How MUCH of the therapeutic relationship is just in my head, as well as how much is just a "natural" or expected psychological reaction to the ways a psychologist interacts with a patient (appropriately)?
I think, perhaps, that psychologists often get a break, sort of an easy in, so to speak, in some ways, because the ways they are trained to interact with their patients, the questions they ask, the ways they phrase them, any training they've received in the manner of their affect and manner of being within their office . . . these things all, seem to me, to invite semi- or sub-conscious avenues of trust, connectedness, positive regard, and other things.
SO. How much of what I "feel" in the therapeutic relationship, what I "feel" about the therapeutic relationship, the depth and quality of the therapeutic relationship, the "human" "connectedness" and "concern" I "feel" as a partner in our working relationship . . . how much of that is just . . . evoked naturally, or should I say, evoked in response to and by the aforementioned aspects of therapy, the therapist, his/her training, his/her efficacy in using that training, and other things.
Have I been "had", as it were, in that I have been at least somewhat fooled into a sense that I'm genuinely cared about (appropriately), that I'm genuinely completely accepted as I am, that I'm seen in a positive, capable way, that I'm RECEIVING a human connectedness and concern that is a useful, positive, and effective aspect of therapy and the/my/our therapeutic relationship?
Have I been "had", by the techniques, skills, and other psychological applications that are de riguer (sp?) and possibly/probably? just a bag of "tricks", or rather, box of "tools" the psychologist pulls out as needed, as applicable?
How much of the therapeutic relationship is in my head, how much of it is in the naturally evoked responses to the therapist's technique (and thus, perhaps just a reciprocal part of the technique, on my part, and possibly thus rather meaningless?), and how much of it is real? How much of it is my wish, my ardent, heartfelt wish that someone, somewhere on this earth, could possibly accept me, and LIKE (appropriately) me, AS I am, and for WHO I am, regardless of my character flaws, personality quirks, and state of physical and mental health?
How much of it is from that longing, that detested longing that I have learned since before I could even be capable of identifying it, that I have learned to loathe and punish myself for? That yearning, that is so inescapable and primitive, the strength and depth of which is overwhelming, and yet I despise it, and my yielding to the tidal wave forcefulness of it? As if I could somehow stand up to it, and deny the undeniable . . . the feeling that SOMEHOW, I should be capable of the impossible, barring entry to this urgent, basic longing?
HOW MUCH OF THE THERAPEUTIC RELATIONSHIP IS ARTIFACT, ARTIFICE, SUBCONSCIOUS REACTION; HOW MUCH IS EVEN PURPOSEFULLY ELICITED BY THERAPEUTIC TECHNIQUES DESIGNED TO ENCOURAGE AND FOSTER THE INCREASE OF TRUST, CONNECTION, CARE, AND OTHER REGARDING THE THERAPIST/PATIENT RELATIONSHIP? HOW MUCH IS IN MY HEAD/HEART WITHOUT A REAL BASIS, BOTH IN REGARDS TO THE PREVIOUS AND IRREGARDLESS OF THE PREVIOUS?
8 comments:
Sara, I am not sure where one begins and one ends as far as the professional climate and real feelings for you as an individual. I would ask though, why would they not like you. I know in your mind you can probably find so many reasons why as you are prone to self-loathing. As I have said, I am not prone to that. Sometimes when I am in an episode of ocd or not sure about something in that regard either during or even after the fact, I have painful feelings and fears in regards to my nature. And in high school, I used to be into trying to make myself feel pain also punished myself a lot for mistakes that I made.
But I am my own friend now and hope you can arrive at that place.
I do like to feel somebody cares about me too. That is human! That is natural! That is good! We were not created to be cosmic bodies drifting along without connection. Being social is one of the most essential parts of our design. And even on a temporal level, I do not think a society could long survive where people did not look out for one another.
I was the one who paged you when I read your comments at M* as I felt we had a lot in common as far as perceptions. So naturally I am going to like you. And maybe I am biased, but I just can't imagine a person not liking you.
Back to the therapeutic relationship... I did not feel that my Psychiatrist had a great deal of empathy towards me or my situation. We only met shortly for med checks and he would elicit a few questions to see how my thought processes were. I am not saying that he did not like me. I just did not feel any special connection even in the professional sense.
I felt closer to my psychologist and do believe that she cared. I think that a lot of caring people go into those professions.
I went to a counselor on campus once that was studying for her Master's Degree. When I told her about my recent compulsivie thoughts and one of which had been several days and nothing bad had happened and I was still in pain, she seemed to have such an extreme level of empathy. I thought I saw tears in her eyes. Being accustomed to people who mare care some but also a lot of people he brush my illness off or tell me that I am "annoying", I told her that most people do not care that much. She said that they probably did not understand what I was saying.
And anybody who understands what you go through on a constant basis and your struggle and has any compassion would have a lot of compassion for you.
But the part of you that is not vulnerable is also loveable.
A therapy relationship is a professional relationship and should remain such. However, there can be genuine concern. And they are the people who get the "memos" on your illness and what it means. Those who have been there themselves will have a unique connection as well. However, therapists of all people with their unique understanding of mental illness can accept you in ways that others are not able to do so.
