Write your own response in an advice column
Dear students:
I do a regular column for an online publication called Phantom Tollbooth:
Phantom Tollbooth
It's called ASK THE ROCK DOC: SOUND ADVICE FOR A SONG. The latest "letter" just so happens to contain issues that involve a cross between content in Chapter 9, Chapter 3 and Chapter 5 of the text, "Introduction to Psychotherapy." You job will be to draw from these chapters in formulating a response to the patient. You will try to reassure the patient, reinforce her self-esteem; identify possible hypotheses for her to entertain concering the etiology of her problems; and try to lead the client to a corrective emotional experience. You will re-directing her focus, by offering what you know to be examples of healthy object relations. You will reassure her that there are good therapists out there, and you will give her an idea of what to look for in a therapist, so she won't fall into the same trap as she did in her past untherapuetic experience.
After my reply is published in Phantom Tollbooth, you can compare your response to mine, to see if you and I are on "the same page."
I do a regular column for an online publication called Phantom Tollbooth:
Phantom Tollbooth
It's called ASK THE ROCK DOC: SOUND ADVICE FOR A SONG. The latest "letter" just so happens to contain issues that involve a cross between content in Chapter 9, Chapter 3 and Chapter 5 of the text, "Introduction to Psychotherapy." You job will be to draw from these chapters in formulating a response to the patient. You will try to reassure the patient, reinforce her self-esteem; identify possible hypotheses for her to entertain concering the etiology of her problems; and try to lead the client to a corrective emotional experience. You will re-directing her focus, by offering what you know to be examples of healthy object relations. You will reassure her that there are good therapists out there, and you will give her an idea of what to look for in a therapist, so she won't fall into the same trap as she did in her past untherapuetic experience.
After my reply is published in Phantom Tollbooth, you can compare your response to mine, to see if you and I are on "the same page."
Posted by Bruce L Thiessen Ph D at 2/8/2011 11:51 AM 
Categories: clinical assessment, diagnosis, advice column, behavioral sciences, diagnosis and treatment of mental health disorders, Brandman university, psychology of music, differential diagnosis, Dr BLT songs, diagnosis and treatment, cognitive psychology
Categories: clinical assessment, diagnosis, advice column, behavioral sciences, diagnosis and treatment of mental health disorders, Brandman university, psychology of music, differential diagnosis, Dr BLT songs, diagnosis and treatment, cognitive psychology
Dear ___________:
My name is Chantelle Montgomery. I am a professional groupie, but I’ve been called lots of names over my sexual promiscuity, and my addiction to meth. My friends call me “Wild Child” but that is mild compared to other names I’ve been called. I don’t respect myself and I’m very ashamed of my behavior. 3 years ago I became involved in a drug treatment program, and I’ve been clean ever since.
A few years back, I followed The Extremes and slept with every member of the band. I am 23 and a single mother of 3. I feel overwhelmed and depressed all of the time. My son, who is now 4, was named after his father, Hazard Duss, the lead singer of the Extremes. Hazard Duss Montgomery was taken from me on one occasion but I fought with every bone in my body to get him back. I didn’t beat him or anything, I just got caught up in partying and he ended up being neglected. I’m very ashamed and feel very guilty over that too. He now lives with me, and, thanks to some good books that have been recommended to me and a good parenting class, I think I’m becoming a pretty good mom to him.
I’ve read some of your advice column posts and I’ve decided to seek out professional therapy since I was sexually and physically abused as a child by my step-dad. But the problem is, my first experience with therapy was terrible. It was with a social worker that I met in my church. He seemed very friendly at first and acted all professional and all.
