What does good therapy look like?

[CameronFrye]

Everyone I've seen so far has not been able to help me. My psychiatrist has been the worst, making me question how I really feel and pushing medication on me that made me feel worse. I also hate how brief and impersonal these appointments are, yet they're supposed to know me well to prescribe medications with potentially dangerous and severe ramifications. Psychologists have been a little better but not by much. I appreciate the longer, more frequent appointments and how they get to know me well. However the ones I've had seem to look down on me and I feel like they are negatively judging me but can't say anything. Their advice hardly helps, and is sometimes demeaning because of how useless it is. I don't necessarily expect a solution but I dislike how they confidently recommend things that don't help, or even make me feel worse. They then end the session feeling accomplished while I go back to dealing with how I feel the rest of the week. Maybe it's unreasonable to expect more and it's all simply transactional.

That's been my experience but I don't want to put off therapy because think it could be better and potentially help if done right. We're expected to figure out this on our own and trust any psychiatrists/psychologists because they are professionals which can be harmful. Also, anyone can become one regardless of the type of person they are and their life experience. As a result bad therapy seems to be common. I think it would be useful for me and this form to hear from others what the experience of good therapy, and even bad therapy looks like so we know what to look out for.

 

[km0990]

Let me know when you find out lol

 

[everydayiloveyou]

• You both talk equal amounts. This is tricky depending on where you are at in your recovery, but basically -- a therapist who just sits and lets you babble can be just as unhelpful as a therapist who constantly interrupts or over you
• You trust your therapist. You feel that they will inform you if they are going to make big medical decisions. You feel that you can talk about the things that matter to you with them.
• You don't feel patronized or unheard during sessions
• Your therapist communicates with you. They tell you if they have scheduling conflicts, or if they are concerned aboout something you are doing.
• Your therapist maintains a purely clinical relationship with you. They shouldn't offer to go out to places with you, allow you to text/call them whenever (as in, they are always available to talk you down), or make advances on you.
• Your therapist has a plan that theyve worked out with you. They may help you set goals, or ask you to do homework. They do not just have you come in and vent without purpose.
• They challenge you but are conscious of your limits. A therapist who just agrees with everything you say and does not attempt to point out distorted/irrational thinking or behaviors may be easier to talk to at first, but eventually they can start to seem uncaring/overly personable which leads to an unhealthy therapeutic relationship. Plus, it does you no favors to just talk at someone for an hour every week. The point is to grow and work on your issues.
• They remember things you've said in previous sessions and take a genuine interest in your journey. They may not necessarily agree with everything you do, remember the names of all your family members, or relate to you exactly, but in general they are clearly keeping up with what you're saying.

 

[whatevs]

I have been to many psychiatrists and psychologists. The first ones are the less useful and more uncaring, but the last psychiatrist, along with basically insulting me, correctly pointed out that I have some narcissist traits, and it has been helpful being aware of that. So if they know their profession well at least they can provide you with an identifying label.

Then the psychologists are, for me, only good for venting, and I mean REALLY venting, letting all out, the ugliest parts of yourself that you can't share with people. Then let them process that and tell you what they think. I want to kill myself, I don't appreciate life, I have criminal urges, I'm happy to think that many people will die if X happens, whatever it might be.

But to me both have been basically useless, as I have a sleep disorder that is behind me being in a suicide forum, not my mental quirks or hurdles. And they have no idea what causes it. I had the mental problems before the unrefreshing sleep and was advancing semi-miserably but acceptably in life all the same.

 

[summers]

Best therapy there is...

 

[ncmxm]

It gives results lol

You're not told the same generic things, you hear something new that makes you think about things in a different way

 

[Angi]

