[Lola5]

I like my T and I've been doing CBT with him for 1.5 years, but have seen no improvement in my anxiety

Half the time, I feel like what we do in therapy is not right for me and a waste of time, but what do I know? If I knew what was best for me, then I wouldn't have this anxiety or need to go to therapy because I could fix it all myself. I wouldn't be vomiting every day and losing sleep at night due to the anxiety, right?

So I go along with what my T says we need to do to help me. I sometimes try to tell him that I don't think it's useful, but he insists it is and I give in.

For example:

• I was feeling anxious about how to respond to an email from a co-worker. We talked about it and I felt we resolved it so I planned to write the email later. My T insisted I had to write the email then and there or I would avoid it. I wouldn't have, but T wouldn't back down so I spent 20 minutes of session writing an email.

• Tuesdays are hard days because I have school and work. I get extra anxious on those days. We spent all session discussing when I would have my meals based on my schedule. I tried to change the subject and said I didn't need a plan for it. I can figure it out as I go along, but T said it's important for me to make a plan...so there went the whole session.

• I briefly mentioned I was frustrated with my boss again. He insisted that we spend the session drafting a script of what I will say to him next time. I argued that I'm not going to say anything because I need the job and it won't change his behavior. My T insisted that despite this, I need to have a script ready and it was important for me to just say something to feel my voice was heard. I protested, but ended up spending the whole session writing a useless message to my boss.

• I mentioned I get anxious ordering at food places. I don't avoid it, but just feel anxiety. He said we needed to do an exposure of going to the local food places and ordering to-go. I felt it was pointless since I don't avoid doing it and it's likely a symptom of my GAD. My T insisted this would be a necessary step and we devoted a session to ordering a coffee in one place and a slice in another and a bottle of soda in the next. I felt it was a waste of time. Still have anxiety placing orders.

• I used to bike, but stopped a few years ago because it was giving me more anxiety trying to fit it into my busy schedule than any relief it gave me. My T keeps bringing up that one of our sessions soon needs to be devoted to the two of us riding our bikes again so I can manage my anxiety about spending time on biking. Even though it's so unimportant.

I feel like T feels I am being difficult and not willing to be helped when I argue with him. And maybe what we are doing is right for me. I just feel like it isn't. At the same time I feel like I don't know anything because I'm the one whose sick and can't help herself.

[awkwardlyyours]

Why are you still seeing this T?

Merely liking him can't be it?

[atisketatasket]

My opinion? Therapists like to think they know better than the client.

They are often wrong. Instead of considering that possibility, they blame the client. It is the profession where the customer is never right.

If you've been working with him for 18 months and have seen no improvement and have made an effort, trust yourself. And possibly get a new therapist if he's not willing to adapt.

[stopdog]

I do. It is arrogance and condescension for a therapist to take the position that they know better than a client. I would not continue to hire one who thought such a thing was even possible. I found cbt to be not only useless but actually damaging.

[Moment]

Maybe you should try an experiment.

Next time he suggests something you don't want to do, refuse to do it. Don't back down. Just tell him you want to and you won't. Do you ever refuse to take his advice?

Frankly, some of it does sound helpful. Regular meals and exercise is important. So the meal planning and biking makes sense to me. Even if the biking itself is not your top priority, it's something you've stopped doing because of anxiety so if the issue is anxiety, why not tackle it?

Not every second of every session is useful for me. If half of what he does is useful, it still sounds pretty useful. But if you *never* refuse to take his suggestions, you could try refusing and if he insists you could say, "It makes me anxious to reject your suggestions, so I am practicing rejecting some of your advice instead of just giving in."

[Moment]

Maybe you should try an experiment.

Next time he suggests something you don't want to do, refuse to do it. Don't back down. Just tell him you want to and you won't. Do you ever refuse to take his advice?

Frankly, some of it does sound helpful. Regular meals and exercise is important. So the meal planning and biking makes sense to me. Even if the biking itself is not your top priority, it's something you've stopped doing because of anxiety so if the issue is anxiety, why not tackle it?

