![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Daisym on November 25, 2007, at 23:47:02
I have an interesting situation. A friend who knows I've been in therapy for awhile asked me what I thought about her therapy and her therapist. Talk about delicate! That is kind of like someone asking you what you think of her husband when she is upset with him -- you never know which way to go! Instead of answering directly, I asked lots of questions.
It seems she is somewhat unhappy about the "strict" boundaries her therapist has. But to me, the way she described things, they are actually pretty typical boundaries of a therapist. She wants to be able to email and her therapist doesn't offer that. (Neither does mine.) Her therapist doesn't run over session times and has an answering service who will page her if there is an emergency. My friend talked about other people who have more "access" to their therapist or get what feels like more individualized attention.
She also asked me what I thought the perfect amount of sessions per week or month were. I thought about some of the threads here and kind of hedged. I think session frequency depends on so many things - including the client's ability to tolerate both the depth of frequent sessions or the length of time in-between them. Money comes into it too, as well as jobs and family and other time commitments. There just is no "one-size-fits-all" in therapy, is there? This was a particularly hard question for me because I see my therapist 4x a week - but I often feel guilty about that - mostly like I'm indulging myself somehow. She is currently going 1x a week but would like to go 3x over two weeks. I told her the standard Babble answer - "talk to your therapist about this. See what she says."
Overall, my friend said she is pretty happy with her therapy. She went in over a bad break up and feels like she has learned a lot about herself. I told her that this seemed the most important thing and that comparing her therapy to other people's might be making her unhappy when she didn't need to be. But I admitted my bias of not bailing on an existing therapy unless it was really not working or detrimental in some way. I think a lot of work gets done in "fighting to relationship" as Dinah would say.
I guess it just made me think that we can't really compare therapy or therapists very well. Each person has to find what works for them.
I wonder if you would have answered differently?
Posted by twinleaf on November 26, 2007, at 0:33:19
In reply to Giving advice about Therapy, posted by Daisym on November 25, 2007, at 23:47:02
You gave all the best answers, and didn't get lured into giving any views about her therapist. But it feels like something unsaid is going on. I think a person must have some serious doubts about their therapy if they ask a friend about it. When you know you have a good therapist, you never need to ask anyone- even in the most difficult times. For example, have you ever felt the need to do that? The unhappiness with lack of phone and e-mail access seems a bit odd, because many of us don't have it. I don't- but it's all right with me. I know my T works 10-hour days, seeing patients pretty much one after the other. Between them, there's time to check for emergencies, but not time for making other calls or e-mailing. On his phone message, he gives his home number, as well as the number of a back-up therapist, but it would take an extreme emergency for me to call him at home! The general message from him is that, if you really need him, you can get him. Otherwise, things are confined to the therapy hours.
I know some people do have easy phone and e-mail access, but I think more of us probably don't. I wonder if your friend was really trying to tell you that she is worried about whether she and her therapist are a good fit.
Posted by Daisym on November 26, 2007, at 1:24:09
In reply to Re: Giving advice about Therapy » Daisym, posted by twinleaf on November 26, 2007, at 0:33:19
I'm not sure I agree with never having to ask - I know there have been times when I wondered if my therapist was "too nice" - and that came out of my strong feelings for him. In retrospect, I didn't trust my own sense about it all - but I was lucky to have a therapist who made it easy to talk about my fears and questions.
I wondered as she talked if she was getting attached and that scared her. I think a lot of people look for fault in order to create distance. But that is a pure guess on my part.
Posted by sunnydays on November 26, 2007, at 8:47:55
In reply to Giving advice about Therapy, posted by Daisym on November 25, 2007, at 23:47:02
I'm not sure I would have answered differently. I probably would have turned it back on her and asked her what she thought, but it sounds like she was already telling you that. I can email my therapist as much as I want, and call as much as I want, so I'm lucky I guess. He doesn't always respond to all my emails and he's realllly bad about returning phone calls (he forgets to check his voicemail at home), but it's the right amount of contact for me. The emails really let me keep secure in the fact that he's there since I tend to freak out that he's going to leave me.
Incidentally, my mother saw my email account over Thanksgiving because I accidentally closed a window when she was standing there, and she was asking me why I had so many emails from my therapist. She was abused by therapists in the past, so she's hypersensitive, but I HATE having to depend my therapist to her because he's so far from abusive. I have to do it though because she pays for my therapy.
