Are all psychodynamic therapists impersonal and emotionally distant?

I don't think I would describe the one I see as impersonal and emotionally distant. She is psychodynamic. She doesn't fall all over herself to be warm as a default. I have experienced her as cold at times, but it usually doesn't bother me. A few times it has. We don't really do small talk at the beginning. She does smile (I think) when she gets me from the waiting area. When we first started talking, there was definitely no warmth. I tend to be very emotionally distant, so I guess I might not be the best person to identify that in others.

However, I get the feeling that what I want in a therapist is different from what you want. Neither of us is wrong, of course. Since you are stuck with this therapist, maybe there are things you can find to appreciate about her in spite of the ways she doesn't meet your expectations. I do this sometimes with people to alleviate the stress that disliking somebody I have to interact with causes. For example, my roommate does many things that I find hard to deal with. She never takes the initiative to send me her half of rent and utilities (I always have to prompt her to pay and it feels like pulling teeth), likes to blast the heat and minimize the AC, insists that I can't be in common areas when she's trying to sleep (it's not like I'm popping popcorn or vacuuming, just opening the refrigerator is more than she can tolerate), and she has a tendency towards passive aggressive behavior.

If I only looked at the things she does that I dislike, I'd be very miserable living with her. So I try to find things to appreciate that help offset the negatives. She allows me to sit dogs at our apartment, which is huge. I desperately need that money, so I really appreciate this about her. I once accidentally ate something that was hers, thinking it was mine, and she was really nice about it. I also try to have sympathy for her because I don't think she's a very happy person a lot of the time, and she's living far away from her family.

Anyway, my point is that sometimes it can be helpful to try to find positives even among the negatives when we are stuck in a situation. Of course, you aren't stuck with this therapist absolutely, but you are if you want therapy. Maybe if you stick with her for a bit, you'll be able to find things you do like about her.

Hi SarahSweden,

Thank you for sharing this.

I think it's important to listen to your own intuition. If you truly believe this therapist is not the right fit, better to find someone else than try to get her to understand and go somewhere she is unwilling to go. Especially if she is under the assumption that treating everyone through a psycho-dynamic lens is and can be effective.

The therapist I am seeing right now is EXTREMELY similar. I don't particularly feel liked by her. I've struggled a lot with her approach and I have been very open about it. Her boundaries are too rigid because it makes me feel that she doesn't care - but she is also keeping me from becoming too attached - and THAT (becoming unhealthily attached) is far worse in my opinion. I have left sessions wanting to rage about the situation - it feels far too similar to my own mother's inconsistent attachment style. In this way it is traumatic and in my opinion - wholly ineffective for those with trauma / unmet attachment needs.

What matters is what works for you. If you need someone who comes across as being more empathic, gentle and compassionate - and your therapist is unwilling to facilitate you - then ask for a referral and never look back. I know it is hard (because I do this) but if you truly need a referral - don't feel badly about your current therapist. A lot of what makes a good fit is beyond our control, sometimes it is a matter of personality and or age, gender, temperament - and in this case it would be therapeutic modality / style.

I hope you find what you need.

Thanks,
HD7970ghz

Maybe the last statement IS the problem? I would certainly like it if people would say, heres the keys to a Cadillac. Heres the keys to a penthouse. Heres the keys to a yacht. Heres the keys to a husband... (im not TOTALLY materialistic!)

Seriously, what is life about, what is happiness about? Getting what you want, wanting what you have, freedom, not being tortured by those near you.

This is a good point (credit goes to Xynesthesia, I know!) I was just telling T Thursday that as much as I hated his giving feedback and suggesting how others might be reacting to me at first, as opposed to just supporting and validating everything I said, I realize that it's ultimately helped me make progress. Because he's challenging me to think more about how what I say and do affect people (and affect me). He seemed genuinely pleased, and I imagine it was a struggle for him to not be like, "See! Told you!" For a long time, I just wanted ex-MC's warm fuzziness, acceptance, and validation from T. But I also think, while it felt good at the time, it kept me from making much progress beyond a certain point.

