[Daystrom]

The thing about the therapy relationship that has bothered me the most is the idea that the relationship isn't "real" in any conventional sense. That it is strictly business, that my T only cares about me when she's on the clock. It's difficult for me to accept that a process based upon digging through my deepest insecurities, fears, and anger must be such a clinical endeavor.

Today my T had to be somewhere else right after our appointment, and I could see her glancing nervously at the clock a number of times throughout the last half-hour of our session. It bothered me a lot, enough that I'm going to call her on it next session. Here I was laying my soul bare, going far back into my past to lay some really heavy stuff on the line, and she was checking the clock.

It isn't only that. Her facial expressions are so.... practiced. So fake, so trained. From her default "blank slate" expression, she shifts so easily and rapidly between "concern", "understanding" and "sympathy". None of these facial responses seem to be genuine; they look like the expressions of someone who's trained to react quickly and "correctly" to the various stimuli they get from a wide range of people. The only genuine expression I see on her face is when she smiles; I love to make her smile not only because it's so beautiful (yeah, I've got it bad) but because that's the only time I know I've disarmed her and gotten through to something that hasn't been trained into her.

I understand that the therapist sees a lot of people in his/her day, and must listen to, process, and wrestle with a lot of things. But sometimes I feel like a piece on an emotional assembly line. I'm more than a "client", T. I'm more than an hour on your schedule. I'm a human being, and I need you to be one to me.

Does anyone else have these kinds of frustrations with the therapy process? Does anyone else see the sort of thing I'm talking about in their own sessions?

[angelicgoldfish05]

Yes, I know what you are talking about and it is an interesting part of the therapy. I know for me, if I were a therapist, I would be emotionally whiplashed if I let myself be emotionally connected the whole time. If I were to feel every feeling with 6 or 7 different people each day, I would emotionally drown, and probably be non-functional. The clinical detachment is important. It provides a perspective that will ultimately be more helpful to you (hopefully) than if one were mired in the emotional responses. I get that it does not feel as good. When you are telling all the soul-wrenching details of your past, you want a t to react in an emotional way to what you are saying. You want it to affect the t and move them because it has sure affected you all these years. But if the t gets in on the emotional boat with you, who will stay grounded and be able to pull the boat back to shore? You need to know t is there holding you and because of this, you are safe. You can go there. You can do what it is you need to do. T holds the space.
That said, it sounds like your t is distracted by her personal life, looking at the clock and such, which would probably irk me too. If t can't be present at their job then maybe they need some time off so they are not taking from the experiences of clients. Sorry she seems so rehearsed and "trained". How long has she been your t? And how long has she been a t?
I've definitely caught my t looking at the clock. Well, me being who I am actually, I'm so damn sensitive about it, hell I check the clock throughout session just to make sure I don't go over or get into anything too heavy or deep too late in the session. But yeah, it has bothered me when she was late and then cut the session early... Stuff like that. I don't feel like I'm getting practiced facial expressions though. They seem real, they just don't go too far into any unpredictable realm. T will smile, or looked concerned. I don't get into anything too deep though. I'm probably afraid to partly for the reasons you are describing. It is really difficult to trust another person with the deepest corners of our wounded souls.

So u the relationship isn't real. What is going on when you're together in session? It's not play accting. If it were I'd run.
Who can 'care' only for so many minutes than switch that feeling of? A sociapatht? Once again I'd run.
See, the trouble with that type of thinking is its unchallenged, see, we tell ourselves this and than believe it as if it were fact.
Its a self fulling prophecy type thing.
A victims type of thinking.
Really Talgarth about it. Challenge it. Learn what real means.

[ruh roh]

I go back and forth on this a lot. I usually try to reconcile it by focusing on why I'm in therapy and signs that it's working in my real life, rather than trying to gauge how real or not real my therapist's reactions are.

When it comes down to it, I'm paying for something that's been practiced, so as long as she doesn't cause harm, I'm good. At the same time, I like to think a person can't fake being present and listening (I mean, they can try, but if it's fake, it shows). The one I see now is a good listener and seems/feels genuine.

So, when I start to think of the artifice of therapy, I focus on the results which are so far really good.

[stopdog]

I don't think it matters for me. It matters if they are bad at it -making it painful like like watching a high school theatre production. I expect them to be good at presenting their therapist persona. But that they are acting does not bother me.

[musinglizzy]

I feel a lot of negative things, but one thing I do know is that my T's care doesn't shut off after the session. She'll text/email a check in, and tells me what makes her think of me outside of session.

