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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Medusa on February 20, 2004, at 4:40:40
A good friend is in the process of shopping for therapists. So far, he's done several sessions each with three different ones. When he left the first one, he canceled by mail and received a nice letter in response, saying the therapist understood and wished him well. With the two others, he's raised concerns by e-mail, and the therapists have gotten straight-out nasty and insulting.
I'm wondering if this happens more in e-mail conversations about therapy, because it's never happened to me this extremely - but I've never e'd a therapist.
To me, the way a therapist reacts when one decides not to see them any more reflects a lot about their character, sense of confidence and so on.
Posted by fallsfall on February 20, 2004, at 6:57:33
In reply to therapists's reactions to termination, posted by Medusa on February 20, 2004, at 4:40:40
I interviewed 5 therapists.
One was so awful that I barely stayed the whole session. Then he wanted to make another appointment - he just assumed that I would stay. I told him that I needed to talk to some more people. I was insulted that he couldn't see that he couldn't give me what I was looking for - it proved that he hadn't listened to me (I was looking for something - anything - else other than CBT. He said on the phone that he could help me with that, but in person all he did was CBT.) I left him a voice mail saying that I was going with someone else.
2 of the therapists and I both knew fairly early in the session that the fit wasn't right. I liked both of them, and thought they were very competent, but it was just very obvious that they weren't going to be able to give me what I was looking for. Someplace in the middle of the sessions, we verbalized that and then used the rest of the session to get as much insight and advice from them as we could. In both cases, the session was worthwhile, and we parted on really nice terms.
The 4th therapist used to be my group therapist many years ago. I had seen her at the beginning of my crisis for a session, and she had been wonderful and very helpful. I called her when I started my search and she said that she would like to me on my list of candidates. I left her an email when I chose the other therapist, thanking her for her help. I think that she is really mature and I'm really hoping that she took it OK, because I do want to have the option of seeing her again if I need a consultation.
And the 5th therapist won! (well, I hope he sees it that way...)
So I guess I did the harder ones with voice mail, and they didn't respond (and I didn't expect them to).
Posted by Dinah on February 20, 2004, at 11:12:52
In reply to therapists's reactions to termination, posted by Medusa on February 20, 2004, at 4:40:40
My therapist was always immensely gracious each time I terminated. He says I taught him all he knows about terminating in such a way that the client feels free to come back.
Such a nice compliment! :D
Posted by Penny on February 20, 2004, at 11:28:13
In reply to therapists's reactions to termination, posted by Medusa on February 20, 2004, at 4:40:40
I interviewed three therapists when looking around this time. All three of them were quite gracious in how they reacted when I told them that I was interviewing around and would get back to them. But it was what my current T said that made me choose her. She said, "Just let me know what you decide, so I can be sure you're in someone else's good hands if not in mine."
P
Posted by Karen_kay on February 20, 2004, at 15:36:34
In reply to therapists's reactions to termination, posted by Medusa on February 20, 2004, at 4:40:40
I agree that the reaction says a lot about the therapist. Next time I'm shopping, maybe I'll test this out...
I know personally I wouldn't want to see a therapist who "got nasty" with me. Especialy not in the very beginnning. Were the emails questions, or were they direct refusals? I'm confused about that... If they were questions or concerns aobut the therapist's treatment, ect and I received a nasty email back, I'd have to say I'd start looking elsewhere. But, the fact that text is rather hard to decipher the tone, ect could also lead to confusion. So, maybe call the therapist directly and question the intent of the email? I'd say that's the best bet to be sure there are not any miscommunications. If the therapist admits he/she was a bit nasty, I'd say, "Well thank you for your time. I do believe I will be going elsewhere for treatment."
Posted by EmmyS on February 20, 2004, at 16:15:53
In reply to Re: therapists's reactions to termination » Medusa, posted by Dinah on February 20, 2004, at 11:12:52
When I first read your post, I thought it said, "My therapist was always immensely "grateful" each time I terminated".
I did a double take and had to re-read it!
Duh! :-)
Posted by mair on February 20, 2004, at 16:55:23
In reply to Re: therapists's reactions to termination » Medusa, posted by fallsfall on February 20, 2004, at 6:57:33
Fallsfall
How could you tell from just one session whether any of these therapists would work out? How could you tell you'd work best with the one you chose?
I've been seeing my therapist for 4+ years, at least half of that time was for twice a week sessions. It would take a lot to get me to switch now, but it also took me a long time to feel comfortable.
