Therapy: It’s All Part of “The Process”

It’s all “Part of the Process.”

I was completely unfamiliar with that phrase until therapist #1. After 6 months with her, I was thoroughly disgusted with the phrase. Perhaps because no one could define “The Process” in terms I could accept. This magical concept that I, a PhD trained engineer, was apparently completely ill-equipped to deal with.

<And friends and neighbors, let’s throw in the completely obligatory ” fck that” right about HERE.>

Now, I just love Behind the Couch. One of my favorite bloggers. Good stuff, lotsa references, good conversation. I’m only half way through her post on why we are not warned how difficult therapy will be, when my dear Kate got her panties in a twist over that Magical Therapist’s Phrase.

I would like to write both pros and cons of my feelings. At least, that is my intent.

Heh, alas, my intent is often hijacked by other “more urgent” intents.

God help us all.

Anyway….

BTC reports:

“I know it can be very painful, but it’s all part of the process” or “if you knew before you started would you have entered therapy?” to which the answer of course is “hell, no!” and their response is of course ” there you go then”. Cue look of smug self-satisfaction.

…and ends up remarking, “I’m being a tad factitious. ”

Ah….., no, my dear, you are not. You must have been secretly recording some therapy sessions with my first therapist. (Hmmm. Little trigger there, eh?)

<oh SO rolls eyes>

So what the fck is The Process?

Well, it is my learned opinion that The Process is some bullshit excuse for not knowing what to do beyond the next session.

I’ve tried to get some definitions…hell, I’m an engineer, give me the project plan. I want milestones. How the hell do I know if I am making any progess?

See, “process” in my field means a defined set of guidelines with clear entry criteria and exit criteria, with “progress” defined by a set of tests to be assessed. And along the way, the process itself is evaluated. If it fails to meet expectations, the process itself must be improved. Through, what might be obviously called, a Process Improvement Plan (PIP).

Process, by itself, is allowed to be crappy.

RECOGNIZE THIS!

NOTHING is perfect this first time, or the 10,045th time. But we TRY to make things better, because as imperfect humans, it is encoded in our genetic code to Make Things Better.

As long as you reevaluate the process periodically to assess how well it works, and to institute measures to make it less crappy, The Process will grow and prosper. You know, in a general sense.

But since The Process in psychotherapy (as a general rule it seems to me) has no points to assess it’s effectiveness, there can be no regular or guided improvement.

<You know, no learning useful because you fcked something else up.>

So it falls to the outliers – the therapists who can think and foresee….

If a particular therapist implements the process, it remains as is.

But the therapist who evaluates The Process while IMPLEMENTING it…and who makes ADJUSTMENTS based on the empirical results…THAT is the enlightened and considered therapist.

The one for whom The Process is not a cop out, but is a guiding light.

<rolls eyes, What is this, some campfire Kumbaya?>

Shut up Kate. You had a point of interest, and now I have a follow-on point of usefulness.

To reiterate BTC wrote…

“…if you knew before you started would you have entered therapy?”

If someone had explained both The Process and the plan of evaluation, perhaps. To weigh the pros and cons.

As my meds doc said, “You are an engineer. This is all about Pros/Cons. Risk/Rewards. View it that way.

Put that way, with a clear disclaimer of uncertainty and turmoil, and acknowledgment and admission of pain, perhaps I would. For the right end.

And thus, so spake, the engineer.

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6 Comments»

  Batesie2012 wrote @

Thank you for this post. I have been with a T for a little less than six months. It is hard to trust him and hard to have faith in a process that I cannot see. I’ve had difficulty deciding if he was really going to be “the T,” because I don’t let people in enough to truly know.

Your post helped me to know. He evaluates the process. When something doesn’t work, he shifts gears and we try something else. He asks ME what’s working and what isn’t. He makes sure the lines of communication about it all stay open, even when I don’t want them to. So, this post meant a lot. It gave me a little desperately needed faith in a T, and a process, that I haven’t really learned to trust yet.

Thanks.

  mo wrote @

oh my god what a great post!!!, I know I struggle with all that mumbo jumbo too I need concrete guidlines, points of reference and evaluations etc. Make it black and white pleeeassse. Cold hard facts and evidence or measurable results. I really struggle with not knowing what to expect, Im one of those people that plans plans plans, for things that are will definately happen. I dont do well when things are thrown at me at least in therapy. IIN the field i work in health care things get thrown at you all the time but even then there is a expected and tested actions to follow with a specific goal. I have explained this to T, she understands I think, but its one of the things about therapy that makes me so anxious and fraustrated, I need a map a very detailed one at that 🙂

  Jackie wrote @

And let’s not forget, the thrown out there phrase, during that 50 minute hour… ” you will/have researched the internet about this”. Well so what if I did/do?
Is the Travelocity Gnome with me 24/7 directing me on the internet or in my head?

