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Dr. Bob is Robert Hsiung, MD,
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Posted by Lonely on September 25, 2004, at 16:40:21
In reply to Reading a file after termination, posted by li hing on September 24, 2004, at 3:16:38
My therapist died suddenly after 3 years with her. That really made things difficult because there were so many loose ends and no one else who knew about the relationship.
I asked the new therapist to get my records and even wrote a letter for her but she allegedly was not able to get them.
During the time I was seeing "C" (the therapist) we had many conflicts. Many of them revolved around things like "why do you think so and so said this or that OR why do you think that happened?" and the fact that I found it rather insulting and finally came to the point where I flat out told her that I didn't know and didn't really care. She informed me that she was putting that in my file. And she didn't say it in a nice way, either. She was putting other negative things in there too - I can't remember what all it was - but I think part of it had to do with the fact that she really shouldn't have been seeing me and needed to justify it. She was, I've come to realize and by remembering back on some sort've off-hand comments she made, keeping me there because she couldn't see me otherwise. There was also the fact that we miscommunicated often. We could use the same words and phrases but they obviously had different meanings and implications. I was often overwhelmed; she didn't make sense to me quite often. At the same time, there were definitely times of intense caring emotion between us.
The new "T" asked me if I wanted to see the records (I did not) and was concerned because, as she explained to me, often the things that are written in a patient's record can make the situation even more painful.
That brings up some other issues that I guess I've just stumbled on in my own thinking ... therapy and Al-Anon seem to focus mainly on "what's wrong" or negativity (whether it really is or not) rather than on support and emphasizing the positive. No wonder I never did really well with either one.
In my professional life I've come across a new concept called "Appreciative Inquiry" which is sort've based on the Pygmallion effect - people respond to images other people have of them. That's what therapists need to have more of. Unfortunately, I've found therapy to usually be anything but theraputic. Maybe therapists need to be evaluated more by their patients - kind've like the concept of 360 degree management.
> I also got to read my file that my old T kept for me. Yeah, I went back to the center and asked to see my file.
>
> My T that I thought cared about me and enjoyed working with me wrote so much mean stuff about me in there. It hurt so bad. It said stuff that I was noncomplient with antidepressants, that I had suicidal ideation. Nothing nice about me in there, yet in sessions she acted as if she liked having me as a client.
>
> She left the center. I'm so mad that she hurt me like this.
Posted by lonelygal on September 25, 2004, at 18:31:05
In reply to Re: contact after termination(a bit long..), posted by li hing on September 24, 2004, at 3:07:38
hi li hing.
i'm so sorry you had to go through this. unfortunately, i really really know how you feel. i had an awful termination with my old t and i am in the process of trying to receive my records from her. after reading your posts, i'm even more scared to see what she has to say about me- i'm sure a lot is not going to be nice, either.
i hope you feel better. i really feel for you, but i don't really know what to say that might help.
Posted by Lonely on September 25, 2004, at 20:46:12
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
Many decades ago (!!!) I saw a therapist at the University counseling center for a semester. He was actually the head of the group and I was lucky to get in to see him. He was really good. Somehow, I found out that he was leaving the university and moving across the country. I was crushed ... really crushed. Panicked. We didn't have antidepressants then and no doubt the theories and practices were different too. I went through various benign "antics" including anger and grief. I even suggested that he take me to lunch which we did - and he paid for it and it was in the faculty dining room! I'm laughing as I think back because that was really pretty brazen for me. I'm a shy person.
Anyway, I did write to him and received, I think, 2 letters back from him. One line I still remember from his letter, paraphrased, was to not let my dad get me down as he was mean and good at that type of thing. I needed to hear that. There probably were a couple other letters that he did not reaply to; I don't know.
A couple years later after I had graduated and moved across the country myself, I called him on the phone. He remembered me. We had a nice visit and I remember him asking me if I was dating yet. I wasn't but a couple months later was engaged! I think that was my last contact with him.
I assume he's probably deceased now although I still think about him and wish I could talk to him again.
But, back to YOUR question (and my apologies for taking over with my stuff here!) I still don't see anything wrong with a T having a platonic contact with a patient after therapy. I'm sure that if you saw it was becoming truly dependent in an unhealthy way you could redirect her and explain what was happening and why and then let it go. I guess the other issue is that you DO feel comfortable with her so that also makes it more affirmative to have friendly limited contact with her for whatever period of time.
I'm curious about how all this works out several months down the road since you are a T. It's good to hear that perspective.
