. I feel judged. Like I should be acting in a certain way and because I'm not on the floor sobbing, I'm strange.

@Hotwaterbottlelove

I had a therapist who gave very little feedback. After saying hello she just stared at me. Which I hated, my mind went blank and u feel like the world was starting at me. We struggled on for about 10 sessions and I did bring it up with her but she just said it was up to me to lead the sessions. I got a few good things from it but ultimately I needed more a more reflective approach.

Sounds like the same kind of approach, sorry it didn't work out. Sounds like you gave it a go though.

Having just read what you said about the bullying in your childhood - do you feel like you are re-enacting the bullying experience with her as the bully?

Because a lot of this goes on in psychodynamic therapy - what you are experiencing is transference.

Why did you reject group therapy? if you struggle with relationships to practice creating and maintaining relationships in a group setting with a therapist at hand seems very sensible. Maybe rethink your stance on that? The consultant is the expert after all

@AnnaMagnani

Having just read what you said about the bullying in your childhood - do you feel like you are re-enacting the bullying experience with her as the bully?

Because a lot of this goes on in psychodynamic therapy - what you are experiencing is transference.

I'm feeling very judged with her. Not bullied exactly, though I'm finding her unsympathetic.

@iano

Why did you reject group therapy? if you struggle with relationships to practice creating and maintaining relationships in a group setting with a therapist at hand seems very sensible. Maybe rethink your stance on that? The consultant is the expert after all

Because I really struggle in groups as I have bad social anxiety. I've had group therapy before which didn't go very well (it wasn't run very well) and, given how I felt (very vulnerable) I wasn't prepared to risk that again. Group has been put on the backburner for now but I'm doing one to one for the time being.

@AnnaMagnani

Some of this does sound v familiar to me from my psychodynamic therapy - it's a long process and v intense.

Saying 'Hello' and just leaving you to start was pretty normal. My head would be spinning when I left, I'd spend the week thinking about things and then I would to some extent have prepped what I wanted to talk about. I soon learned if I sat there in silence not saying anything, the session would be gone - and in effect that was part of the therapy.

Her saying 'it's time to stop now' - yes, mine did that. Again, part of the therapy was learning how to get across what I wanted to say and use the time effectively. But on the other hand, don't worry! This therapy takes time - I took 3 years and only stopped because I moved house! It probably took me a whole year just to figure out how to deal with 'it's time to stop now' - and again, sometimes being angry with your therapist and learning how to deal with that anger in a healthy way is part of the process.

It would be OK, for example to say to her 'I don't like it when you say x' and then you could explore it. Or as you have described 'No, I'm not angry, I'm really really sad and holding it back in. I feel like you don't listen when I describe my emotions'.

Thanks. I really feel as though that's the way to go, to just say at the time how I'm feeling about the approach. I have a tendency not to say how I'm feeing at the time. The problem is I may be talking about something important to me at the time, so I'll then have to interrupt that to say something else.

@gypsywater

This was pretty much my experience of psychodynamic therapy. It did help a lot in the end though.

Did it take a long time? Maybe I need to just give it more time.

Like 5 years
I found schema therapy as beneficial tbh and that is warmer and quicker!

I have a tendency not to say how I'm feeing at the time. The problem is I may be talking about something important to me at the time, so I'll then have to interrupt that to say something else

Well, this is one of the advantages of psychodynamic therapy - you can address an issue from any angle you like (as long as you learn your time management )

You are thinking about your sessions, how you deal with your emotions and thoughts about the painful experiences you talk about and feel you aren't making much progress. But the session is yours to direct wherever you want to take it.

So next week you could start with something like 'I have been thinking about how we talk about my painful experiences. I have a tendency not to say how I'm feeing at the time. The problem is I may be talking about something important to me at the time and I don't think I get across how I am really feeling - and give an example'

How long have you been going? I remember thinking I would talk about my mum and then I spent at least 6 months talking about my dad and being nowhere near ready to talk about my mum. Whole thing took years and I left before I was really finished.