But then, we weren’t even half-way through the first session, and he started giving me advice. He was trying to solve my problems before even taking the time to understand them, or to get to know me. Then, when I mentioned my involvement with The Extremes, all he wanted to talk about was the band and their music. It was like he completely forgot that I was even there other than a source of information on the band. When he finally did get around to making me the focus, he just kept giving me all this advice-----“Make sure you read your Bible and pray every day. Be sure to keep away from the band circuit. Always make sure your son is your main priority...” It went on and on and on and he would talk down to me, like he was God and I was some street hooker. I wasn’t looking for someone to play God, you know what I’m saying? This walking God complex couldn’t take any silence either, he had to fill it up with advice. It was one long, boring lecture. Then he would say things like “You go girl!” I felt like he was trying to be a girlfriend rather than a therapist. When I wouldn’t respond to his advice the way he thought I should, he’d ask me questions over and over again, and the questions were just more advice in disguise----“Why do you think you focus on yourself and not on your son? Why do you think someone like you would have trouble accepting parental responsibilities?” Questions like this got me really mad, I mean, who does he think he is anyway. He’s never walked in my shoes, he didn’t know what it meant to be me.
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Dear Chantelle,
I want to thank you for reaching out and contacting me. It sounds like you have been through a lot and let me begin first by saying that I am sorry to hear about your past experience with your former therapist. Finding a therapist that suits you can be a challenging task, but I am glad that you are still willing to continue the search. I think that the right therapist for you is a matter of personal choice. You should be comfortable with the therapist, enough so that telling him or her that they are not addressing your needs or that you need more encouragement for example is not too scary for you. Think of the therapeutic relationship as a symbiotic one. Yes the therapist is there to help you, but you are also there to help yourself, so don’t be afraid to be clear with your therapist and perhaps conduct a few interviews over the phone or in person before you decide on one. You are on the right track and with a little time and investigation I know you’ll be able to find the right therapist.
Regarding the other concerns you mentioned in your letter I want to start off by saying that I’m really proud of you for picking up those self-help books and taking the parenting classes. It sounds like you are taking steps to being the parent you want to be and taking the time to educate yourself. I think that you are making good progress and I’d like to quote a short proverb that gives me strength during difficult times: “Every journey begins with a single step.” Journeys can be exciting, daunting, scary, and fun, but sometimes the hardest thing to do is to take that first step because it means believing in yourself, trusting yourself, and making yourself responsible for your actions. Even though it is hard, it can be equally as rewarding, and I think that you have experienced some of the rewards in your relationship with your children. I really appreciate your courage and I hope that you see that too.
Making changes can be difficult especially if you have all the good and bad experiences weighing on your thoughts. Sometimes what people say and what they think about you can also influence you, the decisions you make, and how you feel about yourself in a big way. BUT you are more than other peoples’ opinions. The labels other people place on you are just that, labels, they can be removed or replaced with other things, maybe things that you don’t mind being labeled, like ‘mom’ for instance, or even ‘wildchild’ turned ‘wise woman’. The point is that you can be who you want to be and from what you have described in your letter it seems like you know what that is.
I really hope my words have helped you in some way. I am really glad that you decided to write and I hope that you find the right therapist. I think that you’ve made a lot of progress and I would encourage you to continue on the path that you think is right for you at this time. Thanks for writing in.
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He reminded me of a male Dr. Laura----always staying on the superficial level, always rushing in to judge me before getting all the facts of getting to know me better. When I tried to talk, he would just cut me off, and meander into more moralizing. Maybe it wasn’t so much what he was saying, maybe it was the way he said it. He would flat out tell me things like, “Oh, it sounds like you’re having a pity party, well I guess it’s a step up from the kind of parties you used to throw, but this pity party is one I can’t join you in.” Everything he said or asked had this judgmental tone. And he didn’t believe I came into the session with any insight or all. There were actually things I thought I was doing right with my son, for example, but he wasn’t interested in what I was already doing that was working. He assumed I was a complete and utter failure.
To try to cope with all of this, I resorted to something I used to do with dominating, control freaks I used to date. I’d flirt with them. Getting their sexual attention always seemed preferable to getting judged and looked down upon. And, do you know what happened, he went along with the flirting. When I said, “I can see you work out,” he came right back with, “And it’s obvious you do, that’s one of the first things I noticed about you when you came in, and I like the way you dress. I never understood why some women try to cover up their legs. My philosophy has always been, “If you’ve got it, flaunt it.”
