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littleblackdog
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Default May 19, 2019 at 01:20 PM
  #1
Does anyone have any experience of therapy via email (good, bad, indifferent)?

I had a first session with a psychodynamic therapist last weekend (first time doing therapy that wasn't CBT or similar) and it did not go well.
She said some things that upset me and made me feel she was judging me, but the main problem is that my self esteem is practically non-existent and so sitting there talking to someone who didn't respond just made me more anxious.

I emailed her and explained all of this and she replied saying that she doesn't think that talking therapy is best for me at the moment, but suggested that as I "express myself beautifully through writing" that we do therapy by email. I would email her and she would set aside 50 minutes a week to reply and charge me the usual rate for a session.

My main reservations are that she didn't mention the bits where I said she had upset me, and I worry that she would just cherry-pick certain parts of my email to reply to.
Also, I think it would feel too impersonal, and am not sure how this will help with my not knowing what to say/worrying that I am saying something stupid or boring her.

My main problem is that I don't really have any other options. No other therapists in my area are taking on low-cost clients and medication doesn't work...
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Default May 19, 2019 at 01:39 PM
  #2
I tried betterhelp for a month (advertised here). I was looking for some specific answers. I felt that worked pretty well. I got more than 50 mins a week for my money. I'm not sure I'd like her arrangement depending on what she is charging. One thing I liked about betterhelp was that I could email as often as I wanted and I often got 1-2 replies a day (weekdays). This allowed the emails to feel more like a dialog. If you are thinking about doing email and since you were not completely thrilled with her, you might want to check out the other online/email services.
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Xynesthesia2
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Default May 19, 2019 at 02:04 PM
  #3
I would say it depends what your expectation is from therapy. I did sessions in person and never had problems with talking, but I emailed my therapists a lot, especially with complex analyses and to share realizations and my thought processes. They never responded in depth but I often felt it helped to just put those things together and writing allows a lot more room for contemplation and accuracy. If it is going to be the main medium of your therapy, I guess you can always ask the T to respond to specific things, just like you would do in person. But if she wasn't very responsive in session, it can be that she will be even more selective in writing as there is less opportunity for instant feedback and questions. I think you can always try it out for a while and see from experience.

As for email interactions being impersonal - one of my best friends is someone I met online, we never met in person, but have been interacting regularly a lot via email for almost 5 years now. It absolutely does not feel impersonal to me because both of us are pretty articulate and can describe any topic, including those involving feelings. And it turned into a relationship where we mutually are one of the most trusted, reliable and supportive people in our lives. Of course it is limited in that it only allows one channel of communication but it does not feel limiting at all, it is very satisfying. It is an open-ended, ongoing conversation that goes all over the map and gets very deep. He is also very introspective and psychologically-minded and the interaction is far better and feels more nurturing than anything I've ever had with a therapist. Of course email therapy would be much more limited and structured than a friendship, I am just trying to say that people often say purely written communication can never substitute for direct in-person contact but, in this case of mine, this virtual connection is more meaningful and satisfying than many of my ordinary, 3D world relationships have been. There was a time in the past when I struggled with many things and isolated a lot and this one virtual friend was pretty much my only friend and non-professional connection. It enriched my life greatly and still does.

Also, I guess you could start via email and switch to in-person (or maybe phone) sessions if you feel you need more or something different. Perhaps even a more direct, instant messaging-type communication, then you could ask for feedback in the moment.
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Default May 19, 2019 at 02:53 PM
  #4
I would think one could give it a try and see.

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Default May 19, 2019 at 04:52 PM
  #5
I use to write all week and go in with it all. She'd read it and we would talk about it. That way you say what you need to out in writing but you would have that feedback in person. There are things that T's need to see you to gauge responses to know what direction to continue.

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Default May 19, 2019 at 04:52 PM
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This seems strange to me. I have a very tough time talking in person with T, but can also communicate very well in writing. Long story short, I believe my T is trying to urge me to bridge my writing ability into verbal ability by some things she's done recently. This makes more sense to me than to just tell someone that they aren't ready to do talk therapy and try to work via email. I could see email as appropriate for a supplement to traditional psychodynamic therapy, but how would that kind of therapy even work in that medium?
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Default May 19, 2019 at 05:03 PM
  #7
Yes, I think it’s worth a try too, LBD, with the understanding that that’s what you’re doing, trying it out. Her seeming reluctance to address strong feelings directly bothers me, but that’s something you could address when you reply to her. Just say you’d hoped for a specific response to that point and didnt hear one. You don’t have to be aggressive about it or anything, just clarifying things for your future work, if any.

Good luck. Keep in touch. And if this doesn’t work there is the other idea for you to try, above.
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littleblackdog
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Default May 20, 2019 at 03:59 AM
  #8
Quote:
Originally Posted by Elio View Post
I got more than 50 mins a week for my money. I'm not sure I'd like her arrangement depending on what she is charging. One thing I liked about betterhelp was that I could email as often as I wanted and I often got 1-2 replies a day (weekdays). This allowed the emails to feel more like a dialog.
I don't really like the arrangement: the was she proposed it was that I email her during the week but she only sets aside one 50 minute session to reply and so there would be no dialogue. I think that paying £50 for one email a week is a bit steep, and I worry that if she just ignores half of what I say then I would end up feeling worse and getting increasingly frustrated.
there are no other email based schemes here, that I am aware of. I did try online CBT but again, only got feedback from a real person once a week.