That being said, my T, while not as outwardly "warm and fuzzy," is pretty caring and personable. He'll ask me how I'm doing when I sit down, how my weekend was, etc. He shows interest and caring about how I'm doing and even how my friends and family are doing. He'll joke with me. He'll comment on something I'm wearing (like notice that it's a new shirt). He shakes my hand and will tell me to have a good week or weekend (well, sometimes just "Good luck out there") when I leave. I need those more personable elements to balance out some of his more blunt, feedback-oriented therapeutic style.

I'm someone who needs to feel a good rapport and connection with my T. Sarah, I get the sense you are as well. This T might just be the wrong style/personality for you. At the same time, my T has seemed much warmer to me as time has gone by. I had a very different impression of him the first month or two of therapy compared to now. So it could be you just need a little more time to feel more connected and adjust to each other? Does she seem open to feedback at all? Even if she'd just be willing to start a session with "So how are you today?" Or even, "What do you want to talk about?" rather than silence?

I don't see each of these things in your last sentence as being internally consistent. Getting what you want is good; making people kowtow to you by insisting they must engage in particular kinds of small talk and ask you questions about your ride to therapy doesn't fit that.

I'm all for freedom and not being tortured. But if you want the other person on the other side of a relationship to just say and do what you want, maybe a robot you can program for this would be more useful. To me a good relationship is one where both parties get to say and do what they want and can freely choose whether to do what the other person asks. To me torture is having someone demand that I must say or do X or Y or whatever. I like being able to give other people what they want but not at the cost of me sacrificing my independence or autonomy. If I can only be in a relationship as long as I do what the other person wants, then I don't want that for sure.

Hi Sarah,

I'm sorry you're struggling so much, and I'm sure it must feel difficult, waiting so long for the referral and then realizing that this T is not what you expected.

Still, even though she doesn't do smalltalk or seems to be distant, she still could be a good fit for you and your problems.

Over the last year or so I realized that my (psychodynamic) T not accommodating my wishes (for instance with regard to emailing) in fact shows a greater level of caring for my wellbeing than instant gratification would.

Her being firm within her method seemed rigid to me at first. And I started to test her and to test her boundaries. Quite a lot. And we had a lot of discussions about this. And I kept telling her, that to me it seems as if she didn't care. She kept insisting, that in fact she does care. But that her caring for me (as a patient) might show in different ways than I'm expecting. And maybe what I perceive as caring might not be caring after all? She kept saying, why should she engage in all those arguments with me, if she didn't care? In fact, simply accommodating my wishes would be much easier and less stressful for her...

But then she would rob me of important oppotunities of learning new things, firstly within the therapeutic relationship, and later on hopefully, outside in the "real world"...

It's a bit like parents and kids and sweets. Is a parent, who lets their kid eat sweets whenever the kids want some, caring? I wouldn't think so. In fact, the parents' care shows in the fact that they are willing to engage with their kids about those issues, to go through the fits and fights when they withhold the sweets, even if it is more complicated and definitely more difficult. But by denying the sweets they give their kids so much more in terms of healthy eating habits (hopefully....)

So maybe you could try and look at it from this perspective? That this T by not doing the small talk at the beginning /end might actually give you a real opportunity to grow?

Talk to her. about this. You started already by saying that you don't like her. (which is brave, like octoberful (?) said). You could start exploring with her, why you have this strong wish that she talked to you about those everyday things at the beginning of a session. Which doesn't mean that she will do it. But you might start to understand why it is so important to you and why you think that you really need this in order to form a relationship with this T. You might start to understand where this need is coming from which might help you to change some of your patterns...

I understand that this is really difficult for you. But don't chuck this T out with the bathwater. Talk to her about the fact that you find it difficult. Not in order to coerce her into doing the things that you want her to do. But in order to find out why this happens to you. Why the fact that she doesn't do those "little" things makes her uncaring in your eyes.

And I reiterate: Her not doing those things might show a greater level of her caring for your than you might be able to imagine right now. It's a paradox, somehow. And I'm still trying myself to get my head wrapped around this. But do give yourself a chance to find out. Please.

