[Lrad123]

I have seen my current psychodynamic T once/week for 16 months, and mostly due to some fluctuating skepticism and frustrations on my part, he has given me the names of a few therapist who he respects and who think psychoanalitically which is my preference. I like my current T very much despite what we’re calling negative transference, I guess, and I am relieved that he is open to me exploring other T’s while keeping the door open for me to continue seeing him if that’s what I choose. I’m curious about what else is out there.

My current T is my first T and I sort of found him by accident and did not ask too many questions when we first met. I had no idea what I was getting myself into, really. I’m meeting a potential new T next week and I’m wondering what to ask. Here’s what I’ve got so far:

- what’s your cancellation policy? (Current T is 2 weeks)
- what are your thoughts on between session contact/emails?
- how often do you typically see clients?
- what are your work hours? (I have a busy schedule so early/late or weekend hours would be great)

I know many therapists don’t disclose much about themselves, but may do so more during an information-gathering session. Any other ideas for questions?

Questions I wish I had asked in my introductory session:

- Will you adopt me?
- Do you promise to never have any other clients?
- Will you stop wearing that pink jumper?

[Waterloo12345]

Not sure if it's relevant for you but what's their practice if one is in crises? Do you pay for 'your' slot even if don't go? How blank slate are they? Trauma trained?

[feileacan]

I'm wondering what do you wish to gain from these questions? If the T you are going to see is psychoanalytically oriented (not just the psychodynamic mess that could mean anything) then the answers to the three first questions should be rather obvious. I can even make predictions:
- cancellation policy - close to none, you are responsible for your sessions
- between session contact - if you seem to need it then it means that you would need more frequent sessions
- how often - preferably at least 2, but also up to 5 times per week
I would be very surprised if the answers would deviate much from these predictions, or else the T is not really psychoanalytic. It's because these things are part of the frame which is very important in psychoanalytic therapy in order to make space for basically anything.

So, the only really relevant question is the last because whether or not you can agree more frequent sessions when needed really depends on how compatible are your schedules.

I would perhaps ask for theoretical orientation and I would expect to hear about relational and objects-relations. With background in emotional neglect you probably wouldn't want to see an old-school freudian also this type should be really rare nowadays and I doubt your current T would refer you to one. You probably wouldn't want to see Lacanian either, but although this type seems to be quite popular in France and South-America for instance, it should be also quite rare in North-America.

But I still think that the working hours is the most important thing because I think one of the reasons you got stuck with your current T is that you can't work more frequently with him.

[Lrad123]

Originally Posted by feileacan

So, the only really relevant question is the last because whether or not you can agree more frequent sessions when needed really depends on how compatible are your schedules.

But I still think that the working hours is the most important thing because I think one of the reasons you got stuck with your current T is that you can't work more frequently with him.

Ugh. My T has sort of said this too. I just can’t be flexible with my work hours though (sole breadwinner working 4 days/week and I see my T on my day off) so I wonder if I should just email the 3 T’s that my T has recommended and ask what their work hours are before deciding to meet with them. It may not make sense to meet with them if our schedules aren’t compatible. How frustrating.

I did ask my T via email if he’d be willing to meet at 6:00 am once/week (he told me he used to offer this in the past), but since he hasn’t responded then I assume the answer is no.

[LonesomeTonight]

Originally Posted by Lrad123

Ugh. My T has sort of said this too. I just can’t be flexible with my work hours though (sole breadwinner working 4 days/week and I see my T on my day off) so I wonder if I should just email the 3 T’s that my T has recommended and ask what their work hours are before deciding to meet with them. It may not make sense to meet with them if our schedules aren’t compatible. How frustrating.

I did ask my T via email if he’d be willing to meet at 6:00 am once/week (he told me he used to offer this in the past), but since he hasn’t responded then I assume the answer is no.