No, HE is not.

I say that with confidence because I have awoke, in the middle of the night, and searched and searched and no gnome-boy.

(I have spotten, however, who (or is it whom?) I believe to be the Travelocity Gnome’s twin brother. I believe him to be directionally challenged. See my blog for his behavior towards my community.)

Anyway, I have a point. The question is am I getting to it? …..

I have slept walked, and didn’t find him .
I don’t dream, or I would have looked there too.
He’s not hiding out in my office. I’ve searched all 5 floors…even in the men’s room 😉 ok, ok, so I was window shopping, lol

And then I thought, OMgosh!

It’s got to be a Gnom-ette? or Gnom-alita? or even……

HRH, the Grand Gnom-ness!!!

(curtsy in respect , lowering head, in thoughts of wonder at the thought of her gnom-esty) lolololol, I need more sleep I think.

Then I asked myself….
How would I tell if a Gnome is male or female, self?
or I might “yo peeps in da house, check unda dat hood, at dat dare Gnome, and tell me what it be. lolololol

Then I digressed (as is MY PROCESS) How would I tell if a Gnome is single or married (Gnom-ette vs Gnom-alita.

Funny you should ask…..actually, there is a theory, hypothesis, speculation, about them, if only in my imagination. Gnomes are like clowns, in the PROCESS of trying to help you, they scare the S*%t out of ya.

  mo wrote @

So someone tell me is this part of the process ?
Saw my primary doc today, great lady she has been my doc for 18 years. Very supportive over the years. So we were discussing what been going on and before I could even go there, she said knew exactly what the problem is, she believes in DID, she thinks it explains alot for me, she said she has even had another patient with it who she has seen switch between male and female part. Now this is not part of my plan….she was supposed to support me in my quest to find some other rational explanation and order MRI ,s and the likes ****!!!!!^^^^&&. She would love some of the articles I have researched about it to help her understand it better Wtf!!!!!. So no MRI for me…and a voice in my head is screaming “that dirty rotten T…has got to her first and told her to say she believes in DID”……and Im mad too, now what, clearly Im not good at judging people, I thought she would not believe I really did, I really hoped. ah hell !

  Batesie2012 wrote @

Denial is part of the…(insert dreaded “p-word” here). I’ve believed and then not. I’ve hoped that everyone else would agree with me when I decided that none of it is real. I’ve tried to convince the very professionals (well respected by the way) who diagnosed me that they were all wrong. I’ve accepted it all and worked hard in T, and then denied it all and managed to wall myself off from all of the others for several years when the denial got that deep. So, although denial is hard and uncomfortable, it comes with the territory. And, if it helps any, the journey (I have that word too, but at least it’s not the “p-word”) is not dependent on belief. You can heal whether you are in denial or not.

Batesie2012

  Tigerweave/Anna wrote @

I am kinda befuddled by the idea that therapy is painful.

Silly me, I thought the pain was from the trauma, and that what the therapy was doing was helping me heal and process that pain that was there all along and that was so bad I had chopped my psych up into little bits so I never stumbled upon a piece of pain too overwhelming to cope with this side of suicide.

*takes big breath*

Did that make sense?

THERAPY ISN’T PAINFUL. MY past was.

And it hurts to face that pain. But therapy has given me the forum to face that pain. AND therapy has, far more importantly helped me develop skills to help me face that pain and resolve it so that ultimately that pain is *no longer there* anymore.

No pain = no cutting my psyche into little bits anymore = no fragmentation or dissociation = much easier life = HAPPINESS

Right from the moment I got therapy 8 yrs ago there was a clear improvement in how I was handling that pain, how I was functioning inside myself, and therefore how I was moving through the world in general. Not a week to week improvement, but say over two months, any two months in therapy, I was better than I was at the start of that period.

The other thing of note is there was an absence of negative results from the therapy. No sense of manipulation, no self-doubt, no hooking into my fears. Bad therapy is painful. Ugh

Looking back, what hits me the most is unnuterable relief that I was getting the help I needed.

Even when I was going through 18 months of hell when my head exploded and all the memories fell out, there was a clear improvement. Things were getting *better*

Pain? Yeah, that was my childhood. Therapy? Yeah that has saved my life. Bad therapy excused away as “Would you have done this if you had known how bad it would be? Yeah, experienced that. Walked out. Found a better therapist.

I was lucky that my first therapist was f***ing awesome. He set the bar high. I knew its power.

I have seen it in lots of people. They don’t get anything out of therapy, until they get a terrific therapist who leads them through clear, *real* improvement. Once they realise the power of therapy to help them feel a darn sight better about their lives they are there every week knocking on the therapist’s door. Pain? Yeah they go through pain, but only accessing and healing pain they were carrying around all the time already.

Was that a rant?

Meh. I am sure you can cope *grins*

Anna


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