Psychoanalytical therapy.

[Meringue1234]

Could any one help with this, I have been having it for about 16 sessions.The thing is I do not know where it is leading feel no better at all.Last session he spent 5 mins on his mobile texting directions to his office etc to his next client we then spoke about the new office decor etc. Came out with nothing to help me. He is very kind but really not sure if it any help as still got terrible GAD and depression should mention also on medication.
As I said can anyone give advice please?

Last session he spent 5 mins on his mobile texting directions to his office etc to his next client we then spoke about the new office decor etc.

Really not on. Is he registered with the bacp or similar?

It is important to realise that you are in control here. When you are having mental health problems it is easy to tale on the weak role and allow yourself to be sold short.

Whether you are paying this person or you are one of the tiny minority of people who have acquired this on the NHS, you have an absolute right to say what you want to get out of this exchange and to say if it does not seem to be working out in the way that you want.

Did he start by making some sort of contract with you? .... by giving you the opportunity to be clear about what you are hoping to get out of it and how you feel he might be able to help? Being kind is not enough ... and being a receptacle for your confidences is not enough either. The sessions need to have some focus and direction.

It sounds a bot as though you are being sold short here.

I am sorry that you are so unwell at the moment; but that does not mean that you are powerless and have no control over your treatment.

Psychoanalysis was my saviour but then I had an excellent therapist. I would feel very aggrieved in your situation. Please don't feel it's the type of therapy that is the problem, it sounds more like the therapist.

Regarding when I started to feel better, it often felt like 2 steps forward, 1 step back but that's because re-living trauma can be, well, traumatic! But I would definitely say I felt I had made progress very soon after starting the sessions (and I thought I was a bit of a lost cause as I had had a lot of therapy before that hadn't really helped much).

My therapist always encouraged me to speak to her about any concerns I had regarding her and our sessions as you really need to be able to connect with them without feeling resentful. I remember confessing that I felt abandoned that she was going on maternity leave! I would definitely bring up his lack of professionalism (in other words, of course!) before potentially considering changing to someone you are better suited to.

Messaging someone else while you’re there is absolutely not ok.
Apart from that, psychoanalytic therapy tends to take a while to see changes. Was that explained to you by the referrer or by the therapist?

He sounds like a crap therapist. It’s important to get a good fit. I would suggest you start looking for someone else.

Good luck, it can be so helpful

Psychoanalytic therapy is a longer term therapy so usually at least a year. The therapist will need to be able to work within the relationship and the transference, this requires clear boundaries and substantial training.
He should be registered with the UKCP, part of their code of ethics specifies clear contract arrangements

You are paying for your therapists time, experience and attention, it doesn’t sound as though you are getting at least two of those.

Thank you all for your replies he is registered, I was recommended to him by a therapist that had no spaces.Reading what you all say I feel it is not the right match, it is just I am so useless at picking a therapist not sure how to try to find a replacement but it is costing me money and alsoI am so desperate to get better. So not only the money is a factor but also the lost time. I hate being like this it has gone on for so long CBT did not work as my memory very poor at the moment and I just forget everything I am told.

Do not feel you are useless at picking a therapist - it is not something we do every day and there is no reason why we should be good at it!

Psychoanalytical therapy is slow but there is no reason why it should not be clear - you need to have some sense of direction. Since its effectiveness demands that you find the right fit and have confidence in them, the person chosen is very important. You cannot have a therapist engaged in a conversation on their phone. It is not inappropriate to mention the new decor in passing when you are entering the room; but once you are settled into the meat of the therapeutic session it should have no place in the conversation.

One of the problems with this sort of therapy is that it is very slow to show results, but the therapist should be tackling this or it is easy to feel that it is your fault and just reinforce your sense of hopelessness.

I wish I knew how to tell you where to find a good therapist - partly because what suits one ay not suit another; and each has their nuances and pet theories and techniques.

I am sorry that CBT did not suit you - it is not for everyone; but the problem of forgetting what has been suggested should not be a stumbling block as it us common to use written handouts in this therapy.

I hope you find the right treatment for you soon and send good wishes.

Thank you for your reply Mischance, I just wish someone could find me a good therapist, it is so hard to know how to start.I asked my consultant as I trust him but he could not help me.

I would recommend cognitive analytic therapy as it can work well for a range of issues and uses a lot of written work - an initial understanding of the problem by the therapist , an ongoing use of diagrams to demonstrate what is happening then a final letter summarising the the therapy- which would help with the memory

See Acat.me.uk and find a therapist link, it is also available in some nhs trusts.

Psychoanalytic therapy takes a long time. I was seeing a psychodynamic counsellor for 3 years and started with a psychoanalytic psychotherapist, which was potentially open ended but after two years, the whole relationship fell apart.

