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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Dinah on November 9, 2002, at 12:52:22
There's a chance that my long term therapist may be leaving town. I've been seeing him over 7 years and I'm attached to him, perhaps too much so. He seems like my safe harbour.
Has anyone in similar circumstances lost their therapist and had it not be a harmful experience?
I know the theory is that I can take whay I learned from him and apply it in my life, and to another therapist if necessary. I know that the theory is that if I learned to trust him (a huge issue for me, as is fear of abandonment) I can use what I learned to develop trust in another therapist. But that just sounds like theory. I would guess that the reality is that I would be less likely than ever to trust anyone, and more likely to protect myself against future loss in a dysfunctional manner.
But I'd be happy to be wrong about that.
Posted by Tabitha on November 9, 2002, at 17:10:18
In reply to Has anyone successfully lost a therapist?, posted by Dinah on November 9, 2002, at 12:52:22
Yipes. I'm sorry to hear that. I lost a mediocre therapist once, and even that hit me hard. Eventually though I found a much much better one.
Is he willing to do phone sessions from his new location? That might ease the transition.
Posted by judy1 on November 9, 2002, at 18:42:46
In reply to Has anyone successfully lost a therapist?, posted by Dinah on November 9, 2002, at 12:52:22
Hi Dinah,
I'm curious what words he used that gave you the impression he 'may' be leaving, or is this something you heard from someone else? I guess it's hard for me to understand telling someone with your issues (that I share completely, although abandonment is the biggie for me over trust) that he might be leaving putting you through unnecessary pain versus definitely leaving. Because if it's definite then by law he must give 30 days notice to transition you to another therapist. just wondering. take care, judy
Posted by Dinah on November 9, 2002, at 19:52:04
In reply to Re: Has anyone successfully lost a therapist? » Dinah, posted by judy1 on November 9, 2002, at 18:42:46
Hi Judy,
I'm not going to blame the poor guy for telling me. :) He was trying hard to be truthful to a direct question by me. And he tried to be very careful about how to be truthful. And since part of the reason I trust him is that I know he does try to tell me the truth, I can't fault him for it. Besides, if there is even a possibility, I think it might be best to know, because I have a huge issue with fears of abandonment and his telling me at the last minute would probably be worse. I honestly don't think I'd use the transition time. I mean how do you, at that point, work with abandonment issues with the person that abandoned you. (OK I know that isn't fair, but feelings are feelings.)
And as to how I came to ask him straight out, well, I'm a difficult client. I pick up on things very easily but quite frequently misinterpret them. He was trying to correct what could have been a, well, an unfortunate misunderstanding on my part. And in the process aroused my suspicions (ever present I might add) that he would leave.
Poor guy. I really am quite difficult to have as a client, you know. Enormous abandonment fears, and still a bit of an issue with trust. Add a significant tendency to regress (or melt down or decompensate, whatever the right term would be), and he's got a really annoying client. Not that he would ever admit to that. He's really got a lot of stamina and patience.
Part of my fear is that it would be difficult to find another therapist who would put up with my nonsense. :( Not to mention being able to trust someone else after all of the work it took to trust this guy as much as I do.
Posted by Dinah on November 9, 2002, at 20:00:30
In reply to Re: Has anyone successfully lost a therapist?, posted by Tabitha on November 9, 2002, at 17:10:18
Yipes is right. Fortunately, he says at this point that the chances are less than when he first told me, but he still can't say it won't happen. I'd like exact percentages of the likelihood, spaced out over a span of time, of course. Maybe a nice little graph. :) He finds my desire for precision a bit annoying.
At this point it's just a possibility, but I think it is just a good idea to have a contingency plan or two available. Because it's been my idee fixe, almost an obsession, since the beginning of therapy - that he's going to move or stop private practice or whatever. So I suppose I should have been working on a contingency plan all along. I was just starting to ease up on it, and the recurring dreams (where I walk in his office and there is another person sitting there and he introduces this other person as my new therapist) were just slowing down a bit. :(
But now I just think it's wise to back off a bit, and plan for the possibility, and try to ease off the dependency a bit. Even if he doesn't leave, it's probably still wise.
