Follow up: talked to my T about not wanting to get better

Hi guys, I’m the one who made the post earlier this week called “don’t want to get better”. I brought this up to my therapist today. I talked about the resistance I have to continuing to work on my mental health. My T asked if I was saying I wanted to end therapy. I said I was thinking about it but wasn’t sure. She said I could if I wanted to and wasn’t sure why I was hesitant.

It was hard. I know I didn’t explain myself super well and didn’t go into it perfectly. It’s hard for me to really go there and get deep. Basically, this might be the end of our therapeutic relationship or the end for a while. She said that if I really didn’t want to do the work, there was no need for me to keep going. My symptoms have improved a bit. I decided afterward but I’m not wanting to stop going to therapy. However, I might want to go to a different therapist. Mostly because I just felt really uncomfortable with how our conversation went.

1 I felt a little abandoned and felt like I was really on trial for my feelings. This wasn’t really her fault just my past experiences coming up.
2 I think maybe she doesn’t want to continue to do therapy past the point where I desperately need it. So since I’m doing better even though I’m not 100% where I would like to be. Maybe she’s not as interested in continuing therapy. So I don’t know if I want to continue with her. In fact, I was thinking of bringing this up to her when I follow up and let her know where I’ve landed on continuing or discontinuing therapy.

I don’t know what else to say on it. It was a little heartbreaking but I don’t blame my therapist at all. I absolutely loved our sessions but I question if maybe she thinks we aren’t a great fit. I’ve had an inkling recently that maybe we aren’t. It’s been about 3 months total. Sorry this is jumbled, I’m having a hard day.

Erm, I would disagree and say that yes, it is her fault. She doesn't know her job properly. IF she had the proper training etc. she would (should) have known that it is fairly common for clients to 'resist' or not want to get well.

There are myriad reasons for this (and there was a perfect opportunity for her to explore with you what that was about - for you specifically) but in no way does it indicate that such clients no longer need therapy.

It seems like the therapy she does is very superficial. She took you literally, showing (for a T) a lack of knowledge of how the psyche works. So, it's not about you not 'explaining super well' but her being limited as a T & not going deeper when she was offered the opportunity to do so.

No wonder you feel heartbroken and abandoned. She completely missed you and what you were trying to say to her. It's on her, not you.

I’d say you’re probably not a great match, sometimes it can take a while to come to that realisation. You can like her as a person and still not benefit from her therapy style as much as you might with someone else.
I’ve also had periods of not wanting to get better, or more accurately forgetting why I started counselling. I can relate to the feelings of resistance and there can be many reasons for feeling that way.
I’m sorry you had a bad day, hopefully things will feel clearer for you later.

I agree with what the others said. It sounds like she just completely missed what you were trying to express. I'd suggest trying a different therapist.

Well that’s disappointing. She completely missed an opportunity to help you explore this. As others say resistance is common and any good therapist would want to explore that. I’m sorry.

Im in the other side of the coin on this. here in america the way our mental health system is set up ......now..... is that treatment providers are now held accountable for a clients progress or lack there of.

what that means is a therapist has to document things like the client and therapist setting goals, reason why they are in therapy, and actively working on those goals and or making some sort of progress with working on those goals. many states now have it set up that every so many months the treatment provider and client revisit why the client is in therapy, what they want to work on (what they want to do to help get better, goal setting and so forth).

example ... my therapist and I do goal setting every 6 months to a year. we review the present goals, whether I progressed in those goal during the previous 6 months and what problem areas I see that I have now and set new goals accordingly.

if a client goes in to therapy saying they dont want to get better the natural conclusion and response a therapist now has the option of saying / asking..is whether that person is ready to leave therapy.

example if i go in to one of my therapy sessions today and say to my therapist I dont want to get better.

her job standards is to say ok you want to end therapy right thats what you are saying because therapy is for working on your problems and making your life better, if you dont want to get better what you are saying to me is that its time to end therapy.

my therapist legally and job wise can not coerce, persuade, beg or other wise convince me to work to get better, nor do any therapy work. all she can do is tell me the facts. therapy is for getting better, therapy is for talking about problems and coming up with solutions for problems so that ones life is better.

