Best Therapy - How to choose

"ConnieKat" cbdsgn2=...@pacbell.net

I'm digging through one of my goofy books... It has a chapter about how to choose a therapist. I thought a few things out of it might be interesting....
---The best therapists
-Encourage a patient to become a responsible active partner, but also do not follow the patient's every whim. They will make you work.
-Are very aware and sensitive to patients changes.
-Constantly aware of the patients mood and thinking.
-Usually do not insist on one therapeutic method, and often tries a combination of methods.
-Develop and share the therapy goals actively and with the patient participation.
-Take as a first priority the establishment and maintenance of a relationship that serves the goals of therapy.
-Rapidly develop and intense relationship with the patient - emotionally charged, trusting, respectful, confident.
-Explicitly negotiate mutual expectations with the patient.
-Encourage patient re-education.
---Not so good therapists .
-View patients opinions with skepticism, condescension, or just plain contempt.
-Fail to perceive whether the patients are improving or deteriorating.
-The worst therapists get wrapped up in their theoretical ***umptions and miss most of what is going on with the patient. (Janneke, Is this your therapist????).
-Are locked into rigid beliefs and habits.
----Goals that good therapists usually suggest to the patients"
-Development of self sufficiency - autonomy, independence, self-directed planning. Patients usually wish for increased satisfaction and control.
Therapists focus on the development of self-mastery and self-reliance necessary to achieve patients goals.
-Avoidance of permanent harm (counter therapeutic relationships, over dependence, exploitation) One of primary therapeutic tools used is 'stress to the patient' - as much as the cutting edge is used in surgery. Sanctions against permanent harm, especially exploitation of the patient, psychologically, financially or sexually are fundamental.
-Relief of symptoms (psychological pain, depression, anxiety, marital discord, alcoholism...) These are primary reasons patients seek therapy.
While some therapists de-emphasize this goal, the best ones keep in mind that the relief of symptoms is usually central.
-Balancing conflicting needs (intimacy vs. independence, work vs. play, security vs. excitement) A key lesson to the patient is to learn how to care if one's own needs.
-Establishment of a positive self image (self-awareness, self-respect, comp***ion for deficiencies)
-Fostering the inherent capacity for self healing (growth, personal courage, honest self evaluation, careful risk taking) Ideally a goal of good therapy is to dispense the need for further therapy. The best therapists seem to focus on this autonomy related issue early and encourage patients, implicitly or explicitly, to take responsibility for their decisions and actions.
--
Hugz, Connie=^..^=

"janneke" asdaddre...@freeler.nl

Hi Connie, This is a great list to help me sort out what isn't workng with my still-sorta-therp-until-I-find-something-that-works. I'll say some things in response, mainly to get my thoughts going and to see what I will learn.
He does that.
He probably does that, although not in a way that is visible to me.
Dunno.
I don't know, wouldn't know how to notice/what to pay attention to in order to know.
This NEVER happened.
I agree that this should be a priroriy, but I find it hard to tell how this should be done and how to know whether it's being achieved. There are so many possibilites, and I'm ignorant of all of them.
This never happened. The word "rapidly" strikes me as utopian, "intense" as somewhat exaggerated.
I think he tries to do that.
What IS that?
He doesn't do that.
Hm, I think he does, but doesn'tknwoexactly. he tensds to thik I'm doing better thatn I actually am, but I think with me it's hard to tell anyway.
He misses some things, not all. Unfortunately theyare the important things (ATM, my analysis of the problem with him is that I feel entirely unrecognized. That is the very last thing I need, it's bad in itself and a huge trigger on top of that).
Yeah, he is. Not entirely, but too much.
I'm am *very* independent. My goal shouldn't be any of the above, I don't think.
I'm not sure what is meant here.
He would say this is the goal. I woudl say my gaol is not releif of symptoms (I thingk they're chronic, the effort required to get just a *little* bit better woudl be humongous. I see that as a bad investment. I want to be able to feel I exist and to be able to *want* period.
I'd like to learn more about that and haven't. I haven't talked about it much with him, but he didn't go into it either. But then he never goes into anything. IMO because he never gets my point.
I'm starting to feel cynical.
All he ever does is make me feel repsonsible for myself. I ALREADY feel responsible for myself and EVERYTHING around me, I don't need anyone to make me feel this way even more. It just makes me feel abandoned, ignored, neglected. I rarely ask for help, so I don't want a therapist telling me I need to help myself when I obviously don't know how and when I am already trying my hardest. I CAN'T try any harder, it will drive me insane.
I'm feeling like Chimera often does, now, I think.
Anyway, these are my thoughts for the moment.
Thank you for posting this Connie, and for thinking of me.
Janneke

metaphorSPAMBL ...@usaor.net (Stewart/sna)

Sometimes we play "hide and seek" with ourselves. We hide our "true self" from ourselves (and by extension, from those around us). At the same time, we complain that we can't find ourselves and that other people can't find us. Sometimes we seek help in finding ourselves, but when someone else comes close to finding us, we run and hide again.
We can't figure out what we like and what makes us happy. So we complain because other people don't do the things that make us feel happy or because they do things that make us feel unhappy.
The conflict between independence, autonomy, abandonment and engulfment.
Sincerely Stewart
--
metaphorSPAMBL...@usaor.net (remove the SPAMBLOCK if you want to reply in e-mail)

"janneke" asdaddre...@freeler.nl

I know what you mean and it does apply to me. However, there are also things intrinsically wrong between me and my therapist and I am trying to understand what they are. I don't put all the blame on him, if that's what you're thinking.
Janneke

"ConnieKat" cbdsgn2=...@pacbell.net

Yea, that chapter made me think of you, and your struggle, and a few other people in here. Hope it helps a bit.
I responded with few more details in email.
--
Hugz, Connie=^..^=

