Most clients quickly think of the many qualities they want in their therapists.
However, are those clients also thinking about whether or not they are presenting themselves as the type of client someone would want to work with?
As an experienced psychotherapist, I am proposing that there are many criteria for clients to consider about themselves as well as about their prospective therapists.
Many of the following issues pertain specifically to trauma survivors and those with Dissociative Identity Disorder (DID/MPD).
Please consider the following concepts as important guidelines.
1. Stability
- Are you in a constant or repeated state of crisis?
- Are you looking for someone to rescue you immediately?
- Are you repeatedly in a suicidal or self-injurious panic?
- Do you make more than one emergency call every few months?
- Are you frequently in drunken states, or on the verge of over-dosing, or on the verge of self-injury or suicide?
Most therapists are not as interested in taking on heavily crisis-laden clients. The more stable you are, the more therapeutic options you will find.
2. Dependability
- Do you show up for every appointment?
- Do you cancel at the last minute?
- Do you pay for your sessions up-front and without issue, irritation, or complication?
- Do you do you keep your word, and follow through with the things you say you will do?
- Do you regularly pass important information between the leaders of your internal system, and not hide behind dissociative amnesia as an excuse?
The same as employers, babysitters, and doctors, therapists want to be able to count on you. They don’t want scheduling nightmares, and they don’t want to have to beg or fight for their pay. Remember, there are a lot of other people involved in each weekly schedule, so keep your time spot precious to you. Show your therapist that your therapy work matters to you.
3. Motivation and Willingness
- Are you willing to do what it takes to get through your healing process?
- Are you open to new ideas?
- Are you resistant to change? Do you react with irritation, anger, frustration, or refusals when you are expected or encouraged to change?
- Do you complete your homework each week?
- Do you bring new issues of needed work to the table? Are you presenting topics that need to be addressed? Or are you waiting for someone else to point the trouble spots out to you?
Coming to therapy typically means you are looking for some type of change in your life. If you are happy with the way things are, or you do not see any areas that need work, or you do not see any changes that you are willing to make, why are you going to therapy in the first place?
4. Courage
- Change and healing require taking new steps – both little steps and big steps. Can you do that? Will you do that?
- Are you too scared or too anxious or too depressed to try anything new?
- Are you willing to venture into difficult, complicated, painful areas of therapy work?
- Are you willing to look at painful memories when it’s therapeutically needed or recommended?
- Are you willing to look at the reality of toxic, abusive, or dangerous relationships, even those with your loved ones or family members?
Therapists can help you address your fears, your problems, and your issues, but only if you are willing to allow that to happen.
5. Personal Responsibility
- Are you willing to look at what you are doing to contribute to the problems you are experiencing?
- Are you willing to face your part of the problem, rather than focusing exclusively on blaming others?
- Are you genuinely open to hearing feedback about your issues?
- Do you retain the things you have learned from session to session, month after month? Will you be able to apply what you learn over time, or will you continue to use dysfunctional responses over and over?
- Even if you are dissociative, are your adult parts in charge of and responsible for your child parts? Are you able to maintain an adult presence when necessary?
The more responsibility you take for your own healing, your feelings, your behavior, etc, the further you will go in your healing process.
__________
Be sure to check out the second half of this article.
I wish you the best in your healing journey.
Warmly,
Kathy
Copyright © 2008-2017 Kathy Broady MSW and Discussing Dissociation
I tri rely hrd to be good
I promis
I deal with a lot of SI stuff….things like intense confusion, contradictory instructions, feeling extremely vulnerable and unsafe, Catch 22’s, caught between a rock and a hard place tend to trigger it off big time……The internal overwhelm is SO INTENSE that a part sees it as the only option to escape its perceived crisis…..Suddenly “watching” a part collapse to the “floor” Inside in a state of overwhelm is not easy to get through…..
I let my T know the times that I get hit with a lot of SI – but I try to let her know as objectively as possible…..I feel it is VERY important for her to know that I am getting intensely triggered for some reason so we can try to catch a glimpse of the bottom line reason….(most of my trauma is still blocked off)……If i kept “hiding” the SI triggers from her (so she doesn’t get frustrated with me)…then I feel we have lost the opportunity to maybe catch a glimpse of something……
Yes, there are times when I am really scared I won’t be able to “pull out of it”…..but I try hard to keep it in the realm of “it is what the Part is feeling” rather than recognize it as it is what “I” am feeling…..My T is then aware that I am in a major struggle – but because it is the “part” that is feeling “suicidal” rather than “me”….then “I” will get through it…..
It may be a totally wrong approach, but it is how I have gotten through…….SO, yeah, my T hears a lot of SI stuff from me – but she knows we are objectively trying to work together on “seeing” the reason for this stuff…..I have had battles when she has had to ask me if I want to go “into the Unit”…..but we have managed to plow our way through…….
With all the other aspects – I have to say…”If I was THAT together, then I wouldn’t be having to see my T in the first place”…….(No offense meant – it is just how it hit me)……..BTW – I have a great T…..I have been as honest as possible with her (in spite of confusion) and have been very open in telling her everything I “see” on the Inside….she can only work with what I “give” her…….
