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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 40. This is the beginning of the thread.
Posted by alexandra_k on August 31, 2013, at 21:52:00
Describe your ideal therapist.
What characteristics / attributes would your ideal therapist have?
And / or what would make them ideal for you?Aka: What is it that you think you need?
I'd be really interested to hear what people are looking for...
Posted by Poet on September 1, 2013, at 15:38:05
In reply to Ideal Therapist, posted by alexandra_k on August 31, 2013, at 21:52:00
I consider myself very fortunate that I found a therapist that has stuck with me for 11 years. What I like about her is that she has a sense of humor, understands sarcasm, stopped pushing me when she realized it just got me angry,and I believe the compassion she shows is real.
Poet
Posted by Twinleaf on September 1, 2013, at 18:54:10
In reply to Re: Ideal Therapist » alexandra_k, posted by Poet on September 1, 2013, at 15:38:05
The main thing that counts with therapists is their ability to help you feel (and be) better. I think a sense of humor is wonderful, especially in stressful moments, but what really helps, I think, is that you are with someone who "gets" you, and knows how to let you know that. I personally don't care for a huge amount of empathy; I like it to be real between us. There are three things which I have found to be wonderful:
1. Being kept steadily in his/her mind, as a good-enough mother does with her infant.
2. Having unexpected "moments of meeting", when the connection you have deepens.
3. Rupture and Repair - identifying areas where we have misunderstood one another, even about something trivial, and working together to regain a unified sense of understanding.
I have gained an enormous amount from the therapist I presently have, and I think these are some of the important things which have been happening. Honestly, though, the most important factor may be an undefinable, but all-important good fit.
Posted by baseball55 on September 1, 2013, at 19:50:22
In reply to Re: Ideal Therapist » Poet, posted by Twinleaf on September 1, 2013, at 18:54:10
I had a traumatic childhood and adolescence which I completely buried At 49, my life was falling apart, I was drinking a lot and was addicted to opiates. I went to a detox and didn't know how to benefit from it, but I knew I needed help. So I started calling older male p-docs. For some reason, I knew this was what I wanted. I went to 3 appointments and realized I wanted to see the first person I had met.
I saw him exclusively for 6 years. He insisted I find a DBT therapist and I saw them both weekly for a year or so. Now I see my p-doc once a month for half-an-hour, just to keep in touch. I am planning to cut back in the fall to every two months.
he was/is great. When I started to meet with him, I began to feel this overwhelming need for unconditional love which i had not gotten as a child. I had a traumatic childhood and adolescence that I had buried completely. I think he understood at the outset that I was not going to be an easy patient.
My transference issues were out of control. In retrospect, what I love and respect about him is that he (a) maintained good boundaries and talked honestly about the need for boundaries. I would have left my husband for him in a heartbeat, but he wasn't even remotely available. (b) He was always compassionate and kind, but he talked always about what we were working on and reminding my that this was work, not just a fantasy friendship for hire. I needed to get honest and work hard on my problems. (c) he was always very straightfoward and would brook no dishonesty. I learned how to feel and express feelings honestly. When I could barely speak, he encouraged and pressed me, not harshly but firmly, saying things like -- we've talked about painful things before. If you can't, you can't. But try.
I could go on and on. I have never loved or respected anyone in my whole life as much as I loved and respected him.
Posted by Dinah on September 1, 2013, at 22:51:21
In reply to Ideal Therapist, posted by alexandra_k on August 31, 2013, at 21:52:00
I know more about "good enough" therapists. And that really is good enough. My therapist isn't the ideal, I know. But the other day I was tearing up over losing a long time veterinarian. And my therapist smiled ever so understandingly at me and said softly "Veterinarians aren't like washing machines, are they?" and it was just the right thing to say - to me. Because to me it was really a very big deal, and a very real loss.
I think the hallmark of a good enough therapist is to be flexible, and open to self examination. They should be willing to stretch out of their comfort zone.
I suppose an ideal therapist would consistently be present in session. They would have firm boundaries without appearing to be uncaring. They would be skilled at active listening, judicious in interpretations, carefully nuanced in humor, while managing to appear entirely natural and transparent. They combine wisdom, compassion, and genuine-ness.
I see these paragons in the occasional movie or TV series. I don't think I'd much care for them in person. So maybe I think an ideal therapist would have to have the occasional breakthrough of humanity and flaws.
Posted by Dinah on September 1, 2013, at 22:53:51
In reply to Re: Ideal Therapist, posted by Dinah on September 1, 2013, at 22:51:21
Oh, and ideal therapists (or good enough ones) should have an excellent self awareness and/or a really good supervisor or therapist. They have to be aware of what is their stuff as opposed to what is their client's stuff.
