High IQ and Therapy?

People who are gifted are often misdiagnosed and misunderstood. So obviously this can become an issue in therapy.

Yes, my gifted daughter needs special instruction to excel and I'm so pleased she gets it. Seeing how she operates, as do her highly capable peers (I've volunteered in her classroom multiple years as well as hosting a large playgroup of mixed children) compared to students in other programs makes it very clear to me that they have somewhat different needs and I can easily see how in my own life, this distinction translates into needing somewhat different treatment. Giftedness comes with a number of traits in many cases the research shows, as does my experience, not sure why it's so controversial to suppose that people with uncommonly high intelligence might find it a challenge (a worthwhile one) to find a suitable therapist, just as it could be to find a suitable teacher. In our district, highly capable students are placed in classrooms with specially trained teachers because of this. Could they manage with other teachers- in many cases-manage- yes, but there are consequences, sometimes underperformance, sometimes behavioral issues, sometimes just frustration or boredom, other times, perhaps none. But it's great to have the resource, and great to find a therapist aware of how giftedness manifests and understanding of those clients' particular challenges.

OK, then, I'm not at all sure I have misinterpreted, but here goes a bunch of questions:

1) So a therapist should be aware of this. How is this any different from saying that a therapist should be aware of cultural differences, class differences, disabilities, etc.? I am not in disagreement there. But at a certain point you reach a reductio ad absurdum with this kind of argument. Of course a therapist should be aware of differences. But a client should also educate.

2) Someone needs to explain what thinking differently means. It may vary from person to person, but what is the nature of the difference and why is it so potentially inimical to therapy?

3) I also could qualify for Mensa - might not always seem like it! : ) - and clearly you and I think differently. What is there to do except try to listen as well as possible and reply as clearly as possible? And isn't what therapists are trained to do, and don't the good ones do it?

And to the latest poster, there are many therapists who specialize in the gifted. Usually children, but that suggests this issue is not unknown.

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When I started the therapy process with former T, I initially picked up pretty strong vibes from her: she seemed very hesitant in what she was saying, almost insecure.

Towards the end I asked her about this. She admitted to feeling not very confident in the beginning, because she realized pretty early on that my way of thinking and processing information is pretty unique. It almost felt a bit threatening to her. She also emphasised that it wasn't anything in particular I had or had not said, but that this was her overall impression (maybe some sort of (counter)transference due to her own issues) and that she at this point had seriously questioned herself whether she would be able to help me... I'm lucky that she didn't refer me on to someone else, because over the next 3 years things worked really well.

Of course one can argue that it comes down to relationship and alliance whether or not therapy works. But I'm positive that a certain way of processing things and thinking plays a significant role as well.

A T who is not able or unwilling to follow and/or challenge my line of thought will most likely be not very helpful for me. And this is not about having intellectual arguments for the sake of having them, but about having some sort of connection (for want of a better word...) or being able to play (mental) ping pong together: When I serve I want a real return from a real person, so this person needs to able to return my weird/unique/special/twisted serves, otherwise there won't be much of a game taking place...
otherwise I could just play against the wall...

1. And I would point out that just as some therapists are better than others at dealing with cultural differences, class differences, disabilities, etc. some therapists are better than others at dealing with any issues that may come along with a high IQ. Should clients also be expected to educate their therapist on cultural differences, class differences, disabilities, etc.?

2. I don't really know. It's just something I recently came across. Sounds like more research is in order. (the articles I linked early may give you some ideas).

3. You write as if you believe no therapist has even been mistaken about anything. As if no therapist has ever done more harm than good (all right, you did mention "good ones", I suppose that shows you accept that some are better than others). Should I assume that if I'm having an issue, then it's my fault, and I need to fix it? Should I merely pick a therapist out of a phone book at random, and stay with that therapist for the rest of my life? (because, "hey, pyschotherapy and the MH field are perfect and all therapists are perfect. If you're having issues, it's on you.")

I'm using extremes to make a point. It is always useful to consider the possible issues. Hopefully, you will agree that it's not always the client's fault, and that some therapists are better than others. Sure, it might make sense to stay and work out whatever the issue is(including educating the therapist about the any "special" needs someone with a high IQ may have), but that's not the only option.

One of the purposes of my OP is to let others know (as was the purpose of the article I linked), that there is evidence that having a high IQ can lead to issues as extreme as being misdiagnosed, or as subtle as having a therapist just not get where you're coming from.

