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#1
Jul 16, 2014, 04:20 AM
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I have some concerns about the therapy I'm receiving; maybe those of you who have been doing this longer can help. I'm seeing my T about once a week, I guess for CBT. So here are my concerns:
1. He's usually at least 5-6 minutes late, and has been as many as 15 minutes late before. He never mentions this, or apologizes at all. Recently he's been ending the sessions several minutes early, too. Now when I'm paying over $100 for a 1-hour session, that seems a bit... wrong. Am I just being obnoxiously punctual? Am I wrong to expect at least 50 minutes of actual "couch" time? 2. Every session, he asks me how I'm doing, I mumble that I'm fine (because "fine" is my go-to euphemism for "not that good, actually"), and then the silence ensues. There is a LOT of silence between us. Granted, I have a very hard time trusting anyone and I know I'm not opening up as much as I should. But shouldn't a therapist actually try to start a conversation or lesson or something, instead of sitting there in silence, deconstructing his pen or bending a paperclip until it breaks? 3. I've been to maybe 20 or so sessions, but at the latest one he just wanted to "review" everything we've been over. Okay, that's fine, but then he actually told me that he "doesn't know where to go next" with my therapy. And it's been like this from the beginning -- he's always seemed very disorganized. Like he's not following any actual process, just winging it from session to session. Is that normal? 4. He says that I'm ready to try these things we've been going over in real-world situations and insists that I need a job, even though I'm absolutely terrified of interviews, the first day, meeting new people, workplace bullying, etc. I guess he thinks the "talk therapy" part is over, even though I don't feel any better in social situations than when we started. We talked for one session about my past traumas, and I guess he thinks that's enough to "cure" me? I know I'm paranoid and depressed, but it really feels to me like he's just sick of me. I don't know what to do at this point... I honestly feel like I'm "failing" at therapy, and that's plain pathetic. I'm considering quitting the whole thing cold turkey, but I know that I have a lot of unresolved issues and some mental illnesses that aren't getting any better. Maybe I really am just a hopeless case. Any advice or help would be appreciated. Thanks in advance.
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If only real life could be as beautiful as fiction... Diagnosis: Social Anxiety Disorder, Depression, Generalized Anxiety Disorder, possible Autism Spectrum Disorder |
 Aloneandafraid, guilloche, Perna
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 Aloneandafraid
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#2
Jul 16, 2014, 04:58 AM
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Quote:
1. There have been some discussions about therapists who start sessions late and end them early, and while I am all for cutting the T some slack if it happens occasionally, I absolutely think it is a problem if it becomes usual, and especially if your sessions are regularly cut short by as much as 8-10 minutes. And in any case, if you are bothered by it, then it is a problem - anything that frustrates you or becomes a roadblock of any kind in your therapy is worth mentioning. 2. My T almost never starts the conversation. I found this frustrating and embarrassing at first, but I have come to appreciate it. A therapy session isn't like any other kind of conversation, I've found - it's perfectly okay to sit in silence for ten minutes, and that creates a very restful and unhurried environment, where it becomes more possible for me to open up than I had ever thought possible. However, it is a little surprising to me that a CBT therapist works like that (my T is psychodynamic), but of course CBT Ts are different, just like everybody else.  Again, if it bothers you it's definitely something you can bring up. It might make for a good conversation opener if you don't know what to say! (That your T fidgets with pens and paper clips sounds rather annoying, I must say. That would bother me a bit.)3 and 4. This sounds like your T might not be a very good fit for you, to be honest. Maybe you need to see a therapist who is prepared to work on your past. To me it doesn't sound very helpful at all to just insist that you need to do these real-world things - it's a bit like those people who tell you to just "snap out of" a depression as if it were a choice to be depressed. If he says that he doesn't know where to go next, maybe you could ask him about alternatives, such as a referral to a different T? In any case, it is not your fault. I just think that you and your current T might not be a great match. |
| Aloneandafraid, precaryous, someone321, unaluna
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#3
Jul 16, 2014, 05:02 AM
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I really do not think that you are failing in therapy - maybe there is just not a good match between you and your T? My answers to your questions would be:
1). No, I think you are not obnoxiously punctual and it is normal to assume that if you pay (and actually even if you didn't pay) someone for their work, they should respect you and your time and be on time... I'd accept rare situations when T is late or has to finish earlier but I would expect T to say it in advance if possible and apologize - that is what both my Ts always did... 2) There are approaches in which Ts do not talk much as they don't want to "force" you to talk about a certain topic so there might be even a lot of silence... But if you don't feel comfortable with it, you could try maybe more psychodynamic approach in which therapists are more active and not like a "blank slate"? 3) It might be that your T has no idea what to do with your therapy but also that he wants you to take a control over it... But in both cases - there are many other therapists and approaches who would be willing to structure sessions better... My first therapist was a bit like yours but my current gives me more feedback and is willing to structure the session if I ask her for it. I guess different clients have different needs, so also different approaches have to be around. Clearly this approach doesn't fit you the best - Thus, I would try a different one... 4) I don't know what to write here... I think this type of therapy clearly doesn't work for you, but instead of "considering quitting the whole thing", I would consider finding a better match because there are also very good Ts... Good luck, I hope it will work out well for you |
| Aloneandafraid
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#4
Jul 16, 2014, 05:59 AM
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1. You are most certainly not obnoxious, nor are you wrong to expect to have your full 50 mins. If he does that on a regular basis (i.e. he is late & lets you go early) then please bring it up. It is not acceptable for him not only to not apologise but, worse, to cut your time short.
