[PaulaS]

So I´ve been to another appointment with another new T and got disappointed - again. It was a nice practise and the woman was nice but there weren´t the right conditions for good therapy.

I tried to get her to explain how she worked and I mentioned some quite common psychology terms and she didn´t know them. She claimed she "worked that way anyway" because she had worked as a T for 40 years. That did not give me any confidence in her knowledge!

She worked as a psychodynamic T but seemed very unfocused on what methods to use, she babbled about Guided Affective Imagery, and even if that´s a therapy method that has been done research on, to me that feels like mixing a lot of methods without knowing what really works.

Even if it´s very difficult searching for a T, I don´t have any options and it seems there are no good T:s out there. The T:s I can afford that is. Just feeling sad and exhausted.

[ThisWayOut]

I'm sorry it didn't seem to work out... Searching fo rthe right T is definitely a difficult and tiring task.
would asking specifically how a t thinks they could help you with whatever your presenting issues are be more helpful than asking what methods they use? At least for myself, I would prefer a T that feels confident they have enough resources at hand to pull from any method that might be helpful, rather than a T that was very regimented and knowledgable in only one approach.
just a thought. I know some people want a specific approach, and that's fine too (either becuase they have had a good experience with it, or because it is known to work for thier issues).

Sorry it didn't feel right. I imagine you had high hopes. I myself tried two other T's apart from the one I see. I didn't ask any of them any questions. I still don't think I would have had much of an idea what to ask. I just tried out what it felt like talking to them. One had worse eye contact than me so I discounted her, the other I just didn't get a good vibe from. Hope you find someone.

[guilloche]

Aww... I'm sorry PaulaS. I know that all the T-stuff has been really hard for you, and it seems impossible to find anyone that knows what they're doing and would be a good match. I wish there were an easier way to get matched up with therapists!

Good luck, and hang in there!

[Ididitmyway]

Sorry, it didn't work out. I have to say though that if you want to select a therapist based on the methods they use that are only scientifically proven, you won't find any. As unfortunate as it is, virtually none of the psychotherapy methods are scientifically proven, may be not even "virtually", but just none

[Favorite Jeans]

I have to say I really cannot relate to your strategy for choosing a therapist. Good therapists can be hard to find, no doubt, but it sounds to me like you're trying to paint with a hammer. Let go of the whole notion of method, let go of trying to see if they're erudite enough for you and just pay attention to how you feel in their presence and how they respond when you talk about yourself. Good effective therapy is a lot less about the method/modality than about the relationship. Is there a chance that your fear is getting in the way of giving someone a real chance?

[Favorite Jeans]

Originally Posted by Ididitmyway

Sorry, it didn't work out. I have to say though that if you want to select a therapist based on the methods they use that are only scientifically proven, you won't find any. As unfortunate as it is, virtually none of the psychotherapy methods are scientifically proven, may be not even "virtually", but just none

I'm not sure what you mean. There's tons of evidence for a lot of different modalities. The catch is that the issues for which people seek long term therapy are usually not as amenable to being measured. So for example, while it's easy to demonstrate that CBT will help with specific phobias, it's harder to demonstrate that psychodynamic therapy helps people sort out existential unease and nagging sense of inferiority.

[Ididitmyway]

Originally Posted by Favorite Jeans

I'm not sure what you mean. There's tons of evidence for a lot of different modalities. The catch is that the issues for which people seek long term therapy are usually not as amenable to being measured. So for example, while it's easy to demonstrate that CBT will help with specific phobias, it's harder to demonstrate that psychodynamic therapy helps people sort out existential unease and nagging sense of inferiority.

Actually, it's behavioral therapy only, not CBT, which is cognitive-behavioral, that is helpful with specific phobias. That's why I said "virtually no scientific basis" because this particular evidence about behavioral therapy is the only scientific evidence I am aware of.

As far as all other types of therapies, no specific methods proved to be either effective or not effective precisely because they aren't amenable to being measured and, therefore, no one bothered to conduct a valid scientific research on that.

The truth is that it IS possible to conduct a serious research because it doesn't have to be based on quantifiable measures primarily. There could be a qualitative criteria established for such research. But no one bothered with this because not so many people have complained about the lack of scientific basis in psychotherapy so far. I hope this will change in the future.

