Should I switch therapists?

Hi,

I am new here, and have been having some concerns about my therapist and the type of therapy I'm doing. I'm going to try to keep it a little vague just in case, but I needed to hear some other people's experiences and opinions.

I've been seeing the current therapist for a couple years now, and in terms of personality and feeling T is empathetic, nonjudgemental, I like T very much. I am seeing T for sort of a mix of anxiety/depression/OCD symptoms as well as some BPD traits. We do fairly traditional psychotherapy I'd say.

My concerns are that I feel T's not asking me the right questions to keep me safe- I recently spent some time inpatient w/ suicidal ideation and still T does not ask me as I leave if I am having thoughts of hurting myself. The day I was discharged I met with T and was not asked about those thoughts as I left. I sought the inpatient treatment myself at the urging of a friend with some psych training- even after I finally expressed my long history of self-harm for the first time and suicidal thoughts (T never asked despite me being emotionally in crisis for weeks) T did not change anything or offer suggestions of different or new or more extensive treatments. I sort of feel we never alter what we do as my symptoms and mood have changed and developed. The main issue to me is safety and knowing I'm seeing a professional who is helping me monitor my thoughts and plans when I'm in vulnerable times, and who makes sure to check in and dig deeper rather than let me just not talk if I seem quiet that day. I'm genuinely afraid sometimes when I'm allowed to walk out of the office, despite it being comforted somewhat while I'm in there.

Also, it's been a long time and I feel no better than when I started therapy. I feel that I need skills and coping mechanisms, with specific plans of how to handle situations. I also have some obsessive thinking and would really like to work through that in more of CBT form. Whenever I ask about different treatments, or our goals and plans, or voice concerns, T's very nice about it but I always leave feeling that I don't have a satisfying answer or plan. Many of my friends who are health care practitioners themselves are urging me to find someone else and expressing that I need more and different help.

Am I being unreasonable or overreacting, or should I see someone more willing to be transparent with me about plans as well as more apt to ask the difficult questions that are very hard for me to bring up? Or, given that I "like" T as a person and feel fairly comfortable, should I not leave.

I would appreciate any thoughts or feedback! It's a really rough time so of course filled with doubts. Anyone have experiences especially with feeling a therapist isn't asking the questions you'd expect?

Thanks.

Hey, welcome to the forum
I would be concerned about your ts lack of concern. I know most ts do not encourage talk about suicide as it might be taken up by the client as a way of getting attention or manipulation. It is a hard reality of therapy but I do think your t is showing signs of bad therapy by letting you walk out, did they at least get you to sign a contract to state that you would not harm yourself until you saw t next?
Did they ask if you had made a plan? Or Do you have support outside of sessions?
I am sorry you are having such a hard time latelyI would find a t who specializes in cbt. My t does and I used to feel suicidal all the time but don't anymore. She really helped me change my thought patterns so I could be happier.

Thanks for the response (and hugs!)

I guess I understand them not wanting to bring it up if they didn't think the client was thinking about it, but its my understanding that its very important to ask these questions and not miss someone who's really going to hurt themselves? I just have been feeling my distress has been not noticed or ignored, and even when I'm in there bawling and emotional and clearly in crisis we don't make a plan for what to do until I next see T. I often leave feeling lost and alone, like I need more help and its not being offered (though T does give phone # and always calls back if you contact and ask, so that is good).

I am going to look into CBT options, I feel I need more structure and support. But I don't know how to go about leaving especially because its not a really bad relationship, I actually feel quite attached to T which is making me feel even worse that I am suddenly feeling not heard. But my general attachment to her over the past years is making me feel so guilty for this, but I'm just feeling that I need to be with someone who takes more action in crisis times since this was a horrible experience for me. But I feel guilty and scared even thinking about leaving!

Any other thoughts?

Thanks so much

I think there is a therapeutic reason for what T's do and don't do, ask and don't ask.
I would strongly suggest that your next session, it would be good to talk about the concerns in your post. It sounds like you have a good relationship with her, and your concerns are a reason for talking rather than to leaving

I would get a new one if I was you because if you do not fell like the Ts is trying to help you, you're not going to get very much out of you're treatment. And in my opinion the Ts needs to ask those type of questions. but that is just my opinion.

I wonder does your t really believe that you are in such a bad place?
I mean, how are you in session? Do you appear depressed and gloomy or are you trying to be ok for t?
Because if its the latter, it's ok to not be ok, your t will accept you however you are and welcomes your true feelings
I would be blunt with her next app and say t. I am at my lowest here. I am on the verge of killing myself. I need more help from you, if you can't provide that I will find someone who will.
You need to look after yourself and you own needs.
I think your t thinks that you are ok, this happened with my own t1, because I put on a mask and pretended to be happy and that everything was ok and she never took me seriously until I told her I had a plan, then she listened.

I think that anytime you have expectations about what your therapist should be asking you or anything else you expect that they should do or say, you should voice this. It is your therapy, and if you want something from your therapist, you need to ask. You might not get it, and then you can decide if you need to move on and find it elsewhere. But the discussions I have had over the years with my various T's about what I want have been among the most enlightening and healing. It is your therapy. You have to take responsibility and speak up about what you think should be happening.

Sorry if this isn't what you want to hear, but I think expecting your T to telepathically determine the 'right' questions is passive aggressive and unfair on your T. One person's right question is another person's wrong one. If my T asked if I felt like hurting myself, I would potentially twist that and experience it as: my T thinks I should hurt myself/ T wants me to hurt myself.

You have a responsibility to help your T to help you, and to communicate your needs. It may seem obvious to you that you need a T who asks if you feel suicidal and doesn't let you get away with not talking. But everyone is different. I hate being asked if I'm suicidal. I hate feeling pressured to talk. Some people hate to be offered tissues; I am devastated if my T doesn't offer them. There is no one 'right' approach.

If you've asked your T to do these things and had no change, that's one thing. But if you just expect them to work out what you need, you'll have the same issues with any T. As to other treatments and plans, are you ready for these? Have you asked your T any straightforward questions about it?