The good, the bad, the ugly: Therapy and Therapists

It’s no secret that I am a fan of therapy. Since it literally saved my life, what’s not to like? But in reading the comments on this blog and my emails from readers, it has become crystal clear to me that not only does everyone not feel the same way about therapy that I do, there are some serious misconceptions out there about therapy and therapists, particularly with respect to clients like ourselves, the offspring of narcissists.

Each one of us, for all that we have a common background, is unique. And that means that we will have differing agendas in entering (or even contemplating) therapy. And yes, you have an agenda—we all do, whether we recognize it or not. Mine, when entering therapy, was to cling onto something that might lift my suicidal depression…and the agenda evolved as the therapy evolved. Each person who reads this has his or her own agenda with respect to therapy, and that depends on our mindset.

Some of us are so entrenched in our victimhood we don’t really want therapy to work. Our personal identities are as victims and we don’t really want to change that. If being a victim is all you know, when you go into therapy and it works, who will you be then? The security of the familiar but unhappy known is threatened by the unknown.  When we go into therapy with this mindset, we subtly sabotage not only the therapy, but ourselves. Hiding behind labels like PTSD or rationalizations like “I didn’t create this, why should I have to fix it?” we find fault with the therapist, the process, the very idea of change. This is undoubtedly caused by fear because to keep ourselves safe, we tend to be very control-oriented…and therapy and the changes it brings are not within our control. It is frightening to contemplate the loss of our identity, the transformation into something, someone else, when we have no overt, conscious control over that transformation.

Many of us are still very angry with our parents and others who victimized us without remorse. We want vengeance, pay back, to inflict on them the kind of hurt they inflicted on us. Our anger makes us feel powerful and strong…and safe. We hide behind it like a shield, unwilling to give up anger and revenge fantasies, resisting therapy in the mistaken notion that it will render us impotent and vulnerable again.

We sabotage ourselves with resistance…and few us undertake a therapy journey without engaging in resistance at some point. I was desperate for someone to listen to me and validate me, so I attended my therapy sessions eagerly…you’d think there was no resistance there, right? Well, I was clear on my NM and what a cruel, manipulative, sadist she was…but completely resistant to recognizing my husband was just like her! My therapist led me to the realization several times, but I simply did not see the connection. Then one day, after listening to yet another litany if complaints about my narcissistic husband, she said “Who else treats you like that?” I shook my head in puzzlement. “Who else in your life discounts and devalues you, lies to you, ignores your feelings and treats you like you don’t matter?” And suddenly I saw it and I said “Oh my god…I married my mother!” But it took her practically beating me over the head with the truth before my resistance was overcome and I could see it myself.

Too often we go into therapy with completely unrealistic expectations and when those expectations are disappointed, we blame the therapist or therapy itself, without ever looking inward to see what part we had in the lack of success. Therapy is a relationship and we are conditioned by our positions as the children of narcissists to blame the narcissist for our failed parent-child relationship, but it is not accurate to extrapolate that experience to every relationship we ever enter into.

Just like in any other relationship, in order to be successful the people in it must be working towards the same goal, pulling in the same direction. If you have a subconscious agenda of undermining the therapy, there is no way it can work. Why would you want to do that? Well, some people want to prove they are right—they say therapy won’t help them or it is bunk, and by sabotaging the therapy by being uncooperative, they prove themselves right. Some people don’t want to change, they want the people who hurt them to change: they have no motivation to cooperate with therapy. Still others want to be in control: they feel unsafe putting their emotional lives in the hands of others, so they thwart the therapy and therapist in order to keep feeling safe, even at the expense of healing. I am sure there are many, many other reasons that people are unwilling to really engage with the therapist, reasons that aren’t truly the therapist’s fault, that stymie the therapeutic process.

Our expectations, often subconscious, can also be a major cause of disappointment or disillusionment. Some of us expect the therapist to be some kind miracle worker: we sit passively and tell a little about ourselves and the therapist magically heals us. It doesn’t work that way, I am sorry to say. Therapists don’t heal us, we heal ourselves with our therapists as our guides. They prod us when we are reluctant to open doors, console us when we finally face heart-wrenching truths, point us in the right direction when we seem lost and don’t know how to proceed. But they do not fix us…we fix ourselves by facing up to painful, long-suppressed emotions and truths, by going through the pain we have been avoiding, by examining long-held—but false—beliefs about ourselves and our families. Our therapists are there as guides to help us along, throw us a lifeline as needed, give us encouragement and redirect us when we wander off the path of healing. They do not have magic wands and they cannot cure us without our wholehearted participation in the process.

I have heard complaints about therapists and how they act in session but seldom have I heard someone acknowledge his/her part in the situation. I have heard of therapists who spent the therapy hour talking about themselves: but who acknowledges that therapists are human beings who might be made uncomfortable with a prolonged silence on the part of the client? Is there any recognition that a valid technique is to toss out some tidbit about one’s own self in an effort to prime the client, as an attempt to get the client to reciprocate? Some therapists appear to be inattentive and uncommunicative: perhaps this is a style of relating that is supposed to encourage the client to ruminate and even feel uncomfortable enough with the silence to speak up. I have heard complaints about therapists who don’t know anything about narcissism or who refuse to acknowledge such things as personality disorders. So…does the client keep coming back, after hearing from the horse’s mouth, that s/he is not knowledgeable about certain things that are important to the client and shows no interest in learning? How is that the therapist’s fault? If you went to a Porsche dealer wanting to buy a Ferrari and the dealer said “Nope, no Ferraris here, we don’t carry them or even talk about them,” whose fault is it if you keep hanging around the Porsche dealer, expecting a Ferrari to somehow appear? Shouldn’t you say “OK, thanks for the info,” and go in search of a Ferrari dealer?