Sigh.... I'm pathetic.... Maybe the Risperdal will help.
Dinah
Posted by Dinah on November 9, 2002, at 22:37:12
In reply to Re: Has anyone successfully lost a therapist?, posted by Tabitha on November 9, 2002, at 17:10:18
He did say he would consider telephone therapy if he left, but he might have just said that because I was sort of shock-y. He might have just been trying to calm me, although generally even then I can trust him to tell me the truth. But to tell the absolute honest truth, he is not at his best over the phone. So I'm not positive that I'd find it therapeutic.
Posted by Pfinstegg on November 9, 2002, at 22:44:34
In reply to Re: Has anyone successfully lost a therapist? » Tabitha, posted by Dinah on November 9, 2002, at 20:00:30
Hi Dinah- that's a tough issue about leaving. If you KNOW he's leaving, you can direct your energy towards working through your rage and fears of abandonment- the thing that everyone has to do as therapy terminates. But if you just think he MIGHT be leaving, or even that there's a very small chance that he will, it raises all your fears of abandonment when it isn't necessarily going to happen at all.
Maybe the thing to do in your situation is to focus as much as you can on the fear and pain you feel even at the thought of losing him- YOUR feelings, rather than seeking reassurances about what the actual liklihood of it happening is- that sounds like a bottomless pit. The other thing I would suggest (having been through ALL of this myself) is to work on how much of him you are able to internalize and "take with you", even as your therapy with him is progressing- not just at the end of it. I think that is one of the main keys for successfully terminating therapy, don't you? My analyst from long ago pointed out to me that all the time we were working together, one of the tasks I had to accomplish was to learn to internalize his loving and understanding presence and carry it with me when I was not with him; the other task was to continually prepare for the fact that I would eventually terminate, and would not see him again. As it has worked out, although I have not seen him, I am in occasional touch with him by letter. I tell him about the news of my life, and he responds with a bit of news of his own, and a bit of encouragement! I value this amount of connection tremendously, but really do not need any more than that.
Well- I'm just sort of rambling..
Pfinstegg
Posted by judy1 on November 9, 2002, at 23:52:44
In reply to Re: Has anyone successfully lost a therapist? » Dinah, posted by Pfinstegg on November 9, 2002, at 22:44:34
I think Pfinstegg worded it beautifully- that therapy does eventually terminate (unless it's Freudian :-), and you do internalize the positive traits of your therapist and the work you've done together. For you though I wonder if something else is going on, maybe you don't want to write what led to your fears of abandonment so that you felt you had to press him. I test my shrink all the time, are you going to retire?, stop clinical practice and write?- he knows what I'm doing though. Maybe you can concentrate on what precipitated your fears and work on that with him (hmm I think I'm repeating Pfinstegg's advice). It's just when that type of thing happens to me, we can always find something he said (usually an off-hand remark) that gets all the alarms sounding and makes me regress. I hope things settle down for you. take care, judy
Posted by Dinah on November 10, 2002, at 10:12:59
In reply to Re: Has anyone successfully lost a therapist? » Dinah, posted by Pfinstegg on November 9, 2002, at 22:44:34
Ah, Pfinstegg, I think you are at a higher level of your development as a human being than I am. :) I have trouble internalizing anything, or anything positive anyway, and can't seem to internalize his understanding and accepting presence from week to week, much less indefinitely. Sigh. If he "felt" less than his usual calm, warm self, I pick up that energy and carry it for a while. If he "felt" his normal self, I pick up that energy and carry it for a while. But it doesn't last long. Maybe that's good in a way. If I can make it through the initial period, I might forget he even existed except on a very intellectual basis. I think I can retain some of what he taught me, but I don't think I can retain my sense of him. I do really admire your more philosophical and far wiser outlook. I do hope it's something I can learn if he stays. It certainly is what he is always telling me.
