this might be a dumb question, but i really want to understand this...

when T is sitting talking, are they using things they learned in school or are they just talking?

what do they learn?

like is understanding child development stages useful when talking to me? how?

or do T's learn phrases to say?

or do they study how to read body language, so when i shrug my shoulders, T understands what i mean?

or do T's just assume the same about clients that have the same "issues" so it's like one size fits all....?

or how do T's know what the client is feeling? like when T says "i bet you are feeling really alone" and T is right? how to they know that?

what is it that makes T work or fail?

does understanding all the theory of things make a better a T?
does being more in tune with people make a better T?

do they actually learn how to "do therapy?"..like practice it before they get clients?

That's a lot of questions. T's do learn a great deal of theory: developmental, psychological, cognitive, etc. And yes, it is very important that they do so. Whether that makes them "better" or not is a whole other matter.

T's go through internships and supervision during grad school and often beyond.

T's learn various therapy techniques, so yes, some of their response is because of what they have learned, but hopefully they are well beyond using a script.

T's should be pretty good at picking up on body language. They generally are pretty good at having a feel for what we are feeling or thinking, if that makes any sense, but they can't read minds, so don't expect them to. It's all only an educated guess until you are open with them.

I don't think they think it is a one size fits all, but there are tendencies that are somewhat predictable in clients with similar experiences.

What makes t work or fail? That's the big question. I think (a) it takes a really good therapist (b) it takes a client who is ready to do the work, and (c) the two have to mesh well enough to create a safe, honest, and trusting environment.

[jexa]

T's definitely use what they learned in school in the room with you. Some T's more than others. In school T's learn a lot of things! It's really really complicated, and a lot of it doesn't translate to therapy itself but provides the groundwork (i.e., cognitive, developmental, etc), but here is the stuff that is relevant to you:

They learn a whole lot about theory in their classes, and they learn about how to practice therapy, too. T's start by role-playing therapy with other T's-in-training. Then they go on to practice by treating clients with mild problems (who know they are seeing a T-in-training). In time they start seeing harder cases. Their tapes are watched by their supervisors who tell them what they're doing right and what they're doing wrong. The supervisor keeps an eye on them like this for a while. Then T's don't tape their sessions anymore but still go and talk to supervisors. T's have to have supervisors until they have a license. They learn a lot in supervision which is a big part of T training. This training with supervisors tells T's how to implement the theories and the different things they learned in their classes. When T's say, "You must feel really alone right now," they probably learned this from experience with other clients like you. In classes, they might also learn useful metaphors, and maybe even some complicated techniques like EMDR. They learn particular ways of doing therapy, which may start out sort of scripted, but end up coming naturally to the T and they will use their own words then.

They also learn about diagnosis and how to treat the different diagnoses they might run into. Like they will learn how to spot OCD, or PTSD, or bipolar, or what have you, and they will know the right course of action to take. Like they will know that if you are bipolar they should refer you to a psychiatrist to get on some mood stabilizers. Or they'll know that if you have OCD you should probably be getting exposure and response prevention therapy and if they don't know how to do it, they will refer you to someone who does. Just examples of the many things they learn how to do. They learn how to deal with each case they run across.

T's also learn about research in school. They learn about it so they can keep up with the new ideas that are changing the way therapy is done, or the way we view certain diagnoses, and other things.

T's also learn how to do testing. Like IQ tests and learning disability tests and other things. Depending on their school they might have learned other things as well, like how to use an fMRI machine for example, and how to interpret fMRI results and other neuropsychological testing.

As far as what makes T work, I think farmergirl is spot on (although I have some complicated research questions about how/why therapy works, but that is something we will know in the future when I change the world! )

[WePow]

I think a person goes to school to learn to be a T.
And as a T works with clients, T learns to be a person.

[mobius]

what is it that makes T work or fail?

does understanding all the theory of things make a better a T?
does being more in tune with people make a better T?