Quote:
Originally Posted by Xynesthesia2 View Post
As for email interactions being impersonal - one of my best friends is someone I met online, we never met in person, but have been interacting regularly a lot via email for almost 5 years now.
Also, I guess you could start via email and switch to in-person (or maybe phone) sessions if you feel you need more or something different. Perhaps even a more direct, instant messaging-type communication, then you could ask for feedback in the moment.
I also have friends who I met online, and who I communicate well with but I am just not sure how her blank slate approach will translate to email and, given that in our correspondence so far she has ignored the most important points (and where I asked her direct questions) I have reservations about how well this would work.
The aim would be to try this for a few months trial, with the aim of building up to face-to-face sessions but I am not sure I will be comfortable with her methods.
It is frustrating because I know that I CAN open up and talk to people, I was able to communicate with previous therapists (even thought the actual therapy was not helpful) and I am able to talk to my GP (who is fantastic)

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Originally Posted by Nemo1934 View Post
I could see email as appropriate for a supplement to traditional psychodynamic therapy, but how would that kind of therapy even work in that medium?
This is my concern

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Originally Posted by Mopey View Post
Yes, I think it’s worth a try too, LBD, with the understanding that that’s what you’re doing, trying it out. Her seeming reluctance to address strong feelings directly bothers me, but that’s something you could address when you reply to her.
I might suggest a short trial (even a couple of weeks) initially to get a feel for whether this is likely to work (i.e., will she answer all of my points if this is a formal replacement for a therapy session).
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Default May 20, 2019 at 04:15 AM
  #9
Quote:
Originally Posted by Nemo1934 View Post
This seems strange to me. I have a very tough time talking in person with T, but can also communicate very well in writing. Long story short, I believe my T is trying to urge me to bridge my writing ability into verbal ability by some things she's done recently. This makes more sense to me than to just tell someone that they aren't ready to do talk therapy and try to work via email. I could see email as appropriate for a supplement to traditional psychodynamic therapy, but how would that kind of therapy even work in that medium?
When I started in treatment I was almost completely nonverbal in talk sessions. No one could get anything out of me. Then after a terrible session with my psychiatrist, I wrote him an essay. I shared with him some of my history I could never speak. Writing became my key vehicle for communication with him. He understood early on that if he was going to get anything meaningful out of me it was going to be in written form. Over time, my trust grew and I allowed him to nudge me toward becoming more and more verbal. Finally, I made a breakthrough and was able to tell him about a traumatic event that had happened in between sessions, almost in real time. He calls it the session where "I found my voice" That moment changed my life. I even wrote a book about that journey with him.

You aren't alone. Keep writing and keep allowing yourself to be nudged in the direction of being verbal. The key is trust. You will find your voice.
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Default May 20, 2019 at 06:33 AM
  #10
This was in person, but I told one of my Ts (psychoanalyst) upfront, after a couple sessions, that I did not like his minimally responsive style and I wanted him to contribute more to earn my money. I made it very clear that I would not continue to see him with that style and he did change it. It is definitely trickier in email but maybe you could always highlight the questions you want to be responded, like bold or underlie, and emphasize at the end of the email that you want answers to those points. And if she still does not address them, you can refer back and say that you are seeking her help to provide her professional input, otherwise what for. Even if you are a low-cost client, the T still gets something and is supposed to provide for it, a client does not need to adapt to a Ts preferences completely. Being assertive like that might even boost your self-esteem a bit
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Default May 20, 2019 at 07:36 AM
  #11
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Originally Posted by sheltiemom2007 View Post
When I started in treatment I was almost completely nonverbal in talk sessions. No one could get anything out of me. Then after a terrible session with my psychiatrist, I wrote him an essay. I shared with him some of my history I could never speak. Writing became my key vehicle for communication with him. He understood early on that if he was going to get anything meaningful out of me it was going to be in written form. Over time, my trust grew and I allowed him to nudge me toward becoming more and more verbal. Finally, I made a breakthrough and was able to tell him about a traumatic event that had happened in between sessions, almost in real time. He calls it the session where "I found my voice" That moment changed my life. I even wrote a book about that journey with him.


You aren't alone. Keep writing and keep allowing yourself to be nudged in the direction of being verbal. The key is trust. You will find your voice.
Thanks for those words. They are encouraging.
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Default May 20, 2019 at 07:50 AM
  #12
I personally wouldn't do it. That doesn't sound like therapy. There is no dialogue, no give and take, no interaction really. Sounds like an easy way for her to earn her fee without really doing anything.
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Default May 31, 2019 at 11:46 AM
  #13
Quote:
Originally Posted by ArtleyWilkins View Post
I personally wouldn't do it. That doesn't sound like therapy. There is no dialogue, no give and take, no interaction really. Sounds like an easy way for her to earn her fee without really doing anything.
Totally agree. Not safe either
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