Saturday, 2 June 2012

A tale of two therapists

Things are winding up with New Psychologist as T's return is imminent. When I first heard she was returning I was over the moon, as you'd imagine. T had been my psychologist for three years before she left at the end of last year and if you have read some of my blog posts this year you may have picked up that New Psychologist and I didn't exactly get on like a house on fire. Although in recent weeks we seem to have managed to reach some kind of stability in our relationship... well we haven't had any more arguments and she has stopped constantly interrupting me; it didn't mean I wasn't still very happy about the prospect of going back to work with 'my T'. I've been thinking about the differences between the two in their approaches and that is what I am going to ramble about today...

The two therapists are very different in their approaches but I like aspects of both. They both have ways of working that I find really helpful. If I could take what I like from each of them and combine them into one therapist I would be flying. T is an extremely good listener. She really listens. I mean, there's listening and then there's really listening. She doesn't just try to look like she's listening, she really takes in what I'm saying to understand it and reflects it back to me in a way that makes it seem so much clearer. What goes on in the head of someone with DID is likely to be complex, so I generally don't understand it myself or if I do, don't feel capable of putting it articulately into words.  I mumble and stumble my way through attempts at trying to express what's going on in my head and T listens and gets inside there with me and we figure it out together and then she puts it into lovely words that make me look at her in awe and wonder how she 'gets' me so well. I feel understood and well, if you have DID you will know how rare and special it would be to feel understood. If you don't have DID, you may be able to appreciate how it might feel for someone who lives their life with stuff going on in it that would make the average person back away in dismay and avoid you for fear of what a crazy person like you might do to them if you told them about it all (I have learnt that lesson: some people just can't handle that kind of information).

So yeah, T understands and it's great... and that is really important for me. I can't emphasise how important that is for me. I wouldn't swap it. But at the same time, as well as being understood, I need help to change. I need actual techniques and tools used with me. I'm not saying T doesn't implement these: she does. She's been helping me move towards EMDR and I could write a list of the ways in which she has helped me (I keep meaning to do that actually). I don't really mean 'but' when I say I need techniques. I just mean, I 'also' need techniques and this is where I like New Psychologist's approach. She is all about techniques, tools and evidence based practise.

New Psychologist is not such a great listener. She certainly can be a good listener when she wants to be. Sometimes I have felt she is listening attentively, but she is also extremely analytical and sometimes I can almost hear the cogs in her brain going as she tries to analyse what I am saying before I have even gotten to the point of what I'm trying to say. That's not bad in itself except that I do feel it sometimes gets in the way of her actually hearing what it is that I'm saying. She has at times been so quick to want to tell me the meaning behind things that she hasn't actually let me finish. It's like I start to tell her something and she thinks "Ah yes, I know this one" and wants to give me the answer, but she doesn't always get it right. At best this is off putting and makes me lose my train of thought. At worst, it is infuriating. I do really, really, really like hearing insights though and being invited to hear what her analyses of things are.

T is not so open about what she's thinking. She listens, reflects and asks questions but she doesn't often give her own views. I had thought this was how all psychologists work actually, but New Psychologist doesn't work that way at all. She informs me. She says things like 'what you're saying would tend to match with what people who have experienced x, y and z tend to report'. Then she will back that up by telling me about this or that research study and how so many percent of people with this or that experience that or this and so on. I like that. It helps me to understand things better and it gives me confidence that she knows her stuff. I can also ask NP questions. I don't tend to ask T questions, mainly because she doesn't offer views really so I don't like to ask for them. NP is very keen to give her views so it's easy for me to ask her for information or views.

She also does A LOT of background reading and comes with tools and techniques that she has read about which are used for people with trauma histories, dissociation etc. She gives me practical advice on things to try. At the start this was not helpful. Remember how I was devastated about losing T and I really just needed someone to listen and tell me that they understood that I must be feeling rough? New Psychologist's approach was to do none of that but to tell me I needed to find internal resources to cope and then to suggest I try things like 'having a bath', 'watching some TV' or 'painting my nails'. I was feeling frustrated because I just wanted a listening ear and some support and besides, I felt I had been doing those things to try to cope already and found it patronising. Now that I am in a better place emotionally than I was at the start of the year, the practical techniques and things I can do myself at home to help me cope with difficulties are really helpful.