By the way, the fact that there is no scientific basis for most psychotherapy methods doesn't mean they are invalid. They may or may not work in different circumstances with different people. All it means is that we don't know what works, when it works and how it works because there was no research on that.

In general, independent research is lacking in all areas because of private funding. Research has to be publicly funded in order to be truly independent and reliable.

The only thing in psychodynamic process that is an undeniable fact is that trauma is the cause of most mental disturbances. The research on that has been significant even though still not sufficient enough, primarily because for many people, including professionals, this is still an uncomfortable "controversial" topic. However, the data about trauma is registered by every social worker, medical doctor, therapist and all kinds of health practitioners, law enforcement, human rights advocates etc. The amount of data showing the direct link between all kinds of mental disorders and trauma is overwhelming and for anyone who is not willfully blind it's a fact, not a hypothesis.

It's shameful that with this amount of data, most professionals have no clue about how to work with trauma because no one took time and effort to develop methods based on proper research. The first step towards doing it and towards finding a solution is to be honest with ourselves and to admit to how little we know instead of playing a role of all-knowing experts.

[Ididitmyway]

There you go. Here is one of the researches among many showing the link between childhood adversity and mental disorders Connection between childhood adversity, psychiatric disorders seen at cellular level -- ScienceDaily

[Abe Froman]

That's interesting, I also met with a new T today and it didn't work out either. It's frustrating.

Good luck.

[PaulaS]

Yes, I think there has to be a combination between questions about their methods and asking them if they think they could help me with my issues. Believes and therapeutic orientation tells quite a lot about a T.

Some of the T:s I´ve seen work with quite different methods or approaches. For example dance therapy/rythmics therapy, body therapy and so on and it´s then necessary to find out what approaches they see fit me. For example, I would never start a therapy based on dance.

Originally Posted by ThisWayOut

I'm sorry it didn't seem to work out... Searching fo rthe right T is definitely a difficult and tiring task.
would asking specifically how a t thinks they could help you with whatever your presenting issues are be more helpful than asking what methods they use? At least for myself, I would prefer a T that feels confident they have enough resources at hand to pull from any method that might be helpful, rather than a T that was very regimented and knowledgable in only one approach.
just a thought. I know some people want a specific approach, and that's fine too (either becuase they have had a good experience with it, or because it is known to work for thier issues).

[PaulaS]

Yes, I had high hopes about this T as she had her own practise in the same area as my former T, she seemed to be that "down to earth" motherlike type but she wasn´t. I had a rough time yesterday when I realised I couldn´t start therapy with this T.

I close my eyes and then I see my former T, perhaps that sounds stupid, and I wish I was in therapy with her.

It sounds that you are still looking for a T as well? Do you have any other appointments scheduled?

Originally Posted by Brown Owl

Sorry it didn't feel right. I imagine you had high hopes. I myself tried two other T's apart from the one I see. I didn't ask any of them any questions. I still don't think I would have had much of an idea what to ask. I just tried out what it felt like talking to them. One had worse eye contact than me so I discounted her, the other I just didn't get a good vibe from. Hope you find someone.

[PaulaS]

Thanks for following my posts and my situation around termination and looking for a new T. Have you also tried out several T:s? Are you with a T at the moment that feels like a good match?

Originally Posted by guilloche

Aww... I'm sorry PaulaS. I know that all the T-stuff has been really hard for you, and it seems impossible to find anyone that knows what they're doing and would be a good match. I wish there were an easier way to get matched up with therapists!

Good luck, and hang in there!

[PaulaS]

Thanks for caring. It´s interesting this, that the methods aren´t scientifically proven. You always get the impression they are. I won´t look for the scientifically proven methods but I ´ll look for ways of how they practise therapy. That´s a better way to do it as you say science won´t give the answer.

Originally Posted by Ididitmyway

Sorry, it didn't work out. I have to say though that if you want to select a therapist based on the methods they use that are only scientifically proven, you won't find any. As unfortunate as it is, virtually none of the psychotherapy methods are scientifically proven, may be not even "virtually", but just none

[PaulaS]

You made an interesting point. Could you please explain more in detail what you mean by "trying to paint with a hammer". I can´t completely ignore the method as there are several kinds of therapy that won´t suit me. For example rythmics therapy.