There have been times when my openness and bluntness has triggered panic and I have flat out asked her if she is “fed up” with me because my “progress” has been so slow…panic that maybe she (in actuality) thinks I am “making everything up” and wants me to go away……
But, I guess my pattern of “openness” has helped her to “understand” me and we are still hanging in there together….taking steps even if they are sometimes only a fraction of an inch……
MissyMing
07/20/19
Hello, great work. I really appreciate the information you are providing through your website. I have always found it helpful. Keep up the good work.
Geez, my T probably hates me based on this. I suck. 🙁
Thank you for writing this. I have been with the same therapist for 13 years. Ive gotten better in some ways but worse in others. I really needed to read this. Recently my therapist has become distant after being close to me for all these years. I think he is fatigued to tell you the truth. Maybe i need to give him a break. Anyway this gives me a lot to think about. Thank you!
One thing I have learned is that learning how to soothe myself is one of the best things I have done for myself. At first, I didn’t know how to do it. Thus, I was depending on my therapist, time with my therapist, for soothing. So when I had to leave the office, I had out-of-the-box anxiety and virtually intolerable emotional pain. It was excruciating.
How did I learn self-soothing?
I got a workbook on Dialectical Behavior Training. It actually has written instructions on self-soothing, emotional regulation, mindfulness, and interpersonal relationships.
Once I took responsibility for learning this, my life began to improve a lot.
I have to say one thing though: in the beginning, DBT really sucked. It sucked really bad and it was very hard, because I had to learn to do exactly what I wanted someone else, i.e. my therapist, who I loved, to do. I wanted the therapist I loved and was very attached to, to soothe me. And I had to learn to soothe myself and regulate my own emotions.
And I did learn! Maybe I am still kind of dissociated sometimes. But that is OK.
This was quite possibly the most hopeless and infuriating article I’ve read in my life. Some people are just too sick to make a good client for a therapist. Thanks lady. Way to point out how the sickest, those suffering the most, arent “good” clients. What is WRONG WITH YOU?! I honestly can’t articulate how angry and hopeless this article makes me. How can someone who would write something so callous be allowed anywhere NEAR survivors of horriffic child abuse? This article is damaging, and extremely dangerous. This article has the potential (and likely has) to influence people to give up trying to find help, even to commit suicide, since this article informs them that if they’re too sick no one will want to help them. Shame on you. Make your excuses for this article, make all you want, but this article is irresponsible in the extreme. Just imagine someone actively suicidal reading it, while desperately trying to hold on to some small thread of hope long enough to find help. This one article could easily snip that thread. Get off your high horse, mam, and own the fact that you made a huge mistake here, one that is potentially dangerous.
Wow Jj … I really hear your anger and understand your need to vent. We all need to vent sometimes. And, I can see how you may have read this article and interpreted it as negatively as you seem to have from what you have written here. But I would like to say that I am not at all comfortable with what you have said or how you have said it.
We can all have differing opinions and experiences in this space (this website) and often do … that is a good thing. No one of us has all of the answers or the perfect truth. However, I believe that we need to treat each other with respect and kindness and not use language and characterizations that are discourteous and rude. Unfortunately, that is what I have read here in your comments Jj. I cannot support or ignore comments of this nature being addressed to Kathy or anyone else here in these webpages.
What Kathy has offered in this article and its companion piece is the unvarnished truth of the profession. Do not shoot the messenger. If you do not like what you have read, fine — politely say so and offer your own opinion. But, I would like to invite you to do two things Jj:
1) Read the many, many, many articles and comments that Kathy has posted here on this website. She is a woman of immense integrity (demonstrated by the fact that she posted your comments and did not edit them out of the website), infinite knowledge (her too numerous to count articles are testimony to this fact) and endless compassion for all of us (the very fact that she created this free space for information, fun for our little ones and dialogue for us to ask questions and comment speaks volumes to her unselfish commitment to us).
2) Take another read of what Kathy has said here and in the companion article and give the ideas expressed an honest chance. Maybe even take a good look at yourself and how you may not want to see some of the truth in how you are as a client. What I think that Kathy is talking about here is us taking responsibility for ourselves and our healing. She is not talking about therapists turning their backs on us when we are in genuine need. But, rather that, if we are needy 24/7, do not take our responsibilities seriously, do not respect the therapeutic boundaries, etc. then it is going to be hard, if not impossible, to find a therapist who will take us on. And, quite honestly, why the heck would they?! Our therapists have committed to helping us with our healing (not do it for us) during our scheduled appointments not to be our servants around the clock.
Bottom line Jj, Kathy does not ride a high horse. In the three years that I have been coming here to her website, she has shown that she is ready and willing to slog around in the muck with us doing the hard work. I am sorry that you have not been able to see that because you are missing out on a whole lot of insight, compassion and companionship here.
Heya i’m for the first time here. I found this board and I find It really useful & it helped me out much.
I hope to give something back and help others like you aided me.
When I went to a therapist for about 20 weeks I was late only 2X. I ALWAYs paid my bills same day, never came in drunk, never showed extreme anger, I could go on. I told the therapists I went to that my goal is to have an open mind and pls let me know if you think I need to open mind more. This is almost a joke bc everyone who new me new that I would always listen to anyone’s ideas and had an open mind most of the time.
