[KLL85]

In my search for a new T, I’m trying to weigh up whether I should try a different theoretical approach to what I’ve had in the past.
My experience is with person centred therapy, I really need the empathic, compassionate and non judgmental approach but found that it seemed to lack guidance and progress as the sessions were completely dictated by me when perhaps it would have been better for the T to say how about we talk about this today? Plus the fact that person centred Ts don’t believe in dealing with transference which is a big issue for me.
I’m debating trying psychodynamic as I know a lot of my problems stem from childhood but I’m worried about there being a lack of empathy and compassion which would then mean I would struggle to trust.
So I guess I’m just looking for experiences and thoughts on the different styles of therapy to help me make up my mind. Anyone had a really empathic and understanding psychodynamic T or is it all about them being a blank state with no emotion?

[zoiecat]

My T is very empathetic, compassionate and non judgmental but he is also progress driven. He will let me lead the session to an extent a a long as we are working on ways for me to progress and get better. He will not allow me to come in and gripe about my week or my day unless I am telling him how it makes me feel and then we have to work on those feelings and coping mechanisms or ways to better deal with the situation at hand. He will not allow me to come in session after session just for support. He believes that allow me to come in and gripe about my week or my day unless I am telling him how it makes me feel and then we have to work on those feelings and coping mechanisms or ways to better deal with the situation at hand. He will not allow me to come in session after session just for support. He believes that allowing that type of behavior does not help clients improve and it's unethical so if a client does not make any progress or improvements within one year he will refer them.

All of my problems come from childhood I have a history of extreme abuse and neglect. My therapist also does EMDR which we work on regularly with sessions interspersed with CBT and DBT skills.

Occasionally I do have a session where we just talk back and forth but he is still providing alternatives and suggestions for how to better deal with my feelings and he is constantly asking how does that make me feel and where is that in my body blah blah blah I hate it but he seems to feel it's very important.

I guess what I'm saying is I don't think you need to go to psychodynamic just to deal with issues from childhood. You also don't have to go to the Other Extreme with a warm-and-fuzzy therapist that doesn't help you progress. There are therapists out there that provides the compassion but are still progress oriented I guess that would be something to ask during the interview.

[Elio]

My T is also very empathetic, compassionate, non judgmental and I lead the sessions completely. Which from your description would mean that we are following a person centered approach. At the same time, a large portion of our sessions is dealing with my transference; thus more psychodynamic based on your description. My T is in a psychodynamic training program. She is a pretty blank slate as it comes to talking about herself, her life, and her feelings/thoughts/opinions about her personal life. She is open with sharing if she feels it would be therapeutic. It is a different type of sharing and hard to describe. I have no doubts that she cares about me and loves me. Due to her psychodynamic nature, she sees progress differently. She does not believe it is linear and is willing to take a more global view of what progress maybe. For example, I've been going through a very stressful period of time in my life. I used to boost my AD from time to time to deal with the overwhelming feelings of sadness. I've managed to get through this period without taking an additional AD. When we talked about it, she saw that as an act of lowering my AD dosage, which is progress for her. There's other things and she's able to see changes in my overall mood, the way I talk, what I talk about as progress. She's not so caught up in behaviorism type changes (such as seeing my decrease in exercise as set backs or my increase in social activities as progress).

I think the whole psychodynamic modality is a bit more flexible than it might seem; however, a specific therapist might not be that flexible regardless of modality. It might be more important that you understand what you feel you need from the relationship and talk about that during the interview. It seems how one defines progress, how they see their role in your progress, how they handle stagnation in progress might be good things to discuss early on as they seem to be important topics for you. Also, since you've been around the block some, you might want to find out how they deal with transference up front and how you'd like it dealt with.

[maybeblue]

I have discovered that I have made a ton of progress with DBT. I like the type of therapist who lets me talk about whatever I want but I have to admit that I have made more improvement with the more directive kind. Being empathetic and validating is completely non-negotiable. I think that you have to like the therapist. For me that is a necessary but not sufficient requirement. Maybe see if you can get phone consultations with a few. Often therapists in private practice and some clinics will do that for free. You can tell a lot on the phone.

[Omers]

I think the personality of the T has more to do with how therapy goes than their training does. I have worked with two different T’s (one on the east coas and one in the Midwest. They do not know eachother) that both earned their PhDs at the same exact school 3 years apart. Both have about 35 years of experience and are licensed psychologists in their state.

T1 specialized in trauma and did a lot of CBT based work. They were able to help me with symptom management but did not feel that it was possible for me to experience any deeper level of healing. They were very directive and prescriptive in their approach but warm. I did feel a connection and some level of trust. In a bit over 2 years of working with them I did manage to have significantly better control over flashbacks and body memories but continued other unconscious negative patterns. There was never any discussion of transference even though there was some of it that I would have benefited from discussing with them.