Because of that I have to ask them about how they practise therapy. But I agree with you it´s also much about the feeling you get when you talk to a new T. I try to look at that perspective as well as how likely it is they will be able to help me based on their knowledge and experience. You can´t get any guarantees but I´m extra cautious because of my therapy history.

Originally Posted by Favorite Jeans

I have to say I really cannot relate to your strategy for choosing a therapist. Good therapists can be hard to find, no doubt, but it sounds to me like you're trying to paint with a hammer. Let go of the whole notion of method, let go of trying to see if they're erudite enough for you and just pay attention to how you feel in their presence and how they respond when you talk about yourself. Good effective therapy is a lot less about the method/modality than about the relationship. Is there a chance that your fear is getting in the way of giving someone a real chance?

[PaulaS]

This is very interesting, I´ll read this.

Originally Posted by Ididitmyway

There you go. Here is one of the researches among many showing the link between childhood adversity and mental disorders Connection between childhood adversity, psychiatric disorders seen at cellular level -- ScienceDaily

[guilloche]

Originally Posted by PaulaS

Thanks for following my posts and my situation around termination and looking for a new T. Have you also tried out several T:s? Are you with a T at the moment that feels like a good match?

Yes, I tried out several. Not on purpose, and not recently. When I first started, a long time ago (like... 15 years or so ago!) I kind of got pushed into therapy by a friend who was trying to be helpful, but triggered a whole mess of stuff for me, and left me in a bad place.

I tried out a LOT of therapists back then. Some just for a session or three, before realizing they were not a good match. Some, I stayed with for a long time (and some kicked me out!). It was very difficult for me to determine what was a "good match" and who could help, especially because I was (and am!) not very open, so each time, I thought that I did not want to go back through the beginning of therapy again with someone new. It was too awful and hard.

I ended up taking a break for the last several years (~7) to stabilize myself. I think that was a good thing. I focused on my job, saving money, my physical health, and took some music lessons for fun.

With my current T, I didn't try out several. Just him this time around. And, I'm not 100% sure that he's going to be helpful (I want to quit quite often, like every other session!, but I think that's part of my "brokenness").

I don't know if he's "the one", but I think he can be "a one" - so like dating, I don't think he's necessarily the soul-mate of therapists for me, but I think that he can help me to a point, and I think he's very solid and stable and committed.

So, I am sticking with it. I hold on to the good signs:
- He is not defensive. He wants to know if something he says or does bothers me, and when I tell him, he never makes me feel bad. If it's something he can fix, he will.

- He adapts to me, if something bothers me, he stops doing it.

- He is the only T that I've had who has been able to pull me out of dissociation and silence. I get scared, and feel like I'm falling into myself. I get very quiet and unable to really carry on much of a conversation like this. Other Ts have found it difficult, and have reacted in ways that make it worse. I don't know how he's manages (he doesn't specialize in dissociation), but he always manages to throw me a lifeline, and *thank goodness* doesn't make me sit in silence for a long time, trying to get back all by myself.

- He doesn't seem to take my stuff personally, previous T did, and it was awful. He thought I hated him because I couldn't talk about stuff. *Argh*.

By the way, I don't know if it helps, but this T does a lot of work with addicts, and has been working for ~30 years. So he has a lot of experience, but I figured (and hope) that working with addiction meant he probably had a lot of experience dealing with people who were really struggling, sometimes not rational, and had some trauma in their backgrounds. Basically, even though he didn't specialize in my stuff, he specializes in difficult people... so I figured that might give him an advantage with my stuff. He also does a lot of family and child therapy, and since I've got dissociative issues (apparently possibly including a child part), I thought he'd be able to be sensitive/gentle when needed.

So far, so good. But it's a very slow process for me, and like I said, I'm not 100% sure. I'm hopeful, but not sure!

One of the things that I wonder for you... it sounds like you're trying to take a very logical ("left brain", analytical) approach. But, studies have shown that the most important factor in successful therapy is the relationship, which is a right-brain, non-verbal, creative thing.