I wondered why therapy didn’t work if I was willing to change. I think it was easy for the therapists to see me. Some of my challenges were basic, I’m more quiet than loud, more humble than not and respectful of their titles. I think I was too goodie goodie and their was little acutual work getting done. Thoughts please.
We dont be good clients no more.i dont no if we ever did be. That why sharon left. It be us not the t.
Wow.. Kathy. I can remember a time that this particular topic would have mad me and or my insiders very unhappy. It’s a good thing I came here to read it today. It Servs a reminder of how much healing has occurred with me. It also Servs a a compass of where I want to go from here.
I found your article very informative today. It gives me insight into why I have had such a hard time finding a t who will work with me. I realize that I often can portray a not so ideal client.
I have found some things that I want to improve upon. So.. I just wanted to say thanks for writing this…
This article is incredibly condescending and judgmental. There is a tone of barely concealed contempt and disgust and an expectation that clients should be submissive and obedient, as if they are all undisciplined children. And it assumes that therapists are omniscient miracle workers who will fix your life if you will only get off your ass and make some effort. The truth, in my experience, is that therapists rarely have any more insight or wisdom into life’s difficulties than clients.
There is also some real irony in some of the questions above, in that they can be directed toward therapists with just as much relevance. For example:
Are you willing to look at what you are doing to contribute to the problems you are experiencing?
Are you willing to face your part of the problem, rather than focusing exclusively on blaming others?
Are you genuinely open to hearing feedback about your issues?
Therapy is a train wreck waiting to happen unless BOTH therapist and client proceed with self-honesty and transparence and integrity. Collaboration not hierarchy.
This is an interesting point of view on things. I think you’re right that a person should have expectations of themselves and what their role is in therapy. You know that obveously the therapist isn’t gonna just like give them all the answers. And yes they need to pay for their sessions and all that. And other basic things. However I feel like many of these qualitys you have to develop over time and are the very reasons someone would seek therapy rather than being a requirement for geting a therapist.
For example being suicidal, in crisis ETC are often symptoms of those who need therapy the most. Saying that most therapists don’t want to work with crisis laden therapists I think is a blow to those very people desperately searching for help and already feeling like their too needy or damaged or overwhelming for therapists. Saying that one has to have these qualitys even in small doses I feel is a lot to ask for people chronically mentally ill. As I said often these are the very issues they come to therapy for.
I think it’s hard enough for the generally distressed person seeking therapy to find a good fit. It’s harder for someone with a diagnosed mental illness like depression generalized anxiety ETC. It’s hardest for a person with something like severe PTSD, borderline personality disorder, DID or other dissociative disorder like conversion disorder, to find even one therapist that remotely has a clue how to help them. Yes I think this list is informative and maybe as a guide to helping a person look back and see how they’re doing in healing in general/ progress in therapy. However I feel that insisting any of this as I said up front may discourage a person from seeking therapy or from feeling like they are “good enough” to be accepted by the therapists they do try to initiate work with.
I have read many posts that say clients should benefit from therapy. therapy is not for the therapist. I started with mild abuse from my childhood. The first therapist was OK. After that I heard things that were so ridiculous. Those therapists in my area who I had the luck to meet had no sense of what to say and not to say. So I started with what really wasn’t a large problem and ended up feeling really bad bc of listening to therapists who seriously lacked wisom.
In seven years I tried to five therapists. Some of them knew they couldn’t help me but couldn’t admit it. They say that a therapist should help you feel comfortable in the start of therapy. I was always open to therapy. I now say it is for some ppl. Not all people.
The last one I tried was a narcissistic deviant with boundary issues. 25 years of being an LMFT had not taught him anything about boundaries. Live and learn.
Ouch, Lisa. It’s not been an easy road for healing for you. I’m sorry to hear how difficult it’s been. You are absolutely right though. I do believe it can be enormously difficult to find a therapist that is just the right fit.
Thank you for reading here. Hopefully your persistence, determination, research and personal work will give you the peace, healing, and wisdom that you need. I wish you the best in your healing journey.
Warmly,
Kathy
The more they need therapy, the less they satisfy these qualities. I dunno what to tell you, sounds like you’re looking for a job candidate. All of this can be related to mental health, not just people deciding to be a-holes. I prefer people who come to me about their broken leg not hobble into my office.
Hi shasaz,
For what it’s worth, I hope you have reconsidered and returned to therapy. If you haven’t already done so, perhaps you could bring up those thoughts/feelings with your therapist? Tell him/her about your reaction to this blog and open it up for further discussion/expression? You have certainly experienced tremendous tragedy… I hope you’ll give therapy another chance. Sending you supportive and warm karma!
Thanks for the comment, turnstile13,
And yes please…. anyone that reads this blog, and if you have any kind of thoughts or reactions to what’s been written here, please do talk to your own therapist about it.
If you have any questions or concerns, please refer your therapist here to read too — because you know, just like there are a million different recipes for cooking lasagna, there are a million different ways that therapists do therapy. So… yes please, let your therapist know you are reading here and then have as many discussions about dissociation as you need to have. 🙂
Thanks for reading everyone …
Kathy
Wow. This post sounds so disciplinary and authoritarian. Does this mean you won’t allow your clients to react to you with anger?
Wow. I thought therapy is solely FOR THE CLIENT’s benefit. Now I learn clients better mind their p’s and q’s, or risk their counselors’ stern disapprobation.
