# Do's and don'ts when confronting your therapist



## daveithink (Apr 15, 2014)

Hi everyone,

On Monday I am planning to talk with my therapist about some doubts I am having about the way we are doing therapy. I'm feeling pretty nervous and anxious because I don't want it to seem like a personal attack or criticism about her or her competence as a therapist.

Does anyone have advice about how I should approach this? Are there things I should definately avoid saying? Ways to introduce the topic without it sounding like I'm criticising her?

Davey


----------



## RepoMedic (Sep 12, 2013)

Give it to them straight, doc. Don't waste time trying to be super polite but, don't **** everything up by being super mean about it either.

Just say, " Hey, I'd feel more comfortable if we [insert your suggestion] instead of [whatever you have been doing]. " If she were a good therapist, she would understand. If you're having trouble with this person after you've brought up your concerns, switch therapists.

They're trained to be understanding.

Extra line? I think this might help also :

" Can we try something different in our therapy approach? I don't feel like the current one is helping me very much. Please don't get me wrong, I'm not saying you are a bad therapist but, I just feel [suggestion] would benefit me greatly. "


----------



## daveithink (Apr 15, 2014)

RepoMedic said:


> Give it to them straight, doc. Don't waste time trying to be super polite but, don't **** everything up by being super mean about it either.
> 
> Just say, " Hey, I'd feel more comfortable if we [insert your suggestion] instead of [whatever you have been doing]. " If she were a good therapist, she would understand. If you're having trouble with this person after you've brought up your concerns, switch therapists.
> 
> ...


I agree that I have to be straight up about it, but I'm extra anxious because she's the only therapist in the city that claims to do CBT. I live in a tiny city on the west coast of Sicily and there aren't many therapists about so my options are limited!


----------



## RepoMedic (Sep 12, 2013)

daveithink said:


> I agree that I have to be straight up about it, but I'm extra anxious because she's the only therapist in the city that claims to do CBT. I live in a tiny city on the west coast of Sicily and there aren't many therapists about so my options are limited!


Oh crap, I see. Well, think of it this way. I, myself, would much rather try and go for a method of therapy that works for me rather than sitting there wasting my time doing something that I don't feel comfortable with or feel isn't benefiting me in anyway even if I did have to risk 'losing her'.

Though, to be completely honest, I highly doubt she will be pissed off when you tell her, as long as you don't call her names or insult her (like, insult her, calling her incompetent, direct insults.) and from your OP, I know you won't do that, so I wouldn't worry about it so much.


----------



## daveithink (Apr 15, 2014)

RepoMedic said:


> Oh crap, I see. Well, think of it this way. I, myself, would much rather try and go for a method of therapy that works for me rather than sitting there wasting my time doing something that I don't feel comfortable with or feel isn't benefiting me in anyway even if I did have to risk 'losing her'.
> 
> Though, to be completely honest, I highly doubt she will be pissed off when you tell her, as long as you don't call her names or insult her (like, insult her, calling her incompetent, direct insults.) and from your OP, I know you won't do that, so I wouldn't worry about it so much.


I agree with you. She is also my psychiatrist, so if the relationship did end because of these issues, it would mean finding a psychiatrist to prescribe my meds, AND a therapist as there are no others in the area that do both... And since me and my partner are both unemployed as of this week, I'm hoping it won't come to that...
But now that we are in a precarious financial situation, I have to know what she's doing and what she plans to do and how, to know that spending €70 per session is worth my time, and our quickly diminishing money.

She told me we would be doing CBT but I'm doubting her word now, based on what I've studied on the internet, and things she has said during the sessions, and I could probably find a self-help book that would be more use at this stage - and it would cost less than €70!


----------



## daveithink (Apr 15, 2014)

FalseHope said:


> I'm curious as to what exactly you are thinking about your therapy experience thus far and what you are wanting to communicate to her.
> 
> You should address your concerns with her. If you don't feel like therapy is progressing and you are seeing benefit this should absolutely be discussed. However, do it in a constructive way where you can move forward from this and in a direction that is more beneficial for you. She needs to hear the feedback from you but you also cannot act as if you know it all. If you knew how to solve all your problems then why would you even be in therapy in the first place?
> 
> ...


Thank you for your advice, FalseHope. I have had 4 sessions with her so far. I'll describe what we do to give you an idea. First session was longer. I explained what I think is wrong, showed the documents and prescription from a neurologist I saw in Jan.
She gave me a different prescription after discussing my problems, telling me that therapy alone is not going to be enough as I had literally stopped leaving the house and going out only when absolutely necessary.

