Therapist Do's and Don'ts

[Dan Metevier]

I dish out a lot of compliments to others, hope that doesn't make people so uncomfortable.

I think you're doing a good thing. If others are uncomfortable, maybe it's a signal of something they can work on (or something like that). In any case, it's nice that you are considerate of others (in my opinion).

 

[Ylva]

I hate being interrupted. If I stutter it is usually because their staring disturbs me. I do realise that they are trying to look attentive and like they are listening, but really.

I've never experienced it, but I suppose one who actually listened instead of staring and interrupting would be my personal ideal.

 

[Dan Metevier]

I hate being interrupted. If I stutter it is usually because their staring disturbs me. I do realise that they are trying to look attentive and like they are listening, but really.

I've never experienced it, but I suppose one who actually listened instead of staring and interrupting would be my personal ideal.

Seems like a really good personal ideal to have. I wish you much luck in finding such a person. As I read your posting, I was both rolling my eyes and shaking my head at the same time. I'm very sorry that you've never had the experience of a therapist actually listening to you. It seems absurd to me that people in my professional are unable to listen with their mouth shut. Big sigh.

 

[gonz]

This seems very fair to me. Many therapists believe (for whatever reason) that the person they work with should not know anything about them. I find that to be a ridiculous assumption. How can you trust someone you don't know. On the other hand, if a therapist goes on and on about themselves, I sometime feel like I (as the client) should charge them for the session.

Yeah, finding the balance between these extremes is essential. Though, I imagine, probably very difficult.

I have to be open and honest with this person about my most intensely personal issues. And I'm just not going to be able to do that with someone I know nothing about, or if the relationship is entirely "professional."

At the same time, if I start to see this person as a friend, if it feels too personal, I'll worry too much about their mental state. Feel like I have to pretend to be okay, shield them from the worst of the crap going on in mind, just like I do with everyone else.

The other thing is; while I recognize that (of the two of us in the room) the therapist is the expert on mental illness, they sometimes do not recognize that I am the expert on my life and experiences.

Hard to explain, will use myself as an example.

I have generalized anxiety disorder and panic disorder with agoraphobia. If I say to my therapist that I don't want to leave the house because I am afraid that X will happen, it is entirely possible that it is my own negative thoughts and biases causing me to believe that. At the same time, sometimes the reason I am afraid of X is because X happens to me with amazing regularity. And, if that's the case, no amount of CBT or medication or whatever else is going to help if I can't figure out why X happens and how to prevent it.

 

[Lukas]

If it's not too self-serving, I would be interested in your experiences where you worked with a therapist that you either really liked or really disliked. No names of therapists please.

What is the best thing a therapist can do?

What is the worst thing a therapist can do?

Thanks!

Best thing a therapist ever did for me was to think outside the box.... and to really examine the issues and arrive at the real problem or situation. Took me over 30 years and a multitude of diagnoses for a psychologist to finally look at the issues and consider HFA in my case... turns out she was quite correct. I would like to give her a medal for thinking outside the box and not only off a flow chart. She is as passionate about psychology as I am at art and aesthetics. I still see her on occasion.

Worst thing a therapist ever did for me was to fall asleep. He was a 'reality' therapist and I live in reality. Reality is all I have ever had. He didn't bother to notice that. I gave up on him after my first visit.

Another worst case therapist was so interested in one particular diagnosis that she seemingly diagnosed everyone with it. She was so interested in the gay community and the psychology behind homosexuality that she told me that my problem was that I was actually gay and didn't want to admit it. Contrare... Actually I would have embraced being gay like a champion.. I was totally desperate to be a part of a group of people and to fit in somewhere.. omg.... While I have always been very comfortable with my gender and the female side of masculinity... I am not gay. But she refused to look beyond that. She lasted about a 3 months as my therapist.

Hope this helps.. and good luck!!!

 

[DogwoodTree]

A further thought. AS aside, I find many people (myself included) have a difficult time with compliments. The way I see it, as we grow up, our brains may not get "programmed" to deal with compliments, especially if we're not given many or there are strings attached or something like that. Then, later on, if we are given a compliment, our brain doesn't know what to do with it or does something weird with it. Fortunately, our brain can change in this regard and we can get used to receiving compliments and doing something more "appropriate" with them. Anyway, that's my thought.

Agreed...when I'm offended by something, instead of blaming the other person, I'm learning to see it as a red flag for the things in me that I still need to work on. Compliments are one area of particular challenge.

My family often uses compliments to manipulate. If you do something well, you're just as likely to be criticized as complimented because it's too much of a threat to everyone else for someone to excel beyond everyone else. If you do something poorly, people tend to jump in with compliments because "see? you need my input here in order for you to feel good about yourself."

