Is what I want from therapy non-existant?

[Tam]

Hello guys,

This is my first post so maybe it's not in the right place, but wondered if anyone had any ideas that could help me.

I've just spent a fair bit of time and even more money trying to find a therapist. So far I've seen four different people in the space of a few weeks and I've ended up thinking that either there is something so major wrong with me that I'm totally off the planet as far as getting help is concerned, or that what I'm looking for isn't possible in therapy.

Been in and out of therapy most of my life (none of which has helped) and now I'm wanting to try it one more time, a kind of once and for all thing, to resolve major emotional/psychological issues. I'd decided that all the times before, I wasn't very clear in my head about what I needed from therapy (although I would have thought that that's what the therapist's job was, not mine) but this time I think I'm pretty clear about it.

To coin a cliche, I need someone to help me 'get in touch' with my feelings. To make it ok to feel whatever I feel, to help me actually feel what I feel without trying to change it or stop it or give me advice on how to not feel it, to be sympathetic and caring and totally on my side in doing this.

That's about it reallly, Doesn't seem like such a big deal when I write it out like that, but for some obscure reason the therapists I've seen don't seem to get it. (And I've been careful to go for supposedly 'person-centred' counsellors whom I would have thought would be au fait with this kind of thing.)

What I'm wondering is if this is maybe not how counsellors/therapists see their role? Or whether I'm not being clear enough, or maybe asking for too much?

Does anyone have any thoughts on this? Any comments much appreciated.

[TDM]

It's entirely possible, I think. But I think you need to remember that you only get out of therapy and counselling what you put into it. You cant walk in and expect them to wave a magic wand and say a few words and you'll be all better... ie when they give you advice, actually make an effort to follow it.

I've got more to say but don't quite know how to word it... I'll get back to you.

TDM

[Tam]

Hello TDM and thanks for the reply.

I'm going to post this as something you said brings the whole problem into focus.

I am really puzzled by your reference to a 'magic wand' and an apparent expectation on my part that the therapist will somehow instantly make be feel better.

This is the kind of comment I've been getting from the therapists themselves and the fact that you've also said it makes me wonder if what I've asked in my post somehow gives this impression without my being aware of it? (At the time of writing the post I thought I was being pretty clear and can't see how I've given that impression.)

I'd really appreciate your telling me how come you understood it that way - because if you can explain it then maybe I'll have a better idea of where I'm going wrong in what I'm trying to get across to a therapist.

Thanks

Tam

[Fluffy Flowers]

Hi Tam,

Welcome to the forum :)

I can relate somewhat to what you want from therapy. I feel no emotions (or rather, I rarely feel emotions) and when I do its a bit disasterous.

I have been through many therapists but only recently found one who was actually capable of helping me t any degree. She was a CBT (Cognitive Behavioural Therapy) specialist and she was also trained in DBT (Dialectic Behavioural Therapy).

I'm first of all wondering what it was that made you try so many different people in such a short amount of time, and also why it was you didn't feel able to go back to them? That's not a critism or anything (if someone said that to me I would probably think they were being critical), but it may be relevant in terms of you not finding what you're looking for, and also how people perceive you (such as mentioning about a magic wand).

I'm also wondering if maybe you're looking in a way that doesn't work for you. For example, you seem to have focused on one type of therapy, but maybe a different type of therapy might be more beneficial for you. Equally, I've come to realise that the type of therapy doesn't matter as much as 'clicking' with your therapist, so it might be worth trying to look for a therapist you feel able to work with, as opposed to a particular type of therapy.

I'm just throwing ideas around here :)

Having read what you wrote, some of what you said does sound similar to me and I wonder if maybe you feel you are communicating with them, but they are experiencing something different, and hearing something different from what you think you are saying. Again, that's not a critism, that can be down to you (such as struggling with communicating), and equally, that can be down to the therapist (such as their expectations of what you might say, their own baggage, not listening properly, etc).

I hope we can help you on your journey to finding someone who can help you, and also support you, if you want, as you walk further down that journey with them :)

Take care

Fluff x

[Tam]

Thanks Fluff (I like the name!)

What you say makes a lot of sense. I suppose the reason I've seen so many in such a short space of time is that I haven't had that sense of 'clicking' that you're talking about.

