Therapist is unsure if he can work with me

So I'm not gonna bash him. Tbh, there's something very wrong with me. We had our third session on tuesday and since I told him some stuff about me I usually keep to myself the session before that he was surprisingly forward about his doubts.

He has diagnosed me with personality disorder NOS (not otherwise specified) and panic disorder.

I do need someone to monitor me and I suggested he tell me what I can do to make him feel securer around me. Wondering if anyone here has encountered this before and what you and your T did to accomodate the T's understandable doubts?

So far I've got:
-(on his request) Create rating scales for my main issues to be able to rate myself on them and for him to have some frame of reference.
-propose that he may pick someone and I would lift the privacy issues so he can talk freely to that person.

...any advice would be greatly appreciated. Please note his reaction is not at all negative in my opinion. Rather, I am glad he is so forward about his doubts.

Quote:

Originally Posted by AliceKate So I'm not gonna bash him. Tbh, there's something very wrong with me. We had our third session on tuesday and since I told him some stuff about me I usually keep to myself the session before that he was surprisingly forward about his doubts. He has diagnosed me with personality disorder NOS (not otherwise specified) and panic disorder. I do need someone to monitor me and I suggested he tell me what I can do to make him feel securer around me. Wondering if anyone here has encountered this before and what you and your T did to accomodate the T's understandable doubts? So far I've got: -(on his request) Create rating scales for my main issues to be able to rate myself on them and for him to have some frame of reference. -propose that he may pick someone and I would lift the privacy issues so he can talk freely to that person. ...any advice would be greatly appreciated. Please note his reaction is not at all negative in my opinion. Rather, I am glad he is so forward about his doubts.

It seems odd to me that he told you he doesn't think he can work with you, then puts the responsibility on you to "make him feel more secure around you" ???

I'm also skeptical because he diagnosed you after meeting with you only 3 times.

Are you sure he is someone you want to work with?

Therapists are meant to be there for us to discuss whatever we want. To accept us as the humans we are, even if we are very unwell, traumatised, deep in psychosis etc.

In a way it is good he understands that he isn't able to do that for some people, but it's not so great if it means that he thinks he will struggle to help you and it makes you think there's something really wrong with yourself.

From what you wrote, it seems that this T is not skilled enough to help you. I would look for someone with more expertise, rather than a therapist fumbling around with you. This could have detrimental repercussions.

A skilled T won't play around with you in, what seems to me, a guinea pig approach.

It's not a final diagnosis, he just needs a reasoning towards the insurer and I asked to see what he had written. I hear you guys, but I actually like him. He is insecure for all the right reasons, in an odd way it's even unsetteling to me when I tell someone my core issue and they brush it off.

You really think a therapist should take on everyone, accept anyone? Isn't their first duty towards themselves? Mind you, they say someone with my issues will never willingly go to therapy. I wonder where I would find someone skilled to work with me.

How could it be detrimental, though? If it were, that would not be good.

Oh, and he didn't say I had to make him feel more secure. It was me that told him that in my opinion it was not just I that needed to be comfortable with him, but also him with me. I asked him how that might be achieved, not the other way around. Sorry if that wasn't clear.

It's not that he made me think there is something really wrong with me, there just is, I've known it for half my life.

I'm not sure how to answer your main question, but I did want to respond to something in your most recent post. You said, "Isn't their first duty towards themselves?" I would say that their first duty is toward their clients (current and potential). However, that could also mean that they know they aren't good at working with certain types of clients, whether it's due to, say, personal issues (like the client triggers them in some way--a former therapist once told me that he couldn't work with any client who reminded him of his father because he didn't think he could be objective with them) or lack of skill set in that particular area. And that's not about the client, but about the therapist.

I do agree that therapists shouldn't just take on anyone (maybe temporarily, if that person was in a bad way and had no other options), just for a slightly different reason.

As for your therapist, seems like he's insecure. Is he by any chance fairly inexperienced?If so, maybe he's just being honest and worries he won't be able to provide you with skilled enough care. The fact that he's fairly humble can be a positive thing, as opposed to arrogant and acting like he can solve everything. And he does sound willing to learn, which is a good quality in a therapist. So I'd give him a try for a bit and see how it goes.

He is not fresh out of uni, but he worked in corporate psychology for 15 years, so his experience in regards to my issues are probably indeed non-existent. But one can learn. Tbh it's also kind of difficult to find someone at all, and as I feel comfortable with him and just need to explain things in some more detail (which I don't mind doing), I'd like to see where this goes.

My former T, who I was with for a few months before him and is my only frame of reference, was much more experienced, but so much less transperent. I don't think she trusted me much, and I for sure did not trust her. There was no room for honesty, as there is with him. She didn't help me much, btw, never mind her experience. I knew more about her than I do about him, but while she left all the room to me, I felt opressed and judged. I don't feel he judges me on a basic level, he's just judging his ability to work with me.

The purpose of psychotherapy is to set people free. It's a confidential conversation between 2 people, with no goal other than to help the client find or recover their true self. There's no right or wrong way to be human, as long as it makes sense to you.

As a therapist, he shouldn't reinforce your belief that something is very wrong with you.

So a therapist saying they aren't sure if they can work with you already puts a spanner in the works, because it's not a safe place to explore who you are right now.