My mother and father were violently killed 3 months ago in a very tragic way in front of me. I am having really bad issues. I found a really nice therapist willing to work with me 7 days a week if needed and through these meetings I admitted I was suicidal. Something which is really difficult to do as I grew up with a lot of pride and stability. However, I was trying to get help. I found this article and saw the part where it says Most therapists do not want to deal with heavy clients. So two weeks ago I discontinued therapy. I am still suicidal, probably more so now as the therapy sessions were having me discuss terrible things that i dont want to face. I do not want to be a burden on any one. To think that someone is thinking of me as being a heavy burden on them, in fact when I am paying them, is crazy. I do not like this entire Psycho world and figure I will just try to heal on my own. Its sad that people with that thought are in this profession. I applaud the writer for being honest but I am disgusted with the greed that is supposed to be in a helping profession. I am still young, but if this is what the world is going to be like for me for the next 60 years, I dont want to be here.
Phew, I am hugely relieved that I only just read this. Had I read it at the earlier stages of my therapy, it would have told me I am a “bad” client. I grew up believing I was inherantly a “bad”person, this article would have reinforced those beliefs.
StabilityI am so relieved I never read this when I first started therapy, phew. I was very `crisis-laden`. I never expected anyone to give any care to me at all, never mind `rescue` me. I didn`t believe I was worthy of anything positive. Suicidal ideation was a huge problem for me….it still is, though not so often. I don`t know what a `self injurous panic` means(?). I still self injure (not that I remember doing it, since it happens in `lost` time) and do so quite significantly.
Dependability I always have turned up on time, or cancelled if I`ve been unable to attend. I don`t know what you mean by `follow through with what you say you will do`. I am honest, but sometimes I am unable (NOT unwilling) to keep myself together enough to manage working through certain things. I appreciate the fact that my therapist is willing and able to take as long as it takes. I only have [albeit very limited] communication with two child `parts`, but lose lots of time.
3. Motivation and Willingness
4. I always have been motivated and willing to do whatever is possible to `get better`. However, change from very rigid coping mechanisms (mainly avoidance techniques) is a very, very frightening prospect. My life has been pretty chaotic, especially in the earlier stages of therapy. On top of that, my thoughts, feelings and memories are very, very disorganised and fragmented (therefore, as am I). I will try new ways of working in therapy, and am very fortunate that my therapist is happy to explain (sometimes repeatedly) any new therapeutic methods she is considering using with me. My physical health also causes me pretty big problems, which has added yet another layer to the big pile of problems that is my life.
4. Courage
For me, setting foot inside my therapists office was terror-laden. Being seen was hugely difficult. I was terrified, depressed, (etc, etc). I still am, but not to the extent I was. Being `willing` does not always mean you are *able*, does it???
Personal Responsibility
I am and always have taken full responsibility for my problems, and it is only very recently that I have began to realise that I am not responsible for the feelings, thoughts, behaviours, choices or lives of others. I believe therapy can only work when there is honesty at the centre of the therapeutic relationship.
Stability I am so relieved I never read this when I first started therapy, phew. I was very `crisis-laden`. I never expected anyone to give any care to me at all, never mind `rescue` me. I didn’t believe I was worthy of anything positive. Suicidal ideation was a huge problem for me….it still is, though not so often. I don’t know what a `self injurous panic` means(?). I still self injure (not that I remember doing it, since it happens in `lost` time) and do so quite significantly.
Dependability I always have turned up on time, or cancelled if I’ve been unable to attend. I don’t know what you mean by `follow through with what you say you will do`. I am honest, but sometimes I am unable (NOT unwilling) to keep myself together enough to manage working through certain things. I appreciate the fact that my therapist is willing and able to take as long as it takes. I only have [albeit very limited] communication with two child `parts`, but lose lots of time.
5. Motivation and Willingness
6. I always have been motivated and willing to do whatever is possible to `get better`. However, change from very rigid coping mechanisms (mainly avoidance techniques) is a very, very frightening prospect. My life has been pretty chaotic, especially in the earlier stages of therapy. On top of that, my thoughts, feelings and memories are very, very disorganised and fragmented (therefore, as am I). I will try new ways of working in therapy, and am very fortunate that my therapist is happy to explain (sometimes repeatedly) any new therapeutic methods she is considering using with me. My physical health also causes me pretty big problems, which has added yet another layer to the big pile of problems that is my life.
4. Courage
For me, setting foot inside my therapists office was terror-laden. Being seen was hugely difficult. I was terrified, depressed, (etc, etc). I still am, but not to the extent I was. Being `willing` does not always mean you are *able*, does it???
Personal Responsibility
I am and always have taken full responsibility for my problems, and it is only very recently that I have began to realise that I am not responsible for the feelings, thoughts, behaviours, choices or lives of others. I believe therapy can only work when there is honesty at the centre of the therapeutic relationship.
Hi Kathy,
Thanx for a great post ! I copied your questions, all of’em, on my blog and wrote my answers there (in my mothertongue) but I made of course a link to you and your articles. I just hadn’t the force to try to answer the questions in english…
Answering those questions gave me a good overview of what I need to work harder on – that’s great. And I could realize I’ve done good work already and that’s nice to see too 🙂
[M]
When I first read this I was feeling really badly about myself, guilty, worried, ect. because the first 5 on the list are me/us.