So my defenses reject compliments, especially if they're in any way exaggerated or non-specific or unearned. I just can't receive them. Ever read the book The Five Love Languages? If not, don't. Even as a Christian, I despise that book. With completely healthy people, I think it might be helpful. But I live in a world full of codependence, enmeshment, manipulation, and suspicion. Even when I'm around people who are healthy, I don't know how to relate to them, despite all of my efforts to learn. This post said it well:

After years of trying to explain my experience of a lifetime of isolation to someone who's thinking of impaired social communication/interaction in a clinical setting, or of a lonely period they remember in their own life, I now have to take a translator (my sister) with me as backup.

A lifetime of loneliness and love starvation and abuse causes some pretty extensive internal damage. Letting love in is often as difficult and painful for me as I imagine eating is for someone with Crohn's disease.

 

[Dan Metevier]

I'll worry too much about their mental state. Feel like I have to pretend to be okay, shield them from the worst of the crap going on in mind, just like I do with everyone else.

It seems very kind of you to worry about your therapist's mental state. It speaks to who you are as a person, in my view. In theory, if the therapist is a good match for you (and this may take a while to find), they should be able to handle whatever you talk about. It's their responsibility and why they get paid the big bucks. A good therapist will have a therapist of their own, or at least a colleague or two with whom they can discuss issues they might have with their own reaction to what you talk about. The psychobabble term for this is "countertransference." If they are not doing this, then (in my mind) they are not being responsible to their craft and, more importantly, to you.

 

[Dan Metevier]

I recognize that (of the two of us in the room) the therapist is the expert on mental illness, they sometimes do not recognize that I am the expert on my life and experiences.

I believe this is a very profound statement, one that all therapists should know and honor. Only you know where it hurts and, in the end, only you may know how to solve a problem. A neurotypical therapist may serve as a guide to the neurotypical world (a scary place sometimes, even for me), but in the end you make the decisions about what steps to take and how far you want to go on your "journey." IMHO.

 

[Dan Metevier]

A lifetime of loneliness and love starvation and abuse causes some pretty extensive internal damage.

I couldn't agree more. I work every day with people who have this internal damage. It's said that child abuse is the number one public health issue in the US. Yet, there is no "war on child abuse" in the works. There's mostly just denial and sweeping under the rug. I don't know if this type of thing might appeal to you, but here is a link to the results of a study done of how "adverse childhood experiences" (ACE) affect people later in life, both emotionally and physically: Health Presentations - Home

 

[Dan Metevier]

Best thing a therapist ever did for me was to think outside the box

Outside the box is the only place where any valuable work gets done, in my view. I find the view from inside the box, when I venture there on occasion in order to talk to my colleagues, is a scary, weird place, often full of actually harmful ideas and theories. Anyway, that's my bias. I had to learn about the box to get my degree and license, but then threw away the box for the most part in my actual practice. Glad you found someone who helped you.

 

[Dan Metevier]

Another worst case therapist was so interested in one particular diagnosis that she seemingly diagnosed everyone with it.

This is a trap that many therapists fall into and one to be wary of, either as a client or a therapist. Bipolar disorder is an example and ADHD is another. Borderline Personality Disorder is yet another. They're all the rage in certain circles. Sometimes I think it's useful to set aside the diagnostic process for a while and just declare the client to be a "Lukas" or whatever.

 

[Nadador]

For me, having been compliment starved for most of 30 years, I may get bashful or blush, or even feel a little embarrassed, but I love them, and the way they make me feel. Maybe this is due to a distinct lack of positive reinforcement in my life, or something darker, but I dish out a lot of compliments to others, hope that doesn't make people so uncomfortable.

I tend to have a hard time taking compliments as well. My parents were always supportive and gave me frequent praise, but my own personal awkwardness and self-doubts still make accepting compliments from others uncomfortable. I prefer to be humble and wouldn't want to like a compliment too much [some of that is cultural], but it would be nice not to blush or squirm every time somebody says something nice to me. At least I know how to respond aloud. A simple "Thank you," or "That's very nice of you to say" is an easy script to follow.

Like you, I tend to give a lot of compliments, too. I do worry a bit about making people uncomfortable, or that people will think I'm being overly solicitous. But you know what? Screw it! If I think well of someone, or of something they do or say, I want them to know it. We all get more than our share of negative feedback from the world. Why not balance it with as much praise and good will as we find opportunity for?

 

[Ylva]

It's mostly the obviously fake, high-pitched tone of voice, in my opinion. It doesn't say anything factual, it just tries to trick me into believing things that aren't even true.

 

[Nadador]

This is a trap that many therapists fall into and one to be wary of, either as a client or a therapist. Bipolar disorder is an example and ADHD is another. Borderline Personality Disorder is yet another. They're all the rage in certain circles. Sometimes I think it's useful to set aside the diagnostic process for a while and just declare the client to be a "Lukas" or whatever.

