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Dr. Bob is Robert Hsiung, MD,
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Posted by pegasus on May 29, 2005, at 21:08:57
In reply to Chapter 3.The Therapist's Power, posted by Dinah on May 29, 2005, at 9:48:25
The power imbalance in therapy is such an interesting aspect to me. It's what makes it work a lot of the time, but it's so problematic. My ex-T definitely always took a stance as a teacher or guide, while my current T presents herself much more as a co-worker, or peer in the process. It could explain why I had so much more parental transference to him than I do to her, despite their similar theoretical orientations. I actually think I got more out of therapy with my ex-T.
I've taken classes in a counseling psych program, and in one counseling techniques class the instructor told us that the way you deal with the therapist's greater power (as the therapist) is to not identify with it. She said that that eliminates the power imbalance. Excuse me? As if it's only what's in the therapist's head that counts.
I believe that the power imbalance is there anyway, and the therapist can do a lot of things to mitigate it, if they believe that's useful. But from the client's point of view it's always going to be there to some extent. That's why the laws against sexual involvement apply to everyone, not just certain styles.
I think this is maybe an issue of which a lot of therapists are not sufficiently aware. Remember a few months back when someone started a thread about whether you would sleep with your T if you could? There were some 20 responses, and about 80% said they would. That's therapist power right there.
pegasus
Posted by daisym on May 29, 2005, at 22:57:55
In reply to Re: Chapter 3.The Therapist's Power, posted by pegasus on May 29, 2005, at 21:08:57
I think Peg is right -- the power imbalance is as much in the client's head as in the therapist's head. Lott talks about Robert Langs' writings about the first contact with the Patient in which Langs speaks of making a mental note that attributes mental health issues to wanting to understand the fee structure. Aren't we all worried about that at one time or another? We've spoken often here about needing the RULE BOOK. No one wants to present themselves in a way that could be misread, we don't want to ask questions we aren't "supposed to" and I think many of us identify with Lott when she talks about wanting to be "good patients". I think a lot of this stems from the media portrayal of therapy where every little thing is attributed to unconscious motivation. I don't think there are too many of us in therapy who trust that we aren't being driven by some unclear agenda. And I think we think that our therapists have the power to SEE what we can't see -- these unconscious motives. This gives them tons of power. It is intimidating to feel like you don't know your own mind. This chapter helped me understand why I can be so assertive in most of my life and yet not be able to bring this trait into therapy.
The thing that really resonated with me was where she said that to engage in the process a woman must rely on her therapist to "watch the store." That way as clients we can push and pull and demand and step back and know that we are still safe and that the boundaries are still firm. I don't think you can do the work and hold the boundaries for your therapist simulanteously. It reminded me of the way that my therapist often tells me he will "hold down the fort" as I try to figure stuff out or I need to pull away for awhile.
Her closing paragraph that matches some therapy relationships to dysfunctional families brings home yet again the value of Babble. She says "what may empower women clients most may be sharing their therapy stories with each other." I'm so glad we are all doing cutting-edge work!
Posted by gardenergirl on May 30, 2005, at 0:58:55
In reply to Re: Approximate relationships » Tamar, posted by alexandra_k on May 25, 2005, at 23:32:22
> I worry about that sense of 'feeling loved'. One feels loved because of the nature of the therapy relationship. They are supposed to focus on you for that time. Emotionally hold you etc. But RL isn't like that... It is more reciprocal. I worry that therapy teaches us the wrong messages about the nature of love and caring and about the nature of human relationships.
I think that therapy CAN teach us the wrong messages. Or perhaps "teach" is the wrong word. I think we can get the wrong messages from therapy if we don't finish it or don't talk about our feelings (or lack of them) about the relationship. Because we form conclusions about them, and we project stuff onto the T, and if we do not get a chance to reality-check our perceptions and feelings, we may hold the wrong message==like the "T is rescuing me" or something. When really it came from within us and from the process.