Anyway, I'm late for work, but I wanted to respond.
sunnydays
Posted by Muffled on November 26, 2007, at 9:09:01
In reply to Re: Giving advice about Therapy » Daisym, posted by sunnydays on November 26, 2007, at 8:47:55
I think you said it nicely daisy.
I too have had doubts bout my T.
I think T's are, of course, human so they ARE going to screw up occasionally, or miss cues from us clients.
I have had huge doubts bout my T, but then further down the road...duh...I start to better understand what happened, and actually, my T is pretty clever I guess.
I also wondered if maybe your friend has more 'stuff', and so is testing T to see if she gonna be 'safe' to say stuff to?
The whole T thing is SUCH a challenge.
I agree, your friend needs to talk it out with her T, and see if T is gonna work for her. Just in the talking it out, realtionship is built.
Trust is so so hard.
I really hope I'm wrong bout her having more 'stuff' :-(
M
Posted by Dinah on November 26, 2007, at 9:15:50
In reply to Giving advice about Therapy, posted by Daisym on November 25, 2007, at 23:47:02
Those do seem like pretty standard boundaries, and it might be hard to find someone who had looser ones. Especially if you used it as a screening question. :)
I guess two things come to mind. One may be that she really doesn't feel attached. And the other is that she might feel attached, and as happens to most of us one time or another, is bumping into those boundaries and remembering the limits of the relationship. Even though I've mainly come to terms with it, it still hurts now and again.
As far as frequency, that really is something to discuss with a therapist. There may be external constraints, or the therapist might not have a practice of suggesting a larger commitment of time and money to clients but waits for the client to ask, or the therapist might think it is counterproductive.
Definitely you can't compare therapies or therapists. What's right for me might be entirely wrong for someone else. And the perfect therapist for someone else might be one I wouldn't last a month with. Even therapists probably tailor therapy to the client.
The important thing is if someone thinks they're being helped.
Plus, of course, I keep in mind that my therapist might not recognize my posts if he didn't know my posting name. :) My view of what happens between us might not come close to his view, or the view of an objective observer.
I wouldn't have said anything different. And I also believe in the benefit of fighting to relationship, if the underlying fit is good enough.
Posted by annierose on November 26, 2007, at 16:26:53
In reply to Re: Giving advice about Therapy » Daisym, posted by twinleaf on November 26, 2007, at 0:33:19
>> I think a person must have some serious doubts about their therapy if they ask a friend about it. When you know you have a good therapist, you never need to ask anyone- even in the most difficult times. For example, have you ever felt the need to do that? <<<
I'm not so sure. When I bumped up something difficult in therapy and think "this must be my t's stuff", I come to babble asking for help or their opinions. And now that I know some babblers more, I may e-mail them directly, "what do you think about this?". In effect, I'm asking "Is this okay?". Without knowing the presenting problem in someone's therapy, it's hard to know whose stuff is coming up. I can only speak for myself, but over and over in my real life, I bump into problems with my interpersonal relationships. I always assume the other person doesn't really like me, doesn't really have "my back". So it's not a surprise to my therapist that those same feeings present themselves in my therapy. I constantly wonder, "Does she like me?" or conversely "Is she the right therapist for me?"
I don't think it means she isn't a good fit. Or that our theraputic relationships has serious flaws. Quite the oppposite. It can mean that I have painfully, finally gotten to the core presenting problems --- my self worth. And now I can sort through them with her.
Everyone brings different stuff to the couch. Doubt, self sabatoge, resistance ... that can all come into play and make the client wonder ... "Is this 'normal' in therapy to feel this?"
Posted by annierose on November 26, 2007, at 16:35:59
In reply to Giving advice about Therapy, posted by Daisym on November 25, 2007, at 23:47:02
I think you did a great job of balancing both sides of the question. Very delicate question indeed and I can see why she felt like she could ask you.
Maybe she was also asking for reassurance --- that (probably?) most therapist do not accept e-mails, or run over session times. That is typical.
I don't have many friends in real life that go to therapy (or at least share that with me). But in the past I found it interesting to hear about others experiences. It's not just about the therapist. It's about the relationship between the two people in that room and the energy that they share or create. I guess it's possible that if I saw babbler X's therapist, I would have an entirely different experience.
We could be posting about the same therapist and one complaining that he was too rigid and the other swooning about his/her attributes.
Oh - back to your topic. You did a great job with your friend by asking questions and listening to her answers. You are a good friend.
