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Anyway as a question instead of just throwing my 2¢ in there: How do you initially decide what path to go down with a patient? Obviously everyone is unique, but are there certain techniques you've figured out have worked with certain personality types better? For example, do some people initially need a softer or less direct approach, and do some people need a very blunt one to get going?
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Oct 9, 2022 21:57
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womb with a view posted:I think the answer to that might differ from person to person. Thanks for this reply. One thing that took me a good long while to figure out is that there's a sizable and distinct difference between "not being happy" and "being sad". Some days and some times just ARE and I may not be happy go lucky or perky but that doesn't mean I'm down. Not sure why your post reminded me of that particular personal revelation but realizing that I don't have to feel great 24/7/365 is a far cry from being mired in the crippling sadness I sometimes experience and that life is not always filled with endorphin power ups. Like, realizing that I can go to a party or something and maybe feel some slight discomfort or social anxiety but then also realize it doesn't have to be a Banger where all the women dig me and everyone thinks I'm funny. I can just BE at the party. Or that going to work doesn't have to mean I'm either entirely on point versus totally dreading the idea of going in. Sometimes, it's just Thursday. And I don't have to be happy all the time to not feel sad. Hope that made sense.
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Oct 9, 2022 23:13
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BiggerBoat posted:Very very cool thread 1) Bring me down? No. Speaking one's pain truthfully is the essence of the work. Sadness and pain IS the healing. We love that poo poo. poo poo I can't shake? Yes that happens sometimes. Therapists have support systems and networks to disperse some of that. Just like with clients, it helps once we talk about it. After, maybe, a decade (?) of working this happens pretty infrequently I think. There's only so many things a human can think and thus say to their therapist. Some stuff still gets to me. And I won't work with kids for this reason. I can't hear that and sleep at night. For some it's not a problem. I'm not at that point and still get affected by stuff, but it's never the kinds of things you'd expect. So I go to therapy about it. 2) It is horrible. As bad as a client thinks it is, trust me it's so much worse. Capitalism is doing its thing right now and the mental health system is full of vulnerable people and.......therapists, a pretty good population if your goal is to exploit labor and resources. It will not get better. California is doing the best they can though, and sometimes that actually is good enough. It's terrible on our side too. There are often a plethora of clients who want therapists and therapists who want clients but Capitalism does what it does best and separates them so people eventually give up searching. Try openpathcollective though, good site. 3) I like telehealth. In person is more effective though for me and my style. I do a lot of telehealth and may switch it 100% in the future because, again, Capitalism. Rent for offices is insane right now and that won't get better because Capitalism doesn't magically "get better". It goes until it collapses like all systems out of balance. Never heard of GetHelp. Looks like a SASS for providers? I lol'd at the Conscious Capitalism tag they proudly display, but I'm cspam brained so 4) Love this question. There are two schools of thought. 1 is you meet a client where they're at. If they're not ready to quit, don't have the support system, can't stomach it, whatever, doesn't matter, you meet them where they're at right now, in the room. 2nd school of thought is if someone is showing up high on their addiction, they won't be able to do any work, and it's actually unethical to take their money because they literally, neurologically cannot make change or go through catharsis or what have you in that state. And you, as the therapist, are simply hurting them by not upholding your boundaries. The people I learned from were very firm on this, uncompromisingly so and they are of the latter school of thought. When I first started working I was definitely in the former. But I tried it and over and over, it didn't work. If someone is high they can't access their feelings, and if they can't access their feelings what are we doing here? Someone I deeply respect has a 48 hour policy. He says he won't work with someone if they show up loaded or have been within 48 hours of the session. I asked him once, "how do you know? can't they lie?". He laughed and said "they can loving try!" Because when they can't access their emotions, he knows. He will cancel the session immediately and still charge them ($200 for 45 minutes is his rate). If the client or anyone's response to that is, "well what if they're so in their addiction they cant stop?" his response is, "Then they need an elevated level of care that private practice can't provide, and I'll tell them that." He discusses this rule with every client he sees in the first session no matter what they come in for. Every time I broke my rule on this, I regretted it. I'm not saying its the only way to work, but I'm REALLY skeptical. 