I think all therapists have some natural capacity for empathy that they develop and hone during the course of their training. I would imagine you need to know both theory and how to be "in tune" with people in order to be a good therapist. Having one without the other would be like talking with a textbook without feelings or meeting with someone with strong intuition who doesn't have a good working road map to rely on if intuition falls short.

I agree with FG too about some of the elements of successful therapy. I know from personal experience that degree of fit with the therapist is essential - that most therapists are probably good with some clients, but not all are good with all clients. I guess it depends too on how you define "success." Meeting a prescribed set of behavioral goals will likely look different from coming to terms with a history of trauma or changing personality characteristics.

How successful do you think your own therapy has been?

[Perna]

Yes, it's a little like learning to be a school teacher; they learn all the theories and developmental history, and "real" history of what may work with some sorts of people versus what doesn't work/not to do. But though they might start out teaching "language arts" or something, since it's one-on-one, if you don't "get it" they can change and teach a different way and adjust to you rather than just being mostly one way like a teacher is in front of a class.

But no one can teach them empathy and caring and emotional subjects like that so presumably they have natural gifts/talents/interests in those areas (like some people are good with children or good with animals or are mechanically inclined, etc.; we all have gifts and, hopefully, therapists are gifted in emotional connections).

[pachyderm]

Originally Posted by jexa

When T's say, "You must feel really alone right now," they probably learned this from experience with other clients like you...

When T's say this my anxiety level starts to go up! How about "Do you feel very alone now?" in a manner that lets me know they actually are asking a question in order to get information, not making a suggestion as to what I am feeling.

[jexa]

Originally Posted by pachyderm

When T's say this my anxiety level starts to go up! How about "Do you feel very alone now?" in a manner that lets me know they actually are asking a question in order to get information, not making a suggestion as to what I am feeling.

Interesting! For me anxiety would go up if my T wasn't spot-on about what I was feeling. If she was, I would feel good. Heard and understood. My T has never guessed wrong - but she actually doesn't guess much. Anyway, how does a T know he/she is right? If he/she doesn't know, then assumptions should not be made.

If they make assumptions, and you have difficulty defining how you are feeling anyway, this can create a tricky situation where T might convince you that you are feeling differently than you really are. Hmm.

[Perna]

If one talks about how one "has no one" or, "feels like everyone is against me" then the leap to, "you must be feeling alone" is just a restatement of what you've said. It's not a guess or a question or anything, just putting their understanding of what you've said in their words to see if how they see it meshes with what you've said. I was notorious for changing :-) and never letting my T get it quite right. But that's what I was in therapy for, to learn how to be comfortable on the same page as someone else without thinking I'd be swallowed up or something.

[pachyderm]

Originally Posted by Perna

If one talks about how one "has no one" or, "feels like everyone is against me" then the leap to, "you must be feeling alone" is just a restatement of what you've said.

Not necessarily. It depends very much on the tone of voice, etc., which can carry a lot of information. It can be anything from what you (Perna) say to an expression of not wanting to hear what the client is saying. I know that a client can overinterpret this kind of thing, but alternatively, if the client (or any observer) does not get triggered, the amount of understanding, or even having hypotheses about what is happening, can be very enjoyable.

[sunrise]

Originally Posted by pachyderm

When T's say this my anxiety level starts to go up! How about "Do you feel very alone now?" in a manner that lets me know they actually are asking a question in order to get information, not making a suggestion as to what I am feeling.

There are many clients for whom a question like that is too direct, and the T will "scare" the client away or make them clam up. So Ts have to learn to sidle up to some clients in a less direct way. However, for every client that needs a less direct approach, there is probably one that does better if the questions are asked directly (like you, pachy). So the most skilled Ts probably try to get to know all that early in therapy and use language ever so carefully, in an individualized way, with each client. What a job!

