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Can people share *good* therapy examples?

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Aspie1
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14 Apr 2020, 11:00 pm

BeaArthur wrote:
Aspie1, it seems like you might be starting to contemplate that some therapists are good.
Sort of. I listed the criteria that therapists must have in order to fit my definition of "good". With adult patients, such a thing is possible. Difficult to the point of being unworthy of time and effort, but possible.

But a family therapist can never be good. They fail in the "transparency" part, since they're "helping" the minor, but their loyalty is to his parents. I'm sure they won't disclose that little detail to the minor sitting in front of them, because then, the minor won't spill any secrets. It becomes a conflict of interest where nobody wins.



auntblabby
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14 Apr 2020, 11:29 pm

rogerian therapy kept me alive. where the rubber meets the road, it is definitive for me. my rogerian therapist, one T.E. Sterling [RIP] was an ex-marine officer who changed the course of his life via the GI bill, went to psych school, studied rogerian therapy and in between being a psych prof @ U of PS, had a clinical practice dealing with DSHS clients, of which i was one. he was about the only person who validated my humanity, who LISTENED to me and was totally undramatic and matter-of-fact.



ToughDiamond
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15 Apr 2020, 1:51 am

I've no experience of therapy aimed specifically at ASD, so no comment there. I've experienced counselling with a few Relate counsellors who naturally focus on relationship matters, and with one "personal counsellor" who gave much the same kind of service, as my main issues at the time were about a partner, also one who I see with my wife sometimes, just known as a therapist, no idea what the official label or remit is in that case.

The ones that I consider to have done some good - first one probably did too much listening-without-judgement when I'd have preferred a bit of advice here and there, but gently managed to set me on the road to taking more interest in feelings (which I'd hitherto ignored). Another happened to say, when I'd been talking away about behaviour I objected to from a partner (basically fishing for support for my idea that the partner was in the wrong), "there must be some reason why she's behaving like that towards you," which helpfully redirected my attention from the ethical judgement of the thing onto the more productive question of why it was happening.

Mostly it's been new ideas and insights into myself and my relationships that have been rare and didn't seem much use at the time but improved my ways of fathoming what might be going on, and helped me to gradually piece together ways of navigating relationships, to become better at keeping my head during tricky phases and seeing them for what they were. They didn't fix anything for me like I maybe thought they would, I was just increasingly interested in learning about how relationships ticked and how to deal with them more successfully, and they occasionally gave me a clue and left it up to me what I was going to do with it.

The current therapist I see with my wife (sessions suspended till the virus precautions are over), I'm too close to the sessions to be able to say what good is coming of them, except that it feels cathartic to relate our experiences to her. She doesn't give much feedback, though we don't have many problems that we aren't fairly confident of tackling under our own steam. I've often felt a little more able to criticise my partner's behaviour when she's been there, as we used to get this problem where my partner would feel threatened if I criticised her in private at all - possibly down to her previous relationship with a rather tyrannical man - and I would soon feel guilty and under suspicion of being tyrannical myself, so I'd keep too quiet about what was on my mind, which felt unhealthy. But with the therapist there I think we both felt that there was less risk of tyranny or a negative reaction to the feeling that tyranny might be happening, and so the dialogue was less fraught and we were more easily able to hear and understand each other, just because there was somebody there who seems to have a good sense of responsibility.

You might think "that's all very well if you've got a relationship, but I haven't," but as far as I can see relationships are just a particular form of friendship, and once you get a bit of understanding in dealing with relating to people, you can use that understanding to better develop any form of friendship you want. Personally I'm glad I took the trouble to have the sessions I've had. I don't think I'd have made as much progress as I did otherwise. I've got miles to go yet, but it's better than the pitifully inadequate grasp of people skills I started out with, and my relationships and friendships improved as a result.



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15 Apr 2020, 2:27 am

Aspie1 wrote:
But a family therapist can never be good. They fail in the "transparency" part, since they're "helping" the minor, but their loyalty is to his parents. I'm sure they won't disclose that little detail to the minor sitting in front of them, because then, the minor won't spill any secrets. It becomes a conflict of interest where nobody wins.


Why do you assume that parent-child relationships are always adversarial? That seems like an obvious special case, or there would be far fewer children.