Posted by RealMe on November 26, 2007, at 21:08:23
In reply to Giving advice about Therapy, posted by Daisym on November 25, 2007, at 23:47:02
As others have said, it sounds like you said all the right things. Ironically, I would wonder about my T if he did not keep strict boundaries. It is important to me that he do, and I don't think I would trust him if he did not. Down to the last second, we never go over time. As far as phone calls, I could call him at home as I have his cell number, but I just don't think I could under any circumstances. That is pretty bad, but it is how it is. RE emails, I occasionally email him, and he does not email me back usually unless it has to do with scheduling or something like that. My last email to him was to give him my home and cell numbers. Apparently he had only my work number. Darn; I said to him. I should have left it that way, and I got the intent look. So, I would wonder why your friend wants her T to break the boundaries. I don't know how many here have therapists who are strict about boundaries, but if they were trained psychoanalytically as I was, then you know it is extremely important to maintain boundaries.
RealMe
Posted by sunnydays on November 26, 2007, at 22:07:40
In reply to Re: Giving advice about Therapy » Daisym, posted by RealMe on November 26, 2007, at 21:08:23
Well, I think having strict boundaries is one thing and keeping boundaries is another. My T has fairly loose boundaries I would say, just from reading the responses here. I know quite a bit about his life (he tells me little stories about how he interacts with his kids, his wife, every once in a while something about his hobbies, I think to model for me what a healthy adult and a healthy relationship can look like). And he lets me email him multiple times a day if I want, although he doesn't answer more than a sentence or two (and usually only a word or two) and he only answers one or two emails a day. He reads them all, though. And I can call his voicemail whenever I want.
I'm kind of wondering now if people think there's something wrong with having looser boundaries like this? I said in my response to Daisy how it's an issue that recently got raised for me by mother (who is a very dysfunctional person whose perceptions I cannot trust), so maybe I'm being oversensitive. I think that my T keeps boundaries, they're just fairly loose is all. He's told me I can ask him for anything I want to, he has no problem saying no, and I believe him.
Anyway, I guess I'm asking for reassurance. I get worried about what other people think sometimes, which is the downside of Babble. I think I need to trust my gut that this relationship I have with my therapist is exactly what I need right now.
Thanks for putting up with me,
sunnydays
Posted by RealMe on November 26, 2007, at 22:50:45
In reply to Re: Giving advice about Therapy » RealMe, posted by sunnydays on November 26, 2007, at 22:07:40
When I said my therapist has strict boundaries, I also meant he keeps them as well. This works best for me and always has. But that is more of a psychoanalytic approach. When I was doing therapy, I did not share about myself or my family. That is just how I was trained.
I can't say what your therapist does with you is good or bad. I am not in your shoes or your therapist's shoes. I am only saying what works for me.
RealMe
Posted by Phillipa on November 26, 2007, at 23:44:40
In reply to Re: Giving advice about Therapy » sunnydays, posted by RealMe on November 26, 2007, at 22:50:45
All the therapists I've had and had friendships with while working always shared a bit about themselves and their families. I know also that my pdoc's husband died of cancer, she has grandchildren, a condo at the beach and that her dog wandered out of the yard and got lost. Now I know she's just like me both are I think they are no different than me. Maybe better adjusted. Just shows me I maybe can do it too I hope. Phillipa
Posted by Daisym on November 27, 2007, at 0:29:02
In reply to Re: Giving advice about Therapy » RealMe, posted by sunnydays on November 26, 2007, at 22:07:40
I think it is very hard not to worry about whether our therapists are too hard or too soft -- but I think you said it best yourself. He is what you need right now. And that is the mark of a good therapist - to individualize the therapy enough to work for the client.
My therapist is a huge believer in attachment. He helps me feel OK about all these intense feelings for him. We have lots of ways for me to feel connected over breaks - I call and leave messages about how I'm doing, or I'll journal to him and take in the pages. If I need him to call me back, I'm supposed to say so. But if I'm having a really tough time, my therapist will call just to touch base. I've had people tell me how "bad" this is - and others who say it wouldn't work for them because they'd want it all the time. So I worry that somehow I've enticed him to do something wrong - does that sound like abuse stuff or what? He just reassures me that he is very capable of taking care of himself and he only does what he chooses to do. I don't have that much power. (Thank goodness.)
It works for us. Just like what you are doing works for you and your therapist.
Today I was wishing I'd done this work in my 20s - like you are doing. My therapist said a bunch of stuff and then he said, "and if you had, we probably wouldn't be working together. So it is fortuitous that you waited." :) He's right - I needed the right person to do this deep work with. But I'm glad he thinks so too.
You are doing good work. Try to trust your gut. It knows what you need.
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.