Mair
Posted by Dinah on February 20, 2004, at 17:20:12
In reply to Re: therapists's reactions to termination » Dinah, posted by EmmyS on February 20, 2004, at 16:15:53
Posted by fallsfall on February 20, 2004, at 20:34:50
In reply to Re: therapists's reactions to termination » fallsfall, posted by mair on February 20, 2004, at 16:55:23
Hi Mair,
Many of the decisions were easy. The last one, however was hard. This is probably more information that you wanted to know, but I guess my fingers feel chatty tonight.
A couple of months before I started looking for a new therapist my old therapist and I had a crisis. I was incredibly upset, afraid she was going to kick me out, trying to work things out with her and not feeling like I was getting anywhere - it was so awful. At that time I went to see a therapist, who used to run a group I was in, for a consultation. I didn't tell my old therapist I was going. I didn't like the group that this woman ran, but I had seen her for a handful of individual sessions - before I started in the group, and when my regular therapist was on vacation. I liked her a lot on an individual basis. So when I went to see her, I was going back to see someone I knew. I was quite desperate during that session. We had already established trust (5 years before) and I knew that I didn't have any extra time. To explain the situation to her was going to take at least 35 minutes, so I honestly didn't have time to be shy. She was wonderful. She gave me the feedback I was looking for, she calmed me down, she gave me hope. I think that session helped make my search a lot easier, because in that session she proved to me that someone other than my regular therapist could really help me. I knew that if, during my search I didn't find anyone who I liked better than her, that I would be safe and taken care of by her. So I went into the search feeling like I had an excellent choice to start with.
I got names for my list of possibilities from a number of sources - my GP, my pdoc, my therapist, and 2 friends I have who are therapists themselves. So I had a lot of confidence in my list to begin with. Everyone on the list was highly recommended, and had lots of experience.
I started with the people who had been named by more than one of my sources - I figured these would be good bets. I augmented that list with people who had gotten comments from my sources that made them sound particularly attractive to me. Then I started calling around. I got better at doing phone screens. I started with the group therapist I had seen a couple of months before - I was so terrified, but it got easier after that. I had a list of questions that I got off the internet, plus some of my own. Some people were crossed off the list as a result of the phone screen (one had no room, another did only CBT, etc.)
I interviewed 4 new therapists on the list.
The first one was awful. The chairs were arranged at a 45 degree angle so we weren't looking at each other. He seemed really uncomfortable - he didn't know what questions to ask and had to sit there and think about it. I was bored. I asked him some questions and he seemed put out to have to answer them. Plus, it turned out that he lied to me on the phone - I told him I was looking for something other than CBT. He said that was no problem. But when I asked him what other methods he used, he said something vague about EMDR. It was clear that he was a CBT therapist. Then he just assumed that I would be continuing (I was amazed that he didn't think it was a terrible session). I told him I needed to see some other people before making a decision and that I would call him. I could have told him right then that he had flunked, but he was my first interview and I was a little nervous.
During the previous 8 1/2 years I had been exposed to a number of therapists - my regular one, 4 group therapists, the therapist who covered for my regular one, 2 psychiatrists in the hospital, plus a bunch of counselors in the hospital. Through all of this, I had learned that being shy and scared wasn't going to help me. I guess I had enough experience to tell me that, in general, therapists would treat me well, so I may as well tell them as much as I could. Also, if I decided not to see them who were they going to tell my secrets to? They didn't know me at all. So in all of the interviews I was very candid, and tried to give them a sense of who I was as a patient - and hoped that this would let them be who they were as a therapist.
There was one who I didn't do a good phone screen on. I had been told she did Psychodynamic therapy. I told her I was looking for something other than CBT and she tried to pass me on to one of her collegues. But I had been given *her* name, not the name of her collegues and I wasn't going to be passed off. Well, she used to do Psychodynamic therapy, but these days she only does CBT. Too bad, because I really did like her - the communication was easy, she asked reasonable questions to make sure she was understanding me and to get some details that I left out, she was kind and concerned (I cried in all of these interviews because my relationship with my therapist had fallen apart). Early on we knew it wasn't a match (because I didn't want CBT), so we agreed to keep talking and I picked her brain for ideas on what I should do about my therapist. She would have been a candidate if she was still doing Psychodynamic therapy.
