Differences btwn therapy & real relationships

Of course on the surface there is differences... but there is differences in all types of "real" relationships.

For instance... we pay our dog's vet... and yet I've known him 13 years. He is amazingly good to me and my dogs. He allows me to contact him anytime, day or night, via text or email with questions, he invites us to dog events his company will be at, he has come to their puppy birthdays etc, that is a very "REAL" relationship but it' still a person we have paid before and our talks are mostly limited to dogs but he means a lot to us and he has said many times we are like family to him

That being said, the thing the relationships can and do have in common is the emotions. I believe its absolutely possible to feel a REAL genuine connection with your T, especially if they are allowing outside contact and they are telling you things about them etc, if you share things in common with someone, its easy to feel a connection. When you share your deepest emotions/secrets with someone, its easy to feel an emotional connection.

Paid/limited services or not, the emotions for many clients are REAL and it can actually hurt as much as losing a good friend or family member, just like losing a pet for some, is the end of the world to them. I'd never downplay someone's emotions on losing someone, regardless of who it is.

Some T's are actually caring people, they do check in with clients and let them know they are supported and cared about, yes they get paid but I still believe that many of them are actually decent human beings who care deeply about their clients.

Also, some people don't have real meaningful relationships, even with family or friends... so what are they supposed to compare it to? How can we tell them it isn't REAL just because there is money involved? Makes no sense to me.

I've read a bunch of therapy forums. Many many horror stories, but they are often masked by attributing the misery to something else, or by equating therapy with other relationships, or by just rationalizing it as part of the "work". It's obviously not all that way, but enough to call it significant, in my observation.

As for whether this place is representative, nobody knows. To assume not is selection bias. I think therapy forums are the only unfiltered, real way to see the effects of therapy, and thus ought to be studied by people interested in such things... of which there seem to be very few.

Budfox, your take on therapy resonates with me. Interesting to find someone with a similar perspective.

I had a therapist over a span of 19 years. At a point when I was doing really poorly, she invited me in for a "free" appointment. That when she gave me a four point littel speech: 1) "You like to blame people." 2) "Your life's a soap opera." 3) "Don't delude yourself into thinking you've ever really tried to work on your issues." 4) I forget the 4rth point.

Coming out of the encounter, I immediately wrote down what
she said, so I wouldn't forget and confabulate something untrue. I still have the note somewhere. I felt like she had ambushed me. Her not charging was, I think, her being aware that the meeting would be to serve her need, not mine. This was someone I deeply respected. I felt betrayed. I'm glad it happened. I had been naively trusting. I left that appointment less naive.

A pdoc turned on me after 6 years of me seeing him. Again, I was forced to shed some naivete. I had thought that both these individuals had held me in some reasonable degree of positive regard, despite knowing my faults, which I had revealed. Evidently, they had been viewing me with some degree of disdain, if not contempt, that I never suspected. I felt like a fool for having trusted that they had more respect for me. I'm glad of the experiences, painful though they were. I needed to learn how phoney people can be. I had idealized them.

Going to a therapist for a "relationship" is like going to a prostitute for love.

I dont think my relationship with my t is like any other relationship. It is a relationship, but one on its own terms. After all, it is a professional relationship.
I adore my t and wish for more than that a lot. However, I do not start outside contact because I respect her privacy. I think a lit of clients do expect a lit from their t, and I expect what has been agreed upon. If she gives more, I'm in awe becauae I know she doesnt have to.

In a way, tho, it is still a relationship. So, naturally, relationship pattern will show, probably more on my side than on hers. And I see that there are similarities to my relationships to anyone else.

Just becauae she gets paid doeant mean I can't feel close to her or have a personal relationship on top of the business one. I do have relationahips to my employees. It starts out strictly husiness, hut sometimea that changes, I dont think it can change often for a t, tho. Thinking they have many clients, they may here and there feel closer to one than another, but they cannot be friends with all of them. They do a great job (well, I hope,most of them do), but its still a job.