Posted by Partlycloudy on September 2, 2013, at 10:14:18
In reply to Ideal Therapist, posted by alexandra_k on August 31, 2013, at 21:52:00
I think I am too messed right now to fully answer the question except in the capacity at hand, but here goes:
Ideal Therapist will be in contact during a crisis, through whatever method you have worked out beforehand (have a plan worked out early in the process). I would hope them to take whatever side is appropriate in any given situation , but be objective and remark as such. Therapist would have tissue boxes placed all around the room. The Therapist would be candid but not fully disclose any information that isn't germane to the process.
The Ideal Therapist would be in regular contact with my psychiatrist, whom I see at much less frequent intervals. She would feel free to suggest a biological solution rather than a therapeutic one.
The Ideal Therapist's ultimate goal would be the same as mine: to come to eventual conclusion and successful termination.
Posted by Phillipa on September 2, 2013, at 11:36:01
In reply to Re: Ideal Therapist » alexandra_k, posted by Partlycloudy on September 2, 2013, at 10:14:18
Ideal therapist is the pdoc himself back to 50minute visits so not misunderstanding in third party relaying information. And it's just you and him/her. Meds can be adjusted as needed when the doc sees the emotional status. Had two wonderful doc like this one in CT and one in VA Beach. Phillipa
Posted by Partlycloudy on September 2, 2013, at 11:58:43
In reply to Re: Ideal Therapist » Partlycloudy, posted by Phillipa on September 2, 2013, at 11:36:01
It's different everywhere you are. My T is a diagnostician but is not licensed to dispense meds. My pdoc has extended sessions with with me (30 to 60 minutes) but her advice is coordinated with my T it's like double barreled care. I would not want my Pdoc to be my sole source of support because the meds take a long time to talk through, and she is unreliable as far as getting a hold of.
PC
Posted by Phillipa on September 3, 2013, at 22:02:23
In reply to Re: Ideal Therapist » Phillipa, posted by Partlycloudy on September 2, 2013, at 11:58:43
Mine was my pdoc. Had two of them. And they went to school together med school. One in CT and one in VA Beach. Both were wonderful. Phillipa
Posted by alexandra_k on September 5, 2013, at 1:36:59
In reply to Re: Ideal Therapist » alexandra_k, posted by Poet on September 1, 2013, at 15:38:05
> I consider myself very fortunate that I found a therapist that has stuck with me for 11 years. What I like about her is that she has a sense of humor, understands sarcasm, stopped pushing me when she realized it just got me angry,and I believe the compassion she shows is real.
That is wonderful that she has stuck with you for 11 years. I guess... You also have stuck with her. Haven't outgrown her, or gone off to greener pastures.
How do you mean 'understands sarcasm'? I can be sarcastic sometimes... I'm wondering what it is about the way she responds to that that you like.
That is good that she knows when to stop pushing / when to back off. That is important to me, too. Genuineness... That is important too, yeah. Genuine empathy.
I think my t in North Carolina thought I was a selfish little bitch, sometimes. Or that I was full of complaining about a bunch of nothing. It didn't harm me for some reason... Maybe because she was young. But then, I never really got attached to her or made myself particularly vulnerable to her. Perhaps because of that. (Though if it wasn't that reason it would have been another it is still true that that was in fact the reason).
Posted by alexandra_k on September 5, 2013, at 1:42:42
In reply to Re: Ideal Therapist » Poet, posted by Twinleaf on September 1, 2013, at 18:54:10
Yes, humor can be good. I can get carried away sometimes with the focused intensity and deep seriousness... Sometimes it is good for me to have a bit of a laugh at that. Snap out of it a bit. See that life is good. Or something...
I wonder what you mean by 'I personally don't care for a huge amount of empathy; I like it to be real between us.' Do you think of empathy as agreement and the idea is then that you like to be disagreed with / challenged a little sometimes? I'm not sure I understand what you mean.
I'm not sure what you mean by 'moments of meeting', either. Can you describe that a bit more?
Posted by alexandra_k on September 5, 2013, at 1:50:59
In reply to Re: Ideal Therapist, posted by baseball55 on September 1, 2013, at 19:50:22
I have a special kind of transference that I get with older guys, too. In my case I think is because I attached to my father as a relatively safe figure. Well... Distant rather than invasive. And it is nicer to long to be closer than to feel invaded, I think. If one really had to choose.
> I think he understood at the outset that I was not going to be an easy patient.
That makes me think that he was careful with you. And perhaps understanding / forgiving of your transference issues.
> I would have left my husband for him in a heartbeat, but he wasn't even remotely available.It does seem to be a human phenomenon that we most want that which we (only just) cannot have.
> He was always compassionate and kind, but he talked always about what we were working on and reminding my that this was work, not just a fantasy friendship for hire.