New psychologist and I have also been discussing attachment disorders and how my history and descriptions suggest that I have an attachment disorder of the disorganised variety. This is something I have been sure about for a while myself after reading a small amount about these but it's been interesting and helpful to be able to talk about it with a psychologist who can hear my descriptions and feedback her views about it. I might talk about this more in another post because I think it's also relevant in relation to my feelings about T.

Other things I have noticed about T compared to New Psychologist and vice versa are: T has an excellent memory. It amazes me how she remembers such details about me. NP's memory is not poor, she seems to have an ability to remember facts and statistics and can quote these with ease but her memory for details about me is more average. Probably still better than many but not as great as T's.

I like NP's approach to talking to alters. She directly asks if I can get a certain part to come out and I have found this helpful. T doesn't do that. Although she's made it clear that she is happy to talk to any parts, she doesn't ask for them and although I know that's probably more the advised way of doing things, it doesn't help me to let them out, given that my natural tendency is to try to hold them back and appear 'normal'.

Lastly, and I think this is a big one: T sees the best in people. You kind of learn that from talking to her. She respects me in her way of talking and relating to me without questioning what I am saying ie, if I describe a situation or incident, she goes on the basis of what I am saying being what actually happened. With NP, she hears what I'm saying but shows that she is thinking that what I am saying is only my judgement on what happened. She questions my statements and says that maybe it wasn't that way but that's just how I perceive it. This really pisses me off because I am not the kind of person to just see everything from my own perspective and I try extremely hard to always be objective and if I'm describing situations to stick with the facts or at least say that I am guessing it might be this but I could be wrong. I don't need that kind of intervention to help me be reasonable and I find this disrespectful because it seems she just assumes that I would have unrealistic perceptions or biased views. T believes whatever I say, or if she doesn't she doesn't confront me in that way. She also shows that she believes there is good in everyone. I get a sense from NP that she is more suspicious of everyone. It's like you have to earn NP's trust, whereas T is more of the view that she will trust you until you give her reason not to. I really like T's positive outlook on things.

Although I will miss NP's very intellectual approach, her shared analysis and her use of various tools and techniques which have greatly helped me manage some of the troublesome day to day aspects of DID such as flashbacks and unhealthy grounding behaviours as well as the chronic fatigue symptoms, I am looking forward to getting back together with T and the sense of a trusting relationship and respect.


Ruth said...

Glad to here that you will be getting back with T. I noticed too that my 2 therapist have very different approaches. I agree that feeling respected is huge.
Take care,

Ellen said...

Interesting. I'd agree feeling respected and trusted is huge. I wonder if part this difference might be a function of age and experience? You mentioned NP is quite young - sometimes younger people take a more intellectual approach, as they are still so close to being in school perhaps, and don't have experience on which to rely?

Good to hear you get things out of both approaches.

Anonymous said...

Can't imagine having two therapists. Realise I'm very lucky to have the therapist now- though I did fight hard for it.

Old T sounds very much like your NP- analytical, scientific- but never really understood or allowed herslef to 'get' DID.

I hope going back to your old T is helpful.


Justine said...

Hi Candycan

I'm glad too you are getting back with your T and a sense of trust and respect. I work in fostering services and Attachment Theory is something I know lots and lots about - kind of at the centre of everything we do wtih foster carers and reading your descriptions seemed to suggest a strong attachment relationship with T. How ironic though that NP was the one talking about it and bringing the theory in!
I'm so like you - I love theory, understanding things - i suppose becos I'm good at it. but relationship, attachment is much more difficult. I'm glad my own therapist is bigger on those things than theory (although she definately knows her stuff) becos I think DId for me means a plethora of traumatised child parts that need love and trust maybe more than they need theory? my teenage parts like to udnerstand things very much but it's easier to get theory and understanding from books, internet etc. Trust and an attachment relationship is not so easy to find.