I don’t know if we could move past this

I just saw the post about ruptures and was debating posting this because I basically have the same question.

I’ve had a lot of ruptures with my current T and I’ve never had them before in any other therapeutic relationship. I barely have conflicts in my other personal relationships because I’m not that close to anyone.

My T this week suggested that I don’t want to take her suggestions, i.e I don’t want to do the things that would help me feel better.

I’m just enraged that she would say that to a person with depression. Of course I want to do things to help get me out of this situation, I just don’t feel like I can. And I can’t believe we’ve been working together for almost a year and you still don’t get that and think I don’t want to help myself. Even if she thought that, there’s another way to say it where it doesn’t put all the onus on me.

Clearly, I’m really angry about this and it sucks that I’ll have to deal with this anger all week until we can have a session again. At least in a normal relationship, you can talk about it right away.

This might be the final straw for me. Everything else I could move past but I don’t know about this.

It is interesting this conversation is going on with multiple people. My last session went south for me and I feel like it was my therapist who lost her cool over me not wanting to share certain things with her.

I personally feel like therapists have a power trip because the dynamic of the treatment plans, in my opinion, puts the therapist in an authoritarian role while the patient has to do whatever is written down on the plan and if you don't follow the plan exactly we're seen as defiant, resistant, difficult, non-compliant, etc.

I plan to speak with my therapist this week about this dynamic because for me I'm an adult and I put in a ton of effort into therapy and if she thinks I'm wasting her time by not sharing certain things then she's not a good fit for me. I've been in therapy for 8 years now I'm not about to have someone treat me like I have no autonomy in my own treatment, no matter what she thinks she knows, she doesn't know me better than I know myself.

I'm not even angry I'm used to this type of crap from therapists and I'm not putting up with it anymore because I'm confident in the accomplishments I've made I don't need someone to micromanage my life. I went to therapy for one reason... employment and that's the only thing I need help from a therapist to work on.

I doubt it will go well I'm sure she'll fire me and that reflects more on her than me in my opinion. I think if you say anything opposing to a therapist they will get butthurt and blame the patient it's the only dynamic I've ever seen in therapy. That's why I'm a firm believer that therapy is only beneficial for that initial hump of a person hurting themselves or others once that ceases to exist for a patient the therapy dynamic isn't conducive but it could be if the therapist lets go of their ego. And I wish the dynamic could be different and I advocate for it on my social media accounts probably pissing off therapists left and right lol

I think we'd all see a much better improvement in our lives if the therapists allowed us to have our own autonomy when were not hurting others or ourselves.

Sorry, I don't have anything but to vent right along with you. I don't recommend doing what I do unless you want to risk getting fired as a patient because it's likely to happen. They say "well I can't help you if you don't want to work on the goals" the goals they made up for you but gaslight you to believe that you collaborated on them.

My therapist put way more goals on my treatment plan than I wanted and I told her that she is creating problems that don't exist and she is only willing to treat me if I have a thousand problems.

Edited to add:

I forgot to mention I do like my therapist as a person so this was pretty disappointing because I felt like she was one of the more real down to earth therapists I met but it did not sit well with me that me not wanting her help with something pissed her off.

Just keep swimming
I have BPD or Autism or both, we may never know, the focus is always the symptoms, not the diagnosis

did it seem like your T was judging you because you don't take her suggestions, or was she just making an observation? My T has told me that I love to tell her "no" to pretty much any suggestion she makes, which is true. But, she said it in a way that didn't feel like she was making a judgement on me or anything.

I felt it was a judgement but if it was an observation it could have been said nicer.

Do you have any way of reaching out to your T early, email or maybe a phone call? In such situations, it can help to talk about it just a tiny bit in between sessions so that not the whole time is taken up by being angry or hurt.

You say this could be the final straw, has this T in the past done things that bothered you? Were you able to work through those?

If you have an otherwise good relationship with the T, I'd at least see what she thinks about the situation and maybe you're able to work through it. I'll say that my T has at times said stuff that hurt me or were clearly worded badly. Often, he realized right away after the session and was able to explain what was going on for him in that moment. Even Ts slip up sometimes and word something poorly or say something that's maybe not the best. Our brains are also very good at interpreting things the way we "want them to", maybe she perfectly gets that you want to help yourself and just had the wrong phrasing. My T multiple times has asked questions in a way that suggested he had no idea about trauma that we had discussed for multiple years already. Turns out, he's just really bad with words and from all the things he said I am certain he does remember all the things I tell him, he just doesn't have the best linguistic skills.