5) Nobody is utterly hopeless. Every therapist I know including myself would love to work with those people. Lots of people want to believe they're so smart or unique that NOBODY UNDERSTANDS ME AHHHHHHHHHHHH but no problem is that unique. That's incel internet brain. PEOPLE are unique, PROBLEMS are not. I do however not work with certain things because it's outside of my scope of competence. So children and certain personality disorders I will refer out. In CA there's a whole protocol to getting 5150'd. It's not a quick process. And therapists have less power than you think. A separate team (PET hopefully) will still come out to assess (in CA) if you are a danger. Sometimes therapists urge for it and it still doesn't happen. Therapists who break confidentiality and call in a 5150 can get in big trouble if they're way off, I think there's jail time iirc. Everyone has suicidal ideation. It's good to talk about those with your therapist. 6) I like In Treatment but no therapist talks like that anymore. That guy would be really annoying. The struggles he goes through in his home life, and the erotic transference and counter transference and him going to his supervisor and getting pissed at her, those are perfect and spot on, all that stuff is real and really well depicted. The clients in the show are perfect too. The woman, the black army guy, the couple, all good stuff. I mean they're clearly "acting" but still good. If you want to watch a really "therapist-y" show, watch White Lotus and the other one with Laura Dern. Those are the kind of shows we talk about with each other. Oh and the one with Will Ferrel and Paul Rudd, perfect portrayal of a predator and prey, great writing and acting. The boundary crossing makes me nauseous, it's great. 7) Big topic. I'm wondering if you or anyone is good with SA searches, I talked about this in the cspam MH thread. I'll try to find it. For psychedelics, I'm 98% of the time against it. Just neoliberal bullshit. MDMA is interesting though, I've seen some promising stuff. Again though 98% of the time it's done in the wrong way and not lasting. I'm doubtful of ketamine too. Some say it helped, some say it didn't. Some say it helped for a year. Some say they "TRIED EVERYTHING" (they didn't lol) and finally "took their healing in their own hands and it WORKED and CURED THEM." Whatever. If it worked great, but not my thing. 98 isn't 100 though. thehandtruck fucked around with this message at 03:57 on Oct 10, 2022 |
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Oct 10, 2022 03:32
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but I'm making my way through the thread and wanted to chime in on CBT also, some of which I've found useful. For me personally, it was about agency and being able to regulate the way I react to things that helped with letting certain emotions control me. Like, it's one thing to unearth why you have anger towards your mom, why you feel distant from your dad or how denying your sexuality or something has led you to Chronic Sadbrains Syndrome but the question beyond that that a certain point becomes "now what?" In what ways can I digest the effects of all that and not let it control my life so much? Meaning: so...my mother's suicide attempts led me to feel isolated and fear abandonment. AND? Now what, knowing I can't change it?
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Interesting takes on CBT, and it jives with my experience as someone in therapy. Where I've found it helpful is for quick, surface level adjustments. Correcting a thought to be less final. What this thread revealed for me was two things: why my current, excellent therapist seemed to avoid CBT solutions, but without disparaging it. More importantly, when I'd "go deep" with CBT and try to challenge a persistent thought with a worksheet/battery of questions approach, the situation would always get worse. Challenging the thought while still stuck in the morass of feelings derived from the thought was always a horrible process. Failing to arrive at some pat conclusion that evaporated the persistent thought was incredibly frustrating and felt like failure. The problem seemed to be me, not the approach. That wasn't dispelled until I read this thread. Send me a bill? I think, next time I have a persistent thought I need to challenge, I'll try the other kind of CBT and see if it gets me further...
