Are All Clients Equal...or Not?

I for one am not a crisis junky. I am a stability junky. Crisis mode would be unwise for me.

I'm not sure. My therapist has always made it clear that therapy eventually ends, and she has talked about some of the signs she looks out for, when considering spacing out sessions.

I've been in some major, major crisises, back to back in the past 8 months. Any fantasies I had in the past quickly evaporated, including when she legitimately got worried for my life, and wanted me to go in-patient.

I felt I'd be "imprisoned" and psych wards where I live are terrible. Acting out gets people punished and literally traumatised.

I really really want stability. I cannot afford more crises due to terrible circumstances. I don't at all like how my therapist is doing so much for me because of the prolonged struggles I'm facing. I don't want to be "special", it's not worth it.

My occupational therapist wanted me to go to a group home, and that suggestion was also really unwelcome. Even if I could afford it, and I can't, there's no clear benefit because my crisises isn't only mental health.

But that's me, and I've lived a life where I couldn't risk my trauma disorders becoming obvious.

I knew some people who seemed to "like" the attention and connection from repeated crisises: it was because appointments and inpatient was safer than their abusive family environment. They're trying to get needs met, when they had immense barriers to leaving their families.

Having said that, I know someone who actually does fake serious mental illness, and crisises (this is something offline that's been overwhelmingly proven and I still feel so very betrayed about it) in order to get care.

I suppose they'd use that pattern in therapy. Which would probably be their work in the first place: To get to the need behind close to 10 years of lying and faking. Because someone doing that obviously feels they lack care, there's a wound there.

I do not think all clients are equal to a therapist. I don't think that's bad either, everyone has different life stories, different needs and different issues, if they all were the same to a therapist, I'm not sure how much he could help.

Regarding the question about crisis: I for the longest time thought this would be what would be happening to me. I used to have such issues with friends, and why should a therapist be any different. I have to say though that somehow I am now less likely to be in crisis than I used to be. I think this is due to me learning that I'd get attention, whether or not I'm in crisis, whether or not I even need to be in therapy. My T has always reassured me that even if we talk about nothing at all, as long as I find it useful, we can continue doing that.
I am somebody who I'd describe as "walking talking fear of abandonment", yet somehow I have learned that when therapy comes inevitably to an end, even then there is a connection and somehow even "attention", though not in the same way as before.

Also, being in crisis a lot can at some points probably even make a client less "liked" and therefore not equal to another client who is in crisis less. I don't think this should be taken out on the client too much though. My T has told me before that sometimes he thinks "ah, CNS again with this topic", but that is to some part just how interactions go, as long as it's not a constant, it's fine. Some of our topics I am sure he finds both meaningful and can learn from them, I know of some things that I struggle with that nobody else in his client group does. But I do not think that means that another client is less important or "valid", we're just different. It's like at work, sometimes I want a challenge and think really hard about some stuff, but other times I want a cup of coffee and listen to somebody in a meeting.

I do think a lot of this depends on the individual, but after all, most 3 year olds learn not to throw a tantrum every day after a while. And they still get some candy every now and then.q

I feel like this could be the case for some people, but I tend to feel ashamed about needing care. Did part of me like it when my T gave me an extra virtual session at 8:30 pm a year ago when I was in crisis? Yes, because it showed me that he genuinely cared (and I doubt he'd have done that a few years ago--based on how he reacted to a somewhat a similar scenario then).

However, I also felt quite a bit of shame about it. And I worry about being a burden or being "too much." (Not shockingly, this came from messages as I got as a kid.) So reaching out in crisis is something I'd be reluctant to do unless I felt I really needed it.

Even times when I've scheduled an extra (or earlier) session during normal hours, at first I'm thankful he offered it to me, but then when I arrive at the session, I often am like, "Maybe I shouldn't have scheduled this, I probably should have just waited" (and will typically say that to him). And I'll apologize for it, but he'll say it's fine, he had the time, and I'm paying for it. And they typically turn out to be very helpful, and only once have I regretted having one (well, then there's the financial aspect....)

And 3-year-olds generally grow out of the tantrum stage. Ideally, that would happen with therapy, too, though it could take a lot longer for someone who has been through some form of childhood trauma or neglect. (Taking much longer to unlearn thought patterns/habits as an adult than to initially learn them as a child.)

For me, it felt in a way with my former marriage counselor like I was in a sort of child place with him, just wanting his comfort and acceptance. With my current T, it feels more like I'm a teenager at times, alternately seeking comfort and then (subconsciously?) causing conflict between us, then seeking comfort/acceptance again. Like a teen who partly wants their independence but also partly still needs their parents' support and love. Though I suppose some things I've said and done *could* be seen as tantrums, but I feel like teenagers have tantrums, too, they just look a bit different.

Generally, I don't think anyone likes crises. I also don't think people cause or make up crises to get attention they need. I think it's often more about hiding progress than needing a crisis. I also think that life teaches us the crises get us attention. Even as adults, when something bad happens in the media, do you see how many people come out and join the cause? But it's usually only when something bad happens. Then we're taught that the "squeaky wheel gets the oil".