> Hello,
> I just wanted to ask for some input on contact between therapist and client after termination. I received an email today from a former client. It was lovely to hear from her, and she seems to be doing well. This client was someone I worked with all year during my placement, and I enjoyed working with her. Termination was difficult for me with her, as I was aware that I would want to know how she does in the future.
>
> She also had become somewhat dependent for the majority of our working together, but had worked through some of that before termination. Termination happened because she was ready, but also because of the end of my placement at the agency. When we terminated, I used a model set forth by one of my professors, saying, "I would always enjoy hearing from you and how you are doing, but I may not be able to respond to contacts, once our therapy relationship ends." I'm not sure I am totally invested in this approach, but I did try it on for size.
>
> Anyway, I would like to reply, but I am a tiny bit concerned that it could trigger some of the dependency. On the other hand, it could reinforce her internalization of her therapist which helps her with moving forward indpenendently.
>
> What do y'all think? If you've contacted your former T's in the past, have they responded? If they did or did not, how did that feel? What were you looking for in the contact?
>
> Thanks in advance,
> gg
Posted by fallsfall on September 25, 2004, at 20:51:17
In reply to Re: contact after termination(a bit long..), posted by lonelygal on September 25, 2004, at 18:31:05
Therapists often recommend that you don't read your chart without a therapist present (either the one who wrote the chart, or a different one).
Sometimes what they say sounds cold, but is meant to be "clinical". Some of their jargon can be easily misinterpreted by those of us not in that field.
There are many reasons *not* to read your chart. I think that I would want to talk with a therapist about why I *did* want to read the chart fairly extensively before viewing it.
That said, you do have a legal right to read it. It makes sense to me to have someone there if you choose to do so.
Posted by Lonely on September 25, 2004, at 20:58:11
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
Hi ~~~
Just had one more thought/question that I'd like to pose if I may.
My T that died was always talking about "boundaries" which I noticed is going through your mind a great deal too. I'm wondering ... is it ever okay to become real true personal friends with someone that one once knew as a T?
Under some circumstances, I really think it would be okay. I'm not talking about a sexual relationship here - rather, just plain being friends and doing the things together friends would do - shop, go to a play, have lunch together, take them to the doctor when they're sick, etc.
Before my # 1T died, I went to another T one time as a consultant because the #1 T and I were not getting along well. The #2 T also happens to be my husband's T so of course that relationship cannot go on in any form. However, at the memorial for my #1 T, the #2 T was very kind to me, came up to me, hugged me and explained who the other people were there. It was a major humane help and I needed that. Some day, if my hubby died or was no longer seeing her for a period of time, I'd like to be friends with her.
Sorry for my babbling. Best of luck as you continue on!
> Hello,
> I just wanted to ask for some input on contact between therapist and client after termination. I received an email today from a former client. It was lovely to hear from her, and she seems to be doing well. This client was someone I worked with all year during my placement, and I enjoyed working with her. Termination was difficult for me with her, as I was aware that I would want to know how she does in the future.
>
> She also had become somewhat dependent for the majority of our working together, but had worked through some of that before termination. Termination happened because she was ready, but also because of the end of my placement at the agency. When we terminated, I used a model set forth by one of my professors, saying, "I would always enjoy hearing from you and how you are doing, but I may not be able to respond to contacts, once our therapy relationship ends." I'm not sure I am totally invested in this approach, but I did try it on for size.
>
> Anyway, I would like to reply, but I am a tiny bit concerned that it could trigger some of the dependency. On the other hand, it could reinforce her internalization of her therapist which helps her with moving forward indpenendently.
>
> What do y'all think? If you've contacted your former T's in the past, have they responded? If they did or did not, how did that feel? What were you looking for in the contact?
>
> Thanks in advance,
> gg
Posted by li hing on September 25, 2004, at 21:08:42
In reply to Re: contact after termination(a bit long..), posted by lonelygal on September 25, 2004, at 18:31:05
Hi lonelygal,
I have to warn you that looking at your file is going to be tough. There was a ton of clinical jargon about me in my file and seeing something like that for the first time was really tough.
My old T was from a University counseling center. She hurt me so much, I hate her.
Posted by lonelygal on September 25, 2004, at 22:38:58
In reply to Re: contact after termination(a bit long..) » lonelygal, posted by fallsfall on September 25, 2004, at 20:51:17
yes, i realize i will probably get upset, but i am dying to find out what she really thinks or thought, whatever. i want to see her unedited view of me. i think whatever i see will have a major effect on whether i will trust or not trust new t. maybe i wont' want to be in therapy all together after reading it (heck i'm not sure i want to be in therapy even right now), but i have to see it.
