[jennings11]

Hi all, I've been toying with this question a lot. Sometimes when I go in it seems like my T has this grand outline for our entire session and just jumps right in without even asking me my input (which has generally been fine but I just never know what's coming). Other times it seems like he has absolutely no set plan (also fine) and more looks to me to lead the way.

So, I was wondering, who generally guides the discussions at your appointment, you or T? Or does it all just kind of flow and you're not really sure.

I'm particularly asking now because while T's somewhat haphazard method has generally worked for me and always results in good sessions, lately there have been more specific things about my past that I want to bring up that therapy has kind of caused me to reflect on, and I'm not sure if/when I should, as I don't want to interfere with the natural process of therapy/T's plan either.

Any thoughts you have would be appreciated.

Thanks!

[BrazenApogee]

I decide. He generally is silent until I speak. If he is pushing me in a direction I don't want to go, I can say "I don't want to talk about that now" and we move on to something I do want to talk about.
Bring it up with your T. Does your T talk first or do you. Try it out and not say anything for a minute when you first show up and see what happens. Your T may have counter-transference issues going on and may feel the need to "lead" you or the conversation.

[LonesomeTonight]

My T generally leaves it up to me. Like she'll ask how I'm doing and ask what direction I want to go in that day. Sometimes, if I've e-mailed her in the past week (often the case), I'll ask if anything jumped out in the e-mail that she thinks we should address. Or if I'm unsure, I'll ask where she thinks we should go, and she might continue from a topic we brought up the past week. But ultimately, it's up to me.

Same with marriage counselor--he'll just ask us how the past week was and will mostly let us lead, though sometimes he'll jump in to ask more about something, say we should maybe spend some time on a particular area (like if it keeps coming up), etc. Or he'll do this annoying thing where we're talking about an argument we had, and he'll be all "But you got through the argument and are still here together, so that's good!" I used to be like, "Yeah!" but now I counter that more, like, "Well, yeah, but the issues are still bothering me" or something like that.

mostly i do, but on occasion she says there is something she wants to talk about

[AnxiousGirl]

I have never really thought about it until I read your question. Usually when I walk in my T starts off by asking how my week was and things like that. Then my T asks if there is anything I would like to talk about (sometimes there are a few things but I'm too afraid to talk about them in session) so I say no. Then my T would tell me what she has planned/what we should work on and if she has a few items then she lets me pick what to do first. If I send my T an email before a session about what ive been holding back, we usually talk about that.

Basically, I'm horrible at talking about my feelings in session and I'm glad my T is supportive and patient with me.

[jennings11]

Hi all,

Thanks for the feedback, these are all really interesting and helpful responses.

BrazenApogee, just a quick follow-up, what do you mean by "counter-transference?" Sorry I'm pretty new-ish to therapy. As in, he perceives his role in our relationship as one of a "guide" for me? Now that you say that, it is interesting when I think more about it; he tends to give me a good deal of advice, which I assumed was par for the course in therapy, but maybe it isn't?

Also, it's confusing that some days he seems to have a grand agenda of what we are talking about in session and then doesn't ask me if there's anything I want to discuss until the end, and then other days, it seems very free-form/less planned. It's like he almost alternates between the two every other session or something...

[jennings11]

Also, this is making me think...do your T's talk a lot in session or do you do most of the talking? I would say ours is at least 50/50

[BrazenApogee]

Counter-transference is the T's emotional stuff. A Therapist is supposed to be able to recognize this when it happens and keep it out, use it for information about what's going on but not to act on it. If they aren't good at this, they may act on their emotions, such as guiding the conversation example. However this entirely depends on what type of therapy your T practices. If it is one of the behavioral methods CBT, DBT, etc. then there is intentional guidance in the therapy and there is an outline and model to follow. If it is psycho-dynamic, humanistic, or good old psychotherapy than it is client centered guidance, as the principle is that the client knows where to go.

In brief, transference is feelings a client has for the therapist. Generally feelings that are projected onto the therapist and is a pattern from previous relationships, most especially childhood relationships. A big part of psychotherapy is recognizing them and resolving them so the client can stop projecting these things on others and have better relationships. Counter-transference is the same thing, but on the T's side. They should have already worked out their stuff by having therapy themselves, but sometimes things need more work.

It is only on rare occasions that my T's had a plan about what we were going to discuss in session. I'd say 90% the sessions started with a check-in and our discussions sort of evolved out of whatever I brought to the table.