But I do think it's time and past time to do some serious work on my abandonment fears. Perhaps some CBT stuff like flooding, or EMDR work on imagining myself being abandoned? I don't know...
Many thanks for your wise advice,
Dinah
Posted by Dinah on November 10, 2002, at 10:22:26
In reply to Re: Has anyone successfully lost a therapist?-Dina, posted by judy1 on November 9, 2002, at 23:52:44
Thanks, Judy. I do do this all the time, it's just that the answer is usually "no, it won't affect our work". I do a fair amount of testing in many areas, or I used to anyway. I really do trust him as much as I can trust anyone (except my husband). And I do know what prompted me to ask this time.
I just need to convince him that we need to work on this area now, not later. Sigh. I know intellectually that therapy doesn't last forever. But the idea of not having that place that really seems safe to me now is enormously scary. I'm not used to feeling safe, and it's a wonderful feeling. And my immediate reaction is just to cut off the emotions, with medications or whatever, so that I don't have to feel unsafe again.
Posted by Pfinstegg on November 10, 2002, at 19:21:55
In reply to Re: Has anyone successfully lost a therapist? » Pfinstegg, posted by Dinah on November 10, 2002, at 10:12:59
Thank you, Dinah, but I'm not very wise- I do think my old therapist was, though. The main issues that I had were the same as what I think yours are- a complete terror of, first, letting anyone be too important to me, and second, losing that person. In the beginning, it didn't look like those were the real issues- there were all sorts of more obvious ones on the surface, like depression, low-self-esteem, social anxiety, etc. But my therapist did a very interesting thing: he didn't waste any time on the surface, but focussed, right from the beginning, on the relationship between him and me- encouraging me to allow myself to put all of my diffuse fears, longings and fantasies onto that relationship, and to keep talking about it, no matter what! So we had to start right from the beginning dealing with termination- he made it very clear that it was not going to be endless therapy, so I couldn't avoid dealing with my terror of abandonment. If I had had my way, I probably would have liked to stay in therapy with him forever! I was tremendously attached to him, and felt, then, that I couldn't survive without him. The therapy was so painful to do that at times I could barely manage. But I know the really important things got done, somehow, and it actually took only two years of going twice weekly! Then, after termination, I was really grief-stricken for about a year, but, as that cleared up, I realized that I was somehow completely different- not problem-free, by any means, but able to solve the problems myself, and not feeling so empty or terrified any longer. He is still very important to me, but not in the sense that I have to actually go and see him- he's retired, anyway!
That was a long time ago now, and was followed by many good years. But, as you probably know from my posts here, I've got a big new problem now- major depression. With the help of the knowledge people on this board provided, I have looked into the biological aspects of it, and found so many things physically wrong- the cortisol, the thyroid etc. I actually have been given a diagnosis of Cushing's Syndrome- caused not by a tumor, but as the long-term aftermath of childhood neglect and abuse, triggered now by a number of deaths and losses. So, this time around, I am dealing with a real physical disease, and psychotherapy alone just isn't adequate. Still, the wonderful thing to me is that the work I did with my old analyst has held up for a lifetime- and I was even able to improve upon it by myself as time went along. That's true even now, despite the MDD. I couldn't have asked for anything better from therapy- and I wish for the same for you! It goes so much deeper than any medication possibly could..
Pfinstegg
Posted by mair on November 10, 2002, at 20:56:36
In reply to Has anyone successfully lost a therapist?, posted by Dinah on November 9, 2002, at 12:52:22
Dinah
I think of myself as being difficult too, and it seems to be pretty easy for me to convince myself that my therapist would love to terminate, but can't because she knows I have so many trust and abandonment issues that would be exacerbated by her withdrawal. There's almost no way she can effectively counter this other than to tell me as persuasively as she can, that it's not true. Even on those occasions when I believe her, I'm only reassured temporarily.