Not every second of every session is useful for me. If half of what he does is useful, it still sounds pretty useful. But if you *never* refuse to take his suggestions, you could try refusing and if he insists you could say, "It makes me anxious to reject your suggestions, so I am practicing rejecting some of your advice instead of just giving in."

[Shazerac]

You are the ultimate judge of your behavior. Therapy is supposed to be a partnership, not a authority telling you what to do. Like the others said I think your can turn your experience as an opportunity to grow. Stand up for yourself say no I'd rather work on another issue right now. It sound he/she has an overwhelming list of demands and issues to work on all at the same time. Maybe tell them that you would like to pick a key issue or a few and work on them instead of everything at once. Don't give away your power. Even though you have anxiety, you have the final say in what works for you.

[ElectricManatee]

Eighteen months is a very long to be suffering so much, and I sorry you're going through this. I absolutely could not work with your therapist, based on what you've described here, and I completely understand why you're ready for a change. Therapy should be a time for you and your T to work together about what's most important to you. Your T can suggest topics or techniques, but it seems strange for the T to force things on you if you aren't interested or don't think they would be helpful.

Some of the life management stuff is important, but I think he should trust you to take care of it if you say you can take care of it. Are there deeper issues you want to deal with? Stressors you need to dig into? Therapy is your time, not his. I absolutely would feel disappointed and annoyed if my therapy time was spent on writing a work email, if that's not what I wanted to do.

My T will suggest topics occasionally or follow up briefly on an important topic if I haven't discussed it in a while, but otherwise she usually lets me go where I want to go because I know my life and my priorities better than she does.

Would it be possible to try another therapist? Even if your T is well-trained, well-intentioned, and doing all the "right" things, I don't think feeling like you're being pushed around is conducive to healthy therapeutic change at all.

[scorpiosis37]

I know better than any T I have seen. I just moved and have been looking for a T, but I can't seem to find one who (1) takes my insurance and (2) listens to what does and does not work for me. In fact, one T I called practices CBT-- but I have no use for CBT because I don't have any thoughts or behaviors I want to change. I just want a T to listen and provide support. From your descriptions, your T's exercises do not sound helpful. Are you interested in finding a new T? I would not see a T who doesn't listen to me or trust that I am the authority on myself.

[CharlieStarDust]

I think I'm lucky that I have a T that listens. When I profess any doubts about anything (without seeking her opinion) she'll reinforce that I know myself best and what works for me best. If and when she suggests things that I know won't work, I tell her (and sometimes explain why/how I know they won't work) and we move on. She's never once tried to force me or persuade me to try/do something. It sounds like your T isn't hearing you, OR listening to what you're saying. If you like this T and they work for you in other ways, maybe that's something worth exploring - following your lead and working with your, rather than against you?
Good luck!

[StickyTwig]

I'm not sure whether you are doing this already or not, but it may help if you come up with some of your own ideas about things to try.

In other words "T, I don't think X would be helpful to me, but on the other hand Y might be"

If you struggle to think up alternatives to his suggestions, then remember T might do too. Its true he is the trained expert but on the other hand, you know yourself better than he does. I guess you just have to help each other!

[StickyTwig]

(double post)

[Argonautomobile]

My T, probably. I make terrible decisions.

Still, I doubt that T's know better than the client in general.

From the examples you list, your T seems very controlling, and you don't sound happy with it. I'd try looking for someone else.

[Ididitmyway]

Wow. This T sounds like an authoritarian and controlling parent who sticks his nose in every aspect of his child's life. And your relationship with him sounds like a parent-child relationship in the literal sense because he is literally telling you want to do and you obey.

But hey, I hear your struggle...I think. It sounds like you don't feel like you have a choice because you don't know what to do instead. You do know that what your T is doing is not working for you, but you don't know what you need and what you want, because you don't even allow yourself to feel your needs and your desires. They don't seem important to you and you don't believe that they are part of your guidance system. You believe other people should guide your decisions, those who have got their diplomas, professional training and whatever "stamp" of recognition they got from the society that validates their expertise. It's a pretty powerless place to be in.

[DP_2017]

We obviously would know ourselves better.