* Are you in a constant or repeated state of crisis?
Inside, yes someone is almost always in a constant crisis but it is not always just me. However it looks like me because I am the host. Really, my therapist has taken on 17 clients by just taking on ME. That is a lot and I respect her and am really thankful for her taking us on. I tell her that all of the time hoping that she remembers that when we are in a difficult period of time. I take on 16 people inside my body 24/7 AND somehow raise 4 outside kids who miraculously pretty normal kids. Hopefully therapists of DID clients keep in mind that, really, they are taking on many more when they take on DID client and understand that we might have a few more needs.
* Are you looking for someone to rescue you immediately?
For sure I am looking for it. Asking for it. But not always expecting it. I DO draw the line with myself.
* Are you repeatedly in a suicidal or self-injurious panic?
Repeatedly, no. Often, yes. But if I was not honest with her and telling her about it then it would build up inside to point that it would be so much worse. We have attempted suicide before and that is before we were honest about the feelings. Now when we tell her it feels better inside and we can agree to be safe as long as she understands how we feel and why we feel that way. And sometimes I go stomping off mad because she expects me to be safe when my mind is flying all over the place. But I still keep my word.
* Do you make more than one emergency call every few months?
I have her number and pretty much I do not allow myself to call even if I want to. The inside children beg to call her all of the time so I had to make the rule that we cannot call. Usually a call to her answering machine to listen to her voice is enough to get through. Plus, we are allowed to email her. That helps a lot. And if I feel a crisis/emergency I can type those words in the subject line. She will usually read it and reply if SHE thinks it truly is an emergency. We are not the best judges of the definition of an emergency. Just being away from her is an emergency for some alters.
* Are you frequently in drunken states, or on the verge of over-dosing, or on the verge of self-injury or suicide?
No, thankfully, no. So after posting this I can feel a little better that what I feel inside does not always translate to what I do on the outside. It is just that I feel I my body is see-thru and everyone can see the inside chaos and hear the constant noise. I have to remind myself that I contain it pretty well.
As far as the rest of the list we are hard workers and usually begging for more homework which she will not give us. We want to push harder and faster on the trauma work but she slows it down. I guess because the crisis might be so much worse if we went at our desired speed.
Thanks for the article. Thanks for the reminders!
HaleyC
HaleyC, Wow, I am relieved to hear I am not the only person to rely heavily on my therapist. One of my alters constantly emails my therapist. It is never an emergency, one of my parts loves to study and learn about my illness and tell her what I have found. Or some parts want to tell her about the dreams I have. Have any of you been told you are too dependent on your therapist?
A Good client?! lol …. so if I was a your client, I would have to be a good girl. Where is the post about BAD clients?
http://multiplexanimi.wordpress.com/
I don’t think we should be really seeing this as points that that add up to us being good or bad. Maybe we should be seeing this as things we are doing that are helping us heal and things that we can think about doing more of to help us heal. Its all about getting weller.
We are so used to looking for things that reinforce our own feelings and beliefs that we are bad. Maybe we can start looking for things that will help us heal.
Having added this ~ I struggle and struggle and struggle to see a way forward for myself. I dont know how to face things how to be open how to change. I am just so grateful that I can get support and insight form this blog because I do want to heal and I want to hold on to hope.
Kathy is very wise about these things she writes and its helping me learn new stuff.
Hi kindygirl,
If you met everything under stability then that must mean that you are doing well in some of the other areas. That must mean that in lots of ways you are a good client. THe fact that you are going to copy and paste this to your therapist must mean you get big points in the personal responsibility and courage areas.
I felt bad too when I ran through the check list I get big points in the dependability area and fall down in most of the other areas. I try to present myself as stable because I am scared of being seen as a bad client. I guess we get better at this as we go along and keep working on these different areas.
warm wishes.
I haven’t read the lengthy responses to this, but I must say this post really peaked my anxiety regarding my therapist. I think I meet every single stability as a bad client! Ugh. :o( I suck. I know I have been very suicidal since summer and my therapist has been pretty close to hospitalizing me several times. I must drive her nuts. I am going to copy and paste this to her and then apologize. I hope she doesn’t hate me.
Well, i’m nearly a year late to this party, but found it an interesting article and posted it to a group i am in online. i also sent it to my own therapist who has been frustrated – not with me, she says, but with her self in that in 2 years we’ve not found a way to chisle (sp) through the trauma and do productive therapy. I am afraid i’ll lose her. I do email her a lot (because I write more than i talk) and she does tell me that I am in crisis all the time – even when I do not feel like I am. I don’t know what will help. I’m DID and confused and not always tracking…. but i work really hard to the best of my ability – and it’s still not enough.
When I read this, i felt several things (with 6 minds lurking about most times, 14 at any given moment, it’s no wonder, eh?); “oh great, that’s why i’m not moving forward.” “This is why she’s frustrated with me”. “Oh i see what I need to be doing differently”. “I’ll never accomplish all this.” ” Oooh i can start by doing those things…” “Dangit on me for injuring again this week…” and so forth. Then i read all the comments, and agreed with them all at some point too, so now I am just back to confused and depressed. I want SO MUCH to be a good client. Probably even more than i want to be “healed” because that is a more concrete thing I can grasp. I don’t want to lose my therapist – even though she has said she won’t get rid of me. But I know I am such a burden to her.