Much love, c_r

(edit: typo)

I'm not really answering the quote but continuing with a thought that came when I read it.

To my mind to be effective, the therapist absolutely must be and stay autonomous and not let the patient to dominate over his mind. Doing and saying what the patient asks would be submitting and probably in most cases would do no service to anyone. The therapy, i.e. the process of the patient changing, would probably stop and be replaced by something else that perhaps feels good but most likely does not lead anywher.

Anne - i think thats what i meant. "Seriously" indicated a change in tone from the preceding statement. Im asking what sarah wants that she doesnt have, and that she is hiding? transferring to these disagreements with her ts.

Sorry for missing that. I see what you're saying. I think I'm focusing on different aspects of the issue. I don't think it's healthy to insist that others do things just this precise rigid way or it means they are "bad" in some way. I think being less rigid about what therapists must do, that there is only one way to build rapport (which I think is easy, actually), and being open to experiencing someone caring for you in ways you might not expect, might be a good thing.

This, and what i bolded of yours below, are exactly it. Who died and made Sarah god? Sorry, i cant help myself!

Wow. And not the good kind
_________________________

To me, the problem here is lack of choice. I think one shouldn't deal with one of those guys who doesn't work the way you want. And it is fine to want a specific sort. The OP says there is no choice in who she hires. I would choose no therapist over a bad one or one who was selling what I did not want to buy.
The whole therapist as parent thing absolutely creeps me out and is not a model I would buy.

Except that i dont mean just ts. Like octoberful, i am talking about life in general. The difference between you and sarah is that you are functioning in life in general, with a career and friends and hobbies. Idk. Ok. Im out.

I hope all this input is helpful to you Sarah.

I think Ts who practice from a more neutral stance allow the client to find ways to connect, to access or express new parts of yourself as you get to know yourself. That goes back to what another poster said about creating your own therapy or content. It can be more meaningful that way because the therapy becomes about your meaning of your thoughts and feelings and who you are rather than who you are with the influence of another. It took me a while to establish a connection with my T as he seemed distant from me at first, too. We have a very good relationship now and I have a good therapy. It can be healthy and rewarding to allow a relationship to grow organically. Give it a chance.

Another thought I had Sarah was you trusted this T enough to tell her about your inner world and honestly how you feel. Or is that not trust? Sometimes they need to maintain a tough exterior otherwise, they could be too affected considering she works in an area with more complex clients than yourself. Think about a person who has a physical trauma and goes to the ER. The nurses and doctors may remove your clothes abruptly and say sternly move to the side, lift your leg, or move you with no warning, etc., in an emergency situation to get you what you need. If they were anxious around you or overly sensitive to your feelings talking you through each step carefully, you wouldn't get what you needed in an emergency situation. While this isn't an emergency situation, it's possible T may be trying to give you what you need. A T might need to keep some distance to contain anger, and that can be helpful in the long run. I'm not sure a T more easily influenced or prone to absorbing anger would be beneficial. These kind of Ts are usually good at containing negative feelings, and the containment can go a long way as it will enable you to get through it and get to a new place. Just some thoughts.

My psychodynamic T disconcerted me at first, but over time we've developed our own private language . She should be mirroring you, and building trust with you now.

Yes, hit and run. Don't stay around to elaborate on your ideas or to (try to) defend them against contrary ideas. Don't "fight" -- that's the general approach that therapists, mostly people who seem to be conflict-avoidant, too, are pushing on the general public these days. And therapists are our society's "experts" in human relationships, so. . .

That's the general approach on PC, too, which I respect for the most part.

But conflict is a part of human life and relationships, and just avoiding doesn't seem to me that healthy, certainly not in the long term. Sarah pointed out one positive factor, to her, about the therapist:

I never had a successful therapy, perhaps because I never found, and didn't know to begin with that I needed, a therapist who could tolerate conflict with me.

So, Sarah, if you're still reading the comments on here, maybe that is ONE thing positive enough about the therapist to continue -- if she is willing to continue, since she said she doesn't know why you were referred? Maybe it could be something like SalingerEsme suggested:

Maybe accepting conflict with you could be a form of building trust? Or maybe not, I don't know.

