Mary began seeing a new therapist at the age of 31, a time when she was dealing with major life changes and a persistent troubling false memory which frequently arose during periods of stress. Mary initially found the therapist’s female company soothing and conducive to trust. However, she soon noticed the therapist jumbling specific details about her life, such as consistently inquiring about a non-existent brother.
In the beginning, Mary excused these minor inaccuracies, attributing them to initial adjustment issues. Yet, 18 months down the line, the therapist continually fails to remember basic facts about Mary’s life, despite spending around 50 minutes on a weekly basis discussing her existence.
The therapist keeps mentioning Mary’s imaginary brother, and confusingly attributes her to “yoga”, despite her being a Pilates instructor. Even substantial aspects of Mary’s life seem to be misinterpreted by the therapist, a fact that disturbs Mary deeply.
“On multiple occasions, she has mentioned ‘when you decide to have children’, even though we’ve extensively discussed that I may choose not to, and may actually be incapable of it. She has also brought up relationship problems I’ve never mentioned – my relationship is one of the few aspects I don’t complain about,” says Mary.
This constant confusion has immensely deteriorated Mary’s confidence and trust in the therapy, causing her to contemplate quitting it. “It appears as though she’s constantly confusing me with someone else, raising the question if she’s discussing my problems with them,” Mary questions.
“If she can’t even retain basic details about me, then what’s the use? I often wonder, ‘Are my words actually heard by her? Is this therapy just a money drain, considering she fails to remember specifics about my life?’ I have started to question whether the benefits are substantial enough. What if I had spent these 18 months with another therapist, would I have experienced more progress?” Mary queries.
Even though Mary is conscious of her therapist’s errors, she grapples with the idea of highlighting them on the spot. Further complicating matters, her therapist hasn’t established routine intervals to assess the success of their joint efforts. Without these opportunities to raise any uncertainties, the responsibility is thrust upon Mary, a situation she considers distressing.
“I am aware that I ought to be more resolute in addressing things like ‘You must strive harder to recall finer details’, but I’m not naturally assertive – I don’t customarily voice my complaints – and the prospect of expressing my displeasure would likely leave me fretting the whole night. I understand it might seem irrational, but it’s akin to reacting to a disappointing haircut: you praise it, pay the bill, and then sob when you get home.”
The prospect of a dispute with the therapist could potentially intimidate a number of Irish citizens, in a country where therapeutic practices are something of a novel notion.
[ What is the process for someone to identify the appropriate therapy requirements? ]
After long years of imposed silence on the topics of trauma and mental health ailments, therapy is suddenly the talk of the town. A-list celebrities regularly discuss attending therapy sessions as a means of mental hygiene and evolution. Friends casually mention their therapy meetings while organising their social diaries.
Instagram is rife with therapists presenting presentations on complex post-traumatic stress disorder and obsessive-compulsive disorder. While some are seeking a 6ft 5in, blue-eyed man in the finance sector on dating apps, other users of these platforms overtly express their interest in those who are undergoing or have experienced long-term therapy. Participating in therapy – colloquially known as “doing the work” – is officially in vogue.
Nonetheless, as the inclination towards therapy grows amongst individuals, disagreements can emerge between the client and therapist. Often, there appears to be little apprehension about what type of conflicts can be navigated with a therapist and the method to achieve this resolution. This knowledge deficit can leave clients feeling powerless and uncertain, not merely halting their advancement but aggravating their existing mental health struggles.
At 37, Siobhán grappled with infertility for an extended period before welcoming her son through IVF. Hoping to extend her family further, she and her partner revisited the fertility clinic that proved instrumental in the birth of their first child. Owing to Siobhán’s advanced age and health condition, the IVF procedure was stringently regulated, leaving her physically drained and emotionally worn out. Still, she carried on through the challenging process, only to face heart-breaking news later.
“We initially had high hopes for our IVF treatment, but unfortunately lost 13 embryos between the third and fifth day. The disappointment was immense, as we believed we were on a promising track, with numerous alternatives and in high spirits. It felt as though all of this was abruptly ripped away.”
Siobhán was profoundly affected. The clinic suggested psychological counselling and offered the services of an in-house counsellor. Seeing the counsellor was affiliated with the Irish Fertility Counsellors Association (IFCA), Siobhán was filled with confidence. “I felt safe, presuming they would possess a certain level of expertise. But I was sorely mistaken.”
Siobhán walked into her counselling session hoping for understanding, consoling, and validation – but what she received instead was indifference, judgement, and dismissiveness.
“Being just two or three weeks post the unsuccessful IVF, I was understandably very distraught. But instead of support, I had an extremely negative encounter. They kept questioning my expectations from the session, when I thought it’d be rather clear – emotional support, empathetic listening, a reassuring perspective, and most importantly, recognition of my grief. Even though I haven’t been pregnant or lost a baby per se, we had lost all hopes and dreams that we had for our family.”
Instead, Siobhán described the counsellor as unfeeling, professionally detached, and dismissive. “I left the session feeling like I hadn’t really lost anything, and I was expected to simply move on with my life and proceed with another IVF cycle if needed.”