There are differences and similarities in all relationships, I'd say. To me, I could not open o.o to someone I don't feel a connection with, so strictly business really wouldnt work with my t. At least I think, or have to think, theres more to it.

I think just because they try selling it as a relationship is no reason to buy it for that reason. I don't believe the claims of most sale's people - therapists are no different to me.

I believe my T when she says we have a relationship. I think she'd be insulted if I told her she's "selling" it. There are limits but she is not a salesperson.

My T specifically says bc of past trauma, I need to experience a CEE with him. I have a full life full of friends and a boyfriend, but I have kept secrets about trauma my whole life. Because my T is a peer, and so bright and has so much in common and is ingenious with language and funny , I have to police myself to remember he that has a wife and kids, that I am work and go in the work file, that he is a doctor and I am a patient in an office, because it feels real during the sessions. The sessions are intense and full of feelings and connections. His voice is stronger in my mind than anyone who has been in my real life for decades, and it worries me it could come to bad end if I lose my balance.

It is tough to handle being in intense emotional proximity to someone who is asking you for more and more disclosure, gazing in your eyes, and saying caring things one second, and then oops we have to end and not hearing from them day after day until the rinse repeat. It is against the social rules I learned about people who care, and sometimes I even wonder how responsible it is tohave clients sobbing in the stairwell and not knowing ( or caring?). I would never talk about this, bc there is a big risk of crossing those dearly held boundaries, and I would never be a boundary-crosser.

People tell their T's they love them etc- mine , I believe, would, give me the boot if I strayed from the delicate balance between acting "as if" we have a real relationship to learn those skills, and actually thinking we do. He also won't tolerate too much resistance, distance or pulling away, so it really is a tricky to get it right twice a week and all week. Because I have told him things I have never told anyone else, I feel a strong bond. He probably doesn't . I need to keep that in mind at all times. He says our relationship is real yet artificial, and there is no other one like it in the social world- not a friendship, not a business deal, not a romance. There is something painful about that, but yet I improve every month because of therapy. If he terminated me tomorrow, I imagine I would undergo the painful experience described by BudFox, and I am thankful and grateful to BF and others for keeping the reality right there for me to grab like a life raft .

These are all points that help me greatly keep my balance, and I am thankful to PC and BudFox for not letting the dangers slip out of mind. Sometimes I care about this T relationship more than my real one, and that is just wrong and misguided on my part.

3) One is not drawn into attachment or dependency, then prohibited from having proximity to the attachment figure beyond an hour or two per week.

4) The relationship is not rationed into brief, tightly controlled time blocks.

7) The other person is not in a socially and professionally codified position of authority and power.

8) There isn't an ever-present threat of being "terminated", which i think carries a very different meaning than the possibility of a real-world relationship ending.

9) One is not coaxed into trusting the other so soon, with so little information, and with so much on the line (likely in a crisis state).

10) There isn't generally such absolute seclusion

Thanks, Rose76, for making this thread current again.

The differences between therapy and "real world" relationships need to be highlighted and listed in the consent form for any sort of "interpersonal" therapy where the "relationship" is a factor in the therapy.

Because I didn't have any authentically "real" relationships from family or peers going into therapy, there is no way I could tell the difference. "Do the right thing" was what I had been taught, and tried to learn, growing up. It worked sort of OK in terms of work and getting along in society on a day-to-day level. But led to depression, etc., which I why I went to society's mandated, recommended solution for those kinds of issues. Go to therapy, the "right thing to do" under those circumstances.

In addition to the differences between a therapy and a real relationship being listed on the consent form, for people who don't have any authentic, real relationships, education in what that is like should be at the forefront of any psychosocial intervention. This is something very different from DBT, for instance, which seems to be for people who have problematic relationships, not people who numb out to avoid the difficulties with them. It was counterproductive and even hurtful, again, for me because the group leaders didn't "get" me, just told me to do the exercises, etc. "Doing as you are told" was a skill I learned at 5, I didn't need it (again) at 65.