One of the ways we sabotage ourselves and our therapy with unrealistic expectations is to think that all therapists are alike, that they all have the same amount of insight and the same ability to connect…and that they are all equally competent in all aspects of their field. But if you believe this, you are doing yourself a huge disservice. Think of therapists like houses or apartments for sale or rent: what are the odds that, without doing any research whatsoever, without making any calls or inquiries, the first place you see will be not only in perfect condition, but exactly what you are looking for? Slim, eh? Is anything more frustrating than house or apartment hunting, trying to get the right size place in the right location for the right money in the right condition? When I was last house hunting, I swear we saw at least ten houses per week for three months before we found the house we bought—and this house needed a shipload of work to counter the previous owner’s seven years of deferred maintenance.

Why should finding the right therapist be any different? Are human beings any less unique than houses? If you were looking for someone to guide you through the Everglades would you take someone whose expertise is the Rocky Mountains, just because they are both guides and you therefore perceive them to be interchangeable? Whose fault would it be if you got lost if you insist on hiring a guide who has never been in the Everglades and who tells you “this is not my area of expertise”?

The success of therapy depends on several things, but choosing the right therapist for you is the first and most important step. And you cannot be expecting your therapist to not be human, to not have human faults or foibles. Therapists are humans just like we are and act and react just like we do. Faulting another human for being human, expecting your therapist to be superhuman, works against you and the success of your therapy. Furthermore, a therapist with a background of overcoming personal difficulties, someone whose life has not been a perfect bed or roses and who has conquered his demons is probably a person whose life is more likely to have given him the experiences that allow him to empathise with you and be a better guide than someone who has lived without angst and personal turmoil. Do you want a guide who learned the route through books or one who has already trodden the path himself and knows where you are going?

Before you choose a therapist, consider what attributes are important in the right therapist for you: experience in helping adults who had abusive parents? Experience in dealing with the victims of people with personality disorders? Specific training or experience with narcissism? You should find out if the therapist adheres to any specific type of psychotherapy like Cognitive Behavioural Therapy or Imago Relationship Therapy: some therapies address only superficial reactions rather than address the underlying causes of our angst and some therapists are so rigidly bound to their chosen form of therapy they will try to shoehorn you into their paradigm rather than listen to you and help you find your own way, using their insights as guides.

You should book an appointment with a therapist who you think is a possibility and spend that hour interviewing the therapist, asking the questions to which you need answers. It is ok to bring a list of questions. If the therapist balks and tries to control the time and topics, this is a clue that with this person, you are going to have to do therapy according to his/her agenda, not yours. Will that work for you? If not, don’t book a second appointment. You should specifically ask if they ascribe to any particular type of therapy. If they do, write it down and when you get home, go to this website, http://www.goodtherapy.org/types-of-therapy.html , look up the therapy and read up on it. If it doesn’t seem like a fit to you, move on to interviewing the next therapist. You may have to visit several before you find someone you can work with but don’t reject someone simply because s/he is not perfect: you sabotage yourself that way because nobody is perfect. You just need a therapist with whom you can feel comfortable and who is willing to work with you, which includes not forcing you into a therapy model s/he feels comfortable with but makes you feel unheard, and being willing to stretch his or her own knowledge and expertise by learning more about narcissism and its effects upon victims. No matter how great the therapist seems otherwise, if those two essential elements are missing, you are not going to have the best opportunity to cure what ails you.

There are no shortcuts. There are no shortcuts. No magic bullets, no miracle cures, no magical techniques to fix what ails you. You can engage in “alternative therapies” that tap into the placebo effect, but they will not cure you. The only cure for what ails you lies within yourself: you must come to terms with what you have been avoiding, with what you fear, and realize that you will not die either from the pain or from the loss of a toxic family, but you could die from your avoidance: addiction, alcoholism, suidical depression, high risk behaviours...

Therapy works for everyone…that’s right, everyone. But it only works with your participation and your own hard work. It doesn’t work if you don’t choose an appropriate therapist, it doesn’t work if you sit by passively and expect the therapist to fix you, it doesn’t work if you don’t cooperate in the therapy and stretch yourself, it doesn’t work if you sabotage it, either consciously or subconsciously. It only works if you really want it to and you put your comfort on the line: successful therapy is painful and it takes time, but in the end, you come out a happier, more whole person.

All of this said, it would be unjust to neglect the subject of bad therapists and quack therapies: they do exist. Chief among the quack therapies, in my estimation, is EFT (Emotional FreedomTechnique). First of all, it is not meant to fix the underlying cause of your pain, only to temporarily banish it: it is like putting a Band-Aid on a melanoma. Secondly, any effectiveness a patient may feel from its use is attributable to “…well-known cognitive and behavioral techniques that are included with the energy manipulation. Psychologists and researchers should be wary of using such techniques, and make efforts to inform the public about the ill effects of therapies that advertise miraculous claims.”A wise practice, when encountering any “alternative medicine” or “alternative therapies” is to look them up on Quackwatcha site dedicated to investigating and reporting the truth of these alternative methods.

Bad therapists are people who do not resist their own urges to exploit or take advantage of their clients. This can range from passivity to unwillingness to learn about your situation (victim of narcissism) to trying to force you into a specific therapeutic mould that is inside the therapist’s comfort zone but not appropriate for you, to more overt, psychologically damaging behaviour like treating you and your issues dismissively, betraying confidences, even behaving in sexually inappropriate ways with you. Bad therapists do exist…some of them are narcissists themselves, people who found an endless source of Nsupply in the profession. But, this is true of virtually any profession: they all have their share of bad apples and we simply have to be cautious and prudent in selecting the practitioner we will use.

So, is therapy right for you? Yes!! But it is up to you to find the right therapist and then give it your own best effort. And if at first you do not succeed, try, try again!