Just addressing this because I believe very similarly as you do. I don't think you're wrong.

I'm also really sensitive because I know what its like to not be believed. Believing survivors is a good thing. Giving benefit of the doubt and erring on the side of what is kind is also a really great thing. Especially when victim blaming and invalidation can be really common.

Which is why what I found out about the person I mentioned -- actual making stuff up, and other actions which have caused major harm to several people -- it honestly sent me into a horrific crisis.

There's people in my highly specific community keeping an eye out for more victims. There's multiple victims. I defended this person for a long time, and I cannot forgive myself for the harm I inadvertently caused by defending this person.

I can understand why the person does all that, and this is someone I talked daily with, for years on an intimate level. Never invalidated their struggles and so on.

I can understand the need for attention, and even lying to get that. But not the real life, malicious damage done to me and others. Not how they're still actually seeking more vulnerable people to use.

I just want to make it clear because I do have compassion for this person. And I do believe their work, if they're ever willing, in whatever form, would be to get their need for care to be attended to, and met in healthy ways.

That's all I will say in public because I don't want to derail the thread.

QM - I hope my comment didn't invalidate your experience with that person. I know there are people out there who do thrive on getting attention anyway possible: good or bad. That's why there's such things as munchausen by proxy. But I think/hope that that's a very small population. And even those types of people still can learn healthy ways of getting attention if they work on it.

I'm sorry for your experience We can only do our best with the information we currently have.

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Originally Posted by AliceKate I for one am not a crisis junky. I am a stability junky. Crisis mode would be unwise for me.

Were you always a stability junkie, or did you transition from crisis to stability?

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Originally Posted by ScarletPimpernel ...I also don't think people cause or make up crises to get attention they need. I think it's often more about hiding progress than needing a crisis. ...

Really interesting - that makes sense.

There were unstable phases, particularily between childhood and being a young adult, but even then, with the most extreme things, there were lines I never crossed.
For instance, when my parents divorced and I stayed living with my Mum who more and more turned to alcohol to drown her sorrows. I tried to help her, but I couldn't. My mind went places.. dark places. But I decided to move to my Dad when I felt myself less and less able to withstand my fantasies. Even then, that choice was a conscious one.

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Originally Posted by AliceKate There were unstable phases, particularily between childhood and being a young adult, but even then, with the most extreme things, there were lines I never crossed. For instance, when my parents divorced and I stayed living with my Mum who more and more turned to alcohol to drown her sorrows. I tried to help her, but I couldn't. My mind went places.. dark places. But I decided to move to my Dad when I felt myself less and less able to withstand my fantasies. Even then, that choice was a conscious one.

Yes, I understand that. I have also taken responsibility for keeping my life as stable as I can...until I can't which is where therapy comes in.

And that kind of goes with my line of thinking of some therapists working on creating dependency in clients rather than helping them to become independent.

Clients sometimes aren’t encouraged to get better and clients in return are afraid to get better because it means they might lose that special bond or even lose therapy and their therapist all together. So it becomes never ending cycle

I think it really depends on why one sees a therapist. I saw a therapist on and off typically for specific issues. When the issues were under control, I’d stop needing it. My husband on the other hand doesn’t have a goal to stop therapy because it helps him to work on various symptoms of his disorders. He does therapy on and off but there is no need to end it and no such goal. I think it depends what people see a therapist for.

Having said that the cases above aren’t cases of being attached to therapists, but rather needing them. Situation with attachment is probably a different ball game. Sadly many are attached to therapists because therapists made sure of that by creating dependency. Then there likely is no incentive to ever end it. Client is a victim here imho because if therapy ends, there is a massive trauma and tragedy

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Originally Posted by divine1966 I think it really depends on why one sees a therapist. I saw a therapist on and off typically for specific issues. When the issues were under control, I’d stop needing it. My husband on the other hand doesn’t have a goal to stop therapy because it helps him to work on various symptoms of his disorders. He does therapy on and off but there is no need to end it and no such goal. I think it depends what people see a therapist for. Having said that the cases above aren’t cases of being attached to therapists, but rather needing them. Situation with attachment is probably a different ball game. Sadly many are attached to therapists because therapists made sure of that by creating dependency. Then there likely is no incentive to ever end it. Client is a victim here imho because if therapy ends, there is a massive trauma and tragedy

Well, it gets into the subconsciousness of transference/countertransference. I'm clearly going through that with my therapist6 right now. If we work through it, the whole situation will become very productive. If we do not work through it...uh, she walks and I suffer the damage.

My therapist walked out with her client before me. the client said something to my therapist and my T mumbled an answer back but was just automatically focused on me. I found it interesting how quickly she seemed to forget about this kid. In that moment I was equal. I do think my T is a bit more focused on me at this moment since we are trying to figure some things out. She emailed me tonight about it. But maybe she will just end up dumping me.

