T terminated me

My big requirement is that they have endured therapy themselves before trying to inflict it on anyone else.

I think that's a reasonable thing to ponder, but I also think this concept can be used as a convenient rationalization, especially if it's a T saying it (in which case it might also be condescending and moralizing). I learned a lot from my therapy nightmare but I also got traumatized in the process. People also like to say "everything happens for a reason" which I think is even more dangerous, and can be used almost like a weapon. Next person who says it, I am running them over with my car.

Amen....

My school did that too and every for-profit school I know of is doing it. But those I worked with who graduated from state universities were no better. While state schools have more academic rigor, their curriculum also isn't filled with a lot of research findings of neuroscience on trauma and such. So, the real educational level in regards to trauma, psychological development etc varies not depending on the school but on how much self-work and self-study one has done.

Wow thanks for sharing that. That is frightening. My ex T claimed experience with developmental trauma and attachment, but in the real world she was lost. I don't recall her ever articulating what was going on. And her casual approach to termination, which one could argue is the most important thing of all, shows complete ignorance of attachment concepts. I also think even with a good grasp of theory she would still have done damage, because she was too wrapped up in her own needs and impulses. I get the sense her practice revolves around her.

It does seem (from the little I have seen) the focus of therapist training is on learning to become a therapist, rather than learning about clients. I want a T who thinks the DSM is excrement because they understand how human beings actually function, not a T who can recite it from memory.

As for the OP's T, he seems entirely unaware of attachment dynamics, as evidenced by the following ludicrous statement: "The depth and nature of your attachment to me and the manner in which you have fairly consistently attempted to maintain that attachment is the core issue that in my opinion is unresolvable." Maybe like many P-docs his focus is on drugging the patient, which allows him to pretend he is a doctor, and avoids the mess and fuss of dealing with the human being.

The thing is the op has a psychiatrist who was doing therapy, psychiatrists don't have to have much training in any of what's being talked about. Their concentration is in medicine.

Any therapist should have their own therapy. This is how it started, this is how it should be. They should be able to process their own "junk" before they try to help others.

Some Psychiatrists do therapy. This is also how it started, and how it should be.

IMO

My questions are, when and why did we separate these things? Prescribe meds without actually working with the patient? This seems ridiculous. Be in the role of a therapist without attending to your own problems, and continually doing so? Equally ridiculous.

The OP's T in his letter is basically saying that she is hopeless which is unthinkable for anyone in the helping profession to say. If the T feels not competent enough to deal with her issues, that's fine, he just has to say so, he has to own his limitations instead of trying to put his crap on the patient which doesn't belong to her.

As to the training, yes, in the academic training the emphasis is mainly put on 4 things:

psychological theories that are used to conceptualize clients problems that are NOT based on the modern neuroscience findings and trauma research;

psychotherapy methods based on the above theories that have no connection with the recent research data or any research data for that matter and the long term effectiveness of those traditional methods isn't backed by any research.

memorizing DSM "diagnostic" criteria

professional laws and ethics and exercises on resolving all sorts of ethical dilemmas to reduce the risk of getting in trouble primarily;

During internship, the emphasis is on whatever the agency/employer wants you to do, which is usually to increase their bottom line. Many non-profit agencies are contracted with the state mental health department and, in order to survive, they constantly have to produce tons of DMH paperwork to bill the state for services. When you work there, you are constantly under pressure to produce "billable hours". You don't have any time not only to do the quality work but often even to get a complete picture of the clients' situation as 70% of your time is paperwork, and the more billable hours you collect the more paperwork you have to do. Not all agencies are under DMH contract but whatever their model is, it is always about money first and I can't blame them because there is no other way to survive in the market economy. You may be pressured either to retain clients or to market for the agency or to do insurance medical billing, whatever it takes to increase the revenue.

The most ethical, well-intentioned therapists cannot provide quality services under this kind of system.

Sometimes, but not always. In medical programs the reisdency (or internship) site is very selective if it's a good institution. There's a lot more at stake, and a prestigious hospital isn't likely to risk being sued because of a medical student if they can help it.esident.

Grad interns in masters programs, on the other hand, are often no more than free labor to a lot of the sites who use them. So it's the intern who needs to be selective rather than the site and therefore doesn't always tell you much about the quality of the student. A " good" therapist is so open to interpretation that it's hard to find a consencus on what exactly that is. It may sou d strange, but in my experience, the higher the degree the T has had, the weirder and less effective they were.

Which is to say, they are entirely unequipped to address trauma or attachment problems or anything other than crises. Developmental or attachment trauma (as was mentioned) evidently lives in the body and in relationships. It is healed through somatic means and through relationships. P-docs prescribe drugs and pretend they are "treating" the patient. It's a delusion.

