Can people share *good* therapy examples?

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I'm sure you've read many of my posts ranting against therapy. I think it's a useless industry. Therapists technically don't even give advice. They just "empathize" with you, something or other. Many a time, they claim to "help you feel better in the long run", while in reality just working hard to keep you depressed with emotional sucker punches. And equally often, they act in unpredictable ways, like asking you dumb rhetorical questions, cooing at you, or mimicking you. That's done out of loyalty to someone other than the patient (like your parents), to "nicely" tell you to stop complaining, or simply because they're too stupid to actually help you and aren't honest about it.

NT patients usually know how to navigate these therapy tactics pretty well. They intuitively know the right answer the therapist wants, appropriately and firmly tell them to shove it, or just brush off their statements as background noise. Aspies, due to their literal thinking and/or emotional vulnerability, aren't so lucky.

But since a few people on here mentioned that they did benefit from therapy, I'll bite. Do tell. Would you feel comfortable sharing specific examples of helpful therapy? For instance...
You (U): "Such and such happened to me."
Therapist (T): "I'm sorry you had to go through it. Next time, do A and B. It'll work because psychology trick."
U: "Wow, that makes sense. Thanks."
T: "Let me know how things come out for you."
U: "Do you think C could help me too too?"
T: "Nah! They [people mistreating you] won't care. Stick with A and B. Maybe try D, although D is questionable."

Or at the very least...
You: "Such and such happened to me."
Therapist: "That's not good. But I'm sorry, I don't have anything helpful to tell you."

Let's hear stories, with specific dialog examples, if you can. Feel free to change or hide details for privacy reasons. I can't promise I'll be able to relate, but I'll be intrigued by actual therapy success stories, especially for us aspies.

I've worked with my trauma therapist for nearly eleven years. In the beginning I was so frightened I hid under his desk and wouldn't speak at all because of mutism. He was patient and made small gestures to make me feel more safe over time. He's never "told me what to do" in response to anything. He listens, asks questions aimed to reroute my focus or clarify my belief system, and he remembers what I say. That's the most important thing. For example if I mention that I'm scared of the colour orange as a trigger, from that moment onward there will never be an orange item in his office and he will never wear orange again. Nothing goes forgotten and nothing is treated without significance. Several years into therapy he would meet me out of office for sessions to deal with my agoraphobia, fear of people, and anxiety with women in particular. We spent lots of time in open parks being used to the outdoors. One time we went to the shops so he could watch me interact with sales staff, including women. It wasn't quite exposure therapy because I'm not ready for that, but it was a type of supportive exposure where I knew that he would support me as needed. At the end of our sessions we often listen to music, laugh and dance around having fun to break the tension. His favourite song is Tutti Frutti and we've done some crazy dancing to that song. It will always remind me of him and the friendship we've developed.

He's in his 80s and almost completely retired but we still speak now and then. He texts me when stressful events are happening in my life, and I can talk to him if I need to.

Not all therapists are paid lackeys like yours.

I simply ‘make’ myself listen to some happy , uplifting music . .. it just works ! !

I have had therapists who clearly misdiagnosed me, and terminated those relationships pretty quickly.

Right now though I am "seeing" a psychologist who is about my age if not older (very mature, that is). "Seeing" is in quotes because as long as coronavirus is in effect, we use a HIPAA compliant Zoom method for face-to-face telemedicine.

She has told me several times that she is impressed with how resourceful I am, which gives me confidence to figure out for myself the solutions to many of my roadblocks. She can empathize with my caregiver responsibilities as a spouse of a dementia patient, because she herself had a similar role with her own husband (now deceased).

Mostly there, I am seeking supportive "therapy" (not a lot of changes intended) and I see her at a low frequency, approximately monthly. She frequently asks me what is important to me to work on or talk about, which is her meeting the client where I am at. This is not a standard therapy approach, but she allows me to take it because this is what I need and want.

She asks questions that stimulate me to reframe a situation or an outlook, without telling me the "correct" outlook. Let me see if I can remember an example. "Do you see any ways you could deal with that?" "What do you think is going on there?" That kind of thing.

She admitted from day one that she is not knowledgeable about autism. (Remember, she undertook her clinical training some 40 years ago!) But she lets me point out ways that I think it is affecting my experience, such as executive function problems.