In fact I saw the first therapist several weeks ago and got the impression she did more or less understand what I was rabbiting on about - but the next time I saw her (four weeks later after her holidays) it was quite clear she hadn't got it at all (apart from the fact that the moment I got there I was met with quite a strong criticism - real, not imagined, which even though I brought it up and it got discussed, didn't help the trust/safety issues.) I felt so bad at the end of the session, totally misunderstood like I'd been talking on and on and getting responses that didn't seem to relate to what I was talking about at all, that by the time I got home and thought about it I realized it wasn't going to help me - as far as I'm concerned it's not down to me to guide and direct what happens in therapy, even if I could, it rather defeats the point of getting help from someone else in the first place!

Another therapist actually said she didn't think she could help me right from the start (this based on the phone conversation we'd had) which was really quite good of her and when I asked her what it was that led her to think that, she was decent and honest enough to say 'I don't understand what you are saying.' Only at the end of the session I made some throw away comment about how the most important thing I was after was having a caring sympathetic listener she suddenly said 'oh now I understand' and decided she could help me after all. I was left thinking - but I've been saying that for the last 45 minutes, what about it didn't she previously understand?

And another one was forcing parent/child/adult TA stuff on me - all very well and good to have a theoretical psych model from which to work, but when everything I was saying was getting comments like oh that's the child speakig, that's the parent etc etc it rather got my back up. Actually, it's ME speaking can you just relate to me as a person and leave the model fitting to write up in your notes or something.

I suppose I get really defensive about 'magic wand' comments because after all these years that's the one thing I KNOW doesn't exist, and I'm also pretty clear that no matter how helpful or caring a therapist is it's not going to make me feel better in a hurry. I can only assume that because I say I've been in and out of therapy most of my life and it hasn't helped, that they automatically assume I'm expecting some kind of instant 'cure' without bothering to check WHY therapy hasn't previously worked. Don't know.

It's interesting you mention CBT - that's the one therapy I would avoid like the plague! Not because I think it's useless or anything, just that I'm already endlessly aware of everything I think (and I mean everything) and I already have an automatic set up whereby I question everything I think and assume, seeing motives and connections and behaviour as being caused by the internal belief system. And it's constantly focusing on what I think in order to try and understand and change the negative belief system that's caused most of my problems in the first place! From what I understand of CBT, that's the approach such therapists take, and I think that hooking into a negative self-monitoring pattern would be really dangerous for me.

But DBT sounds much more effective, I don't know that much about it only what I've read on the internet (and of course where I live no such therapist exists!) Maybe you have some experience of it?

I've tended towards so-called person-centred therapists because that seemed to me to be the type of therapy (and consequently type of person who becomes such a therapist) that fitted best with what I'm looking for. But you're right, it's not what they do, it's whether you get on with them that's the important bit.

Sorry to have gone on and on - I guess it's pretty obvious that the whole thing has upset me no end. But I really do need to find someone so any comments, advice, thoughts would be really welcome.

Thanks

Tam

[Fluffy Flowers]

Hey Tam,

You haven't gone on and on, and even if you had, you don't need to apologise. If you can't do it here, when you need to, where can you do it. Talk as much as you feel the need to.

I agree that it's pretty clear that you are upset by all this, probably on many levels, and there seems to be a desperation to be heard and understood, as well as validated, and also to know that there is someone around who can help.

I think what you've said DOES show good self awareness, so I'll agree with you on that.

It does sound like communication is something that is a problem for you (not in terms of you with the problem, in terms of the two ways aspect of it), and I truly hear how frustrating it is when you're saying things the best you can and they STILL don't get it.

That is something I can really, REALLY relate to. One of the things that me and my therapist realised really early on was that I could say what was going on, and she would have a different interpretation of it, so we both thought we undertsood, but we actually understood different things, so we experimented and tried different ways of communicating with each other. What transpired for me was that if I wrote things down it was easier to communicate my point to her. We also tried drawing, which did NOT work because I got frustrated that I couldn't draw what was going on in my head.

Maybe it might be worth trying something like writing down what you want from therapy, and maybe then sharing it with people, such as on here, and we can give you our understanding of what we think you want, and could help you tweak it a bit, if necessary. At the very least maybe give you the confidence and the validation to know that you are heard and that hopefully if you share it with someone, that they too should hear what we do.

With the therapist that I found I really clicked with, it took a while to realise that click was there. I first met her during group therapy, and I found her really hard to work with, and when we were one to one (like if I'd had to leave the room or something) she was really good, but often she asked me questions and I felt stupid because I didn't know the 'right' answer.

