Budfox: Thanks. I agree that it can be hard to know much about the therapist. And, some clients don't need that... in some cases, that actually works to their advantage. But, some people *do* need to know, at least a little.
Did you see this article, by Ken Pope:
Therapeutic Relationship As The Foundation for Treatment with Adult Survivors of Sexual Abuse
Someone posted it here awhile ago (and I'm so sorry that I can't remember who shared it originally, as I reference it frequently!). What I thought was fascinating is that he talks about how, for some people, the traditional dynamic of a neutral therapist is actually damaging, and replays family dynamics (that rings very true for me). Sometimes, the therapist needs to actually step forward to meet the client.
Quote:
Ken Pope:
The transferential expectations victims may bring to the therapeutic process, which include failure to protect, abandonment, indifference and even assault, can be intensified by the therapist's silence and passivity (Rose, 1991). A neutral stance, appropriate for some types of clients, is not effective and can even be harmful for adult survivors. As Spiegel (1986b) explains, "traditional analytic reserve is often perceived by the patient as a lack of concern or even a sadistic pleasure in the patient's suffering" (p. 72). Attitudes of "distance" or "therapeutic neutrality" are likely to remind abuse victims of their dysfunctional family's patterns of interaction and therefore reinforce the patterns of denial. A similar recreation of the abusing family's attitudes can also result from instances where the therapist manages the intense countertransference reactions to these client's painful experiences, by distancing from or minimizing the significance of the abuse.
The therapist, therefore, must abandon traditional reserve and shift to a stance of "active engagement" (Olio, 1989). This stance offers explicit, repeated invitations for contact between the therapist and client, followed by observation and inquiry regarding the meaning to and impact on the client. Active engagement reflects the balance of sufficient initiation by the therapist, to create a responsive environment without reaching a level or intensity of intervention which becomes intrusive or controlling. If the therapist holds back, out of fear of intrusion, he or she may fail to provide the level of contact and emotional involvement necessary to encourage disclosure and access to the traumatic memories and accompanying affect.
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This is what happened, I think, in my early therapy. My last therapist (who I shared the article with) was better about this... when I shut down, he was good at (verbally) reaching out in a non-threatening way, and helping get me back in the room. You'd think that would be a fairly basic therapist skill, but most of the ones that I've seen were not able to do it well or at all.
I understand your point about career duration not really being helpful, but I think that there has to be something you gain from doing something over and over. I don't think a new therapist would be in a good place to really handle my issues... I think they'd get stuck very quickly.
I really want someone who has dealt with my issues a bunch, so that they're efficient and know what's typically helpful and what things mean.
(I should say, I deal with some dissociative issues... it's been hard, because some therapists don't seem to believe in dissociation at all, and others think they can treat anything, but have no experience with it and don't really know how to approach it.)
It's all very frustrating, and hard to deal with when you're already feeling like crap.
Ididitmyway: Thanks, I appreciate the good advice. It's really hard when you're struggling with depression though... goals just feel... ugh. Very hard. With the last therapist it was very weird, I actually had some good initial goals, we discussed them, he wrote them down... but then what happened afterwards felt like it had no relationship to the goals at all. It was like, "OK, now that we have that out of the way, let's talk about something completely different." Later, he asked about goals again... I reminded him that he wrote them down (and I had put a lot of thought into those initial goals, but didn't have them memorized!). He lost them! He said that he didn't lose them, but he moved them to another folder (because my folder was too big!) but still... he didn't have them to reference. What the heck? I'd think that would be an important page to keep in your working notes! *sigh*.
Thanks
Puzzle Bug... that's a good point about therapists being more upfront about how they might not be a good fit, although I see how they may not know. My last one thought for sure that he could help (although he did have the humility to later say, "that's part of my own stuff, I think I can help everyone.").