change, choice, desire...

sittingatwatersedge · Jan 14, 2013, 12:07 PM

from a fairly recent post..... I think the choice(s) we do need to make can only ever be based on where we’re at in any given moment, and that’s just go to be good enough. Even if that happens to be an ostensible no-choice. And that a good T gets that and doesn’t try and impose a model of moral/psychological perfection on a client not even if that’s what both client and T (think they) ultimately want.

I wonder whether this may not be the point where a T gives up; if there is no desire to change coming from Client, then how can there be change?
It can happen that one's damaged worldviews are so deeply accepted, so desperately defended, that to hear a proposal of change, by relinquishing those views, sure sounds like being asked the impossible.
What does T do then?

stopdog · Jan 14, 2013, 12:39 PM

I think a therapist has to be willing to let the client decide what change is desirableand in what time frame. The therapist cannot inflict change upon the client and doesnot get to decide what cfhange is worthwhile and what change is not - that is the province of the client. And the client may not desire just any change - there are changes which would or could be much much worse than the current condition, in my opinion.

sittingatwatersedge · Jan 14, 2013, 12:48 PM

Quote:

Originally Posted by stopdog

I think a therapist has to be willing to let the client decide what change is desirableand in what time frame. The therapist cannot inflict change upon the client and doesnot get to decide what cfhange is worthwhile and what change is not - that is the province of the client. And the client may not desire just any change - there are changes which would or could be much much worse than the current condition, in my opinion.

I agree with most of that, SD. although I do think that with experience, a T can know how 'worthwhile' a change will probably turn out to be.

But what I was posting about was the client's level of desire to change, and how the T deals with that.

LadyShadow · Jan 14, 2013, 12:59 PM

Hello,

The T deals with it as an human being deals with it, sit backs and waits. I spent 6 years (and counting) with my current T and most of that was me complaining about my life and how unhappy I was with my weight, my life, etc. T did the best he could, he suggested I make small steps to change my current situation. He suggest goal setting strategies that were helpful. I set small goals so the big ones weren't so unreachable and it really helped me. But it took a lot of work on both our parts. I was very unwilling to try for a long time and all T did was be the supportive rock he was and kept saying "small steps Lynn you can do it". That is all I really needed.

Hope that helps answer your question.....

stopdog · Jan 14, 2013, 01:00 PM

I am loathe to let the therapist judge my level of desire to change and god knows I don't trust them with knowing how worthwhile something would be to me. I guess I don't see those as any of the therapist's business. But I can see that therapists, like every other professional, can quit working or want to quit with a client for various reasons. Unless you meant some other result from the therapist giving up.

shlump · Jan 14, 2013, 01:07 PM

Quote:

Originally Posted by stopdog

I am loathe to let the therapist judge my level of desire to change and god knows I don't trust them with knowing how worthwhile something would be to me. I guess I don't see those as any of the therapist's business. But I can see that therapists, like every other professional, can quit working or want to quit with a client for various reasons. Unless you meant some other result from the therapist giving up.

Stopdog,

If someone is in T they have a desire to change that goes beyond sitting around *****ing about it. Anything other than at least a small desire to change is just wasting the T's time. One can always leave therapy and return when they are more willing to work on themselves.

Jan 14, 2013, 01:23 PM

IMO anyone who is willing to pay the money and shows up for appts has a desire to change... whether they are able to make those changes at this time or at the speed the T or even the person wants does not mean they don't have the desire...

shlump · Jan 14, 2013, 01:36 PM

Quote:

Originally Posted by Readytostop

IMO anyone who is willing to pay the money and shows up for appts has a desire to change... whether they are able to make those changes at this time or at the speed the T or even the person wants does not mean they don't have the desire...

I think that's what I mean. They are not sitting around *****ing about it. They are going to T, hence desire to change....

stopdog · 02:47 PM

Quote:

Originally Posted by shlump

Stopdog,

If someone is in T they have a desire to change that goes beyond sitting around *****ing about it. Anything other than at least a small desire to change is just wasting the T's time. One can always leave therapy and return when they are more willing to work on themselves.

I said nothing about sitting around and *****ing about anything. And I don't think a client ever wastes a therapists time. Therapists get paid for their time. So at worst, a client wastes their own money. But I don't think that is for anyone else to say. What is a waste for one person is not necesarily a waste for someone else.
I just believe the client gets to choose how and when and what to change. Not the therapist. Plus I don't actually think a therapist can make someone change faster than that person is going to do so. I think of it as a balance - if I change x what will the results likely be and am I willing to pay that price for that particular change.

shlump · Jan 14, 2013, 01:44 PM

Simply going to T equals desire to change. Walking in the door equals desire to change.

The sitting around *****ing about it occurs at home before undertaking T or during a break when not willing or ABLE to work with T.

The T is getting paid. It is there job. They are there to help you move forward. They will certainly try to help you make the improvements that you clearly desire because you showed up.