My first experiences of her were NOT wonderfully positive, although I knew she was good at her job.

It took for me to have a complete breakdown in front of her for her to fully understand what was going on and for her to 'get' me and that was about 6 months after I started group (which I did for 3 months) and after 2 individual sessions, I think. What I'm trying to say is, that it can be hard to establish a relationship, and actually it can take time, and maybe sometimes it might be easy to act quickly and decide it won't work, whereas maybe with some time and effort on both sides, it might have the potential there.

Last summer I was super desperate for someone, anyone. I found the Counselling Directory online, and I sat and wrote an e-mail. I wrote all my problems and what I needed help with and sent the e-mail to every single therapist in my area and asked if they were willing to take me on. I got back mostly those saying I was too complex for them to help, but I got back a couple that would be willing to take me on. I then read their responses and approached the lady I thought might work bst for me. It didn't work, but it was quite an effective way to do it. Maybe, if you wrote out what you wanted from therapy, this might be a good way to do it, to 'sound out' all those therapists in your area.

I think CBT is different with every therapist. I have seen three ladies who all do CBT and they all do it differently, so I think it comes down to personality and style as to how they do it, and how useful it is for you. When I came to this third therapist I wasn't keen on CBT but actually, I never felt like I was doing CBT, I felt like we were walking a jounrey together and she was going to help me fight through this.

Maybe another way to look at CBT might be that they could help you ease your over analysing. Just a thought :)

DBT is a good therapy, but is very hard to get anywhere because it is in such high demand. It was originally designed for people with Borderline Personality Disorder and because there are just so many people who have it and not as many places on DBT courses as needed, they are often in very high demand.

It basically teaches skills that are useful to everyone and that some people learn along the way. I guess it just speeds up the process of learning.

If you could not get DBT therapy, there are places online you can do it, and teach yourself the skills, but it sounds like you need that other person contact and the support they provide right now.

I seem to have garbled on about my situations quite a lot, but I was trying to just offer different options and views on things. I apologise if its been unhelpful.

Fluff x

[TDM]

I say a magic wand because it seems to me that you've been going through therapists incredibly quickly, and yes you say it's for good reason and I can understand that. But, it can take a while to 'click' with someone, as has been said. In order for therapy to work you have to give it a chance, I think. Although I get the impression that you are trying to, I can see it from their point of view as well. Communication seems to me, to be a clear issue for you, perhaps its something you need to be upfront about? I dont know... I'm writing ideas as they come to me.

TDM

[Tam]

Thanks so much Fluff and TDM for your answers.

TDM whatever more ideas you have about it I'd welcome your comments (even if you think they might be 'critical' because as you say it's their point of view that I'm not getting here) and everything is useful for me to know.

Fluff, I'm glad you wrote about your experience with it all, that gave me a real insight. Part of my problem is not knowing how other people find therapy so it's good (and interesting!) to read how it's affected you.

By the way, ever thought of being a counsellor yourself? You read like a natural!

That is a brilliant idea about writing it all out and emailing everyone - it plain never occurred to me to do it like that, and I ended up just making a 'short list' of therapists about whom there was more than just the basic info on the directories and phoning them up - not that talking to them on the phone was much use so ended up making appointments with the ones I'd phoned as obviously it's not until you meet someone and talk to them for a decent length of time that you get any idea of what they're like.

In fact I had a bit of paper with stuff written on it to keep me on track when talking to them, but that didn't seem to make any difference! By the third one I actually typed out as best I could what I wanted, read from it, left it with them - that didn't seem to work either! Maybe I should have got them to feed back to me in their own words so to speak what they thought I was on about. Again I would have assumed they would do that anyway. It's really difficult to keep myself on track let alone try and interpret what they are saying when I'm feeling anxious and defensive in the first place.

So writing it in an email is a very good idea - that way they have time to digest and think about and formulate replies that aren't going to be so easily misinterpreted by me because of my anxiety etc. In fact it's even better because that way I could get to ask stuff like - what sort of structure would they give to the therpay, what sorts of goals and steps could they implement to address the problems etc yeah that really makes sense thanks so much for that suggestion!

That's also a good idea about posting what I've written because then people's comments would help me see whether it's totally incomprehensible, or maybe where it's not clear. I have a copy of it so will do that next post maybe.