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Oct 10, 2022 13:39
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womb with a view posted:Anyway as a question instead of just throwing my 2¢ in there: 2c from everyone is welcomed and appreciated. Every client gets my love and containment. That's non-negotiable, and people will try to negotiate. "I don't deserve it" "You can't imagine the things I've done" "I'm fine, already feel safe" "I'm unlovable, don't even try." Some people have been so hurt over such a long period of time they don't feel they deserve love or safety (containment). That can be interesting because when they fight me on it I uphold appropriate boundaries. I communicate (without being explicit) that it's my choice who I give my love and containment to. Of course, this is all done without words, it's usually all unconscious, they don't even know they're doing it. There's a battle for the room that goes on sometimes, maybe this is more to your question. Some people have been dominated by their trauma and past, and it has dominated every situation in their life, and they expect the same in therapy. There's a show of real live therapy sessions called Couples Therapy and you can watch this play out in every single couple and the therapist. I believe that a therapist can't be effective if they can't win the battle for the room. Conversely the client has to win the battle for motivation, or for doing the work. That's your loving job, not mine. My job is to provide a container powerful enough to fit your trauma inside of it, which most spaces in your life can't do. I want to be clear here, I'm not trying to dominate the client. I'm trying to communicate that the trauma they carry with them on their back, which is always too much for most people and most situations, isn't too much for here. I'm showing them that this room won't be dominated by the trauma they carry. The trauma is finally smaller than the room. It's contained and now we can view it, touch it, understand it, manage it, shrink it, and heal it. When people feel safe and loved, they go where they need to, I just follow. I never decide the path. Even if someone says on the consultation call that they have anxiety about whatever, I don't start with that topic or question. I just let them decide where to go. In terms of specific personality types like you asked. Ehhh I dunno, therapy and the way I approach clients can differ a ton from one client to the next. But me being blunt or very forward is a therapeutic technique, usually I'm trying to interrupt some unhealthy process. For example I had a client who talks a lot and really fast and hates doing it and sometimes he'll talk the entire session and get nothing out of it because he's not really working he's just on autopilot, just GOING, we all know those people. He knows he does this and hates doing it. So I've said in the last 20 min of a session, "Bob, how's this session for you?" "Terrible" "Why" "Because I just talked the whole time and there was no connection and I dont feel better" "Yeah I hated it too, why do you do it then?" and then we'll get somewhere. I've said all manner of things that would sound strange to people outside the room, without context so I dunno, does that answer your question? Maybe you can be more specific but I fear my answers will all be annoying and nebulous.
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Oct 10, 2022 16:28
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Which personality disorders do you normally refuse to work with and why?
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Oct 10, 2022 23:17
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thehandtruck posted:Never heard of GetHelp. I think it's GoodHelp. One of those sites that advertised a lot on podcasts and radio where you go online and select an online therapist.
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Oct 11, 2022 00:07
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Cool thread, OP. Wallet posted:I don't want to ruin the CBT debate, but I would be interested to hear your thoughts (if any) on EMDR. On the one hand as described it sets off every skeptical bone in my body and sounds like insane nonsense. On the other hand a lot of apparently intelligent and experienced therapists I know believe in it, and having experienced it a number of times I find it difficult to argue with the results. Same. Friend did it, changed her life so i begrudgingly tried it for CPTSD after churning through about 8 therapists who all eventually hit a wall with me. They all wanted me to figure out how to talk past my shutdown responses or journal it out. Lol. OP, I’m actually curious how you deal with bad-to-sever dissociative issues from trauma with talk stuff. Or do you? I was seeing students for free, so maybe that’s the difference. I needed led out of my survival brain, but they wanted me to come up with my own solution. Regardless, even a therapist winging EMDR protocols on me while attaining certification worked, then I upgraded to a CARF certifier. CARF Certifier was 10/10 skilled and changed my life completely. I could feel my hypervigillance dissipate. My vision literally became more vibrant. I could remember stuff again. Truly incredible. Still seems like woo woo magic to me in retrospect, but it worked. Took a little over a year of 2x/week sessions though. I will evangelize strict EMDR protocols to anyone. I do side eye therapists who just mix it in, cause it seems like those don’t trust it to do what it says in the box.