Needless to say, I never came back to see this idiot. I’ve been shopping for a new therapist, but now I’m afraid. Will he find out about my past, and begin to see me as his future one-night stand----a way of getting some cheap sex? Will he think I’m some kind of nut job and have me committed to a mental ward? Will he rush in and get too personal, causing me to lose control of my emotions to the point where I get suicidal? Will I leave the sessions feeling more hopeless than ever? Will he see me as someone to take advantage of----some weak woman who needs a man to control her? Will he spread vicious rumors about me? Will he lead me to the point where I feel vulnerable, and then leave me hanging or drop me as a client? Maybe he’ll be totally out of his league, and inept----relying on clichés and quick advice that doesn’t match me or my life? I want to be taken seriously. I don’t want to be just some statistic. I don’t want to be misunderstood. I keep thinking of that song from the seventies, “Oh Lord, please don’t let me be misunderstood…” I’ve rambled on and on. People say I talk too much. I hope you can help. I’ve been praying too, but that doesn’t seem to get me anywhere. God must be mad at me. I’m not sure if he even still considers me his child. I’m like the prodigal daughter that is afraid to come back home. I’ve gone forward on the past 5 or 6 altar calls at my church, but I never quite feel like God wants me. Help. Please help. I’m desperate for answers.
Miss Understood
Dear Miss Understood
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Dear Miss Understood,
What I hear you saying is that you felt misunderstood and judged by this therapist you saw and it is understandable that you would feel that way. I also hear that you really want to be a better mother to your son and work toward a stronger relationship with him and your other children. It is a sign of strength that you are willing to seek therapy to resolve issues from your past in order to build a better future for you and your children, so you should feel comforted by the fact that you are even on the road to changing behaviors. Not all therapists are alike and it sounds like you went to one who didn't take the time to really get to hear who you are and what has made you the person you find yourself to be today. He was judgmental and quick to assume about you and the right therapist for you will be someone who listens to your story and works WITH YOU to come up with better solutions that fit your current lifestyle and way of being. You are a caring person and want to help make things right between you and your children so through working with a therapist who earns your trust and works alongside you to uncover issues from your past, you will better be able to understand how your past relations and events that you were involved in have molded and shaped a lot of your behaviors you find yourself in today. With a better understanding of uncovering these past experiences, you will be able to move forward past the behaviors you want to change, into a place of much healthier choices that will only serve to benefit you, your children and the life you hope to build for all of you in the years to come. It is a very powerful part of life to understand that what has happened to us in the past has a huge impact on what we are doing in the present and how we perceive ourselves in relation to what happened to us in the past and who we've known. The therapist will work with you to establish what each of these past relationships meant to you, what happened during each realtionship and what effects have occurred in you later in result of what happened to you in the past. Gaining a deeper understanding of this will help you decipher what events have contributed to your present behaviors and low self esteem and therefore you can start to rectify what needs to change and where you want to make things better. The therapist should walk with you carefully as you begin to explore the sexual abuse in your past, which seems to be linked to current sexual behaviors you feel uncomfortable with in relation to others and how you perceive yourself in moments where sexuality can be used as a tool to gain control. This is understandable and should be worked with and accepted gently by the therapist who will help you heal from your past sexual abuse in orders o feel more confident and secure with your sexuality and womanhood in the present, so as to make you feel more secure in yourself and less insecure and self-doubting, especially in the presence men.
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DEAR Chantelle :
It is truly obvious that you have had some disturbing interactions with a seemingly unprofessional therapist. Not only did the therapist break all the keys to being a good therapist, he additionally seemed to make sexual comments directed at you, which may be reason for filing a formal complaint. Anyway, I would venture to state that this therapist is not the norm, and other, good therapist do exist out there, it is just a matter of getting connected to the right one who can help you along your journey. As far as giving you advise based on the limit knowledge I have of your circumstances, I would say it would be beneficial to seek help from another therapist or a support group or church of some sort that fits with your spiritual faith. I find that many have experienced (myself included) what some have called religious abuse from a pastor or priest or parent which has the potential to carry over into many other areas of life such as ones self esteem or relationship with other people. I believe ones relationship to God is a personal and spiritual matter and one should not allow other people to command them in how to go about this process, but one should also take initiative and read some spiritual texts on the matter such as the bible or other texts in order to seriously explore the matter.