I think you're both absolutely right about the clicking taking a while - that you've got to give it time to develop trust and things - and I'm always aware that the reason I'm going 'oh that one's no good' may well be something in me and not in them, so it's a bit of a catch-22. I guess my criteria is whether I come away feeling a bit positive, as in 'yes I think this person might be able to help me'. And as these are first sessions all talk talk talk I'd get that sense from having felt I'd been understood on at least an intellectual level.

Yeah you're right - communication, being understood IS a big deal and now that I think about what you've said I'm getting the sense that maybe that is the core of it all. Being understood. Yes. Hmm. Wow you really should be a counsellor (or maybe you are already one?) because that's suddenly drawn a lot of different confusing strands together. Not quite an epiphay, but pretty close!

Going to go away and think about that now, because maybe if instead of going into endless detail about the what and why and how mabye it would work a whole lot better if I just stuck to the surface and kept bringing everything back to that - I want to be understood. I don't feel understood. You are not understanding what I'm on about etc etc yes.

Wow that's made a big difference. Thanks so much again, that's been really helpful.

Tam

[Fluffy Flowers]

Hey Tam :)

I'm glad my experiences were of use to you :)

I'm glad I was accidently able to help you put some pieces into place. From what you said it does sound like the need to be heard and understood is very important, and that is completely understandable.

I think that focusing on that need for being heard is a good thing. If you can find a therapist who can work with your need for being heard, who can help you work on different strategies to communicate, that you feel able to say 'wait, that's not what I mean' and then try a different way of conveying it, then you may be on to a winner. If they are understanding you, and you know they are understanding you, then you might find the rest comes.

I found that when I was misunderstood I wouldn't try and correct the person, just shut down and sort of nod and agree knowing full well that wasn't what I meant. That obviously was completely ineffective because I was left feeling rejected (because she had misunderstood), misundertsood and super frustrated (with myself and her). I wonder if maybe you identifying that the reason you don't go back may be to do with you, maybe be to do with the defences that you put up when you feel unheard and misunderstood. That is purely speculation of course and I'm saying just what I'm getting from your post, but if I'm wrong then please correct me :)

If you can find a therapist who can understand the defence mechanism and welcome you correcting them, or re-explaining, and invite that from you, as well as who is someone who is good at feeding back to you about what they think you have said, then it may make working through those defences easier.

I do think that is a super important thing to communicate to any potential new therapist; i.e. what your needs are (that you need to be understood and heard and you need to know they understand and hear), what you need from them (maybe things like clarifying things, understanding that there may be communication issues and to help you work through them).

If they can understand that you have things you feel you need to work through, but that being heard and understood is just the starting point, and be willing to work from then, then it might formulate a good foundation for a therapeutic relationship.

When it comes to therapy, often the first few sessions are not like the therapy would actually be, because the therapists needs to sort of assess your situation, what you need, etc, and also you need to get to know each other a bit, which is why in some cases that click can take longer to establish. I'm wondering if maybe you base whether or not they can help you on whether or not they understood what you need from them, which might get in the way of that click? Because potentially the click could be there, but the communication issue may be blurring it because of how important it is for you.

Maybe if you enter into therapy again you could try and tell yourself you will do X amount of session with the new therapist to explore all the potential (the X being something like maybe 4, 6, 8 sessions, etc) and also to see if whether you get into it a bit more you get more positive feelings in all the regards that are important to you. That won't always be easy though, but it might be one of the harder things that is worthwhile.

It sounds like the e-mail idea could be something that could work really well for you, and I truly hope it does. If you want to post any part of that, or what you need, then please do feel free :)

Take care

Fluff x

[Tam]

Hi Fluff,

Thanks again for the long and very informative reply.

In fact yesterday I had a further appointment with one of the four original therapists (decided there was a lot of merit in giving at least someone the benefit of the doubt!) and though all the same issues are still going on, there's at least the possibility that I may get some help.

So I've agreed another three sessions to see how it goes.

In the meantime I'll store all those great suggestions and if it doesn't work out I'll start again (groan) but this time with a better idea of how to approach it.

Thanks of much for your help.

