Hello everyone, Its Dr Caroline Lloyd. Today I am going to share a bit of a personal diatribe I guess, based on my own experiences of therapy! I know that this is a bit personal, and Im not going to give you all the juicy details of my life, but I have dipped in and out of therapy on and off during my lifetime, sorting out a few issues. So I have had a bit of experience on the other side of the room, on the couch so to speak.
And I have been reflecting on what makes a good therapist - in uni we heard about 'super therapists" who seemed to have just the right combination of listening and advising, validating and challenging, care and knowledge. When I heard about this concept, I, like probably the other 30 students in the room, decided that that was going to be me, that I was going to become a supertherapist, that became my new ambition. With a little bit of reading and reflection about compassion based therapy, (which was developed by Paul Gilbert, and just recently I heard that Gabor Mate utilises this methodology) I am moving more and more away from the distant/detached psychology approach. In fact it has long been a dislike of mine, that classic psychiatrist type 'all knowing' figure who writes everything down, and just utters a knowledgeable 'hmm' every so often. And even worse, related to this, is the 'silent treatment' that some professionals use when their client is not feeling comfortable to share. In my view, it is our job to make the space comfortable enough so that the client is able to freely talk about something, even if that is the train timetables or the traffic, and then we can make the space to move on from that. I have heard about therapists who use silence as some sort of competition - and I quote one therapist I worked with who said openly " Oh I can outlast any teenager who wants to play the silent game, I have worked in prisons where we got lots of practice at that" which I thought was absolutely terrible. Yes I understand that people who are mandated to have therapy are reluctant to disclose, but surely there is a way of creating a therapeutic relationship without that punishing method. And then to insist that a teenager participate in this conflictual, combative pose, feels very punitive and awful. In fact someone close to me once went to a psychologist and felt so intimidated by this professional just looking at them, staring silently, that they were put off therapy for years. In my view, this silent waiting is almost a gaslighting technique, and creates more barriers than were there in the first place.
So these two techniques, the silent challenge and the all knowing 'hmm' couldn't be further from my style, I hope! I like to think about the session as more of a conversation than an interrogation. And it was nearly 40 years ago that I started Med school and at that time the interrogation, professional, all knowing model was very much in vogue. Things have changed a lot since then! Even in the psychiatry world.
So that's my first beef about therapy - the distant formal all knowing therapist, and the silent treatment therapist - I am pretty sure that I don't fit in to that model!
My second pet peeve about therapy sits around the concept of arguing. Now I grew up in a household that avoided conflict. There were no robust political discussions, there was no debate, no dissent, no contradiction, no playing devils advocate. Which has left me a little conflict avoidant. Now I'm not saying that this is good or bad, but how it shows up in therapy, when I am the client, and I have had some more CBT based therapy, I do find that the concept of thought challenging, is difficult for this reason. The therapist telling me that my thoughts are wrong, that I should think a different way, feels like an invitation to conflict, which feels quite threatening to me. It feels like the therapist is arguing with me and telling me to believe something I don't believe. This is the main reason that I don't gel with the CBT model of therapy - it feels like gaslighting, like my beliefs are my fault and I should just discard them and believe something thing else, which feels impossible and therefore my fault that I can't do this work. It is kind of shaming. Which is one of the reasons that I love EMDR so much as a therapeutic modality. EMDR is very accepting of where the client is at right now, and allows us to work through it together, to explore it and understand it, and then you will find their own resolution. You find your own way to a healthier, better understanding of the situation, and once the distress has resolved, the positive belief just arises out of the new understanding of the trauma. There is no need for the therapist to challenge or contradict or persuade, so there is no creation of conflict within the session.
The last thing I want to talk about, that weekly model of therapy where you go to your therapist, unpack the weeks goings on, dive in to talking about the trauma or the history, then at the end of the hour (or 50 minute hour which is the usual allotted time nowadays) you have to just finish up, say goodbye, and leave feeling like nothing has changed. It may be a relief to get a few things off your chest so to speak, but the relief is short lived and there is no lasting change. With the therapy that i have engaged in over the past years, sometimes that weekly support can be invaluable, and I don't want to diminish that, but I do believe that change is necessary for lasting releif. I heard a psychotherapist on a podcast recently say confidently that the rate of change with psychotherapy is a snails pace... which is very disheartening! But EMDR can virtually guarantee change, even in one session. With every session, something shifts, it may be a big shift, seismic, or it may be a small shift, incremental. So leaving an EMDR session, there is a sense that change has happened, something has resolved, big or small, and the trauma load has lightened, the distress has lessened, and the positive beliefs about yourself feel much more accessible, much more present and solid.
And that's another reason that I so love EMDR. So I am an EMDR therapist. This is a podcast about EMDR, so I hope you'll forgive me for just every time coming back to, uh, again and again, why I think EMDR is really the bee's knees. Anyway, I hope this has been helpful to you. I feel it's a bit self-indulgent just to complain about my own experiences of therapy.
But I hope it's a little bit helpful in helping you to understand some of the differences between standard psychotherapy and CCBT based therapies and EMDR type therapies. So I hope this has been helpful to you. I will talk to you next week. In the meantime, take good care. Bye for now.