Still best thing I ever did, I was so lucky to get it.

If a lot of the stuff you want to work through is relationship based I'm wondering if relationship therapy with an emphasis on attachment might suit? Relate centres often offer bursaries for reduced fees if you are on low income. Can't get that free through the NHS though. I'm a r/ship counsellor and I often work with single/individuals on past relationships with parents/previous partners and how they impact on our present.

My first ever counselling tutor was traditional psychodynamic in approach and I found her so cold. Someone in class asked about offering water to clients for session - she looked appalled at the suggestion and said why would she do that, they can bring their own?! I felt that offering water was just a kind thing to do. I knew then that working with the psychodynamic approach was not for me. It can work for some but it wouldn't suit me.

You could ask her why she keeps bringing anger up. I have been having psychodynamic therapy for several years and fairly early on the therapist said that I wasn't expressing anger. Eventually I asked her why she kept talking about anger when this wasn't at all what I was feeling. She said everyone feels anger and that repressing the anger causes all sorts of problems. She said you don't have to act on the anger but you do have to acknowledge that it is there.

After lots of discussion about anger (and lots of thinking about it outside sessions) I think she is probably right but I am still having trouble recognising anger in myself.

Thanks. I'm not feeling the alliance and I don't feel as though my therapist is trying to understand how I express myself or why I express myself in a particular way. She also keeps telling me that I am describing painful events but am not showing that pain. I feel as though she wants me to perform for her. What I'm actually doing is trying to hold it together so I can finish what I'm saying. She is interpreting that as anger; which I find odd as I'm nowhere near angry. It's very frustrating.

I actually believe that your therapist is on the right track. Telling you you're not showing pain is mirroring back to you what she sees; it isn't judgement. And there is the possibility that you are feeling anger but you aren't aware of it. This is psychodynamic therapy. It is not a normal conversation, and your therapist is not there to make you feel better in a session, but rather to help you make sense of those aspects of you that you are unaware of, and to be able to start to process feelings you have closed yourself off from completely. You feel like an outsider in the process; and you have felt like an outsider in life. Can you see how the sessions are taking on the flavour and form of your everyday experience? That's what it's all about.

I have sometimes worked with clients for a very long time before they can admit to certain emotions.

I think it's working for you OP and you should definitely stick with it.

You have gone into therapy for reln difficulties and it's not surprising that you are finding this therapy relationship difficult.

That is the work you're doing - you feeling judged/ignored/ill attuned to and so on.

I don't doubt that you really do feel those things and experience them that way. But I am also pretty sure your therapist is listening harder to you and thinking harder about you than anyone has ever listened/thought before in your life !

It's the start of a long process of understanding that what we experience as reality is coloured by our internal world/template. And that there is a gap between that and external reality.

I really appreciate everyone's thoughts and insight into this. It's been really important. I was trying to respond to everyone at once but there's been so much help I'll try to sum up here.

I didn't really understand what the therapist was trying to do. I have never observed psychodynamic therapy, so had no idea that this is what it is. I just thought the therapist was quiet.

Posters explaining the process to me, (thank you) has really helped me to see the dynamic that is at play. I had really bad group therapy before and was accused of being borderline for expressing anger at past abuse. So I suppose I'm a bit sensitive to be told I'm feeling angry, especially when what I think I'm feeling is grief and sadness.

I think what I'm going to do is bring this all back into therapy next week and tell my therapist that I feel judged, misunderstood etc and I'll also be more open to what she is picking up rather than seeing it as an attack.

We're going to have a review in three months so I'll see how I feel then. I also did think mistakenly it seems, that therapy was supposed to make you feel better and I'm finding it very, very difficult. I'm left to cope with these intense emotions by myself until the next session and I was wondering what the point was!

Thank you so much. This has really helped.