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Oct 11, 2022 06:11
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Ice Phisherman posted:Which personality disorders do you normally refuse to work with and why? Sorry I've taken so long to respond. Paranoid, histrionic, antisocial (who are probably right up Chili's alley given his work experience), are the main ones. I also don't work with schizophrenic people or anyone with DID. It's just too crazy for me. I had one client who was probably right on the line with antisocial and he was my favorite client of all time, but I would never see him in person if he had asked. I do however really enjoy schizoid PD, and narcissistic if I can find 'em. Schizoid is incredibly uncommon (at least in my experience, I don't know the data on it) and was unlike any other client. ThePopeOfFun posted:OP, I’m actually curious how you deal with bad-to-sever dissociative issues from trauma with talk stuff. Or do you? I was seeing students for free, so maybe that’s the difference. I needed led out of my survival brain, but they wanted me to come up with my own solution. Wow, what a great outcome for EMDR! Yes, there are a few things I do with clients whose defense mechanism is dissociate heavily. 1) I help them regulate when they are starting to go into the dissociative state. This isn't too much unlike how I'd regulate any client whose defense mechanism is panic or anxiety. I breathe with them, ask them to breathe with me, I talk to them, I speak calmly but confidently, I remind them they're OK, that I'm there with them, etc. Sometimes it doesn't work, sometimes it does. Probably one of the many things I want to get better at. Sometimes it doesn't matter how "good" I am though, because we're finding their limits together. This may be one of the few situations where I will "work" harder than normal. I'll never work harder than my client, but I will probably have to do a lot of work regulating them in these sessions. If I have two of these clients back to back I will try to move them around because it's draining for me. 2) Somatic work. "What are you feeling in your body?" "Where are you feeling it?" "Where is the depression, where is the sadness, what color is it? Is it loud? What's loud feel like? Can you touch it? Tell me about it." Reintroducing a connection between their body and mind. "What was your BODY feeling during that traumatic event?" Everyone knows what they were thinking, and probably how scared they were, but what were they physically feeling, and how are they physically feeling now. Somatic work is very very very powerful in conjunction with psychodynamic work. It can be much more intense than other modalities, which may cause them to dissociate, so you find that roadmap together. Evening reading this right now if someone thinks of a traumatic event in their life their sympathetic nervous system may activate it if hasn't been fully processed. 3) Go really loving slow. thehandtruck fucked around with this message at 04:08 on Oct 13, 2022 |
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Oct 13, 2022 04:05
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thehandtruck posted:I do however really enjoy schizoid PD, and narcissistic if I can find 'em. Schizoid is incredibly uncommon (at least in my experience, I don't know the data on it) and was unlike any other client. i'd love to hear more about why you enjoy narcissists. i kind of love narcissists too, as people they're often hugely entertaining, but as a therapist i'm guessing you're not just in it for the comedy value.
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Oct 13, 2022 04:16
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an egg posted:(i deleted a few previous posts on this topic because they were made in a spirit of high exasperation and weren't all that helpful to anyone)  your deleted post and ill post my post 
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Oct 13, 2022 04:28
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If someone wanted to openly discuss their mental health online with other people in the same situation and possibly get some helpful input from therapists and other people in the industry, is there a resource you would recommend? Any others that are best avoided? I’m talking about forums-type discussion here, not paid online therapy sessions or any other kind of formal work.
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Oct 13, 2022 06:16
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Comrade Koba posted:If someone wanted to openly discuss their mental health online with other people in the same situation and possibly get some helpful input from therapists and other people in the industry, is there a resource you would recommend? Any others that are best avoided? Im not 100% sure what you're asking. Not therapy but you want therapists involved? But you also want others in a similar situation to be involved? Sounds like you're for a support group maybe? Support groups are explicitly not therapy, just a circle of people in similar situations helping each other emotionally and offering and giving support outside of the group as well. edit: oh I missed the forum piece sorry. I mean there's a thread somewhere on SA for AA members IIRC? or people getting/staying sober
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Oct 13, 2022 06:30
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thehandtruck posted:Im not 100% sure what you're asking. Not therapy but you want therapists involved? But you also want others in a similar situation to be involved? Sounds like you're for a support group maybe? Support groups are explicitly not therapy, just a circle of people in similar situations helping each other emotionally and offering and giving support outside of the group as well. Sorry, I should have clarified. Basically what I would be looking for is something akin to this thread or the various MH threads on SA, except in a non-SA environment. Posting about personal mental health issues here on the forums is a no-go due to the fact that there are posters who trawl the mental health threads for information they can screenshot and use to own their posting enemies next time there's a huge forums drama event. I've also seen screenshotted posts from SA mental health threads posted for funsies on offsite Discords.
