Very Bad Therapy podcast

[Eve B]

Episode 9: "Real therapy is anything that helps the client."

[Mary S]

6 hours ago, Eve B said:

Episode 9: "Real therapy is anything that helps the client."

One thing that particularly hits home for me in this episode is something Carrie said to the effect that one thing that often leads to bad therapy is when the therapist says the client means something other than what the client means -- but that some therapists think that their job is to tell the client what the client means. I certainly found it bizarre for the therapist to tell me that I meant something different from what I said. It left me speechless, and seemed so arrogant.

Another thing that I recall from the episode is that Carrie more than once brought up how important it is for the therapist to be transparent about what they are doing. That makes sense to me -- but therapists I have tried rarely if at all practiced what I would consider transparency. (However, perhaps the therapist who said, "Consider me to be something like a computer: What you say goes in, mixes around with my training and experience, and out comes a response," thought that was being transparent? It sure doesn't sound like transparency to me -- especially since her analogy shows a lack of understanding of how computers work.)

[Mary S]

On 7/6/2019 at 5:33 PM, Eve B said:

... And whose to say what's bad therapy vs "very bad" therapy? Not that I see much difference between the two when it comes to the damaging effects, and I still think many therapists are either too thick-skinned or thick-headed to see or accept that they could be the source of the harm even when told directly and honestly by their clients.

I noticed that Carrie and Ben actually say what they mean by "bad therapy" on the first page of their website:

"What is very bad therapy? This podcast gives voice to the stories that begin with an exasperated “You would not believe what happened with my therapist.”

[Eve B]

On 7/17/2019 at 10:10 PM, Mary S said:

I noticed that Carrie and Ben actually say what they mean by "bad therapy" on the first page of their website:

"What is very bad therapy? This podcast gives voice to the stories that begin with an exasperated “You would not believe what happened with my therapist.”

After having been through enough of my own bad experiences, many of those stories would be very easy to believe. Not sure, though, how people who have never had bad therapy or any therapy experience would take it. I don't think clients can really understand the shock and confusion of that moment until it actually happens to them for the first time.

[disequilibrium1]

I knew my bullies made my shameful and intimidated, without realizing deeply how bad they were. But I didn't realize until much later how poor the directive, syrupy, "maternal" therapist was. I needed the opposite of what I thought I needed. But in fact even if I found someone the equivalent of the good parent, sympathetic while encouraging my independence, would that have in fact helped me?  That person still isn't my parent, and we only have one childhood.

[Mary S]

3 hours ago, Eve B said:

After having been through enough of my own bad experiences, many of those stories would be very easy to believe. Not sure, though, how people who have never had bad therapy or any therapy experience would take it. I don't think clients can really understand the shock and confusion of that moment until it actually happens to them for the first time.

Based on my own experience, I think Ben and Carrie were getting at something, but their description was aimed at people who had not experienced "very bad therapy" (nor imagined it) themselves. It would probably be expressed better by saying something more like, "Very bad therapy is where the therapist says and  does things that leave the client shocked and confused".

[Mary S]

On 7/10/2019 at 2:03 AM, Sylvester McMonkey McBean said:

i see that there are two new episodes that have been added and i have not listened to them yet. i hope in later episodes they can find and interview more clients who are not professionals already in that industry, like in episode 5.  i'm assuming they approached peers to help with topics until their podcast gains more popularity, but for some reason, i really don't have as much sympathy or empathy for the professionals who have been 'harmed'.  it just doesn't have the same impact for me.   

Good point. Someone in the profession is more likely to be able to bring what they were taught in their training to back up their case that their therapist did something wrong, whereas clients who are not in the profession have no such backup. I wonder if my worst therapist would have been more likely to answer my questions if I were in her profession, rather than say things like, "Are you sure you're not trying to second guess me," or "Do you realize that you're asking me to give up my control?" 

[Eve B]

There's some truth to the observation that doctors often make the worst patients, so therapists who undergo their own therapy and challenge their treatment could also be seen as not behaving like good clients.

[Mary S]

On 7/19/2019 at 2:48 PM, Mary S said:

Based on my own experience, I think Ben and Carrie were getting at something, but their description was aimed at people who had not experienced "very bad therapy" (nor imagined it) themselves. It would probably be expressed better by saying something more like, "Very bad therapy is where the therapist says and  does things that leave the client shocked and confused".