That makes me think that he had your interests in mind. I think that is important. That is also rare. Really very hard to find.
> I could go on and on. I have never loved or respected anyone in my whole life as much as I loved and respected him.
That is wonderful. I'm so happy that you have had a good experience with that. 6 years is a long time... Opiates is a hard one. Sounds like you have done really well, indeed.
Posted by alexandra_k on September 5, 2013, at 2:01:38
In reply to Re: Ideal Therapist, posted by Dinah on September 1, 2013, at 22:51:21
I've come to think that "good enough" isn't so much about coming to terms with the fact that nobody is perfect... As it is about that is what is "perfect" or "required" in order for the client / patient to make psychological growth / to get better.
It is like there is this gap or this hole or this failure... This void maybe, even. And something has to fill it. Something... Negative. Something... Positive. Or at least neutral. And the client can't do it. Because they haven't been modeled that enough / taught how. So the therapist helps teach them... But then there have to be gaps in order for the client to see that now they CAN do it. If there weren't gaps then the client wouldn't be able to extend their new ability. Stretch their new wings. Or whatever.
I think Kohut saw it that way, anyway... Pretty sure I read that somewhere.... Because some therapists misinterpreted it as they were supposed to TRY and create these empathetic failures and he said NO - they would happen all by themselves by the very best therapists...
> "Veterinarians aren't like washing machines, are they?" and it was just the right thing to say - to me. Because to me it was really a very big deal, and a very real loss.
That is wonderful. And I see how it was the perfect thing to say to you. Shows that he really knows you and pays attention to what you say to him. And empathizes. And some of that is about being stretched...
I keep thinking of you stretching me with your talk about coral colonies... And the whole washing machine thing, too... Sometimes I feel like we are two sides of a coin... So different... Yet so much the same...
Perhaps.
> I see these paragons in the occasional movie or TV series. I don't think I'd much care for them in person. So maybe I think an ideal therapist would have to have the occasional breakthrough of humanity and flaws.
Ahaha that is funny. I wonder what is wrong with the 'perfect' ones. They seem... Artificial? Contrived? Cold? Not in tune with their own emotional responses?
>Oh, and ideal therapists (or good enough ones) should have an excellent self awareness and/or a really good supervisor or therapist. They have to be aware of what is their stuff as opposed to what is their client's stuff.
I wonder sometimes if the whole therapy thing... Might really be about working through the client-therapist encounter. That the issues are client-therapist issues. And some of them the client experiences with other individuals, too. And some of them the therapist experiences with other individuals, too. I wonder if it is more that the process of working through... Gets easier with practice. Or something like that...
Posted by alexandra_k on September 5, 2013, at 2:03:10
In reply to Re: Ideal Therapist » alexandra_k, posted by Partlycloudy on September 2, 2013, at 10:14:18
Taking sides?
Can you say more about that?
Posted by alexandra_k on September 5, 2013, at 2:09:06
In reply to Re: Ideal Therapist » Partlycloudy, posted by Phillipa on September 2, 2013, at 11:36:01
Hmm... I've never had much sympathy for medication (in my own particular case). Perhaps because of my history of drug abuse. My thought was always 'if you are going to have a drink then have a DRINK!' or whatever... And I basically took that approach with psych meds, too. So there were periods early on where I was happy enough to be sedated practically into a coma or... Whatever... And then when I quit my drug abuse (mostly) I sort of quit psych meds along with it...
But there is something that I read yesterday (and I need to spend more time doing a more careful reading) that talked about findings for different relative transmitter levels and different global processing that seemed to go along with those... And there might possibly be something useful there for me...
I see how it might be useful to have a p-doc who was appropriately sensitive to what was going on (by spending some actual time really talking to you about how you are finding things) doing medication adjustments.
I do wonder about psych meds... I am going to need to learn more...
Posted by alexandra_k on September 5, 2013, at 2:11:16
In reply to Re: Ideal Therapist » Phillipa, posted by alexandra_k on September 5, 2013, at 2:09:06
> I do wonder about psych meds... I am going to need to learn more...sigh.
and of course a huge part of it was the whole conspiracy theory drug company thing... which is of course partly true... but also often conceals a lack of science background. part of the whole arts / humanities / social sciences running down science because they don't understand how it works enough (ie *why* it is so successful and that of course there are very real limits and there is actually a *lot* of humility over there)
Posted by Partlycloudy on September 5, 2013, at 11:06:05
In reply to Re: Ideal Therapist » Partlycloudy, posted by alexandra_k on September 5, 2013, at 2:03:10
> Taking sides?
>
> Can you say more about that?
