When therapy doesn't work

Maybe psychologists or others need to come up with some other approaches that will.

I would have posted this on the thread about why doesn't work but I am on the OP's ignore list and can't.

Nobody is on my ignore list. I don't have one. Doesn't mean I reply to every post on my threads, but . . .different strokes for different folks, I guess.

A diet rich in fish might help.

Albacore, Beluga, Carp, Dolphin fish, Eels, Flounder, Goldfish, Halibut...

I didn't even know you could have an ignore list. How about that. I agree that therapists do need to come up with different treatment approaches, and they are. I had an extremely poor response to psychodynamic therapy. It made me worse. But I'm not entirely sure if it was really the type of therapy or the personality of the therapist. I expect part, but not all of it was me. I didn't know what to expect or how to communicate what I needed from her. However, I'm not sure she would have listened anyway. I should have quit sooner.

I have had a very good response to more cognitive/solution focused therapies and a therapist who doesn't over share and who is good at empathizing and allowing me to take the lead in setting and reaching goals. The personality of the therapist seems to have a whole lot to do with it.

Are you interested in discussing why therapy does not work for some of us (I think you had a similar thread a while ago, even more than one, with lots of interesting discussion), alternative approaches to improving mental well-being (I posted about mine on various threads in the past, for example https://forums.psychcentral.com/6051491-post5.html), or about selecting/ignoring partners for discussion? For the latter, I personally have never used the ignore function on any online forums I have tried. I don't see a reason why and am too curious/open-minded to just stick my head into the sand from people/points of view that I find less in line with mine. I was even asked once on another forum by a moderator to put another member on my ignore list because she had a lot of negative irrational reactions to my responses to her - I refused. It wasn't my problem, why should I ignore. I can easily see why some people find the 'ignore' useful though, why it was developed I guess... just not my style.

Going back to why therapy may not work for some of us - there are many factors, but I keep thinking that strong realism (and associated critical thinking) is one. The whole therapy enterprise is built upon imagination, illusions, mimicking, designed feedback and relationship etc - a large dose of realism and willingness to stand up to one's own opinions and values can be quite incompatible with all that.

If therapy were a movie instead of real life, it would be comical how much the profession seems to twist in pretzels to bash clients who fail to thrive under their masterful care.

It all started with Freud who, by many indications, had no respect for his patients at all save exploiting them as objects in his performances. By at least one account he only "cured" one patient, and Freud told another colleague his patients were "rabble," or the German word for it. He wrote vindictively about patients in his explorations of "negative therapeutic reaction," in which he blamed patient narcissism and psychosis. Freud acolytes continued the fine bashing tradition with explications of secondary gain from illness, the need to punish themselves, jealousy of the therapist and need to undermine the therapist as reasons for therapy failure. Papers like these completely put failure on the patient, but the therapist is infallible, of course.
http://internationalpsychoanalysis.n...icReaction.pdf

(brings up pdf)
https://tinyurl.com/yaapmwhf

http://www.psychoterapiaptp.pl/uploa...apia2015i1.pdf

Lest one argue that such arrogance is from the bad old days, this client kicker was published in 2004.
http://www.sakkyndig.com/psykologi/a...ritton2004.pdf

And the even more recent "Red Flags in Psychotherapy" begins with JE Groves' "Taking care of the hateful patient," and continues to several chapters of hilarious examples of contemptible, illiterate risible clients who were disobedient enough to file ethics complaints against their therapists.

Obviously this "theory" was pulled out of the sky--I can think of a less polite description of its source--but I've found nothing on iatrogensis derived from actual feedback from actual clients. Scott Lilienfeld tiptoes lightly into professional criticism, but I believe limits his condemnation to modalities off the beaten track.

http://lukemuehlhauser.com/wp-conten...a-taxonomy.pdf

In my blogging, I've met a few of the www.therapyabuse.org/ women and three other bloggers. They were invariably bright, perceptive, and highly functioning.

Perhaps I should write an equally unfounded paper on the reasons psych professionals "resist" understanding why clients fail to thrive. It couldn't be any more ridiculous than what these self-protective bantam roosters have said.