I see in my own T, his hits and misses. Last time he said a phrase to me that was an exact copy of a phrase I used with him a session or two back. He had never used that phrase himself before with me. It was like he was parrotting what I said. Trying to mirror me so exactly, that I would... Do what? I didn't like it! I felt it was a rather blunt instrument he used to try to accomplish... something. It wasn't a big deal to me, but just something I noted inside fleetingly as he said that (to which I made no comment, LOL).

[pachyderm]

Originally Posted by sunrise

What a job!

I think it can be a real gas if you really know your stuff, though!

[Perna]

LOL, sunrise; my T is Filipino and didn't always know all the words I used; I had to teach her "ornery" and she later tried to use it only it came out sounding like "ordinary". I explained to her, "I'm a lot of things, but ordinary isn't one of them!"

[pachyderm]

Originally Posted by Perna

I explained to her, "I'm a lot of things, but ordinary isn't one of them!"

Are you ornery?

[Perna]

Yes :-) but not as much as I use to be. That was back in the early 1980s.

[pachyderm]

Perna, you see that I asked you a question without a smilie. That question could have been many things, and which one it was might have been clarified at least partially if I had included a smilie such as .

[Perna]

But, Pachy, what difference does that make? You just asked a question. There's an answer; do I feel I'm ornery or not? My answer shouldn't be predicated on how you ask your question. If you had made the statement, "Perna, you're ornery!" I would have replied much the same.

Now that I've had so much therapy, you could even say, "Perna, I hate ornery people" or, "I don't take to ornery people or people who think they're ornery" and that would not have bothered me much (I would be a little sad you wouldn't talk to me anymore :-)

I'm sure I've told the story of when I said something, I forget what, and my therapist announced, "Ah, you're stubborn!" (and my knee-jerk reaction was, "She can't say that!") but then I looked at what I'd said and guess what? I was being stubborn. That's why it bothered me (and probably why she said it?). Is being stubborn okay with me? Was I aware I was being stubborn? How about her calling me stubborn? That was hard for me but since I felt she was right, I have to look at it and work with what's there, not what I'd like to be there. If I didn't think/feel I was stubborn, why would her calling me stubborn bother me?

My T made me work on my own between sessions with the word/feeling "humiliation" one week and at work a vice president started making fun of me/my speech (my not making sense) in public, very humiliating. I left the arena almost in tears but then I thought it through. I was working on my speech in therapy, I was doing the best I could and focused on it and doing well/getting better thanks mostly to my T and my husband. This vp was making fun of me and, it so happened, I had been trying to help him! I realized I was angry at that! So, what am I going to do; what's my plan to solve MY problem? I decided I was not going to volunteer to help him (I'm helpful so love to jump in and help!) and I was going to "avoid" him unless he specifically asked me to do something. If he ever spoke to me again the way he had spoken to me moments before, I would calmly explain to him that I knew I had a speech problem and I was working on it the best I could but his humiliating me in public did not seem to be very helpful in that regard and I would appreciate it if he did not speak to me in that manner ever again or I would quit on the spot. I would not tolerate being treated in that fashion by him or anyone else.

Having come up with a plan, I felt entirely better and was thrilled about what I'd learned about humiation and anger and how to care for myself. Fortunately I got another job before I had another run-in with him (the avoiding him worked fine; he wasn't in my normal chain of command and I had no trouble not wanting to help a thoughtless cretin :-)

It's all about us and what we think and feel, not the other person. What happens in us is 100% ours. If we feel unhappy about what someone else says, that's not the other person making us feel unhappy, that's our own life experience and thoughts and way of looking at things. I'm responsible for me. I enjoy being around other people who enjoy being around me :-) Those people tend to "get" me the most and/or I feel best from what they say/do. But, back 30-40 years ago, there weren't many of those people because I wasn't responsible for my own feelings and couldn't deal with/didn't like myself much.

[emilyjeanne]

I want to add my 2 cents....