I agree. But then it would (at least partially) invalidate what many of them use as a basic tenet of psychotherapy: that it is a model for "ordinary" relationships and can be used to analyze, practice and change real life relationship patterns.

I personally never bought into the relationship thing in therapy much, probably in part because I got into therapy for the first time when I was 40 years old, with enough information and theoretical knowledge to question it and be skeptical. Sure, it is a form of relationship. I was open and curious to see from first hand experience.

I did find it annoying right at start when one of my Ts emphasized even before ever meeting me, in our first phone consultation, that therapy is a relationship that we will develop together and he will be very interested in everything I have to say as they will reveal important information on how I build relationships. It really irritated me as I just had a bad therapy relationship experience behind me, but did not comment. I discussed it with him later how I felt that therapy was extremely limited and artificial compared with any natural relationship, and that I refused using it as a model for highly personal things, e.g. "working on" attachment patterns. He never forced that luckily, but my first T (psychoanalyst) tried many times. I never really wanted to use therapy to work on relationship stuff, more the intrapersonal problems I had, like anxiety and addictions.

I know that my thinking about it in this way is, in part, related to my own avoidant tendencies, but they actually protected me from delusion and harm in therapy, I think. Well, they protected me from therapy in general, we could say

May very well have been good use of some self-protective tendencies, seems like. I didn't have enough intrinsic ego strength, or something, and I tried very hard to "be a good girl", be a "good client", do what seemed to be "expected" of me to do -- and hence invalidated my own tendencies, falling deep into the delusion and more and more harm that I didn't consciously know was possible -- eventually reenacting the damage from family of origin, which I have processed much of, thankfully, I hope.

But I still need a "safe" place to learn to be real AND interact with other people who are sometimes, in varying degrees, real.

Ain't nothing like that "out there" and I'm tired -- but still posting on here! ;-0

I once had a job where I worked alongside professional counselors - Master's degree clinicians with other letters after their name. I was saying to one of the therapists that I felt bad for some of the clients we worked with who came from bad home situations. He explained to me that he believed every person's soul has a choice as to where it will be born. He said some souls choose bad people as parents. Ultimately, he said, our souls choose what kind of circumstances we will be born into. Therefore everything is the individual's own fault. I was appalled to hear this.

Every therapist has a view of life that is shaped by that person's religion, politics, family background, ethnicity, education, experience and general philosophy of life. Therapists are not uniform in what they believe or the values they hold. When I worked with a group of therapists, some of them heartily disliked each other. Some I admired, and some I thought held deplorable views - like the example I gave above.

You walk into a nicely appointed office, see a certificate of licensure on the wall and think: "I kind of know what to expect from this person." That's how I used to be. Not any more. I figure this person could have all kinds of baggage that I know nothing about.

Sounds like typical therapist sleight of hand. The clinical persona hides the same petty bullsh*t that everyone else is harboring. And nothing brings out therapist wrath more than a client who is doing poorly. It crashes all the savior and guru fantasies. Too much reality. I was ambushed also, though not so blatantly. As long as I was a devotee, it was a lovefest. But when I clued her in on my real experience of therapy, she went a bit mental. It was all about her. From beginning to end.

I've been doing poorly for most of the two years i've been seeing my T. She has never re-enacted any savior or guru fantasies with me. If she has them, she hides them in the room. I don't even look at her most of the time, prefering to hide in a pillow. She has never once tried to get me to not hide in a pillow, and is okay with whatever I am in the room.

"Therapist wrath" is a very apt phrase to label what I experienced. The therapist self-esteem is very bound up with believing that he or she is effective at what he or she is doing. So, if you go into the office saying "I'm not making any progress." the therapist is likely to go into super-defensive mode. The therapist needs to pin the blame for lack of progress on the client. That's unfortunate. It may be that the client would be stuck no matter who the therapist was. Or it may be that the therapist needs to find a different modality of treatment. But, usually, each T. seems to only know one approach.

