[SarahSweden]

One thing that has really struck me is the very unequal relationship one have with a T, a doctor or a psychiatrist. I haven´t thought like this before but I feel very bad about the fact that when a T/doctor/psychiatrist is being nice to me it isn´t because he or she needs me. It doesn´t even have to mean this person likes me, it "only" means he or she wants to help me.

I understand it has to be this way, a T or a doctor can´t at the same time be my friend but I still think this is very patronising.

One example is when I complain about something. If a T or a doctor is somewhat proffessional he/she´ll listen and lets me complain and even if he/she doesn´t agree or like what I say he or she will act in an understanding way.

I know for sure this person doesn´t appreciate my complaints but he or she doesn´t act out or talk back at me because in his/her role he/she has to be forgiving, understanding, to look behind reactions from a patient.

Of course I don´t think a T or a doctor should argue and act mean against me but on the other hand it feels very bad knowing he/she isn´t nice to me because of who I am. He/she is nice to me only because I hopefully will get better within a certain treatment and he/she tries to mediate such a treatment.

I think it feels bad both being treated badly, for example being ignored but it feels almost as bad being treated with "false" understanding and compassion.

I´m being treated nice but outside the therapy or medical office I don´t matter at all to this person who treats me nice. He/she doesn´t need me for having someone to treat him/her nicely and I´m actually a nobody, nothing more than part of his/her income.

By that I don´t say he or she doesn´t care but a gentle word or being treated nice will never be because he or she needs me as a human being.

So sad, don´t know how to cope with this.

[stopdog]

They do need clients. They may not need any particular client -but they do need clients to make a living. I also happen to believe no client needs any particular therapist or md. They are expendable too.

[SarahSweden]

I´m not talking about needing clients to make a living, I talk about need as in needing another person to be liked, to have a friend or a partner. That you care about someone and act nicely because of feelings from one human to another. That´s not the case between a patient and a T/doctor.

Being treated nicely is just a component in a treatment, it hasn´t to do with my personal qualities or being liked as a human.

Originally Posted by stopdog

They do need clients. They may not need any particular client -but they do need clients to make a living. I also happen to believe no client needs any particular therapist or md. They are expendable too.

[Daystrom]

Agreed. There is nothing I hate more than seeing practiced expressions of pity or compassion flash across my T's face, that are SO fake and come off as so patronizing. I feel like I always have to be on guard, even with her.

[stopdog]

I don't think anyone is nice to me because they need me. I am not nice to anyone because I need them. I sometimes like some people and sometimes other people like me - but that has nothing to do with need. I would not expect someone to be nice to me only because they thought they needed me.

I haven't found therapists to be all that nice and I only work with mds professionally and usually because I am on the other side against them for a client - so I have never found them to be nice either. Usually the client has found them to be not nice either.

I do think therapists are quite manipulative and may try being nice at a client to get a particular response. A technique of sorts I suppose.

[SarahSweden]

How do you cope with this? Knowing for example that you being nicely treated has nothing to do with who you are and that there´s nothing "between you" outside the therapy office?

Originally Posted by Daystrom

Agreed. There is nothing I hate more than seeing practiced expressions of pity or compassion flash across my T's face, that are SO fake and come off as so patronizing. I feel like I always have to be on guard, even with her.

Originally Posted by SarahSweden

I´m not talking about needing clients to make a living, I talk about need as in needing another person to be liked, to have a friend or a partner. That you care about someone and act nicely because of feelings from one human to another. That´s not the case between a patient and a T/doctor.

Being treated nicely is just a component in a treatment, it hasn´t to do with my personal qualities or being liked as a human.

I've known plenty of doctors apparently completely incapable of treating even their patients nicely, so I don't take for granted that those that do treat me or family members with respect and care are doing it only as an act. I appreciate that they believe I deserve the respect and understanding that they choose to give me because I know they have a choice. They could be complete jerks if they chose to. I find those that truly do choose to treat their clients and patients with care and respect do so because I AM a human being worthy of that treatment. Don't take that for granted.

[Salmon77]

When I read your question, in a sense I understand it because I feel something similar; the restrictedness and lack of reciprocity in the therapeutic relationship bothers me to some extent. I think partly because other relationships are not like this, so I have few models. But on the other hand, I wonder if it isn't better (meaning: more productive) to turn the question on yourself: why do you want so badly to feel needed? Why can't a relationship be meaningful unless you are needed?