>
> I worry that it fosters desires along the lines of the golden fantasy. That once those desires are fostered all you have done is made that person dependent on therapy relationships to get those desires met.When therapy is done right, the person learns that they wish the T to fulfill this fantasy, but the T does not and can not. In fact, no one can. No one but ourselves to ourselves. Now if therapy is not done well, or the T has needs of his/her own that enter into the therapy, then the T might try very hard to fulfill this fantasy, and this is doing a disservice.
gg
Posted by gardenergirl on May 30, 2005, at 1:08:14
In reply to Other aspects of Chapter 2, posted by Dinah on May 26, 2005, at 19:09:47
>
> The disproportionate importance of small things -This is funny...I never think about how a change in my appearance or the office or whatever might be jarring to the client. And I generally do not notice changes in his office, although I don't know that anything has changed. But last session I asked him if his desk always looked that clean. And he said no and laughed. :) I'm not sure if I had much reaction to it, but now that I think about it, it didn't look like "his" desk anymore.
>
>
> Attachment and dependency -This one resonated with me, too. I remember the moment I felt attached and dependent. I was shocked. I had that "oh no, not me. I won't get attached" feeling. I don't know why I thought I would be different. Arrogance, I guess. :)
Last session he said something that reinforced my attachment and made me feel good about it. (I still struggle with feeling weak or ashamed about being dependent at times.) He said "it's just you and me in this" referring to it not mattering what others' think. That felt so good to me. Just a simple comment....
>
>
> Therapist's Presence Brings Comfort -I think this is true for the most part. But then again, I have some anxiety lately, too. And the first session after the blow up was not comforting at all. Yuck. But I know I have internalized him. I tend to imagine, like the woman who imagined her T in the back of the plane, I imagine my T is somewhere nearby watching me when I am out running errands and such. I felt so embarrassed at first, but now I just take comfort. And I recently heard his voice in my head--his soft and gentle voice which he uses when I am crying really hard. It was soothing to me to be able to bring that back on demand.
>
>
> Child - ParentI'm sure there is some aspect of this present, but I think it's what I'm resisting right now. D'oh!
>
> Alike and Different -Oh, I SO assume that my T shares traits with me. Some are evident...like being late, liking the same catalog for clothes, sharing the same orientation. But I tend to assume others, and he's never really said much to confirm or deny. I think I need him to be a mirror for me in order to feel good about myself. Or maybe I need to identify with him in order to feel safe? Hmmm.
>
gg
Posted by gardenergirl on May 30, 2005, at 1:12:50
In reply to Chapter 2. Communicating feelings., posted by Dinah on May 26, 2005, at 19:13:46
I was not so surprised by this, if only because the majority of my clients never bring up the relationship. Or if they do, it's in very vague and almost rhetorical terms, like if they feel they are making progress, they sometimes attribute it to coming to see me versus any specific thing they learned.
I did have one person talk a lot about the relationship. This was when I was very green with therapy. And it was so painful for me to wait him out to hear what he was going to say. I tried to make it okay, but inside I was scared to death. And I'm sure that showed.
My T has done a foot waggle recently and acknowledged he might be nervous, too, about deepening in our sessions. I kinda feel like he is waiting for me to get there, but he assumes I will. (Hmm, I should tell him that.) I think it must be such a skill and art to convey that it's okay to discuss feelings for the T, even sexual ones, without suggesting them or assuming them, and putting off the client.
gg
Posted by gardenergirl on May 30, 2005, at 1:15:39
In reply to Chapter 2. Wanting to be special., posted by Dinah on May 26, 2005, at 19:33:57
I have this feeling. I want to be the client he most enjoys seeing. So I try to be interesting, and at the same time pleasing, etc. I don't feel this take up a lot of my feelings in the relationship, but when I feel stuck or circular, I worry that he might get bored with me. And of course, he can't get bored with ME! Not ME!
ack.
gg
Posted by gardenergirl on May 30, 2005, at 1:28:12
In reply to Re: Chapter 2. Wanting to be special. » Daisym, posted by fallsfall on May 27, 2005, at 13:56:45
>
> Not exactly on topic with the book... I'm reading along, but having trouble thinking of things to say...
I'm finding I have to let things digest a bit, or percolate, before I can post about it. Otherwise I read it and I just have feelings but not much in the way of words.gg
Posted by pegasus on May 30, 2005, at 8:03:36
In reply to Re: Chapter 2. Wanting to be special., posted by gardenergirl on May 30, 2005, at 1:15:39
This is so true for me also. I think probably for all of us. And I've felt such shame about wanting to stand out, and knowing that I absolutely don't. I love Daisy's T's statement that who wouldn't want to be special? So validating.
