When does a therapist become untherapeutic?

[Currer]

I've been seeing a psychologist for a couple of years for anxiety/depression.  Last year she said I had a lot of Asperger's symptoms (autism spectrum disorder).  I looked it up and I was a text book case.  She referred me to a specialist for a diagnosis and I was formally diagnosed with ASD.

I have continued to my psychologist monthly, but she is now focused on "fixing" my perceptions.  She sees my anxiety, depression and confusion over my relationships with people as 100% my misperception.  This includes my increasing distress over her increasingly dismissive attitude towards me.  I have always been "difficult" in that I get angry when I get hurt, but before the ASD diagnosis she was empathetic, supportive and intuitive, which was extremely helpful to me.     I continue to be depressed and suicidal, but her response is now mechanical, like a robot, straight out of the CBT textbook.  My main anxiety with all people is that I can never do the right thing.  Whatever I do and say I end up with people getting angry with me.  This is now happening with my psychologist.

We were talking about that today and she asked me today if I trusted her.  I told her the truth:  "no".  She got angry and asked why I had bothered to keep coming back if I didn't trust her.  I replied with the truth:  "I keep hoping things will go back to the way they were and I keep wanting to give you another chance".  This made things worse.

I am beginning to think that despite my best efforts to reconnect, she is unable to see me as the "normal but depressed" person I was, and now sees me as someone who does not have anxiety or depression (I still do) and only needs feedback about how inaccurate my perceptions are.  She sees me as being  critical of her, which is not my intent.  However, not saying things in the "right" way has always been my problem.  Prior to my ASD diagnosis she  intuitively grasped the feelings and intent of what I said.  Now she argues about details and seems to be deliberately ignoring my hurt and distress (although she states that this is my misperception, too).

I've tried to re-connect with her, but can't.  Is it time to get a new psychologist?  It is very hard for me to trust and the loss of this sole source of support  will be huge, but is it hopeless after a year of trying to reconnect?  I now hate CBT, so how do I find a new therapist who does not use CBT?  The thought of CBT makes my skin crawl.

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[Jacko777]

Hi Currer,

Welcome to the Beyond Blue forums, I am glad you are talking about this.

I really think you could give the Beyond Blue phone service a call and talk to them about this, get a professional opinion. I guess if you can't 'reconnect' with your doctor then it could be time to find another. I can imagine that it would be fair for a doctor to be firm but not angry. It took me half a dozen professionals before I really connected, it was CBT though!

Talk any time. Jack

[Pixie15]

Hi Currer,

Welcome to the bb forums. I did therapy a couple of years ago and it sounds a lot like you are experiencing. When we were going through the discovery phase it was a lot of talking about myself which was really to sort out what I needed help with. I actually made a conscious decision to trust the therapist because I liked him and I wanted to be helped.

From what I understand CBT is about learning new tools for dealing with things. When I first signed up for the treatment it was with a specific outcome in mind. It was never meant to be long-term. I actually had an estimate in advance of how long I would need to commit for. Anyway that was my experience.

If you are having trouble connecting it might be that you and your therapist now have different expectations of how things are meant to be. 

Anyway just thought I would share my experience.

thanks,

Pixie.

[Currer]

Pixie,

You  hit the nail on the head.  When I first went to the psychologist I told her that I didn't want CBT (I'd done heaps of it before and it was helpful, but this time my anxiety and depression was situational so I needed support to get out of an  abusive situation).  Reconceptualising  abuse as a cognitive distortion would not have been appropriate and the psychologist agreed with me.

So my psychologist did a lot of active listening and just validated my worth as a person. This was exactly what I needed.

Then came the ASD diagnosis.  I think CBT is the recommended therapy for ASD  so the problem started because my psychologist switched from active listening to CBT without discussing the need or benefit of doing this. From  my point of view she went from being  attuned to being confrontational for no apparent reason. It was like a slap in the face.

I was unable to explain why this unexpected change was so distressing to me.  (ironic because my inability to understand people was what led her to diagnose SD in the first place).

My problem (which I now understand because it is typical of ASD) is that I couldn't explain why I hated what she was doing BECAUSE SHE DIDN'T ASK.  If someone doesn't ask me "why" it never occurs to me to say why.  I can  only answer direct questions that are asked.  She knew I was getting angry and frustrated with CBT but kept interpreting this as my not accepting I had a cognitive distortion.  I replied to her direct statements, but could not provide UNSOLICITED essential information she needed to help me. I just kept saying she was wrong. She saw this as a personal attack.

I just wanted a good cry and someone to understand my despair.  She never asked me what I wanted.  It was as simple and as tragic as that.  The mistake I made was in assuming (a cognitive distortion?) that if I kept going back she would eventually ask me what I needed. She never did. When I finally tried to explain to her where I think we got off track, she took this as an attack.  It wasn't.  However, I am terrible at describing what I feel and what I want, and I get inarticulate and frustrated.  I have limited emotional control in  fraught situations so I was rude in the conventional sense, but never deliberately so.

