Article: Clients that Didn't Get Better

I hid my weaknesses from myself, mostly in order to hide them from anybody in my family rather than my own ego, I think. I numbed out and there was no emotion to see even in my face, so there would be no criticism or punishment. "I", a child's reaction, put part of myself in a dungeon and threw away the key -- that's something I could have said, or tried to say, to therapists years ago. That's all I knew -- not what was in the dungeon because I didn't/couldn't know at that point.

Yup. I agree with this.

Scary. And surprising.

They wave their magic wand, and when that doesn't work, they say, "Well, I don't have a magic wand."

It can be read in many ways.

By the way:
T uses blank slate, mirror and brick wall strategies, and then complains about being treated as furniture?

I relate to the part about the therapist not seeing the full extent of my problems. But in my opinion that is my fault, I can't expect my therapist to read my mind. Regardless, it leaves me in a position where she thinks I'm better off than I am, and it's been two years since we started, and I feel like I can't randomly bring up all these things I haven't told her. Oh well.

I will say that I think my T takes me more seriously than I take myself, and that is not necessarily a bad thing.

I don't like to say it because it's a completely douchey thing to say, but I honest to God feel like I'm too smart for therapy a lot of the time, which ironically makes me feel really dumb because I can't figure out how to get my therapist to see past my defenses and "together" act I have perfected. I know how to present to others as someone who is handling life just fine. How much of an internal wreck I am only comes out in a handful of specific situations my therapist will never see. I don't do drugs, don't self harm, don't engage in any overly dramatic behavior, don't have wreckless spending habits or engage in risky sexual behaviors. I'm not needy or demanding as a client; my therapist never hears from me outside of sessions. There aren't really any obvious indicators that scream, "This person needs help!!" I'll sometimes tell my therapist I'm struggling with something, and she will straight up insist that I'm not and then say to trust her "objectivity" when I try to disagree. How does one get help if no one believes they have a problem?

well said...i could not have said this any better

yes, this was my experince too. and i was not expecting my ex-T read my mind that i was in trouble because i was not only open and honest in telling him, but showing him the evidence (self harm wounds) that i was in trouble and he still refused to discern that i was deteriorating.

ETA: as an after thought, ex-T probably analysed my concern that i was deteriorating as nothing more than mere manipulation

Thanks guilloche for posting this article. Which describes some of my past (failed) therapy experiences almost down to a T.

I have a very high functioning, highly competent outside persona. And inside there's some shrivelled emotional core that I cannot really get in touch with myself. Whenever there's some contact with this core being (which quite often feels to me as if it isn't there at all) it feels like a short circuit, and it's almost unbearable.

Since I'm so out of touch with this innermost area of myself it doesn't surprise me that Ts find it difficult if not impossible to connect with this side of me. It took me years of therapy to find out that this is actually happening, to find images to explain to my T what is going on on the inside when I'm 'not there'. To me, the metaphor of "only half the patient" being there in the room really hits the nail on the head. This is what it feels like for me, and this is what my current T quite often reports back to me what it feels like for her.

I've only been with my current T for about six months so far. After a major rupture with my last T (which followed the pattern described in the article) I made sure to inform this new T right from the start that there's more to me than my highly competent facade. That we need to work together to get behind the scenes, that this is as much terra incognita for me as it is for her, since I cannot hold the connection to myself for very long... I outright asked her whether she was up for this adventure? Whether she could relate at all to what I'm telling her.

I was lucky as she had picked up the highly contradictory information between my outside and deepest inside already by herself. And she stated herself, that she would find it "terribly" easy and comfortable to just bond with the competent outside persona. Since she (the outside persona) is so agreeable and draws people in in a big way. So we keep having meta-talks about our mutual perception/s of what is happening in the room or not, I keep telling her when I find that she is focusing too much on the outside, at the same time we have to keep some balance since having a process that is totally deficit-orientated would be devastating in itself.

So basically, with this current T I'm (cautiously) hopeful that things might turn out more satisfactory in the end. That we don't end up entangled and enmeshed and full of mutual resentment and criticism. But then, with the last Ts before that I was hopeful as well at the beginning... But somehow, this article really helped me to see what might be happening on the Ts side... And this is not so much about just focusing on the T, but to be aware of potential dangers in this joint expedition.

Yeah, you can. I think that's pretty normal in therapy.

Thanks for sharing. It was a very interesting article. I am definitely one of such patients and I feel I have been extremely lucky with finding a good therapist who has been able to go beyond what was described in this paper.

Interesting articles, biggest non surprise?

That most of those therapists couldn't spot when what they were doing wasn't working or their client was deteriorating, nor could they amend their tactics if they did.

feileacan, if you don't mind me asking: How does/did your therapist go about 'going beyond' the obvious on the outside?

I'm asking because for me (and my therapists) all attempts to get behind the upfront persona are incredibly painful and frustrating. I cannot get hold of myself in there, it's not that I don't want to talk about it, I simply cannot get in touch most of the time, and if I do, it's extremely unpleasant.