Tam

[Fluffy Flowers]

That's brilliant Tam :D I hope that you find you can work with him/her and that you do feel they give you the support and help you need. :)

[cat1]

hi Tam,i have read your post and wanted to offer you my opinion on things.Im a qualified counsellor,so know a fair bit about how counselling works.One thing you might be misunderstanding,is when you say that it is not up to you to guide the therapy.Thats where youre wrong.It IS down to the client.Therapy is client led.You go there,tell them what issues you have,and talk it through with them,using whatever method youve chosen might work for you.The counsellor does not have the answers,and they are not there to dictate where the sessions should go.Counselling is hard work,being the client,as it is you who have to do the work.In regards to your first counsellor,it was not her place to criticise you,unless she was using it to challenge you on some behaviour shes noticed from you,which should only be done once a good relationship has been established betwee you both,which it sounds like you didnt have.I dont mean this in a nasty way,but your attitude towards counselling influences the success of that counselling,along with other factors.I appreciate this first counsellor may not have been right for you,but did u try to discuss with her the fact that she didnt understand you?
In regards to the second therapist.Often it takes more than one session for a counsellor and client to establish trust and to be able to both understand what the issues are.It sounds like she didnt understand what you wanted to talk about in the counselling.Another session may have changed things around on this front.Sometimes it takes several sessions to build up trust.But i agree that rapport with the counsellor is important but not the most important thing.
In regards to the third counsellor,did u discuss your concerns with him/her? that you didnt feel the approach was helping? how many session did u have?
Maybe you could consider that your attitude to counselling may also be affecting the outcome,as well as other factors.In regards to cbt,it is not about encouraging you to engage in negative thinking patterns or analysing.Its about identifying your beliefs and behaviours that arent working for you,and working to change those.I think that approach might help you,as it seems that you are looking for something proactive to help with your issues.But whichever approach you try,bear in mind that it takes time for counselling to help sometimes,and sometimes it makes you feel worse before you feel better.And that giving a therapist several sessions gives you a fairer chance to assess if the therapy will help you.I know about overthinking,as i have ocd,so i can understand what you mean about thinking too much about things! I think that thinking about how to change your negative belief system would be very helpful to you,if you feel that this is one of your issues.good luck.


Thanks Fluff (I like the name!)

What you say makes a lot of sense. I suppose the reason I've seen so many in such a short space of time is that I haven't had that sense of 'clicking' that you're talking about.

In fact I saw the first therapist several weeks ago and got the impression she did more or less understand what I was rabbiting on about - but the next time I saw her (four weeks later after her holidays) it was quite clear she hadn't got it at all (apart from the fact that the moment I got there I was met with quite a strong criticism - real, not imagined, which even though I brought it up and it got discussed, didn't help the trust/safety issues.) I felt so bad at the end of the session, totally misunderstood like I'd been talking on and on and getting responses that didn't seem to relate to what I was talking about at all, that by the time I got home and thought about it I realized it wasn't going to help me - as far as I'm concerned it's not down to me to guide and direct what happens in therapy, even if I could, it rather defeats the point of getting help from someone else in the first place!

Another therapist actually said she didn't think she could help me right from the start (this based on the phone conversation we'd had) which was really quite good of her and when I asked her what it was that led her to think that, she was decent and honest enough to say 'I don't understand what you are saying.' Only at the end of the session I made some throw away comment about how the most important thing I was after was having a caring sympathetic listener she suddenly said 'oh now I understand' and decided she could help me after all. I was left thinking - but I've been saying that for the last 45 minutes, what about it didn't she previously understand?

And another one was forcing parent/child/adult TA stuff on me - all very well and good to have a theoretical psych model from which to work, but when everything I was saying was getting comments like oh that's the child speakig, that's the parent etc etc it rather got my back up. Actually, it's ME speaking can you just relate to me as a person and leave the model fitting to write up in your notes or something.

I suppose I get really defensive about 'magic wand' comments because after all these years that's the one thing I KNOW doesn't exist, and I'm also pretty clear that no matter how helpful or caring a therapist is it's not going to make me feel better in a hurry. I can only assume that because I say I've been in and out of therapy most of my life and it hasn't helped, that they automatically assume I'm expecting some kind of instant 'cure' without bothering to check WHY therapy hasn't previously worked. Don't know.

It's interesting you mention CBT - that's the one therapy I would avoid like the plague! Not because I think it's useless or anything, just that I'm already endlessly aware of everything I think (and I mean everything) and I already have an automatic set up whereby I question everything I think and assume, seeing motives and connections and behaviour as being caused by the internal belief system. And it's constantly focusing on what I think in order to try and understand and change the negative belief system that's caused most of my problems in the first place! From what I understand of CBT, that's the approach such therapists take, and I think that hooking into a negative self-monitoring pattern would be really dangerous for me.