I'd suggest doing this--emailing about their available hours and also making sure they're taking new clients. Some T's work evenings (not sure what your work hours are like) and/or weekends (my T works some Sundays and ex-MC worked some Saturdays).

Maybe you'd also want to ask about their rates and if they take insurance.

[stopdog]

I have known therapists who worked at night and on weekends.

[feileacan]

Originally Posted by Lrad123

Ugh. My T has sort of said this too. I just can’t be flexible with my work hours though (sole breadwinner working 4 days/week and I see my T on my day off) so I wonder if I should just email the 3 T’s that my T has recommended and ask what their work hours are before deciding to meet with them. It may not make sense to meet with them if our schedules aren’t compatible. How frustrating.

I did ask my T via email if he’d be willing to meet at 6:00 am once/week (he told me he used to offer this in the past), but since he hasn’t responded then I assume the answer is no.

I'm not sure why you conclude that because the T hasn't responded the answer to your request is no. I've understood that your T would prefer discussing things in person and I assume that you have not terminated yet and thus you meet with him after holidays. Why not discuss it with him in person?

Btw, one of my sessions is super early in the morning (5:45) because I have to catch a morning train to get to another city that day. The other sessions are quite early too (7:30).

[Lrad123]

Originally Posted by stopdog

I have known therapists who worked at night and on weekends.

Yes, I’ve heard of this too, particularly on this site. I suppose a simple email could answer the question about their work hours as I can’t seem to find that info online.

[Ididitmyway]

Originally Posted by Lrad123

I know many therapists don’t disclose much about themselves, but may do so more during an information-gathering session.

Just wanted to note that there is a bit of confusion in this statement.

You are not asking therapists you are going to interview about "themselves". You are asking them about their professional policies, which is something they are absolutely required to inform you about before therapy starts.
You have the right to know what their policies are and everything related to your work together: their methods, their work philosophy, their views on how the process should be conducted..Every question related to therapy is legitimate and they are ethically required to answer it. You wouldn't want to get any service without being fully informed about how it's done. Psychotherapy is no different. You are a consumer and you have the right to get full transparency from a provider about how they do the work.

[Lrad123]

Originally Posted by feileacan

I'm not sure why you conclude that because the T hasn't responded the answer to your request is no. I've understood that your T would prefer discussing things in person and I assume that you have not terminated yet and thus you meet with him after holidays. Why not discuss it with him in person?

Btw, one of my sessions is super early in the morning (5:45) because I have to catch a morning train to get to another city that day. The other sessions are quite early too (7:30).

He responded to my email where I asked about 6:00 a.m. sessions and addressed different things I had asked, but not this. Also, the context in which he brought it up was to say that he used to offer 6:00 a.m. sessions, but no longer does, presumably because it was too tiring. His website clearly states that he starts work at 7:00 a.m. I emailed him asking if he’d be willing to consider 6:00 a.m. sessions once/week and said any day of the week would work for me. I have seen him since this email exchange and he did not bring it up. Reading between the lines, I believe he is pretty clearly stating this is not an option for him. But you are right, I should bring it up in person and perhaps I will this week.

Also, WOW. 5:45 in the morning? Lucky you.

[LonesomeTonight]

Originally Posted by Lrad123

He responded to my email where I asked about 6:00 a.m. sessions and addressed different things I had asked, but not this. Also, the context in which he brought it up was to say that he used to offer 6:00 a.m. sessions, but no longer does, presumably because it was too tiring. His website clearly states that he starts work at 7:00 a.m. I emailed him asking if he’d be willing to consider 6:00 a.m. sessions once/week and said any day of the week would work for me. I have seen him since this email exchange and he did not bring it up. Reading between the lines, I believe he is pretty clearly stating this is not an option for him. But you are right, I should bring it up in person and perhaps I will this week.

Also, WOW. 5:45 in the morning? Lucky you.

If he didn't reply to that part, did he maybe just miss it, or intend to discuss it in session then just forgot? I'd check in the next session. Are your work hours at all flexible? Like could you go in an hour late and stay late (or possibly take some leave) one day a week?

