I don't like the way my therapist talks to me.

Post Reply New Topic

I should start by saying that I've only met my therapist twice so it might be too early for me to know what she's really like. Also, it's my first time in therapy (this is CBT by the way) so maybe this is the way it works and maybe this is how a therapist should talk (which is why I'm asking you what you think).

While at the session on Thursday last week I just felt like my therapist talked to me as if I was a child or as if I was stupid (it was the same the week before but even worse last time). I don't think she realises how much I know and how much I've read about things even though I've told her. Her tone of voice annoyed me. I can't specify why (because I don't really know) but it sounded almost condescending/patronising. Also, I felt as though she didn't really listen to me.

You see, during my first session she gave me an assignment where I was supposed to write a list of things which make me anxious and then write down which of those things make me the most anxious (ranking them). During our last session we talked about the assignment and the different things which make me anxious. I for example told her that I find it extremely difficult to meet new people. It can often make me so anxious I pretty much go mute. I told her how I feel very uncomfortable with eye contact and small talk, initiating conversation and a lot of other social things to which she replied "well, I think you should just stop thinking about what other people think of you". We also talked about a lot of other things (compulsions, obsessive planning, worrying about studies etc) and her standard comment to all of those things seemed to be "just do this", "just do that", "just don't worry until you know more", "just don't give in to the urge of double-checking things", "you do seem like you might have Asperger's because you're so inflexible but just try to make small changes" etc. The word "just" made me really frustrated. It's not that easy. I told her it's not that easy. She didn't seem to understand/care about that. She also tried to make me do things I'm nowhere near ready to do yet.

Other things she said made it seem like she thought I was stupid. She might not think I am and I might be interpreting her behaviour all wrong but at least it seemed that way. I'm not stupid and I hate when people make me feel like I am. Before starting therapy I was really looking forward to it (starting therapy that is) but now, after I've met her twice, I'm already starting to dread it. I don't mean to be mean to her. She's probably a nice person. I just feel like perhaps she's not right for me. I don't trust her. I don't even like her. Is it possible to feel this way after only two sessions? Are therapists supposed to make you feel this way (I've felt more angry and frustrated after the sessions than before the sessions)? Am I just pessimistic and stubborn?

I want therapy to work.

Made me think of this by the way:

[img][800:1676]http://i.imgur.com/rqHHb9J.jpg[/img]

I have had therapist like that. I switched to different therapists. First I might tell your current therapist that her tone, phrasing, and use of the word just comes across as condescending. See if anything changes. If not find someone you are comfortable with and who understands you. I am not sure what iptions you have available but I have found therapy to be a big help only if I was comfortable with them and felt they understand me.

Sounds like she's incompetent. That's the kind of stuff I'd expect from a layperson, not a therapist. She seems to have no understanding of why her job is even necessary.

That is kind of how my last therapist was, but she didn't treat me like I was stupid and I don't think she was trying to be condescending Cognitive Behavioral Therapy in general comes of that way to me though. It seems thats the only approach any of them use. Then I had one I liked for 4 sessions and because the place I go for therapy sucks I have to switch to another one again. I don't know why I bother going let alone trying to afford it with no income both my parents give me a little money here and there. If it was any more than 5.00 I wouldn't go.

I would like it to work as well, but I've gone to lots of different ones since I was 15 all using the same approach and it hasn't helped thus far.

Your therapist sounds quite dismissive to me. I had that "just" thing too, when I was in therapy. Here's an example:

Me: I'm really anxious about going to the doctors. I can't make an appointment because even walking past the building makes me feel panicky at the moment.
Therapist: Well, just try.
Me: *Thinking, sarcastic" Oh, just try! Why didn't I think of that?

Sometimes I feel that if you're not the typical, standard patient they learned about in training then they don't know how to deal with you.

Rebbieh, it sounds like (brief) Cognitive Behavioural Therapy (CBT; http://en.wikipedia.org/wiki/Cognitive_ ... al_therapy ). The idea behind the behavioural component is to decrease anxiety through exposure to the feared/ anxiety-inducing stimulus. The idea behind the cognitive component is to restructure one's thinking. Hence her instructions to "just do that" and "stop thinking about what other people think of you". It is possible that a different therapist might be better at CBT. (If these therapy sessions are part of a health insurance plan, there is probably a fixed number of sessions. Unfortunately, you may have difficulty getting treatment in the future if you leave before those sessions are up.)

Research has shown CBT to be very effective for treating simple phobias (such as a fear of heights), and fairly effective at treating complex phobias (like social anxiety) in the general population. The problem with applying CBT to social anxiety in autistic people is that people with autism have genuine problems with social/ interpersonal interactions due to various skill deficits (e.g. reading non-verbal cues, difficulty maintaining eye contact, etc.), and so there is some merit to their fears. On the one hand, this may mean that the therapist needs to spend more time improving an autistic client's skill set. On the other hand, it may mean that there are serious limitations on what can be achieved.

Many years ago, before I found out about autism, I used to think that I was simply introverted with some social anxiety. I read a lot of psychology, including some CBT, and I tried to be more outgoing and social. At best, this produced mixed results. At worst, I was probably acting like the stereotypical, "active but odd" autistic (and coming across as annoying and arrogant ). These days, I do not fear interacting with other people, but I hate doing it, so I keep my interaction with the rest of the world to a bare minimum. I seldom feel lonely because most of my time is consumed by other things (such as work).