Receiving my destructive therapy caused me to do a huge amount of deconstructing. I'm highly aware of the little man backstage behind the Wizard of Oz effects. If someone needs to establish authority, or play savior, or guru, I'm highly aware of subtext. (I have to deal with an ego queen therapist in a nonclinical setting, and I'm far more aware of her games than she is.) I can't be a naive believer anymore, putting myself in anyone's powerful sagacious hands. I'd be a terrible patient.

A condescending APA past president took me on in an Amazon book review discussion, attempting to nullify my opinion because I had a bad experience. His only counter-argument was ad hominem; he didn't have the substance to address my actual argument. I called him on it.

Did recovering from bad therapy make me resistant, on-to-the -therapist's-devices narcissistic ? I guess it did according to some of their dog logic.

To me that sounds more like disillusionment and cynicism, jadedness: personally I perceive simple high intelligence differently. When I consider how it manifests in my daughter (and to an extent in myself), for example, it's more about processing speed, ability to make connections, to think critically, intuitively comprehend flaws in logic, etc.

Somehow I feel a resistance to therapy and disillusionment is different, maybe a combination of intelligence plus the bad experience plus depression? To feel an entire profession is tainted after bad experiences?

That the high intelligence could cause frustration at times, but that disillusionment is distinct... I do see a correlation at times between alienation (to a degree) and giftedness when there is a lack of peers, but I think having "peers" is a complex experience, not solely tied to the giftedness either.

Thought provoking!

I just noticed this list earlier in the discussion, it details very well my understanding of how high intelligence presents though in my experience, no one will have all those traits, I know in children, while they may thrive on certain types of challenges, for example, unexpected difficulties can be highly frustrating as they're not used to being stuck or stumped:

• perfectionistic and sets high standards for self and others
• has strong moral convictions
• feels outrage at moral breaches that others seem to take for granted
• is highly sensitive, perceptive or insightful
• is a good problem solver
• has unusual ideas or connects seemingly unrelated ideas
• thrives on challenge
• fascinated by words or an avid reader
• learns new things rapidly
• has a good long-term memory
• is very curious
• has an unusual sense of humor
• has a vivid and rich imagination
• feels overwhelmed by many interests and abilities
• loves ideas and ardent discussion
• can't switch off thinking
• is very compassionate
• has passionate, intense feelings
• has a great deal of energy
• feels driven by creativity
• needs periods of contemplation
• searches for answers in life
• feels out-of-sync or out-of-step with others
• feels a sense of alienation and loneliness

........Wow.......

I'd be really curious to hear your take on that, if it feels like it's all coming from being highly intelligent?

Is it solely or primarily the intelligence that gives one the ability to conclude that therapy is sort of a... sham, which is the context I get from the Wizard of Oz reference, or that the intelligence confers consistently superior judgement, moreso than those with "sagacious hands" or that because of the intelligence one can't humble oneself, be all-trusting, or assume a position of inferiority with a therapist, which are implied to be necessary to participate in therapy?

I'm really feeling out which experiences and conclusions arise solely from being intelligent and which from other sources, and how they function in combination. To me they seem to function in combination as certainly not all highly intelligent folks come to the same conclusions or have the same experiences. But considering propensity is interesting. I can see where high intelligence could correlate with a higher incidence of disillusionment... an outgrowth perhaps... but they don't always concur, nor concur in equal strength...

Sure. That is a good point. Alliances are possible.
I'm still not sure how this got to be a discussion about any disparity in IQ.

No, I don't think therapists are perfect or that none has ever made a mistake. I know that to be untrue from my experience and others'. If you'd read any other posts I made on this site, you would know that.

I am going to agree to disagree and go on my merry way.


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That's true although I think that IQ alone is the issue hen this happens since IQ alone shouldn't have much impact on why one is in therapy. Disorders are often missed because a high IQ is present though. That happens often.

I don't think it's that IQ is "the issue" but that a high IQ can complicate the interaction for a therapist not suited to working with highly capable/intelligent folks. Just as cultural differences or other factors can- they're not pathological and still complicate therapy.

If you look at the lists of traits common to highly intelligent folks, I think it becomes clearer- differences aren't a bar to therapy, but they are real and can require working through with someone appropriate.

I have a high IQ as well. My T says I intellectualize every thing
I have a great therapist but I analyze everything, from her words and actions to the process itself.

The treatment program I work in often works collaborates with a similar on in another New England state. This similar program has another satellite program in California, where the culture of the program is different as far as therapist style goes. Mostly it has to do with the Ts level of self disclosure and general boundaries. Where we work, and in much of New England, there is little acceptance of self Disclosure and fairly conservative boundaries.