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Oct 13, 2022 07:16
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You could register an alt
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Oct 13, 2022 07:19
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Anne Whateley posted:You could register an alt Alt or not, I just don't feel that Something Awful is a safe place to be sharing that kind of deeply personal experiences. (But it obviously is for a lot of other people, and that's a great thing.  )
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Oct 13, 2022 07:33
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It's certainly not private or what I'd call a safe space but the cspam mental health thread has been a good place to put some stuff I've had in my head in lieu of therapy or just talking with friends/family. lol posting enemies If you're looking for a private web community for what's basically forum based group therapy I'm not aware of anything like that specifically, but you could organize one pretty easily. Even a invite-only discord server could fit the bill. Jorge Bell fucked around with this message at 07:44 on Oct 13, 2022 |
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Oct 13, 2022 07:41
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thehandtruck posted:When people feel safe and loved, they go where they need to, I just follow. I never decide the path. Even if someone says on the consultation call that they have anxiety about whatever, I don't start with that topic or question. I just let them decide where to go. If you're letting your clients decide where to go, and putting them, it sounds like, in the driver's seat of their therapy, do you have suggestions for how they ought to learn what that means and what their role is? Are there articles or books that are geared towards helping a client prepare themselves to use their therapy time effectively? I'm asking because I have found this tactic you describe to be very frustrating as a client, and it feels like someone forgot to mail me my copy of "Starting therapy for dummies" when I booked my first appointment.
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Oct 13, 2022 16:43
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Why's it frustrating?
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Oct 13, 2022 18:01
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thehandtruck posted:Why's it frustrating? Because it's like an oncologist walking into your room and waiting for you to tell them how to treat your cancer.
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Oct 13, 2022 18:53
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Baronash posted:Because it's like an oncologist walking into your room and waiting for you to tell them how to treat your cancer. Fair enough. Here is it how to treat your [mental health issue]: you talk about what hurts. Now that you know the role and prescription is it still frustrating?
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Oct 13, 2022 19:04
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Comrade Koba posted:Sorry, I should have clarified. Basically what I would be looking for is something akin to this thread or the various MH threads on SA, except in a non-SA environment. Ah okay. Yeah I think that's threading a needle that probably doesn't exist in many places. Particularly the part where therapists are "involved". If they're not being paid for their time they're probably not going to be too involved. I have seen forums here and there though, might have to google "[mental health issue] forum" and see what comes up. In terms of how good the info being floated around is.....eh....it probably varies. Might be a bit of the blind leading the blind or it might simply be a nice support network if people experiencing similar issues. I'd say give it a shot! ----i feel like i missed someone's question somewhere in one post or another. if i did repost it please thehandtruck fucked around with this message at 19:15 on Oct 13, 2022 |
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Oct 13, 2022 19:12
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admin deletion at poster request
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Oct 13, 2022 22:36
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an egg posted:the post contained absolutely no useful information, it was just venting because i finally convinced someone to try therapy and it fell through after a few sessions. i deleted it because it seemed like a breach of privacy - i'll talk publically about my own therapy, but not somebody else's. I see. Thanks for sharing. I'll reply to your original question tomorrow when I'm fresh. As it happens tonight in my psychodynamic process group (where I'm a member) the narcissist quit after a year of being in the group. It was extremely triggering and very uncomfortable for everyone else, myself included. So it's fresh! thehandtruck fucked around with this message at 06:23 on Oct 14, 2022 |
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Oct 14, 2022 06:20
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an egg posted:i'd love to hear more about why you enjoy narcissists. i kind of love narcissists too, as people they're often hugely entertaining, but as a therapist i'm guessing you're not just in it for the comedy value. Okie dokie. Yeah, it's hard to find any comedy or lightheartedness. Narcissists are extremely lonely and sad people underneath the Chomp Your loving Head off personality. It's unusual they will ever change, which is very disheartening to therapists and anyone else close to them. When children have parents who are Narcissists they learn they can't have their own feelings, and their needs get swallowed up by the parent's needs. Again it's just so sad because they often exit therapy (like my previous post mentions) and you know on a deep level and on a concrete level that they will probably not change. The reason I like working with them is because it's very challenging for all of those reasons. And it will turn you on your head. There's doublespeak, devaluing, denigration, none of which is done overtly. So by working with them you need to learn patience as well as the ability to not get roped into their orbit. You have to be completely centered yourself. Anyway, that's all just saying it's challenging and interesting and you will learn your own shortcomings working with a Narcissist because they will spot them and intensity them and put them into a powerpoint and show them to you. Sometimes even being TOO centered will trigger them to feel unsafe because they realize they can't gain any ground over you, prompting them to leave therapy. So my condolences to you for having an SO that is a Narcissist. That angst of wanting so badly for them to see your feelings and pain and them never getting there, despite removing your armor to tell them is horrible. Hope you've been able to let go and learn who can see you and who to give up on.