However, my T also is typically in a rush to get out after our session too. It's the same days/times, and usually she has to pick her daughter up, or rush her to an appt or something...so she watched the clock and at times has rushed me out, but even on times she doesn't, she watches the clock. I used to see it as "yikes, she's bored!" But I've learned to view the clock watching as her way to help me in my mood/emotions to leave "in a better place," by determining how much time we have, and where I am at that time. And of course watching the clock as not to start a heavy topic with only a few minutes left. Thinking of it that way, does that help? By the way, Happy Birthday T!

I did briefly try out some therapists who were kind of like what you describe. They seemed to be just playing a role, or going by some technique or manual they learned in school somewhere about how to look genuine or empathetic or whatever. I didn't stay with them beyond a few sessions. I suspect their style would have worked for someone out there, but there just wasn't any kind of connection that gave me any incentive to return.

The three therapists I worked with long-term never gave me that feel. They were very natural in their interactions with me and their level of care and concern was easy to see as quite real and not at all staged. They cared beyond our session times, and there was plenty of evidence for that. It never crossed my mind that they were just caring as part of their job. We connected very naturally from day one and worked well together.

We won't mesh with everyone with work with. Perhaps it isn't so much about them not caring or them putting on an act as much as it is simply that something about personalities just doesn't gel with certain people. Personally, I would have trouble working in a therapy relationship with a person that I just felt rather ambivalent about, so personally, I have always felt comfortable continuing to look for a therapist that clicked with me better. I generally didn't have to look that long to find them. In fact, the three the really did click with I found practically without trying at all weirdly enough.

Neither my current T nor my ex-T seemed fake, I feel they are both very genuine and even a bit vulnerable too, and very present with me in the room. I think there are two possibilities in your situation, one is that your T is not very present and genuine with you, or the other is that your doubt relates to your 'stuff', perhaps you are finding it hard to trust and feel accepted? A greater connection might come with time. Talking about it will probably help.

[emptyspace]

.
I agree with you. It is their job and they probably only care within the boundaries of that relationship.
I know I will get blasted for saying this, but we are a job to them. We pay them for their service and 30+ other people pay for their service too.

They can't seriously care about all their clients, otherwise they would end up with "compassion fatigue" or exhaustion.
They pretend so that the relationship works, because without a solid relationship, the client won't change.

If you were a fly on the wall, you would see your T act very differently with another client than she does with you.
They have to act sometimes, because clients need different things.
Think about how different a T would have to act for StopDog versus someone who wants the relationship badly.

I sometimes think that they purposely act how we need them to, so that we keep coming back and paying for more. But that is another discussion....

Originally Posted by emptyspace

.
I agree with you. It is their job and they probably only care within the boundaries of that relationship.
I know I will get blasted for saying this, but we are a job to them. We pay them for their service and 30+ other people pay for their service too.

They can't seriously care about all their clients, otherwise they would end up with "compassion fatigue" or exhaustion.
They pretend so that the relationship works, because without a solid relationship, the client won't change.

If you were a fly on the wall, you would see your T act very differently with another client than she does with you.
They have to act sometimes, because clients need different things.
Think about how different a T would have to act for StopDog versus someone who wants the relationship badly.

I sometimes think that they purposely act how we need them to, so that we keep coming back and paying for more. But that is another discussion....

Not going to blast you, but I will qualify what you are saying a bit.

My T has talked about what good therapists know how to do so they don't run into "compassion fatigue" as you call it. He said that good therapists are masters at compartmentalizing. He has trained himself to keep each session/client in their own space because he can't be thinking of client A's problems when client B steps into his office. That doesn't mean he doesn't care. That means he does care because he is committed to giving himself fully to each client. He also compartmentalizes his work life from his outside life. That doesn't mean he doesn't think about his clients when they aren't in his office. He does. He just has a very strong ability to keep those aspects of his life from bleeding onto each other. If he couldn't do that, yes, he would be an exhausted, emotional mess. It's basically a boundary.

But he does think about his clients and care about them outside session. I suspect most of them do to some degree. Not every client every day. Certainly not every client every hour of the day. But just like the rest of us, people come to his mind, sometimes in the strangest of times and places. I remember him telling me once after he returned from vacation that he had had an aha moment about me while standing in the middle of a river fly fishing in Arkansas. It was a pretty funny image -- him in his waders, probably his beard all scruffy, doing his fishing thing -- but it reminded me that he doesn't just turn off his brain concerning his clients when he walks out the door. We have a way of coming to him, even when he is far removed from his job.

And yes, of course a therapist's interactions with each client are going to be different and their feelings and thoughts about clients are going to be different. How could they not be? But is different necessarily unreal or artificial? I have many different people my life personal and professional, and each of those relationships has a uniqueness to it. Would you really want your therapist to be the same with every client? They don't behave differently necessarily as an "act" so much as differences are just completely normal.

[ruh roh]

Daystrom, it would bother me a lot if my therapist were looking at the clock. In fact, I don't think I would be able to not say something. If it's a rare thing, I would let it go after saying something, but if it were a regular happening, I would see that as a sign of disrespect.