I think that the more education T's receive the better they are. I have seen 2 social workers. Both were "exerienced." By this I mean in the field for a long time. Without any advanced training (except for continuing education). But it wasn't until I saw my P'doc for therapy did I see a big difference in the level of treatment. Of course my P'doc not only learned her trade thru medical school and residency (8 years), she has done advanced training in psychoanalysis (4-5 years). I'm not saying the social workers are not good. I'm just saying that the more educated they are the better.

I hope this makes sense.

[deliquesce]

Originally Posted by Perna

LOL, sunrise; my T is Filipino and didn't always know all the words I used; I had to teach her "ornery" and she later tried to use it only it came out sounding like "ordinary". I explained to her, "I'm a lot of things, but ordinary isn't one of them!"

gosh. i've even done university english and would have needed someone to tell me what that meant. and because i'm a little word-nerd, i looked up the etymology, and "ornery" comes from "ordinary" so perhaps in some ways...?

re: when to say "You must be feeling xyz" vs "are you feeling xyz". when i did my training to become a crisis counsellor, we spent about a month practicing these skills and learning the difference. like perna said, you can kind of paraphrase what a client is saying "no one is around", "i have no friends", "i try to meet up with people and no one ever replies" etc and guess that they might be feeling lonely. of course, tone of voice comes into it to (most of our communication is nonverbal anyway) so i wouldn't be saying that to someone who is yelling the above statements at me. for some clients who really didn't like having their feelings identified, i would often say something like "i'm not sure how it is for you, but if i was in that situation i would feel xyz" and it was sometimes enough of an invitation for them to agree or clarify (some people positively delighted in telling me i was wrong ), or for people who just "DON'T DO FEELINGS!!!!" it was something they could possibly reflect on later (in private) and we could continue the conversation.

[pachyderm]

Originally Posted by Perna

It's all about us and what we think and feel, not the other person. What happens in us is 100% ours. If we feel unhappy about what someone else says, that's not the other person making us feel unhappy, that's our own life experience and thoughts and way of looking at things. I'm responsible for me

I think that is speaking from a position of considerable maturity and self-knowledge. If you are not in that position, you will not see it. I should know. I don't think a therapist should act assuming a client is in that position of health. Many, I think, simply do not comprehend how disturbed a person's life can be. Those will not be able to help people with a large amount of disturbance.

[FooZe]

Originally Posted by deliquesce

for some clients who really didn't like having their feelings identified, i would often say something like "i'm not sure how it is for you, but if i was in that situation i would feel xyz" and it was sometimes enough of an invitation for them to agree or clarify (some people positively delighted in telling me i was wrong )

Taken literally: if you were in their situation, no you wouldn't feel xyz!

In that case, the next question I would have wanted to ask them would have been, "Well, then -- If I were in that situation, how would I feel?"

[deliquesce]

^ yes, because most people clarify a part of the situation i overlooked, or give more information about how they were thinking which ultimately leads them to disclose how the experience was for them (and make me own it, because they're telling me how i should've felt ).

Solar, I love this post... so informative... I am interested in different t's phrases... I wonder if there is a book out there that they go through every three months or so...T had one phrase that he used all the time, then switched to "I hear you" made me feel like he never listened to anything I said all the other times.... he quit using it when i complained... thank goodness

[pachyderm]

How about "I feel your pain"?

No, that was not a T, at least in theory.

[Perna]

Originally Posted by pachyderm

I think that is speaking from a position of considerable maturity and self-knowledge. If you are not in that position, you will not see it.

But I think it's only being exposed to the harder situations, the one's we don't get, over and and over (like remedial math) and working with them that we'll ever get them. Just saying, "I don't get it" (or "I don't like it") and avoiding situations like that will pretty much ensure one never gets/likes it? You have to eat a lot of cooked carrots when you're a kid before you decide they're not too bad :-)

I'm not talking forcing someone to see or accept but exposing them to situations in a contained environment like therapy, is something that helped me. But I had to at least accept the exposure, even though it was often extremely uncomfortable and painful.