Another therapist was an Art therapist. I had learned an enormous amount about myself through the art program at the hospital. I think art therapy is really cool. I could only find one art therapist in the area. I didn't really know what to expect, but there wasn't really any place to do "art". We talked about how she organized the sessions (usually it ended up with about 3 just sitting and talking sessions for each "art" session - she "knew" when it was time for an "art" one). She didn't ask me anything about any art that I had done already - I found that strange. She listened carefully to my lament about my therapist, and then was very adamant that I should go back to my therapist and work this out. Essentially, she was telling me that she didn't want to work with me because she thought I needed to work it out with my current therapist - even though my current therapist knew I was looking (and in fact had given me her name). The conversation wasn't as smooth as some - she asked questions in an unusual order (from my perspective), she wanted more detail on things that didn't seem important to me, and didn't seem interested in things that I thought were important. It just didn't "feel right". I did get some interesting insights from her - I'm glad that I spent the time with her. But there were lots and lots of things that said that she wasn't who I was looking for.
My current therapist gave an interesting interview. He knew I was looking around and the first thing he wanted to know was what I was looking for in a therapist. I told him I wanted to be understood. Then we talked. He was much stiffer than my current therapist, but he was clearly interested in what I was saying, and he told me a little about another patient he had who had similar issues and how they had worked on those issues. He seemed to understand quickly what I was saying - he didn't ask extra questions - everything was very efficient. There was plenty of time for me to talk about my situation and also to ask him questions. At the end he asked me how he had done (he showed just a bit of ego...). I told him that he had "pretty much understood my problem" (I was almost in tears again, because he really was understanding me, and it had been a while since I felt that way with my current therapist). T: "Just 'pretty much'?" Me: "... No ..." T: "More?" I nodded. He knew EXACTLY where I was, and he wasn't going let me weasel out of it - but he was really sweet and gentle during that exchange. I also asked him if I should see a man or a woman (my transference with my current therapist was "Mommy" based - at least that's what I thought at the time...). He said that it didn't matter if I saw a man or a woman, that the transference would happen with either - that it was important for me to choose a good therapist. This seemed like a really good answer.
So then I had to choose between him and my group therapist. She was a known quantity (I knew that she could understand me and calm me down etc.), but I had some hard feelings left from the group, and she almost made me feel too comfortable. I have dependency problems, and the more I thought about it, the more I was afraid that she would swallow me up - it would be much too tempting to be dependent on her. The guy's stiffness gave me more confidence that I could avoid ending up in the dependency hell that I was in with my current therapist. So the therapist I knew better had some minuses, and the one I knew less seemed to have some plusses.
This was the hard decision - to go with someone I knew who wasn't exactly right, or someone I didn't know who seemed to have (slightly) more potential. I sent summaries of each interview to my 5 closest friends and got reactions. I ended up asking my current therapist for her recommendation between the two (she had suggested both of them - so she knew them both). She recommended the guy, and that is who I chose.
In my next session with him he asked why I had chosen him over the others. I told him that he was efficient. I'm really happy with my choice.
I think the most important thing was that I was able to be really honest with them and not hold stuff back. That gave me the best chance to see how they would deal with me.
Posted by mair on February 20, 2004, at 22:49:10
In reply to Re: therapists's reactions to termination » mair, posted by fallsfall on February 20, 2004, at 20:34:50
I'm so impressed. I mean you obviously went about this in a very systematic and thorough way.
I'm afraid it's never really occurred to me to be a saavy consumer. A few decades ago, I ended up with my first psychiatrist because he was the only shrink I knew. This was pretty much true of my second one as well. I wasn't much better about choosing my current therapist either. She was recommended to me by pdoc #2.
I've never really second guessed how I got to each of them to begin with, because really given the shape I was in, it's amazing enough that I got it together to get any help at all. It's been a little harder not to second guess my decisions about how long I stuck it out; it's hard not to think about what might have been with a different choice. Who wants to conclude that a ton of time with a "bad fit" therapist was a waste? I'm pretty loyal (and basically a chicken) so I would be more likely to drift away than to actually terminate a relationship.
Your gender comment is interesting. My current therapist is the first woman I've worked with, and i really do think I've made more progress with her and been more committed to the process as well. I have a great deal of difficulty opening up, and I just seem to have an easier time talking to her about things I was reticent to discuss with my male therapists. (although to be honest, it's all a matter of pathetically small degrees - there's tons of things I have great difficulty being able to talk to her also) I think she feels that gender makes a difference too. She asked me recently if I thought I might have done better with my last therapist. I told her I didn't think so. Her comment was something to the effect of "I don't think so either given all of your issues with your father."
Mair
Posted by terrics on February 23, 2004, at 17:02:56
In reply to therapists's reactions to termination, posted by Medusa on February 20, 2004, at 4:40:40
Think I hurt her feelings. terrics
This is the end of the thread.
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