Or perhaps their “You would not believe what happened with my therapist.”  should be replaced with "“You would not believe what happened with my therapist (unless you've had very bad therapy, too).”

[Sylvester McMonkey McBean]

On 7/17/2019 at 5:29 PM, Mary S said:

One thing that particularly hits home for me in this episode is something Carrie said to the effect that one thing that often leads to bad therapy is when the therapist says the client means something other than what the client means -- but that some therapists think that their job is to tell the client what the client means. I certainly found it bizarre for the therapist to tell me that I meant something different from what I said. It left me speechless, and seemed so arrogant.

 

i actually liked this episode, #9,for the exact thing you mention above. this too was my ex-T.  he thought he knew better than me what was really going on inside my head and what my motivations were.  he was so far off the mark more times than i like to admit. plus, even in my detailed sessions notes that i requested from him his interpretations of me in my sessions were sometimes so insanely incorrect that all i could do is shake my head in disbelief and chuckle. 

[here today]

Ben and Carrie still believe in the therapy model, though.  I don't.  So as instructive as some of our stories might be I wouldn't volunteer to go on it.  How about any of the rest of you?

[Mary S]

17 hours ago, Sylvester McMonkey McBean said:

... even in my detailed sessions notes that i requested from him his interpretations of me in my sessions were sometimes so insanely incorrect that all i could do is shake my head in disbelief and chuckle. 

Oh, how I wish I had had the ability to just chuckle at the "interpretations" my therapist made! Instead, they eventually pushed me into one night standing in a corner of my kitchen saying,  "I don't exist; I"m  figment of everyone's imagination." That was really scary. But at least it convinced me that I needed to quit that therapist. (Regrettably, the next one I tried wasn't a whole lot better -- she had a tendency to laugh at me at really inappropriate times, and was inconsistent in her willingness to tell me what she was doing and why -- she did it just enough to "seduce" me into going back, but then started saying things like, "I have my reasons" and going back on things she had said before.)

[Mary S]

Episode 10 is up. It says "Today's episode is a deep dive into the nuances of harm reduction therapy. " My first thought was that they were talking about therapy that tries not to cause harm. But I quickly realized that, no, they were talking about substance abuse therapy that focuses on harm reduction from substance abuse. I think the latter is something worthwhile  -- but the former is also something that is needed!

[Eve B]

On 7/23/2019 at 11:03 AM, here today said:

Ben and Carrie still believe in the therapy model, though.  I don't.  So as instructive as some of our stories might be I wouldn't volunteer to go on it.  How about any of the rest of you?

I would have trouble trusting them because they laugh too much. I had a therapist who chuckled at something I said that wasn't funny to me or he tried to joke around to lighten my mood, but it just made me shut down.

[Mary S]

I looked at Episode 11. The client was a therapist trainee, and had a really bad time -- the t did an intake facing away from the client typing things into the computer,  and things went downhill from there. Then the rest of the interview was with therapist Daryl Chow, who promotes Feedback Informed Therapy. I looked at his web sites. One page that is particularly worthwhile for a site for therapists is on how to receive feedback:  http://darylchow.com/Daryl_Chow/Blog/wordpress/blog/2016/10/27/how-do-you-get-better-at-receiving-feedback/

[Mary S]

I've looked a little more at Daryl Chow's website. Another interesting page is at http://darylchow.com/Daryl_Chow/Blog/wordpress/blog/2015/01/19/why-our-self-assessment-might-be-a-delusion-of-reality/

Also, wandering outside Chow's site, I came upon an interesting article on empathy, at http://bostonreview.net/forum/paul-bloom-against-empathy

[Eve B]

"I’m sorry. I’ve let you down today. Again, it’s tough to hear this, but thanks for telling me.” (from Mary's Daryl Chow website link)  How many therapists would really have the guts to admit this after offending their clients, and how many therapists would a client have to try before they finally get one who could even come close? Episode 11 acknowledges that psych research data often can't be replicated, and I also wonder about the real honesty of feedback from therapist trainees who may disagree with their supervisors. 

[Eve B]

11 hours ago, Mary S said:

Also, wandering outside Chow's site, I came upon an interesting article on empathy, at http://bostonreview.net/forum/paul-bloom-against-empathy

If empathy is biased and narrow, then maybe clients should expect many therapists to personally rub them the wrong way more often than not?

[Mary S]

Is it the problem that empathy is biased and narrow, or that the therapists are biased and narrow? I suspect that latter.