Most of the time, I'd say our talking was about 50/50 -- we had real dialogue and discussion most of the time. The only times it was different were those times I was in a serious depressive episode. When I am severely depressed, thinking and talking is very difficult; it's like thinking through quicksand -- my whole thinking and communication ability was slow and labored. So, in those times, he did more of the talking because he was helping me find my words and sometimes helping me go through the decision process about how to proceed, decisions I needed to make.

[Yzen]

For who decides, I usually make notes of what I want to talk about before my session and tell her at the start. She expects it now. Of course, sometimes she will move the discussion to areas she thinks would help me.

For the percentages...I've had two therapists. My first T talked about 20% of the time--primarily asking questions to keep me talking and making a summarizing comment here and there. I didn't feel I was getting as much out of it when I talked 80%. My current T talks about 40%. I prefer the more balanced session.

[ScarletPimpernel]

Mostly I decide. If she has something important to bring up (i.e. homework, scheduling, talked to my Pdoc, etc.) then she'll bring it up at the start. Otherwise it's "How are you doing?" and moving onto what I want to talk about. And if we run out of things to talk about, then we have the DBT workbook to turn to.

We share talking about 50/50. It's like having a normal conversation with someone. She is actively involved asking questions and giving commentary.

You should be able to bring up whatever you want to in session. It's your therapy. It shouldn't mess up the "flow". I mean what happens if something spontaneous happens? You cry? You get upset? Someone tells a joke and you laugh? You never get side-tracked? Sometimes it makes therapy better. Try it out. Just tell her from the start that there's something you want to get to.

Usually I do, but sometimes she'll say "before we start, there's a bit of house-keeping" or she'll ask about something from the previous session. Whenever I have a list written out, which I do sometimes, I start talking before we sit down lol and say "I'm gonna just jump right in...." We usually both end up talking about equally as much, very conversational, except last time I had a ton of stuff I wanted to say and I kinda bombarded her with it haha so she didn't have a chance to get much of a word in edgewise. But usually it's very much a conversation.

[stopdog]

I actually believe those guys should do a better job of letting a client know the sorts of things it would be useful to talk about.
The first one I see was total crap at it - so I don't let her talk much at all.

[Coco3]

My T lets me decide what we're going to talk about. At the beginning of the session, he mostly asks how I'm doing and we'll start from there. I keep notes that I bring to therapy, so that I won't forget anything important. Sometimes, when I'm afraid to bring something up, I email him prior to the session and ask him to bring it up.

The talking is 50/50 I think, like a real conversation. Not all the time though. When I'm very emotional, it's like my brain shuts down and I can hardly think, let alone talk. So then he has to be the one to keep the conversation going. He's very good at that, he always knows what to say and what to ask, there are no (awkward) silences.

Originally Posted by stopdog

I actually believe those guys should do a better job of letting a client know the sorts of things it would be useful to talk about.
The first one I see was total crap at it - so I don't let her talk much at all.

If my T tried to tell me what he thought is useful to talk about I would find it presumptuous to be honest. A couple of times he has suggested things are not useful to talk about and I've told him if I find them useful then they are useful.

[retro_chic]

The topic of conversation is definitely up to me. My T will ask me how I've been when she greets me at the beginning of the session but it is entirely up to me what we talk about. If I don't want to talk about something anymore she doesn't pressure me but instead asks me what I would like to talk about instead. I found out first hand that if I have nothing to say T is quite willing to sit in silence for an extended period of time. I see a psychodynamic therapist so that probably has something to do with it.

My T has said a couple of times that ideally I would be doing most of the talking but that is something we will have to work up to as I have a lot of trouble opening up. Sometimes the conversation is 50:50 but sometimes it is more 25:75 (25% me, 75% T).

Originally Posted by stopdog

I actually believe those guys should do a better job of letting a client know the sorts of things it would be useful to talk about.
The first one I see was total crap at it - so I don't let her talk much at all.

Mine were pretty good at starting with what was on my mind at steering the discussion from where I started. I always found it interesting how I might go in with absolutely no agenda (I went that way most of the time), and yet they were able to help me see the relevance and gain insight from what trivial things (at least in my mind) I brought into the room.

My t will ask me t take a moment and to trust what come up for me at the start of sessions. We both close our eyes and then I will start talking about what I need to. As a t I start by asking the client how they would like to use their session and if they had anything they would like to look at or work on.
Could you discuss this with your t and maybe ask if it could be more predictable or planned. Perhaps it's a communication issue and your t thinks you would like him to lead but in fact you would like to decide on what you talk about.

Sent from my iPhone using Tapatalk

[stopdog]

Originally Posted by Echos Myron

If my T tried to tell me what he thought is useful to talk about I would find it presumptuous to be honest. A couple of times he has suggested things are not useful to talk about and I've told him if I find them useful then they are useful.