[Lrad123]

Originally Posted by LonesomeTonight

If he didn't reply to that part, did he maybe just miss it, or intend to discuss it in session then just forgot? I'd check in the next session. Are your work hours at all flexible? Like could you go in an hour late and stay late (or possibly take some leave) one day a week?

Work hours are not flexible, unfortunately. I work 4 days/week so am expected to do appointments on my day off. I could occasionally take time off during the work day, but not on a regular basis which is what my T is suggesting.

I will certainly bring up the 6:00 a.m. question in person this week though. That makes sense even though I assume I know the answer.

[starfishing]

These all seem like good, reasonable questions. Not all psychoanalysts have the same policies or approaches to the treatment frame--my therapist is an analyst and doesn't have me pay for missed or canceled sessions, seems to have a very case-by-case approach to between session contact, and has patients he sees once a week.

And sometimes the way people answer questions gives you just as much information as the answers themselves. I'd personally be much more drawn to a therapist who could explain the reasoning behind their policies and approach in a way that resonated with me, as opposed to someone who just said they do things a certain way because it's the traditional psychoanalytic way to handle it. Even if their reasoning was very grounded in traditional psychoanalytic thinking, the explanation could still be valuable information about how they think.

I do wonder about continuing with your current therapist though. It's not a bad idea to be looking at options but it seems plausible that over time you could still work through the negative transference at once a week, just more slowly. Either way, I hope it works out.

Since I always comment how your T works similar to mine, I'd say ask about school of thought. Like my T, yours seems to use the object relations approach heavily. (Note that some people confuse this with Freudian; not necessarily on this thread but in general. There really are very few Freudian analysts out there, if they still even exist. Maybe in NYC.)

Analysts who primarily work from the object relations approach seem to be more exploratory, while those who work from the self psychology and relational psychoanalyst approach seem to be more supportive while employing the exploratory approach. Psychoanalysts usually incorporate an amalgamation of approaches, but these are conclusions from analyzing patterns and materials as well as different analytic Ts; just something I've picked up on over the years.

My bet is that your T referred you to those who use the self psychology and/or relational approach. Just to clarify--the object relations approach is not the same as the relational approach. My T seems to be trying to work more like a relational psychoanalyst now, which was new to him. It has made a huge difference. This may not be a big deal to everyone, but I have a heavy trauma background.

This, imo, is the one question that informs me about how the T works.

PS: Good luck! Any time I scoped out other Ts, I'd get disappointed and always went back to my T. Sometimes the grass seems greener on the other side but when you get there, you realize it is not.

PPS: I realized I may have sounded code-ish again. When I refer to exploratory, I mean drawing feelings out from you; this involves more withholding to generate more transference and come to conclusions. It also involves work with defense mechanisms and arriving at truths and insight. Supportive meaning more 'gratifying' and warm and involves feel good stuff to some extent. My T would probably argue that all therapy is supportive, but this is terminology I use to apply certain concepts to compare and contrast techniques and working styles.

[Lrad123]

Originally Posted by starfishing

I do wonder about continuing with your current therapist though. It's not a bad idea to be looking at options but it seems plausible that over time you could still work through the negative transference at once a week, just more slowly. Either way, I hope it works out.

Yes, despite the negative transference, I do really like my T, and something about making an appointment with another T and discussing it openly with my T and watching him be kind, supportive and nondefensive about it has probably been good for our relationship which was unexpected. I do plan to talk to him again about whether he thinks progress can be made at once/week.

I also agree that it’s possibly not so much what the new T’s answers are to my questions as how she answers them.