She provides "unconditional positive regard," something Carl Rogers defined as an important aspect of a good therapy relationship. She never criticizes me or appears to revile anything about me. I think if a therapist cannot do this with a client, the therapy is doomed because the client will want to earn approval instead of trying to work on their own problems and issues.

Enough for you, Aspie1? The therapy is successful because of what I bring to the table and what she brings to the table; and because of my ability to quit bad therapy relationships but seek out a profitable one. Maybe these factors don't exist for you.

Well, that's the thing. I wanted to be told what to do. Namely, "What do I do when someone does ____?" or "What does it mean when someone does ____?" I mean, she was trained in psychology---LCSW, to be exact---so wouldn't she know and be able to share with me? I guess not.

But back on topic. Those of you with *good* therapists, what did he/she tell you in a similar situation?

If I asked for specific advice of "what should I do? ..." He would have me list my options and do a pro / con type of assessment for all the choices. The answer is never his. He isn't me. The answer has to come from what I'm capable of choosing on my own. That doesn't mean he doesn't care or doesn't know what to say. He's able to guide my thinking so that I can see the pitfalls, catch 22's, or self-defeating behaviour in some of my thought patterns. He has a PhD in trauma therapy from working with Holocaust victims. He was a Holocaust survivor himself. He is very much "trained in Psychology" but that doesn't mean that he makes decisions on my behalf or tells me what to do. The beauty is that he helps me discern right from wrong on my own, with free agency.

Maybe your expectations of therapy were not congruent with your therapists' models. In some kinds of therapy, the therapist actively changes your behavior, but in other models, the therapist strives mightily to get the client to figure out a better option on his or her own. So, in these latter models, the therapist might answer your query ("What do I do when someone does _____?") by asking you what have you tried in the past, and how has that worked out; OR what do you see other people do in that situation, and is it something you would like to try; OR what kind of outcome do you desire in that situation? All of these responses are aimed at helping you be more successful in navigating life, rather than giving you a cookie-cutter response - which is, of course, what many autistics want, but which doesn't fit reality very well.

Edited to add: This is a lot the same as what @IsabellaLinton just said immediately preceding this post.

She asked me those questions many times, and I could tell by her face that she was expecting a specific answer. Her reactions varied: sometimes she'd say "OK" no matter what I said, other times she'd keep grilling me until I answered correctly. It was a basically a cat-and-mouse game.

Rogers is the same schmuck who invented the "How did that make you feel?" question, so he's questionable at best. I don't agree with "conditional positive regard" (UPR). At best, it's naive; at worst, it's insincere. I "tested" my therapist's UPR many times. I even once told her that I drank a jar of pickle brine with a glass of milk, and she had almost the same reaction as when I told her I had a test in school. I can only imagine how she'd react if I told her I killed a squirrel by stomping on it (as a lie, of course), although I was too afraid to try that on her.

I think a *good* therapist would give direct feedback to a patient, using concrete, relatable analogies. For example...
Therapist: "What you said to that boy when he asked you about about your picture hanging in the hallway was self-deprecating. It means putting yourself down. If you truly can't give yourself a compliment, then reacting neutrally is fine too. You may not like your picture, but others may merely feel neutral about it."
You: <confused blank stare>
Therapist: "It means they neither like it nor dislike it, like you neither like nor dislike another teacher you met once. You might think it looks ugly, but in their mind, it's just another picture 20 students they share a classroom with. The phrase 'if you can't say anything nice, don't say anything at all' applies to yourself too, not just other people."
You: "That's true."

Mine tried a little bit of that. But the problem is that no matter what I answered her, her reactions in facial expressions, voice tone, and spoken statements were nearly the same. That was whether my answer was right or wrong, or the difference was very, very subtle. (I'll allow the possibility that my aspie wiring prevented me from seeing that.) Which effectively nullified the usefulness of those questions; how the heck am I supposed to learn if I'm not even told if I'm right or wrong?

I soon realized that trying to learn from her was Sisyphus's labor, and turned to teenage sitcoms on TV, in order to learn how to be "cool", make friends, and meet girls. I can't say that helped very much, but at least I had concrete examples to model myself after. For example, it was Steve Urkel who taught me that showing one's intelligence was uncool, at least in teen years.

