being damaged and connecting with T

It seems that so many people have very positive feelings and connections to their Ts. Many even use the word "love" to describe their feelings.

Do you think it is possible for a client to be so damaged that a client cannot stay connected with a T and will "fail" at therapy no matter what the circumstances?

Would this "failure" be due more to the T not knowing how to work with a severely damaged client.... or the client?

I worry about this. I swing in and out of attachment like nobody's business, then remind myself it's only been a couple of months and deep levels of trust can't be rushed.

I voted "both" on your poll - because I believe if the therapeutic alliance isn't there, it simply might be down to a wrong combination of therapist and client. Neither might be wrong in themselves but just wrong for each other, wrong insofar as not helpful to the client's healing. Really though I know so little on this type of thing!

I truly believe therapy is a collaboration. Both the client and the therapist share the process and responsibility. With the exception of gross lack of professionalism (which would mean the client didn't "fail" in the first place), each party has a function in the therapy relationship.

Who gets the blame? Who is keeping score??

Sorry I dont mean to be snippy - I like the poll because it brings up a difficult question. If a client is hoping to blame someone, maybe they're not ready for therapy. It's like they're still playing games or something. I think you can't go in planning to consciously play games, because your unconscious is a much better game player than your conscious mind will ever be. So a t can help you win the games your unconscious mind is playing on you, but only if you consciously let them. Which isn't easy, because your unconscious tells you not to. clear as mud!

I put other since there was not a no one option. If both parties tried their best, and things still didn't work out - its okay. It's okay to try with someone new, its okay to try when the patient is more ready or at a different place in life - maybe both is needed. I'm sure both parties would feel responsible but I wouldn't blame either myself or the T if we both gave it our best effort. Everything doesn't work out perfectly on a preset time line. Thats just the way life goes.

I don't think anyone should be "blamed" and I don't believe a client can "fail" at therapy. If it doesn't work out, and this can happen for various reasons, then the client's need to seek a therapeutic relationship elsewhere should not be seen as a "failure" with the need to "blame" anyone (assuming no misconduct has occurred on the part of the T, of course). Oftentimes we just figure out we need something different then what we are getting and move on to other T options.

I did not love or feel particularly connected to my first therapist. I was truly so damaged I was incapable of a real connection with anyone. Therapy failed in the sense that I was still very damaged and not capable of a healthy relationship at the point therapy ended. But, I improved quite a bit, and most important, I continued to use the lessons I learned in therapy to continue improving even after it was over.

I don't think there necessarily needs to be blame. Sometimes things just don't work out or aren't a good fit. If both parties genuinely tried their best, that's all anyone can expect.

I don't see failure or blame necessarily ascribed here to anyone. Sure some T's may not know how to handle certain difficult cases but none of us are experts at everything are we? Some clients are ill matched with T's and vice versa. I don't think therapy can necessarily "fix" anyone (even if the match were made in heaven, so to speak ). Certain goals may be achievable for some clients but I believe others simply need someone to share their struggles with. Perhaps to learn coping skills from...to be supportive...encouraging...caring (oops! forgot we're not supposed to ask for that). Every problem in life is not surmountable. Sometimes we just need a T to help us get through the day, week, month or year. Life will take it's own course with all of us but T's can be instrumental in giving us hope and encouragement to see the way.

That is a loaded question. However, therapy rests more on the shoulders of the client. At best, you are with a T for one hour out of all the hours in a week. Clients have to do the work. I have a phenomenal T, and we have an excellent therapeutic relationship. However, beyond that, I had to do the work and make changes in my life in order to get better. No matter how awesome my T is, she cannot do any of those things for me. So, yes, you need a good T and a good relationship, but one hour of talking can only take one so far. The client has to do his or her work and make changes outside of the room.

I don't think it is accurate to say a client "fails" T. It is more nuanced and complex than that, with an interrelationship of different ingredients if you like. Ingredients that both the client and the therapist bring to the table. And for 'effective' therapy, I think there has got to be a perfect blend & match between these two sets of input.

(PS: when I say perfect, i mean a set of circumstances that would work for a particular client and with a particular T. I.e. what works for one individual could very well have someone else running for the hills).

I don't think therapists explain (either at all or well enough) what they do and what the client is to do. Broad and (ultimately without more specificity, useless and blaming) descriptions such as "the work" (much like "process" whatever the hell that is) does not do a client much good. And the client should not be blamed for not knowing.

