[CantExplain]

DISCUSSION TOPIC:

There are some things, eg soothing the patient, touching him or self-disclosure that might not be "therapeutic" in the strictest sense but might still be necessary in order to win the patient's trust.

Do you agree or disagree?

[stopdog]

I think the therapist needs to be flexible in assisting the client. I don't think of her as winning my trust necessarily. For me, the therapist has to be willing to stay back and wait for me.

[content30]

For me...yes...I completely agree. One of the reasons I clicked so much with my current T is through a little self-disclosure on her part, through her showing some emotion, and through her effectively soothing me (verbally). I hugged her once, after I had gotten out of the hospital and she had gone on vacation...didn't see her for two weeks during a very bad time. She hugged me back, did not reject me or act weird at all. I honestly didn't know therapy hugs were taboo at that time, but we have not hugged since. She also bought me a coffee once, and has mentioned thinking about me outside of session twice. That definitely made me feel more bonded to her, more special. In turn, that led to more disclosure and more trust on my part. I guess I feel like I am more than just a paycheck to her, and that has made all the difference....

[Yoda]

If a T touches me more than just a professional hand shake I'm out of there.

[murray]

My T moved further away from me when he realized how uncomfortable I was with him being within 5-6 feet of me. He also reassured me that he wasn't going to touch me, other than the initial handshake. (after 4 yrs I am now ok with a very rare fist bump) He also didn't push me to make eye contact once he understood that I wasn't comfortable with it. And he thankfully doesn't stare fixedly at me either as that made me feel too scrutinized.
Another thing that was crucial was that he waited months for me to be able to even disclose the smallest things and just made me feel very safe and accepted once I finally did share something hard with him via email.

[feralkittymom]

I disagree with the premise. Any of those examples can be therapeutic with the right client at the right time for the right reasons.

But those same things not at the right time, with the wrong client, and for the wrong reasons, are not therapeutic by definition--even if the client thinks they want them.

[stopdog]

I believe sometimes the client is correct about what they need and what would be therapeutic for them. The client is not always wrong about that.

[sunrise]

Originally Posted by CantExplain

There are some things, eg soothing the patient, touching him or self-disclosure that might not be "therapeutic" in the strictest sense but might still be necessary in order to win the patient's trust. Do you agree or disagree?

I don't really like that phrase "winning trust." It sounds like it is a game. If my T is authentic, then I may come to trust him, if being trustworthy is part of who he is. But if he is deliberately trying to "win my trust" rather than just be himself, then I would feel he was not being genuine. I wouldn't like it. It would seem fakey and like he had an ulterior motive. I would also hate it if my T tried to "soothe" me. Yuck. I might run for the hills. My T and I do hug, and I like it. However, we didn't do it until after we trusted each other. Self disclosure he did from the start, because he is authentic. I expect we all feel differently about what makes a trustworthy T and also what interventions we find therapeutic.

I think if a T doesn't think something is therapeutic for a particular client, then they shouldn't do it, even if they think it might help the client trust them more. To me it's debatable whether an action that is not therapeutic can even help engender trust. (I do not consider touch, soothing, or self-disclosing to be necessarily non-therapeutic. Perhaps for some clients, but not absolutely.)

[sunrise]

Originally Posted by stopdog

I believe sometimes the client is correct about what they need and what would be therapeutic for them. The client is not always wrong about that.

I think the client is frequently right. My T has told me before, "only you know what you need to heal," and I have believed him.

[anilam]

Originally Posted by CantExplain

DISCUSSION TOPIC:

There are some things, eg soothing the patient, touching him or self-disclosure that might not be "therapeutic" in the strictest sense but might still be necessary in order to win the patient's trust.

Do you agree or disagree?

If those things are really necessary to earn ( I too don't like the idea of T winning my trust) client's trust then they ARE therapeutic.

[tinyrabbit]

I am reading The Gift of Therapy by Irvin Yalom - really great book, highly recommend it - and he says Ts should create a new therapy for each patient. Because everyone is different. Something could help one patient but distress another.

For example, if I start talking about something that's obviously important, my T sometimes asks questions in quite a demanding way. I once started this whole conversation about the therapist in Good Will Hunting breaking boundaries and quietly added something about how my dad spent time in the care system. T realised that was the real reason I brought up the film and said, quite forcefully: "Tell me about your dad being in care." Some people would hate that. I loved him for it. I needed him to realise it was important and not just let the conversation move on.

I don't think the client always knows what they need. Or rather they may not consciously know it.

[tinyrabbit]

Also, just thinking of murray's example of how close you sit. It took three months before I told my T that we were sitting too far apart and I felt I was talking across this big imposing distance. It's not that big, I just want to talk very quietly. If he moved further away from me it would be really distressing. Everyone needs different things from their T.

I don't think it's about winning trust either. Trust is one evolving part of a process. I think it's about feeling more or less contained.

The most therapeutic things my T has ever done are offering to move the chairs, asking if I want him to sit on the floor with me, and telling me "you don't have to do anything except show up".