With that being said I believe every one is in some sense, a child of God and it could benefit you to seek out this more thoroughly. It may benifit you to seek a therapist with a similar spiritual orientation but who displays humanistic or person centendered characteristics like unconditional positive regard. You have to shop around till you find the right one for you but thats all i can suggest to you.
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Dear Miss Understood, You have brought several heart felt issues into the open and that takes tremendous courage. The most serious one is the unfair treatment and ethical issues by the social worker, the actions of promiscuity, and feelings of hopelessness. Regarding the ethical issues of the social worker. A therapist or social worker must follow restrict guidelines of Code of Ethical Conduct, and the inappropriate behavior of this social worker surely has crossed the lines of these standards. A therapist should never discuss or direct their personal judgment toward the client. Personal comments, such as how fit you are and how nice you look in a dress, is inappropriate. Further, the client's feeling should not be discounted by the therapist but should be acknowledged. A therapist should avoid all assumption about the client's feeling and/or resolution to solving the client's problems too readily. They should take the effort to calmly discuss the important issues and make sure that the client's needs are being understood. A good therapist will listen actively and not interject with their personal presumption that they know the answers before hand. On the other hand, the therapist can be seen as a friend but only as an therapist capacity that will support the client in helping them to make changes in the lifestyle or thinking skills. As for the promiscuity, you open yourself to numerous sexually transmitted diseases. The hopelessness that you are feeling during therapy session is a natural fear. The client that is new to therapy sessions often has feelings of apprehension, and that's ok too. You might want to ask or think about the following three questions, they will prepare you for the next time you try to enter a therapy session. "How will I (the client) be treated?" How will I be viewed?" and "Will I like the outcome?" These are legitimate questions that all clients feel and should be discussed during the first or so therapy sessions. Further, you have taken the first positive steps in changing the way you see things. Not every therapist or social worker will have the unethical perspective that you have experienced. Not every therapist-client relationship will work out. Keeping trying, you have a right to choose the right therapist that fits your personality or needs. Don't give up, keep seeking advice from a professional licensed therapist.
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Dear Miss Understood,
First of all, I think that you deserve a big congratulations here! You were able to recognize that some things were not working for you in your old life, and have taken measures to change those things. That is not easy to do, and you should feel proud of yourself for having the inner strength to perpetuate positive change in your life.
Everybody has past experiences that they are not proud of. This is not something to feel shame about but rather something to look at as a platform for change on the journey to become the best possible versions of ourselves. Life does not come with an instruction manual. We make the best choices in the circumstances that we are thrown into, learn from them, and adjust our lives accordingly.
It is truly horrible that you have experienced abuse from your step father. It was likely that abuse that caused you to devalue yourself and your sexuality, and consequently led to you making life choices that have caused you unhappiness, confusion, and low self-esteem. Abuse is something that takes a lifetime to recover from emotionally, and a trained therapist that you have a meaningful connection with can be indispensable in your healing process.
With that said, I think that it would be beneficial to you to seek out a new therapist. Unfortunately, as you have already discovered, there are some not so great therapists out there, but keep looking because there are also many really amazing ones! You mentioned that you are currently "shopping" for a new therapist and that is a very wise way of looking at it. Take care in the selection process and do not feel bad for trying out a few before you find one that fits.
I would suggest trying a female therapist this time, and also asking around to see if any friends can refer you to someone that they might have liked. Always make sure that they have obtained the proper education from a regionally accredited school, and that they hold a license to practice therapy.
Good luck on your journey, and remember to always be kind to yourself!
