Wondering if my therapist should guide our sessions more

[Ink]

Hey everyone, I'm new here but I've been reading this forum for a couple of weeks now and have been finding it really useful.   I was hoping to get other people's thoughts on my experience with my therapist/counselor.

I started seeing her in August. I like her a lot - I think it would be hard to replace her even if I wanted to - and her list of qualifications/experience seems quite extensive. She lists trauma counseling as one of her primary interests on her website, and specifically mentions working with people who self-identify with complex ptsd. But, I've never seen a counselor before, so I don't have anything to compare her to and sometimes I feel it's hard to judge exactly how we're doing.

She knows what my problems are pretty thoroughly by now, and when I first started seeing her I thought that once she understood them she would automatically know the best way to work on them or the most useful thing to talk about at any given time - or at least would be able to figure it out fairly quickly by asking me questions. But in reality it seems like a lot of what we do is guided by me, which I don't always like.

She also seems quite flexible in the way she works. One example: she explained EMDR to me as something that might be useful and said that there are 8 steps to the official process, but that we don't have to necessarily follow those steps exactly. Toward the beginning, she was also doing some CBT-type stuff with me without rigidly following a structure. I guess this is great in some ways, although it probably adds to my feeling of being very much in control of what we do, and being slightly overwhelmed by that.

Probably as a result of being guided by me and of this flexibility, the work we've done seems pretty scattered/disorganized to me. It seems like we've started to do a lot of really interesting things, but haven't followed through with many of them as fully as we could have.

I'm probably going to talk to her about all of this, but I thought it might be helpful to see what you guys thought as well.

Thanks for reading!

[Whobuddy]

  Hi and welcome to OOTS.

I am sorry I cannot help you with your question but I am eager to see what others write in their replies. My T experiences were unsatisfactory and I do wonder if I should try again.

[C.]

Hello Ink,

I've had some similar feelings off and on with my T with whom I've worked for almost 3 years.  Usually when I bring up the topic he's able to specifically reflect back to me the progress that I've made and state some strategies for moving forward along my continuum, like experiencing, noticing and reflecting on triggers.

Your idea to speak directly with your T seems spot on as do her qualifications.

I was thinking about your topic and feel like highlighting a list of thoughts I have about the topic.

Some things that I've noticed about therapy and having CPTSD are the following:

*I had a therapist who was pretty directive for about 5 years, usually problem-solving, giving advice, and taking the lead if I didn't.  She re-traumitized me so my new T had to start by helping me heal from that experience.  My point is that for people with CPTSD some of the significant symptoms like a very strong self-critic, doubting our perceptions and decisions, not being truly seen or understood can actually be worsened by traditional distant and advice type counseling/therapy.

*I suspect she started with CBT-type info. to help you develop tools to be able to cope with the more challenging work when you get there, like very strong and painful EF's.

*Complex PTSD says it so well.  It's complex because it's truly complicated to figure out cognitively, then emotionally and finally how to cope and prevent and heal.  There are holes and blind spots.  Difficult to retrieve memories and memories that won't seem to go away.

Your perspective of being a consumer and finding the best therapy for yourself is admirable.  You have every right to question the therapy and figure out what works best for you.

I hope that your next conversation with your T brings some clarity and I look forward to hearing how things go if you'd like to share them here.

[Anamiame]

First, what C. said. 

I've had many therapists.  With CPTSD we can easily be re-traumatized by well meaning therapists who don't 'get' what we are going through.  I've had my current therapist for 12 years and just this week have truly started to work on deep down issues.  I would run and then come back and run and come back...then stopped therapy and used her for situational counseling (i.e. running), LOL.  I would get frustrated with her for 'pushing' or feel like I was wasting my money just to get her 'opinion.' 

But she stuck with me. 

The thing is, each one of us is unique and each therapeutic relationship is unique.  Each one of us can only give you our opinions based on our experiences--and your experience is going to be different.  So ultimately...only you can truly answer your question. 

The best way to find out if she is truly the best therapist for you is to be honest with her.  Her reaction will tell you and you will know in your gut if it's the right 'fit' for you.  Sometimes my therapist pushes me and other times I wish she would take the lead because I don't want to. 

I don't know if that makes sense.  Therapy isn't easy.  But the rewards are amazing. 

[Butterfly]

What the others said, I would think too forceful an approach would be traumatic. My T allowed conversation to flow organically and would suggest homework but never forced or reprimanded if I didn't get to it or wasn't up to doing what she suggested I try, we just tried something else instead until something stuck that worked and I liked or could handle doing.

Have you expressed your desire to change how the therapy is flowing?

[wingnut]

I have had exactly that same feeling over the 3 years that I've been working w my T. I wanted someone to come with me with a battering ram and knock down all of the walls standing in my way. However, that ain't happening. I feel like we are over here and then next week we are over there and then the following week back someplace else. I think they do leave it up to us, though I put a lot of the onus on my T to help me figure out what to talk about. My life is not a series of dramas I need to discuss from week to week. I have to unbury crap and confront it, which seems much more difficult to me. I also realize that my T is incredibly skilled and knowledgeable and that it is definitely a process that is going to take time. And I am not always happy with the slow progress, but hey, it took me decades to get to the point where I am. Kind of like losing weight - it didn't come on over night, blah blah.

Any time I have expressed frustration, she "understands' it, but that doesn't change it. I would encourage you to talk about it, too. It's possible your T has different methods he/she can utilize. Ask for homework then do it, or come up with your own. Write in between sessions so you have some direction when you go in. There have been times when she has wanted to me to engage in some role playing, etc., and it made me feel silly so I refused to do it. Yes, I stand in my own way sometimes.

One thing that I told her I want to work on is lack of trust, and yet, trust with her can come and go - a snail that runs. LOL. Anyway, I used to ask myself if I was with the right person, then I went to a different therapist one time to test the waters. I think I liked the slow, gentle approach of my current therapist versus the more direct approach of the one I was test driving. I felt like I wanted to stay with the one who already understands me (more than I gave her credit for until I saw this new person). So you may want to test drive or interview others.

Ultimately, we're paying them for their service and should feel we're getting the best bang for our buck. I hope this rambling has made some kind of sense.