I used to be all those things; responsible, stable, consistent…. but the closer we get to the trauma, the worse everything falls apart. I have become needy, clingy, a nervous wreck, wracked with debilitating anxiety. I’m getting worse even while I work to get better. I’ve been in therapy for 6 years (2 with this Psychologist). I was told once by a former therapist that I was her star client. Yet, my abysmal living conditions have not changed in the 3 years since I’ve seen her. That is what has my current therapist so frustrated. She knows I can’t heal living here, and yet i can’t seem to create change. I don’t see how things CAN change, unless i give up and go live in my car. I’m scared, alone, frustrated, depressed…. I can see what needs to happen, but I can’t figure out how to make it happen.
At this point I may not even be making sense. =(
Anyway – thanks for reading, if it is not to far away timewise to be viewed.
Kiyacat
David,
Thansk for your comment! I agree completely. I feel I have all of the main qualities too, the 5 things. But, when you go into the specific questions Kathy asked, some are yes, some are no. And, I guess that gives me a list of stuff to work on.
Kathy,
I actually found this really empowering. I feel like it gives me a list to work from. And, I like to know that I WILL be held responsible. Yeah, sometimes it sucks, like right now when I am temporarily cut off. But, I know that I have the power to make sure its only temporary. Being held responsible gives me hope that I can do better, and iot also gives me a reason to. Why bother doing the hard work to get better if no one cares that you have problems in the first place? Why worry about my time issues if they aren’t causing a problem?
My old therapist once said to me when we were talking about similar things that, if I murdered someone, she would not defend me in court. She would tell the truth, and she would stand by me throughout, but she wouldn’t let me play the “my illness made me do it” card. Might sound weird, but I really appreciated that.
I guess, its all about getting our lives back. Our bad decisions and our good ones are both ours. No one can take them away, no one can make us a puppet again. There is nothing worse to me than the illusion of having a choice.
Hi Kathy,
Interesting post… I had to read it twice to move away from the knee-jerk reaction of “I’m none of those, no wonder I’m not moving forward…” “Yes, I am too much work for any therapist, no wonder they can’t help…”
Now the next day, I can stand back a little more and do further reflection…
In some respects the areas that we overcompensate for (e.g. MUST attend appointments and work) means that a certain level of stability must be maintained – I need to turn up for work, so can’t self-injure or be sectioned under the Mental Health Act. So there is some sort of controlling balance established. Possibly not the healthiest of checks and balances, but it works for now and can be adapted to healthy mechanisms with work and healing.
Thank you for the lists Kathy, it will help us when we’re searching for a new therapist – which of these qualities we can highlight, and which ones we can be open about needing to work on immediately.
Take care and have a good holiday season.
M.
Hi M. –
Thanks for writing. And I’m really pleased to hear that you stopped, and thought about it, and then realized you really do have some of the positive qualities I was writing about. I already know that you do!!! Even in the short time that you have been posting here, I have seen, through your writings, that you have honesty, courage, willingness to learn, determination to heal, dependability, stability, gratitude, appreciation, responsibility, etc etc, etc. I really think you are selling yourself short. I’d honestly be willing to bet you have a lot of strengths.!
I think it’s great that you have found various things that work for you and have significant enough meaning to help provide checks and balances. Having internal rules of behavior and making sure you keep your job are not to be overlooked – I think that is very good, important, and smart thinking. Good for you.
Be proud of yourself, M. Maybe you are doing better than you realize!! 🙂
I hope you are having a safe and happy holiday —
Warmly,
Kathy
Kathy,
Thank you so much for taking the time to write that explanation in response to my comment. I can see you have the whole “non-defensive” thing down really well. : ) And thank you for giving me such positive feedback even though I was criticizing, you’re very gracious.
I’m glad I did comment though, because I really did misunderstand. You weren’t stating the way things should be, you were talking about the way things ARE. And it’s a good warning. For a victim of trauma to start opening up and trusting someone, only to be abandoned because the wrong issue comes up would be painful and injurious. I can certainly understand the need for a client to be aware of those issues and on guard with them.
And I understand why so many of those qualities are important. Healing has a cumulative effect. The healthier and more stable you become, the faster you can heal, so that there’s an acceleration as you move along.
I also really do recognize how difficult working with trauma victims can be, I have marveled at the patience and boundless compassion of my therapists, and their ability to walk alongside me in places that many people are not capable of going to. You’re correct, I’ve found two really excellent therapists who have made a huge difference in my life. I think I reacted so badly to my understanding of this post because a large part of what my present therapist has done for me is to make it clear that I will not be abandoned or asked to leave. That’s been key to my healing and what has allowed me to become so vulnerable, and open with him in order to go deep enough to heal. . Although, even with that commitment, I do understand that there are limits. I wouldn’t expect him to continue as my therapist if I was doing something really extreme, like threatening his life. (Not that I’ve ever come close to that.)
And I’ll be doing more reading. Thank you again for your time and effort
AG
Hi AG,
Thanks for writing back — it is good to hear from you again. And thank you, for your very kind words, and I’m really glad to hear your thoughts on how you are putting all this together. It’s good that you and I are having a chance to communicate more as well — it does help to clarify what’s being said.