But DBT sounds much more effective, I don't know that much about it only what I've read on the internet (and of course where I live no such therapist exists!) Maybe you have some experience of it?

I've tended towards so-called person-centred therapists because that seemed to me to be the type of therapy (and consequently type of person who becomes such a therapist) that fitted best with what I'm looking for. But you're right, it's not what they do, it's whether you get on with them that's the important bit.

Sorry to have gone on and on - I guess it's pretty obvious that the whole thing has upset me no end. But I really do need to find someone so any comments, advice, thoughts would be really welcome.

Thanks

Tam

[Tam]

Hi Cat,

Posted a reply to you the other day and it seems to have disappeared. Won't repeat everything I said in it (can't remember properly to tell the truth). So just wanted to say thanks for the reply, I appreciate it.

[Jenny]

Not sure what happened to the posts (will ask Thumper if we can retrieve) but I have a log of what you wrote, so will post it here :)....



Hello Cat,

Thanks so much for your advice. Certainly things to think about there!

All I can say is that having had a lot of previous experience of therapy, therapists and the like, my instinct now is to go on whether I feel reasonably comfortable with a person right from the start. If I don't feel that, then no amount of blaming myself for how the therapy works or doesn't work can make it effective, even taking into account my own resistances and possible unrealistic expectations.

And I do have to disagree on one point you made - for someone like me who has an excrutiating awareness of what's going on in my head, it's absolutely imperative that a therapist be willing to get involved, take some responsibility for actively directing the work and be able to give me some sense that they have an overall understanding both of what is 'wrong' with me and how I can be helped. If I get the usual 'this time is yours, what do you want to do with it' approach, I will go around the houses forever, going over all the things I already know. I suspect I'm not the only one who wishes that therapists would be prepared to get a little more actively involved in the work.

I read in another post that you are looking to set up in private practice. Wanted to post there about the advertising thing - just thought it might be useful to say that when I am looking for a therapist privately, the more information I can find on them the better, and those who have a website are the ones I gravitate towards. (Now that's probably enough to convince you against such an idea!) But best wishes for it all the same.

[cat1]

Hi Tam,thanks for ur reply.
I agree that being comfortable with the counsellor is very important,but it is also important that if u do feel comfortable with them,to give it several sessions before deciding if the therapy is starting to help you,as some therapeutic techniques take longer to work than others.It is not about blaming either yourself or the therapist,its about having realistic expectations of what therapy can and cant do.

I think that maybe you misunderstood what I said.I didnt say that the counsellors job was to sit there and say nothing,they are there to help implement techniques such as cbt,if that is the approach they use.But whatever approach they use,it is still YOU who has to do the work.Theyre only there to guide you.It is also you who directs what you discuss,and where the therapy goes.I think that you need to understand that,in order to get more out of any future counselling.Counsellors are not able to solve your problems for you or give you any advice,theyre not allowed.No,i agree that person centred counselling may not be right for you,as that requires no practical techniques carried out by the counsellor.The aim of cbt is for the client to learn to use the techniques,and then you will be given 'homework' which you have to do by yourself.Then at the end of therapy,you go away and carry on using the techniques yourself.



Not sure what happened to the posts (will ask Thumper if we can retrieve) but I have a log of what you wrote, so will post it here :)....



Hello Cat,

Thanks so much for your advice. Certainly things to think about there!

All I can say is that having had a lot of previous experience of therapy, therapists and the like, my instinct now is to go on whether I feel reasonably comfortable with a person right from the start. If I don't feel that, then no amount of blaming myself for how the therapy works or doesn't work can make it effective, even taking into account my own resistances and possible unrealistic expectations.

And I do have to disagree on one point you made - for someone like me who has an excrutiating awareness of what's going on in my head, it's absolutely imperative that a therapist be willing to get involved, take some responsibility for actively directing the work and be able to give me some sense that they have an overall understanding both of what is 'wrong' with me and how I can be helped. If I get the usual 'this time is yours, what do you want to do with it' approach, I will go around the houses forever, going over all the things I already know. I suspect I'm not the only one who wishes that therapists would be prepared to get a little more actively involved in the work.

I read in another post that you are looking to set up in private practice. Wanted to post there about the advertising thing - just thought it might be useful to say that when I am looking for a therapist privately, the more information I can find on them the better, and those who have a website are the ones I gravitate towards. (Now that's probably enough to convince you against such an idea!) But best wishes for it all the same.