Other approaches are available and have been for some time. All kinds of alternative therapies like bodywork, acupuncture, herbal therapies, homeopathy, yoga, tai chi..you name it. There are so many out there. No need for psychologists to invent anything outside of psychology. It's not their job anyway. What they do need to do IMO is to change the system they invented and make it work differently because clearly the existing one fails many people.

So I've had compassionate therapists listen to me and console me but did it help? Not really.

I also had one therapist that said very little. He would scribble on white paper and it looked like he drew lines across the pages while I talked about my problems. I even pushed him to say something, anything and he was mostly a listener. I even told him I need some direction on what to do.. nothing. 10 weeks and about $1500 down the drain.

One therapist got me into meditating which was actually very helpful. I would leave very calm but we didn't really address the underlying issues. For me therapy has been expensive and about 50% useful.

Other things that help me very much was having a personal trainer to get me working out. It was a great for my anxiety/depression and I saw weekly results that boosted my self image. I don't regret investing in that. I have read a little about EMDR therapy and may try it. I also want to try a holistic diet approach to feeling better and get away from all processed foods and sugar. I think many of us would benefit from a natural diet.

I think several other things than therapy might work, as several people has suggested like doing yoga, exercising or such. It all depends on what goals one has.

To me personally, when it comes to why or when therapy isn´t working, I think it´s because I´m rather lonely and I´ve been unemployed for several years and I don´t really believe in change. Even if I sometimes also have a good chat with my therapist that doesn´t lead to any change and I never get that much motivation to change things so life really changes. I manage doing small things for some hours a week and that´s not because I´m actually tired but because I get reminded of loneliness when I'm around other people and other problems also surface.

When many things are missing in life I believe a therapist can be your weekly support and a kind of activity during the week but I don´t expect to change or feel better. It´s more like a weekly maintenence and me knowing that I still try even if nothing ever changes.

Among the essential issues is that the therapist, and to some extent the client, has no limited over many/most external factors causing the client distress. My therapist even sent mousy me for a beauty makeover, but that and therapy didn't transform me into vivacious date bait.

Furthermore, a therapist can't hope to understand most milieu in which the client operates. A truck stop has a different culture than a university philosophy department.

A therapist might give the client some assertiveness coaching, but speaking up has consequences that a therapist never will be able to calculate.

So stated or implied promises of transformation often will be unrealistic no matter how much the client "works."

I’m a therapy success story!

Since I’ve been in therapy — including this morning — I’ve seen dozens upon dozens of ‘other approaches’ introduced. (I’m unsure of what type of therapy didn’t work for you?) The most recent and acceptable has been CBT.

Personally, I found CBT to be a bad joke when it was first used exclusively for depression and my disdain continues. I am fortunate now in that I’m seeing a shrink/therapist who is ‘a little bit Freudian.’ So am I!!

“Therapy” doesn’t really have any meaning with no description of the type of therapy that one is involved in, does it? I respond best to ‘talk therapy.’ Others, CBT. Oh, and ECT!!

I’m sorry that (whatever type of) therapy didn’t work for you. You can rest assured that other types of therapy are being tested on humans on an hour-by-hour basis!

I don’t know anything about ignoring other users, either.

Anyway — I just noted in another thread my belief that 40% of what makes a therapist is personality.

And your therapy is so very different than mine! I really wished that I responded well to “cognitive/solution focused therapies,” but I don’t!!

As noted, I believe that clients need to be schooled in the myriad of therapy ‘types.’ And I’m tickled to hear that your type of therapy is working for you.

I have to admit that “strong realism” might not be mine, since I’m delusional. But I continue to be an apt critical thinker and I don’t quite see how ‘strong realism’ is in any way attached to ‘critical thinking’?

And I will defend my opinions and values (the few values that I have remaining) at any cost. So...

... I’m not certain where you got the ideas for your descriptions for ‘the whole therapy enterprise’ but I’ve had none of those experiences in the past 33-years. Using your criteria therapy becomes a parlor trick or seance — and I overstep the boundaries, sometimes, with my extreme skepticism and would never suffer an illusion in my therapy.

I believe that it’s becoming more important to distinguish between different types of therapies. CBT and ECT are both ‘therapies’ but are quite different.

Could you elaborate upon your experiences and observations?