For me it feels as if this core inside is surrounded by some incredibly strong magnetic force, which results in repulsing all things trying to get closer beyond a certain stage. It results in both me and T being catapulted through the air and experiencing some hard landing, again and again.

I don't know what it takes to get through this. Current T says: Accepting where we're at. Time. Patience. And very gradually easing our way forward. Me trying to hold the connection despite all the unpleasantness that surrounds this. Her offering support while I'm trying to hold the connection. Maybe my innermost core realising with time that there's no reason any longer for those incredibly strong self-defences? Dunno. Any insight would be deeply appreciated. Thx.

Maybe what I wrote was ambiguous and you misunderstood me a bit? I did not mean that my T has found a great way of helping me heal quickly (because I don't think it's even possible). Rather I meant that we don't really fight that much anymore. And when we do then it is me fighting with him and him not coming along anymore and instead really trying to understand what am I fighting for at the current moment.

Also, a big part of it is something I just wrote today in another thread that he has relaxed the requirement for me to fill the space because either I can't do it or I do it in a superficial way. Rather, he let's me be and is willing to create the room or space himself and is willing to wait if I am able to make a use of this room (even if just a tiny bit).

Also, he allows me to be ugly and bad. Sure, he doesn't allow me to attack himself physically but he has endured the extremely angry parts of me and survived them without taking it personally.

Also, he has become quite good understanding when I'm presenting the intellectual half-me and not going along with it at the same time not insisting that I have to somehow magically bring the other part into the room.

Also, it doesn't mean that the process still isn't frustrating. It is, sometimes extremely so. But I feel that slowly, very slowly I get a sense what we are really trying to do there. And occasionally I also sense some continuity in our interactions and relationship.

I don't truly know if I can ever heal from my main issues (which are very similar to those described in that paper) but I can definitely say that our relationship is not artificial and I have gained a lot from it.

I think it's difficult to explain to someone else how "your" therapy works.
It's, at a deeper level than words. Plus that unique relationship between a client and a T is just that, unique.
The biggest factor I can express is T's knowledge of the human condition and the unconscious. She seems to know what I'm trying to express before I do. Her ability to put words to the feelings is at the crux of it.
Of curse it's difficult painful, frustrating. Thsts a given.
I don't see that as a negative.

I very much relate to those "traits" in the OP and concluded the same after a while, that therapy is not really for me - I just pay a lot of money and more use it as a distraction than anything else. I gave up on it in less than a year with both Ts but do not regret trying, it was an interesting experience, also to arrive at that conclusion, especially because originally I assumed that I would want to do it long-term, given my interest in psychology and tendency for introspection. I usually get much more out of professional assistance that is centered around specific and more practical goals and very personal discussions with friends. I can imagine using therapy effectively if it is just short-term consultations and seeking advice, focused on a specific purpose. I do not believe a T would have to know everything about me to provide an opinion on something specific, much like seeing a medical specialist.

No I didn't look for the instant healing. I was curious because I was simply wondering how you and your T might navigate around those problems. Not necessarily to copy, b/c yes, therapy is something highly indvididual, but because it might give some input in the sense of "there are things that have worked for others in a similar situation"..

I read what you wrote in the other thread, and I can identify very much with this, that when this void or empty space takes hold, things don't start moving or happening for me, but become impossible because of dissociation and those unbearable feelings.

That is brilliant, that your T is so perceptive and gets it when you're intellectualizing and yet gives you enough space and doesn't put pressure on you...

For me it's not so much the intellectualizing, but the fact that all of a sudden (?) I'm losing the connection to myself or to my feelings. It's as if someone (me??) has suddenly wiped everything out, and it's impossible for me (and for T as well) to re-establish a connection in those moments. Almost like a blown fuse... T notices when this is happening, we are both aware of those moments when this is happening, but it seems difficult if not impossible to get connected again. Me with myself. So T doesn't feel the connection either.

For me this goes along with panic and a feeling of imminent danger. It's some black hole energy...

I know all of this will take time. And a lot has changed already. I'm much more aware now of what is happening, than I was 2 or 3 years ago... So yeah. I guess things will change a bit more, eventually.

Thanks everyone who has replied... I'm a little overwhelmed by all the responses, but I've read them all and am thinking about it.

I feel like, in my case (and this is over the last ~18 years or so, several therapists) - that I just can't get to the point of feeling any kind of safety/bond. I *know* what that feels like, because I've been lucky enough to have a couple of friends that I felt that close to. I have a friend now who, while he doesn't know everything about my history, does know me incredibly well... and I feel like I can really be myself around him. He's very non-judgmental (more so than the therapists I've seen!) which has been a tremendous gift...

Why can't I have a relationship like that with a therapist? Why can't we ever seem to be on the same page?

In therapy, I tend to feel:

- not accurately seen, not understood.