2. That depends on the therapist’s approach/therapeutic ‘leanings’: some will probe and/or initiate conversations, whereas others will adamantly let clients take the lead and wait accordingly. Still, there are some things you might try: could you ask him to help you out in starting the conversation or to bring up topics? Could you write some issues (bullet points) and bring them up? It would still be best for you to take the plunge, however hard it is. As you rightly pointed out, you pay for it so make the best use of the time that you can. 3. Usually there is a plan as in, they ask what issue brings you in and typically, you (both) will work on this. Obviously, other issues might crop up and the work can take a detour but i find this unusual that he claims not to know where to go next... What is his background? 4. Can he help you with interview preparation? Maybe role-play it (as if he were the interviewer) and work on your anxiety etc.? He needs to give you the ‘tools’ and in a progressive fashion before setting you off in the big bad world... Finally, I wouldn't say that you are failing at therapy but maybe either he is not the right match for you or his technique/therapy modality is not suitable. |
| Aloneandafraid
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#5
Jul 16, 2014, 06:10 AM
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Try a different orientation of therapy
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#6
Jul 16, 2014, 10:30 AM
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It sounds like you and your T are in very different places and I would try to discuss that with the therapist (quit saying you are fine when you are not, ignoring you feel he is late and resent that, and have these questions you should ask him) change therapists and start over better with another, and/or discuss therapy types and find out for sure what type of therapy this therapist practices and decide to change types or maybe sex of therapist to see if that would be more comfortable/helpful for you. I did much better when I got a female therapist.
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"Never give a sword to a man who can't dance." ~Confucius |
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#7
Jul 16, 2014, 02:17 PM
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My t's have been late on occasion but they always make it up at the end. Being cheated of your time is wrong.
I'm surprised to hear that a CBT T is so aimless--that is strange to me. Silences happen way more often in my psychodynamic therapy. Sounds like your T is not attuned to your needs--definitely think about seeing someone else!! |
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#8
Jul 16, 2014, 05:03 PM
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It has nothing to do with CBT. My T is CBT and doesn't do any of those things.
And it doesn't sound like you're failing therapy, but that your T is failing you. My T is slowly pushing me to get a job. But right now, she knows that it's progress that I even leave the house. My next goals are "trying" DBT group, and maybe getting a volunteer job once a week. In a completely humorous and non-threatening way, she told me I need to try it even if I go kicking and screaming 
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"Odium became your opium..." ~Epica |
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#9
Jul 16, 2014, 06:57 PM
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I think the time issues are worth bringing up with him, if you can. When I have to bring up stuff like this (with anyone, not just Ts), I try to go in and ask them with... well, genuine curiousity (rather than accusing) to avoid putting them on the defensive. Sometimes they have a good reason for doing things the way they do. In this case, I'd be upset too... therapy is expensive, they shouldn't be short-changing on time!
I also want to reiterate what some other folks are saying - there are different types of therapy, and some seem to provide more structure and direction! I am just getting started with a new T (3 sessions in!) and he is sooooo much more structured/directive than the other Ts I've seen... With previous Ts, I never knew what to talk about - and either completely clammed up in fear (eek!) or spent way too long on small talk. This guy has found a way, so far, to keep me talking about things that are important, but not so scary that I shut down. He knows more about my family after 3 hours than other Ts did after 3 years (!!!). I think he does "family systems therapy" (but I'm not 100% sure). So it might be worth checking out other Ts, and specifically looking for someone a bit more directive? T-gone-awry is really dreadfully awful, and I'm so sorry you're going through this. I hope you find a way to either work it out with this T, or find one who can help you, and not waste your time! Good luck... |
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#10
Jul 22, 2014, 04:49 AM
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The more I think about it, the more I just want to quit. I want to call the place and cancel all my appointments. But then again I feel really unstable and think I need therapy.
Maybe CBT in particular just isn't working for me. I can recite all the positive crap while staring at myself in the mirror all day; it doesn't make me FEEL any different. Like, logically I know that I'm not stupid and worthless and hopeless, but logic doesn't stop me from FEELING that way. Maybe my beliefs are mistaken but they're still my beliefs, and they're ones I've had for decades. And six months of therapy is supposed to magically cure me of all that? Riiiiiight. I feel like I'm falling apart 
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If only real life could be as beautiful as fiction... Diagnosis: Social Anxiety Disorder, Depression, Generalized Anxiety Disorder, possible Autism Spectrum Disorder |
| Anonymous200320
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#11
Jul 22, 2014, 05:02 AM
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Quote:
if youre not too attatched to him to leave (like i am to my t) i say you bail on his *** and find a new, more competent T. coming late and leaving early is NOT OKAY AT ALL. |
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