It would be marvelous if a T. could say, "I don't seem to be having success in helping you." It could be a simple truth, not necessarily reflecting lack of appropriate effort on the part of either the therapist or the client. But no. Therapists are ultra-defensive. Any insinuation that seeing a therapist doesn't seem to be changing anything brings forth vehement proteststion from the therapist that the client must not be working at it . . . because the therapist is never wrong.

No other clinician gets away with this. Your doctor prescribes a medication that doesn't help, so he tries a different medication. Or he tells you that your problem may simply not be responsive to drug intervention.

A lot of what goes on in "therspy" is the T. greets you and says, "So what's going on?" Then the T. settles back and waits while you pour out your issue of the week. Now and then the T. interjects some question or comment. 45 minutes pass, and you go on your way. I don't see a whole lot of science behind this. People do this for years on end (as I did) and they go around with the same problems they came in with. I don't see where T.s have a "quality control" system for assessing whether the client is actually benefitting from the so-called "therapy." Many clients are lonely and happy just to have someone be interested in them. Many have suffered abuse and neglect in their lives and want someone to validate that. Therapists are no fools. They know what will gratify a client and incentivize them to return for more "therapy." The holy grail that many clients are seeking is the absolution expressed as "It's not your fault."

It's my suspicion that the majority of the damage t's do is within the realm of working with clients who have C-PTSD and attachment disorders. I think one of the big problems is that t's, in general, are not well instructed or equipped to work with such patients. I don't think they get much training in school on how to work with adults with attachment disorders. I have not seen many psychological studies done on the subject. There are not many professional journal articles that discuss it. So many t's are pretty much "on their own" when it comes to how to treat clients with C-PTSD.

Another big problem I see over and over is that therapists confuse C-PTSD with BDP. Although both BPD and C-PTSD have some overlapping symptoms, there are definite differences between them. The way a therapist handles a BDP patient may not work the same with a C-PTSD patient.

Also, C-PTSD isn't even considered a legitimate diagnosis in the DSM-V Manual for diagnosing mental illnesses. It's considered an offshoot of PTSD, but again, it has differing presentations and needs.

What gets my goat at times is this...

Why is it that we, as patients, have to be the ones to do the time-consuming, complex research necessary to understand our own issues? Shouldn't it be the therapist who is responsible for keeping up with the latest in psychological research, studies, statistics, and therapy modalities...rather than us?

Wouldn't it be weird if many of us knew just as much, or more, about our issues than our t's do?

I'm not saying that we wouldn't benefit from therapy with them, because "knowing" about our issues doesn't always provide what's necessary to translate the cerebral information into personal practice.

I'm just saying...

Therapist are the least self-aware human beings I think I’ve ever encountered.

I agree with you about blaming the client. However, it is also very prevalent in the medical profession!

They just have different ways of doing it; perhaps more creative. It's better than it used to be, but they often have huge egos, so if they can't figure out the problem or how to help, they default to blaming the client by claiming the physical issue is a psychological problem. Or they simply assign a basket case diagnosis--IBS, fibromyalgia, etc.

I think all these people need supervision, some sort of accountabilty to the client.

Hmm, I don't know. They usually say the reason for lack of success is "the match". I'd be interesting in hearing more about the training, especially if what you say is true.

About the CPTSD-BPD issue, I know there is an article or 2 out there that claim difference, but those in practice I've known don't believe there is no difference. I personally never see a difference between anyone who says they have a CPTSD diagnosis and that of a person who said they have the BPD diagnosis--they seem to have identical issues or symptoms.

I think the difference is the person assigning the diagnosis. Some don't use the stigmatizing, damaging diagnosis of BPD. Which I support. But some of us believe diagnoses are bs anyway.

I guess they consider that a selling point, but one could argue that is what make it dangerous. They have made up their own conventions that are not subject to anything real. For example, clients are encouraged to have or express strong feelings for the therapist, knowing the feelings will not be returned, but wil be analyzed instead. That's a pretty insane proposition. Seems clients are systematically pushed to abandon their instincts in favor of weird therapy orthodoxy. Another example is the one you gave -- intense attunement, then adios for a week. That is also insane. But it's considered normal within this alternate reality.