I gathered that the OP's p-doc was in fact conducting talk therapy, and then threw in the towel because his ego/authority was threatened, and because he doesn't know what he's doing, or doesn't want to deal with it. He can just replace OP with another patient who will be more compliant and obedient.

I really don't know if he actually conducted therapy? I might be wrong but I recall op having 15 minutes long appointments. I can't imagine 15 minutes therapy appointments. Those were more like doctors appt. I might be wrong

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I had the same impression. In previous threads started by the OP posters pointed out that therapist was a misnomer for this guy's role, and encouraged her to find a true therapist. Perhaps a misunderstanding of their relationship led to some of the problems that developed.

Yep. That's the sad reality of many counseling sites.

True. Therefore, no consensus is necessary. When I speak of "good" therapist I certainly express my own ideas of what that entails and don't insist that my vision should be universal. In my view, a "good" therapist for one particular person could be a disaster for another. What is necessary, however, for any therapist is to be fully honest and elaborative in their informed consent about how they practice so the prospective client can see clearly if that's what they need and wouldn't get surprised later in the process.

It've had a different experience. All Ts I've known as my personal Ts and as colleagues, instructors and supervisors differed in their effectiveness depending on their personalities, common wisdom and emotional intelligence, not their degrees and not even the number of years they'd worked in the field, which is what we usually call "experience".

Hopealways are you all right?

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She posted on another thread earlier.

OP I am sorry for what you are going through.

First of all, I am a physician assistant that had worked in psychiatry. I used to do 15 minute medication management visits with my patients because that was all that my supervising physician hired me to do; I simply was not allowed to go beyond 15 minutes due to issues of insurance. I eventually got frustrated and left for another field because I found that that was not enough time for patients with complex medication issues.

The clinic was set up where we wouldn't see patients unless they had a therapist. So, on the first meeting, I would do an evaluation, and gently include that all therapy issues must be dealt with by the psychologist.

It sounds like your psychiatrist was very confusing: I think I remember reading that he talked about issues that had nothing to do with your medication issues. Yet, he stated that he was only there for medication issues.

Also, in the letter he was clearly unprofessional and inappropriate when he stated, "It is like you are addicted to me." He could have said that you still need help with your issues of attachment and that he doesn't have expertise in this area. So, it wouldn't be in your best interest to continue to see him.

Everything about being a needy woman is completely inappropriate, as others have said. And the fact that he would say that you could milk yourself, he sounds like he has countertransference issues.

Put all your effort into finding a psychiatrist and a psychologist or find a psychiatrist that does therapy and medication management. There are many psychiatrists that still do both. There are some that will only do both meds and therapy.

I know this must be very hard for you, but you don't want to see a psychiatrist that is not empathetic and possibly not dealing with his issues of countertransference.

I see two therapists; one who is so careful that she continues to keep a distance between us and therefore never makes any mistakes, and one who is very real and open and makes mistakes all the time.

I personally prefer the one who frequently gets it wrong, because it feels more like a real relationship and I learn so much more from that. But I suppose the important difference is that she always admits to her mistakes and tries her best not to do the same thing again, and as a result we can work through it and come out on the other side with a much stronger bond. And of course I also apologise when I do stupid things, though she always says that she is at least partly responsible for anything that happens between us. It has been more emotionally challenging than my relationship with the other therapist, but it is worth it. I can see how much I have grown from it. She continues to say that she is a flawed human being, and of course she is - we all are. I also know that she has gone through five years of therapy herself in the past.

The problem, it seems, is when a therapist (or other treatment provider) fails to recognise their own weaknesses and shortcomings. I'm not sure that any amount of training can make a person more self-aware? That's why every therapist needs to go through a minimum amount of hours of individual therapy themselves so they can see what it is like on the other side, as well as developing that self-awareness they may be lacking. That's what therapy has been about for me; becoming more aware of myself and my own behaviour, as well as all the pain I have suppressed over the years, in order to become a better version of myself. Shouldn't every aspiring therapist want to do that?

OP, I am sorry this incompetent jerk has been messing about with his treatment of you, and I am especially sorry that he is putting all the blame on you rather than owning up to his part in it. He clearly fails to see his own actions and seems utterly unaware of his own crap. I really hope you'll reconsider that complaint, because he should not be able to get away with this; you deserve better, and so do his potential future patients.

I hope you are able to find a new psychiatrist so you can continue to receive medical treatment. I also hope you will seek out a psychotherapist for any future therapy, and that you'll consider your options carefully before choosing the one that seems right for you.

I really wanted him back. But he's not letting me have another chance.

Basically, you have to have written proof of all of the claims and most of them are verbal.

Except I have one email that said,

"you probably wouldn't even care if I took my own life"

and he responded,

"Probably Not."

No