Posted by li hing on September 26, 2004, at 2:54:49
In reply to Re: contact after termination(a bit long..), posted by lonelygal on September 25, 2004, at 22:38:58
Hi lonelygirl,
I totally understand how you want to see your file. I saw my T from 2001 to 2003 and just got to see my file 2 weeks ago.I understand about how the result of your file will determine if you'll trust your next T. I totally trusted my T during that time period and when I read some of the stuff in my folder and saw my unopened letters I realized that she was a fake. I'm going to have trouble trusting other Ts as well as others in my life. Trust was a big issue for me and I really trusted my old T. After seeing so much contradictory stuff in my file I am so angry and hurt. I wish I could yell at her but she left the center already.
Good luck and let us know how it goes!
Posted by Pfinstegg on September 26, 2004, at 12:59:57
In reply to Re: contact after termination(a bit long..), posted by lonelygal on September 25, 2004, at 22:38:58
I am wondering WHY you feel you need to see your clinical records. You seem to feel that if they are sort of neutral-sounding, or contain things which you may interpret as negative, that it will confirm in your mind that you are right to be shaky in your trust towards both your new and old Ts. Could it be that you are looking for evidence of caring in the records? I'm afraid no-one ever finds them there. Even if you had a very caring and devoted T, you wouldn't find any proof of that in the records he/she kept, because they aren't for that purpose.
It sounds like feelings of trust and security are really difficult issues for you, as they are for all of us. Getting better involves learning to trust. Would seeing your records do anything positive for you in this regard, or, really, at all? I do take advantage of the law to obtain copies of my medical records, which I find helpful in tracking things like my TSH level, cholesterol, etc. I personally would never want to ask for my files from my analyst. I think they would seem cold, compared to the immensely meaningful, wide-ranging relationship I actually have with him.
Posted by Lonely on September 26, 2004, at 15:19:06
In reply to Re: contact after termination(a bit long..) » lonelygal, posted by Pfinstegg on September 26, 2004, at 12:59:57
There are a LOT of control issues that go on in therapy. And a lot of it has to do with the therapist trying to control the patient. Therapists have anger and resentments of their own. I've been the victim of those projections.
It might be good to try some different T's even if it's in defensive mode.
Here is the URL for the list that I found helpful, and, by the way, I'm not in NY nor do I know anything at all about this therapist and I'm not recommending her, nor am I opposed to her either. I just thought the list mentioned a few things that I wanted and didn't usually get.
http://www.a-tech.com/joyce/index.html
Scroll down the page about half way to "About Psychotherapy" and click on "List of 10: Why and How Psychotherapy Works"
Then ask your own therapist why she/he failed so miserably. OR, ask a new therapist how she/he is going to help you reach these goals (whichever items fit for you).
Finally, if things still aren't going well, I would (and have done so) just plain tell the T that she-he is greatly lacking in competence and should perhaps consider a different career.
Posted by lonelygal on September 26, 2004, at 21:04:50
In reply to Re: contact after termination(a bit long..) » lonelygal, posted by Pfinstegg on September 26, 2004, at 12:59:57
i think you are completely right about why i want to read them. i was always upset about the power differential too- she was a psych grad student and i'm a med student... so i think being in med school is adding to my curiosity- b/c its weird that i will be in the position to write others' records shortly & it's weird having the process happen to me. also, i miss her very much- she has since graduated- and i have no clue how to reach her- that the only thing that i will have left of her are these records. call me psycho.
Posted by Pfinstegg on September 26, 2004, at 21:20:19
In reply to Re: contact after termination(a bit long..) » Pfinstegg, posted by lonelygal on September 26, 2004, at 21:04:50
I do understand. Is there any way you can find out where she is now- what her address is, etc.? Being in a university community, I would think there might be a way to do that. Perhaps if you could just write or e-mail her so as to keep a bit of contact as long as you need to, it might help a lot in overcoming those terrible feelings of loss. From what I have read here, a number of people have found a way to do that, and have felt a lot of caring from even sporadic contact. Not all, though- a few people have not had good experiences. But I do get the feeling that the good experiences outnumber the bad ones by quite a bit.
I can empathize with you on another level- I was once a med student myself, and know how many stresses, as well as joys and accomplishments, go along with that! The stresses, to me, anyway, were pretty huge. I hope everything goes well for you, and especially that you find the close connections and support that you are looking for. I hope you will keep posting here, too!