Hi Rayne,

Yes, there are differences between C-PTSD and BPD. For example, self-harm suicidality, risky behavior, and an intolerance for being alone are key symptoms of BPD. Although they sometimes occur in C-PTSD, they often do not. As an exampe, I'm diagnosed with C-PTSD and have none of those symptoms.

Also, people with C-PTSD commonly suffer from nightmares, emotional flashbacks, and greater dissociation, which are much less present, or even nonexistent, in people with BPD.

The main reason BPD and C-PTSD are often confused is because they do share some common symptoms, such as problems with identity, disordered attachment, intense emotions, and fear of abandonment.

From what I've read, the BPD symptoms that are present in people with C-PTSD are caused by the C-PTSD itself. If the C-PTSD can be successfully treated, the BPD symptoms will also often disappear.

I think therapists can do plenty of damage in the here and now, independent of the client's early childhood problems. If your present reality includes e.g. isolation or illness or recent loss, and you get mixed up in a dysfunctional relationship with a therapist, could by very stressful. The usual framing is that client distress is due to their "attachment style", and then the therapist is off the hook as usual.

As for adults with attachment disorders and so on, I think a major fallacy is this idea that therapists can be trained to work with such people. What does "work with" even mean? Usually it's implied to mean having a relationship wherein the client "attaches" to the therapist, learns how to have a secure attachment, then re-enters the world fixed. This ain't exactly scientific, nor even logic-based. It's more like a religious conversion. My guess is that this process is nearly always improvised, and thus is not really a "process" at all, but a psychological experiment, carried out on the backs of clients.

Agree BF. My T asked for a ton of trust and risks before his vacation , and then through my tears he was pretty much like See ya wouldn't want to be ya time for vacay. It is a simple fact we are their work, not people in their lives, and we belong to the collective category "patients"( my T doesn't say clients). I even relate, bc there are times I go away for a few days, and don't always dwell on my job, although I always give some thoughts to work as it is important to me. This I know in my brain/mind, but I feel brokenhearted about it. It is unnatural for someone to drink in another person's life story with such intense empathy, then be like. . . peace out cub scout. That is therapy though, and why it isn't real life.

The hypothesis about attachment might be a good idea to try out, maybe, if it was listed as a clinical trial, clients know that it was, and data were collected from the clients undergoing such "treatment". As it is, when the "treatment" fails, as it has for a number of us in this forum, including me, the client is nearly always thrown back on their own resources, frequently worse off than before "treatment", or given referrals to other "experimenters", but no results or feedback data are ever collected. So the myth/fad perpetuates until. . .the next fad therapy comes around.

You made some other good points, but the thing about self-esteem seems key. I guess this could be said of any profession, but therapists appear to be particularly invested in their life-fixer role, and go to pieces when it doesn't work out as they imagined it in their head. One of mine went into a panic upon hearing that I felt harmed, blamed me according to her programming, then just s**t herself silly.

I concur with what you say about therapists being so "invested in their life-fixer role . . . " Consider that, in ads, many of these folks bill themselves as "life coaches." This suggests that they are particularly adept at living skillfully and well and can teach that talent. On what, exactly, is that claim based? That is about as preposterously self-adulating a claim as a person can make. But they make it! They claim expertise in the art of living and the ability to impart that.

Living well, by the way, is as much art as it is science, if not more. So I don't believe that there are college courses that equip a person to be expert at life. When I worked with therapists, they seemed about as screwed up as people in general. Some had bad marriages or substance abuse issues themselves. And they sure didn't get along all that great with each other.

In the confines of an office, the therapist assumes this aura of being all-knowing and all-wise. It's just a pose. We clients enable it, though, because we want to believe these folks can lead us to the promised land of joy and self-fulfillment.