Aspie1
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15 Apr 2020, 4:57 am

auntblabby wrote:
rogerian therapy kept me alive. where the rubber meets the road, it is definitive for me. my rogerian therapist, one T.E. Sterling [RIP] was an ex-marine officer who changed the course of his life via the GI bill, went to psych school, studied rogerian therapy and in between being a psych prof @ U of PS, had a clinical practice dealing with DSHS clients, of which i was one. he was about the only person who validated my humanity, who LISTENED to me and was totally undramatic and matter-of-fact.
My therapist listened to me and validated me too. But the "validation" in my case was more like mockery: the cooing, the exaggerated "awwww", and the mimicking ("awww, you felt sad and powerless"). I never figured out what that meant. Well, I decided that it was her politically correct way of saying "toughen up, buttercup; nobody cares how you feel". I don't know if that was Rogerian therapy or not, but that's how it went. Maybe I'm wrong, but wouldn't be better if she said "that's not normal, that's disgusting" in a compassionate but serious tone. (Come to think of it, one psychiatrist I saw as an adult did just that.) Otherwise, it's something bullies say when they taunt a victim. I thought they teach these things in therapy school. Or is that asking too much?

Dear_one wrote:
Why do you assume that parent-child relationships are always adversarial? That seems like an obvious special case, or there would be far fewer children.
Well, if you think about it, parents want more discipline, and children want more freedom; even if they find a mutually satisfactory solution, it's still a zero-sum game. But that's not what I was talking about. I was talking about how family therapists pretend to be the child's friend, when in reality working for the parents. And when you're a shrewd, vigilant aspie, having that simple fact withheld from you (even if you figure it out yourself) easily destroys trust.



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15 Apr 2020, 5:05 am

Aspie1 wrote:
My therapist listened to me and "validated" me too. But the "validation" in my case was more like mockery: the cooing, the exaggerated "awwww", and the mimicking ("awww, you felt sad and powerless"). I never figured out what that meant. Well, I decided that it was her politically correct way of saying "toughen up, buttercup; nobody cares how you feel". I don't know if that was Rogerian therapy or not, but that's how it went. Maybe I'm wrong, but wouldn't be better if she said "that's not normal, that's disgusting" in a compassionate but serious tone. (Come to think of it, one psychiatrist I saw as an adult did just that.) Otherwise, it's something bullies say when they taunt a victim. I thought they teach these things in therapy school. Or is that asking too much?

i'm sorry that was your experience but it was not mine. i lucked out in that i had good therapists. no bullies in my experience. if there had been one bully i think i'd be in a different place now [prison].



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15 Apr 2020, 5:12 am

Aspie1 wrote:
Well, if you think about it, parents want more discipline, and children want more freedom; even if they find a mutually satisfactory solution, it's still a zero-sum game. But that's not what I was talking about. I was talking about how family therapists pretend to be the child's friend, when in reality working for the parents. And when you're a shrewd, vigilant aspie, having that simple fact withheld from you (even if you figure it out yourself) easily destroys trust.

There are parents, and therapists, who are addicted to being in control. However, the usual purpose of parental control is just to keep their link to posterity safe until it can be self-sufficient, and then get back to their other interests. The child wants freedom, but needs some guidance in learning how to deal with the world and take care of itself. Sure, you are shrewd and vigilant, but you are not seeing over half of the picture - just the part that fits with a hostile world view. Nature does involve a mutual eating, but it turns out that during actual lifespans, co-operation is far more important.



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15 Apr 2020, 5:27 am

ToughDiamond wrote:
The ones that I consider to have done some good - first one probably did too much listening-without-judgement when I'd have preferred a bit of advice here and there, but gently managed to set me on the road to taking more interest in feelings (which I'd hitherto ignored). Another happened to say, when I'd been talking away about behaviour I objected to from a partner (basically fishing for support for my idea that the partner was in the wrong), "there must be some reason why she's behaving like that towards you," which helpfully redirected my attention from the ethical judgement of the thing onto the more productive question of why it was happening.
There's a school of thought that it's a bad idea for a therapist to play devil's advocate---siding with the person a patient complained about. It inadvertently sends a message that the therapist is not on the patient's side and therefore not to be trusted. (Hmm... where have I seen that before? ;)) I get why yours did that, but it'd rub me the wrong way. I suppose it can be done, but it has to be done just so---which is far from easy---as not to destroy the patient's trust.

