Tuesday, May 6, 2008

Does my therapist suck?

Whatever do my head-lumps mean?AJD: FIRST QUESTION: How do you know if your therapist is any good?
JSGS: OOOOH. Did you just make that up?
AJD: Nope, it's a bona fide query*.
JSGS: WHAT. Fascinating.
JSGS: So Miss Doe, how do you know if your therapist is any good?
AJD: Hallmarks of a bad therapist: S/he says "mm-hmm" a lot.
S/he doesn't remember anything you told him/her the last time.
JSGS: I once asked my therapist in a really mean voice if she practiced her empathy noises in the bathroom mirror at home.
AJD: S/he gives you "homework" but doesn't, like, follow through

JSGS: S/he tells too many personal stories.
AJD: When I was in high school I got pretty good at redirecting all conversations with my school counselor so that he was talking only about himself.
S/he suggests that you just "get over it."
JSGS: S/he cancels appointments or is often late.

AJD: How do you feel about therapists who don't ask questions? I need, like, direction sometimes.
JSGS: Ooh, that's tricky. On the one hand, sometimes it REALLY IS TRUE that if the therapist doesn't talk a lot you end up saying a lot more than you would, often things that are sort of surprising. And sometimes the therapist's questions can derail you from something you think is important.
JSGS: THANX. I think it depends on whether you ask the therapist to do it.

AJD: Ok so a B.T. looks at the clock a lot.
JSGS: Ha ha ha ha ha but I do too; does that make me a bad patient?
AJD: No, that makes you normal. I look a lot because sometimes I really just want to get out of there but if s/he's looking it makes you feel like s/he does too, and damnit I AM PAYING FOR 50 MINUTES and you will listen to me for 50 MINUTES

JSGS: A good therapist will always ask you what your goals for therapy are.
AJD: And will keep track of those goals and your progress toward reaching them
JSGS: And a good therapist will have healthy, assertive boundaries, but will not make it taboo for you to ask a question and will explain why s/he won't answer it.
You don't REALLY want to know that much about your therapist.
AJD: A BT wants you to know about his/her life outside the office. I don't give a good goddamn.
JSGS: You sure THINK you do, but that curiosity is never filled in a satisfying way. Lots of therapy relies on you being able to think the therapist is whoever you want him or her to be. At least if it's a PSYCHODYNAMIC APPROACH.

AJD: Oh god a BT asks you how YOU think s/he SHOULD respond.
JSGS: My therapist asks how I think I WANT her to respond
AJD: How does that make you FEEL?
JSGS: It's annoying but it also really helped me to understand the difference between just wanting to know something and wanting to get a specific response that I am somehow invested in.

AJD: For me it all comes back to empathetic noises
JSGS: Man, you hate those. What about the empathy face? But doesn't stone silence kind of drive you nuts too?
AJD: Yeah I guess. I’m VERY COMPLICATED. I like a therapist who reminds me to get over myself. A BT won't, like, be aware that you're lying.

JSGS: Sometimes a "bad therapist" is just someone whose methodology doesn't work for you. So it's worth thinking, before you go, about the STYLES of therapists who have helped you in the past. If you can tell the new therapist about that, it can guide your relationship.
AJD: I think ultimately it's pretty difficult to objectively determine whether a therapist is "any good". It’s more important to figure out if your therapist is good for YOU. I mean, therapy requires honesty and clarity and straightforwardness and hard work. Oh! One more thing. You shouldn't feel BAD for your therapist.
AJD: Mostly because you shouldn't know enough about his/her life to feel any way about it.

JSGS: But I would also caution against bailing at the first sign of trouble, because sometimes mistrusting a therapist has nothing to do with how good the therapist is, and sometimes the most valuable work of therapy comes from working through those feelings WITH someone IN a relationship. Wow, clearly 8 years of therapy over here.
AJD: I think we've COVERED the MAIN POINTS

* thanks to Miss L. for asking our very first question! You can do it too!
** thanks to Google Image Search for leading us to the ridic phrenology diagram!

1 comment:

Attention Deficit Disorder said...

My experience is that if a therapist he/she will actually remember your name. Many times, therapists aren't able to develop a repore.