How to know if therapy's working or need new therapist, etc?

I've been seeing a psychologist for therapy since December for anxiety...she's mentioned once possible dysthymia as well. I see her every few weeks (plan on every 2 but sometimes it's longer due to appointment availability since I need evening appointments).


I'm not sure if it's making a difference. I'm using more strategies, but overall I still feel just as anxious, lost, blah, and just...you know. I feel like part of it is that I have trouble opening up and explaining myself. I'm not good about changing the subject or bringing something up if she's not already asking about it. She also tends to do a lot of the talking, helpful stuff usually, but still. I've also been annoyed sometimes for saying things like "you'll meet someone" (regarding anxiety over being still unmarried) and I wanted to say you don't KNOW that!

I just feel like there's so much going on in my brain that I need to spit out, but I can't. I'm not bold enough to say that, so how would she know? I feel like I'm worse than she thinks I am, but how do I know what she thinks?


This is my first experience with therapy so I'm not sure if the sessions are typical or not, and/or if my struggles are due to my own mind working against me and just needing more time, or because she's not a great fit for me. Don't get me wrong, she's very nice, I like her as a person, nothing unethical by any means I just don't know. I'd hate to switch (and honestly don't know how long it would take for me to bring that up, lol) and just wind up in the same boat - or even further back since I'd be starting over with someone new.


Thoughts?

Well... I'm probably not the best member, here on PC, to reply to your post. I've only seen a few different therapists for brief periods over the years & I don't see one now. However just "off the cuff", as the saying goes, I would think that perhaps the thing to do is to share the concerns you have with your therapist. Assuming she is an experienced mental health professional, she won't be offended & she'll know how to guide you through how you're feeling as well as what to do about it. If she does take offense then, at least from my perspective, you have your answer as to whether or not you should change therapists.

Here are links to 4 articles, from PsychCentral's archives, that may be of some help:

https://psychcentral.com/blog/6-ways...sts_position=0

https://psychcentral.com/blog/10-rea...dium=popular17

https://psychcentral.com/blog/7-tips...dium=popular17

https://psychcentral.com/blog/overco...es-in-therapy/

I expressed some of my thoughts on how to know if one's therapy is working in this article Therapy Consumer Guide - How Do I Know If My Therapy Is Working? but it may not describe your specific situation.

In your case, the first step, I think, is to talk about your concerns with your therapist, as was suggested in the previous post. If she seems to understand, give her a chance to change the way she works to fit your needs. If during the next session you feel that she is not "getting" it, I wouldn't give her any more chances. People either "get it" or they don't and you can see it immediately. So, if you see no noticeable changes after you talk to her, then it's going to be clear to you that it's not working. What you do with this knowledge is up to you.

But, personally, if a therapist said to me "you'll meet someone", that'd be enough for me to leave and find someone else. "You'll meet someone" sounds more like a bad advice from a friend, a kind of advice that friends give each other all the time, not something a professional would or should ever say. Frankly, I wouldn't appreciate this statement even from a friend, let alone a therapist. It is dismissive, minimizing and invalidating of your current emotional struggle IMO. It basically implies that your present emotions should not be taken seriously because "everything will be okay" in the end (which no one knows if it's going to be the case, as you correctly pointed out). In my training as a therapist I was specifically taught not to make stupid and insensitive statements like that. So any professional who makes them is unqualified to do their job by my standards. Or they just need more training.

If you're having trouble saying things in session, one thing I've done is e-mail my T about it (depends on if your T allows outside contact) or else typed it up, brought it to session, then handed it to him to read. I would just try to find a way of telling her what you said here.

And you could always try out another T, even temporarily or just to see one for a consultation session (some offer a free 15-minute phone call or in-person consultation). When I didn't think things were working anymore with my ex-T (who I'd been seeing 6 years), I decided to see another T, with the idea of consulting with him for a month or two about certain issues, then going back to ex-T (I told ex-T this after making the appointment). But then I found his different perspective and approach was helping me, so I opted to just stay with the new T. So that's something else to consider.

Wow. I feel like this post could have been written by me 15 years ago when I saw my first therapist. I felt so similar to this. In between sessions I'd come up with all kinds of things that I wanted to talk about, but once I got there I couldn't express any of them. And she just filled the time talking about some helpful and some not helpful stuff. That therapy experience made me worse, not better.

Some of it was her fault. She was the professional, she should have been able to help me open up more. But it's never all one person's fault in a relationship. And besides, I can only control myself, not the other person. And over the years, here are some of the things that I have learned about being a client:

1) I pay them. Not the other way around. That means that I have every right to ask for what I need, politely tell them if something they said hurts my feelings, and fire them if I have to.
2) When I know that I need to tell them something, but feel like I can't, it helps a lot to write it down and hand it to them, or email them or send them a letter in the mail. It's so much easier to express myself when they aren't sitting there looking at me.
3) Those guys can't read my mind, no matter how much I wish they could. Generally they have no idea they have messed up until I tell them.
4) A therapist who responds to polite criticism thoughtfully and non-defensively is worth keeping, even if they aren't perfect in every other way, at least for awhile.
5) A therapist who gets defensive and angry will never, ever work for me.
6) I feel so much better when I express myself honestly with them...even if I cry and even if I have to do it by handing them a note. In fact forcing myself to do it, and feeling proud of myself for doing it, has been the most helpful part of therapy period. Anything else I really can get from a self-help book. But the relationship is irreplaceable.

In my experience therapy does not make sense as an anxiety remedy. I found that it created new anxieties and dramatically increased compulsive rumination. It solved nothing. I found meditation helpful. Also, anxiety can be a product of physiological factors and the external environment, neither of which can be addressed by talking.