I think of myself as being difficult because for every step forward I take, I seem to take ten backwards. When I started seeing her 4 years ago, it was for some very directed CBT. However, she seems to have decided a long time ago that she'd get nowhere with me by just using CBT, and for the last year and a half, I've been seeing her twice a week for fairly intensive psychotherapy which is hardly what either one of use bargained for in the beginning. I get frustrated by my lack of progress and assume that she is getting impatient as well.
I'm not sure this is appropos of anything other than I wonder if you are a difficult patient only in your eyes and not in his. My therapist tells me that my abandonment issues notwithstanding, she'd have to jettison me if she really thought she couldn't make progress with me. So maybe the mere fact that you're still with this therapist means that to him, you're not really as difficult as you may think.
Mair
Posted by Ginjoint on November 11, 2002, at 7:52:54
In reply to Has anyone successfully lost a therapist?, posted by Dinah on November 9, 2002, at 12:52:22
Oh, holy hell, Dinah. I do feel with/for you -- just when I admitted to my pdoc that I was terrified she'd get pregnant again (and leave), that was when she told me she was pregnant again...and going on several weeks maternity leave. Truly a moment from the Kick in the Crotch School of Timing. I digress, but only to demonstrate my empathy.
Hmmm. Sweetness, the only thing I can think to say is that until your therapist makes up his mind, this is going to suck. You will be on pins and needles. BUT....although he may not "give good phone", IF he does move, some phone sessions seem like something that can ease your spirits more than you may think. I don't like phone sessions either, but sometimes just hearing my pdoc's voice for five minutes calms me down during a hard time. It's a connection, even though it may not be as "intimate" as you'd like/need.
Something else....with my pdoc's upcoming absence, it's obviously forcing me to imagine getting along without her. I have been seeing her for 2 1/2 years now, and am very attached. But now, part of me is curious to see how I'll do...Dinah, go for a ride with this sort of curiosity. Daydream with it -- let your inner spunkiness, which has been heavily cloaked under depression, out for a spin.
I know that my situation isn't the same as yours MAY be, in that my pdoc is coming back (or so she says!) But until you know things for sure, as a temporary coping mechanism, think of that tough spunky core that I KNOW you have, (hell, give her a name even!), and let her watch out for you until things are smooth once more. Even if it's only for a coupla minutes at a time. I'll be honest, this doesn't always work for me....but, sometimes it does.
Remember, in cyberspace people can hear you scream. That's what we're here for.
Ginjoint
Posted by Dinah on November 11, 2002, at 8:12:29
In reply to Re: Has anyone successfully lost a therapist? » Dinah, posted by Pfinstegg on November 10, 2002, at 19:21:55
It does sound like you had a great therapist. But don't under-rate yourself either. I would have been out the door pretty quickly with all of that spelled out for me. And I'm not sure I could have handled the year of being grief-stricken. So give yourself the credit you deserve for having the ego strength to be willing to work on those things. That's what set you up for so many good years.
I'm sorry you're having such trouble now. Have they found the right medication?
Thanks,
Dinah
Posted by Dinah on November 11, 2002, at 8:28:10
In reply to Difficult clients » Dinah, posted by mair on November 10, 2002, at 20:56:36
I think you're right Mair. I'm probably not as difficult as I think I am. At least that's what my therapist tells me.
But I do think I'm a much more difficult client than you are. :) I'm not just talking about therapeutic progress, although I confess that he told me after I had begun to trust him at five years, that he had from time to time considered whether he could help me during those five years.
I'm more talking about my challenging him constantly, not letting him get away with vague statements. Taking offense very easily and letting him know it. And mostly the phone calls. When I have a meltdown I might call him five or six times. Never long phone calls, and mostly left on his machine, but I'm sure they're annoying. Especially since I am not at my most rational at the time. Then there are the times I internally battle over calling him and call and hang up before anyone answers several times. He knows about these because he has caller ID.
