Have you asked your T...

Have you asked your T outright if they think they can help you?

I understand that we assume they can, and that ethically, they're supposed to tell us if they can't. But have you asked? And if so, how did that go?

Yes and the woman said she did not know.

I did during our last session. She was very honest about it. She said that she isn't positive she can, but she thinks she can, and she cares about me and is willing to try. I quite liked that answer.

Honestly no T can say that they 100% believe that they can help you because it is not up to them, it's up to the client. You can have the best T in the world and if you don't take their help outside of session you won't get better.

I disagree that it is all on a client. You are paying them to do something - I pay them to sit there and not give their opinion or advice. You can be the best client in the world and if the therapist can't communicate with you, or does not listen to you or is just plain wrong or stupid - they will hinder not help.

This is an excellent question that I think people should ask. I didn't ask it when I was in therapy because I just assumed that if I didn't like what they do, I'd just leave, which turned out not to be so simple.

As a therapist, if someone asks me this question, I'd clarify the definition of "help". If someone is not clear about what they want to achieve as a result of therapy, what their goals, hopes and expectations are, then no one can help them. If they tell me clearly what they expect to achieve, then I can tell if I can help.

And, yes, you are right, if the therapist believes they can't help you, it's their ethical responsibility to refer you to another practitioner.

Thanks Stopdog and Yearning0723. I assume this wasn't at the very first session? Did you probe to see *how* they thought they could be helpful? Right now, therapy is not looking very helpful to me... Thanks.

I might have waited until the second appointment - but maybe not. I asked about every week for the first year.

I also think it is on therapists to be clear about what it is that therapy and therapists can possibly do or not do. IT is not like those people are exactly forthcoming about it.

My T said that I can heal from my issues and that she would be honored if she could be there to support me through this journey. She also said that even if it's someone else helping me she wishes me well. She believes if we both work together she thinks we can make great progress.

So yes I did ask and no she didn't promise she could help me but with my permission she will try.

Thanks.... a couple posts popped up while I was posting.

BrokenWarrior - Thanks... I get that the client needs to do something. But I think I agree with Stopdog, it's not 100% the client. If it were, we wouldn't need therapists at all! I think a therapist should be able to assess whether or not they understand the client's issues, and whether they have the tools to help. That doesn't mean that they're guaranteeing success, just that they feel like they have a reasonable understanding of the problems and how to address them.

Ididitmyway - Thanks... That's part of the problem. I had goals when I started therapy. But, therapy seems to turn things all inside out. My T says that one of his professors used to say that "when your parents enter the room, your IQ drops 40 points". That's how therapy feels to me - when we start muddling through emotional stuff, my IQ just plummets, along with my ability to hold onto plans and goals and whatnot. So I don't feel very goal-driven right now.

Perhaps this list by the guy who runs this site will help:

10 Secrets Your Therapist Won?t Tell You | World of Psychology

Stopdog - thanks for the extra info. And, I agree. I wish therapists were more clear about what therapy can do, but also about what WE'RE expected to do. Sometimes it feels like this weird game where nobody will tell you the rules. That part doesn't make sense to me

JaneTennison1 - Thanks... that's a really nice way of putting it! Did you feel (or do you feel) clear about your goals? I feel like once you get into therapy, it's so easy to lose sight of them and just feel like you're in the middle of the ocean, with no land in sight!

Thanks... and ironic... "1. I honestly don’t know whether I can help you or not."

100%. I feel like I constantly have to hold onto my goals. It's so easy to get lost in a world of my t showing me the care and compassion I missed out on. It gets safe and comfortable and that does not push me. My T and I are still working on boundaries, when to challenge the safety and ultimately moving toward my idea of healing my past and enjoying the present.

I'm sorry, I didn't mean to make it sound like it's all on the client because it's most definitely not. However, if I T tells you that they are sure they can help you that is a red flag in the psychotherapy world (I'm in training). No T should tell a client that they WILL get better under their care. They should be honest with the client if they have an issue that they are not well informed of. For example, my T does not have enough experience with eating disorders so she refered me to a nutritionist.

Thanks JaneTennnison1 - that's interesting. Between this and what Ididitmyway said... I can see him asking what my goals are, or what I think I need help with. Yikes. I just don't know anymore. Thanks.

That is why I posted it.

Thanks BrokenWarrior ... and sorry, hope I didn't sound like I was jumping down your throat! I'm just feeling lost right now, and would feel better if my T could say that yes, he feels like he has a good handle on the issues I've presented so far, and that yes, he can see a way forward - because I can't, and having us both stumbling around in the dark seems useless and expensive and worse than me stumbling by myself right now!
Thanks!