In short, she never asked how I was feeling, and I didn't know how to convey this in a "normal" way that she could hear. I'm grieving for one more lost relationship. I don't want to keep repeating this history.

[Pixie15]

Hi again Currer. Just had another quick thought when I read your latest post. If you have trouble explaining this in person have you thought about maybe putting this in a letter or an email. At least that way you will know that you have communicated what you feel. Cheers, Pixie.

[Sophie_M]

Hi Currer, thanks for your post.

It looks like you are going through a challenging time with your Psychologist and that you once had a supportive therapeutic relationship. It sounds like you are trying really hard to reconnect with your Psychologist but this is proving difficult and it’s healthy to question whether the relationship is still therapeutic and supporting you in your recovery.

In your post you want to know how to find a Psychologist that practices with another therapeutic modality other than CBT. You can conduct a search for Psychologists and the various types of therapies and approaches they use on our website under the Advance Search option and the details can be found here. If you need any support to use this search option you can contact our Support Service and speak to one of our professional counsellors.

In your post you mentioned thoughts of being suicidal and it sounds like you could really use some extra support around managing the overwhelming emotions that trigger these thoughts. If you are at risk of harming yourself it is important to get help immediately. You can do this by calling your local Mental Health Team. If you feel unable to keep yourself from acting on your thoughts about suicide this is an emergency and you need to call 000 (triple zero).

Self-care can be quite an important strategy given the emotional strain you can experience during this time and some useful things you can try to help you are:

• Stay connected to friends and family and use support groups
• Don’t be afraid to ask for help.
• Stay healthy – Eat healthy meals, exercise regularly, get a good night’s sleep and keep use of drugs and alcohol to a minimum.
• Make time to participate in enjoyable activities.

You might like to also look at the recovery and staying well section on our website for information on things you can be doing now to improve your overall mental health, here is a link for you to refer to

It is important that you take steps to keep yourself safe Currer. We encourage you to call the beyondblue Support Service on 1300 22 4636. We can help 24 hours a day, 7 days a week with counselling support, information and referrals.

Please continue to reach out for support and we are here to support you and hope you find some helpful responses here online.

[Lozano]

1. Hi Currir I saw a councillor for a while then one day after a session I left in tears I was that bad I ended up in bed for 3days . A good person that I trust very much and has worked in mental health informed me that you should never leave a councillor feeling worse that what you did when you went in this is not a good councillor for you I resized she was right as every time I visited her she would make me relive everything that had happened to me to make me like this and then never finished on a good note and I would run out of time and leave every appointment in tears so I bit the bullet and stopped  going to her and I felt so much better then I decided to find someone else and I did yes we went over things that caused my depression but she showed me strategies to work with while we spoke one of these were the whole appointment as we spoke I learnt how to use tap so as we spoke I would tap my fingers together or tap the temples on my head tap each wrist and I found that I could talk without braking down after the 3rd appointment 
2. so find someone that you feel as good or if not a bit better when you leave the appointment hope this helps 

[MindfulStep]

Hi,

One thing I do respect from therapists/psychologists is that they remain professional. I've stopped a session with a psycholgist recently because they shared about their history with depression - this is after three sessions and to be honest I don't want to know. I want to know my psychologist experience and training. I've also had a psychologist who I met once demand I understand how it made her feel running out of the office crying - I was living in a boarding house, starving and desperate to see her and I don't want to think about her feelings at that stage.

 It is ok to shop around. As we get older our symptoms and knowledge of ourselves change and now you have a diagnosis that makes sense it might be time to find a psychologist with this experience - perhaps the other psychologist was just there to help you to get to the diagnosis.

It is not a personal relationship - it is a professional service which they get paid for. It is not your responsibility to manage their feelings.

[Pixie15]

Hi Currer,

I am wondering how you are doing and I had a thought about your post when I was reading and reflecting on a journal article today. You have in brackets in your second post that you went to see your psychologist for help with getting out of an abusive situation. Is it fair to assume now that you believe your psychologist is basically saying it is your perception which needs to change and not the situation.

If this is the case you might want to seek a second opinion. Some questions you might want to ask yourself and your psychologist was how thorough the specialist was in making an assessment of you and giving you a diagnosis and how is the treatment going to help you with this abusive situation. There are many people on the site here who have had experiences of multiple diagnosis before they find one that works for them. A diagnosis is really just an aid to treatment delivery.

Abuse is not always physical. There is evidence to indicate that emotional and psychological abuse can be much more debilitating especially in the context of an intimate relationship. It is also more difficult for counselors to recognize. You do not want to learn CBT to help sustain a situation which is harming you.

I hope you are doing okay.

cheers,

Pixie.