Here are some resources about the supportive vs exploratory/expressive approaches:

The Nuts and Bolts of Supportive Psychotherapy

A supportive approach in psychodynamic–oriented psychotherapy. An empirically supported single case study

Basic Strategies of Dynamic Supportive Therapy

Analytic vs. Dynamic Psychotherapy in the Era of Managed Care

Choosing Appropriate Techniques

The Ts position about the application of this concept alone provides me most of what I need to know about how an analytic T works. Some say a more supportive way of working dilutes the therapy in a sense that it doesn't really resemble psychoanalytic therapy, and I tend to agree.

I didn't read the articles so can't say how reliable they are, but I scanned them and found that key words and concepts are there.

Glen Gabbard is my favorite resource on all things psychoanalytic; he is also very easy to follow:

Gabbard's Treatments of Psychiatric Disorders

(If you read that book then you can speak in code too )

[Lrad123]

Originally Posted by octoberful

Since I always comment how your T works similar to mine, I'd say ask about school of thought. Like my T, yours seems to use the object relations approach heavily. (Note that some people confuse this with Freudian; not necessarily on this thread but in general. There really are very few Freudian analysts out there, if they still even exist. Maybe in NYC.)

Analysts who primarily work from the object relations approach seem to be more exploratory, while those who work from the self psychology and relational psychoanalyst approach seem to be more supportive while employing the exploratory approach. Psychoanalysts usually incorporate an amalgamation of approaches, but these are conclusions from analyzing patterns and materials as well as different analytic Ts; just something I've picked up on over the years.

My bet is that your T referred you to those who use the self psychology and/or relational approach. Just to clarify--the object relations approach is not the same as the relational approach. My T seems to be trying to work more like a relational psychoanalyst now, which was new to him. It has made a huge difference. This may not be a big deal to everyone, but I have a heavy trauma background.

This, imo, is the one question that informs me about how the T works.

PS: Good luck! Any time I scoped out other Ts, I'd get disappointed and always went back to my T. Sometimes the grass seems greener on the other side but when you get there, you realize it is not.

PPS: I realized I may have sounded code-ish again. When I refer to exploratory, I mean drawing feelings out from you; this involves more withholding to generate more transference and come to conclusions. It also involves work with defense mechanisms and arriving at truths and insight. Supportive meaning more 'gratifying' and warm and involves feel good stuff to some extent. My T would probably argue that all therapy is supportive, but this is terminology I use to apply certain concepts to compare and contrast techniques and working styles.

No worries about speaking in code! You have obviously done a lot of reading. I thought my T said he was relational, but I don’t quite remember as those terms were not familiar to me when we first met. I know he has said that he does not practice supportive therapy and that his job is not to make me comfortable. This surprised me because he is actually very nice, but also made me realize that I don’t ultimately want to be comfortable in therapy (so I guess I’m getting what I want, negative transference and all!).

Interesting what you said about how looking for a new T always made you want to go back to your old T. Although I am very curious about meeting with at least one T, just setting up the appointment with the new T has made me nostalgic for my T and has made me want to work hard at overcoming the negative transference, etc. I am glad he’s been so supportive of me meeting with other T’s. The whole process is kind of strange.

I thought my T said he was relational...I know he has said that he does not practice supportive therapy and that his job is not to make me comfortable.

My T said this very same things...that he is relational and does not do supportive therapy and that his job isn't to make me feel good....the question whether we have the same T actually crosses my mind sometimes.

He has changed a bit and is now more supportive. Not a lot but enough to make it more effective. They can be somewhat flexible and not relinquish who they are and how they work. I think he only did that because of the extent of my trauma history. It's not good to work that way if people have a certain level of stressors or instability in their life, and my T made the mistake of not taking that into account. You wouldn't work that way, for example, with someone whose depression is so severe that they are at risk for suicide.

The exploratory therapy is imo always more difficult but also more transformational. With a good T, the negative transference likely represents the issues that prevent you from living how you want.

But yeah, just this one concept can answer to how the way the T works. It took me years to figure out that's what it boils down to. When people say a T is 'freudian' they are usually referring to Ts who are more exploratory rather than freudian. Therapists who are ignorant about psychoanalysis or had no training in it, get it wrong all the time in their articles and blogs.

