The Reddit psychotherapy board is a safe space for therapists: patients are banned from participating. It can make for interesting reading, like this thread: What was your toughest client/hardest situation to be in?” The original post:
I know a lot of people are dealing with imposter syndrome. Maybe it would help if some of us share those moments when we thought ‘holy shit, I’m so in over my head here’.
LOL I have imposter syndrome over being a person.
I’m less interested in the responses like, “Someone brandished a firearm at me.” This is more interesting:
I remember sitting with a client about a year after I finished my doctorate. I was working in a group practice at the time. As the client was telling me about the serious garbage he was wading through in his life, I noticed the thought pop up in my head, “wow, you really should be in therapy.” Followed quickly by the realization that yes, he’s in therapy, and he’s taking to a therapist right now, me. Now I can look back on that moment and smile, but then it shook me up a bit.
Therapists are mostly normal people or good at faking it. This is because you need to finish grad school and more before you can do it. To me, this anecdote means that therapists might not be identified with their role, so they’re just speaking from the position of a normal person looking down on you. There you are, having overcame the hurdles of finding a therapist and getting to their office on time. Already you’re a problem and not a person doing something about your problem.
The hardest for me are clients with overlapping issues. I have had several people with Gender Identity crisis, who register on the autism spectrum, with a family dynamic that would drive a healthy psyche over the edge, showing all the signs and symptoms of a bipolar depression. Since I have had several clients like this, I don’t believe I’ll be breaking confidentiality by talking about them in a general sense.
These folks are tough to work with! They have a tendency to jump on society’s bandwagon of “you’re broken, we don’t need you.” Keeping them alive through any sort of treatment protocol is difficult, but worthwhile in the end. If they are the type who want to transition, you have to keep with them though the hormone affects, all the antidepressants their PCP puts them on, all the while trying to break through the ASD personality affects…the struggle is real for both of us.
Presumably I’m a bummer somewhere around that level of badness. Awareness that I’m likely to be perceived this way is called “jumping on society’s bandwagon” that I’m broken and unneeded.
This person isn’t understanding that stigma is inescapable and imposed from the outside. That makes it a practical reality that you have to adapt to, like the weather. Thought experiment: while you’re out and about, imagine that, for certain people, you’re covered in really gross slime that’s imperceptible to you. It’s a handicap having to overcome that first impression of you, and you need to be aware of the signs. I can see the assumptions behind what people are saying very quickly, so that’s how I can usually tell. Just imagine going through life having no intuition for what people are privately thinking about you, but knowing that it’s bad with high probability. It’s a certain mindset, but it’s not the same as “jumping on society’s bandwagon.” It’s getting run over by society’s bandwagon.
He’s not perceiving the effects of knowing you’re a freak no matter how people patronize you. He sees it as an obstacle to his intended outcome for the patient, so he develops a hatred for it. I like to use this Stuart Schneiderman quote wherever possible:
When it came to saying something about the reasons that lead a person to do a psychoanalysis, Lacan knew that it was not the wish to be normal, not the wish to be informed of the latest experimental results or the wish to adapt to the environment or the wish to have another caring and concerned friend, that led people to his door…
When psychology defines normal stages of human development and when therapists attempt to make sense of their patients’ experience by referring them to some putative normality, what they are doing is finding a convenient place for their patients within the concept they have of humanity. They teach their patients to identify with mankind. This is another identification that patients in analysis do not seek and should not be encouraged to develop. Such an identification is nothing more or less than the repression of subjectivity, of personal style, of quirks and idiosyncrasies.
People who present themselves for psychoanalysis are…alienated because they have had a taste of something else, and once they have had that experience the norm does not seem to be worth the bother. Analysands, and not only Lacanians, often say that they do not want to become part of normal life because it strikes them as insufferably boring. Their problem is not that they are alienated from the norm, but that they have considerable difficulty in dealing with normal people…
A person who sees an analyst is seeking a therapist who will not meddle in his life. Paradoxical as it may seem, the analysand is not looking for advice about how to live his life; he does not want to know what the analyst would do in the same situation, and he does not expect the analyst to be his friend or confidant. Basically, the analysand wants his analyst to mind his own business, to be interested in the things that concern him, directly or indirectly. And the analyst’s business is the transference.