I just wonder if it might be possible/helpful to worry less about the details like what methods they use, and try to focus on how you feel with them. Do they listen? Do they understand you? When they answer questions, do you feel like they understood what you're asking - and like they're explaining things in a way that you can understand? Do you feel like they care (assuming that's what you want) - and like they respect your boundaries?

I don't think you can get all this from one session, though some people do know it one session. With my T, I didn't. I didn't want to come back... but I kept getting pushed back by the universe (very long story, I posted about it here last summer). It took me... quite a while to feel like, "OK, this guy might be ok!" and some days, I still feel ready to quit!

I think too that it's important to maybe recognize that part of that might be wrapped up in your own issues. I come from a pretty crappy family with poor attachment and parents that weren't really interested in being parents. So, I'm sure that makes therapy hard for me... hard to attach, hard to trust, hard to see how this person can help, hard to stick around, hard to feel connected at the beginning of every session. It sucks (and I think you mentioned your family was similar?). But it's important to see that, because sometimes you have to realize that the feeling to leave isn't really because the T is bad, it's because you learned from your family that nobody is going to (or can) help you - and so you find a reason to dismiss T.

(But some Ts really are bad Ts, or bad fits, so I'm definitely not saying just pick one and stick with them!)

Good luck, I hope this helps!

[guilloche]

Hey PaulaS...

Something else. I didn't think I was going to stick with this T. I didn't think he was going to be a good match. I kept wanting to quit.

I had a turning point, somewhere around session #7 (!). Yes - that's a crazy long time for me to keep going, but I just wasn't sure, and kept getting signs from the universe.

Session 6 had been really bad. I came here and posted about it. You can read my post here: http://forums.psychcentral.com/psych...y-t-today.html

There were so many red flags and things just seemed awful to me, I really thought that, seriously, there was NO WAY this guy was going to be helpful. That session that I wrote about just left me feeling like it was completely over.

You know what, I went back... and I brought that post with me! (Ha! And now re-reading it, I'm thinking - oh wow! I mean, it was great - because I got to see how he reacted when I basically listed out all the reasons he was terrible, but I can't believe I managed to give it to him!)

I didn't even SAY much, because I did NOT want to be there. I wanted to hand him the check, tell him I was quitting, and just walk out. But, I didn't - I handed him that post instead.

And, you know what? He read it very carefully, replied to the various issues I had raised very calmly, and did not get angry or defensive *at* *all*. To me, that's something I really need, and I think is kind of awesome. That ability to let me be mad at him, to criticize him, to present him a list of grievances (!), and for him to thoughtfully consider them all, and do what he can to fix them.

I really think that was a turning point for me.

I don't know if that helps, or is meaningful... especially since I'm still working things through with him and figuring it out (i.e. I can't give you a happy ending to my story yet!). But, maybe it's helpful to know that even though this T was SO FAR from perfect in the first several sessions, he's been able to adapt and get better (once I told him what things he was doing that I didn't like.)

Good luck

[Favorite Jeans]

Originally Posted by PaulaS

You made an interesting point. Could you please explain more in detail what you mean by "trying to paint with a hammer". I can´t completely ignore the method as there are several kinds of therapy that won´t suit me. For example rythmics therapy.

Because of that I have to ask them about how they practise therapy. But I agree with you it´s also much about the feeling you get when you talk to a new T. I try to look at that perspective as well as how likely it is they will be able to help me based on their knowledge and experience. You can´t get any guarantees but I´m extra cautious because of my therapy history.

Maybe it wasnt a great metaphor! I just meant that I don't think you're using the right tool for the job. I don't think a therapist can tell you how they will help you because how can they really know before they know you? Stuff just comes up, no? Therapy is messy, unplanned, non-linear, full of surprises. All they can do is be there, listen, not judge, reflect and start again next week. If their technique is wacky that will make itself apparent very quickly. No therapist can fake good listening, respect and true acceptance for long. If you don't have that, you have nothing--no matter how smart or educated or well-read they are. And if you do have it, a little unfamiliarity with their modality won't likely matter too much.