What is realistic to ask of my therapist?

[.Poppy.]

I started therapy with one therapist, but for a couple of reasons I had to switch to another in June of this year. I've been seeing her weekly. I was really excited to see her at first but after several sessions I'm just confused.

Most of our sessions focus on family dynamics between my parents, me, and my brother. This is totally important to talk about - I get that - but we haven't addressed my anxiety at all. She said she was trying to realize the core of my anxiety, which I think(?) we've started working out, but anytime I come in and start to talk about the anxiety that has plagued me that week she kind of blows right past it. Last session she told me that I needed to make a list of what I'm trying to get from therapy because she 'doesn't understand my anxiety'. As we rarely talk about it, of course not!

I do see the importance of talking about family dynamics...I went on a trip with a friend overseas and traveled solo for part of the journey and did really well anxiety-wise...I was feeling more empowered and my friend and I being so busy was a great distraction. So yes, coming back home kind of started up the anxiety again but it wasn't the ONLY thing.

So, here's what I want to accomplish:
- find a way to set goals for myself (she says I have none, I told her I didn't know how to set any and we never talked about it again).

- discover and practice coping mechanisms, particularly so that when I feel anxious or upset that I don't immediately get exhausted and/or give up, but can instead work through it.

- see if there's a possibility I can be off medication. This one's tricky, because my therapist has said a couple of times that my health concerns are probably just a way for me to get attention from my family (*I* don't agree) so I'm not sure if she really thinks anything is "wrong" with me in the first place.


I think I would be good with just those three things. Is it okay to go in with a set of demands? I just feel like she's not taking my anxieties very seriously or really helping me cope with them or learn to cope with them. It's just kind of a lot of talk therapy but she's not super empathetic when it comes to what I have to say.

I am so confused.

[maya77]

What's her approach to psychotherapy? CBT? Psychodynamic? Integrative? I doubt it's person-centred, based on what you've said.

[MyNameIsTerry]

Well therapy is a partnership, of sorts. She has to listen to feedback and work with you. She's there to guide you, not in the way a line manager would manage.

I can't say I understand her reasoning for you attention seeking. I could see that in some people e.g. those who post a lot for reassurance, but you don't seem to need much of that. Maybe she is picking up on things you say that show you want validation from your family but seeing as a bigger issue?

Her role is to determine what is best. It's a two way thing but that doesn't mean you place demands on her role if they are unreasonable i.e. if they won't help you to get to where you need to be. Having said that, what you suggest is reasonable and to be honest - why isn't she doing 1 & 2 anyway?!!! They should be pretty standard.

Goal setting is part of therapy. Not the level you would learn in being trained in goal setting, that's different.

Coping skills should be part of it. These tend to be early on as the idea is to get past the need for coping skills.

Maybe it's the method she is using? If it doesn't fit though, she needs to adapt.

[KeeKee]

How many sessions have you had poppy?

I wouldn't say anything you've wrote about sounds unreasonable and I'm in a similar boat to you. I've had 7 sessions so far (I get 16 total) and have no idea what it's all about still. I was given homework this week but I know I won't be doing it. It's kind of one of those things where the situation has to arise for me to be able to do it.

Perhaps discuss things with her? Although of your shy like me I know that will be really hard to do.

[maya77]

It all depends what sort of therapy it is. Solution-focused therapy focuses on future and finding ways to achieve goals. Cognitive-behavioural is about changing negative thinking and modifying behaviour. Psychodynamic therapy focuses on the unconscious, the repressed feelings which are the cause of emotional distress. Person-centred therapy is about allowing the client to explore their feelings and issues. It is non-directive, there is no guidance, no homework etc. It is based on the belief that we all have an innate tendency to self-actualize and the purpose of therapy is to "unblock" that tendency. It is totally client-centred. The client decides what to talk about, what direction to take etc...

So, to summarise, it all depends on the approach of the therapist. Usually at the begging of therapy, the therapist should explain how they work and what to expect from therapy. Regardless of the therapeutic orientation, you should be able to voice your opinions, concerns etc. about the course of the therapy.

[.Poppy.]

Oh gosh, I have no idea what kind of therapy it is. I only remember her saying at the beginning that we were going to talk about the reasons 'behind' my anxiety.

I do look for some validation, Terry. Not to the point that I want to be sick, but to the point where I wish my family would be more supportive through the process. I have a twin brother and I feel very inadequate to him. He also suffered from a bit of anxiety right before he moved and there was a LOT of caring support for him. I suffered for years without speaking up until my first therapist encouraged me to and it was pretty good at first and then just fizzled out. So we definitely talk about what I can expect from my family but at the end of the day I have no idea honestly.

I'd like to learn independent coping skills so that I can handle myself as best as possible.

I have crazy low self esteem, so I have a lot of homework regarding self compassion - mainly checking out the website and watching some of the videos.

I guess I just feel very confused; I went in because my anxiety was starting to spiral a bit again and she stated she had no idea where I was anxiety-wise but we never really talk about my anxiety so perhaps that's something I need to bring up next time we meet.

KeeKee - I've been seeing her once a week since the beginning of June.

[Fishmanpa]

To answer your question... You can talk about anything at all. I know I did

Sounds to me like your therapist is focusing on what she feels is the core source of your anxiety.

Positive thoughts

[maya77]

To answer your question... You can talk about anything at all. I know I did

Sounds to me like your therapist is focusing on what she feels is the core source of your anxiety.

Positive thoughts

Agree with you. However, some therapies are very directive and the therapist leads the client/patient. A person-centred counsellor would never lead or influence you. You lead and he/she follows.

[georgewing]

Well anxiety its developed in majority of cases from childhood and famili has an important role .The therapist try to find the cause of your anxiety and treat the cause so try to understant it .Also focus on good parts of therapist and you will atract more of it

[NoPoet]

It sounds like your therapist is pursuing her own theories and you don't fit into them, but she carries on pushing them anyway, like she's trying to make them fit. This is a waste of time. If your therapist isn't helping you, get another one as soon as you can. Therapy is about you and no-one else.

This may seem hardline but it's the logical course of action. Therapist not helping = try a different therapist.