[Daystrom]

Originally Posted by SarahSweden

How do you cope with this? Knowing for example that you being nicely treated has nothing to do with who you are and that there´s nothing "between you" outside the therapy office?

The same way I cope with all the other things that hurt; I try to forget about her in between sessions (without much luck). Wish I had a better answer.

[Daystrom]

It seems to me that for those of us with abandonment/rejection issues, therapy is a trap that only ends up making things worse. I don't know the solution.

[Chummy]

Sometimes I have it difficult with this. My T is nice to me and so is my pdoc. But a good professional T will be nice, kind, understandable, without judgement to you. And I've read some stories/articles from therapist and if they don't like a client for whatever reason, they will find something in that person that they like so the T can work with that client (it was something like that).
I've no idea if my T or pdoc really like me or that they are just polite to me and act nice because they're professionals. I don't think they would ever be totally honest about me to me, because of rules and they have to respect clients. If they think I'm pathetic, ugly, annoying, hopeless or whatever, they probably won't say that to me. They won't say to me ''I don't like you''.
It bothers me sometime and make it hard for me to talk to them. Like you getting paid to listen to me and help me, but you probably think I'm boring and my stuff isn't interesting. I know I should just talk to them about whatever I want and not care so much if they like me or not, I pay them to help me. But I can't.

I also think I'm just one of the many clients, they're getting paid to help their clients. I don't mean more or less to T or pdoc than any of their other clients (though I think I mean nothing to them). When I leave their office, they won't think about me until it's time for my next session. I don't like it. They mean a lot to me and I think often about them, but I'm nothing to them.

[SarahSweden]

I absolutely agree to that a T or a doctor treats you nicely as a human being in a therapy or treatment. But that´s different from being nicely treated because who you are and because a person needs you for who you are. Being nicely treated in therapy is a means to mediate treatment, you´re being nicely treated foremost as a patient.

Originally Posted by lolagrace

I've known plenty of doctors apparently completely incapable of treating even their patients nicely, so I don't take for granted that those that do treat me or family members with respect and care are doing it only as an act. I appreciate that they believe I deserve the respect and understanding that they choose to give me because I know they have a choice. They could be complete jerks if they chose to. I find those that truly do choose to treat their clients and patients with care and respect do so because I AM a human being worthy of that treatment. Don't take that for granted.

[SarahSweden]

You ask a very interesting question. I think I need to feel needed to be able to feel that a person is genuine and to feel that I´m seen as a human being, not just as "a patient needing treatment".

In a therapy/patient relationship or a doctor/patient relationship compassion, kind words and so on is similar to that between a child and a parent in that respect that a mother/father also has to have more understanding for a little child "who doesn´t know any better" than in a relationship between adults.

That what´s making the T/patient relationship so patronising, it´s like "I forgive you every time because you have to learn how to behave". When you for example make a complaint which have no real grounds and a T or a doctor still keeps smiling and acting understanding. It´s not real, it´s just a means to mediate treatment.

If a person shows compassion but at the same time doesn´t need me in anyway it feels like I´m a child or less intelligent and that I go back to some kind of childhood where I´m in need because I can´t cope on my own.

Originally Posted by Salmon77

When I read your question, in a sense I understand it because I feel something similar; the restrictedness and lack of reciprocity in the therapeutic relationship bothers me to some extent. I think partly because other relationships are not like this, so I have few models. But on the other hand, I wonder if it isn't better (meaning: more productive) to turn the question on yourself: why do you want so badly to feel needed? Why can't a relationship be meaningful unless you are needed?

I've had the displeasure of being a client of obnoxious, arrogant, insulting, and overbearing primary doctors (MD's), counselors/therapists and psychiatrists. I've always walked out after one or a few appointments. They are not pleasant experiences and for me, life is too short to put up with someone who thinks that they can treat clients with contempt or disrespect.

Personally, the only kind of therapist/psychiatrist I want to sit down with is one who is actually taking the time to listen, focus on what I'm saying, show interest in my complaints/comments and who is willing to ask me to be an actual partner in my treatment. Sure there have been times when I've felt that one or two were a bit too sugary sweet or overly emotional, but I haven't stuck with those individuals any more than the arrogant ones. But if they look as though they're trying a bit to hard initially, but are relatively sane and have a sense of humor, I like that.

