First, I'd like to say that this is an incredible blog, and this particular post (I've only skimmed the others as yet) has a wonderful depth for something so short.

Second, I'm not saying much, because god am I tired, & I don't want to encourage my insomnia yet another night.

Finally, I think the truth here is in the middle of the gray area. There certainly are bad therapists, and vulnerable patients in their hands certainly can come out the worse for it. Anyone who holds too rigidly to a psychiatric or psychological orthodoxy of any sort would be (I think) in the "bad therapist" category. But much of the "fetishization of childhood" that is so prominent in stereotypes & caricatures of therapy (thanks largely to the popularization of Freud) is mitigated or dissolved in actual practice precisely because most therapists have the intellectual honesty not to be rigid or dogmatic in their approach, to deal with each patient as an individual in the present instead of a test case for a pet theory.

Did I say "I'm not saying much"? Oy! And hardly scratching the surface.

Finally, Part B, now that I've been lucky enough to find an effective therapist (whereas most I'd tried were bad-neutral [as opposed to bad-harmful]), I have found myself more depressed than I remember being in the past as I dig down to layers of my psyche into which I've never before penetrated. At the same time, I'm more willing & able to be in those places, & observe without running away through compulsion. In fact, much of the "more depressed" comes from the fact that I stopped drinking, & can't effectively run away from the pain.

Is this a net positive? I guess. That's what they tell me. Subjectively, I hate it, and I don't think it's ever going to end. But the objective ego I've developed so far in therapy is willing & able to hold on & see what's on the other side. If the bone doesn't set right the first time, we may have to break it again & help it heal properly. Right?

Jeffrey,
I found your comments really helpful, and wondered if you'd like to do a guest post here about your experiences in therapy -- examining what makes therapists "bad-harmful." "bad-neutral," and, finally, helpful. (Personally, I want to know more about what it means to be "bad-neutral." What puts a therapist into that category?)

Nathalie,

My immediate reaction to your questions is "Oh my god, I'm an absolute fraud, and I'm going to be found out. That's what I get for pretending that I have something to offer. Now everyone will know ..." on and on, ad nauseum.

Therapeutic relationships are like romantic relationships or family relationships in many ways. The interplay between the psyche of the analyst and the analysand, or what have you, is complex. Maybe any therapy you can walk away from is automatically not in the "bad-harmful" category. I don't know. And this deals with so many deeper issues of competing schools of therapy, professional ethics, the individual's ultimate responsibility for his/her own mental health, etc.

Would I like to explore it, suss it out, write a guest post on it? I am deeply honored that you asked, and in fact was thinking of asking you if I could guest about something. I could argue with myself all night about whether or not I'm capable of saying anything meaningful or coherent on the subject. But instead, I'll just answer ...

Yes, I'd love to. I'll have something for you in a week, if that's OK.

Some quick thoughts: you should feel free to include any insecurities (i.e., self-accusations of fraudulence) in your essay -- since self-doubt is often honest and intellectually useful -- or you can organize the post around personal experiences -- which might feel like a less "fradulent" entry point for your ideas and comments. (No matter how you organize it, though, I'd love to read about your personal experiences with different therapists and I think others would, too.)

So, anyway: I'm really, really, happy you said yes. Don't worry about making it sound formal; a casual style would also be great. And I don't care about the length: do whatever feels right.

Thanks again for leaving such smart comments, and if you have any questions while working on your post, don't hesitate getting in touch ( NathalieC at aol dot com).

Different things drive people to therapy and I think its success hinges on a combination of things - most particularly the quality of the practitioner and the patient’s willingness to confront and reconfront (and reconfront again) painful memories and feelings.

I've been lucky to never encounter a dangerously bad therapist, and far more lucky to be in the hands of a really extraordinary one, who is characterized by flexibility and a non-dogmatic approach. I started to say I was more than familiar with the neutral/bad therapist, but even as I begin to say it, I think that I must take some of the blame myself. During past attempts, I think I myself was too unwilling to do anything hard to get much more out of the process than the immediate relief of unburdening the soul.

Pain IS the cost of self-improvement - therapy is HARD. Pain in therapy springs from learning to feel things suppressed the first time around; like so many things dreaded and delayed, the backlog of sensation can hurt terribly, but also with a terrible relief. Breaking up the scar tissue is the only way to regain fluidity.

The questions you raise about self-pity and betrayal are certainly ones I've entertained myself, but I am starting to realize they are merely a stage in the therapeutic process. A certain amount of self-absorption, self pity and navel gazing is a necessary byproduct of kick starting arrested development. But as the wheels start to grind forward, you can leave these things behind, or perhaps more accurately, put them into a context where you can see how patterns are playing out in the here and now, rather than just revisiting the past.

The more time I spend on this process the more clearly I can see how I, in order to move forward, have had to dismantle not just my own history, but also language and my own set of expectations for therapy itself, in order to benefit. If I'd known how long it would take, how painful and terrifying it would be to look into a mirror in the company of another, I am not sure I would have started - or maybe I would have left after the resolution of the immediate crisis that brought me to the office.

Some days I feel like a half renovated house - I look a lot worse than when I started, and the end is not in sight, the contractors are late and more expensive than I thought, but my foundations are pretty good now. Not to beat a simile to death or anything, but ... yes I think therapy is more self aware, more adaptive, more compassionate, than many give it credit for. The trick is to stick it out. I have wanted to flee that fucking room more times than I can count, but I stay, and weep, and rip those scabs off again and again. Sometimes it seems pointless, sometimes imperative, but if I look back three years ago and then look into the here and now - there is no question it's been worth it.

I think the key to useful therapy is trust. I am seeing a phychologist these days and the single biggest reason that the sessions are effective is that I trust her in ways that I did not trust the others. Because I trust her, I am willing to go into the hard places and really look at what is there. Painful? Yes. Worth it? YES.
You are right, Jeffrey, she is not rigidly orthodox. That helps a lot. Any theory of human behavior that can be written down coherently is automatically suspect.
And NathalieC thanks for creating this site.

i have just terminated with a therapist. one day later i collapsed in a suicidal depression. all along i had heard many of her comments and tried to challenge her in the hope of working through the problem but she would not see my points. i don't know why but i stayed on. i can't write anymore it is too upsetting. i have an appointment with a psychiatrist in a few days and i dread having to tell my story because i feel like a complete fool and awful person. i wish i had been more careful and researched therapy. i am clinging to life at the moment becaue every day i wake up and think oh, my god, what have i done? what did i listen to? why did i beleive her? these were the first three years of my son's life and half of it was spent obsessed and getting no help. how do people become like this. what kind of world do we live in?