Thanks Stopdog. I thought therapy was just pouring your heart out to someone who would listen and support you. Maybe offer some suggestions for improvement, etc. I had no idea there were so many different approaches to it.

I don't feel like 'blame' should be assigned to either.
But i think it's incredibly rare to find someone 'too damaged'.
When i started therapy 4 years ago, it was said that it was highly unlikely to work for me because i was too traumatised and hostile to ever be able to form any attachment.
I sure showed them!

A T can only do so much. They can't force you to participate in therapy. They are not miracle workers or anything. Sometimes a person just isn't ready to put in all the hard work it takes. Sometimes a t is an idiot though, and in those obvious cases the T would be at fault.

A clear definition of what "work" is for each party would be of great use to a client in my opinion. I think it is far too quick and easy for a therapist or outside observers to blame the client for "not doing the work" without knowing if the client even understood what is "the work" or how "the work" was supposed to be performed. Plus it is not consistently defined across methods different therapists use. I really find the phrases "the work" and "the process" to be useless, empty, and often insulting (you failed because you did not "do the work" or because you did not "trust the process" regardless of a client trying their best to do what they thought was supposed to be done in therapy and how to do or why would you"trust" what is not understood?) non-informational combinations of words used to blame clients.

you're right...the term "the work" is kind of a catch-all, and they most definitely should explain what they mean. When I used it above I meant it as "being open and honest". I wouldn't handle a T that didn't explain things at all.

In my case, the reason T doesn't work is my fault. I just suck at it. I can't explain my feelings, I can't talk about the past, I can't even talk about the present. So, it is a frustrating waste of money and time.

I think more often than not, it's on the therapist. Every case I know of, the client was willing to do their work, and the T messed up. I'm sure there are clients that are difficult to impossible, although I'm not sure. I thnk there are a lot more Ts that let their stuff get in the way, don't have effective supervision, if they have any supervision at all, and generally lack the skills.

Further, I think Ts have the option of telling clients that they are concerned they can't help the client, and suggesting transitioning to someone who is more qualfied to work with this client.

So I vote that most often, it's the T. Clients are there because they have issues, and they are paying the T to help them. If the T can't help them, they have an obligation to address that issue, not just say that the cl is responsible.

P.S. What's the difference between a client and a damaged client?

I think a huge issue also is that therapists really don't know whether they can help a client or not. By the time it may become apparent they are not the correct therapist for any given client - the therapist's ego may make it very difficult for them to accept they are unsuccessful with that client. I think it is on the therapist to at least discuss this with a client. The client is not always able to tell if it is horrible just because of the normal doing therapy is horrible or if it is the incompatibility or incompetence of the therapist at play.

I struggled with answering this because I can't define "fail". Having read the above replies, I think that there is more than one way of failing:
The client can resist engaging (for whatever reason) to the point where therapy isn't possible.
The therapist can misunderstand and therefore mislead.
There are probably others but those can be interpreted to cover a lot of different problems.

I really appreciate that my T has a "supervisor" who checks what we are doing. I don't know who this is, and don't need to, but am reassured that there is more than one person tracking our progress.

I like to blame the therapist.

Yes, there are difficult patients, but the therapist is a trained professional and she should be ready for that. She must win the patient's trust, and if she can't, she's failing him.

The patient recognizes that he needs help, puts in the time and pays the money. For a damaged patient that is a huge investment. To begin with, he may not be capable of much more than turning up for sessions. It is the therapist's job to build on that.

Ah, for once we agree.

What is "work?" For one client, just the act of showing up could be "the work." For another, the act of sharing feelings, yet another, the act of attaching to someone to learn trust etc.

I don't think there is a universal definition of "work," and to use it as a reason to terminate a client is problematic. I also think "the work" can change as the client grows.
The only time this might be different is something like DBT where there are defined homework assignments and if a client does not do them, then that might be problematic.

I should have used something along the lines of severely traumatized. Your point is well taken.

Hmmm... I get what you are saying. I will say that once my T helped me process big life events, we specifically discussed various changes that I could make (a little bit at a time) to improve myself. We also consistently made goal lists (have do be lists). Also, T assigned various readings and assignments. So, I would say that much of my "work" was quite clearly discussed. I can honestly say that I did everything that we discussed to a t (pun intended) except I have not been good about exercise or as good as I should be about eating healthier.

As a result, I made huge strides in my life fairly quickly.

Everyone's needs are different, and what helped me may have the opposite effect on you. However, this is just me detailing my experience with my T.