I had this great moment in my session on Friday that made me feel so special. I've not gone to therapy lately because I have a new baby, and Friday was my second session back. I was walking around in her office jiggling my baby to sleep, and talking. In the middle of whatever I was saying I suddenly remembered a dream last night that I'd wanted to tell her about, so I interrupted myself and said, "Oh! I have a dream to tell you!" She laughed and said, "I'm so glad you're back, Peg." See, that means I'm *special*! (Warm glowing)
pegasus
Posted by Dinah on May 30, 2005, at 10:09:48
In reply to Re: Chapter 3.The Therapist's Power, posted by pegasus on May 29, 2005, at 21:08:57
You aren't going to get me to disagree with that. There is a power imbalance, and those therapists who don't recognize it are dangerous. Not as dangerous as those who abuse it. But dangerous.
> I've taken classes in a counseling psych program, and in one counseling techniques class the instructor told us that the way you deal with the therapist's greater power (as the therapist) is to not identify with it. She said that that eliminates the power imbalance. Excuse me? As if it's only what's in the therapist's head that counts.
>
Sadly that sounds not untypical for a lot of therapy issues. I always tell my therapist he needs to read someplace like this board to find out what's really happening in therapy, to a fair size number of clients. He's very naive sometimes. And I think that's a reflection on the training programs.
Posted by Dinah on May 30, 2005, at 10:12:42
In reply to Re: Chapter 2. Wanting to be special., posted by pegasus on May 30, 2005, at 8:03:36
You're right. It does!
:-)
I'm glad you're special to your therapist, Pegasus.
I'm impressed that you bring your baby. I only did that once, when I couldn't make other arrangements. I knew he couldn't understand what was being said, of course. But I was still as stiff as if any other third person was in the room. Silly I was. :)
Posted by happyflower on May 30, 2005, at 13:46:35
In reply to Re: Chapter 2. Wanting to be special. » pegasus, posted by Dinah on May 30, 2005, at 10:12:42
Hey, I know I am late, but I am going to start reading the book tommorrow. Tons of people have recomended this book to me ( I wonder why, hmmm.)lol :)
Posted by Dinah on May 30, 2005, at 16:17:50
In reply to can I join the reading party?., posted by happyflower on May 30, 2005, at 13:46:35
Posted by pegasus on May 30, 2005, at 17:29:50
In reply to Re: Chapter 3.The Therapist's Power Daisy and » pegasus, posted by Dinah on May 30, 2005, at 10:09:48
> I always tell my therapist he needs to read someplace like this board to find out what's really happening in therapy, to a fair size number of clients. He's very naive sometimes.Or, he could read this book! I think every therapist should read this book.
pegasus
Posted by messadivoce on May 30, 2005, at 17:58:51
In reply to Re: Chapter 3.The Therapist's Power Daisy and » pegasus, posted by Dinah on May 30, 2005, at 10:09:48
I've been reading along but haven't posted yet because I didn't really have anything to add to the discussion that hasn't already been said.
But in chapter 3, Ms. Lott talks about questioning your T about their therapetic approaches, and quotes two T's who have psychodymanic and CBT approaches on how they would explain their orientation to a client.
I think this is SO important to find out. I first was in therapy when I was 16, and my T was a woman in her fifties who now I can identify as a CBT therapist. She told me that we were going to "reframe" my view of the world. I ended up making lots of lists about things that sucked, and then re-writing them to make them better. She told me I was finished about 4 months into the game, and although I felt better short-term, it really didn't work well. I had no tools to work with after therapy. I think that she was probably not the greatest CBT therapist, because I know there are people who swear by CBT therapy.
My second T was the man I write about so much. He didn't explain the process until we were deep into therapy, and I didn't think to ask him. He did a lot of listening in the first 8 or so sessions, and then started challenging the destructive things I was saying about myself. So that is kind of a CBT thing, but he did tell me after about 2 months that "the kind of therapy I do, works with the relationship between the therapist and client."