I agree the woman does not get to stop me from talking about something. But I do believe they could be more forthcoming by saying "often people who have X issue find it useful to talk about Y"

[SoConfused623]

It is me who absolutely decides...when I sit down, she ALWAYS says, "Where would you like to begin?" And she NEVER follows up on anything from the past week. I could say that I'm having open heart surgery and she would not ask me how it went!

[laxer12]

My T definitely leaves it up to me to start the discussion. Sometimes we'll end a session and she'll suggest we continue the conversation next week but it always falls on me to actually bring it up again. One time I actually asked her if she could decide what we talked about and even though she was reluctant to give in, we did an exercise that she guided me through which led to a decent discussion. Afterwords, in a lighthearted way, she told me it was going to be up to me to start the conversation in future sessions.

The amount my T talks really depends on what the topic is and how much I'm talking. For example, this last session, I sent her an email beforehand and had a hard time talking about it with her so she kind of dominated the discussion to start (which is what I wanted. I said all I had to say in the email). But as the session went on, the topic shifted a bit and I talked a majority of the second half. It really varies but I'm not always much of a talker so she is super patient with me.

[jennings11]

Thanks guys, all your responses are much appreciated.

After my most recent session I think I've noticed that T really dives into things right away and doesn't really specifically ask me if there's anything else I want to talk about until the end, which I think is a bit strange? I'm not going to bring something up when we have almost no time. Part of me maybe feels like he thinks that he knows better what to talk about than I do and that's why? But then maybe it's all part of the process.

Also, I'm increasingly sensing that he feels like it's his role to "guide" me, as he definitely dictates the direction of the convo, etc. I'm not opposed to this; it's generally very helpful and I like not having all of the pressure being on me to guide the convo, but I'm more just wondering if it's normal? It's not like I'm un-talkative or socially anxious; I'm not shy and am very contributory in conversations, and he does ask me a lot of questions, etc, it just almost feels like he very much wants to dictate the direction of the convo.

He also lately has become more oriented towards "telling" as opposed to "suggesting" if that makes sense? Like previously if he'd assign homework or something he wanted me to work on he'd basically ask if it sounded good or if I was comfortable with it, and now he's kind of moved more towards, "I want you to do this..." and framing things less as a suggestion and more of a directive. He obviously does it politely and respectfully and not it a mean way, and I don't think it's a negative thing, I'm just curious about others' experiences. I'm thinking maybe that as I've been in therapy longer he's increasingly maybe either more comfortable being more assertive in "telling" me what to do, or starting to view himself as some type of "guide" for me, which I guess concerns me a tiny bit, but could make sense given our age difference, etc (I'm in my late-20s, he's in his early 40s)

Anyway, this is way longer than anticipated but thoughts are much appreciated!

[stopdog]

I would not deal well with a therapist who thought they got to tell me what to do. I certainly don't view a therapist as a guide.

I would simply tell them no. But I also would not let them guide the conversation if I had something I wanted to say, or I would ask what they were doing and why.
If you don't like it, just tell the guy to stop it is what I would do. Seriously - you are hiring him and if you want it done differently -why not tell him.

[Waterbear]

I don't think it is normal. I interviewed about 8 therapists and all mentioned that it is up to the client to lead the sessions. I actually really struggle with this and, while we work on it, have agreed that my T will help me out but it should certainly not be directed by them if you are perfectly capable and willing, which, by the sounds of it, you are. Talk to him about it.

[Argonautomobile]

Everyone's got a different style. Some T's are more directive and life coach-y than others. Yours seems further on that side of the spectrum than not, which I think is fine in and of itself but has cons as well as benefits. If it is on your mind enough to post here, I'd ask him about it.

My T, while not as directive as yours, took more of a lead in the beginning. I think you're right that part of it could be an age thing--I'm in my mid-twenties, my T's in his forties (I think). I was even younger when I first came to therapy, not well, not confident, and kind of needed a designated Adult to tell me what to do. To the point that our sessions could look like this:

Me: "I'm bummed out."

T: "Why?"

Me: "My car engine light's on. I think something's wrong with it. I don't know what to do."

T: "Have you thought about...taking it to a mechanic?"

Me: "Oh, wow, That's a really good idea."

Haha, kind of a toy example, but I think you get my drift. Again, nothing inherently wrong with it, necessarily, but if it's a change you've noticed and it's on your mind, I would ask. Counter-transference is a real thing, and it could be he's appointed himself "guide" without even really realizing it, and without giving you a fair chance to be your own guide.

Anyway, thanks for sharing and good luck!