I liked the examples of good therapy so far. Keep 'em coming.

I can’t for the life of me remember exactly how conversations went, but I found it extremely useful to be introduced to CBT.

At other times, I have found that just the act of talking frankly about something can help me see a different way of thinking about it. The therapist may or may not facilitate that by asking questions that tease out your own conclusions.

A therapist usually isn’t someone who will tell you what to do. That might be a support worker or a life coach or an adviser. A therapist also isn’t there merely to provide emotional support - that’s a councillor (although most therapists will do some of that). A therapist’s role is to help you change how you think in order to improve your mental health. If you want focus on practical problems and being handed solutions then you need to make that clear in your first session with the therapist, who may then suggest you see someone else.

Well, you called Carl Rogers a schmuck, and said unconditional positive regard wasn't something you wanted, even though I and many other people have found it essential.

Keep 'em coming so you can argue them down?

Has it ever occurred to you that your failure to succeed in therapy was not because your therapists were crap, but because you are not a good candidate for therapy?

For me, counselling has been a place to explore my head with an interested audience who occasionally had some tips. The single most helpful response came when I was describing my struggles over feeling stuck in a useless loop, but unable to see an alternative. She said that she wasn't smart enough to fault my logic, even though she agreed it was not working for me. Later, she didn't remember the incident. That was the beginning of my real appreciation of the independence of IQ and EQ, a key for me to understand others.
Generally, she was suggesting I give up "black and white thinking." She failed to identify that as a complication of the sleep problems I was dealing with, which would have been extremely helpful.
I should point out that even though she had few answers, her interest as a collaborator was extremely encouraging. We could talk about various psychologists as a shared special interest, and it was never rude for me to talk about myself. I didn't see it as an adversarial relationship, which seems to be the OP's usual approach.
I don't think this kind of stuff has to be expensive. Mutual help groups such as co-counselling lists can work too.

The problem is that nothing was explained to me. I was marched into the office and told to "talk to the nice lady". Which meant share with her what's troubling me. So when I did, my problems got worse, not better. And neither my therapist nor my parents cared.

You might be right. I stink at therapy! Even so, is it too much to ask that when I share how my parents put me down, I want something more constructive than a cooing noise? Ideally, a psychological trick my therapist knew and I didn't. At the very least, an admission: "sorry, kid, I can't help you".

It's ok to have had a bad experience in therapy. Therapy can be damaging, and it's important to be aware of it. I've experienced both good and bad. A lot of therapists don't really know how to deal with autistic people. It's important to find the right person.

In my experience, the bad ones were people who jumped to conclusions, didn't understand complex questions, thought I was essentially like them, and were overly emotional.

The good were open minded, ethically steady, well educated and really just decent people. A logical mind helps.

I've read quite a few of your posts over the years, OP. It's quite clear that your experience was really damaging for you at a quite young age - and the proof is in the fact that you keep returning to this topic, trying to process it from different angles. I hope in time you will be able to have other experiences. I think you are right to be cautious, but it really is possible - with the caveat that therapists are not always right, even when they are nice.

That's true. The three traits a good therapy must possess are directness , congruence, and transparency. Everything is explained upfront, the good parts and the bad parts.

Directness means disclosing to the patient at the very beginning what's expected from him. If a patient will be required to give specific answers about feelings, a therapist must warn the patient before those questions are even asked. And if possible, provide study guides, so the patient can read up on what's expected from him, in order to study for the next session.

Congruence means the expectations match the process. So if a patient is promised real help, explicitly or implicitly, the real help must happen, no ifs, ands, or buts. Not "feelings" questions, not cooing, not empathizing, but actual, concrete help. And if a therapist is unable to give the help the patient expects, he/she must refer the patient to books or websites.

Transparency means the therapist is honest about their role. In other words... "Hey, listen, kid, I'm here to help your parents, not you. You're just sitting in my office so that I can help them manage you. I can imagine how you feel, but it is what it is. I want you to be cooperative with me, but I wouldn't feel right pretending to be your friend, either. Capisce?"

If a therapist is able to offer all three of those things, then they're a good therapist in my book.

Aspie1, it seems like you might be starting to contemplate that some therapists are good.