>Presenting alternative viewpoints, some of whichI might find upsetting. She isn't confrontational, but if my state of mind is so distorted - say, by a bad depressive episode - she will point out other ways to look at what I consider to be a distressing situation without ever offending me.
It's funny, she often remarks on how very civil I come across when I am describing an argumentative situation. And I think to myself, "thank goodness she hasn't read the archives at Babble" where she'd see the very dark and sick side of me.PC
Posted by Twinleaf on September 5, 2013, at 11:42:30
In reply to Re: Ideal Therapist » Twinleaf, posted by alexandra_k on September 5, 2013, at 1:42:42
I think that I meant that I like a quiet, very respectful response to the most painful feelings that I express. I like the silences, when I feel very understood and connected. I guess I like the way my therapist does it.
I think "moments of meeting" are another way of describing that. It refers to those wonderful moments when one's anxiety calms, and you feel safer, closer, more connected. I think they are probably instances of growth and the formation of new connections in one's right hemisphere because of the unconscious things which go on between therapist and patient. Afterwards, I always feel I have taken a step in the right direction.
Posted by alexandra_k on September 5, 2013, at 22:58:56
In reply to Re: Ideal Therapist » alexandra_k, posted by Partlycloudy on September 5, 2013, at 11:06:05
Ah, I see. I wondered if you were talking about couples therapy...
It is funny, isn't it, how some therapists can get away with raising things that would typically be hurtful or distressing or upsetting... And do do without causing offense. I guess it is about the background relationship.
I don't remember you being particularly black / dark here...
Posted by alexandra_k on September 5, 2013, at 23:03:28
In reply to Re: Ideal Therapist » alexandra_k, posted by Twinleaf on September 5, 2013, at 11:42:30
Ah...
My last t...
Used to lean in when I was hurting. I would always look down... Can't look at anyone... But he would look straight into my eyes. Empathetically. Like he was... There with me. Willing to be there with me in my pain. It was too much for me. I needed to back off or squirm away or whatever... Change the feeling. Was the only thing I could do. Say something. Change the subject.
Maybe if I was little I would have thrown my arms around his neck and clung to him (it would have been okay for me to stay there and feel it because he couldn't have seen my face) but as it was... Things felt too intimate or something somehow...
But it helped. That he was willing to do that. Even though I couldn't tolerate it.
Don't know if that makes sense. And I'm not sure what it was about. Maybe it is similar... I don't know.
Posted by Twinleaf on September 6, 2013, at 7:07:49
In reply to Re: Ideal Therapist » alexandra_k, posted by Twinleaf on September 5, 2013, at 11:42:30
You have actually described them perfectly. Even though it was very hard to bear, that particular therapist sounds as though he was doing just what you really needed him to do. If you had had more time with him, you would have become more comfortable and able to return his gaze, as has happened with me. Maybe in the future you will be able to find another therapist like that. Or find that one again if you move to Australia?
Posted by Dinah on September 6, 2013, at 8:31:14
In reply to Re: Ideal Therapist » Partlycloudy, posted by alexandra_k on September 5, 2013, at 22:58:56
T3 was like that. She had an absolute genius for saying things that appeared on the face of it very confrontational or hurtful, but saying them in a way that really wasn't confrontational or hurtful at all.
Then she went a bit too far, and in addition to the hurtful thing she said that day, a score of other really hurtful things she had said came to mind. I wasn't so much really hurt by them as amazed that I hadn't been at the time.
She was very good at beveling and polishing the truth, as I much prefer. But in the end, it added up to too high a number of "truths", and I was unable to escape the conclusion that she didn't much like me.
Even the best beveler and polisher needs to make sure to balance negative and positive to some degree.
Posted by Dinah on September 6, 2013, at 8:50:27
In reply to Re: Ideal Therapist, posted by Dinah on September 6, 2013, at 8:31:14
To be clear, it is apparent that PC's therapist doesn't share the weakness of T3. It's just that when I read about that particular talent, I was reminded of T3. It's funny. She wasn't even particularly warm. I don't think I could pinpoint how her skill worked at all.
But I can appreciate it, and recognize that she would be an excellent therapist if she had a client that was a better fit.
Maybe that's the ideal client! The one that is a proper fit for what the therapist offers. And of course, also pays and is respectful.
Posted by Partlycloudy on September 6, 2013, at 12:01:32
In reply to Re: Ideal Therapist » Partlycloudy, posted by alexandra_k on September 5, 2013, at 22:58:56
>
> I don't remember you being particularly black / dark here...
>
>I have said things on the board here that I would never dream of saying to someone face to face. I have learned a lot in my participation here. What not to do. What not to say. How to alienate people in one simple step. Argh, what a steep learning curve for me. No website or forum should affect me to the point of making me so upset that I cry.
PC
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