Sincerely,
Tanya Jackendoff
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I can totally understand why you are apprehensive and why you do not want to continue or go back to therapy. I think that you will need to find that “perfect” therapist out there for you and it might take time but you will find someone that you are comfortable with. I would maybe try a woman therapist instead of a man that you feel like you can manipulate. Also you are not alone in all your fears that you have many many people have the same ones. It also is not wrong to have these fears it is very normal. You are opening up about yourself and relying on this person to not judge you or tell anyone else. Just to let you know all therapists have ethical codes and legal obligations that they need to up heal if they break any of these they can loose their license and their practice. I hope that gives you a little more piece of mind. Therapists can also make mistakes they are human after all. If you feel uncomfortable about something let them know. If you do not like the way they are doing therapy then leave you do not have to see them if you do not want to. This is supposed to make you feel better and help you understand yourself and what you want out of life. It sounds like to me you know what you want and you are trying to get there with your son. Let me know if I can help you with anything else.
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Dear Ms. Chantelle, Firstly, I think you should congratulate yourself for the good you are doing in your life right now—for you and your son. You’ve made mistakes, but you are a brave person and you are facing your responsibilities. That is to be commended. Secondly, I am more than sorry that you had to go through all that with your therapist. He obviously forgot two important things in being a good therapist: “Will the therapist share my values and will the therapist understand my problem”. Obviously by talking about the band and forgetting about you, he was forgetting to really listen to you and wow, it’s not his therapy session! Another thought, his reference to reading the bible—is he assuming you read the bible? If not, he is forcing his beliefs on you—not a good sign. I guess that would actually be a part of competence. I say this because he wasn’t listening, he didn’t know you, and he was giving out advice before he knew what the problem was. Also he acted in appropriate in regards to conversation with you. I realize he was not a good therapist, but there really are some good ones out there who are competent, who listen, who don’t give out advice so freely, and who want to help you. Look for those things. If we were to look at your problems, let’s say just to think about their origin—it may actually come down to one or two ideas. One idea could be “poor choices”; another idea might be “being in the wrong place at the wrong time”. Just think about those ideas in your mind and ponder them for a while—see how that feels. Whatever idea makes sense to you may help you to understand why things haven’t gone so well for you in the past. (Very important to say, “In the past”)
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Dear Miss Understood,
I admire your courage and tenacity in considering a search for a new therapist. To help you embark on this endeavor, I will list some qualities that a good therapist will exhibit. Overall, good therapists LISTEN and focus on the client. By listening, therapists gradually come to a better understanding of the client. That still does not grant them omniscience in making an authoritative judgment on the overall picture of the client’s life. Non-listening therapists also are tempted to solve the problem before understanding the problem. No therapist can always identify key issues in the first session. Good therapists do not engage in “friendship chatting” advice giving, and commenting on the client’s personal appearance. Therapeutic issues need to be the focus to promote progress. Also, good therapists know that silence is okay. Clients need time to reflect on what has been said. Therapists are human beings who also encounter problems throughout life. However, healthy therapists are also aware of how their own difficulties may be impacting their performance as a therapist.
Now, we’ll examine some of the fears you have about therapy. After successfully connecting with a good therapist, you will be respected and treated as a person of value. Your problem will be taken seriously and your values respected and incorporated into the goals you wish to accomplish. Confidentiality will always be implemented and you will not be exploited in any way. You will be accepted as a person of great worth and may even learn to be more forgiving of yourself in the process. Also, throughout therapy, you may gradually feel safe enough with the therapist to risk the vulnerable, spontaneous parts of yourself. If this involves losing control of your emotions, you will be supported by the therapist to address that fear.
If I were an Object Relations therapist, I may hypothesize that your search for gratification from men may be a result of having internalized your “lost” step-father and relating to others as if they were him. You may be trying now to re-identify with the current “object” (man) by attempting to control it (projective identification). This defense mechanism may be influencing the other person to behave in a manner consistent with the feelings projected onto him (having sex). However, the internalized object relations pattern does not bring gratification. Therapy would consist of you developing a “transitional object” – something that may be treated as if it were the parent your step-dad should have been. This "transitional object" will then fulfill the nurturing role that you are searching for. I sense that you wish to be reassured that you are still God’s child. Perhaps we will look at Him fulfilling that role. Then, when your need for attachment, individuation and growth are met (“holding relationship” is in place), we will re-evaluate your emotional state to see if your depression has been altered.