Although in my case, my age was working against me. My therapist was an adult, obviously. Which effectively put her on Team Adult in my mind, and therefore made her untrustworthy a priori. Not unlike doctors or teachers, who were nice at first, but then did painful procedures or gave me bad grades. (For some reason, I felt more comfortable with male doctors than female doctors as a child, although most pediatricians are women.) I suppose, hypothetically speaking, if my therapist were a 13-year-old boy like me, I'd probably interpret his statements differently and give them more credibility, because he'd be on My Team.



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15 Apr 2020, 7:15 am

Aspie1 wrote:
BeaArthur wrote:
Aspie1, it seems like you might be starting to contemplate that some therapists are good.
Sort of. I listed the criteria that therapists must have in order to fit my definition of "good". With adult patients, such a thing is possible. Difficult to the point of being unworthy of time and effort, but possible.

But a family therapist can never be good. They fail in the "transparency" part, since they're "helping" the minor, but their loyalty is to his parents. I'm sure they won't disclose that little detail to the minor sitting in front of them, because then, the minor won't spill any secrets. It becomes a conflict of interest where nobody wins.

Family therapists and couples counselors identify the "patient" as none of the individuals, but the group as a whole. So there is a lot of focus on communication and noticing bad patterns of interacting (such as triangulation i.e. talking to another person thru a third person).

Let me offer you a little bit of Cognitive-Behavioral Therapy (CBT), Aspie1. When you use an absolute phrase such as "_______ can never be good," you are probably making an untrue generalization. Watch your own language for words such as always or never. You used to say those things about therapy in general, but I see you softening your stance since many people here are offering testimonials of how much therapy has helped them.


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15 Apr 2020, 7:16 am

auntblabby wrote:
rogerian therapy kept me alive. where the rubber meets the road, it is definitive for me. my rogerian therapist, one T.E. Sterling [RIP] was an ex-marine officer who changed the course of his life via the GI bill, went to psych school, studied rogerian therapy and in between being a psych prof @ U of PS, had a clinical practice dealing with DSHS clients, of which i was one. he was about the only person who validated my humanity, who LISTENED to me and was totally undramatic and matter-of-fact.

Thank you for sharing that, auntblabby.


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BeaArthur
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15 Apr 2020, 7:26 am

ToughDiamond wrote:
I've no experience of therapy aimed specifically at ASD, so no comment there. I've experienced counselling with a few Relate counsellors who naturally focus on relationship matters, and with one "personal counsellor" who gave much the same kind of service, as my main issues at the time were about a partner, also one who I see with my wife sometimes, just known as a therapist, no idea what the official label or remit is in that case.

The ones that I consider to have done some good - first one probably did too much listening-without-judgement when I'd have preferred a bit of advice here and there, but gently managed to set me on the road to taking more interest in feelings (which I'd hitherto ignored). Another happened to say, when I'd been talking away about behaviour I objected to from a partner (basically fishing for support for my idea that the partner was in the wrong), "there must be some reason why she's behaving like that towards you," which helpfully redirected my attention from the ethical judgement of the thing onto the more productive question of why it was happening.

Mostly it's been new ideas and insights into myself and my relationships that have been rare and didn't seem much use at the time but improved my ways of fathoming what might be going on, and helped me to gradually piece together ways of navigating relationships, to become better at keeping my head during tricky phases and seeing them for what they were. They didn't fix anything for me like I maybe thought they would, I was just increasingly interested in learning about how relationships ticked and how to deal with them more successfully, and they occasionally gave me a clue and left it up to me what I was going to do with it.

The current therapist I see with my wife (sessions suspended till the virus precautions are over), I'm too close to the sessions to be able to say what good is coming of them, except that it feels cathartic to relate our experiences to her. She doesn't give much feedback, though we don't have many problems that we aren't fairly confident of tackling under our own steam. I've often felt a little more able to criticise my partner's behaviour when she's been there, as we used to get this problem where my partner would feel threatened if I criticised her in private at all - possibly down to her previous relationship with a rather tyrannical man - and I would soon feel guilty and under suspicion of being tyrannical myself, so I'd keep too quiet about what was on my mind, which felt unhealthy. But with the therapist there I think we both felt that there was less risk of tyranny or a negative reaction to the feeling that tyranny might be happening, and so the dialogue was less fraught and we were more easily able to hear and understand each other, just because there was somebody there who seems to have a good sense of responsibility.