I wish I would have had a clue what I was in for--attachment, dependency, pain, longing, lust, love, anger, fear, attraction. Psychodynamic therapy should be thoroughly explained before it begins. It's just so risky to develop a relationship with a client and use that therapeutically without discussing the potential ramifications and consequences first. I think that practitioners view it FAR too clinically. For us it feels and hurts and seems like it's real (back to the approximate relationship thing again). If it looks like a duck, and quacks like a duck.......
I just wish I had known what I was in for, potentially.
Posted by alexandra_k on May 30, 2005, at 18:36:50
In reply to Re: Approximate relationships » alexandra_k, posted by gardenergirl on May 30, 2005, at 0:58:55
> I think we can get the wrong messages from therapy if we don't finish it or don't talk about our feelings (or lack of them) about the relationship.
Yeah. But how many people 'finish'? And how many people get 'stuck'? I mean stuck in the golden fantasy stuff with the t meeting (sort of sort of) those desires and... well... just kind of staying there.
> When therapy is done right, the person learns that they wish the T to fulfill this fantasy, but the T does not and can not. In fact, no one can. No one but ourselves to ourselves.
Sure. But the t focus solely on the clients stuff for the time they are together. The t isn't supposed to talk about or act from their needs or desires - it is supposed to be all about the client. Isn't that something along the lines of golden fantasy fulfillment right there?
I don't know...
I have been thinking about this a lot...I'm not sure.
Posted by Daisym on May 30, 2005, at 19:55:09
In reply to Chapter 3.The Therapist's Power, posted by messadivoce on May 30, 2005, at 17:58:51
Me too, Voce. I had no idea that I'd feel this way. But I suspect that even if my therapist had told me potentially it could happen, I'd be arrogant enough to think "not to me."
And I didn't ask questions about his orientation either. There were times when I'd say this or that, and he'd say, "that's not how I work." Now he'll say to me, "you know how it works in here..." especially when I'm censoring. He will engage in debates about theories, however, especially self-psychology and attachment theories. He always wants to know what I'm reading on the internet and he gets frustrated by the amount of misinformation and therapy bashing that goes on out here. He often warns me away from "trauma" sites.
I've read and studied enough over the last two years to probably test out of most of the psychology undergraduate classes. But I still don't exactly understand "how" it works. So how on earth do you know what to ask at the beginning?
Posted by Dinah on May 30, 2005, at 20:20:18
In reply to Re: Chapter 3.The Therapist's Power Daisy and » Dinah, posted by pegasus on May 30, 2005, at 17:29:50
I've told him. Even brought it and showed him.
But he won't. I don't think he respects my opinions all that much.
Posted by messadivoce on May 30, 2005, at 21:08:34
In reply to Re: Chapter 3.The Therapist's Power Daisy and » pegasus, posted by Dinah on May 30, 2005, at 20:20:18
> I've told him. Even brought it and showed him. But he won't. I don't think he respects my opinions all that much.>
That's too bad!! Every T should read this book. I read it about 3 months into my therapy, and I was just bursting with wanting to tell him and discuss it. I mentioned that I was reading this good book, and he gave me this withering look that totally said, "Oh I'm sure it's a book written by someone with no clue as to the highly intellectual things I do", and what he said was, "Oh really? From the client's point of view or the therapists'?" as though it would be really dumb to read a book from the client's point of view. I dropped the subject, and when we terminated, he replied to an e-mail I sent and asked me "what the title and author of the book you were reading was, because if it reasonated with you then I figure it must be worth reading." I told him, and then when I called him about a month later, he asked me if I remembered what he had said earlier. I lied and said no, and he told me that he had engaged in "professional snobbery, and that he hopes to not do that too often in his career." He really liked it, a lot, and reccomended it to collegues, so he said. But I wonder if all that talk of boundaries that she does made him pull back from me later.... :-(
Posted by littleone on May 30, 2005, at 21:52:06
In reply to Re: The Introduction (In Session), posted by gardenergirl on May 17, 2005, at 22:01:58
Sorry I'm so far behind :( but there were a couple of things I wanted to talk about.
> My T said something similar when I was very sad and also angry at him (irrationally) because I could never work with him as a professional due to our therapy relationship. He said it was a sacrifice on both sides, which was very touching, and one of the only times he has allowed his personal feelings into the therapy space.
Oh, this is a very touching statement gg. It made me smile.
> It did remind of when my T and I were discussing increasing to twice a week, and how that had a big potential for more intense feelings on my part. I felt like all the cautions he was presenting were an attempt to warn me off of increasing. He admitted that he might be coming across that way because T's can be frightened about deepening with a client just like a client can, but it's up to the T to manage that fear in order to do the work.
This has just flabbergastered me. I could understand that they may not want to attach to someone who has a big chance of bolting, but I can't understand this in regards to a steady client. I kind of thought T's don't have attachment issues. They've either grown up healthy or have had them all sorted out in their own therapy. I don't understand why they would be scared to deepen the relationship.
Posted by littleone on May 30, 2005, at 22:04:48
In reply to Re: The Introduction (In Session) » gardenergirl, posted by daisym on May 17, 2005, at 22:52:54
> I think we should debate what she wrote about therapists' authenticity. She offers that much of her group worried that their therapist was different outside the consulting room. And later, she goes on to say that "good therapists are able to bring the essence of their real selves into the therapy room without having their needs compete with the client's. They are able to be authentic while maintaining clear boundaries." I agree that they should keep their needs out of the room. But, does it matter if they act differently outside of the consulting room if they are consistent with us? If so, why? Aren't we different outside the therapy room than we are in it? Don't we put on our "therapy patient" hat, just like they put on their "therapist" hat? Don't you think we all, to some degree, play roles in certain settings? And, do you think men are better at this than women?
This is a big one for me and I get so confused over it and over what I think I actually want.
I had been seeing my previous T for a while and he was very consistent with me. Then he asked me to bring my husband along to a session. My husband and I are very different people and when my T started interacting with us both, he was a completely different person. I can understand that it was because he probably had to be more careful when dealing with me, or more aware of everything he said/conveyed, or maybe he was trying for the old blank slate with me. But either way, I was very very hurt at the change in him and in the fact that he wasn't authentic with me.
With my current T, I feel he is a lot more authentic, but I am really scared off bringing anyone else into my session because of my previous experience.
Also, I notice that with my current T that he'll sometimes chat with the client as they are paying and whatnot and on several occasions he has acted in a very different way than what he has with me. I think he matches his language to the client's and also there is some matching of relating if that makes sense. Like more extroverted chatting with extroverted clients. More reserved with other quieter clients. There were other differences too that I can't put my finger on.
I guess what I'm saying is that even if they are consistent in session with you, I still think they need to be authentic because it's going to come out otherwise.
> Universally it is believed that men can go to work and leave their personal lives at home, unlike women. Do you think this applies to therapists as well?
My T has admitted to me that he hides behind his T role (in regards to self disclosure). But I think this also helps them to compartmentalise their lives. I just think that if they self disclose more, it is harder for them to separate work/other life.
Posted by littleone on May 30, 2005, at 22:18:36
In reply to Re: The Introduction (In Session) » daisym, posted by littleone on May 30, 2005, at 22:04:48
The other thing I thought about when reading the intro was re how we attach so much importance to everything said/done etc by our T's.
And it got me wondering, I know most of us spend huge amounts of time thinking about our therapy between sessions, but do you think you spend more time:
- thinking over the exact things said/done,
- thinking over your T in general,
- thinking over the topics discussed, or
- furthering your progess on the topics raised?Obviously I think it would be all 4 for most people, but I just wonder where your thoughts are focused the most.
Posted by daisym on May 30, 2005, at 23:00:13
In reply to Re: The Introduction (In Session), posted by littleone on May 30, 2005, at 22:18:36
I think I spend most of my time thinking over the therapy itself. I wonder what the he** I'm doing to myself, I wonder how long I'll take, I argue with myself constantly about pulling back, cutting down and handling my own dependency. I think about topics a great deal too -- and I chase myself in a circle thinking, "this is important" "this isn't important" "I've said this already" and so on.
I do the "he said, I said" when I write about it. but that isn't how i think about it. does that make sense?
Posted by Tamar on May 31, 2005, at 3:06:12
In reply to Re: The Introduction (In Session) » daisym, posted by littleone on May 30, 2005, at 22:04:48
> I had been seeing my previous T for a while and he was very consistent with me. Then he asked me to bring my husband along to a session. My husband and I are very different people and when my T started interacting with us both, he was a completely different person. I can understand that it was because he probably had to be more careful when dealing with me, or more aware of everything he said/conveyed, or maybe he was trying for the old blank slate with me. But either way, I was very very hurt at the change in him and in the fact that he wasn't authentic with me.I thought about this and I realised I am different with different people in everyday life. It's not that I'm being inauthentic; it's just that different people bring out different aspects of my personality. Mabye that's what happened with your T when you brought your husband to therapy. What do you think?
Posted by gardenergirl on May 31, 2005, at 3:21:38
In reply to Re: Approximate relationships » gardenergirl, posted by alexandra_k on May 30, 2005, at 18:36:50
Hi alex,
>
> Yeah. But how many people 'finish'? And how many people get 'stuck'? I mean stuck in the golden fantasy stuff with the t meeting (sort of sort of) those desires and... well... just kind of staying there.Good question. I suppose "finish" is not the best word to use, at least because I view myself as a work in progress. But at any rate, I do think there is a significant proportion of those who terminate before getting to fully work through a transference. This might be for a variety of reasons, indcluding funding, logistics, premature termination, giving up, the therapist leaving, etc.
>
>
> Sure. But the t focus solely on the clients stuff for the time they are together. The t isn't supposed to talk about or act from their needs or desires - it is supposed to be all about the client. Isn't that something along the lines of golden fantasy fulfillment right there?Well, yes my T focuses soley on my issues in sessions. But he does not fulfill all my needs. In fact, as time has gone on, he leaves me hanging more and more. I hate that! But I see why he does. I'm starting to answer my own questions, and I'm learning not to count on him to rescue me when I get stuck. So this feels more realistic than the golden fantasy. Hmmm, I think I just tripped myself up. My head hurts now. :)
>
>
> I don't know...
> I have been thinking about this a lot...
>
> I'm not sure.You're not alone in being not sure. :)
gg
Posted by gardenergirl on May 31, 2005, at 3:30:57
In reply to Re: The Introduction (In Session) » gardenergirl, posted by littleone on May 30, 2005, at 21:52:06
>
> Oh, this is a very touching statement gg. It made me smile.Me too...just thinking about it again. :)
>
> > He admitted that he might be coming across that way because T's can be frightened about deepening with a client just like a client can, but it's up to the T to manage that fear in order to do the work.
>
> This has just flabbergastered me. I could understand that they may not want to attach to someone who has a big chance of bolting, but I can't understand this in regards to a steady client. I kind of thought T's don't have attachment issues. They've either grown up healthy or have had them all sorted out in their own therapy. I don't understand why they would be scared to deepen the relationship.Well, I don't know if T's have everything all sorted out. I think it's important that they recongnize what's theirs and what's the clients. And if their stuff is leaking in, they need to plug that leak ASAP. I think maybe "scared" is too strong of a word. And maybe that's not even the word my T used. He might have said "anxious." It didn't surprise me too much when he said it. It seemed like a very human and authentic reaction on his part to my saying it felt like he was warning me off.
Now, what might he be anxious about? I'm not sure. Perhaps he is anxious about how it might go if I were to develp erotic feelings about him. That's a tricky area. Even if T's have their own issues dealt with, sex is a very personal thing. And there are reactions we can have that are more physiological than psychological. Maybe he's worried about that? Or maybe he wonders if he's up to the task of deepening. I know it takes more out of me, and I know that emotional sessions with my clients can be draining for me, too. Maybe he is anxious about what "dark secrets" I might have. Yes, T's are supposed to be able to hear anything and still provide unconditional postive regard. But I can tell you from experience, some things I hear can resonate with me viscerally. And that kind of stuff has stayed with me longer than other stuff. I feel confident that my reaction made it safe for the client to go on, but it was such a dark, gut-wrenching story, you couldn't help but be affected by it. So maybe he's anxious about that? Golly, I could go on and on. Insomnia at play here.
I should print this out and bring it in to my next session.
Thanks for making me think!
gg
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