I also have to admit that for me, I don't want them to need or want anything from me. I don't want them to talk about their "day" or their "problems" or their "issues". I'm paying them to focus on me and my day, problems and/or issues. If I actually ask them about their "day" or if they have ever experienced an issue/problem similar to mine, I'd like them to respond normally--in other words, be honest and be respectful enough to answer me honestly . . . .But I'm not there to solve or delve into their issues/problems. So I guess I have to admit that for me, I like it that the therapist/psychiatrist isn't in need of me. I'm even okay with them not thinking about me once I leave the office and focus their attention on their next client . . . and honestly, I'm not thinking about him/her either, unless he/she ticks me off Then I discuss that at our next session.

I think the question from the other poster who asked you to consider why it's so important for you to see or feel, on a deep, personal level, the respect/need from your therapist/psychiatrist and exactly what the therapist/psychiatrist would have to do (behave) to demonstrate this need to you in a session is a great question. Once you figure out exactly how the therapist would have to behave in order to demonstrate this connection to you, you might be onto something that might help you in your search for the right therapist. It would be pretty incredible to be able to go into the first few initial sessions and describe to the potential therapist what you feel you need and if he/she feels he/she could provide that level of connection for you. Just something to consider.

Originally Posted by SarahSweden

You ask a very interesting question. I think I need to feel needed to be able to feel that a person is genuine and to feel that I´m seen as a human being, not just as "a patient needing treatment".

In a therapy/patient relationship or a doctor/patient relationship compassion, kind words and so on is similar to that between a child and a parent in that respect that a mother/father also has to have more understanding for a little child "who doesn´t know any better" than in a relationship between adults.

That what´s making the T/patient relationship so patronising, it´s like "I forgive you every time because you have to learn how to behave". When you for example make a complaint which have no real grounds and a T or a doctor still keeps smiling and acting understanding. It´s not real, it´s just a means to mediate treatment.

If a person shows compassion but at the same time doesn´t need me in anyway it feels like I´m a child or less intelligent and that I go back to some kind of childhood where I´m in need because I can´t cope on my own.

Have you considered that perhaps you have a hard time accepting that a person's willingness to help and listen and support you could possibly be unconditional? It sounds a bit like you think you don't deserve a person's help unless you offer them something back. Perhaps some people help people without strings attached to the relationship; you don't have to "pay" them back by somehow helping them back. What would happen if you simply accepted their help at face value, without feeling the need to "do" something for them, without that burden of having to be "needed" back by them?

[Lauliza]

I think therapists or pdocs who are nice to clients are nice because they respect you as s human being and believe you are worthy of kindness. I think many professionals are this way. True, a T 's competence may be tied to being kind and sympathetic and that makes it a strange relationship. So in that respect you're right, I imagine an unfriendly T stands to lose more clients than an unfriendly lawyer. Still, I think many people assume the best about others and will generally like them unless they've been given a reason not to.

[SarahSweden]

Very interesting. (I mean it, not being sarcastic or anything). How do you see this behaviour pattern in what I describe? Is it something you´ve experienced yourself?

Well, if kind words, compassion and so on are unconditionally given it doesn´t really correlate to me, does it? I mean, as an adult I know if I criticise a T or a doctor, I know if I behave rude. If care or help is given unconditionally, then it´s like I have some kind of "fault" that makes me not responsible for how I act?

If they don´t need me back, then I´m in a very unequal relationship. Even if therapy has to be this way (in this discussion I don´t classify receiving money from a client as a need) the feeling still stands. It´s like someone being nice to me IRL just because they want a favour, like lending money or something, they´re not being genuinally nice, being nice serves a certain purpose.

I haven´t thought of this as a burden but I think it´s an interesting perspective. At the moment I´m not in therapy but when I was I always felt it was important that the T liked me and that she felt she also got something from me. For example I often told her I liked what she did for me. I really did by the way so it was nothing about just making things up to sound nice.

Originally Posted by lolagrace

Have you considered that perhaps you have a hard time accepting that a person's willingness to help and listen and support you could possibly be unconditional? It sounds a bit like you think you don't deserve a person's help unless you offer them something back. Perhaps some people help people without strings attached to the relationship; you don't have to "pay" them back by somehow helping them back. What would happen if you simply accepted their help at face value, without feeling the need to "do" something for them, without that burden of having to be "needed" back by them?

[SarahSweden]

I think the big difference is and what also creates my feelings is that if I´d behave like I do in some situations when seeing my doctor or T when meeting with people in real life, they hadn´t stayed with me. If I spoke freely about that I think he/she doesn´t care enough for example.