T2 is my current T... AKA awesome T. Graduated from the same exact school three years after T1 with their PhD. They provide psychotherapy to individuals, couples and families and see all age ranges but mostly adults. They have extensive training (continuing education) in group therapy (if they specialized this would be it as it is their favorite), psychodrama, and experiential therapy. They are much more interested in my feelings and are very eager and optimistic that they can help me achieve a much deeper level of healing. There has been some transference in this relationship which we talk very openly and freely about. T has been able to both be very structured and directive when I didn’t know what to do or when I don’t feel safe enough. When I have something I want/need to do T steps back and let’s me run with it. He will offer ideas from his trainings of options I may not have thought of. T is incredibly kind, compassionate and nurturing with IMO appropriate boundaries.

Again, both came out of the same school and both are state licensed psychologists and members of the American Psychological Association. How they treat me is night and day different.

[Salmon77]

I have a psychodynamic T who is empathetic and compassionate, enough for me anyway, but I wouldn't say there's a lot of structure or guidance. I always have to talk first, I mostly choose what to talk about. So I don't think psychodynamic is necessarily what you'd be looking for. On the other hand, as someone said, it probably has more to do with the individual T than it does the theoretical stuff.

[LonesomeTonight]

I agree with Omers that so much of it depends on the T themselves--their personality, how they choose to practice, etc. My T has mentioned studies showing it's more the strength of the therapeutic relationship than the specific modality that determines success in therapy.


My ex-marriage counselor was a PhD who was pyschodynamically trained, but he didn't believe in the "blank slate" thing and shared quite a bit about himself. He was also very warm and caring (current T, who used to work with him, says he's "squishy"). Current T lists his methodology as "eclectic" (mixes stuff like CBT, mindfulness, some training from different types of marriage counseling, etc.). And I thought I wanted someone warm and fuzzy like ex-MC. As T would say, he's caring, but not warm and fuzzy, which is something I miss at times. He's more boundaried (doesn't disclose much about himself) and progress-oriented. However, I feel I've made considerable progress with him because he will push me on things, such as examining my role in, say, an argument with my husband. There are times when he pushes me too much, or gives "feedback" (his word) when what I just need at times is support and/or reassurance. So we've had a few conflicts. But I've given him my own feedback and times when he's helped and times he's missed the mark, and he has, over time, generally adapted to my needs.

So, I guess what I'm saying is, don't go by therapeutic orientation alone. I think sometimes you have to see what a T is like in person, probably over more than one session (as first session is often intake), unless in your very first meeting (or initial phone call, if they offer that), you're like, "Nope!" (Which has happened with me.) I find it can also be helpful to look at the T's website, if they have one, to see how they present themselves.

[Omers]

I definitely agree with the website. My T did a weekly blog for a while which he had stopped by the time I called. The blog was SO helpful though. It got me past my fears from the phone call and my fears about his training which I found very intimidating.

[Lonelyinmyheart]

My first T came from a psychodynamic stance. She was one of the most kind, warm and affectionate Ts I've ever known. She didn't say much at all about herself though, barring things like where she was going on holiday (as it helped me to get a physical sense of where she was) and other snippets. Nothing about her family, but I never wondered about them. I was very young on seeing her, and it never occurred to me that she had a life outside of where I saw her. Much like I never saw my teachers having a life either.

It IS much more about the T's personality. The very last way I'd describe my ex T is blank slate, yet she was very much psychodynamic. She didn't give much away...and yet she was completely in the room with me in every moment. She was just a lovely person. If a T isn't good with emotions full stop, they are much more likely to hold back with you.

Actually, I think that modality matters a lot. CBT would never suit my needs, regardless of the therapist's personality. The difference between specific therapies within a general field (e.g. those covered by the umbrella of humanistic therapies) are probably less important, but still significant I would think. Psychodynamic is very different from Gestalt and somatic psychotherapy is totally different again. Whilst the warmth of a therapist and the relationship you build with them is undoubtedly valuable, their approach to the relationship will be informed by their modality training and is relevant in the therapy room.

[starfishing]

My current therapist practices psychodynamically/psychoanalytically and is incredibly empathetic, compassionate, non-judgmental, and supportive. They're definitely not mutually exclusive. It's a modality that really works for me, and that's been very well suited to the fact that I find it extremely difficult to trust therapists.

[stopdog]

I don't think it much matters what sort they claim to do - if you look on Psych today at their lists of therapists - some of them claim to practice everything. I think they mostly make up what they do and when pressed -come up with some answer to justify what ever it is that they did. I would suggest finding one you can tolerate long enough to sit in a room with them for 50 minutes.

[susannahsays]

Psychodynamic definitely isn't directive, so if sessions being led/dictated by you is something you don't want, it probably won't be a good fit.