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Originally Posted by Mountaindewed My therapist walked out with her client before me. the client said something to my therapist and my T mumbled an answer back but was just automatically focused on me. I found it interesting how quickly she seemed to forget about this kid. In that moment I was equal. I do think my T is a bit more focused on me at this moment since we are trying to figure some things out. She emailed me tonight about it. But maybe she will just end up dumping me.

If I was a therapist I would have a back door for clients to exit from. I think there are all kinds of potential issues that can occur when clients cross each others' paths. In addition, confidentiality is broken.

You've brought up an excellent point. T's seem to be intrigued and attentive when they have a new client to "figure out." But as therapy progresses it often seems to become just a job for the therapist. At that point, if the client feels like the therapist is treating the client as less interesting/less important don't many clients create crisis (either consciously or unconsciously) to "win back" the attention of the therapist?

Well, mine literally said to me today that if a client is very reliable (like me--I don't no-show, for example), then he'll be more flexible with them about certain things. Like in the current example, I can let him know about a potential time change for my session (depending on my travel plans) with less than 24 hours' notice (I'm scheduled for one time, but now I could potentially be traveling during that time--he offered a later slot, and instead of requiring 24 hours notice, he's saying I can let him know a bit later). So that's one answer to the "are all clients equal?" question for him.

All equally as likely to be screwed over.

I agree.....

I've never created crisises. But I've tried to prove to them that they are looking too deeply into an issue. Mainly I just feel like therapists can be shady back door people who worry about themselves more. I checked out an old therapists facebook page and one of the other therapists posted "if you come back to in person you can get unlimited paid days off." That comment rubbed me the wrong way because it sounded like they could just cancel on their clients whenever they wanted to and take the day off for whatever reason. Idk. I shouldnt be snooping in the first place though.

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Originally Posted by comrademoomoo All equally as likely to be screwed over.

Hah....I'm kinda getting a sense of that....trying to avoid becoming cynical, but... Ten times burned, 11th time shy

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Originally Posted by LonesomeTonight Well, mine literally said to me today that if a client is very reliable (like me--I don't no-show, for example), then he'll be more flexible with them about certain things. Like in the current example, I can let him know about a potential time change for my session (depending on my travel plans) with less than 24 hours' notice (I'm scheduled for one time, but now I could potentially be traveling during that time--he offered a later slot, and instead of requiring 24 hours notice, he's saying I can let him know a bit later). So that's one answer to the "are all clients equal?" question for him.

Yes, that's decent and fair of your t. And good for you for being reliable! That's a big thing in my book.

I'm more referring to therapists being intrigued and stimulated by clients who have a colorful, interesting life story to tell...as opposed to, "My husband is always the one to choose which movie we see and I feel like I have no power." You know, the standard stuff that t's hear 100 times a week.

Yes, I know--mostly just looking at the overall question that's the thread title. But I imagine they do start to sort of internally roll their eyes at clients presenting with certain generic issues.

With my T, yes, I have some parenting issues (among other things), which are likely sort of standard fare, but they're also with a special needs child (autism, plus ADHD and recently diagnosed intellectual disability), so more challenges than the usual "my 11-year-old won't listen to me!". He seems especially interested in that area of my life and is particularly empathetic when I talk about stuff with my D.

I'm not sure if it's potentially due to relating. When I first started seeing him, my ex-T said, "Oh, he also has a kid on the spectrum!" (he used to work in the same practice as her). After a few months, I told him that, and he was (rightly!) bothered that she'd told me that and said how that would have been 7 years ago, so it might not be accurate now. But wouldn't give more info, trying to protect his son's privacy and also not wanting it to interfere with my therapy. Then there was his wife posting in a local Facebook group for kids with special needs (which I told him about, and she left the group)--note that I was in the group before I started seeing him and had no idea she was a member. Some things he's said and ways he's reacted (occasional tears) have led me to believe he has personal experience with some sort of special needs (not necessarily autism) in his son. So that could be part of why he's particularly interested and empathetic with that area?

But I try not to question it too much--it may just be that he's a fellow parent and is empathetic to kid issues due to that or simply that he's interested in it as a psychologist (he does treat some teens/young adults with autism, he's said).

I think even with colorful, interesting life stories, there's still some generic issues? At least, my T seems to have conveyed that's how she gets to the root issues under the chaotic life stories. She says many humans have certain fundamental desires like wanting to have self worth or a sense of belonging (for example, I vaguely remember she said more.)

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Originally Posted by Mountaindewed I've never created crisises. But I've tried to prove to them that they are looking too deeply into an issue. Mainly I just feel like therapists can be shady back door people who worry about themselves more. I checked out an old therapists facebook page and one of the other therapists posted "if you come back to in person you can get unlimited paid days off." That comment rubbed me the wrong way because it sounded like they could just cancel on their clients whenever they wanted to and take the day off for whatever reason. Idk. I shouldnt be snooping in the first place though.

Geez, nice comment

See, I don't think you were wrong to "snoop." I look at it as being informed. But maybe I'm paranoid, I don't know. But if I am, it's because I've been burned too many times.