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Oct 15, 2022 00:54
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Any good resources for dealing with narcissists as a non-therapist? I feel like I'm surrounded by them. I'm tired of being forced to acknowledge that my opinion is wrong.
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Oct 15, 2022 02:15
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bort posted:Any good resources for dealing with narcissists as a non-therapist? I feel like I'm surrounded by them. I'm tired of being forced to acknowledge that my opinion is wrong. I wish I did. They may be out there but I don't have any in my resource pile. I don't want to give you advice, but excluding clients for *me* no amount of empathetic approach was successful with any of the narcists I've dealt with in my life. It only tore away from me and gave to them. In *my* experience, gaining as much distance as possible including severing relationships with them, having mental and physical boundaries, that was the only thing that ever worked..........for me.
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Oct 15, 2022 19:33
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thank you for the info on narcissists. it sounds like you have had pretty bad experiences - thank you for trying.
an egg fucked around with this message at 21:49 on Oct 15, 2022 |
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Oct 15, 2022 21:41
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i'm starting to reassess my use of the term narcissist in my personal life. once i label someone in my mind as a narcissist, i find i'm constantly critically evaluating their behaviour against a mental list of diagnostic checkpoints trying to prove to myself that they are or are not a narcissist, which actually isn't helpful at all for me or for them. i've decided to stop focusing on whether various people close to me fit the diagnostic criteria of clinical narcissists, and just concentrate on meeting them where they are, as a therapist would say. for various reasons i do want these people in my life, so help me
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Oct 17, 2022 01:20
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it is such a tease to start this thread and then tell us you had an irl therapy disaster with a narcissist when you know drat well you can't legally tell us what happened
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Oct 26, 2022 00:33
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I'm diagnosing you as being obsessed with narcissists and my treatment is to 5150 you!
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Oct 26, 2022 15:49
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an egg posted:it is such a tease to start this thread and then tell us you had an irl therapy disaster with a narcissist when you know drat well you can't legally tell us what happened Oh, whoops! I can definitely say what happened, just can't give identifying details. Most of training is people recounting cases. Basically she had been "leading" the group for a while, softy pushing who spoke and for how long. To me it was extremely obvious but I guess to the other members they either didn't care didn't notice or enjoyed that the dynamic of her leading and them following. At some point things shifted in the group's unconscious and it was harder to boss people around. This, imo, probably felt to her like she was losing her identity. Since that was the only role she had because she was unable to share openly and honestly and feel safe doing so, which is part of the narcissist dilemma. Because of this eventually she said she's not getting anything out of the group, like we all were. We pointed out that all she had to do was share her feelings or share her true inner world. She of course said, "I HAVE BEEN!!" and got very defensive. When a narcissist gets defensive it's very difficult to stay present, I think we all just kind of shrank into our chairs, despondent. The next week she declared she was quitting and blamed the facilitator, who took it like a pro. For a narcissist, the idea that the group would continue without her was extremely hard, and she lashed out at us and insulted us, and it shut down the session again. The next week, she said she had an individual session with the facilitator, and asked to stay in the group, but the facilitator said its not good to flip flop so she has to leave since she declared her leaving many many times. Thank loving god.