I think perhaps for other approaches alternative to therapy could come from people other than therapists. But I can see why one may say that therapists themselves should signpost alternatives, because it seems to be a sort of cultural "default" that for emotional or relational or mental health problems, a therapist will fix it. I guess like calling for a first aider for any accident that happens.

My ideas of potential alternative and/or adjuncts to therapy are exercise and nutrition, I know that could sound cliched but I think those are also things that can hugely help. Basically we often can't control many things - we can call the police for dangerous situations, but we can't rewind time and make them not have happened, or we can't create loving parents if we don't have them and so on. There are major stressors or problems that we can't really change. So then my philosophy is that we can work on the things that we can change and make our life as stress-free as possible. Within all the areas that are under our control.

I think that this is a healthy and self-caring sort of attitude that I've actually learned from working in therapy, but at the same time it doesn't have to be through therapy that one would do these things, and for myself as well paying attention to nutrition, exercise, relaxation and other things like that have helped me in body and in mind.

Yeah, but we skeptics believe that if alternative medicine (or therapies) actually worked they would have become accepted.

For me it was mostly because I never could figure out what was supposed to be going on. What the point of their questions was supposed to be.
“Tell me about your mother and your feelings” – well okay I had one of each once. But what is the point of that question? What sorts of answers make a difference for that which I want helped? Any story could be told any number of ways. What is the sort of way that one uses in this sort of circumstance. And how is one supposed to know if it is working. Therapists give some nonuseful answer - you will feel lighter or less heavy in your left earlobe on days with m in them. Well if I did not hire one of them to feel less heavy on Mondays -then that is not evidence that therapy is working.

Certainly there will be those who blame the client (you did not work hard enough or want to change or do it right - with the implied "like I did because I am better at it than you are")

Utter contempt for the unsuccessful client began with Freud and doesn't appear to have abated. I sense that many experience therapy as a moral imperative, some kind of assumed purification for which one shall not be truant. The mystification and magical thinking seem to run rampant.

I find the scorn very interesting. It replicates the power dynamic I experienced in exploitative therapy. Maybe therapy has replaced those sanctimonious congregation members who made it their business to berate those who failed to appear at church.

Yes, scorn is an interesting thing. Not sure what it is, in terms of personal experience or what gives rise to it. Hmm. . .

Now... thinking of and speaking about my mother was extremely important to my ‘talk therapy.’ She was killed when I was 4-years-old and her death was my first abandonment. Others followed. Maybe talk therapy isn’t for you? Did you not have any feelings for your mother? Mothers? You had two mothers?

I’m not sure who is supposed to be speaking in the... implication? The therapist or another client?

Sometimes the client is to blame when a particular therapy doesn’t work. That’s <<yawn... shrug>> possible. I’m having a real horror show right now because I am not cooperating with my much-needed exposure therapy. This has been going on for... years and my therapist prods me and goads me and I’m failing myself.

What did your therapist say when you told him that you had no feelings for your mothers?

I assume some core defense is threatened. For instance if a therapist needs to see himself as a masterful savior, he might go into contortions reconciling that with an unhappy client.

Analyst Karen Horney, with whom I sometimes agree, talks about an idealized self that people can go through extreme ends to protect.

Noooo... I experience therapy as medicine for my mind. I’m never going to attempt any sort of ‘purification,’ again. (I was baptized as an infant... I suppose I can say that I put purification to shame for the rest of my life.)

Ya know... as a widely acclaimed atheist and lesser know skeptic (but maybe best known as a scoundrel) I am not mystified by, nor do I think magically about, my particular brand of therapy (talk therapy).

Noooo... I disagree with those who dismiss everything under the umbrella of ‘therapy,’ and I can be argumentative (and see my posts disappear — I’m guessing that this post will be deleted even before it appears — now that’s magic!) but I reserve genuine scorn for the deservingly scornful. I’m unsure of how scorn — disdain — becomes a ‘power dynamic... experienced in exploitative therapy?’ Again, as an atheist, skeptic, and scoundrel, I’m not even in the congregation, much less sanctimonious. About church attendance. I can be a really sanctimonious SOB at other times and concerning other subjects.

What type of therapy were you in that was exploitive? Because there are at least one-hundred types of psychotherapy I think that it’s important to name our brand.