The reason that anyone consults a mental health professional is suffering. What he asks for is relief from this suffering; his demand is for a cure. Lacan, who was so meticulous in distinguishing demand from desire, said that what he demands is surely not what he wants…The question of the beginning of a psychoanalysis is whether the analyst accepts or refuses the patient’s suffering…Suffering…is not a foreign element in the patient’s life, but essential to the patient’s existence. Suffering is the existence the neurotic knows and is not something to be rejected as sick, therefore only valid as it gives the therapist an occasion to practice his trade.
No love for the borderlines, as usual. LOL that I considered becoming a social worker due to not having this attitude:
I totally agree with your comment on counter transference. While working my prn inpatient psych job last weekend I was working with a patient that I very quickly recognized as likely being borderline. The patient continually would make self-contradictory statements that I would try to help them recognize through open ended questions and double-sided reflections.
After 20 minutes I had the strong feeling of “I really do not have the patience for this. This person just needs to be called out on their bullshit.”
That to me just reaffirmed my decision to stay in assessment/case management/brief intervention type roles.
I feel like that about normal people all the time, and I’m better at logical consistency than they are. They’re still in charge.
I’m finishing my masters degree in Counselling and gets super intimidated with a couple of clients who are extremely intelligent,articulated, and seem to have read so many psychology books, on their own. And whenever they say they want to book another appointment with me, I can’t help to think:but why?
Because if they’re so smart, and they still haven’t figured it out, they must still be missing something, right?
I did a year of therapy with somebody who didn’t even like me and tried to get rid of me more than one time. I found my way to reading Frantz Fanon and The Half Has Never Been Told even though I had to break up with the therapist for not understanding things like sharecropping or colorblindness.
My therapist suggested a tantric sex lady, which I wasn’t really feeling very much. But why? I thought a bunch of complex shit about Tibetan Buddhism, discovered Chod, which was very meaningful to me. The concept of wrathful deities led to questions about violence and Buddhism, which brought a childhood interest in martial arts back to life. Next reading project: Taoism. I started a tai chi class, since I was finally special-interested enough in something I couldn’t do alone at my computer. The Tibetan Buddhism reading also got me interested in Bon, shamanism, and visualization during meditation. This led me to see the connections between meditation practices and earlier shamanism. Seeing Tibetan practices that involved movement and stretching the legs made me reconsider forcing myself to sit zazen on top of sitting all day in front of a computer.
I’ve been going to the park and doing the 24 form instead of zazen recently. This is someone doing it super perfectly (or at least it looks good to me, starts 1:05):
My thinking was that it’s perfect for little breaks during the workday. I can now be doing something interesting in public, where people might approach me about it. Who can say if I would’ve found my way to tai chi without the tantric workshop suggestion I didn’t even like. That’s not the point. I thought about it and felt my feelings, which was productive. I wouldn’t have thought of that. It was all too woo for me to spend time on before. Turns out I was missing cool stuff.
I also didn’t know I was autistic, so that was helpful to learn.
The therapist making the comment is wallowing in self-pity instead of listening! Maybe the person needed to talk to someone who could understand their self-understanding, which was based on knowledge of psychology. Maybe they’re autistic, too, and don’t give a fuck about titles, having seen both smart people and dumbasses with and without degrees. Maybe they’re really detached from their body and need help with that. Who knows? Maybe they won’t be able to explain until they work on their alexithymia.
This person is wondering why the patient is there, when the patient helpfully explained in concise professional jargon. WTF.
Jacques Lacan understood so many unpopular things: the only resistance is the resistance of the analyst. Ironically, knowledge of theory, that the therapist can perceive as resistance, actually helps to cope with the therapist’s resistance.