[Waterloo12345]

Originally Posted by octoberful

Here are some resources about the supportive vs exploratory/expressive approaches:

The Nuts and Bolts of Supportive Psychotherapy

A supportive approach in psychodynamic–oriented psychotherapy. An empirically supported single case study

Basic Strategies of Dynamic Supportive Therapy

Analytic vs. Dynamic Psychotherapy in the Era of Managed Care

Choosing Appropriate Techniques

The Ts position about the application of this concept alone provides me most of what I need to know about how an analytic T works. Some say a more supportive way of working dilutes the therapy in a sense that it doesn't really resemble psychoanalytic therapy, and I tend to agree.

I didn't read the articles so can't say how reliable they are, but I scanned them and found that key words and concepts are there.

Glen Gabbard is my favorite resource on all things psychoanalytic; he is also very easy to follow:

Gabbard's Treatments of Psychiatric Disorders

(If you read that book then you can speak in code too )

Not read the book (yet ) but those were fantastically interesting articles.

I was groping to something in my last session before the break about how I thought my t's method had been too harsh or the harshness only ameliorated because I had the support of my doctor.

I told her a number of times that I would 'run away' to my d after sessions, and if I did not have his support I don't know what would have happened. It was the last session before the break and we were both keen to finish light and with me as content as possible so we didn't really pursue it but I'll come back to it.

It was in the context of us discussing my negative transference to her and my positive trans to my d. She asked why (and this is a subject we've circled back to a number of times over the year) and this time I answered 'because he gives me what I want' and she laughed in a wry fashion and was like yes (I read into that that she did not entirely approve).

Reading the articles, and in particular the 'basic strategies' one I see that my t and d are at opposite sides of the therorectical framework - one is very supportive and the other very exploratory (obvs not everything is black and white but generally speaking).

I really think that I needed both methods to start recovery this year. I was very dysfunctional and t took some time to see and appreciate this, and appreciate quite how important e.g. just getting back to work was for me. D did all this side and quite frankly enabled me to live in a practical sense.

But then t provided the exploratory side that I needed to understand and with understanding is coming change.

I stress it's not been so black and white e.g. d 1st put me on to trauma, and t thinks our extensive emailing is a major bending of the rules in recognition of my needs.

But it's been really interesting as I had a therorectical framework to put t's actions in but not d's. Now I've read that 'basic strategies' article it's literally like he's following it point for point. (I know he's not a t; he's a gp with a speciality in general psychiatry.)

This literally means that I've been in fairly intense 'therapy' over the last wee bit. Like 4/5 face to face a week. Wow. (Not for 50 mins with doc; 10-15 mins maybe).

Anyway, the point of me wittering on about my self is that you may need a t that can do both types????

[starfishing]

Originally Posted by Lrad123

Yes, despite the negative transference, I do really like my T, and something about making an appointment with another T and discussing it openly with my T and watching him be kind, supportive and nondefensive about it has probably been good for our relationship which was unexpected. I do plan to talk to him again about whether he thinks progress can be made at once/week.

I also agree that it’s possibly not so much what the new T’s answers are to my questions as how she answers them.

That's really great that you've had such a good experience talking with him about this! It seems like no matter what you do next, you've built a really strong foundation of work with this therapist.

[Lrad123]

Originally Posted by octoberful

Here are some resources about the supportive vs exploratory/expressive approaches:

[URL="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330607/"]Basic Strategies of Dynamic Supportive Therapy[/URL

I thought it was interesting that this article had a nice definition of the term “observing ego” which you recently used (can’t remember if it was in this thread or another one):

“The term observing ego refers to an individual's ability to step back, get some distance or perspective, and observe himself as he would a friend or family member.”