if I dont want to do the therapy work, dont want to get better Im not going to do it whether I stay in therapy or not so its a waste of insurance money, waste of my money waste of my time, the therapists time, gas/ transportation and so forth. and someone else somewhere who really does want to get better is waiting somewhere with out a therapist on some waiting list.

my point is if I ever felt I was not wanting to get better and didnt want to do therapy work of working on my problems. my therapists response would be the same as above. they would offer to stop therapy until I was ready to get back to work. with no begging, pleading or deep conversations about my not wanting to get better,

what is it they say in AA if your not ready to give up the bottle dont we are here when you are ready, we cant make you give up the bottle.

they say the same thing in NA and in mental health therapy.

if your not wanting to get better your not ready and nothing anyone can do to change that, then they say good by and see you if and when you come back.

welcome to the new mental health system of waiting lists and not alot of time to waste on convincing clients to work to get better.

my suggestion is take a break from therapy and then go back when you feel you are ready to get back to work on getting better.

I have taken many breaks in therapy over the years. it gave me the time I needed to decide important things like why did I want to be in therapy and what my therapy goals would be.

It makes sense that maybe she can’t convince me to keep doing therapy or maybe she has a policy against it. I think in the moment I just needed some encouragement that I could work through the really hard stuff. I didn’t say this obviously because I didn’t think of it yet. Not sure how to proceed going forward but that makes sense.

Thank you. It sucks that with therapy if you’re not a good fit you just never see or talk to the person again. I hadn’t come to the point of being okay with never seeing my therapist again even if I noticed that we might not be a fit. I think I will try some other therapists to see if there’s a better fit for me out there.

I do think there's a general ethical policy that if a client wants to leave therapy or switch therapists, the therapist shouldn't "chase" them. Like if they said, "You need to keep working with me in order to get better." Because therapists are paid for their work, trying to convince a client to stay could seem like they're just trying to get money from them, for example.

However, from what you said, it didn't seem like you were saying you wanted to leave therapy. It seemed like she sort of put the words in your mouth, after you mentioned your resistance, then you went along with it. It seems odd to me that she questioned your hesitancy, too--I would also think that hesitancy to leave or indecisiveness about leaving is a very common thing in therapy. Out of curiosity, how many years has your therapist been in practice?

As I mentioned in my other comment, I do think trying another therapist would be a good idea. If you think you might want to work with this one more, then I'd tell her what you said here, how you think it's not that you want to end therapy, but that you need some encouragement to work through the hard stuff.

I'm not sure where you are; this is not how my therapy has gone. I'm in USA. And I use insurance.

If I was to bring up feelings of not wanting to get better, as I have in the past, we'd be curious as to why that is at this moment. What part is feeling that, what my fears are, how I imagine being better would be like and so on. My T would not immediately jump to the thought that I wasn't working on getting better. She'd probably even see the fact that I brought up that feeling/though as a sign of getting better; being more open with her about my fears.

I do periodically bring up how I feel in terms of progress or stagnation - so in a way we do talk about goals. It is not so formal nor does discussing any of it immediately change the course of my therapy/treatment.

In fact there was a period of time in my therapy that we took a break from therapizing without taking a break from seeing each other. It was after a rupture and we both knew that if I stopped going, I wouldn't return as that is my pattern. I didn't want to lose my connection to her; but I needed a break from having my every thought, feeling, action, ... analyzed. For 6 weeks I went to session and we did jig saw puzzles. I tried to talk sooner and it didn't go well, so we waited until it felt right for me.

I'm not sure I completely understand the 3 months here - have you been seeing this T for only 3 months or have you been having the thoughts about not wanting to get better for 3ish months?

Her response does seem a bit black/white. I can see how her response would bring up feelings of disappointment and abandonment. It sounds like you had some thought/wishes that her response to your statement would be met with some type of encouraging to continue, a welcoming to her space so to say. Maybe some type of warmth - that may have led to feeling cared for, wanted... or something along those lines. It's understandable that not receiving something along those lines would hurt and be confusing.