I am not trying to be argumentative, but I want to clarify what this article is actually stating. The author does not write that merely thinking you're smarter than your therapist is a trait of narcissistic pd. A client who goes to therapy and after a few meetings comes to the conclusion that they are smarter than the therapist is obviously not a narcissist and that's not what the article says. The author is talking about grandiosity - believing you are superior in intellect as well as other traits to not only therapists but pretty much everyone. Whether the client is more intelligent or not isn't the issue. It's going into a situation cold believing you have greater intelligence that is questionable. In some people it may just be arrogance, but if you combine it with the long list of very specific traits, it can be narcissism.

This. Having a high IQ can be very similar to experiencing cultural differences, if the articles I've been reading have any veracity.

Why is the fact that someone is intellectual an issue? Why is the fact that someone is analytical an issue?

Is there something wrong with being intellectual and/or analytical? I would think this would only be a problem if it leads to some kind of paralysis. (Maybe some people are just doing it wrong. If a person is paralyzed by analytical or intellectual thoughts, then they're doing it wrong, IMHO).

There aren't really therapists who suggest their clients should stop being intellectual and/or analytical, are there?

I see this as two separate issues. Some people have a high IQ and some people have narcissistic traits. Some people with a high IQ also have narcissistic traits. Not everyone with a high IQ has narcissistic traits and not everyone who has narcissistic traits has a high IQ.

My therapists automatically assumed they were smarter than me. Hmmm.

Well, I don't have much to say about the original question, but I wanted to take a stab at why so many people are responding about *relative* IQ between client and therapist, versus *absolute* IQ of the client.

First, is it really not that clear why a question that boils down to, "Does my high IQ make it harder for a therapist to work with me?" might sounds like "Am I too smart for a therapist?" I see that they are not the same question, but one does sound quite a bit like the other.

Second, there's a bit of an underlying assumption here, which is that therapists might not be trained to work with people who think "differently". I too feel confused about what you mean by "differently" -- I agree that it is generally true, but it's extremely vague, which makes the question extremely vague. So it sometimes feels like the question is just, "Are therapists trained to work with people who think differently?" in which case my answer would be, good grief if your therapist doesn't realize that some people think very differently then run, do not walk, in the other direction. I am aware that such therapists exist, and I wouldn't think they'd be of use to most (if any) patients, high IQ or no.

Anyway, what I'm saying is, either it's a very vague question about some "difference" in thinking, or there's an assumption that the way of thinking of someone with high IQ -- and I'm not convinced there is just one, which also makes the question vague and confusing to me -- is one that is unfamiliar to a therapist. If "high IQ thinking" is unfamiliar to the therapist, the implication would then be that the therapist does not have a high IQ. Hence the feeling that there is an assumption of an IQ *disparity*.

It's like asking if being, for instance, non-white in a very white community would make therapy more difficult. Which is not a ridiculous question, but the assumption would be that the therapist would not understand or be prepared the struggles of the non-white client, which kind of assumes that the therapist himself is white, so I wouldn't be surprised if someone asking this would get responses taking this on as an assumption.

Again, I'm not saying that this is what you intended. I'm just trying to show you, at least from my point of view, why whenever I think about replying to this I find that I can't because the question itself is too slippery. What I *can* do is tell you my experience with intellectualizing things, how that has impacted my therapy, and ways that my T has dealt with it that I think have worked well for me. I don't know my IQ, though.

Narcissistic personality disorder is a lot more than assuming you're smarter than somone else, so that trait alone doesn't give you a the personality disorder.

Still, they sound like they were at the very least arrogant and maybe narcissistic.

[QUOTE=shakespeare47;4663621]I see this as two separate issues. Some people have a high IQ and some people have narcissistic traits. Some people with a high IQ also have narcissistic traits. Not everyone with a high IQ has narcissistic traits and not everyone who has narcissistic traits has a high IQ]

Right, but the article is specifically about narcissistic personality disorder, not individuals with narcissistic traits. So the point of the quote originally shared in this thread was to illustrate the presence of grandiose thinking, not the actual intelligence of either client or therapist (or any link between narcissism and intelligence).

I was always trying to steer the conversation towards the question, "What are the issues for those with a high IQ in therapy?" Some people think there aren't any, or shouldn't be any. I get that.

In regards to being vague? I find if you want to have a conversation, it's best not to be too specific. Ask a question that can be answered simply "yes" or "no" and you will get a "yes" or "no" answer. Considering the length of this thread, I think I did okay.

I'm glad you found the thread length helpful.