[stopdog]

Do you have a concept of therapy appointments being productive or non-productive and can you tell a difference? Do you know what the difference is?

I never experienced an appointment I would have described as productive. When my person was sick and dying - the appointments has a use as a place to vent but I would not describe that as productive - just not completely useless (and even a therapist couldn't make that situation worse so there was that). Before my person got sick, appointments were completely pointless and some were horrible and pointless, while some were merely neutral and pointless- but I still do not have any comprehension of how anything that happened - even when I let the therapist speak - would have been productive.

Therapist: you don't like being humiliated
Me: no one likes being humiliated
Therapist: you don't like it more than most
Me: how do you know? Who are the most? Have you talked to the most
Therapist: No
Me: And so? What is the point of this?
Therapist: __________(nothing)
Me: (left frustrated because I have no idea what that meant)

Therapist: your mother was X
Me: I doubt it, but so what? What difference does that make even if it is true
Therapist: I don't know
Me (Homicidal)

Therapist: Most people who come here think I can help them.
Me: Poor misguided souls.
Therapist: You don't trust me
Me: You have not been trustworthy.
Therapist: Do you trust me?
Me: With what?
Therapist: What do you mean?
Me: I trust you will be at the appointment if you say you will, I trust you won't try and get more money than what I contracted for - that is about it.
Therapist: That is all?
Me: What else do you think you should be trusted in?
Therapist: I don't know.
Me: What is this about? Why are you talking about this?
Therapist: I don't know
Me: (frustrated rage)

[atisketatasket]

So one definition of productive might be when both parties leave the session alive?

Another is when Info says something insightful or useful to me--this does not happen often. I know it's happened several times, but the one that comes to mind is when she told me I didn't need to feel like I had to write every day, I should write when I felt like I had an idea (I was frustrated by following the write-every-day mantra but feeling like I wasn't engaged in the process when I did that). So that was productive in that it did help my writing.

[SoAn]

When it helps me realize something about myself (my assumptions, mostly), or the world, that I didn't realize before. Especially if it is something which explains why some things are difficult and painful for me, but don't necessarily have to be if I can somehow internalize/use whatever it is that I realised.
Also: when I can practice expressing emotions which I otherwise do not dare to express, for us to then analyze / explore them in the neutral way that is so safe about therapy.

The therapist responses you describe sound too vague to me, I would also be disappointed. Have you tried bringing up the concerns you bring up in your post? (Or switching therapists, if possible).

[ArtleyWilkins]

There were appointments where I left feeling less anxious/worried/overwhelmed (whatever adjective you want to put in there). That was a productive session.

There were appointments where I left with some clarity about a matter that I didn't have when I walked in. That was a productive session.

There were appointments where I left with a plan for something. That was a productive session.

[stopdog]

There were a few appointments where I did not leave more anxious, or with even less clarity, than when I went in but I never (literally it never happened) where I felt less anxious or had more clarity from when I went in.
I don't have any idea how talking to the woman would have lead to those things occurring. I believe you when you say they did for you - just that for me with a therapist - I don't see how it would have ever happened. It is like most people here are speaking in a completely different language than I am and I don't know why.
Even where I did not disagree with the woman or think she had simply not been paying attention with even a scintilla of understanding what I was trying to get at, I don't see how any of it was supposed to help me be less anxious etc.
I don't remember a time when I went in trying to get a plan for anything.

I do see that sort of thing could be considered productive - just that I never had that sort of thing occur.

[stopdog]

Originally Posted by atisketatasket

So one definition of productive might be when both parties leave the session alive?

Another is when Info says something insightful or useful to me--this does not happen often. I know it's happened several times, but the one that comes to mind is when she told me I didn't need to feel like I had to write every day, I should write when I felt like I had an idea (I was frustrated by following the write-every-day mantra but feeling like I wasn't engaged in the process when I did that). So that was productive in that it did help my writing.

I did want them to say insightful useful things.

