Is this guy really doing anything?

Hi all this is my first post on the board.

I have a very esteemed, high paid therapist trained at Harvard and Austin Riggs. He was referred by the NY Presbyterian Center for BPD. I honestly don't think he's really doing anything.

His only participation is a few offhanded observations that feel apropos of nothing. He says I'm one of the most therapy-resistant people he's seen since Austin Riggs and I really should be in a center like that but I could never afford it.

I'm paying him for a month what he normally gets for an hour of treatment, and his book is full, so he's not getting rich off me. I still feel like he's mailing it in, but he is VERY confident in his credentials and I don't know if I'm being "resistant" or we aren't a good match.

I like the guy and all....we can talk boating and Bowie for hours, but when it comes time for therapy talk I feel like I am just forcing to talk about something and he is largely disengaged.

Maybe he is playing a long game and this is all part of it. I am told it takes 2-3 years of this to get better. I don't trust my own judgment when it comes to this I've torn through most of my therapists and psychopharm people.

HOw do you all evaluate your therapist?

Thanks

Dear DiamondDog,

I am sorry this is happening. Wish I had something helpful to offer, but sadly I have rarely benefited much from therapy, [no disrespect to the fine and dedicated people who tried to help me.] Luckily for me I was able to be helped be reading books written by famous cognitive therapists and others. This is not advice for you or others though since I am an odd person. I really hope things get better for you. I'm sorry I could not be helpful to you. Hopefully others with more knowledge, experience and insight will see your post and have something that will be helpful to you.

Sincerely yours, Yao Wen

What are you waiting for?

I think good therapy is an outcome of a good match. Someone could have a degree from the greatest universities of the world and still be a poor match for a number of people. It's not the credentials, not the expertise, but the therapeutic relationship that is the most important in my experience.

If T says you're one of the most therapy-resistant clients T's met, and yet it feels like T is disengaged when you're poking at the heart of the matter, this is something that could be rewarding to talk about with him.

I find it a bit discouraging to read that T would say of anyone that client is therapy-resistant. Therapy is a 2 person enterprise. It feels like T disclaims his responsibility at this point. You are definitely not therapy-resistant as a person. At worst, you resist therapy with him.

I dont care where somone was educated or how well they were trained. He it takes an interested engaging people person to be a good therapist. If you dont have a connection and are not clicking then you should find another and move on. And what kind of therapist would tell someone they are the most resistant? That is unprofessional and unnecessary. I puts the blame on you. He is an asshole imo.

I agree with all of this. I'd suggest trying someone else.

I think telling any client they are therapy resistant is shaming and unprofessional and diminishes them of all responsibility. I have been told I’m resistant in the past. I definitely wasn’t I was just terrified of making myself vulnerable because the risk of getting hurt again was too much for me to bare. Any adept therapist would look at that scenario and say some of the responsibility fell to the therapist to ensure they created an environment for me to feel safe enough to drop some of the barriers that made me look like I was resistant. If they were incapable of making that happen then clearly the relationship just wasn’t a good match.
If I were you I would get away as quick as possible, as shaming a client like that is not acceptable no matter how good his credentials may be.

I certainly think I would try to find a new therapist. The credentials matter but not as much as the connection. If you don't have the connection, it's hard to trust. And to me, in my opinion, without the trust, it's hard to heal. Best of luck to you.

Credentials and whatever are nice, but it's more important that you feel comfortable and like you're making progress. Trying a different T sounds like a good option.

If you're in a therapy session, it is always time for therapy talk. What do you do when you feel like he's disengaged? Have you told him you don't feel like he's checked out and you're not making progress? Sometimes it helps to be really up front about it.

It's true that therapy can take years, depending on what your issues and goals are. But I would say you should see at least some benefit within a few months.

Another vote for a good match.
I’ve worked with two T’s that both got their PhDs from the same school and graduated 2 years apart... so should have had some of the same professors and requirements. T1 was very prescriptive, she was warm-ish but very direct. She was straight CBT. Yes, she got some of the symptoms to stop but TBH my life still sucked because of all the other impacts of trauma. She shrugged and said that was the best I could hope for. T2 is crazy warm and nurturing and he is having to undo some of what she did but it feels like real healing not a bandaid. We have a very close bond. So... credentials don’t always make a difference.

And, in my not so humble experience... calling a client “treatment resistant” is a BS cop out if you are voluntarily showing up to therapy (at least the majority of sessions... cancelations and occasional ghosting happens).

A month is way to early to assess the therapy, in my opinion. I wasn't at all sure that I particularly liked my therapist for the first few months. But the time passed and now I am so comfortable with her, and have progressed a lot.

Why the heck do you have to pay him so much, though?

Quote:

Originally Posted by BethRags A month is way to early to assess the therapy, in my opinion. I wasn't at all sure that I particularly liked my therapist for the first few months. But the time passed and now I am so comfortable with her, and have progressed a lot. Why the heck do you have to pay him so much, though?

Apparently it’s the “Harvard tax”. The more expensive the degree the more expensive the rate ?

IMO, I beleive you have done your own evaluation and reached an accurate and very honest, telling conclusion. I think your judgement is spot on. Learn to listen and trust those instincts; they are rarely incorrect.

Quote:

Originally Posted by sarahsweets Apparently it’s the “Harvard tax”. The more expensive the degree the more expensive the rate ?

Sheesh!!

DiamondDog, Therapy is for You and whatever therapist uses it should be done to your advantage or at least with honest intension to be used like that. I have no idea how telling someone that she/he is one of the most therapy-resistant people ever seen could be usefull in therapy. Personally, I had unpleasant feelings while reading it. I agree with BarefootBeach, but also I am not suprised You are asking for advice. The interaction between therapist and the person who seeks support is uncomparable to any relation we know, we also usually treat therapists differently that just any other "service providers". If I were You I would start at least looking for another therapist. Take care !

Thanks everyone for your thoughts! I haven't received any thread reply notification and have honestly been avoiding the issue, although I've told him I fear he's mailing it in, and that I have to wrestle important insight out of him. He still wants me in Austen Riggs, which I'm considering, because I don't know if I can do the work while I'm on my meds, and I can't really work or maintain relationships off the meds.

Quote:

Originally Posted by DiamondDog Thanks everyone for your thoughts! I haven't received any thread reply notification and have honestly been avoiding the issue, although I've told him I fear he's mailing it in, and that I have to wrestle important insight out of him. He still wants me in Austen Riggs, which I'm considering, because I don't know if I can do the work while I'm on my meds, and I can't really work or maintain relationships off the meds.

Does your therapist want you to go inpatient at Austin Riggs, or do an outpatient program?