I remember the first person who was a therapist on campus who confirmed my ocd diagnosis. She told me that they did not have the services to help me there. However, I am ever glad that I went to her. She had the kindest expression in her eyes. Her forehead was contorted in such a concerned way. To tell a professional the bizarre thoughts of an ocd person and to have her show forth love and approval was wonderful. It was very special to me. I imagine she touched many people in such a way. She was an incredible woman.
There are compassionate people in this world and loving people. I had a woman come once who was either my visiting teacher or accompanying my visiting teacher(not sure which) who had made some mistakes in life and was very candid about that. And she also told me that from a young age that she had a profound sense and love for people. It softens my heart when I think of her though I have not seen her since.
Well, I did not know exactly where I was going with all this before I started and am not sure if there are any transititions or flow. These are the things I think about though.
Yeah, I know it's a professional relationship.
Apparently, how good the outcome of therapy is is highly dependent on the quality of the therapeutic relationship.
It's a very unusual thing, there's nothing else like it. Again, nothing inappropriate, though.
That's a good question and I hadn't really thought of it that way before.
Like a lot of things, I think it really depends on the individual. Barb remarks on a psychiatrist who was less than empathic but I think the patient/client can really sense that.
As you say, it is a professional relationship and certain boundaries have to be maintained, but I absolutely do care about my patients/clients. I don't think I could do this job otherwise.
Sorry for not dropping by for a while - have been in thesis hell. :)
I don't know you but based on what you have been blogging, it would seem like you "think too much" and would perhaps be better off just taking the medicine and taking the doctor's presumably good advice. It is a basic reality that people who are always verbalizing or writing that people do not like them somehow manage to create a self-fulfilling prophecy. Maybe a new tactic for you would be to presume that you ARE LIKED and learn to like the self that you presume is LIKED by others, including your doc. You've got one life on this earth and if you concentrate on healing your imbalances rather than simmering in them and develop hobbies that take you outside your tormented self absorption, your life could really be healed in such a way that you could live pretty normally despite chemical imbalances that need to be managed with medicine. :-)
anonymous,
I'm trying to phrase this in a way that doesn't lose the meaning in vague politeness.
Sticking a smiley face at the end of a condescending and ignorant comment doesn't make it okey-dokey. It doesn't change you coming across as a jerk.
Telling someone to set aside their concerns, take their medicine and be 'normal' is insulting. Not "thinking too much" before typing a reply, like you just did, is a greater problem in this world than those who take time for introspective contemplation. Perhaps you could learn a great deal from this blog...
To presume that everyone likes me is sheer arrogance. I shudder to think of how off-putting such a person would be...but maybe you've shown me by your own example.
Sara, you can delete this if needed, I just couldn't let this cowardly anonymous comment sit there without rebuttal.
Thanks, Tea (I've forgotten the number for the accent again . . .!)
I can see some positive in what Anonymous was saying, but my first thought was, I've tried to turn off the "thinking too much" my whole life, and it doesn't work. My brain just whirls and whirls on stuff, if it's not one thing, it's another.
It is difficult for me to see that anyone likes me, when I see myself as so unlikeable. That's not really what anonymous was saying, but a related concept. And I can't just snap my fingers and start liking myself.
My life isn't all about my illnesses, but on this blog, I post alot about it because people appreciate my perspective, point of view, different and hopefully interesting things to say, my over-thinking that leads to analysis and realizations that some have found to be of value or inspiration to them, among other things.
I have other things I think about, and when not depressed, I do have hobbies I engage in. Hobbies other than the more-than-hobby of mental health awareness and related issues.
Tea, again, thank you. I see some bits of positive in his/her comment, but also saw what you did, and I appreciate your comment and the things you had to say; it warms my heart, as well as shows that I AM liked, lol.
Sara, I hope that when I said that I like you that it did not seem that I did not accept that you have times when you really loathe yourself. Also, I want to add that I have my share of insecurities too. I so want people to think that I am smart. And yet, when people tell me that I am smart, I worry that they will find out the truth. Oh oh, isn't that a sign of a perfectionist from those lists. And I have had some incidents of late where I felt rejected. And it still hurts some. I cling to the fact that so many people make me feel like I am of worth. They do not seem like they are being nice to me just to be nice. They seem to genuinely like that. I get that feeling here that we are really friends so I keep coming back.
I want to add that some people you would never suspect have insecurities. I knew a young woman who seemed very popular. At one time, people had mocked her and she was aware of this and she had paranoia about being mocked. She was very cool. She also had problems with being in sad moods. People would probably not know that about her were they to see her in public. She was a neat person.
Sara, I think you did an excellent job of listening to the view of Anonymous and not being defensive. You took it to heart and explained how as much as you try that you are not able to stop thinking. I know that thinking is both a strength and a weakness of mine. I love to think though. If I didn't have time to muse, I would get so down. I remember in high school when my thoughts were so full of anxiety or fear of failure in the future and I was depressed how the thought of joining a cult where people do not think appealed to me. However, I would not want to abandon my faith for something I did not believe. I did change religions at 19 to become LDS. And that was not without thought and prayer and I have been thinking ever since and as I age I think even more.
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