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Originally Posted by BudFox
Wow thanks for sharing that. That is frightening. My ex T claimed experience with developmental trauma and attachment, but in the real world she was lost. I don't recall her ever articulating what was going on. And her casual approach to termination, which one could argue is the most important thing of all, shows complete ignorance of attachment concepts. I also think even with a good grasp of theory she would still have done damage, because she was too wrapped up in her own needs and impulses. I get the sense her practice revolves around her.
It does seem (from the little I have seen) the focus of therapist training is on learning to become a therapist, rather than learning about clients. I want a T who thinks the DSM is excrement because they understand how human beings actually function, not a T who can recite it from memory.
As for the OP's T, he seems entirely unaware of attachment dynamics, as evidenced by the following ludicrous statement: "The depth and nature of your attachment to me and the manner in which you have fairly consistently attempted to maintain that attachment is the core issue that in my opinion is unresolvable." Maybe like many P-docs his focus is on drugging the patient, which allows him to pretend he is a doctor, and avoids the mess and fuss of dealing with the human being.
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The OP's T in his letter is basically saying that she is hopeless which is unthinkable for anyone in the helping profession to say. If the T feels not competent enough to deal with her issues, that's fine, he just has to say so, he has to own his limitations instead of trying to put his crap on the patient which doesn't belong to her.
As to the training, yes, in the academic training the emphasis is mainly put on 4 things:
psychological theories that are used to conceptualize clients problems that are NOT based on the modern neuroscience findings and trauma research;
psychotherapy methods based on the above theories that have no connection with the recent research data or any research data for that matter and the long term effectiveness of those traditional methods isn't backed by any research.
memorizing DSM "diagnostic" criteria
professional laws and ethics and exercises on resolving all sorts of ethical dilemmas to reduce the risk of getting in trouble primarily;
During internship, the emphasis is on whatever the agency/employer wants you to do, which is usually to increase their bottom line. Many non-profit agencies are contracted with the state mental health department and, in order to survive, they constantly have to produce tons of DMH paperwork to bill the state for services. When you work there, you are constantly under pressure to produce "billable hours". You don't have any time not only to do the quality work but often even to get a complete picture of the clients' situation as 70% of your time is paperwork, and the more billable hours you collect the more paperwork you have to do. Not all agencies are under DMH contract but whatever their model is, it is always about money first and I can't blame them because there is no other way to survive in the market economy. You may be pressured either to retain clients or to market for the agency or to do insurance medical billing, whatever it takes to increase the revenue.
The most ethical, well-intentioned therapists cannot provide quality services under this kind of system.