• You both talk equal amounts. This is tricky depending on where you are at in your recovery, but basically -- a therapist who just sits and lets you babble can be just as unhelpful as a therapist who constantly interrupts or over you
• You trust your therapist. You feel that they will inform you if they are going to make big medical decisions. You feel that you can talk about the things that matter to you with them.
• You don't feel patronized or unheard during sessions
• Your therapist communicates with you. They tell you if they have scheduling conflicts, or if they are concerned aboout something you are doing.
• Your therapist maintains a purely clinical relationship with you. They shouldn't offer to go out to places with you, allow you to text/call them whenever (as in, they are always available to talk you down), or make advances on you.
• Your therapist has a plan that theyve worked out with you. They may help you set goals, or ask you to do homework. They do not just have you come in and vent without purpose.
• They challenge you but are conscious of your limits. A therapist who just agrees with everything you say and does not attempt to point out distorted/irrational thinking or behaviors may be easier to talk to at first, but eventually they can start to seem uncaring/overly personable which leads to an unhealthy therapeutic relationship. Plus, it does you no favors to just talk at someone for an hour every week. The point is to grow and work on your issues.
• They remember things you've said in previous sessions and take a genuine interest in your journey. They may not necessarily agree with everything you do, remember the names of all your family members, or relate to you exactly, but in general they are clearly keeping up with what you're saying.

If you feel therapy could benefit you, do give it another go! I second everydayiloveyou's list and would like to add some things:

Not all points need to be true at all times. I trust my therapist, but I think we have failed all of the above at some point in time. The important bit for me is that we can resolve that. For example: I feel unheard. I hurt and grumble a bit. Next session I bring it up and we find a way to fix it. With more serious shit it may take several sessions to resolve. I found a lot of literature saying that this kind of work is actually the meat of therapy, the part that allows you to grow for your future relationships and as a person.

When looking for your therapist, I think you want to give them benefit of doubt for a session or three and then think about whether you can imagine having a productive argument with this person. Imagine they said something that hurt you, or suggested you do something in therapy which you think is a terrible idea, could you imagine telling them and getting a productive answer?

Most importantly, I think a good psychologist/psychiatrist must always know that this about you, and be willing to adjust if they are missing your point, make you feel invalidated, or anything of that kind. Even when they disagree with your thoughts or choices, their job is still to make your head more user-friendly, so whatever is in your head is the ground they are working on. The gist of this is already present in several of the points above, but it think it is so important it should get its own separate statement.

Also, you might want to avoid sharing your suicidality with them. Depending where you are they may hospitalize you, and they will certainly be worried, which according to other people on this forum makes them less helpful.

Then the psychologists are, for me, only good for venting, and I mean REALLY venting, letting all out, the ugliest parts of yourself that you can't share with people. Then let them process that and tell you what they think.

I also like the venting feature. I never had any of them tell me what they THINK, though. Why would I need to know that? I can do my own thinking. What has been helpful is looking into what I feel, or felt. This is where the worms live that keep me up at night.

 

[whatevs]

I also like the venting feature. I never had any of them tell me what they THINK, though. Why would I need to know that? I can do my own thinking. What has been helpful is looking into what I feel, or felt. This is where the worms live that keep me up at night.

Well, the whole point of going to the psychologist is to get feedback from someone that supposedly can distinguish between quirks and pathological delusions or personality disorders. So, even though venting is mostly what I have found them good for, they should be able to criticize your beliefs when they fit an undesirable or deranged category.

 

[Sherri]

To me a black couch where I can lie, darl lighting and have the therapist asking me questions. In real like I've had an uncomfortable chair white light, and therapists who just look at me waiting on me to do all the talking, not pushing me to talk. so that's why I let them all go and just stayed with my shrink.

 

[Dr Iron Arc]

I think that good therapy, which in my opinion means tangible improvement in whatever is afflicting you, is only obtainable for people who fit within a certain framework that the therapists, psychiatrists, or other professionals are prepared to deal with. One wrong assumption they make about which techniques or dosages will work on you and it can all go wrong, potentially to a point of no return.

I also think therapy probably can't be perfected by actual humans because therapists themselves are human and thus can be influenced negatively by their patients. They're not immune from the biases and flaws other humans have but sadly they really need to be in order to deal with certain people or conditions. It's like asking a horse about the finer points of horse racing. Just because it's the thing doing the racing doesn't mean it knows anything about what's going on except to move forward. That's what trying to understand and cure humans seems like to me sometimes.

 

[JealousOfTheElderly]

No. I've never had luck with therapists. They make me feel worse afterwards. They don't care and have issues of their own which get in the way of them doing their job.
Also, they're not the sharpest tools in the shed. They treat their patients Iike the patients are inferior.