The second one, who didn't usually piss me off as much as just cause me to shake my head - once she said I should use her as an excuse - She said I should say "My therapist said...." -I was flabbergasted at the sheer nonsensical and absurd idea that I was somehow looking to her for permission to do or not do anything compounded by the idea that I would tell another human I hired a therapist and then would actually say such a thing to the other person as an excuse. Why did she think using her her as an excuse would be a good thing? What had I done that would make her think I considered her "my therapist" or that I would somehow think invoking her profession carried weight of any sort? I was either going to do it or not do it and it had nothing to do with her. I still get worked up remembering that completely absurd exchange. Her words included the implication I thought of her in any possessive terms at all. When I told her all of that - she just blinked at me and told me I was hard to read. I was not hard to read -I specifically told her - no reading was involved. I told them in what I thought were small, easily comprehensible terms and they both still told me they found me hard to read.

[Amyjay]

I guess for me it's when I leave the session with a little more self-awareness and self-understanding than when I went in. Noting that this is a result of the work I do, not the T.

[LolaCabanna]

Perhaps by “hard to read” they actually mean hard to elicit an emotional response of which I can respond with confidence based on my training?

[maybeblue]

For me I think it depends what I need right then. Sometimes it is simply having another person understand that I am hurting. I don't necessarily think that she is going to change anything. I just want her to validate that hurt.

Sometimes though I do want them to say useful things, and I have had frustrating conversations very much like you describe. It's like they are speaking a whole other language or they are completely delusional. I remember once a therapist told me that to "fix" a trauma, I should turn it into a black and white movie in my head and then play it backwards while tapping on my arm...or something like that. And first I get stuck on why black and white? What is the purpose of that? Then I got pissed and for me pissed often looks exceptionally logical. So I asked him to provide me one placebo controlled research study that proved that was even a thing. Pretty soon that relationship evolved into him just sitting there and validating me when I was hurting and laughing at my jokes when I wasn't. He was good at that at least.

Occasionally though I do get a piece of potentially useful information or insight, but I'm often very angry about it before I actually understand it. Like "letting go of being right and focusing on being effective." I really, really like being right. It feels good, especially if the other person admits it. But I have to admit that I can be completely right about something and still not get what I want.

[Echos Myron redux]

A productive session is one where I am in the right frame of mind to try to figure some stuff out and T doesn't get in the way.

Productive: treatment goals met for the correct diagnosis.

Not productive:

Therapist speaks about her problems.
Therapist assumes, as opposed to asking and trusting your answer.
Therapist falls asleep, eats, answers the phone, or answers the door during session.
Therapist ends the session heavy, without deescalation.
Therapist accuses you of something you are not.
Therapist remains stoic.
Therapist talks too much.
Therapist talks too little.
Therapist does not explain.
Therapist infantilizes.
Therapist mistreats or misdiagnoses.
Therapist lacks consistency.

[Xynesthesia2]

Originally Posted by lillib

Productive: treatment goals met for the correct diagnosis.

This for me as well - taking the term "diagnosis" more broadly, because many of my issues were not things within the range of psych diagnoses. Some were, actually the biggest one definitely. It is productive if I experience/make changes in my everyday life that I wanted but somehow wasn't able/willing. And this is why I always feel therapy wasn't really useful for me - I did make changes in the context of my major goals eventually, but I am certain the majority were not due to being in therapy or even related to it much. Smaller good things, yes. I would describe my past therapy as something that had made quite moderately productive contributions.

[seoultous]

I think it is important to go into therapy with a clear goal. Suppose the goal is not to hate myself. If I left that session hating myself a little bit less because of the work done in session, then I would say therapy was productive.

I find therapy productive 85% of the time. That's good enough for me. I'm not always on my "A" game and I don't expect my therapist to always be on her's. I know that when I am at work I don't always have my "A" game on so I believe it unreasonable to expect that from others, including my therapist. I trust her (I have confidence in her) to guide me toward my goals.