Hmm..Interesting list and it probably applies to many therapists. Not to all of them. Not to me for sure.

1. I honestly don’t know whether I can help you or not

As I said, that to me depends on the definition of "help", so it's contextual.

2. I’m not your friend, but I want you to open up to me anyway

Why is this a "secret"? I think, everyone knows that a therapist is not a friend, and you open up to them anyway because that's the whole point of therapy, otherwise what do you need to see a therapist for? Pretty stupid point me thinks.

3. If you ask to see your chart, I’ll probably give you a hard time about it

I won't. You have the right to see your records and I will give you the copies upon your request.

4. I’m not supposed to give you advice, but I will anyway

I won't. It's my general life's philosophy not to give anyone advice. It makes life so much easier. I can tell you the situation as I see it and your options as I see them, but I couldn't care less what you do about it.

5. This is probably going to hurt, but I may not tell you that up-front

Gimme a break here..Many therapists describe the risks and the difficulties of therapy in their informed consent. There is certainly no problem for me to say it upfront.

6. My graduate degree probably doesn’t matter much; neither does where I graduated from

The degree itself doesn't matter. The accumulated knowledge of psychology I got in academic settings and during practice and from my own personal experience matters if I can discern what is and isn't useful.

7. If I’m pushing a particular brand of medication, you can likely thank a pharmaceutical company.

Luckily, I don't have to push meds on anyone because my license doesn't allow me to prescribe meds. The dude who wrote the article is a psychologist and is also not allowed to prescribe meds, so I don't know what he is talking about. Only psychiatrists and other MDs can prescribe psych meds.

8. I work for you, but battle your insurance company to get paid

Doesn't apply to me as I've not taken insurances.

9. I will give you a diagnosis whether you need one or not

Thanks to our stupid health care system that requires psychotherapy to follow medical model, we all have to do it because we are legally required to, not because we want to.

10 I love my job, but hate the long hours, client’s often-slow progress, and the difficulty in being understood as a profession.

I did love my job when I was practicing, I did NOT hate long hours, I did NOT hate client's slow progress because I was not the one to define their progress for them. I did NOT feel misunderstood by others as a professional. The only thing I hated was the idiotic profit-driven system that drives humanity out of the profession, the medical symptom-oriented model where you have to pretend you are a "doctor" and many other system-related things that stay on your way of doing the best work you can do.

I've asked my T. She says she believes she can help me. But the word "believe" is different than the word "know". My T would never say something that matter of fact.

I have also asked if she thinks I can progress and what that progress would look like.

But my T also often asks me if I find her helpful. Of course, I panic and have a breakdown because I think she's trying to push me away when she asks that. Come to think of it, I have never answered the question . The messed up part: she only asks that when she feels like I'm pushing her away. Oh, the wonderful emotional cycle I put myself through: fear being too needy, push T away, T questions my desire to be there, I fear abandonment, I become needy, and right back to the start. Sigh...

But yes, I think you should ask.

Thanks ScarletPimpernel... I have to say, I'd interpret T's question (of whether you find her helpful) the same way! It makes me feel a little less crazy to hear someone else does this too! I don't think my T really *gets* that yet though... It's hard!

All I can suggest is to keep talking about these things. Ts are human and sometimes we have to teach them. My T seems to often forget how severely I'm afraid of abandonment and rejection. She seems to forget how much I care about her. We're both perfectionist and both are picky with words so it makes it even harder. I try to point out how something she did affected me and she questions why I feel the need to put blame on her. She tries to provide me with a different perspective and I feel like she's invalidating me. But we're both learning. Relationships are difficult, even the therapeutic ones.

I think it's a good question to ask. Not all T's are good/competent at handling all kinds of issues due to their own issues (like a T who had csa in their past might not want to work with a client who had rape fantasies, etc.) So asking the question up front might weed out a T who was uncomfortable with your particular problems. Of course that assumes that the T will be honest....

It sounds like you need more reassurance from your T. It sounds like you feel a bit lost and are hoping that he will be able to see the way (where you can't) and be able to guide you. If there is any way you could let him know that you really need some reassurance that therapy is going to help, it could be really helpful to him. Some T's are not really the reassuring type (mine, for example). He can be rather brutally honest about things, when I sometimes need a little more coddling and reassurance. It's something I had to talk about with him (a lot!!) and now sometimes we can even joke about it, but it took a long time to get to that point. Hope this helps.

This is a great question to ask. I didn't do that, but the topic came up anyway (can't remember how) and my therapist said it was her hope. Her answer works for me.