She asked me to keep a situational diary with 4 subheadings: situation, thought, emotion, behaviour. I only have to write a few words, and we use these entries as discussion starters. So far we have just talked about my week, and then from there she leads me into talking about my life, the people in it, my thoughts on my problems etc. She takes notes, checks her phone every 5 minutes and even answers the phone during my hour.

Last session I asked her if the zoloft would help with my compulsion. I had spent two whole days lost in it during the previous week. She said yes, but that I have to work on it myself, too. I agree with her 100%. But it finished there, she didn't offer me suggestions on how to control it, or strategies or ideas or anything.

That made me start to doubt her to be honest. From what I've read, a CBT therapist would help you to come up with ways to control the complulsion or at least start to get it under control.

When I leave her studio, I have the feeling that I did nothing but talk about the issues, without learning anything or coming away with ideas on how to organise myself.

I completely understand that the therapist must get a clear picture of the client and issues before starting to tackle them, but is it normal to take this long?

It's my first time doing therapy, so I'm a newbie, but her response about my compulsion made me feel even more alone in my problems. The phone thing, and also her insistance on using zoloft instead of a generic because 'the ingredients are better' are all worrying me.

She mentioned in the first session that it seems I have both generalised and social anxiety with secondary depression. I agree. One of the big issues is my appearance, and my inability to feel okay with it. It causes me terrible distress and she believes it is not one of the central issues, but honestly, from what I've read about body dysmorphic syndrome, it describes my symptoms almost perfectly, and can co-occur with anxiety and depression. I would like to mention this syndrome to her but I'm afraid she will think I'm trying to play doctor.

She hasn't once helped me to organise 'leaving the house', I've taken the initiative alone. The first week or two were hood and I made progress, however in the last two I feel like I've run out of steam and courage and I feel back at square 1...


----------



## masterridley (Jan 20, 2007)

The things that are worrying from your description are


she answers the phone during your hour. That's a big no-no. No therapist I've been to did that. It shows disrespect really. When the phone happened to ring, all my therapists either put it on mute or, if it was urgent eg another patient, asked for my pardon and replied as quickly as possible.
She told you that non-generic drugs have better ingredients. That's a flat out lie. What counts is the active substance or component or whatever the hell it's called in English. So no, that's a big fat lie that casts doubt on her qualifications.
I don't know about the length of time but 4 sessions are not that many to get the necessary info. However, if you've asked for help and she hasn't provided any practical advice, then I'd say she's not a good match for you.

Remember, you choose the therapists and they are many. Don't feel obliged to keep going to this one if you really think it's not helping.


----------



## JustChill (Apr 27, 2014)

Ive met with a few different therapists, last one was a year ago, but i never know about these things : 
- getting a medical marijuana card
-talking about suicide
I'm probably not being open enough by not asking, but have any of you touched on these with a counselor? If so, what did they say?


----------



## daveithink (Apr 15, 2014)

masterridley said:


> The things that are worrying from your description are
> 
> 
> she answers the phone during your hour. That's a big no-no. No therapist I've been to did that. It shows disrespect really. When the phone happened to ring, all my therapists either put it on mute or, if it was urgent eg another patient, asked for my pardon and replied as quickly as possible.
> ...


I would also add that:
-she hasn't given me any indication of a time frame, 
-sessions are very unstructured, we just seem to ramble from one thing to another.

From what you all are saying I see that she is probably still getting a clear picture.

Maybe I could just ask her for some feedback on our sessions so far, and ask her what she thinks the main issues are. If she needs more time to get a clear idea of what to work on, and if she thinks CBT is the right path to take...

I will have to tell her about my disappointment at her response to my question about controlling my compulsion because it seemed too vague an answer and it made me feel bad.

I will just have to prepare it all in advance and try pitch it as more of an inquiry about progress and what stage we are at.
Plus the vague response thing... I don't honestly want to change therapists, she is quite easy to talk to and I feel comfortable talking about my stuff, it's just some issues that I have to come clean about.

Easier said than done, the appointment is tomorrow and I'm a nervous wreck about it!


----------



## daveithink (Apr 15, 2014)

JustChill said:


> Ive met with a few different therapists, last one was a year ago, but i never know about these things :
> - getting a medical marijuana card
> -talking about suicide
> I'm probably not being open enough by not asking, but have any of you touched on these with a counselor? If so, what did they say?


I'm afraid I can't help you with the marijuana card. Here in Italy it is very much illegal and there are no provisions for the medical use of marijuana. Plus, weed makes me more anxious, and is pretty much proven to exacerbate existing anxiety. I steer clear of it. No point in making myself worse.

As for talking about suicide, I've mentioned suicidal thoughts but she just said 'really?' And left it at that. Another dubious point. But if you are suicidal or have thought about it it is very important you bring it up, both for your counsellor to understand your situation and for you to help yourself control those thoughts.

Davey


----------