- sometimes not really listened to. I'm working on this with my current T, but she's got a tendency to interrupt to ask questions, which is bad enough (it makes me feel like she doesn't care about what I'm saying) but the questions often feel like she doesn't understand the point that I'm getting to. It's kind of like, if you were telling someone that you came home and found an intruder in your house... and they interrupted to ask where you had just been, how long the drive home took, etc.

- In the end, I just don't tend to get the cues that make me feel cared about, listened to, understood, etc from therapists. And, what I'm finding is, that I'm often hopeful when I first start seeing one... but as time goes by, and they continue to not get me, I feel like there's less and less that I want to or can talk about. I end up crossing things off my mental list as possible topics to address with T, because their reactions either frustrate me, or are just not helpful.

I don't understand this... because again, I've had friends that were wonderful and incredibly helpful to talk to. Not just that they understood me, but that they offered insight in our discussion that was helpful. Not necessarily advice even, sometimes it was just another perspective or their experience or telling me what pattern they noticed in my behavior, but it always gave me something to think about, and often ended up being helpful.

And I don't seem to get that with Ts.

Even with this T, who is really great in a lot of ways, and is genuinely trying to help me figure this stuff out. It's hard when I talk to her about something, and the response just doesn't *resonate*. Do you all know what I mean? It's hard to put into words, but it just doesn't really seem to click with me... so it feels almost tangential, not related to my situation, etc.

I am in this same situation. I feel (and like you said, this is douchey I guess) that I am "too smart" for at least the mode of therapy I am in -- CBT doesn't work. I know how to identify my thoughts and how to react to them. I know how to identify my behavior.
My problem is, some sick part of my brain doens't WANT to do that. By the book, if I followed the instructions, I should be getting better. But I keep spiraling -- on purpose -- but because my T has seen me doing so well (she seriously thinks my most important issue is my perfectionism), she can't see that I'm an addict, I've almost died, I WANT to die. She can't see it and I'm not showing it.
So she insists if she could just help me learn to be less self-deprecating, I will get better. Sis doesn't know the half of it.

Maybe it's the T's, not you. Maybe they don't care that much. Maybe you are picking up on the real cues, it's just not what you expected or wanted? It's great that you DO have friends that you can talk and relate to, so you know what the real thing is like.

And your current T may be able to help in some ways, just maybe not in the ways you were expecting? Hope talking about the articles helps. Thanks again for posting them, very interesting.

Thanks, Here Today. Maybe you're right? I'm not sure. I think my last T did care. I go back and forth, because there's something there that I miss (and I think it's that he was good at "caring loudly"). But, he also screwed up things... a lot. And was insanely expensive. And was kind of making things worse. Argh.

I think this T cares, and is a fairly genuine person. But there's something weird going on.

I *do* think it's cool though that she's the first one who's been willing to really talk about the "something weird going on" (and she can see the pattern too, when I tell her about my past therapists).

She said that there are points in our interaction where she feels awkward. Off. Not herself. And she's not sure why, or what to do about it. I'm not sure who's introducing the awkwardness (i.e. if she's reacting to me being "half present", or if I'm reacting to her being awkward?). Anyway, I guess it's good that we're talking about it..

Sigh - was looking at some old writing about Ts from long ago on my computer. That first T (who kicked me out) - I wrote, "he's not as patient as he thinks". LOL. I think a lot of them are like that - they *think* that they're super patient and understanding and exuding caring, but... no. Maybe I pick up on that (b/c I feel like I wear people, and therapists, out.)

Maybe that's a starting point?

That's where I'm at with current T, she gives me some very honest feedback about her perceptions/feelings in the process. Which I find very helpful. She says, that in certain moments, she cannot get a connection to me. It's as if I'm not there. And I know what she means and which moments she describes. Last session I told her that she is the first T (of my many Ts) who's speaking to me about this. I'm sure the others must have noticed. But they made their assumptions, or blocked it out, and concentrated on my highly functioning part, which is much easier anyway. So speaking about it, her telling me what it feels like for her and me telling her vice versa helps us both, to gain a mutual understanding of what is happening in those moments. Maybe to develop ideas together how to get closer to this "shrivelled" core of mine. How to nuture this core that is so fearful that it mustn't be the focus of attention or otherwise it will implode...

As I experience this at the moment, it's very straining and exhausting. Both for me and for my T. And in a way, I can relate to why Ts would rather connect with the functioning part of mine. Because it is more present, more tangible, and much easier to relate to.

Also, I keep talking to current T about the last therapy experiences. Not for bashing those Ts but because those experiences have been so highly confusing for me. This article helped a lot - to understand some of the frustrations those Ts might have experienced. At the same time, current T says, that those moments when I'm only half there, that this is so obvious, that she herself is wondering why a T wouldn't register this and bring this up - eventually...

With regard to feeling cared about and feeling safe: Maybe it would help to talk about what you need in this regard? This might not necessarily mean that your current T will concur. But it might help you to get to the core of those feelings and needs, and why you 'never' feel 'safe enough'. And would T acting and behaving differently would really result in a 'safe enough' feeling? I think this would very much be worth exploring, and I would hope that your T might be up for it as well.

All the best,
c_r