[Mary S]

12 hours ago, Eve B said:

"I’m sorry. I’ve let you down today. Again, it’s tough to hear this, but thanks for telling me.” (from Mary's Daryl Chow website link)  How many therapists would really have the guts to admit this after offending their clients, and how many therapists would a client have to try before they finally get one who could even come close?

I suspect that very few would have the guts to admit this. I haven't found a therapist who ever said anything like this. But I did have one who listened when I questioned his diagnosis, and was willing to change it to something that made more sense to me. I think he was something like the 13th therapist I tried, over a period of several years. There was a lot I did respect about him -- especially his willingness to listen to my perspective and try to take it into account.  I ended up saying, "You're a nice guy, and I like you, but I don't see what you have to give."  He did show potential, but it wasn't yet developed enough to give me much more than the experience of being willing to listen to me and take my perspective seriously -- I don't want to knock that, because it was so much better than most previous therapists had given (there was one exception, who actually seemed to have some modicum of accurate empathy). Possibly, if one of those two had been my first therapist, they might have been able to help me. But by the time I got to them, the problem was more the experience with the previous therapists than the original problem I went to therapy for help with.

[Mary S]

On 7/31/2019 at 12:55 AM, Mary S said:

Also, wandering outside Chow's site, I came upon an interesting article on empathy, at http://bostonreview.net/forum/paul-bloom-against-empathy

Thinking more about this: Different people have different definitions of "empathy". Bloom's article is really opposing what I consider the most extreme definition of empathy: the "I feel your pain" type, where the empathizer actually feels the emotion that the other person  is experiencing.  I have encountered a couple of other definitions. One is being aware of  and taking into account other people's feelings. Still another is being aware of and taking into account other people's thinking and feelings. But it's also important to distinguish between what I call "perceived" and "accurate" empathy. For example, if someone believes they know how someone else is feeling, that is what I would call perceived empathy (perceived by the empathizer), but the person having the feeling is the only one who can judge whether the purported empathy is accurate or not.

To me, the important kind of empathy (especially for a therapist to have) is accurate empathy in the wider sense of understanding and talking into account the client's thinking as well as their feelings. As an example, to me someone who says, "I feel your pain" to me would be expressing perceived empathy, but their statement would (for me) be expressing inaccurate empathy because it would show that they did not understand (or did not take into account) how offensive it is for someone to say "I feel your pain" to me -- in fact, saying, "I feel your pain" would come across (especially if said by a therapist to me) as a boundary violation: using me to pursue their own agenda that I haven't consented to.

I think accurate empathy (empathy in the sense of understanding both thoughts and feelings and taking that understanding into account  in working with the person) is an important quality for a therapist -- it is the means to giving individualized (rather than one-size-fits-all) treatment. But it seems like a rare therapist who has it -- or even who tries to develop it.

Also relevant: I think the kind of empathy I describe as an important quality for a therapist may be what Yalom was trying to get at when he said, “Look out the other’s window. Try to see the world as your patient sees it.”"

[Eve B]

23 hours ago, Mary S said:

Also relevant: I think the kind of empathy I describe as an important quality for a therapist may be what Yalom was trying to get at when he said, “Look out the other’s window. Try to see the world as your patient sees it.”"

Do clients also have some obligation to help their therapist with this? 

[Eve B]

On 7/31/2019 at 10:39 PM, Mary S said:

Is it the problem that empathy is biased and narrow, or that the therapists are biased and narrow? I suspect that latter.

Could these therapists be less biased and narrow if they had better compassion training? 

[Mary S]

3 hours ago, Eve B said:

Do clients also have some obligation to help their therapist with this? 

The client can try, but the therapist has to be willing to listen. If talking to the therapist is like talking to a brick wall, there is little if anything the client can do to get through to the therapist. Therapist training should include learning to really listen -- and probably trying to refrain from  "interpretations" (regrettably, a lot of therapists seem to think they have some direct line to reality, and don't even consider the possibility that they're wrong). Therapist training should also include learning to say (routinely) things like, "Am I correct in assuming ____, or am I off base on that?"

[Mary S]

3 hours ago, Eve B said:

Could these therapists be less biased and narrow if they had better compassion training? 

I don't know how to answer this. Do therapists indeed have "compassion training"? If so, what does it consist of? (The phrase "compassion training" could mean very different things to different people.)