Posted by: gtcounseling | July 7, 2016

The Rocky Road of Therapy

Dear Ms. Miller,

I see a therapist for social phobia and paranoia, and have visual and auditory hallucinations (hearing voices). My therapist and I have explored other causes like drugs, alcohol, traumatic events, etc. But, there is no apparent reason. I often have trouble speaking, and before going to therapy I was functioning less and less. I’m scared it will get worse again, and my therapist doesn’t seem to want to talk about why I have these symptoms. I can feel myself losing it again. What’s wrong with me? Is he not telling me for some reason?


Hi Estee,

Thanks for writing in. It sounds like you are having an increase in your symptoms and have some serious concerns for your well-being which is understandable.  I am glad you’re currently in treatment and hope you give yourself credit for this. Maybe I can help you revisit some “therapy basics” to help get you moving along again.

While social phobia and paranoia are fairly common, hallucinations can be distinct presenting symptoms apart from this, depending on their exact nature and pervasiveness. Identifying root causes and how to proceed in treatment can be difficult. But, this shouldn’t be confused with being impossible. With courage and patience on your part, there is hope. There are likely trust issues to explore with your therapist too, your level of trust and openness to him and the therapy process itself, as well as your own perceived ability to heal. Although it may not go smoothly at times, trust covers a lot of areas and is very important. I encourage you to discuss this aspect of your treatment with your therapist. The healing pace can sometimes seem slow, especially if you experience setbacks. A good therapist is sensitive to this too. Try not to let this deter you.

And, most people who deal with social phobia in general do not suffer from hallucinations. It sounds like there may be something else going on, which could be a number of things. Some mental health disorders, like schizophrenia and brain injuries, manifest with visual and/or auditory hallucinations. They are referred to as organic brain disorders because they are not typically environmental by nature, but can be hereditary, the result of an individual’s own physiological (bio-chemical) make-up, or due to traumatic-physical brain injury. It is concerning that your therapist isn’t talking with you openly about your experiences. Being open with your therapist about his reluctance, and your fears and questions, is important to keep that two-way street open. I encourage you to share your fears with him, and let him know how important it is that the two of your address this together. Ask to discuss your fears and whether or not there in anything he is not telling you. Be open about it and the fact that you need clarification on it.

In most cases, the quality of the therapeutic relationship you develop together often determines the outcome. You also mentioned that you were functioning less and less prior to getting therapy. So conversely, that means you are doing better because of reaching out for the help you need. Keep this in mind as you go forward, and remind yourself that the therapeutic relationship is a collaborative effort that takes time to build upon. Be open and honest about what you need from your therapist, even if it is hard at times, and give him a chance to join with you and earn your trust. This can make all the difference in your continued healing and getting the answers you need.

Carole Miller, LCSW-C


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s


%d bloggers like this: