How Do/Would Therapists Feel About A "Perfect" Patient?

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Aspie1
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15 Nov 2022, 8:09 pm

We all know therapists expect certain things from patients. But imagine if a therapist had a patient that fulfilled all their expectations perfectly.

Such a patient knows all the correct answers to "how did that make you feel?", delivers them on the spot, and is able to elaborate on them without exaggerating or seeming fake. He cries on cue whenever he senses the therapist wants to see him cry, but calms down pretty quickly. He knows what the therapist wants to hear and doesn't want to hear, and only talks about the "right" topics. If the patients is a minor, he knows he's supposed to talk about good grades in school and not about being emotionally abused at home, and only talks about good grades. He reads the therapist's hints (like the mocking "awww", meant to hint to the patient to stop whining) like the alphabet, and always acts as expected. When he hears mockery or sees a scowl, he changes the topic immediately. He doesn't talk about anything that conflicts with the therapist's loyalty (like asking for help with being emotionally abused by his family), and chooses to suffer in misery, rather than ask for antidepressants, because he knows the therapist doesn't want him to have them. (He may go to a real doctor elsewhere, but he doesn't tell the therapist, because he knows they're against antidepressants and to stay on their good side.)

It seems like I was nowhere close to a perfect patient, which explains why my therapists were so unhelpful to me. Well, I was good at noticing mockery/scowls and changing the topic quickly, but I sucked at everything else.

So... how would therapists feel about such a patient? Would they be more willing to genuinely help him, since he's so "perfect"? Or would they see him as a gullible cash cow, and prolong his suffering, while fleecing him for $100+ per session?

Discuss!



IsabellaLinton
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15 Nov 2022, 10:10 pm

My therapist cost $255 / 45 minutes.

She never once asked me how anything made me feel.



Aspie1
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15 Nov 2022, 10:35 pm

IsabellaLinton wrote:
My therapist cost $255 / 45 minutes.

She never once asked me how anything made me feel.

You were lucky because you weren't asked those questions. But they're ubiquitous in therapy otherwise, and you're expected to deliver the right answers, at least by NT therapists, or else they get angry with you. A "perfect" patient knows them; an average aspie doesn't.

Which raises the question: How would a therapist feel about a patient who gives the right "feelings" answer every time?

I suppose it's not the same as "How would a clubgoer feel about a highly skilled dancer?", but it's gotta be very close to it.



IsabellaLinton
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15 Nov 2022, 10:51 pm

Have you ever worked with a PhD clinical psychologist?
You mentioned a bad experience with a family therapist many years ago.
She was a Social Worker according to your posts.

I'm curious how you know what is ubiquitous for therapy.
Have you been to therapy at all since your adolescence?



Aspie1
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15 Nov 2022, 11:00 pm

IsabellaLinton wrote:
I'm curious how you know what is ubiquitous for therapy.
Have you been to therapy at all since your adolescence?

Yes. One criticized me for not readily buying into his CBT agenda---although be did it politely, and he was otherwise an intelligent man. The other one again mocked me for wanting practical advice instead of her woowoo crap; I should have reported her ass to the state.



IsabellaLinton
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15 Nov 2022, 11:11 pm

That represents all psychologists, then?

I've had thousands of hours of trauma therapy over 20 years.
They know I'm autistic and I have Alexithymia.
That means I can't discuss emotions and I don't respond to CBT.
Therapists get this information during intake, and go from there.
They tailor my treatment to my needs.

My partner is a counselling psychologist.
I just asked him what makes a perfect patient.
He joked: "They don't cancel last minute."
Serious answer: "They tell me what they need."



ToughDiamond
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15 Nov 2022, 11:46 pm

I've seen 6 counsellors (I suppose they could be called therapists) - comprising 4 Relate counsellors, one from a personal counselling centre, and one of unknown label. They varied in their aptitude to help me, but even the worst of them weren't half as bad as the OP's implied experiences. Was I just lucky?



lostonearth35
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15 Nov 2022, 11:47 pm

Therapists are monsters.



Aspie1
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16 Nov 2022, 6:11 am

IsabellaLinton wrote:
My partner is a counselling psychologist.
I just asked him what makes a perfect patient.
He joked: "They don't cancel last minute."
Serious answer: "They tell me what they need."
I tried telling my therapists what I needed, both that social worker trash and the ones I saw as an adult. None of them gave it to me, which was practical, applicable advice. Well, the social worker can be explained by the fact that she was loyal to my parents, not me. But the others, I don't know.

lostonearth35 wrote:
Therapists are monsters.
They are. But what if a "monster" found themselves sitting across from a perfect patient? (To get the thread back on topic.) That is, someone who had emotion words memorized like the alphabet song, knew what not to bring up, picked up on hints instantly, never asked for antidepressants, etc.



Mountain Goat
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16 Nov 2022, 6:41 am

Just a thought. Would a perfect patient need therapy?


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IsabellaLinton
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16 Nov 2022, 10:38 am

Just a thought: There are therapists here on WP. I don't think they should be called monsters.



ASPartOfMe
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16 Nov 2022, 11:00 am

Off Topic
My assessor did ask feelings question and I had a lot of trouble answering them. It turns out there is an association between alexithymia and autism.

The therapist might think the patient is faking autism because there is no such thing as a perfect patient.


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Aspie1
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16 Nov 2022, 11:15 am

Mountain Goat wrote:
Just a thought. Would a perfect patient need therapy?
He/she might. But it's not about mental health. It's about the social skills for meeting the therapist's expectations.



Last edited by Aspie1 on 16 Nov 2022, 11:39 am, edited 1 time in total.

kraftiekortie
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16 Nov 2022, 11:21 am

The therapist can only offer advice and provide a supporting bulwark.

The client must be in charge of him/herself; never should a client rely fully on the therapist.



IsabellaLinton
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16 Nov 2022, 11:53 am

Good therapists don't offer advice.

It seems like no matter what people say, the OP is going to belittle therapists he's never met.
It's OK for the OP to talk about his own therapy trauma in The Haven.
Personally, I don't think it's OK to denigrate ASD therapists and mental health professionals as a whole.
That's no different than attacking men, women, or people of colour.
Also this seems to be a duplicate thread topic that he's started several times before.

Many of us wouldn't be alive today if it weren't for the care received from our therapists.
Please have respect and realise they aren't all caricatures of a woman from your past.



Aspie1
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16 Nov 2022, 12:18 pm

IsabellaLinton wrote:
Good therapists don't offer advice.
...
Many of us wouldn't be alive today if it weren't for the care received from our therapists.
Please have respect and realise they aren't all caricatures of a woman from your past.
This isn't the thread topic. The topic is how a therapist would react to a patient who does everything correctly. After all, if a therapist is pleased with a patient, he/she is more likely to respond in kind.

I already know how a therapist reacts to a "bad" patient, from learning the hard way. Now I want to know how he/she reacts to a "perfect" patient, and maybe learn to be perfect myself.