One of the main things I learned (all on my own) in therapy took me about six years. One day I realized that either the sky was not falling (as I reacted to life) or that my T was crazy.

My T was a very calm, quiet person, didn't get ruffled or excited like I did and I wanted to be more like that. But then I realized that the difference was more than just personality or our backgrounds; her worldview had to be different from mine. How'd she get that worldview?

It was the simple realization that I did not believe my T was crazy, so her reactions could not be that "wrong". The sky must not be falling, it must be "me" that started me on my life change for the better.

I'm not stupid; I left home because my stepmother called me stupid one time too many, I do have a good "base" so my self esteem is not that hard to access. So, I didn't berate myself for realizing that I had been wrong all that time, that the sky was not falling and thus my reactions to what experiences came my way were "wrong". Instead, I took that kernel I had learned and the next time I felt too anxious or felt I was at odds with those around me, I remembered my T, whom I admired and wanted to be like, was calm and wouldn't have viewed the situation as direly as I did, therefore, the situation was probably not as dire as I viewed it. Didn't make me see the situation as less dire but did make me feel supported (if a bit split as how I felt and how it actually "was" weren't the same).

That's when I realized that some of my T's favorite phrases were good for me. One that I immediately told her I really liked was "It's not like that." She was a little surprised I liked that statement but I liked it because it freed me to let go of whatever "wrong" way I was viewing something and try to find another view. It forced me to ask the question, "If it's not like that, then what is it like?" I got into sleuth/experiment/curiosity mode and away from focusing on me and what I was doing "wrong" or the other person and what I liked/didn't like. Instead, I started to focus outward a bit more. My navel had collected quite a bit of lint by this time and was looking a bit bedraggled and useless :-)

I quit taking everything to be about "Me" and started to look at the "everything" instead. I looked at the situation instead of my feelings about the situation, (Am I stubborn? If I'm stubborn, do I want that? How would I like to be instead?).

As good as "It's not like that" was for me, my #1 T phrase I still use with myself over 35 years later is, "Not with THAT attitude!" I did a self-pity party one session :-) and made some statement/question and that was the response I got. Woke me right up, LOL. It made me look at what I was saying and THAT is what I think therapy is all about. Only I can change my way of relating to what comes into my life. What comes in is not the problem, my attitude and response are and they're the only thing I can control.

I can't make other people do/feel/respond/understand in a certain way; I can't change what comes into my life because I can't predict or avoid the future. All I can do is figure out how I want to respond and to do that, I have to see how I am responding and how that works/doesn't work. I'm not talking about feeling, I can't control that either! Feelings are tools; they let me know what's going on with me. "Not with THAT attitude!" isn't a criticism, it's just a statement that my T doesn't think how I'm going about responding is going to work well for me. It forces me to look at MY attitude, my way of responding.

If I insist on swimming upstream when everyone else is swimming downstream, I'm gonna get buffeted and if I'm gonna get buffeted, it behooves me to look at what I'm doing, not try to get everyone else to swim the way I'm swimming or to "hey, watch where you're doing!" If I truly understand about swimming upstream and WANT to go that way, that's one thing and I'm probably going to be able to pay better attention to that job, go faster and not get buffeted as much as if I'm clueless and just going the wrong direction because I haven't looked at the situation and how things "are". If I understand about swimming upstream, I understand the other people aren't in my way, that I may be in theirs and impeding their journey and I'll work hard to avoid running into them, not decide they're all idiots.

While it's true that I'm the right size and it's the pants that don't fit, it's silly to decide that all the wrong-fitting pants SHOULD fit me. If everyone else is going the other way, it's usually not because they're idiots, it's usually because they're going the way and I'm going the "other" way. Once I notice that, I want to stop and look at what the situation is versus what I think it is.