I've run into the problem of a rush to diagnosis because of family history. While I understand that some disorders/clusters of disorders can be passed genetically, and that for coding purposes a preliminary dx is necessary, I resent any doctor who makes assumptions before taking the time to learn more about me. There is so much symptomatic overlap between so many diagnoses. I may have missed getting something that runs in my family, but have another condition with similar symptoms. Beyond that, every individual expresses their own load of problems slightly differently. Co-morbidity is common. I may be the first in my family to have a certain condition, due to the combination of my particular parents' genes. Being cognisant of these, how am I to have faith in a doctor or therapist who seems so quick to jump to conclusions?

 

[Dan Metevier]

how am I to have faith in a doctor or therapist who seems so quick to jump to conclusions?

A point well taken. For better or for worse, doctors (physicians) are trained in an environment where quick (almost knee jerk) diagnoses are the norm. This is essential in an emergency room. It also has become a necessary evil outside the ER where physicians (in the US) typically only get about 15 minutes with each patient. It does not make for a very good diagnostic process, in my mind. Therapists, on the other hand, have much more time and, in my mind, should take that time to get it right. No excuses there.

 

[@iam_cloud]

If it's not too self-serving, I would be interested in your experiences where you worked with a therapist that you either really liked or really disliked. No names of therapists please.

What is the best thing a therapist can do?

What is the worst thing a therapist can do?

Thanks!

I think that the best thing a therapist can do is to offer support and openly acknowledge that ASDs aren't something to be cured. So often NT people try to fix those of us with ASDs. I grew up not knowing about my Asperger's and everyone either tried to to tell me how to "act normal" or they pitied me. True, most of the time neither of these reactions are done consciously. But anyone who can make an effort to treat us as people who happen to have ASDs (rather than ASDs who happen to be people) will be accepted much more readily.

I've seen several therapists, not all of them helpful. The best therapists helped me find a way to help myself cope with my differences. The worst therapists tried to make me like my NT peers. My favorite and most helpful therapist was never afraid to tell me when he didn't have an answer to a question. The worst thing anyone can do for an aspie is lie. If you don't want to tell us something, "I'm not comfortable answering that" or "I don't know" are both perfectly good responses.

 

[@iam_cloud]

A point well taken. For better or for worse, doctors (physicians) are trained in an environment where quick (almost knee jerk) diagnoses are the norm. This is essential in an emergency room. It also has become a necessary evil outside the ER where physicians (in the US) typically only get about 15 minutes with each patient. It does not make for a very good diagnostic process, in my mind. Therapists, on the other hand, have much more time and, in my mind, should take that time to get it right. No excuses there.

I actually had a therapist (the one I mentioned before) who gave me his email so that we could talk more. He told me that I any questions he couldn't answer in person, he would try to via email.

 

[Dan Metevier]

I think that the best thing a therapist can do is to offer support and openly acknowledge that ASDs aren't something to be cured. So often NT people try to fix those of us with ASDs. I grew up not knowing about my Asperger's and everyone either tried to to tell me how to "act normal" or they pitied me. True, most of the time neither of these reactions are done consciously. But anyone who can make an effort to treat us as people who happen to have ASDs (rather than ASDs who happen to be people) will be accepted much more readily.

I've seen several therapists, not all of them helpful. The best therapists helped me find a way to help myself cope with my differences. The worst therapists tried to make me like my NT peers. My favorite and most helpful therapist was never afraid to tell me when he didn't have an answer to a question. The worst thing anyone can do for an aspie is lie. If you don't want to tell us something, "I'm not comfortable answering that" or "I don't know" are both perfectly good responses.

Thank you for this. I guess I have kind of lost track of what "normal" really means, so it doesn't come into play when I work with people, unless it's important to them. I try my best to just take people as they are and, if they want this, help them become comfortable with who they are. Or, try to help them change from whatever they don't want to be, if that makes sense. I really take your point about "I don't know." The therapist's ego has no place in the therapy process, in my mind. They need to "get over it" and just be with the other person. Thanks again.

 

[Dan Metevier]

I actually had a therapist (the one I mentioned before) who gave me his email so that we could talk more. He told me that I any questions he couldn't answer in person, he would try to via email.

I've done this too, in certain cases. Although I have to be careful that someone doesn't flood me with emails, since there is only so much of me to go around, so to speak. But, some people express themselves well/better in writing, so it works well. In fact, in some cases, I've wondered if much or most of the therapy could/should be done via email, especially if the person is doing relatively well and only needs "spot-treatment."

 

[Lukas]

Outside the box is the only place where any valuable work gets done, in my view. I find the view from inside the box, when I venture there on occasion in order to talk to my colleagues, is a scary, weird place, often full of actually harmful ideas and theories. Anyway, that's my bias. I had to learn about the box to get my degree and license, but then threw away the box for the most part in my actual practice. Glad you found someone who helped you.

I had issues getting inside the box throughout my life in all aspects... Somehow I could not tolerate that enough to make it through employments, assignments, etc.

Thank you!! Patience and persistence paid off. I have now a great team of people working with me... I am also very thankful that ASD/HFA is being recognized and diagnosed.. it is making life much more acceptable for me knowing where I stand in relation to the rest of the population now...