He has chosen to take a compassionate stance towards the phone calls and reassures me that they are not a bother. I never call in the middle of the night or anything. He says that he sees them as a measure of my distress. But I'm not sure most therapists would choose to take that stance. :(
Posted by Dinah on November 11, 2002, at 8:45:22
In reply to Re: Has anyone successfully lost a therapist? » Dinah, posted by Ginjoint on November 11, 2002, at 7:52:54
> BUT....although he may not "give good phone",
ROFLMAO, Ginjoint. And thank you for that. :)
You're right. And if he does ever give me the bad news, I think I'll find out if he'll do that. It may trick me into getting through the worst of it without doing something incredibly stupid. Because honestly my emotional memory is so poor that if I get thru the worst of it, I should make it.
I'm afraid my inner core is anything but spunky. My outer shell is the spunkiest part of me (scary isn't it?). My inner self is needy and immature and scared of everything.
I'm sorry about your therapist, Ginjoint. As you say, the timing was rotten, if the timing can ever be good to say that. :( As part of my general preparedness plan I have started a list of requirements for my next therapist. On the top is ties to the community, and no women of childbearing years.
But I have to tell you that I think your curiosity embodies by "But now, part of me is curious to see how I'll do..." may be a wonderful sign that you're getting stronger and may not need her as much anymore. I can assure you that I never have one whit of curiousity about that. :) And my husband says that he expects that if my therapist leaves I'll have to get another, or else he will. Which helps considerably in the medical spending contribution decision. :)
So far, I'm dealing OK with this now. Partly because the possibility is more remote now, but mostly because the Risperdal has caused me to separate from my emotions and view this from a reasonably logical position.
Thanks for the empathy,
Dinah
Posted by Ginjoint on November 11, 2002, at 21:07:16
In reply to Re: Has anyone successfully lost a therapist? » Ginjoint, posted by Dinah on November 11, 2002, at 8:45:22
> I'm afraid my inner core is anything but spunky. My outer shell is the spunkiest part of me (scary isn't it?). My inner self is needy and immature and scared of everything.
Look deeper.
If no part of your inner core had any spunk, you wouldn't still be here.
TRUST THE SPUNK!
;)
Love,
Ginjoint
Posted by Dinah on December 15, 2002, at 12:30:48
In reply to Re: Has anyone successfully lost a therapist? » Dinah, posted by Ginjoint on November 11, 2002, at 21:07:16
For the moment. :) I hope they long stay that way. Unfortunately, because of the discussions we've had since this event, I don't think he'll be all that open about things in the future, and probably won't tell me until he's ready to go. :(
Posted by mair on December 16, 2002, at 8:39:33
In reply to Re: Things have settled down., posted by Dinah on December 15, 2002, at 12:30:48
"Unfortunately, because of the discussions we've had since this event, I don't think he'll be all that open about things in the future, and probably won't tell me until he's ready to go."
Dinah - I don't think you can know this, and you certainly can't worry that he's ready to drop a bomb shell on you with no warning and no time to adjust. You've been seeing this guy for a long time and I'm sure he feels that he's very responsible for you. Also, my therapist relishes the opportunity to talk about our relationship because she thinks it's a good jumping off place for dealing with other relationships. Try to maybe get comfortable with the idea that your therapist now may feel that there is a frame of reference for dealing with these issues when and if they arise again.
You've observed before that you can talk to him about almost anything except your relationship. Far from being horrifying to him that you're so vulnerable on the issue of him leaving, he may be gratified that the two of you worked through this to some degree. The true end result may not be that the crisis passed because he's going to stay. It may be that you were forced to bring out into the open your fears about being without him.
Mair
Posted by Dinah on December 16, 2002, at 21:45:16
In reply to Re: Things have settled down., posted by mair on December 16, 2002, at 8:39:33
Hi Mair,
We've had discussions where, as far as I'm concerned I totally revealed how dependent I am on him, and how much I care for him. Yet each time he seems like it's a new revelation. :) I think *his* therapist would have a field day with that. We had a long long discussion on Tuesday about it, and everything worked out wonderfully, and I feel like he really understands. Yet I also know next time we discuss it, it will be exactly the same conversation, because he won't have retained a thing. :)
Oh well, he has many fine and useful qualities.
Thanks,
Dinah
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