* You seem attached to this T already. Might want to keep that in mind and/or discuss whether he's experienced with transference or not.
* It's not your job to make him feel secure.
* Yes, I think a T's first responsibility is to take care of themselves so that they are well equipped to work with clients. That being said, it's not right to make the client take care of the T.
* Transparency in a therapeutic relationship "can be" beneficial to some. Though again, it's not the client's responsibility to take care of the T. The T should be determining what and how much to share especially with a new client.
* I'll go against the grain here, but him raising concerns isn't necessarily a bad thing. I've had professionals who told me about their concerns, and we had a great relationship (ex-Pdoc, a college counselor, etc.). Even L has told me that if I didn't do the work with T, she probably wouldn't have been able to work with me. I've experienced the opposite too: I don't think ex-T was skilled enough or in the right areas to work with me. I wish she would have realized that much sooner.
* Requesting a rating scale: I think that's a great idea and a reasonable request. T and I did that, and L and I adopted it. It has been super helpful for both of us.
* Consulting with another T: again, not a bad idea. Both T and L have consult groups that they regularly attend. They ARE confidential. They do not give away any information about their clients that could be used to identify them. L won't even use pronouns. And yes, I had to sign a document stating that I was informed that L uses a consult group. However, you shouldn't have to give away your confidentiality. That is inappropriate, unethical, and unprofessional.

He is reinforcing my belief that something is wrong with me. That much is true. Former T didn't do that. To me though, her approach was less validating than his. I feel that by his reaction, he understands the gravity of the issue much better than she did. Perhaps I am wrong in this, and she got it, but simply did what you guys say is professional, while he is less professional, but his style works better for me. I need my T to understand what s/he is getting into.

You're right though, I might perhaps be too attached already. I'll keep it in mind and bring it up at some point.
He's not actually making me take care of him, and I am not taking care of him, I think. What I am trying to do is to ensure a stable therapeutic relationship on both ends. It won't do us any good if he leaves half-way through because he feels he can't keep going. So I need him to be honest and somewhat comfortable, certainly knowing that he can bring stuff up. Again, he never indicated it was my job to take care of him or of the basis of our relationship.
Transparency and honesty are key to me. I am both, and I need to have a therapist who is open to this, too. Obviously not about his life or such, but about his thoughts and feelings in the therapeutic relationship. It's fine if he won't answer every question, but former T sometimes seemed to lie, and how can I in turn be honest in such a szenario?
I love the idea of the rating scale, I've never put it into a system before. I haven't even finished writing it fully, but it's already obvious that it will provide a fundamental tool that we can work with and that will over time show the dependencies or lack thereof of my multitude of symptoms. In addition to that, I am writing a diary for 30min every night (an idea from my previous T that we are adopting), so we will have daily ratings and qualitative writings for each day.
Consulting with another T is very important. I also lifted his and my former T's privacy constraints for that purpose. I have no problem with 1 more person knowing who I am and what I struggle with, so long as they in turn are bound by privacy constraints. It's time for me to let go and accept help.

There are wrong ways to be human. If me being me causes harm to others then that is wrong. Period. So no, he cannot set me free by letting me be who I am, he can set me free by helping me change. I have worked towards that change for over a decade, and I am now stable enough to work with someone else by my side. Me being totally free is however nowhere near my goal. Me getting attached to the chains that keep me sane however is.

I'm a high risk patient and my therapist will only work with me while medicated. Which is fair because they are risking review with working with me. They're allowed to freely talk to my husband and he can call them but I am always in the conversation. If you have found someone willing to work with you even with reservations maybe a great therapist for you. Only you and them can make that decision. I'm much more stable then I was but still high risk but not at the point that hospitalization is a constant concern. If you want to look for a new more experienced t look for a crisis therapist.

You seem dead set on working with him. I hope he's experienced enough to help you, and is honest with himself and you if he can.

Yeah, I'm not interested in looking for someone else, it's true. I like him, I don't want to search forever and his office is super convenient for me to reach. Kind of enough reasons for me. I'll only search for someone else if there is a very good reason to, such as if one of us discontinues the agreement.

He has a professional duty, if he feels he cannot help you, to refer you to someone else.

You guys have very high expectations ^_^' They're just people... I waited 4 months to get an appointment with him, he might not even know someone with an open slot, let alone with the will or ability to take me on. He might not want to refer me either - I'm assuming that there is somewhat of an in-culture amongst therapists, as there is in any other field of work, and it might cost someone social credit points refering someone like me. Therapists are not omnipotent or something. They have needs, emotions, etc same as anyone. And a right to them, same as anyone.

These are his decisions to make, not yours. He has to decide whether he is competent to work with you and then you can decide whether you feel safe working with him. You can't mould yourself to be a more appealing client and nor can you judge his expertise. This isn't about having high expectations of a therapist, these are basic aspects of the initial therapy contract. Has he explained why he doesn't feel capable of working with you?

Erm, not really. If a T says he is unsure he can work with you unless you convince him otherwise?! Sorry, that doesn't sound professional at all. He has to know whether he can take any client on or not - from his training, skills, interest, competency etc. It is not up to clients to convince or 'prove' to a therapist that T should work with them. This is not ethical.

That was his point, I think. He told me in our last session that he wasn't sure where this was going and that he was going to apply for a short term therapy with the insurer so we would have 12 more sessions to figure out if this was a good setting.

Again, he didn't say I had to convice him. That's all me..

He has explained his doubts to a point, as one of my issues (perhaps my core issue) is extremly volatile in nature. I understood that he wasn't sure if he and I were a good fit because of it, though he didn't littlerally put that into words.

If you feel comfortable trying even with his reservations or stipulations then make sure you don't hide anything from him. I've been with T's that I can't be completely me with and they don't last long.

Yes, that's part of the point, that I feel I can be open to him