Siobhán felt unsupported and misunderstood after her counseling sessions, resulting in intensified feelings of unworthiness for help. This intensified her negative coping mechanisms such as overindulging in food and alcohol, causing arguments in her personal relationships, all of which she traces back to unattended grief. “In retrospect, I realise how the negativity emanating from those consultations impeded my grieving process. I felt like I was not allowed or deserved the right to grieve because of how damaging the experience with that therapist was. It was horrendous. I never took any time off and confided in no one at work; I was just striving to keep my life together, when all I needed was the space to fall apart. But that consultation offered no support or guidance at all.”
Subsequently, Emma’s therapist overlooked the gaps in Emma’s understanding, obliging her to use her sessions to define basic ideas instead of facilitating her own growth.
Philosophically, opting in for therapy is an immense act of faith, exposing yourself from a position of susceptibility and demand, as well as dedicating energy and hard-earned cash with the anticipation of obtaining professional aid and guidance.
When therapy succeeds, results can be transformative and even life-preserving – but as Siobhán experienced, when it falls short, it can also harm the well-being of the client. Or occasionally it can merely evoke a sense of irritation, making clients feel like they are squandering their resources, both temporal and emotional, in a futile attempt to enlighten therapists who are unfamiliar with their ongoing struggles.
Emma, a 32-year-old from the southeast, found herself in a post-Covid situation grappling with intense anxiety. She sought help from a therapist, but felt extremely exasperated when she discovered that she had to enlighten her therapist about the fundamental aspects of being a woman and a member of the LGBTQ+ community in today’s society.
“She professed to be a feminist, but I would argue, a rather dated one,” Emma commented. “I sensed that she was uninformed about many topics and made no effort to amend this. When I mentioned biphobia once, she responded with ‘What’s that?’ That was when I hit a brick wall.”
Notably, Emma’s therapist failed address her lack of insight, obliging Emma to use her sessions to define basic concepts rather than prioritising her personal development.
Stephen Vaughan, a certified therapist and co-founder of Mind and Body Works, a health institution with a team of over 200 therapists, believes in the continuous training and education for psychotherapists that will enable them to provide robust support to their clients. He emphasises on the importance of transparency when dealing with clients and encourages therapists to admit when they do not understand a term a client uses. Vaughan trains and supervises therapists himself, passionate about maintaining a high standard of care within his field.
Key to this is keeping up with the fast-changing terminology around sexuality and relationships. Vaughan highlights that if a therapist does not understand something – such as terms related to biphobia and homophobia – they should be honest about it with the client. Furthermore, therapists have a responsibility to educate themselves on new terms and issues, not relying solely on the client to enlighten them. They can enhance their knowledge through articles, books or training sessions. As Vaughan suggests, therapists must take the lead and seek out these resources instead of habitually demanding explanations from their clients.
Emma, a former client who experienced frustration due to a lack of understanding from her previous therapist about biphobia, has found solace with an LGBTQ-friendly therapist where she’s seen improvement. Despite her past misgivings, Emma continues to advocate for therapy, promoting its benefits to those close to her, but acknowledges that one might have to try different therapists before finding the perfect match.
“Mental health discussions are indeed difficult, especially for the older generations, such as my parents, who tend to conceal their feelings due to the stigma they associate with it,” she notes. “Many are even terrified by merely the thought of seeking assistance for their emotional wellbeing, let alone gather the courage to reattempt it after an unpleasant episode.”
She further adds, “I even have family members who strictly prefer Marks & Spencer for their sock purchases. I tell them, ‘This isn’t about socks. You must search for a therapist that you grasp and connect well with.’ One must realise the multitude of therapy forms available, only because one type doesn’t resonate with you, doesn’t mean you deny yourself the benefit of therapy completely.”
Despite therapy carrying significant importance, past poor experiences with therapists can deter people from seeking help again. Take Jenny, 29 years old, for instance. She decided to take couples counseling with her partner, despite having communication issues in their five-year relationship, one of which led to Jenny being accidentally hurt by her partner during intimate moments.
“It was highly distressing,” Jenny admitted. “On one hand, I knew he didn’t intend to hurt me, but on the other, I was terrified. I had nights where I struggled to sleep besides him due to fear, despite knowing he didn’t mean to harm me. It was essential for me to devise a method to overcome this fear and regain my sense of security with him.”
Jenny and her partner wanted their counsellor to present possible coping mechanisms for Jenny’s ordeal, strategies for them to address these issues collectively, and actions to rebuild trust and security in their relationship. Regrettably, the therapist overlooked the trauma Jenny suffered and blamed her instead, which made Jenny feel rushed, thereby undermining her experience.
Jenny talks about her challenging experience with couple’s counselling, expressing that she felt blamed and re-victimised. She recalls nights when she was unable to sleep due to distress from sessions, resulting in her taking days off work. Jenny found herself discussing the difficult counselling sessions during her personal therapy sessions.