You might think "that's all very well if you've got a relationship, but I haven't," but as far as I can see relationships are just a particular form of friendship, and once you get a bit of understanding in dealing with relating to people, you can use that understanding to better develop any form of friendship you want. Personally I'm glad I took the trouble to have the sessions I've had. I don't think I'd have made as much progress as I did otherwise. I've got miles to go yet, but it's better than the pitifully inadequate grasp of people skills I started out with, and my relationships and friendships improved as a result.

Thank you for sharing that, ToughDiamond.


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ToughDiamond
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15 Apr 2020, 2:05 pm

Aspie1 wrote:
There's a school of thought that it's a bad idea for a therapist to play devil's advocate---siding with the person a patient complained about. It inadvertently sends a message that the therapist is not on the patient's side and therefore not to be trusted. (Hmm... where have I seen that before? ;)) I get why yours did that, but it'd rub me the wrong way. I suppose it can be done, but it has to be done just so---which is far from easy---as not to destroy the patient's trust.


I didn't really pick it up as the counsellor siding with my "assailant." I felt more that she was showing me an alternative to picking sides and getting polemic at all. I remember my first counsellor saying something like "I can't sit in judgment" as part of something rather longer that she said, though my ability to focus on the words of others was so impaired in those days that I had no idea of the context of that little snippet I managed to catch. But it did help me to realise that judging people isn't an activity that's likely to get me anywhere in my thinking. One of the things that Relate used to warn clients about before they started the sessions was "we aren't here to reinforce your prejudices." I guess that fact can be a problem for anybody who's looking for that kind of reassurance, but personally I think it's a little like taking heroin - it may be very soothing at the time but it holds the user back from dealing with their problems. Over and over I've heard this reaction to some of the things I've said to people - "Who's side are you on? Why won't you empathise with my moral judgement?" My answer is that all I can do for them is to try and arrive at the truth with them, that I can't much relate to this "we are good, they are bad" thing that people use so commonly to falsely bolster their sense of pride. I'll help them to fight an assailant if I care about their welfare, but I'll tend to skip the moral judgements.



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15 Apr 2020, 2:07 pm

Aspie1 wrote:
Although in my case, my age was working against me. My therapist was an adult, obviously. Which effectively put her on Team Adult in my mind, and therefore made her untrustworthy a priori. Not unlike doctors or teachers, who were nice at first, but then did painful procedures or gave me bad grades. (For some reason, I felt more comfortable with male doctors than female doctors as a child, although most pediatricians are women.) I suppose, hypothetically speaking, if my therapist were a 13-year-old boy like me, I'd probably interpret his statements differently and give them more credibility, because he'd be on My Team.


I didn't get any counselling till I was about 26, so I didn't get that generation gap problem myself, though I'm sure it can be a problem. Looking back, I saw some adults as "suits" and others as "cool," so I guess I'd have much preferred a "cool" adult and that a "suit" would never have influenced me at all. I'm secular, but some of my counsellors were religious, though I don't know which ones for every case. The smart ones left their faith at the door. One that didn't had already come over as an arrogant piece of work before he revealed his faith, doing nearly all of the talking himself and acting more like a teacher. When he did come out, he added, "we're not supposed to tell you that," and I figured that if that was so, maybe there was a good reason for it that in his arrogance he'd chosen to override. He'd always done this thing where he'd look vaguely skywards, nod and smile, and then try to teach me an idea. After telling me of his religion, I couldn't help but imagine he thought he'd got a hotline to his deity to prompt him, so naturally I wasn't impressed, to say the least. I certainly wouldn't say that my counsellors must be atheists, but I would say that it helps if they don't tell me - I know of some religious ideologies that I personally feel so strongly against that it might prejudice me against respecting such a person's judgement on anything. It shouldn't, but I'm only human.