"ConnieKat" cbdsgn2=...@pacbell.net

| Sometimes we play "hide and seek" with ourselves. We hide our "true self" | from ourselves (and by extension, from those around us). At the same | time, we complain that we can't find ourselves and that other people can't | find us. Sometimes we seek help in finding ourselves, but when someone | else comes close to finding us, we run and hide again.
| | We can't figure out what we like and what makes us happy. So we complain | because other people don't do the things that make us feel happy or | because they do things that make us feel unhappy.
| | The conflict between independence, autonomy, abandonment and engulfment.
| | Sincerely | Stewart That's all very true, Stewart, but shouldn't a good therapist make a decent attempt to crack that armor?
--
Hugz, Connie=^..^=

"ConnieKat" cbdsgn2=...@pacbell.net

He, your therapist, being that he is a *trained professional* at his, I think has a larger percentage of blame, than you do.
--
Hugz, Connie=^..^=

metaphorSPAMBL ...@usaor.net (Stewart/sna)

It doesn't sound to me like you put all the blame on him. Not at all.
But I suspect the more you resolve these sorts of issues within yourself, the easier it is to see when it's your problem and when it's the other person's problem.
Not that I know how to resolve these issues or anything like that tho.....
Sincerely Stewart
--
metaphorSPAMBL...@usaor.net (remove the SPAMBLOCK if you want to reply in e-mail)

metaphorSPAMBL ...@usaor.net (Stewart/sna)

Sure, I think a good therapist should make a decent attempt to crack that armor.
But if the therapist can't crack the armor, then you might want to ask yourself which came first, the lousy therapist who didn't make a decent attempt to crack that armor, or your choice of a lousy therapist because you didn't want to find yourself. Or your sticking with a therapist who wasn't working because you didn't really want to find yourself. Or your complaint that the good therapist is really a lousy therapist because the "lously" therapist was actually getting uncomfortably close to finding you (or leading you uncomfortably close to finding yourself).
It's not to say that there aren't people really looking to find themselves who get trapped through limited opportunities and no fault of their own with really lousy therapists. I suppose that happens all the time.
Sincerely Stewart
--
metaphorSPAMBL...@usaor.net (remove the SPAMBLOCK if you want to reply in e-mail)

"ConnieKat" cbdsgn2=...@pacbell.net

"janneke" asdaddre...@freeler.nl

:) That's why I'm seeing a therapist in the first place, to resolve issues.
And with this therp, the ones that stand in the way of other ones can't be resolved, so there's a problem. *I* don't know *how* to resolve them, and my therp doesn't either. So we're stuck. I do think it is part of the therapist's job to help me work on that, and I think that whatever he's doing it isn't working for me.
Janneke

"janneke" asdaddre...@freeler.nl

Oh, maybe this is why you brought this up. You think I chose this therapist and the complained about him anyway.
I didn't, he was appointed to me.
In The Netherlands, there are long waiting lists for therapy. There's the kind that you pay for yourself, and the kind that your health insurancewill pay. There is no real difference in quality, it's just separate systems.
There are waiting lists in both types.
I get the kind that my insurance covers (90 sessions tops, I pay about US$ per session myself). With that kind, you have no choice, you take what you can get. Even then, you're lucky to get anything at all. It took me 6 months to get my first proper appointment, the time was spent on the waiting list (5 months) and the intake procedure (1 month).
If I would pay for it myself (which I can't afford), I'd still be on waiting lists freom several months to over a year. So in order to find a therapist, I'd put myself on several people's waiting lsits, then see whoever has time to see me first and hope for the best. If I don't like the first, I can wait and see about the next one who has time. Since they have different waiting lsits, I could never see severla in the same time frame and compare. Afaik, it's not possible to even get an initial, getting to know each other appointment before it's your turn.
I've been seeing this therp for about 18 months.
To get a different one, his referral would be the best way. It could help avoid waiting lists (he could possible ask a colleague to let me jump it), and at least I think he'd refer me to someone good. Without a referral, I'm condemned to the phone book. Which is like a casino.
Even my very sensible family doctor says it's almost impossible to find a therp.
When I got this one, basically I was very lucky to get one at all. I think they thougth I was a fairly serious case.
Hope that explains some things.
Janneke

metaphorSPAMBL ...@usaor.net (Stewart/sna)

Well, it explains a little about how you got your therapist and how people in general get therapists in the Netherlands, but other than that, it doesn't really explain anything to me personally. Maybe it does to you tho....
It might be time to change therapists. Maybe you've gotten about as much as you can from this one at this point in time. On the other hand, maybe you're getting too far with this one. I don't have a clue.
Sincerely Stewart
--
metaphorSPAMBL...@usaor.net (remove the SPAMBLOCK if you want to reply in e-mail)

"ConnieKat" cbdsgn2=...@pacbell.net

Well Stewart, over there it's not that easy to change doctors, therapists...
As it is un US.
Welcome to the socialized medicine!!!
As much as we like to b*ch moan and complain about how things are in this country (US) we have it pretty damn good. It really takes living elsewhere to find out.
--
Hugz, Connie=^..^= | | Well, it explains a little about how you got your therapist and how people | in general get therapists in the Netherlands, but other than that, it | doesn't really explain anything to me personally. Maybe it does to you | tho....
| | It might be time to change therapists. Maybe you've gotten about as much | as you can from this one at this point in time. On the other hand, maybe | you're getting too far with this one. I don't have a clue.
| | Sincerely | Stewart

"janneke" asdaddre...@freeler.nl

That's what I'm doing, I'm in the process of finding a different therapist.
Janneke

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