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Oct 26, 2022 20:51
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Ok that makes me realize I do have a question. Backstory first. The first time my then-therapist Natalie talked me into joining a group, it was horrible. One other member of group, Gina, just loving hated me. If I made comments to her, she'd snap; during my turn, she'd bitch and minimize my issues -- stuff like that. And Natalie would just sit back and watch it play out. I brought this up during our next one-on-one, only to discover Natalie was thrilled about this. Natalie said that group was all about people pushing each other's buttons, and that based on what she knew about Gina, I reminded Gina of her mother, who Gina hated, so this meant group was a space for Gina to work out her issues with her mom. I told Natalie that I felt like a punching bag -- that I was deliberately being as polite and neutral as possible in group to not set Gina off, but no matter what, she would find something to be upset about and chew me out. To be clear, this wasn't "Gina and I fought like crazy" -- I tried to avoid interacting with Gina as much as possible, but any time I would contribute, she would get pissed and rail at me. I was in group to deal with my issues, not be a stand in for whatever the gently caress Gina was dealing with. Natalie was also happy hearing that from me, because she said this meant I could work on setting boundaries. That I should stop group and say something like "Gina, I don't feel like you're being respectful of me right now, and I'm asking you to take that back, or I'll leave." She also encouraged me to get up and say "I'm going to use the restroom and I suggest that you calm down while I'm gone" and other boundary things. A few sessions later, when Gina went off on me, I did the whole "I don't deserve that, I'm going to the restroom" and did in fact just book it out of there. But I didn't go to the restroom -- I just got in my car and left, and I was shaking the whole drive home. During our next one-on-one, Natalie enthused about how great that had been; that after I left, Gina had had a huge breakthrough, and everyone had helped her through it. Also, I had asserted myself! She was so proud! I told Natalie I wasn't going back to group. She was confused and disappointed and tried to talk me into rejoining several times. A while later, I stopped seeing Natalie altogether. This was my one and only experience with group. I avoid groups like the plague. So, a few questions. Is any of this normal? Because this felt horrible and traumatizing to me, but maybe I'm just a delicate flower who really can't deal with conflict. But isn't therapy supposed to be a safe space? Does that not happen with group? Is it ok for one person in group to use someone else as a placeholder for their resentments? Shouldn't Natalie have done something, at least to stop Gina from being deliberately cruel?
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Oct 26, 2022 21:28
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I'm gonna try to answer best I can without being snarky but that's kind of the nature of the beast we're in right now so if you're able to lend charity to my post I think it will come across a lot better.spacing in vienna posted:So, a few questions. Is any of this normal? Because this felt horrible and traumatizing to me, but maybe I'm just a delicate flower who really can't deal with conflict. Normal to have the dynamic play out the way it did? A million percent yes. Normal for Natalie to respond that way........eh......maybe. We all, at all times, in every situation, ALWAYS, playing out with situations and dynamics that occurred with our caretakers, with other people in the world. Which you noted. What you may have missed was while Gina was playing out a situation from her childhood with you, you were playing out the dynamic of your caretakers with your therapist, wanting her to step in. Wanting her to protect you. Wanting her to own the room and stop this bully. Natalie saw you being triggered as an opportunity to have a reparative experience. Meaning, at one point in your life maybe you weren't able to stand up for yourself, to your caretaker, to a bully, whoever, and she wanted you to have that reparative experience where you finally do stand up for yourself. Gina would have been the "stand-in" (jargon word is projection) for that person, just as you were for her. This is the essence of a psychotherapy PROCESS group. Interestingly enough, maybe "the work" wasn't so much telling Gina to gently caress off, but explaining to Natalie how you felt she had failed you and the group, how unsafe that made you feel and things in that nature. And how disturbed you were that she seemed gleeful when you brought up something tender to her. spacing in vienna posted:maybe I'm just a delicate flower who really can't deal with conflict. Don't do that! spacing in vienna posted:But isn't therapy supposed to be a safe space? Does that not happen with group? Welllllllll.......Individual therapy should be extremely safe, but there are still many times where pain and loss deep down bubbles up, and emotions can fly. It should be safe enough to contain those things, and it should be safe enough to GET to the point where a person is able to access those things. I challenge things a lot as a therapist, but in my own therapy I don't like to be challenged that much right now. Hard to say what's right or wrong, it's where a person is in their journey and the relationship with the therapist that matters. Important note though, a PROCESS group is very very very different than a SUPPORT group. Support groups should have next to zero challenge, or confrontation. They should not feel like individual therapy, they should not feel like PROCESS group therapy at all. They are truly a safe place where people come for support between members and the facilitator. Often people talk about their week, their lives, their struggles, etc. They get support from the group. Now a PROCESS group is so different. Members should be bringing in a lot less from their outside lives into the group. It should be primarily focused on the interpersonal. Meaning members should be talking about how they feel towards other members of the group and why. This of course brings up a lot of emotions and anger. spacing in vienna posted:Is it ok for one person in group to use someone else as a placeholder for their resentments? Shouldn't Natalie have done something, at least to stop Gina from being deliberately cruel? "Is it ok?" What's "ok" mean? Legal? Ethical? Helpful to Gina's journey? Helpful to your journey? Help to the group's journey? I think you'll figure out a lot your role in that situation if you try to answer those questions internally. I think I may have handled it with a more nuance than Natalie, but ultimately our goals would have been the same. There's a sacred sentence in group therapy: "Bring it to the group".
