Last week John Grohol posted 10 Secrets Your Therapist Won’t Tell You. For whatever the reason, I seem to feel compelled to respond when I read these kinds of posts. So here goes with this one:
1. I honestly don’t know whether I can help you or not.
Of course this is true. Because whether or not the work we do will help a given person depends on both of us. I have no magic, no guaranteed solutions. What we do works through our relationship and the willingness of the patient to do her part of the work -- reflecting on sessions, acting on insights, be willing to show up and to say what comes to mind.
Also of course, I wouldn't keep doing this work if I did not believe that I can work with most people with most problems. But I also know my limits -- so I don't work with children or couples, for example.
2. I’m not your friend, but I want you to open up to me anyway.
This is also true. And opening up in therapy is not the same as opening up to even the closest friend. Because I won't tell you what to do and I won't expect for you to listen as I open up to you either. The basic rule of therapy is to say whatever comes to mind. Friends are not so tolerant of that kind of talking, nor should they be. Friendship is mutual and reciprocal. Therapy is a whole different thing.
3. If you ask to see your chart, I’ll probably give you a hard time about it.
I disagree here. I would ask about what the desire to see it is about, because I am certain that is more important than what is or isn't in what notes I keep. And I would suggest that we talk about that first. But my notes are minimal so there would not be much for my patient to see. If, however, she still wanted to after we talked about why, I would agree.
4. I’m not supposed to give you advice, but I will anyway.
I make suggestions -- like writing down dreams, sometimes about keeping a journal. But I don't advise patients about what to do. I don't because those decisions are about my patient's life, not mine, and any decisions made need to come from him or her. I may ask questions that help sort out their options, but I don't give solutions.
5. This is probably going to hurt, but I may not tell you that up-front.
It is not my experience that patients expect therapy to be painless. I do sometimes say that things may well seem t become worse before they become better.
6. My graduate degree probably doesn’t matter much; neither does where I graduated from.
When someone asks, I tell them where my degrees are from and what my field of study was. And I also tell them that my theoretical orientation is more important for me than for them. There are people who seek me out specifically because I am a Jungian. Usually they have already done some reading in Jung and so we have a bit of vocabulary in common. But it isn't necessary and it is one of my tasks to put what I see into language they can understand and use.
7. If I’m pushing a particular brand of medication, you can likely thank a pharmaceutical company.
It is not my job to recommend medications. If asked or if I believe it useful, I will make a referral to a psychiatrist.
8. I work for you, but battle your insurance company to get paid.
This one is easy -- it is absolutely not true for me because I do not accept third party payment. I don't ever have to battle insurance companies for payment for my work with patients nor send them reports of what we are doing.
9. I will give you a diagnosis whether you need one or not.
See #8. No third party payment and attendant requirements, like assigning a diagnosis.
10. I love my job, but hate the long hours, client’s often-slow progress, and the difficulty in being understood as a profession.
I do love my job.
I have my practice set up so that I don't have long hours -- I know my limits and I stay within them. For me, 15-18 patient hours in a week is my maximum.
I do long term work so I don't expect progress to be rapid. It takes as long as it takes. It isn't for me to set the psyche's pace.
I determined a long time ago that I needn't take personally how my profession is understood.
There you go. Ten secrets that aren't really secrets with me.