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bad outcome - please help!

Posted by octavia on April 8, 2005, at 21:10:17


I hope I'm posting in the right place.

Thanks in advance for reading this. I've been very sad about my situation for a long time and I'd really appreciate your perspectives. I don't really know many people who've had therapy. Most people are empathetic but they kind of don't understand how important the therapeutic relationship is. They don't understand when something goes bad in therapy it can be really painful.

My apologies if this turns out to be an incoherent jumble. I'll try to be as concise as possible...

Starting about six years ago, I saw a pdoc once a month for medication management to treat major depressive disorder. He's about 60 and I'm in my thirties and female. Then almost 2 years ago I became suicidal. We made changes in my medication and I started therapy with him, initially once a week but by the end I was going [or not going but I'll get to that] 3 times a week.

At first therapy was very, very difficult. I'd never had therapy before and I didn't know what to expect and found talking about myself awkward. Over time, though, I thought we had built a wonderful rapport. There were small bumps here and there but over all I came to feel for him as I feel for my closest friends. I've read plenty about transference and I don't think there was much maternal or paternal transference there. I was abundantly aware that I was seeing a narrow slice of who he is, but the slice that I saw I liked very much. Once in a while I'd arrive early and sit in the hall and he'd come out of his office to go to the mailboxes. I would invariably see him before he would see me and he'd sometimes look sad. Then when I'd smile at him he'd give me a big smile back. I'd watch him out of the corner of my eye and he'd smile all the way to the mailboxes and all the way back to his office. I actually said to myself, "Maybe he's happy to see me too!" That's not like me - I don't readily think that I have any effect on people.

About 9 months ago things started to go funny. He'd have bouts of yawning [for example, 70% of sessions for about a month]. It hurt my feelings but I wasn't sure what to say, especially since it may have had nothing to do with me. The last period of yawning I finally said to him, "Ok, you've been yawning a lot lately AGAIN. I guess I'm boring you." He said, "Yes. Let me explain something. Sometimes people feel anxious and they are subconsciously suppressing thoughts that are more exciting than what's going on currently they get bored. Oh I see time is up." Holy cow. I staggered out of there not knowing which end was up. So he's thinking exciting thoughts. I didn't know quite how to bring it up again.

The topic of love was not comfortable either. I rarely brought it up. When I did, within a few minutes he'd be fighting to stay awake. That never happened at any other time. I called him on it the last time it happened. He just said, "I didn't know I was doing that. Why do you suppose I'm having that reaction?" I said, "I don't know but it hurts my feelings." He smiled but looked puzzled. Again it just happens to be the end of the session and he says, "Time's up." I didn't know quite how to bring it up again at the next session. Certain topics started to feel off-limits. His reactions started to feel unavailable for discussion.

Then not long after that I went on vacation. I was at the door saying "good-bye" and I didn't even get to the "bye" before he shut the door in my face. He knew I was speaking to him because he had just been looking me in the eye. I tried to blow it off.

Once I returned he started canceling my appointments without rescheduling. I had one evening appointment and two daytime appointments each week. He usually axed the evening appointment. His excuse was that he had to work on his consulting projects [he sees patients plus does consulting so on fairly rare occasions we'd have to reschedule or skip one appointment]. For the last 2 months I was there he cancelled about 30% of my appointments without making an effort to reschedule them. I felt completely unimportant.

The last week went something like this:
We had an argument [the only argument we'd ever had] about all the missed appointments. His answer was, "You know I do consulting work." Not acceptable in my view and I told him I was going to look for another MD. But then by the end of the session we had sort of patched it up. The following night he called and canceled my next appointment with apologies. Then the following day called and said that the time conflict had cleared and the appointment was on if I still wanted it. I left him a message saying, "I can't come." I arrived for my last appointment of the week on time but hopping mad. I sat for 7 minutes in the waiting room, during which time I could hear him taping up boxes in his office. I snapped inside. I got up and left. He leaves a message, "I thought you were here. Call me." I was so angry I didn't call. The following Monday morning, without giving me a chance to respond he leaves a message to the effect that he's going on a week-long vacation in 4 days [He NEVER told me about this vacation] and if he didn't hear from me before he left that he'd assume I wasn't coming back. I was so hurt and angry I couldn't call. That's it. The end.

It's been quite a while and I'm still hurt and confused and angry. It's a lot like heartbreak. It's that bad and it just doesn't seem to get any better. I was so very fond of him and I miss him terribly. I'm also incredibly angry.

I'm left with so many questions. Did he only pretend to like me/care about me? Why did he give me an ultimatum at the end? This can't be a normal termination, right? Has this had any effect on him at all? Do I try talk to him? I feel lost.

Thank you thank you thank you for reading this. I'm sorry it's so long. I'm not usually this wordy but I guess I just had to get it out. If you have any thoughts I'd be grateful if you shared them.




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