This article is interesting, but since my T has repeatedly said he doesn’t do supportive therapy, it may not pertain perfectly to my situation. Although I’m pretty sure he was doing a fair amount of supportive therapy for a while just to establish rapport and make me feel less anxious with him. I still have to read the other articles, but am hoping there is a similar type of article for the type of therapy my T is doing (depth or exploratory?). Anyway, nothing like intellectualizing it all to make me feel more in control!

[Lrad123]

Originally Posted by Waterloo12345

Anyway, the point of me wittering on about my self is that you may need a t that can do both types????

Yes, I agree that a T that does both types would be good, but I really am ultimately interested in the exploratory type. The fact that I fall apart between sessions and get negative likely shows that I’d benefit from more frequent sessions which is logistically not possible right now. I’m also high functioning outside of therapy (perhaps my T would disagree as it depends how you measure this) but have found that therapy has created a dimension of my life where I’m not high functioning, probably because I’m opening up to feelings, etc in a way that’s completely new to me.

I’m interested in your comment about how your T thought your emailing was not good. I can’t remember if you’ve elaborated on that before, but do you mind saying more? Obviously that’s something I’m really stuck on, so I’m curious about others with the same predicament.

[Waterloo12345]

Originally Posted by Lrad123

Yes, I agree that a T that does both types would be good, but I really am ultimately interested in the exploratory type. The fact that I fall apart between sessions and get negative likely shows that I’d benefit from more frequent sessions which is logistically not possible right now. I’m also high functioning outside of therapy (perhaps my T would disagree as it depends how you measure this) but have found that therapy has created a dimension of my life where I’m not high functioning, probably because I’m opening up to feelings, etc in a way that’s completely new to me.

I’m interested in your comment about how your T thought your emailing was not good. I can’t remember if you’ve elaborated on that before, but do you mind saying more? Obviously that’s something I’m really stuck on, so I’m curious about others with the same predicament.

I just checked my email history. We started in Nov. Until end of May it was scheduling only. I'm not sure now what the trigger was to change.

I had thought it was the summer break which was 7 weeks in July/Aug. She said I could email during that cause it was so long (a combination of her and my holidays and we did do some skype).

I've just scanned some and it basically seems I was in crises (SUI) and emailed her for support. So basically I just reached out. And she responded. This was only very intermittent. It was genuine crises by anyones standard.

We knew the summer break would be difficult so she offered email contact in extremis to help me. I did keep to this except of course the definition of in extremis kept expanding. So I got use to contacting her when distressed.

She would always reply with an acknowledgment, a sentence relating to the email and a comment redirecting to the next session.

After the summer break she went back to the no emails. But she didn't tell me. For her we had an exception to no contact over the break and were just going back to normal. This was Sep. For me the two periods had elided and we had been in email contact since end of May. So I was like ??????? Big rupture.

She owned up to the process mistake but tried to row back to no contact. It triggered all sorts of abandonment bells. Plus I was seriously deregulated and had at least 2 more crises so I was like email demon. She generally responded in the same way. But we had many sessions about why I emailed, what got out of it, etc etc, the guilt I felt in still doing it and not being able to stop.

She tolerates it, said something like 'but you still do it' which I interpreted to her prefering I did not but she said she is not going to 'make' me stop. One of my reasons for sending was to have someone to bear witness to pain which didn't have before.

She's moved to only acknowledging the ones I am in distress I think. She doesn't think so so I could be wrong. Says she may have missed some cause she gets them together. Also she responds in hrs mainly. Unless she's away when she will tell me what the delay might be.

Forgot to add her reasoning was that I needed to bring these things to the sessions, to learn how to contain myself, that we'd up to 3x a week, to learn how to express myself in session, to feel in session.

Hope this helps. Happy to answer any questions.

Originally Posted by Lrad123

I thought it was interesting that this article had a nice definition of the term “observing ego” which you recently used (can’t remember if it was in this thread or another one):

“The term observing ego refers to an individual's ability to step back, get some distance or perspective, and observe himself as he would a friend or family member.”