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Part One, of Two Part Response
Dear Ms. Montgomery,
My name is Mark Pfost. I am currently in the process of completing the curriculum towards licensure by the state of California as a therapist. Your letter has been referred to me to provide any relevant response which may be useful for you.
First and foremost Ms. Montgomery, I would like to point out, as you yourself tried to bring to the attention of your previous therapist, you have made significant strides towards positive goals! While it may be true, as you present, that you feel there have been choices you made in the past which you would do differently, it is important to accept that positive changes are not only possible – you have been, and are already making them! In addition to the progress you have made through the substance abuse program, there have been the benefits you gained from your work with the self-help books. Such benefits come about through your own choices and labor. Adding to the realistic situation is the fact that you have made the choice to find out if further progress could be gained through therapy.
The search you have before you, of finding a worthwhile therapist, can be facilitated by allowing appropriate organizations to assist. The American Association of Marriage and Family Therapists (AAMFT) is a good place to start. Additionally, they will be able to direct you to the association for your state. Local references for therapist available to you in your area can then be compiled. As for what you should be looking for in a competent therapist, let us agree that you have been given a good list of issues to evaluate the worth of your next therapist by the failures of your previous one! One thing is certain, if there are any questions you have, such as you raise in your letter, ask your new therapist about them at the initial session. He or she should be able to answer the individual questions to your satisfaction. This interaction will also give both you and the therapist good opportunity to discuss issues that are important to you, because that is what you will ultimately be looking for in a competent professional: Does he or she discuss with you the goals that you seek via the therapeutic sessions.
One related significant factor is the recognition on your part that you are in charge of your decisions, and that the therapist is not your boss. For example, just as you have mentioned striving toward being a good mother to your son, some of your earlier efforts included more directed supervision for your emerging son, progression on his part towards being a person requires the shift in relation. So also will it become apparent that, while you and the therapist may eventually look at relationships you have gone through, early on with family members, as well as will others, the bottom line remains that you are in charge of your decisions.
(Response continued in next part)
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Part Two, of Two-Part Response
In summary, I would encourage you to stay focused on the growth that you have already made such progress towards. As you mention your efforts each week at your church, you might ask one of the members if there are any spiritual guidance counselors available through your church. This could be a valuable function in addition to your new therapist. Should you have any further questions please contact this publication. I hope that at least some of the input I have provided proves of assistance to you.
Respectfully,
Mark C. Pfost.
California Association of Marriage and Family Therapists
Member #: 100828
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Miss Understood,
Thank you for reaching out and sharing your story. This was probably a hard thing for you to do because someone you thought you could trust to share your life story failed you. I am glad to see that deep down you believe that there are good therapist our there. Your previous counselor had issues that prevented him from being able to deal with your issues. He made judgments and decisions about you and that affected his ability to hear what you had to say and prevented him from being open enough to assist you. I hope you find encouragement in these words and that they will help you to see that there are people in this world that care and will listen without you having to fall back into old patterns to get their attention.
You have a lot of issues you are dealing with but nothing that cannot be overcome with dedication and hard work. When I read this letter it seems that the situation of having your son taken away was a huge turning point for you. You turned a very negative situation into a positive. You reached out and found others who suggested books and courses. You are reading the books and taking parenting classes. That is something you should be very proud of. You have made a decision that will positively affect you and your children by giving yourself and you children a new chance at life.
I hear the voice of a strong woman looking to change who she is and how people view her. You had a trying childhood dealing with abuse from a family member. This led you to find comfort in being a “wild child” and taking on the mannerisms that your family probably disliked. Now you see a bigger picture because of your children and are ready to change the focus off of your childhood and re-direct it to who you want to be as an adult, mother and woman.
There are wonderful therapists out there. Find one that you feel you can be yourself around. If you feel they are not interested in focusing on helping you and focus more on whom you used to hang out with, don’t feel obligated to stay. Ask questions and don’t fear setting your on course of discovery. You deserve a second chance. Have faith again in what you believe in. Trust in yourself, your family and your faith.
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