As someone with very poor attatchment and used to a lack of attunement and poor care in general actually figuring out if your T is good or not is proving difficult.


Context- Been seeing them for 3 years. I find opening up very hard and so its been a slow 3 years. I am starting to trust them more. I have disclosed more and feel more comfortable.


Pros: They remember everything and know my history inside out. They have been through some key events with me and I find having someone automatically know this context very reassuring. There is a reason I have stayed with them for 3 years, usually I runaway. i genuinely feel the absolute positive regard and she is very generous in session with her time.


Cons: I question their method. There is very little structure. They never asked me key questions at the start and have only just found out i selfharm etc. When I dissociate they asked me whilst i am dissociating when i started dissociating. I don't think this is very aware behaviour from a therapist. Am I just still with them because we aren't actually getting anywhere and I am not facing anything. Surely after 3 years I should have made some progress?

[Out There]

It doesn't sound to me like you haven't made progress. You sound somewhat like me , took me a very long time to start trusting and opening up , and it' s slow work. I don't have any alarm bells going off about your T , but maybe you could discuss making your sessions more structured if you thought that might be helpful ? Remember you can ask for what you need in therapy.

[Salmon77]

If after three years you haven't made any progress in your life or whatever you first went to therapy for, it seems like maybe it would be worth seeing what your other options are.

But it's also worth talking to your T about what you want to get out of therapy that you're not. Maybe it can change if you ask. Or maybe now that you feel more open and comfortable with your T change can happen faster. If she just found out that you self-harm then you must not have told her that before.

[stopdog]

I doubt it -but I doubt any of them are actually competent. I think the best one can hope for is not completely and disastrously incompetent.

I found therapy was about building me up inside, so I could tolerate life.
Not sure about what progress would look like.

[seeker33]

I think because your T sensed you didn't trust him much and didn't open fully in the beginning he decided to make you more comfortable by allowing you to lead the sessions in your own tempo. Now, if you have some specific goals, I would definitely talk to him about it. Tell him something like: "I have this goal X", can we work on achieving it?
Or "I would like to see more progress in my life but I'm not sure about how to set goals. Could you help me set some goals and then work on them?"
Your T seems quite good from what you describe and managed to make you comfortable so I would try to continue with him. Just tell him that you'd like to get more practical.

[Anne2.0]

Originally Posted by 502041

Am I just still with them because we aren't actually getting anywhere and I am not facing anything. Surely after 3 years I should have made some progress?

For me a lack of structure from the therapist is good, because I prefer to control my sessions. I make fun of my therapist when he asks me a direct question, especially if requires me giving up any specific facts I haven't openly shared. But there are therapists out there that will structure the heck out of a session or its content, look for someone very gun ho about CBT. You get homework and work sheets and maybe some useful skills in there.

But it *sounds* like you are "facing" things right now, such as self harm and dissociation. But what is it that you want to see, what is it that you are wanting to "face" or where is it that you want to go?

After three years, I would want to feel comfortable enough to say to my therapist what you said here. I'm not facing anything and don't feel I'm getting anywhere. Can we have a discussion about this? I think you'd need to have this discussion even with a new therapist so they understand what you're after.

[LonesomeTonight]

I agree that you should discuss these feelings with your T. If you want them to be asking you more direct questions, tell them that. As Anne mentioned, many T's let the client lead sessions and topics. My T does ask lots of questions and will suggest topics to address, and I find that to be helpful. I'm already making much more progress with him in a year and a half than I did with ex-T, who I saw for 6 years. Different people need different therapy styles. Or it could be that a particular style or T works for someone at one point in their life/therapy, but to move forward, they might need a different style or T.

If you generally like this T, it would be worth having this conversation with them. See what they say. Are they open to changing up their style a bit? To work on certain goals? Another option (or could be along with this) is to try consulting with another T, even just for a session or two. When I started seeing my current T, it was initially with the plan to see him for just a month or two to help me with an issue I felt stuck on. But then I just opted to keep seeing him and not go back to ex-T. He said it's common for people to consult with another T to get a different perspective on an issue (and has said if I want to do that while seeing him, it's fine). You could try looking around at other T's, and if someone seems appealing, try them out, then decide later if it will be temporary or longer-term.

But I do think the first thing to do is try to have a talk with your T. If you have trouble saying it, type/write it down and hand it to them at the start of session, or email it, if allowed.

[WishfulThinker66]

I thought I had posted on this already; was it removed?

Is your therapist competant? That would depend on your own expectations of how they ought to be. While it is true that anyone could be incompetant in their profession it doesn't hold truth that your opinion makes them so. I think before painting one's therapist with such a brush stroke one needs to ask themself what then are their expectations of therapy and are they realistic?

If that question fails the litmus test, then I suggest one take action and do something about it - like reporting it to the body that governs the profession. Ultimately, if such a problem exists there is a simple answer - stop going.

[stopdog]

Blaming the client for unrealistic expectations is off base in my opinion. So many myths around therapy created by those people and the obfuscation by those people of what therapy actually can or cannot be expected to do or what it is they are actually doing - certainly can lead clients into being confused or misunderstanding what they are buying.

[BudFox]

Competent at what exactly? I rarely if ever see therapists define the service they are selling.

I also think competence and method in the context of a relationship are weird concepts.