Please find the first part here.
Pressure and ignoring your feelings
Working through negative periods is not an easy task in itself, and it is completely unacceptable for the therapist to become a source of additional discomfort and negative emotions.
Impugning your feelings, judgments about you or others, inappropriate jokes, and sarcasm, ridiculing, a passive-aggressive tone, inattention, neglecting and ignoring requests, a condescending attitude, lack of flexibility and empathy, judging or trying to impose “right” views on life are all provide good food for thought about the need to change doctors and a reason to abandon further interaction immediately.
Disturbing the context
The other extreme is the therapist, who tries to artificially neutralize difficult moments and solve problems for you, that is, they go beyond analysis and counseling to become an “adviser”. Imperative instructions, imposing your vision of the situation, attempts to control your actions and manage the course of events, ready answers to questions instead of joint reflection are evidence of incompetence. Another unacceptable situation is such behavior of the psychotherapist when you start to try to please him, to deserve encouragement and approval.
The professional community has developed protocols for psychotherapeutic interaction for almost all cases – for example, there are guidelines for working with acute stress, guidelines for working with LGBTQ+ clients, protocols for working with chronic depression, or for helping patients with breast cancer. A competent psychotherapist follows appropriate protocols and ethical principles, and “manual control” of the client’s life is not part of them.
Problems with discipline, respect, and ethics
This point may seem obvious, but due to the lack of uniform standards and regulatory mechanisms, in a huge number of cases psychotherapists fail to comply with the basic rules of professional (and sometimes purely human) ethics and norms of interaction. You are perfectly reasonable if you do not tolerate tardiness, disrespect for your time and efforts, indiscipline, or breaches of confidentiality. Simply put, on your “journey” to healing, the therapist is a travel guide who should not only help you get to your destination in one piece but also not break the “safety rules” themselves in the first place.
Being indifferent to your needs and breaking agreements is also a reason to end the relationship and see another professional. It is clear that force majeure can happen to everyone, and it makes sense to be guided by common sense and look for compromises. However, eight cases out of ten are not force majeure, but a pattern worth making conclusions about.
Psychotherapy can well be a source of negative emotions and unpleasant experiences. Often the way to solve a problem is through a “traumatic” period, dissecting fears and complexes and re-experiencing the situations that, in fact, made one seek help. This is not the most pleasant process, but understanding the goal and algorithm of actions together with professional “accompaniment” compensates for the painfulness of the experience.
It is important that “storms” do not drag on and do not turn into a leitmotif of your meetings with the therapist. Psychotherapy should not turn into a series of feats and a constant race for survival. The feeling of hopelessness of efforts, fear of telling the truth, constant anxiety and depression, and a lack of feeling of relief are reasons to conduct an audit of interaction with the therapist.
Failure to meet professional requirements
One more obvious point, a kind of checklist inside the checklist: regardless of a psychotherapy field, type and school, there is a number of conditions, violation of which makes it not worth even beginning cooperation. An obligatory requirement is a qualitative, thorough, and systemic education (confirmed by a diploma), constant advanced training, compulsory personal psychotherapy, and supervision. Participation of the specialist in international professional associations and conferences is also desirable.
Specialization in specific problems and tasks is not a prerequisite, but it usually indicates expertise, experience, and high competence in working with family relationships, addictions, or specific diagnoses.
Lack of result
If you have spent adequate time in therapy, as agreed in advance, but the intermediate goals have not been achieved, there is no positive momentum and no sense of progress, you feel that you are simply treading water – it makes sense to evaluate the effectiveness of your approach or professionalism. In successful therapy, it also happens that after a long period of work, all the resources of the specialist or method are exhausted – and it’s time to look for something new. You don’t have to be shy about discussing these situations; together (the therapist consults with his or her supervisor in such cases) you can figure out what the best course of action would be. If your doubts, negative feelings, and a feeling of crisis are ignored, it is a reason to end the interaction unilaterally.
It is important that from the very beginning of cooperation, the therapist has to inform you as much as possible about the course of therapy and possible risks. For example, the fact that at the initial stage, you may feel worse should not become a frightening surprise. The principle of the patient’s informed consent, which governs medicine, also applies to psychotherapy.
Of course, even this doubled list is not a complete list of reasons to end your “relationship” with your current specialist. However, it can give you a benchmark for understanding what can go (or has gone) wrong in your sessions. So be attentive to the therapist’s behavior and don’t be afraid to say “enough” if they start behaving unprofessionally.
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