This article is interesting, but since my T has repeatedly said he doesn’t do supportive therapy, it may not pertain perfectly to my situation. Although I’m pretty sure he was doing a fair amount of supportive therapy for a while just to establish rapport and make me feel less anxious with him. I still have to read the other articles, but am hoping there is a similar type of article for the type of therapy my T is doing (depth or exploratory?). Anyway, nothing like intellectualizing it all to make me feel more in control!

Most of the analysts use both supportive and exploratory approaches but some lean heavily to one or the other. What I was trying to say was that your T practices more from the exploratory approach rather than the supportive approach (as you now know). Object relations oriented analysts usually do the more exploratory, while the self psychology and relational analysts lean more towards the supportive type. Your T likely referred you to the latter. But again, most incorporate both to some extent. My T also leaned heavily to one end of the continuum.

With my own T, recently, all he did was adjust his approach to be more supportive at times. Ts should have SOME flexibility, and the literature speaks to that too...My T used to interpret my requests to modify the therapy as transference wishes, but now we have a T-client relationship instead of just the transference relationship. He made a few adjustments and it works well.

I'm curious why your T wouldn't make a few adjustments and wonder if he is like my T in the regard as well. The exploratory type restructures personality/sense of self. In my opinion, that makes it worth it and other therapies do not have that impact.

To answer your question, the Psychiatric Times article talks about the primary components (exploratory and expressive are the same):

Balance Between Supportive and Expressive Approaches

Supportive approaches do not require adherence to psychodynamic theory (Pinsker, 1994), but they are compatible with it, as they are also compatible with cognitive-behavioral therapy and medical practice in general. Addressing the topic of how to determine the balance between supportive and expressive techniques, Wachtel (1993) advised, "Be as supportive as you can be so that you can be as expressive [or exploratory] as you will need to be."

When psychotherapy is based on the expressive model (i.e., the assumptions, premises and techniques of expressive therapy), the therapist only gives up as much neutrality as necessary. In the supportive therapy model, however, the therapist is no more neutral than necessary. My colleagues and I have proposed that instead of applying the expressive model to all but the most supportive end of the psychotherapy spectrum, the supportive model should be paramount in all but the most expressive treatment (Hellerstein et al., 1994).

The supportive component of expressive-supportive treatment entails being alert for opportunities to offer praise and encouragement, solicit feedback and explicitly define the agenda. Efforts to minimize or prevent anxiety are appropriate with most patients. At the middle of the psychotherapy spectrum, the therapist must determine for each patient whether to utilize transferential aspects of the relationship, or to keep it to himself or herself.

As the patient's condition and goals change, the role of expressive elements may become greater. At all times, however, therapy should be coherent and consistent. One does not make transference interpretations one day and not the next, or alternate between ignoring or challenging defenses. And although discovery of unconscious forces is not an objective when the supportive component is prominent, it is important that the therapist be aware of the ways that the unconscious process and transference can affect the patient, the therapist and the therapeutic relationship. Unconscious forces do not cause all the mental disorders once attributed to them, but they often determine the outcome of treatment.

In a nutshell more neutrality means no reassurance, comforting, affirmations, that sort of thing. They don't 'bend' to what you need, which causes all sorts of anxieties and heavy transference, which is one reason why you need to go twice a week. My T pushed me for over a year (years?) to go twice a week in order to do expressive therapy. It never happened and he eventually made the adjustments. Your T can too but seems to not want to.
I'm curious if you could ask him if he could be less rigid and incorporate some supportive concepts. That would be a win-win situation for you. If you go with a more supportive therapist, you won't get the benefits of expressive therapy of course.

I think the neutrality is the main difference. For more concrete comparison, basically take the methods of supportive therapy discussed in these articles and think of the opposite-that will tell you what expressive therapy is about. lol Some thing psychoanalysis is mysterious and complicated, but it really is that simple though I reached this conclusion only after years of my own 'research' and experience.