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

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kraftiekortie
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16 Nov 2022, 12:32 pm

A good therapist would probably be suspicious if a patient reacts "perfectly" to him/her.



Where_am_I
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16 Nov 2022, 12:44 pm

In the UK, they recommend CBT for people on the spectrum. It's mentioned in the autism guide for therapists. 8O

To the OP, not sure how a therapist would feel about a perfect patient. Relief, perhaps? They won't have to put much effort into doing their job.


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16 Nov 2022, 1:13 pm

Where_am_I wrote:
In the UK, they recommend CBT for people on the spectrum. It's mentioned in the autism guide for therapists. 8O
This was true in the US for decades as well. But now, there are schools of thought that CBT isn't as effective as previously believed. At its core, it's ABA/masking for emotions: necessary at times, but not a panacea.

I tried CBT as an adult in 2012, and didn't find it very helpful. After 6 sessions, my therapist praised me for becoming less anxious. While I found him to be intelligent and sincere, I don't know if it was his CBT helping or me masking.

As for me, I was a better patient than I was 15 years prior, but still not perfect. I was on Klonopin at the time, and admitted to it. He didn't seem pleased, although he was polite about it.



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16 Nov 2022, 4:05 pm

For a few years I went to a therapist experienced with young-adult clientele on the Autism Spectrum.

I strongly feel that therapists "worth their salt" (as with my experience) would spend very little (if any) time on considering just what makes a "perfect client."



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17 Nov 2022, 12:15 am

Trying to do therapy with the idea that you are expected to do certain things and not others is not really engaging with the therapy. A therapist can only help if a client is willing to work with themselves. Having an antagonistic relationship with the therapist is just a non starter.
I would suggest looking inside yourself for why you feel certain things are expected of you. Perhaps you are projecting some internal issue onto the therapist. It may also help to read up on "transference".
At the very least one should be honest enough with the therapist to say exactly how you feel about the therapy. And then be open to working through that with them.


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Aspie1
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17 Nov 2022, 8:05 pm

ThisTimelessMoment wrote:
Trying to do therapy with the idea that you are expected to do certain things and not others is not really engaging with the therapy. A therapist can only help if a client is willing to work with themselves. Having an antagonistic relationship with the therapist is just a non starter.
I would suggest looking inside yourself for why you feel certain things are expected of you. Perhaps you are projecting some internal issue onto the therapist. It may also help to read up on "transference".
At the very least one should be honest enough with the therapist to say exactly how you feel about the therapy. And then be open to working through that with them.
Is a therapy lobbyist group sponsoring WP now? Serious question. (Sort of.)

Nobody said anything about antagonism! Adapting to your therapist is like adapting to any other authority figures, like parents, teachers, police officers, or bosses. Children obey their parents to avoid being grounded or losing their TV "privileges" :roll:. (Parents watch TV any time they want, no matter how they act.) Students obey their teachers to avoid getting detentions (and being punished at home on top of that). Drivers go the speed limit to avoid getting stopped by the police and getting a ticket. Employees listen to their managers to avoid getting written up or fired. And patients comply with their therapists' expectations to prevent those people from retraumatizing them in retaliation for being "resistant" :roll:.

Adapting to expectations, a.k.a. "having social skills", is something NTs can do before they can walk. So why can't aspies learn it too? Which includes adapting to therapists, which leads to positive therapy experiences.



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18 Nov 2022, 1:01 am

My point is that the relationship with a therapist is NOT a relationship with an authority figure. I can understand that might be the feeling one has if you are being forced into doing therapy. But to my mind that kind of arrangement is not great to start with.

A therapist is someone you are paying to help you with understanding the relationship between what is happening inside you and what is happening in your outer life in the world. Feeling that the therapist is an authority figure rather than a helper is going to skew the results that are possible.
There certainly are a spectrum of therapists, from good to bad. And if the therapist doesn't understand autism, that can be a huge issue. In such a case being honest about it with them is probably the best idea.
That aside, your attitude going into therapy is yours. You can change it as you wish. Without a sense of cooperation between therapist and client, there is no point in continuing. The relationship is the most important thing.

Please realise I am not being judgemental here. I have experienced the same feelings myself. In my case I finally managed to see that my feeling that the therapist was an authority had more to do with how s**t I felt about myself, than with the therapist. I was putting myself lower than him. Once I saw that how I felt about myself coloured everything in my life, I began to improve. The relationship with the therapist is precisely a tool for understanding that, so we can move forward.


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18 Nov 2022, 6:17 am

ThisTimelessMoment wrote:
A therapist is someone you are paying to help you with understanding the relationship between what is happening inside you and what is happening in your outer life in the world. Feeling that the therapist is an authority figure rather than a helper is going to skew the results that are possible.
There certainly are a spectrum of therapists, from good to bad. And if the therapist doesn't understand autism, that can be a huge issue. In such a case being honest about it with them is probably the best idea.
That aside, your attitude going into therapy is yours. You can change it as you wish. Without a sense of cooperation between therapist and client, there is no point in continuing. The relationship is the most important thing.

Please realise I am not being judgemental here. I have experienced the same feelings myself. In my case I finally managed to see that my feeling that the therapist was an authority had more to do with how s**t I felt about myself, than with the therapist. I was putting myself lower than him. Once I saw that how I felt about myself coloured everything in my life, I began to improve. The relationship with the therapist is precisely a tool for understanding that, so we can move forward.

Well, you kind of are lower than your therapist, and he/she kind of is an authority figure. Your therapist makes $100+ USD an hour. You make what you make. A therapist knows how to put a person into a crippling 2-week depression where they're crying for hours nonstop, with just one "perfectly" (no pun intended) worded phrase. (Which happened to me, and caused me to turn to alcohol and household inhalants at age 12.) You don't. And they wouldn't do it to a patient they genuinely respect; they'd only do it to a patient they feel is "resistant" or "immature". That's why it's extremely important to stay on your therapist's good side.

Therefore, I want to know how therapists feel about a "perfect" patient. Because all I know, from first-hand experiences, is how therapists feel about a "bad" patient.

P.S.: Maybe we're having a cultural difference here. Maybe therapists in South Africa are equivalent to shopkeepers, rather than wealthy, intimidating woo-woo wizards/witches like in the US.



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20 Nov 2022, 1:15 pm

Probably someone who always pays their bill.


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20 Nov 2022, 3:24 pm

Mountain Goat wrote:
Just a thought. Would a perfect patient need therapy?



Yes, otherwise they wouldn't be a perfect patient. Job security is important.