She felt the therapist didn’t provide any guidance or support on how to process the counselling, often leaving both her and her boyfriend feeling emotionally drained and unsure on how to interact during the following days. She became so upset by the process that the couple decided to discontinue the sessions. Despite this, they intend to find another couple’s counsellor, but need time to recuperate.
Jenny admits, “At the moment, I have no desire to venture into couple’s counselling again, but that may change someday.” Her faith is partly restored by her positive experiences with her personal therapist, with whom she has been working for three years. She acknowledges finding a competent therapist is difficult, comparing it to locating a needle in a haystack.
In her view, the counsellor lacked the necessary skills to handle trauma or guide them through the turbulent time. Stephen Vaughan agrees, noting therapists should be honest about their limitations, and refer clients to others if necessary. “In instances of complex trauma or when a therapist feels out of depth, it’s their duty to suggest another professional or different therapeutic approaches,” he says.
John O’Connor, a board member of the Irish Council for Psychotherapy, advises clients to carefully choose their therapists and engage in frank conversations about their expectations.
Numerous interview subjects have voiced a variety of unfavourable therapy experiences. These experiences encompass therapists making unsolicited comments about their bodies and weight, therapists regularly cancelling sessions unwarrantedly, thwarting any progress, and therapists persistently advocating for the continuation of ineffective and non-progressive treatment, leaving the patients feeling exploited for financial gain.
A recurring obstacle is the uncertainty on whether or not they can communicate their grievances to their therapists, and the lack of confidence to do so. Stephen Vaughan asserts that it’s essential for patients to realise that they are always entitled to highlight their issues with their therapists.
Vaughan states, “Patients need not worry about safeguarding their therapist emotionally and should communicate when they feel something is amiss, or if they’ve been feeling frustrated with recent sessions, or if they sense a drift in the therapy. You’re in the power to voice your concerns and feelings.”
Vaughan further illuminates that therapy might sometimes seem challenging or make the patient uncomfortable, and embracing this discomfort can be crucial to gaining knowledge and comprehension – but encountering challenges in therapy is distinct from feeling ignored, disrespected, or injured by a therapist.
John O’Connor, a board member of the Irish Council for Psychotherapy, states that three paramount issues that could necessitate an official complaint include breaches in confidentiality, unsuitable boundaries, and therapists endorsing therapies they don’t possess sufficient training in.
He emphasises the significance of clients investigating the therapist’s training. The terms “therapist”, “counsellor”, and “psychotherapist” currently lack legal protection in Ireland, a problem that the regulator for health and social care professionals, Coru, is aiming to resolve.
O’Connor admonishes the possible lax interpretation of the term ‘therapy’, as it could imply multiple things. He warns that anyone could undergo a weekend course and present themselves as a ‘therapist’ with a deceptive appearance of legitimacy.
According to O’Connor, it is essential to verify a therapist’s qualifications and credentials. It is also vital to ascertain the membership body of the therapist, such as the APPI (Association for Psychoanalysis and Psychotherapy in Ireland), or the IACP (Irish Association for Counselling and Psychotherapy.) This information should be easily accessible on the therapist’s website and serves as the initial point of contact if lodging a complaint becomes necessary.
I’d strongly advise people to be discerning about those they choose to collaborate with and to engage in a forthright dialogue about their needs. Consider the therapist’s qualifications and skillset, the patient’s requirements, and how these align. It’s crucial to assess this as a relationship and to question whether this person is someone you can collaborate with.
But note that this is a relationship involving two parties. Thus, getting ready for therapy, preparing to discuss it, and being prepared to ask questions is equally valuable. An essential aspect of psychotherapy is that it affords a space where we can practise conveying arduous topics — so it’s vital to be able to broach such topics.
(Some identities have been altered to maintain confidentiality)
Choosing the Right Therapy: Varying Methods
Since there are numerous types of therapies available, knowing where to commence can be daunting. Listed below are a handful of distinct therapy types that cater to varied problems:
1. CBT (Cognitive Behavioural Therapy): Aims at recognising and altering detrimental thought cycles and conduct. Primarily utilised for conditions like anxiety, depression, and other mental health disorders.
2. Psychodynamic Therapy: It accentuates the understanding of repressed thoughts and early life experiences.
3. Humanistic Therapy: It highlights personal potential and self-development, founded on the notion that all can attain self-consciousness and personal growth.
4. Behavioural Therapy: Centralises alterations in destructive behaviours using conditioning techniques. Frequently used for treating phobias and addictions.
5. DBT (Dialectical Behaviour Therapy): A variant of CBT concentrating on emotional control and interpersonal effectiveness. Particularly beneficial for individuals with intense emotional responses, including those suffering from borderline personality disorder or past suicidal tendencies.
6. Somatic Therapy: Generally used for handling PTSD and other emotional and mental health issues by focussing on the mind-body interconnection. This may insert body-oriented methods like breathwork, movement, meditation, and dance.
7. Family Therapy: Invites family members to get involved in the therapeutic process to better communication and address conflicts that exist within the family.
8. Mindfulness-based Therapy: Infuses mindfulness techniques aiding individuals to pay attention to the present moment and minimise stress.