Maybe if she’s noticing that you’re not into her suggestions, she should just stop making them? Maybe she should just talk less and listen more? If you felt like it, you could make that suggestion to her and see if she likes your suggestions any better than you like hers.

My T and I have hit a point where he just sort of does shorthand for his suggestions. Like he might say, "You know my suggestions for getting more exercise. OK, that's all I'm going to say." It works because he's acknowledging them, I'm acknowledging them, but he doesn't need to go into a long discussion again and again.

There's a model in public health that talks about the different stages of change. One of them is what's called "precontemplation," which is where a person is just considering making a change, like, "Hm, maybe I should think about quitting smoking at some point." So they're thinking about it, but not ready. Then there's actual contemplation, where they're thinking more seriously about it, but still not ready to actually take the steps. My T has said how people tend to spend a long time in those stages. And how changes can be happening inside, like you're getting closer to them, but aren't ready for them yet. And pushing people doesn't help them to be ready any faster. So maybe that's the case for you?

Or maybe your T is just really off base in what changes she thinks would be good for you, vs. what you'd want. An example might be a T suggesting that a client get out and be social with people. But maybe the client is an introvert, so that's not something that will help them, or it would just feel overwhelming.

I'd tell your T basically what you said here. Maybe see if she'd be willing to back off the suggestions for a bit, too. And talk about what you think might be helpful--maybe you want to do some of the things she suggested, but you need small steps to get there. Or maybe all you can do right now is focus on getting through the day, and that's OK. But I'd definitely try talking to her about it.

It seems like you two have different goals for yourself. Have you discussed goals and/or progress with your T?

L lets me set my own goals. For example, this years goal was being more direct. We also discussed my progress overall last session. She sometimes suggests things for me, but they are never expectations and she's never upset if I don't follow through.

L has also told me about the different stages of change that LT mentioned. That would be a good topic to bring up with your T!

I’ve never heard of that model but it makes sense. The thing is I have tried the “usual” recommendations: exercise, mindfulness, etc. and it worked ok at least to put a bandaid on what was going on. I didn’t always talk about it in therapy after I tried those things so I guess for me, I know I’m trying even if for her, she has no idea of how much I’m doing.

I think the biggest issue is that the suggestions are out of the scope of what I can handle right now. (T would say: “how do you know you can’t handle it if you haven’t tried it.”) So another part of me is hurt because I feel like my mental illness isn’t being understood or taken seriously if you think I can do that.

I think she should listen more. I don't think I would want to work with this therapist.

Ugh. So sorry you are going through this. I have been there many many times with previous T’s and art T seems to like to hit this nerve often.

Awesome T knows that on the rare occasion he suggests something that if it doesn’t fly with me it was either poorly timed or not a good suggestion and he backs off.

your therapy, your problems, your solutions… she is just along to support. I would be OK with her continuing to make the suggestions… but to say you aren’t open to them makes it sound like it is about you… It isn’t!!! It is HER inability to be attuned to where you are.

Just my not so humble opinion… salted with my own emotions towards art T…

Quote:

Originally Posted by pixiedust72 I’ve never heard of that model but it makes sense. The thing is I have tried the “usual” recommendations: exercise, mindfulness, etc. and it worked ok at least to put a bandaid on what was going on. I didn’t always talk about it in therapy after I tried those things so I guess for me, I know I’m trying even if for her, she has no idea of how much I’m doing. I think the biggest issue is that the suggestions are out of the scope of what I can handle right now. (T would say: “how do you know you can’t handle it if you haven’t tried it.”) So another part of me is hurt because I feel like my mental illness isn’t being understood or taken seriously if you think I can do that.

Dont you want to scream sometimes when mindfulness, exercise and self care are mentioned when youre in a crisis? Like duh, are you reading from "how to be a therapist first addition"?

Yes, yesterday my T was mentioning using gratitude to deal with some of my anxiety and depression over Covid and other things going on. And I was like, "You know that when I try to do that, I end up just feeling guilty." He still pushed it a bit, though reframed it some.

I was saying to a friend later that it felt as though he was just being "generic therapist" there rather than "LT's therapist."