Posted by li hing on September 26, 2004, at 22:14:09
In reply to Re: contact after termination(a bit long..) » lonelygal, posted by Pfinstegg on September 26, 2004, at 21:20:19
Am I the only one here whose old T didn't want to e-mail them back?
I feel so sad.
Lonelygirl, good luck with seeing the file. My T was also a training T and left the University recently. I was deeply hurt from reading my file but now I know the truth about what my T thought of me. It is going to be weird reading about yourself though. They write in the 3rd person format so it will feel like you're reading about someone else.
Someone here gave you the advice of trying to e-mail your T? I tried that with mine and she sent me a really nasty hurtful letter in the snail mail not to contact her. Just be prepared that not all Ts may want contact, especially training Ts who are scared to cross boundry lines.
Posted by li hing on September 26, 2004, at 22:15:30
In reply to email contact after termination, posted by gardenergirl on July 21, 2004, at 23:56:47
I hurt so much, I almost want to post my T's name on here and tell her how much she hurt me.
Posted by lonelygal on September 26, 2004, at 22:46:57
In reply to Re: contact after termination(a bit long..) » lonelygal, posted by Pfinstegg on September 26, 2004, at 21:20:19
Hi Pfinstegg. Thanks for posting to me. I noticed recently that you were a physician & have been sort of looking for your posts :). About trying to contact her, the only way I would know how to do that would be to call the psych dept at my school and have them page her wherever she is now somehow to get back to me- and I'm not so sure that is a good idea, seeing as I freaked out on her when i was terminating and sort of paged her like 3 times when I shouldn't have. I dont' think she would want to encourage any contact with me either- she was really adamant when I was leaving about not having contact with me then, saying that it was unethical for her so that I would find a new therapist here.
Yes, med school has been very stressful for me- almost too stressful. Right now I'm doing research for a year across the country before I go back to start my clinical years. I worry all the time about trying to decide what I want to do with my life or how will I get into a good residency when my boards scores were only mediocre :( . Well I worry about those things when my normal day-to-day life worries aren't as prevalent- so I guess I always have worrying material.
Posted by lonelygal on September 26, 2004, at 22:51:01
In reply to Re: email contact after termination, posted by li hing on September 26, 2004, at 22:15:30
i'm sorry you feel so badly. i have a feeling i'm going to be in the same boat as you if i ever do get a hold of my records. and if it makes you feel better, i think my old t would not want to be in e-mail contact with me either. being abandoned sucks, and i understand why you hurt so badly.
Posted by Pfinstegg on September 26, 2004, at 23:14:36
In reply to Re: contact after termination(a bit long..) » Pfinstegg, posted by lonelygal on September 26, 2004, at 22:46:57
I guess you're right. She sounds like a young T in training who is quite worried about boundaries, as you say, and doesn't know (yet) how to handle a post-termination phase in a helpful or supportive way. I guess not everyone in training is as secure or intuitive about that as Gardenergirl is! If you can, could you consider it HER problem, and not yours? Try not to let her hurt you any more. In general, I do think mature, experienced Ts take a lot of care to continue support as it's needed even after *termination* - a term which I think is kind of falling into disfavor, anyway. The analyst I am seeing makes a very long-term commitment to his patients, and that includes as much contact as is needed *after*.I think experienced Ts know how powerful the dependency feelings naturally are in therapy and analysis, and they do hold it as a sacred trust not to hurt their patients at any stage, either during or after active treatment.
It sounds like a smart idea to give yourself a break before starting clinical work. I was quite frightened of it- with all its responsibilities- but the first weeks were by far the hardest, and it got much easier as I gained a bit of confidence in myself, and also realized that I had many more senior people to turn to and rely on. It dawned on me a few weeks into the third year that the hardest years were actually the first two! I hope this will be a good year for you, in which you can increase your confidence, and become clearer about your own personal goals. And I do hope you can develop a good relatonship with your new T - that will help so much. Will this also be one who will leave after a year?
Posted by gardenergirl on September 27, 2004, at 0:00:32
In reply to Re: contact after termination - » lonelygal, posted by Pfinstegg on September 26, 2004, at 23:14:36
Aww, thanks for the nice compliment, Pfinstegg. And I think your thoughts here are spot on.
> If you can, could you consider it HER problem, and not yours? Try not to let her hurt you any more. In general, I do think mature, experienced Ts take a lot of care to continue support as it's needed even after *termination* - a term which I think is kind of falling into disfavor, anyway.