Unfortunately, and yes trauma survivors can be abandoned by therapists when certain behaviors surface, or “cross a line”. There are reasonable arguments on both sides of that fence.
My hope, is to encourage and challenge survivors to protect themselves — by checking ahead of time (especially as that pertains to therapeutic relationships), but also to foster more positive and healthy behavior overall, so there are fewer risks in being rejected by others.
As David said so very well, having core qualities of honesty, courage, and interpersonal ethics can be strengths for everyone, including trauma survivors.
Thanks for coming back, AG. 🙂
I hope you are having a happy and safe holiday week,
Kathy
FWIW — I am a DID client, and I meet all of the criteria listed above, so I’m pretty sure that a lot of other trauma clients have those same qualities, maybe without realizing that they have them. Do I have all of those qualities every day of my life? No, but I have had each of them at some point, so I know they’re there. Sometimes they come and go, and sometimes I need help with them, but — at the core of who I am, I have evidence that I am a responsible person. The traits listed above are, I think, just kind of a dissection of interpersonal and personal responsibility. Personally, I don’t think that extreme psychological and emotional wounding is incompatible with responsibility, especially in the case of those of us who have dissociative disorders. One of the reasons we dissociated was to keep an intact core, and the client qualities listed above are, I think, core qualities of honesty, courage, and interpersonal ethics. Having interacted online with lots of trauma victims, I firmly believe that we have those things accessible to us.
Regarding retraumatization in therapy — my experience of therapy was massively and dangerously destabilizing after the first few months, but it wasn’t a problem, because I was willing to learn how to restabilize, and my therapist was of course willing to support me. I mean yeah, it was a problem, but it wasn’t indicative of my ability to continue therapy, because I had learned some degree of stability and functionality prior to entering therapy, so we were both pretty sure I could learn it again in another destabilizing context. I am expecting to be severely destabilized again during the course of therapy, and I am also expecting to re-learn stabilizing skills as that happens. So I’d say it’s not lack of stability that’s the problem … it’s the client’s attitude toward it. I know unstable people who are always in crisis because they thrive on that crisis and can’t let go of it … they don’t want to learn to stabilize themselves. I also know unstable people who have honestly sought help all their lives, and have never found anyone who can help them. But their instability reflects a lack of competent assistance, rather than an attachment to being in crisis.
Just from observing myself, I would say there’s a difference between expectations that reinforce unhealthy perfectionism, and expectations that encourage personal responsibility. I was parented by a textbook classic narcissist, and I am very wary of anyone telling me what to do or how to do it, or telling me how I need to be for someone else’s benefit. But I also know that there are ways I need to be, in interpersonal dynamics, for *my* benefit.
If we take this out of a therapeutic context, it’s maybe less threatening to think about. If I were to show up at my doctor’s office, knowing that I needed to have blood drawn, but my fear of needles was such that the doctor and a team of nurses had to chase me around the hospital, tackle me, pin me down, sedate me, draw blood without my cooperation, and then I told them I didn’t really believe I needed the test anyway and I didn’t know why I’d bothered to show up … that would be incredibly non-productive. I wouldn’t be acting from a place of personal responsibility or interpersonal responsibility. And it would be destructive to me as a patient to disregard those things. But if I show up with a fear of needles and tell the doctor I have a fear of needles and need some extra help and care to get through the experience, that’s different. In the second case, the doctor’s job is sure a heck of a lot easier … but I wouldn’t really be modifying my behavior for the doctor’s benefit.
I think the same holds true for being a productive client in therapy. Coming from a place of personal and interpersonal responsibility enables the therapist to do his or her job … but we don’t do it for the benefit of the therapist. We strive toward those “good” client qualities because they’re good for *us*. And they’re good not just in the therapeutic framework, but in our lives generally speaking.
wow, David.
Yes, you got it! Bingo!!
I very much agree with you, and you said it better than I did! Thank you for that!!
I appreciate that you wrote such a long, thought-out comment. You’ve obviously spent a great deal of time in your life addressing these issues already. And I do agree with you — more trauma survivors have these qualities, even if they don’t realize they do.
Excellent work, David and all. 🙂
Well done.
Kathy
Hi Kathy,
I appreciate that you have a lot of experience especially with trauma issues, but may I respectfully say that I got very angry while reading this blog entry. I read through your list and all I could think was if someone was capable of ALL of this would they really need to be going to therapy? Don’t get me wrong, I think the patient is responsible for their therapy. I’ve been in therapy for a while dealing with childhood physical and sexual abuse. It took a lot of time and a dedicated therapist to clear the trauma and working with another gifted therapist to deal with my attachment issues. I know that therapy only succeeds if you’re willing to walk into the room and be as honest as you’re capable of being and that the therapist doesn’t “fix” you. They give you a safe place to heal. And that you need to take responsibility for your own life. But I know one of my major issues with my parents was the fact that their needs always came first and that the only way I was accepted and could get some of my needs fulfilled, was if I first met their needs, that is if I performed well enough, I might be able to maintain some kind of relationship. So when I read “Most therapists are not as interested in taking on heavily crisis-laden clients. The more stable you are, the more therapeutic options you will find.” my reaction was then go find another job. This was like hearing “if you behave correctly, maybe a therapist will deign to grant you treatment.” In other words, first get cured, then we’ll treat you. And your relationship with me will depend on how well you behave. This seems like just the opposite of what I need from a therapist to help me heal. Forgive me if I am taking this out of context, I haven’t read a lot of your other entries and I do not wish to be disrespectful, especially as I am in your “home.” But this just sounded very arrogant and condescending to me. Thank you for providing for comments to be posted.