You are going to T?

Jan 14, 2013, 02:23 PM

Sitting, I think we all desire to feel at ease. Unfortunately like you say, some are held back by their wounds. A skilled therapist can help make a decision with the client whether its in their best interest to continue therapy or not.

Jan 14, 2013, 02:25 PM

Quote:

Originally Posted by shlump

You are going to T?

Nail on head :-)

stopdog · 02:51 PM

Quote:

Originally Posted by shlump

You are going to T?

If this was directed at me - I usually see two of them weekly. I get different information from each of them. Neither one gets to decide how or when or what I change. I can decide to not see each of them, each of them can decide they don't want my money. But they do not get to decide for me what changes to make or when I make them. Other clients can make different decisions for them. I am just reporting how it works for me. The ones I see seem fine with how I operate and with me seeing other therapists.

I do believe there are therapists who get frustrated quicker. I would not remain with those who did.
There are those who operate differently than do the ones I see and people who want them them to do so. which is good for client choice. If a therapist judged or tried to weigh my desire to change - I would discontinue with that therapist also. Others would and do make different choices than I do, which is their prerogative.

Lamplighter · Jan 15, 2013, 09:52 AM

SAWE that's an interesting question (there's been a few of them in this forum lately!)

I suspect there's probably a fine line between a T just sitting and giving the therapy over entirely to the client who can then get mightily stuck in old defences and ways of being that militate against change, no matter how motivated client might be - and a T who is a tad too directional and making it plain that it's not really ok for the client to just 'be' in therapy. Perhaps ideally is the combination of total acceptance within a framework of actively encouraging change (isn't that the basis of the dialectic in DBT?)

Sounds good on paper but how does that translate in reality? It's horses for courses isn't it - what might work for one client at a specific stage might be anathema for another at the same stage. What I do think is that a T who refuses to continue working with a client who seems unable or apparently unwilling to change is not doing them any favours - in fact is probably enacting past scenarios. Unfortunately in time limited and state funded therapy that probably happens more often than it should.

Lol just reread what I wrote and of course I'm speaking entirely from my own personal view, I expect there are clients who might even be motivated if their T turned around and said no change, no more therapy, get your act together. The longer I'm in therapy and the more I hear about other people's therapy the more I realize I don't really know much at all except for my own experience, and even then sometimes I don't think I know anything either

.

SAWE I wonder why this comment struck you - do you feel that you might be stuck or were you thinking of other people you know who seem unwilling to change in therapy? Just curious as you haven't elaborated on your own thoughts about this

.

Torn

~EnlightenMe~ · Jan 15, 2013, 05:56 PM

Change is different for each person. There are so many factors that lead to change, or that hinder change. I want to change, but I have to do it in my own time, in my own way. I have to do it in an atmosphere of acceptance and honesty. I need my therapist to be beside me on this journey, helping me, but I don't want him deciding what I need to change. That feels too scary to me. But I will listen to suggestions

There is one story that I find fitting to this thread that I'd like to share. (I may not remember it exactly) It is from a psychologist that I like to read. His patient is telling him about a dream he had. The patient is in a tall building that is on fire. The patient's therapist is running up the stairs behind the patient trying to save him. The patient is throwing stones down at the therapist telling the therapist that he will never reach him!

The building represented the patient's self, and the therapist was trying to save him from himself, thereby invalidating who he was. It was actually about resistance, how the patient was fighting the therapist because the patient knew the therapist was trying to change who he was, not what he did. These are my words, but I think the patient just needed the therapist to help put out the fires and start rebuilding his self. This story really moves me for some reason. I just love it. So, I think the patient has to be the one who decides what to change and he has to be given the time it takes to put out the fires and rebuild before he can change. Plus alot of other factors.

mixedup_emotions · Jan 15, 2013, 11:59 PM

I'd imagine that there are some people who go to therapy who aren't willing to change....merely using therapy as a means of support, for being heard, cared for, etc.

I know, for me, there are some areas that I've progressed quickly...and other areas that are still very, very slow going. And then, areas that are at a complete standstill.

WikidPissah · Jan 16, 2013, 03:46 PM

I know that when I was in college I used t just for an ear each week. I had nothing to change, I had a good life. I had good friends, good grades, no major issues. I just needed to talk about my goals and areas of study. I wanted to talk about day to day problems. No changes wanted or needed.

Some people don't want to change, and that's okay too I think. Different t's for different folks.

sittingatwatersedge · Jan 16, 2013, 05:33 PM

[quote=mixedup_emotions;2828497]I'd imagine that there are some people who go to therapy who aren't willing to change....merely using therapy as a means of support, for being heard, cared for, etc. quote]

yes probably... and these sound to me like very valid reasons to go to therapy, too.

like I said - why does it have to be just for the rich and famous? A permanent T resource - everybody should have one.

Hmm... I feel a new bumper sticker coming up for the Therapy Client Accessory Store