Therapy does not help in all cases. My son who has Aspergers never finds therapy helpful. His black and white thinking style gets in the way of the work to be done simply because he doesn't think he has a problem. I respect his decision not to continue therapy because when he is there he doesn't see the point - it's not productive. Nothing the therapist could do or say would cause him to change his mind.

[Omers]

For me most sessions with current T have been productive.
1st session he was awesome at establishing safety which I desperately need. The next session he asked me to identify an emotion and I went into freeze mode which he very gently and easily brought me out of. So the second session he proved not only was he safe but he could manage my emotions/fear comfortably which was a huge relief and trust builder. We decided to have a “lite” session one week when he would be gone the following week and he showed me pictures on his phone of a project he was working on. While flipping through project pictures there was a random picture of him with his granddaughter which was the catalyst to a lot of progress between us. Sessions where he invites me out of my comfort zone and proves to be safe are productive sessions. Sessions when he creates the safe space for me to talk about trauma memories and put the little pieces together are productive sessions. Sessions where he can show me that the outside world *might* be a safer and more loving place than what I grew up believing are productive. Every session where he adds one more positive experience with a man to counter all the abusive ones are productive.
As for my Dx of autism (which is the excuse other T’s have used for their lack of progress with me) he believes I still deserve to live a healthier more whole life. His gentle exploration of my infancy and very early childhood have brought the autism Dx into question. He is confused by my suddenly questioning a Dx I have found helpful and validating for so long but he is happy to help me explore that option. But weather or not some of the challenges are connected to autism there are some productive sessions there. Helping me learn to identify emotions, express needs, helping me let go of the scripting I use for most interpersonal conversations...

[Mopey]

I always figured that if I felt terrible when I was going, and a lot better when I left, the session had been productive.

A productive session, to me, means finding your own sense of clarity. Uncertain how long a shadow can keep me from seeing my truth, knowing the light is out there somewhere makes me feel safe.

[missbella]

I thought I plumbed all sorts of "insights" from therapy, the meanness of my parents, the hurts, the slights, the unfairness of life. I felt I had such courage and mountains were moving

However none of this helped me function in the world better. I could only earn that through time, age and experience.

[BudFox]

Most of my sessions were pointless. Many were counter-productive... i left more tired, vaguely degraded, and my head full of intrusive and useless thoughts. It often took hours to unwind and settle this mental indigestion.

[susannahsays]

Sometimes my sessions are productive in a positive way and many times they are productive in a bad way.

[kaleidoscopeheart]

For me, productive sessions are ones where I leave with something to think about and eventually lead to change in my life. Sometimes these sessions look as simple as a conversation about something I am doing in my life or that I want to do, other times it looks like a rupture where I am encouraged to be assertive and stand up for myself with my T.

[WarmFuzzySocks]

I don’t know that I can tell about an individual session when I leave.

Sometimes I walk out feeling exhausted like I have worked hard and I feel I have accomplished a lot. But sometimes I walk out thinking, What was that??? or having whined the entire time. It’s not until later that I either realize I learned something or left with something important to work on...or I didn’t. Meh. I never know at the time. The cumulative impact seems positive so the endeavor as a whole is productive even if individual sessions aren’t always.

[HD7970GHZ]

Interesting thread! Thanks for posting this StopDog!

I would think that any successful therapy appointment ought to provide insight for the client. Not all therapy sessions with be fun or enjoyable, so I think it is important to first strip the idea that productive therapy appointment should elicit a positive reaction.

On the flip-side, if a therapy appointment brings about a negative reaction in a client, it is only ever productive in the client can find useful insight in that experience.

So I suppose in some way or another, a productive therapy appointment requires additional insight, however large or small that may be, and that in the end - if that insight is useless in allowing a client to make strides forward - it can then be labelled unproductive.

Thanks,
HD7970ghz

[Alioi]

The vagueness and misunderstanding is such a problem with psychotherapy. Should improve in time but doesn't necessarily.

I feel to be productive that needs to be openly discussed. And improved.

And that's just the first step, towards shared understanding, and then the problems you're there for have to actually be changed, which may require methods beyond 'talking therapy'. .

Easier said than done.