It´s about being excused because I´m a patient and because a T or a doctor doesn´t need me. They have to be compassionate to create a certain treatment environment and not because they like me or because they value my personality. To me it´s like false acceptance, it´s like losing my real value as if "She doesn´t understand better" or "she can treat me like this because she´s only my patient".

Originally Posted by Lauliza

I think therapists or pdocs who are nice to clients are nice because they respect you as s human being and believe you are worthy of kindness. I think many professionals are this way. True, a T 's competence may be tied to being kind and sympathetic and that makes it a strange relationship. So in that respect you're right, I imagine an unfriendly T stands to lose more clients than an unfriendly lawyer. Still, I think many people assume the best about others and will generally like them unless they've been given a reason not to.

Originally Posted by SarahSweden

Very interesting. (I mean it, not being sarcastic or anything). How do you see this behaviour pattern in what I describe? Is it something you´ve experienced yourself?

Well, if kind words, compassion and so on are unconditionally given it doesn´t really correlate to me, does it? I mean, as an adult I know if I criticise a T or a doctor, I know if I behave rude. If care or help is given unconditionally, then it´s like I have some kind of "fault" that makes me not responsible for how I act?

If they don´t need me back, then I´m in a very unequal relationship. Even if therapy has to be this way (in this discussion I don´t classify receiving money from a client as a need) the feeling still stands. It´s like someone being nice to me IRL just because they want a favour, like lending money or something, they´re not being genuinally nice, being nice serves a certain purpose.

I haven´t thought of this as a burden but I think it´s an interesting perspective. At the moment I´m not in therapy but when I was I always felt it was important that the T liked me and that she felt she also got something from me. For example I often told her I liked what she did for me. I really did by the way so it was nothing about just making things up to sound nice.

I have no idea if this is a pattern for you. Just wondered if you had considered the idea because it just sounds like you have a really hard time trusting that a person, particularly a professional, might care enough to just want to be nice for no other reason than they choose to treat people that way. No expectation of reciprocation.

As an analogy, some people buy presents for others just because . . . not because they expect a gift in return . . . just because it gives them pleasure to be kind to someone, to do something that might lift a person's spirits. That doesn't mean we don't have the option to give them a hug in thanks or a gift or whatever; we have that option and personally I do, but there are people who actually give of themselves because they just like to do that for others. In a way, that IS their "pay" because it gives them great pleasure to do so. That IS their "need" actually and by simply accepting their kindness, you ARE fulfilling a need in them that perhaps you don't even realize.

Is everyone like that? Of course not, but I've run into enough people in my life who are truly kind people by nature, very generous of themselves. Yes, T's and doctors are being paid to provide a service, but that kindness and care is a choice they have made in the way they interact with people. They really don't have any "need" except to be paid if there are fees for their services, but they do appreciate being appreciated. We just don't "owe" them that necessarily and they would continue to treat us respectfully and with care regardless because . . . well. . . they just do.

Originally Posted by SarahSweden

They have to be compassionate to create a certain treatment environment and not because they like me or because they value my personality. To me it´s like false acceptance, it´s like losing my real value as if "She doesn´t understand better" or "she can treat me like this because she´s only my patient".

Try reframing that sentence: They CHOOSE to be compassionate to create a certain treatment environment because they value you as a human being, a human being with flaws and quirks that they are able to see beyond.

I've personally never had a therapist or pdoc "accept" poor behavior directed towards them because I'm only a patient. They have had healthy boundaries and have been quite willing to let me know if I was overstepping their boundaries or misdirecting my emotions and behaviors in some way. Therein lies a great deal of the work of therapy which is where that inequity falls in the relationship, but if my relationship with my therapist was the same as all of my real-world relationships, what would be the point? What would I learn? How would I ever know that relationships could function differently, less conditionally, more openly?

[nottrustin]

I think the reason they treat us nicely as they know for the most part their clients have been treated like crap in the past and clients tend to be hard on themselves.

My situation is different in that with both T and pdoc I have a dual relationship. I wouldn't consider either a friend per se. With pdoc we worked together. So like coworkers we discussed personal lives. Knowing all the pscyh providers I specifically asked to work with her. So we do occasionally discuss more person things in her life than normal...

[unaluna]

I dont know if this is related but - my mother thought she didnt have to be nice to me. She thought i would still stick around. Well guess what. My heart thought different and started giving me panic attacks. So you are right - if you tell people IRL that they are constantly doing the wrong thing, that is if you are not nice to them - they can decide to not associate with you. Nobody HAS to be around anybody else. If you DO want to continue to be around someone, it is probably better to be nice to them.