If those are verbatim quotes, she isn't really doing CBT. In fact, that's giving (useless) advice, not therapy.
Unfortunately, there isn't much quality control in psychotherapy, so someone can claim to do CBT because it sounds good (and because that's what's covered by health insurance) but then do whatever they want. I'd ask her to explain her approach to therapy and how it is supposed to work (actually that's something I'd expect a therapist to do on his/her own). Then you can decide whether you think it would be helpful.
The relationship between therapist and client is important - if you don't like her or the way she talks, you should probably try to see someone else.

I know it's CBT and I think I know how CBT works. I just didn't think that the therapist was supposed to tell me to "just do" things and then not guide me/help me/explain how to do it. I mean, I've tried on my own pretty much my whole life and since that obviously hasn't helped I thought perhaps therapy could help. But if therapy just means that I still have to do everything on my own without any help and the only difference is that someone else will be there and make me feel angry as well, then it's just better for me to not go and let her "help" someone else. Also want to add that I very well know that the therapists won't do the work. I will have to change the way I think etc. I know that. I just expect some help and some guidance or something. I want someone to talk to. I want someone to understand. Do you know what I mean?

I'm not sure which country you're from and how things work there but I've been referred to this therapist by a psychologist and I know I'm supposed to get 20 sessions at first and then we'll see how that has been going. I think you can probably try someone else but I'm not sure how to go about that.



I can imagine CBT is very effective for treating simple phobias. I for example have a phobia of flying and, without therapy, I've exposed myself to my fear and nowadays I no longer get panic attacks while flying. I still don't like flying, I'm still scared and the thoughts are still there but I no longer show any physical symptoms of that phobia. So exposure obviously works for things like that but this is my whole life we're talking about here. CBT has obviously helped a lot of people with anxiety disorders and the like and I'm not saying CBT won't help me. I think CBT could work for me but I don't think this therapist will do me good. I have my next session on Wednesday and I'm already dreading going there.

I don't remember the exact words but yes, that's pretty much what she said. Perhaps I'm just overreacting though. Perhaps I'm just remembering what I "want" to remember because I don't like her. I really want therapy to work though so I don't think I'd lie about these things (irrational thoughts about being a liar is one of the things which make me anxious by the way).

How is therapy supposed to work? What am I supposed to expect from a therapist?

CBT is not about telling you to 'just try' without giving you guidance on how to do it. In fact, CBT gives a lot of guidance.

Take the example of a phobia. Let's say the person is terrified of flying on an airplane.

What a CBT therapist would do, first of all, is ask the person to identify specific thoughts associated with the fear of flying. For example, one thought might be 'the plane's going to crash'.

Then they would examine the factual probability of that. They might, for example, point out that the proportion of car rides that end in a crash is much greater than the proportion of plane trips that end in a crash. They might talk about the training the pilot has received, and the safety procedures in place.

And then the person would be given a task of, whenever they think 'the plane's going to crash', they need to remind themselves of the low probability of a crash, the training of the pilot, the safety procedures, etc.

This same technique is applied to many other conditions. For example, with depression, they would identify depressing thoughts, such as 'no one loves me', and teach the person to counter those thoughts with factual statements that are more reassuring.

My advice to you, rebbieh, is to find someone who actually does CBT. It really doesn't sound like your therapist does that. You don't need to go to a lot of sessions to know it's not going to work if your first two sessions went really badly.

The psychologist I see actualy told me that CBT does not work for people with Asperger's, because it does not take into account that our problems have a different cause from those of the general population.

I think I'd trust him much further than the majority of other psychologists, because he has specialised in autism/asperger's at least since his doctoral thesis (which can be found online). You may have been refered to someone competent in CBT, by someone competent in psychology, but the question is, are either of them competent when it comes to ASDs, or are they just using a once size fits all treatment?

Ok, my therapist hasn't done any of that yet. But perhaps that's just because we've only met twice? She spent the first session asking me things like "how would you describe yourself?", "how would your mum describe you?", "how would your dad describe you?" (how am I supposed to know that by the way?), "how would you describe your parents?", "what are you good at?" etc. During the first session she also told me she wasn't sure the diagnoses which the psychologist and psychiatrist I saw before the therapist had "given" me were correct. She hadn't read my file (since they apparently don't share the same system) so when I told her about the diagnoses she just said "we should be careful about saying you've got all of those. That's for me to decide." Made me confused.

During the second session she told me all of those "just" comments. She also tried to force me to agree to do some sort of relaxation technique session with another patient next week. I said no. The reason I said no is because I don't even like or trust my therapist yet (if ever) and I have a huge problem meeting new people so meeting yet another stranger while doing things I'm not comfortable doing anyway is out of the question. Not going to do that until I trust the therapist I'm seeing. When I said no she laughed a little (not in a nice way) and said "it's really stupid to say no to things you haven't tried yet".

Anyway, she actually does CBT. Or at least that's what she's supposed to do. The name of her company or whatever is "[Surname]'s CBT clinic" (not sure "clinic" is the right word but I don't really know how to translate it).

Seriously, I get annoyed even when writing about this.

The thing is they don't know if I've got AS yet. I'm waiting to get assessed. I've been waiting for 10 months now and it's still a while to go. But, even if it turns out I don't have it I think and function in a similar way to people with AS (at least so it seems). The therapist knows what AS is but I doubt she knows a lot about it. I don't think she has any experience with it. According to her website she's got experience with people with social anxiety, relationship issues, phobias and people who have issues with physical pain.

You definitely need a different therapist. Calling your patient stupid is not good therapy.

Just to clear things up: she didn't really call me stupid. She said it's stupid to say no to things I haven't tried before.