Another psychoanalyst I saw on an ad hoc basis was later struck off!

I love psychoanalytic theory but my actual experience of it has been quite poor.

You might be better off with someone who works using a different modality, possibly something more trauma focussed?

Spending YOUR time on a other client is a red flag. It would be perfectly acceptable to tell him how that made you feel. This type of therapy is all about the relationship between you and the therapist.

@Meringue1234

Thank you for your reply Mischance, I just wish someone could find me a good therapist, it is so hard to know how to start.I asked my consultant as I trust him but he could not help me.

@Meringue1234

Is the therapist you were seeing registered with the British Psychoanalytic Council?

You can check at www.bpc.org.uk

The British Psychotherapy Foundation offers an assessment service which enables them to find a therapist they think will suit you.
It is a slow process - I am into my 3rd year and have only really seen changes over the last couple of months (although it might have been quicker without covid and a couple of traumatic events along the way).
However testing in your session (doing anything other than being totally focussed on you) is not right.

Hello again, I have looked him up he is on the UKCP as a Psychoanalytic Psychotherapist.
It is maybe my fault talking about things like the plants in the office etc.
I really need to try to get better as my thoughts at times are so dark and they frighten me.

@Meringue1234

Hello again, I have looked him up he is on the UKCP as a Psychoanalytic Psychotherapist. It is maybe my fault talking about things like the plants in the office etc. I really need to try to get better as my thoughts at times are so dark and they frighten me.

So not registered with BPC?

Roseau1Can you tell me how do arrange an assement please?
I must say he did make the time up for me but I think the session was chit chat rather than trying to open up what in the past might have caused me to be in such a mess now.

I don't know how to do a proper link. If you go on their website ànd choose assessment in their menu it explains.

Truthfully I would find a registered clinical psychologist - check they're registered with the HCPC. They're almost always trained in a few approaches so can tailor it to your needs

@Meringue1234

Hello again, I have looked him up he is on the UKCP as a Psychoanalytic Psychotherapist. It is maybe my fault talking about things like the plants in the office etc. I really need to try to get better as my thoughts at times are so dark and they frighten me.

It is not your‘fault’ . A decent therapist would be exploring with you why you are talking about plants and not the real issues.

@sayithow

Truthfully I would find a registered clinical psychologist - check they're registered with the HCPC. They're almost always trained in a few approaches so can tailor it to your needs

Most clinical psychologists are not trained to work with deeper issues, training usually covers some approaches, usually shorter term therapy as it more accessible in the nhs. The most common is cbt. Some training covers others approaches like cat, but even then it is to practitioner level not psychotherapist. Some will go on to do further training but it depends on the individual trust funding opportunities.

Well that's not true @whatsnext2 - I am a clinical psychologist and myself and my entire team work with very complex high risk clients on 'deeper issues' and we aren't unusual in doing so.

Finding the right therapist is so very hard. A huge amount of trust is required for this leap in the dark. This sort of psychoanalytical therapy is by its very nature very very slow - but clearly it is also an ongoing source of income for the therapist who has a vested interest in prolonging this.

Now I am in no way saying that all therapists would do this - I am sure the majority are honest and professional - but you simply have no way of knowing. By the time you begin to feel that things really are going nowhere, you will have invested so much both emotionally and financially that it is hard to walk away.

This is why it is so iniquitous that most NHS mental health services offer only a narrow range of therapies - where I live it is CBT or nothing. If more psychoanalytical therapists were employed by the NHS then you remove the financial interest to prolong the therapy. But that would cost-a-load for the NHS and it is not going to happen any time soon. CCGs like to see quick results.

I really feel for you in this dilemma. But would simply say that it does need to be the right person.

I did once spend some time talking about a picture in my therapist's room and the colour of her wall but it was after I had been seeing her for a while so she picked up almost straight away what I was really talking about. I'm not sure if it would have made any sense to her in the 1st few sessions.

@helpinglkeabelpthing

Well that's not true *@whatsnext2* - I am a clinical psychologist and myself and my entire team work with very complex high risk clients on 'deeper issues' and we aren't unusual in doing so.

Apologies I know you probably deal with very complex cases, and some teams do deal with ‘deeper issues’ but the reality is the nhs isn’t set up generally for the longer term work I have found. I used to work in the psychotherapy department of a London hospital and quite often we were referred clients from psychologists for that reason.

The OP hasn’t described her problems so I don’t know if Short term or long term work is appropriate but if the OP is having ‘dark thoughts’ then her GP should be first port of call and IAPT as first step.

Interesting how thread started up splitting dynamics in me for one anyway.

I also work in NHS mental health services and it frustrates me how much we routinely spend on psychiatry and yet psychology is seen as expensive