I know this sounds similar to the GOlden Rule but maybe i will use it to start my own religion!

[Nammu]

Originally Posted by SarahSweden

I think the big difference is and what also creates my feelings is that if I´d behave like I do in some situations when seeing my doctor or T when meeting with people in real life, they hadn´t stayed with me. If I spoke freely about that I think he/she doesn´t care enough for example.

It´s about being excused because I´m a patient and because a T or a doctor doesn´t need me. They have to be compassionate to create a certain treatment environment and not because they like me or because they value my personality. To me it´s like false acceptance, it´s like losing my real value as if "She doesn´t understand better" or "she can treat me like this because she´s only my patient".

The Ts I've had would not excuse bad rude behavior on my part or any other patient they had. They give respect and the expect the same in return. Maybe it's just me but I wouldn't have it any other way. My illness not not excuse me from being responsible for my own actions.

[SarahSweden]

Yes, perhaps this is also a trust issue. I agree to what you say that seeing clients getting better and treating them nicely could be like fulfilling a need in that person who gives care, that is a T or a doctor in this case.

But the thought I can´t let go of is that their kindness isn´t about needing me as a person, they don´t choose me because of my personality. I come to see them because I´m referred or because I call them and ask them for an appointment.

It will always be an imbalanced need where I need them more than they need me. I will always feel like a little child as I´m in so much more need of my T or doctor than they will ever need me.

Originally Posted by lolagrace

I have no idea if this is a pattern for you. Just wondered if you had considered the idea because it just sounds like you have a really hard time trusting that a person, particularly a professional, might care enough to just want to be nice for no other reason than they choose to treat people that way. No expectation of reciprocation.

As an analogy, some people buy presents for others just because . . . not because they expect a gift in return . . . just because it gives them pleasure to be kind to someone, to do something that might lift a person's spirits. That doesn't mean we don't have the option to give them a hug in thanks or a gift or whatever; we have that option and personally I do, but there are people who actually give of themselves because they just like to do that for others. In a way, that IS their "pay" because it gives them great pleasure to do so. That IS their "need" actually and by simply accepting their kindness, you ARE fulfilling a need in them that perhaps you don't even realize.

Is everyone like that? Of course not, but I've run into enough people in my life who are truly kind people by nature, very generous of themselves. Yes, T's and doctors are being paid to provide a service, but that kindness and care is a choice they have made in the way they interact with people. They really don't have any "need" except to be paid if there are fees for their services, but they do appreciate being appreciated. We just don't "owe" them that necessarily and they would continue to treat us respectfully and with care regardless because . . . well. . . they just do.

[SarahSweden]

I look upon this partly differently as I experience myself first as a patient and second as a human being when meeting with a T or a doctor. As a T or a doctor isn´t and shouldn´t be my friend I don´t feel as a human being with them in the same way I feel with a friend.

In a therapy you must be able to show your bad sides of yourself, for example give criticism and every good T accepts this and talks about it with the client. With bad or rude behaviour I don´t mean acting out, yelling and such but saying things like "I don´t feel like you care" or "You seem to forget important things about me". Things like you couldn´t talk about as freely if you talked to a friend.

I think you point to something very important, that the therapeutic relationship is different from relationships outside therapy. This is very true and for me it all has to do with that a T doesn´t need me, he or she has friends, perhaps a partner and so on and because of that they are nice and friendly because of the very nature of the relationship.

They may get hurt in the moment I say something less polite or friendly but they don´t need me in that sense they have to solve things on a personal level. They can resort to guidelines and recommendations if a client is being "hard to handle" and they can act that way because there isn´t a reciprocal need for each other.

I´m not at all writing this only to argue, I write because I feel sad about this.

Originally Posted by lolagrace

Try reframing that sentence: They CHOOSE to be compassionate to create a certain treatment environment because they value you as a human being, a human being with flaws and quirks that they are able to see beyond.

I've personally never had a therapist or pdoc "accept" poor behavior directed towards them because I'm only a patient. They have had healthy boundaries and have been quite willing to let me know if I was overstepping their boundaries or misdirecting my emotions and behaviors in some way. Therein lies a great deal of the work of therapy which is where that inequity falls in the relationship, but if my relationship with my therapist was the same as all of my real-world relationships, what would be the point? What would I learn? How would I ever know that relationships could function differently, less conditionally, more openly?