That being said, he is VERY good at reading me and I've only been a few months in, if I am trying to hide something from him, he knows, he knows a lot of the ways I will react or respond to stuff already....

For example, for something difficult, that I've done for homework, he will have my email it to him because if I bring it in, I'll skip over it. Its frustrating because I can't get away with stuff but I also like it, because it pushes me and I need that. I've come along ways so far in a few months time with my T.

[Apollite]

Lola5, your therapist sounds very demanding and that's making you more anxious. It's fine for T's to suggest things that might be helpful to you, but forcing you into situations you aren't comfortable with is unprofessional. It sounds like he has lots of boxes to tick and isn't taking on board your feelings or personality. I'd try to find another T if I were you.

CBT might not be the best fit for you at the moment either because it is very regimented and is based on making changes, so if you are unable (or don't want to) change your outlook or behaviour, both you and your T will end up very frustrated.

As for who knows better? I think that ultimately the client does, because they are the ones who have to live with their problems.

A therapist may see dozens of depressed clients in a week, and they won't all present themselves in the same way. Some may be withdrawn and dead behind the eyes, others might be angry and combative, and some won't seem as though they are suffering too much. It is up to the T to adapt to their clients and treat them as individuals with their own personalities, because not everyone fits the "text book" description of mental illness.

[ruh roh]

Wow, what a controlling therapist, lola5. In those instances, I don't see how he knows best. However, I do think there are times when a therapist knows better how to move through difficult territory--for example, trauma recovery. I pushed and pushed and pushed to do things my way and ended up with a damaged hand (and door) because I overwhelmed myself with material I wasn't ready to get into, against my therapist's advice. So, with certain things where there's a safety risk, I've found she knew/knows better than me what to do.

[Daisy Dead Petals]

Your therapist sounds like a paternalistic control freak. You may not have all the answers, but he does not either. It sounds like you have a gut level idea that your therapy is not working for you. If your T won't respond to your feedback, why not try out a few other therapists to see if you can find a better fit?

[healinginprogress]

Sometimes I do and sometimes she does. There are certainly times where she misunderstands the importance of something to me. She's only human after all. But I I find that having the conversation about that helps me to better understand myself (as part of the reason I'm in therapy is that I stuffed my gut instinct into a locked box and threw it in the ocean of my soul a long time ago). If you feel like you can't bring up your issues verbally, can you write a letter or email?

[malika138]

Lola5,
I too spend some time talking about what to write in emails to get me out of anxious settings, but the difference is that I write the emails after the session. If my T asked me to write them during session, I would question whether she trusts me. I guess that is one approach. When writing an email comes up, volunteer that you will demonstrate making progress by writing the email on your own.

[Elio]

As T says, I know me better because I was with me when I experienced my life, so I know what I felt during those experiences. That being said, I am not doing CBT and CBT did not work for me primarily because changing my behaviors did not change my beliefs. It actually added to my negativity towards myself because even though I learnt how to pause and logically get through events (push through events), I still felt whatever. I still was triggered and I still had/have those instinctual responses. I just had more mastery, discipline, or willpower over them.

As far as how your T is spending your time - my T lets me lead, almost 100% of the time. There have been a few times where I did ask for help in finding words on how to say something. And we have done some activities in session, all initiated and directed by me.

Perhaps, this T is not the right one for you, perhaps he would be willing to try different things, or perhaps he could explain better why he feels these things must be done in session rather than as "homework". The only way to address it is to really sit down with him and talk to him about it.

[lucozader]

I believe the client knows better... always.

[missbella]

Someone as autocratic as you describe would leave me feeling more anxious, ineffectual and enfeebled rather than less. I felt better as I got older realizing I'm the expert on my own life, and my judgment was no worse on average than anyone else.

[nottrustin]

Yikes. The client should know themselves better and be able to do what's right for themselves. There have been times my T has felt strongly about something but I disagree. She always tells me though she will support me whatever I do. She may ask about it at another appointment. She has always told me She wants her clients to know themselves better than she does.

[InnerPeace111]

The client always knows themselves and what is best for them better than a T ever could know.