Hi Attachmentgirl,
Thanks for writing. I’m glad you had the courage to speak your mind – that’s great. I certainly didn’t intend for this blog to be offensive to anyone, and if (when?!!) that happens, I’m very happy to have people write their thoughts. So thank you for that — you just demonstrated some of the very qualities that I was writing about!!! (strength… courage… honesty… responsibility… ) Well done! 🙂
It very much sounds as if you do have a good handle on many of the skills I was writing about. You can recognize your feelings – that’s good. You are honest, and communicating your thoughts to me – which I think is great – plus it gives me a chance to clarify a little more. Thanks for that.
And frankly, I think we are saying something very much along the same lines. And, let me explain how…
I am very much aware that most of the therapists in the mental health field are not fond of dealing with crisis issues. And even fewer, will work with someone that self-injures or expresses suicidal feelings. And for that reason, it is very important to assess how your therapist (or potential new therapist) will handle those kinds of situations. I have known of therapists who “fire” clients asap because of self-injury issues. For that matter, for liability reasons, many mental health professionals will absolutely refuse to even go near complicated issues, and complex people, and they feel proud of themselves for setting such a “healthy boundary.” That’s great for them. BUT, that doesn’t help the folks who really do struggle with some of these issues. So, for example, if you have issues with self-injury, it will be crucial that you find a therapist who can deal with those issues without shutting the door in your face.
It looks like to me, attachmentgirl, that you have been very fortunate in finding two excellent therapists to work with. That’s great — it sounds like you have been making lots of progress with them. Excellent!! From what I’ve heard from a variety of survivors, it is hard for many people to find therapists that will work with them as effectively.
My point was not to say, you can’t have those issues. (Most – probably all – of my clients have had self injury/ suicidal issues surface for them.) My point was more to recognize, that when you do struggle with those things, there will be a big handful of therapists who won’t be able (or willing) to work with you — your options will be less. And, if that is their approach, then yes, you are better off to move on down the road and find someone else who can address those issues with you more effectively.
Yes, there are therapists out there that very much understand and are trained to work with these issues — keep looking until you find one!
And, in the meantime, everyone, do your best to work hard at reducing the amount of crisis reactions you have. (more on problem-solving skills, and increasing stability, etc, at a later time.) Developing these skills is critical for your own healing, regardless of any therapist’s opinion!
Thanks for writing, attachmentgirl. I hope you do read more of this blog — it will give you a better sense of who I am, and how I approach things over all.
Have a good day —
Kathy
Wow, this is depressing. If I could meet all of those criteria I don’t think I’d be mentally ill and seeking help from a professional. I would love to be the person that you are describing, but how to get there if I’m not already there? What a Catch-22.
Oh Harriet, please don’t get depressed!!
Actually, a lot of people can be mentally ill, and be very dissociative, and had a lot of trauma in their life, and still have all of these positive qualities within themselves as a person. Many of my clients really do have these traits! They are delightful people, and I admire how hard they work at their healing process. I’m not saying they are without issue – the point is more about how hard they work at this stuff, and how much they put effort into developing more and more of these positive qualities in their life.
I understand that stability can go up and down a lot (and I’ll be writing more about that), but trauma survivors can absolutely be dependable, they can certainly demonstrate a lot of motivation and willingness to work on their issues, they can and usually are very courageous, and hopefully, they have a strong sense of personal responsibility, because that is pretty fundamental in the healing process.
Try reading the post again, with the idea that these things really could be your strength. And the areas that aren’t your strength now, could become your strength in time, especially if you work on those areas. The good news is, the more you get a handle on these kinds of qualities, the easier and more progressed your healing process will be overall.
It is possible – I promise you!!!
Take heart — and be gentle with yourself. I bet you can do more of these things than you are giving yourself credit.
Thanks for posting —
Kathy
Hi Kathy
Interesting blog. I have a question about stability. I accept that I need to be reliable, motivated, responsible and willing to delve into things I generally don’t want to delve into. As for stability – I can see how a stable client is easier to work with for a therapist. However, what if the beginning stages of therapy have resurfaced old issues or retraumatised the client to the extent that they are now “unstable”? How would this fit with your schema? And what should the therapist’s (and client’s) roles be in re-stabilising?
Thanks
Kerro
Hi Kerro,
Thanks for writing. I”m glad you are finding this blog to be interesting — that’s great news. 🙂
And yes, absolutely, there are periods of time that are less stable than others. There’s no doubt about that. You have asked a good question — what to do to help the re-stabilizing. I’m thinking about that now, and oh, yes, that’s a very good question. That’s going to take a long post for a response, so I’ll think about it more, write it up, and add that to the blog. It’s the holidays tho’, so give me a little bit of time, but yes, I’ll write a post about that.
Thanks for the question!!
I hope you are having a good day —
Kathy