[stopdog]

The first one I see simply has a clock behind the client so looking at it is not different from looking at the client. That is what I mean by being good at it - not that they don't look at clocks, but that they arrange it so it is not glaringly obvious. I watch the time myself so for me- it is not a big deal. In my own office at the university I have two clocks - one behind the students and one they(or both of us) can see. Often they do not even notice the clock behind them and give me (completely undue) credit for knowing timing stuff. They would get twitchy if I looked at the clock that they can see, but have no adverse response to me looking at the one behind them.

My T watches the clock, but like stopdog says, he's good at it so it isn't obtrusive. It sounds like the OP's T was very obviously continuously checking the time like there was someplace he needed to be. That would be more bothersome, but my T is pretty good about telling me if he does have to cut and run right at the end of session, so it isn't some sort of mystery. Normally he doesn't, but of course those things will come up. By my T just giving me a head's up at the beginning of session, it helps explain if I do notice a bit more clock watching than normal.

[LonesomeTonight]

I feel my T, marriage counselor, and p-doc are all genuinely concerned and reacting to what I'm saying. With my previous p-doc, it felt like she was just going through the standard questions so that she could get to the prescription-writing part--so I changed p-docs, once another joined the practice. Current p-doc seems genuinely concerned about my well-being and approaches her job as more than just prescribing drugs (she has 25-minute med checks, for example, which previous p-doc had 15-min ones).

I actually talked about this to my T recently. She strikes me as a very emotionally stable, pulled together person (unlike me!), so I had assumed she was just able to switch off thoughts about her patients at the end of the day. But she told me no, that she keeps thinking about them, and that some of her colleagues have told her she cared *too* much. After that conversation, I saw her in a different light. She's also teared up a few times recently when I've told her things. But times I needed her to just listen and not react, she's generally done that too. She keeps track of the time, as we always end on time (with a few exceptions), but I also keep close watch on the clock, so it doesn't bother me that much.

My marriage counselor doesn't seem nearly as pulled together, and his emotions are easier to read. It's clear (most of the time) that he's reacting to what H and I are saying, that it's not rehearsed. We haven't specifically had the discussion with him that I did with T, but I can tell he's the type that takes work home with him mentally/emotionally. A family member that lives with him (wasn't more specific than that) was having a bunch of health issues a bit ago, and during a few of those sessions he seemed rather distracted (and he had to cancel a couple). But he apologized to us for letting his home life interfere with his job and seemed genuinely sorry (he does a lot of apologizing--just like me). He seems to keep track of the time, but not in an obvious way, and if it's a particularly difficult session, he's let us go over time by as much as 20 minutes.

That type of therapist would work fine for me. I consider what they do to just be a job and I also think they are good at acting the part. I think they can care, but I'm not really sure that means much to me. I just want one to be able to help me or to listen objectively. Everyone needs something different in therapy and I don't really want warm and fuzzy and caring. I want competence. (Not that a therapist couldn't be all of those, but I don't want to first qualities.)

[Daystrom]

I need to stress that the clock-watching isn't a normal thing with her. I've never really noticed her doing it before, but yesterday she was on a harried schedule. The clock is on a table behind and to the right of me, not obtrusive, but yesterday I noticed.

Not that I'm excusing it happening even once; I didn't like that and will be letting her know next time.

And as practiced as her reactions are, I've never gotten the sense that she isn't listening or that her compassion is false. I believe she does care, we're alike in so many uncanny ways (in our respective personal histories, attitudes, beliefs, etc.), we both know it, and it's why I like her so much and am able to open up to her. I call her expressions "practiced" because I'm sure they're exactly that -- drilled into her over years of doing this, and she's probably not even aware she's doing it.

I completely understand about the potential for "compassion fatigue". I realize that Ts have to limit their emotional exposure or they'd go crazy from the sheer number of issues brought into their offices each day. All the same, knowing this doesn't help the frustration I feel at my end of that room. Given that one of my issues is profound alienation from people and an inability to form and maintain healthy relationships, it drives me insane to feel that this woman with whom I feel such a deep connection can't be any more "real" to me than anyone else. It makes me want to seal myself away and never talk to anyone again.

[Daystrom]

Originally Posted by Brown Owl

Neither my current T nor my ex-T seemed fake, I feel they are both very genuine and even a bit vulnerable too, and very present with me in the room. I think there are two possibilities in your situation, one is that your T is not very present and genuine with you, or the other is that your doubt relates to your 'stuff', perhaps you are finding it hard to trust and feel accepted? A greater connection might come with time. Talking about it will probably help.

Trust and acceptance are huge problems with me. I've been burned by a lot of people in the past and it's made me a wary and distrustful person.