Thanks. At the moment I´m only seeing her for evaluation sessions, four times. I have two sessions left. I was referred to her clinic after I´ve seen several psychiatric nurses and other staff at a clinic for depression and anxiety disorders and they don´t offer psychotherapy. By that I was sent to this therapist.

Thanks. I was sent there as they don´t offer psychotherapy at the clinic I was at before. I don´t think I have a more complex diagnosis as I have went through a more thorough evaluation a year ago where they tested me for diagnoses like ADHD and autism and they didn´t find anything.

I haven´t seen my psychiatric nurse in a while but as those two clinics are separate it´s not much she can do about the situation. The referall seemed to be the only valid choice but after meeting with this new therapist there seem to be some miscommunication between those two clinics.

I think when the premise is that a problem caused by therapy should be the content of therapy, one should be very skeptical. Starts to look like a form of racketeering.

Also, if the goal is to avoid unhealthy situations and retain some self-respect, i think it's more prudent to walk away from something that feels degrading or unnatural, than it is to continue based on intellectual rationalizations.

Thanks. I think it´s good a T can withstand negative feelings from a client but if most of the session consists of me having negative feelings towards her it just creates an unpleasant atmosphere.

I´m going to try to see her for those four evaluation sessions that are already scheduled. I told her last time that I didn´t feel support from her but at the same time I said to her I know those first sessions are more of an interview.

I don't really see therapy as something that needs to have a pleasant atmosphere. It's not a tea party or some other social engagement.

If the therapist prioritized a pleasant atmosphere, for me, that would send the message that my "unpleasant" feelings and thoughts are something I should keep to myself. I would hesitate to bring anything "negative" into the space.

I value that the therapist, who is psychodynamic, does not make me feel like I'm on a social call where it would be inappropriate to engage in conflict.

Thanks. Yes, as you say I also think there has to be some kind of relating besides just focusing on issues and problems. I think my new T is the kind of T that thinks frustrating the client is the way to healing and I don´t agree on that.

There´s no clinic where you can get a long-term psychotherapy within public health care based on a depression and anxiety diagnosis only. There seems to be some kind of miscommunication between the two clinics, my former and this current where this new T works. I don´t know what they´ll do with me next as me and this new T probably won´t continue together and at the former clinic they don´t offer psychotherapy, just brief counselling.

I liked what you wrote @Xynesthesia2 because it highlights for me how people differ in how emotionally demonstrative they are. It's not just "it feels wrong", it's "people differ in their personalities so there is no one size fits all psychotherapy". I didn't know that about therapists, really.

I think that there can be valid reasons for not wanting to do therapy with an emotionally undemonstrative or disengaged helper. I suffered a traumatising education for 7 years as a result of being fast-tracked to an elite school. The teachers all saw me as "different" from their normal intake and hence my simple presence was a nuisance to them. As a result of this on top of my family history of violence I became completely unable to use words. Expressive speech had been taken away because my social origin didn't match the dominant behaviour.

Until I met a therapist who "got" my social origin, I was never going to be able to speak coherently about myself again. Someone had to reconnect for me what was completely and utterly broken.

You can't do that work of reconnection as an analytic observer: you have to model the connection.

Horses for courses.

On the other hand you can't be oversensitive about any situation in life. Have to persevere when stuff is difficult.

I can understand your wanting some social chats, sorta leading up to a deeper talk or even sharing...I felt the same with a therapist in 2018 to present. Much of this has to do with professional ethics and boundary's set by the profession as well as the individual. I think it may help to see some of the articles in the "Psychcentral Psychology" section, searching for articles like "boundaries" here and even general searches on Wikipedia google, etc brings up some great reading and understanding.

Give the weather a chance...one day it may be so bad that it would be impossible to not at least acknowledge a thunderstorm.

I think engaging in social greetings has nothing to do with the type of therapy being provided. I have met many psychodynamic therapists that greet clients and make small remarks about things. Maybe this is her personality. She may just be very, very task oriented. But, I didn't like her statement about your case not being complex because you have anxiety and depression. It sounds rather dismissive (I can't think of another word).