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Oct 26, 2022 22:13
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Isn't it possible that spacing in vienna's therapist failed to set proper expectations? If I got asked to join a group without knowing how this particular group therapy works, and then no one stepped in when someone went off on me, I'd dip immediately. Would not waste my time with someone who failed to prep me for that.
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Oct 26, 2022 23:00
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admin deletion at poster request
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Oct 27, 2022 00:11
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I mean...it's not really a major shock or surprise to think about the idea that assembling 5-10 people with varying degrees of mental issues that require treatment into a group situation might devolve into a bit of a poo poo show. Hell, I see it all the time just interacting among groups of people at work - who are varying degrees of hosed up - myself included. And I guess it's certainly ramped up to a degree and another notch when you have a group of people who actually able recognize their problems enough to consider therapy in the first place. There are tons of folks I run into that are passive aggressive, narcissistic, depressed, addicted, anxiety ridden and all sorts of poo poo who are required to function in a group environment (work) without any of them having the self reflective ability to realize that perhaps they are contributing to the problem(s). I'd say that 90% of the world just goes about poo poo believing that the other 90% are the loving assholes. Again, I include myself in this group what with being a part of it. And the old saying in workplaces that "there's always one" almost always rings true. I've got one at my current job ... Q: What's the clinical term for a person who will say something and then assume you took offense to it and are being defensive about it? Or, more in my specific case, project the aggression onto me even if was I not offended and was not the least bit mean? Not sure I'm wording that right but "the one" at my job has claimed that he and "go tit for tat" and are always arguing and I honestly am not doing that. It can be something as simple as a movie, a TV show or a band that he likes and I'll say "I never got into The Big Bang Theory/Larry the Cable Guy/Def Leppard" when it's my turn to talk and it's like a personal attack rather than a simple difference in taste. I don't insist that this guy enjoy Halloween, Hunter S. Thompson or the music of Prince and, to me, it's just dudes talking about poo poo but it never seems to shake out that way. I've examined the way I communicate and haven't identified a problem but admit that I have blind spots sometimes. I try to check my sarcasm and not talk like I post here. I talked to another coworker that runs LARPS, which I find weird, but we get along great and I listen to him and then tell him why I never got into it and we just bullshit before clocking in. This other guy, Robert, seems to be seeking acceptance (?) and is insecure is my amature analysis. But is it as simple as "passive aggressive" when someone does that? He'll say something and then immediately apologize for me taking offense when none was taken at all and almost require that I acknowledge that.
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Oct 27, 2022 00:29
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admin deletion at posters request
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Oct 27, 2022 00:44
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ThePopeOfFun posted:Isn't it possible that spacing in vienna's therapist failed to set proper expectations? If I got asked to join a group without knowing how this particular group therapy works, and then no one stepped in when someone went off on me, I'd dip immediately. Would not waste my time with someone who failed to prep me for that. This is how I felt -- she didn't say it was a process group vs a support group, she just said she was starting a group and she thought it would help me. I told her that I couldn't figure out what I'd done to piss Gina off, and she explained that bit about Gina's mother. Maybe I don't "get" group and maybe I'm not cut out for it. Because it felt to me like she was delighted that there was conflict and cared zero percent that I felt like I was being asked to share vulnerable past trauma in front of someone who would mock me for it. I don't feel like I got anything out of group, except learning that groups are awful, and that I couldn't trust my therapist, which ultimately left to me leaving her practice. Have you had people leave groups because of things like this? It feels like you're saying this is a perfectly acceptable way for a group to run, in which case, I definitely don't want to try one in the future.
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Oct 27, 2022 01:02
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ThePopeOfFun posted:Isn't it possible that spacing in vienna's therapist failed to set proper expectations? Not only is it possible, it's exactly what happened. that's why I said our goals would be the same, but me and that therapist would have gone about it very differently. it sounds like she missed a lot of steps in the beginning and end of the situation and it played out as expected. there was no containment
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Oct 27, 2022 01:36
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