I don't need hugs or touching or emails...if I call, which I don't very often, and am really upset, a return call would be nice. Allegedly the last time when I called I was crying so hard he couldn't really understand me (his words in session) and when I said something about calling me back he was like "um yeah, I think that was one of those things that just slipped through the cracks." Reassuring after about 2.5 years. Things like that do the opposite of "winning" my trust. Providing an insight I was not aware of and had not heard before is what I find helpful because it shows they are really thinking about me and not just breezing through like I am the client before the next client (who he probably didn't call back, either).

[elliemay]

Meh, trust can become safer, but in the end it is something that must be given not won. No one is ever perfect, or is ever going to NOT hurt us.

Trust comes from the ability to trust yourself, and the knowledge that, even if this person does something that I don't like, or hurts me, that I will be okay.

I can trust myself to trust you. In my experience, that's almost always the way it plays out.

[elliemay]

traction,
I love your cat squirt.

[sittingatwatersedge]

no, not really.

I do think that 'soothing', and even touching, can become something that the client can come to crave, and then definitely non therapeutic.

self-disclosure is in a different category, as it were, and maybe not so open to client abuse as above, or so much potential to adversely affect the work, depending of course on what the self disclosure is.

I read through all the posts and don't see a vote from you, CE. Care to share?

[WikidPissah]

Trust is earned, not won.

I don't think touch or self disclosure does it though.

(if a t touches me, I shall deck them)

When my T finally touched me, it was not about affection or bonding. It was very much about helping me get grounded and not walk out of his office and continue shivering for hours after. The touch came long after the trust. If he had tried to touch me in the beginning (for perhaps the first year or more), my response would have been a fairly cold, don't ****ing touch me, kind of thing. My T says touch in therapy, for him, is a very individual thing that depends on the client and why they are asking.

[Paige008]

I'm with a few others here. I really don't like the phrase 'winning your trust'. I think if there are therapists that have this mindset, then I don't want them anywhere near me.

My T has worked hard to gain my trust, to show me that she is deserving of my trust, and to teach me that trusting her has no negative side effects.

In turn, I have to learn how to trust myself enough to know that I can trust her.

I don't think it has anything to do with touch or soothing and self disclosure. It has to do with showing me or the client that you care about them and that they are there to support you and take you as you are. A lot of those are her words.

Trust being won sounds like deceit or manipulating to me. I wouldn't trust someone who was just trying to 'woo' me.

[WikidPissah]

XT touched me a few times, and I freaked and he knew it. Still he tried.

Once the touched my knee while I was deep in a story. Then he continuously patted my back on the way out. And there were a few arm/back squeezes in there too. He once asked me if I would hold his hand while he was trying to get me grounded. The asking was like a bucket of cold water, and that in itself pulled me out of the dissociative state, but no way would I hold his hand.

I have a pastor who isn't much older than H. He hugs me on Sunday mornings, and he is very tall so he frequently kisses my forehead. I rather like that, it feels kind and caring. He has earned my trust over years of just being there for us. But he is a dear close friend and I am there for him and his family as well. It's not a t relationship.

I think certain behaviors are necessary for certain patients to develop a bond. My T said he "meets people where they are".

[content30]

Originally Posted by tinyrabbit

I am reading The Gift of Therapy by Irvin Yalom - really great book, highly recommend it - and he says Ts should create a new therapy for each patient. Because everyone is different. Something could help one patient but distress another.

I read this book and recommend it as well. It was a great book and a quick and easy read!

[stopdog]

Some people like yalom and some (such as myself) do not. I found him insufferable and misogynistic.

[BlessedRhiannon]

Originally Posted by CantExplain

DISCUSSION TOPIC:

There are some things, eg soothing the patient, touching him or self-disclosure that might not be "therapeutic" in the strictest sense but might still be necessary in order to win the patient's trust.

Do you agree or disagree?

While I think a therapist needs to be flexible enough to meet a client's needs, there are going to be some therapists who are simply uncomfortable with certain things. In those cases, I think it's the therapist's responsibility to tell the client that it is simply not something they are comfortable doing. At that point, the client can decide to accept that or to find someone that is more willing to meet that particular need.

As far as doing things to "win the patient's trust"...I'm not sure if I agree with that at all. I think the client and therapist need to build a relationship that contains mutual trust through an honest interaction. If a therapist is doing things they aren't comfortable doing or that they feel is not therapeutic or that they are going to stop doing once they have the client's trust, then that's not a basis of honesty and it could break the trust further down the road. Instead, I would expect both client and therapist to work towards building trust with each other by starting as they mean to continue. Each needs to be as honest as possible with the other (even if that means saying "I can't do that" - therapist or "I can't talk about that yet" - client). Each needs to be willing to talk about issues within the client/therapist relationship, and own their own stuff. I feel like trust is a two way street. It's impossible for a therapist to win the trust of a client who doesn't want to give their trust or doesn't want to also be trusted by the therapist.

[tinyrabbit]

Stopdog, I think I like the book because my T is a relational therapist.