Respond to everyone individually, not at once.

Keep going OP. It’s hard, but psychodynamic therapy is not ‘tea and sympathy’. It’s hard work. And the key to it working is saying everything you feel. So tell your therapist what you have stated here. The therapist is responding to what you are projecting onto her, which is likely mirroring how you are in relationships- are you avoidant in your relationships? Do you hold back? do you disconnect and separate the detail from the emotion? How we are in life and relationships and attachments plays out in the therapy room , and this is how it is uncovered and examined...
Good luck x

Good to hear from you OP.

I have had a lot of this kind of therapy myself. It took me a long time to learn how to use it and it creates a whole load of difficult feelings. It doesn't make you feel instantly "good" in the way it would if you had an approach where they said "gosh, that sounds hard for you".

You get in touch with lots of difficult feelings and you might also get very attached and miss your therapist like hell in the holidays!

But over time you work through these feelings that come up in the presence of your therapist and with the help of his/her separate mind.

Then you internalise some of that reflective capacity yourself.

I expect over time you will start to feel better in ways that you can't quite put your finger on. Like you have more space and freedom in your life, you are not a prisoner of your own internal world anymore. Something like that anyway.

I remember being very upset that my therapist was quiet and that I had to sit there and do all the talking.

The cheek of it! Why should I be expected to do all the work?

Then I realised over time that my therapist was working very hard over there .... and providing a space for me ... into which she tried very hard not to intrude.

It was only then that I started to realise what it might all be about ...

Someone I know was very upset when her therapist said to her "I'm not here to make you feel better, I'm here to help you learn to manage your emotions" but for me that seems to sum up what psychodynamic therapy does.

A couple of things which have come up in my sessions which you may also find helpful to think about:

• what you "hear" the therapist say may not have been what she actually intended, or even what she said! I have now got to a point where I can recognise when I am probably misinterpreting what she has said and I'm comfortable saying "I don't know if this is what you meant but this is what I understood."

• everything is open for discussion. She hasn't decided once and for all what she thinks about you

• she can be wrong and make mistaktes but she won't know unless you tell her you think she is wrong/has made a mistake and explain why

• the more you talk to her, the better she will get to know you and the more pertinent her interpretations will be.

• you can tell her that you have found a session hard/have trouble managing your emotions after sessions/between sessions. That may be a sign things are progressing too fast.

On a personal level, there are things she has said that I have vehemently denied, only to realise several months later that actually she was right.

As someone else said change happens gradually, almost impercepitbly and I have realised that I have changed a little bit mainly when other people have commented on something I have done or said.

Why isn’t at least some of this (very helpful) information shared at the first session?

I think that anger can be a very difficult emotion to get in touch with and to express, especially for women due to the expectations of society.

I also think it's possible you may be feeling sad in order to suppress deeper feelings of anger.

Why isn’t at least some of this (very helpful) information shared at the first session?

Its about making a space into which the patient brings/creates whatever they need to bring/create. So therapists don't tend to tell you how it is going to be (because they are waiting to see themselves).

Why isn’t at least some of this (very helpful) information shared at the first session?

Also because real change comes when people experience and discover things for themselves and have an live experience of it. you could think of therapy as just one long set of experiences from session to session.

It is no good just "telling" people things real change doesn't work like that.

Why isn’t at least some of this (very helpful) information shared at the first session?

I had many discussions early on about the process and have returned to that subject a number of times. I think its reasonable to expect that. I would be very wary, and think therapists should be too, of engaging in a process where those discussions can't happen.

OP i have learnt that the best thing is to try get all feelings/thoughts like those you express here into the therapy sessions. I know how difficult that is at times. Often i don't know how i feel until afterwards. I have never ever been made to feel like i am being difficult for questioning the process. I hope that is the same for you.

I needed to understand and question the process and my therapist has never been anything other than open to those conversations. (And of course we have also had conversations about those conversations!)