I think this is excellent advice. Especially given that the therapy in question was at a training clinic. I just want to mention that when T's are in training, it IS hard in that they are usually only at a site for one year at a time. This can make it hard for the idea of continuing contact. Therapy, even after termination, is supposed to leave the client with the option of returning at any time later if more turns up that needs working on. The difficult part of working with a trainee is that you can't go back to the same person. So it could be that the trainees that have been mentioned here prefer to have no contact after termination in order not to interfere with a subsequent therapy relationship.
I'm just speculating here. I know at the university clinic where I trained, we were encouraged to develop our own decisions unless it was something that was strictly against the rules.
Somebody posted above, I think, asking if it could be possible for a friendship to occur between a T and a former client down the road. Ethics discourages this, but it is not a hard and fast rule. It depends on the people involved, and I think a bit on the nature of the therapy. The fear might be that the friendship still has a therapy "flavor" as we often ask our friends for advice. What if you asked your former T/friend? That seems a little muddy. But I can see it happening and being okay, too.
warmly,
gg
Posted by Susan47 on September 27, 2004, at 8:08:44
In reply to Re: email contact after termination, posted by li hing on September 26, 2004, at 22:15:30
Being where I've been I now know that time does not take care of things, it only seems to lessen the their immediacy in our conscious. If I had a wish for you, it would be that you find a way to deal constructively with your pain, for your self. Do you dream vividly? Pay close attention to your dreams right now, if you have them. They may hold the solution for you. I've been watching your thread and holding you in my thoughts. (I sound like a blo**y astrologer or something, but I guess it's my mood)
Posted by lonelygal on September 27, 2004, at 20:27:20
In reply to Re: contact after termination - » lonelygal, posted by Pfinstegg on September 26, 2004, at 23:14:36
Thanks Pfinstegg...
Yup, I'll be leaving this therapist after a year too, so that's another reason why I'm not sure therapy is worth it.
Posted by Pfinstegg on September 27, 2004, at 21:28:30
In reply to Re: contact after termination - » Pfinstegg, posted by lonelygal on September 27, 2004, at 20:27:20
I'm assuming that this one is short-term, also, because you'll be moving at the end of the year to return to med school. Could you consider any therapy you do this year as more supportive in nature, and wait until you are in a more long-term situation before undertaking more intensive therapy? I guess just reading any post here reinforces how painful in-depth therapy is for everyone- not just for some people- and we all do need a long-term commitment from our Ts to make it helpful, and really, sometimes just to be able to bear it. Repeated abandonment by Ts, whatever the reason, make worthwhile therapy impossible, i think.
Posted by Annierose on September 28, 2004, at 8:28:49
In reply to Re: contact after termination - » lonelygal, posted by Pfinstegg on September 27, 2004, at 21:28:30
Just curious, if you are willing, you started this original thread sometime ago, about a past client that wrote/e-mailed you. In the end, if you care to share, did you decide to do? And if you did respond, did she respond back?
Posted by 10derHeart on September 28, 2004, at 16:58:47
In reply to Re: contact after termination - Garden Girl, posted by Annierose on September 28, 2004, at 8:28:49
...the same thing as Annierose. If it's not too intrusive? I am living out this scenario literally right now w/ex-T and the first contact has stirred up both wonderful and painful things. So I have a very personal interest....:)
Posted by gardenergirl on September 28, 2004, at 19:31:48
In reply to GG, I Was Also Wondering..., posted by 10derHeart on September 28, 2004, at 16:58:47
Hi ladies.
Thanks for asking. I did respond, and she has since emailed me twice more. Once with a specific question about a project she is working on for school. She associated something about it with a question I used to often ask her and she wanted to know where that came from...(the sad answer is...uh, I heard others ask it and it seems like a good question?) :-)The other email was just a quick thank you and a promise to share with me the results of her research. So I feel okay about this. It's not intrusive to me so far, but I have a tiny smidgeon of concern I am putting on hold at the moment just to see what happens.
Does that help?
gg
Posted by Annierose on September 28, 2004, at 19:42:11
In reply to To Annierose and » 10derHeart, posted by gardenergirl on September 28, 2004, at 19:31:48
Thanks for responding. It's a minefield, but I feel you are acting responsibly. You don't want to open up pandora's box, but at the same time,
you don't want her to feel ignored. Your life as T is just getting started, but you seem to be doing a great job! They are lucky to have you.
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