I think what you've said here is really good stuff to bring up in therapy - letting her know that you do want to continue with therapy and how her response felt. There's lots of maybe's as to why you might be fearing or thinking about not wanting to get better and those are some really powerful things to explore, as is the feelings/thoughts that came up from her response.

The thought/feeling is not the doing - as my T often told me early on, thoughts are thoughts, feelings are feelings and we are humans that have thoughts and feel things. So, the fact that you brought up your thought/feeling about not wanting to get better is actually doing some of the deeper work that you say you struggle with - it is the doing. It's a shame that your T didn't recognize how open you were being with her when you shared that and doesn't/didn't see it as being curious as to some of your inner world. It is possible that her question/comment about you being hesitant was her way to try to explore if you were saying you wanted to quit or if you were saying, hey I'm having this feeling/thought, can we explore it. I have gotten better with my T about saying qualifiers around my thought/feelings.. saying something like -- I've been thinking about something and I'd like us to talk about the thoughts without us/T doing anything about it or with it.

There maybe another element to this exchange at play and that is your T's modality of practice. If your T is more solutions focused or skill building focused; she might be limited in the way she practices therapy. And like some other's have stated, there is an element of not 'chasing' the client and the client has to want to be there. I'm not sure you were saying that you didn't want to be there. I think your statements were around the realization that changing meant something was going to be different - loss and gains, uncertainties.... that getting better means changing/being different in some way.

Good luck with how you choose to handle this experience.

This isn't a universal truth. I'm also in the US and I recently expressed some reluctance about getting better to my therapist. Not once did he assume I wanted to or suggest quitting therapy. If he had suggested it, it would have caused a rupture. We did have a deep conversation about my feelings about not wanting to get better. He told me my feelings were normal and that it was important to talk about them when they came up. I'm only commenting to show that there are therapists that won't take this approach.

I tend to go with amandalouise. In my experience, she is correct. Also in my experience, if a client actually says to a therapist, "I am thinking about quitting therapy" the therapist may encourage the client to reconsider, and might explore reasons why the client is displeased with the therapy. But if the client says, "I am not interested in doing the work and I want to quit therapy" the therapist will not resist the client's wishes. They might express concerns about whether the client has a support system if they quite therapy, but they will not beg you to stay. Actually, I had a group therapist who did beg a client to stay when the client voiced her plan to quit the group...it was creepy, like the therapist was a cult leader. If a client says she does not want to make changes and wants to leave therapy, a considerate T respects that.

Interesting. Since it’s been mentioned a few times I’m in the US but don’t use insurance. My therapist offered a sliding scale and I pay at the low end of the scale.

I think the approach was sort of ‘you don’t have to force yourself to be in therapy if you don’t want to.” And only in having that conversation did I realize I really did want to stay. As someone else mentioned it was more like she brought up leaving and I went along with it. I have social anxiety so it’s really hard for me to feel like I belong somewhere and like everyone doesn’t hate me. I guess that’s why this conversation sent me spiraling about whether or not she wanted me to leave therapy and that’s why it went this way.

We did plan to email later on this month so maybe we could talk about it then. I wouldn’t really feel comfortable continuing therapy without addressing this I guess but starting over with someone new would also be hard.

I wonder if the therapist was using a technique that backfired. The technique is that the client says they’re ambivalent, let’s say about quitting smoking, the therapist says “why don’t you just keep smoking?”

This is meant to prompt the client to list the reasons why they prefer to quit smoking. So then the client is convincing themself rather than listening to the therapist say why smoking bad and arguing with therapist that quitting is too hard.

It’s too crude a tool IMHO for something like “I feel ambivalent about mental health recovery.” In my opinion, a more skillful response is not to question whether the client wants to continue therapy (especially not the first time they bring it up in month 3 of therapy!) but to just listen and try to understand what they they mean and where this is coming from.

It sounds like this therapist missed an opportunity to explore what role (mental) illness has played in your life, what role you played in your family because of it, what skills you did or did not develop because of it etc.

Change is hard and feeling ambivalent about it seems pretty understandable.