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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 39. This is the beginning of the thread.
Posted by Aphrodite on November 26, 2004, at 7:30:19
I really need to stop reading articles meant only for clinicians. I start to worry about what I am doing to my T as I read that working with trauma patients is, well . . . traumatic . . . for the therapists as well.
That said, I read a piece on countertransference after a particularly rocky week with my T. I couldn't believe how the article was line for line an analogy of my week in therapy! I was a mess -- I had been getting stronger, some techniques were working, so my cynical, abusive side came back with a vengence. My T said my internal critic, who has protected me thus far, was afraid things were changing and leaving her out. So, she reasserted herself.
My T has been using visualization techniques with me to help the various ego states deal with their conflicts. It had been working very well. I had some stressful work and life experiences in the meantime which made those techniques not so helpful when I returned Wed. I was his last appt. Wed. night before Thanksgiving. I really just wanted to talk, but I thought my suicidal ideations and some of the life stressors would cause him to worry over the holiday, so I was trying to walk a fine line. I went ahead with the visualizations -- I told him my "little girls" were not easily soothed that night. He was persistent. He spoke sternly to the cynic and gently to the girls. So, as many women do, I faked it. ;) I purposely slowed down my breathing, pulled myself together, thanked him for the "comfort" and left.
Thus began the "dance of empathy" I read about. The T comes on strong, arguing with my distortions, "forcing" me to relax. I then see him as the abuser and then I comply. The next step in the dance is the T sensing that he has done this and retreating. When I came home, he called and said he felt that perhaps he didn't allow me to control the session. He wanted me to have the opportunity to ask for what I needed on the phone. In the dance, the patient sees this retreat as the failing mother protector. The patient is now alone with a passive figure and is frightened. I didn't know what to ask for. I was empty when we hung up.
OK, I thought I should tell him I had faked it. I called him back and told him. He was silent. I asked, "What's wrong?" He answered, "I am going through in my mind all the other times we've done these techniques and trying to figure out what has been the truth and what has not." Ouch! He got a little flippant. "So, when I saw your shoulders drop, that was something you did on purpose?" he asked sarcastically. We hung up again. I called back in tears and left a sobbing message that he never allows me to be honest, he punishes me, "you turn your compassion on and off when it suits you!" Who knows what else I hurled out! In the dance of empathy, the patient identifies with the abuser and lashes out to hurt others and then recoils in horror. That was me! I was hurting, I blamed him, and I wanted him to have to feel some pain too and immediately regretted it.
He called back (it was now near midnight), I was sobbing, and he said and did all the right things. I don't feel great but definitely better. This is the end of the dance of empathy when the T "gets it" and assumes the right balance of strong protector and sympathetic guide.
I think I need dance lessons. I can't keep doing this!
Posted by Dinah on November 26, 2004, at 8:31:08
In reply to The Dance of Empathy (long), posted by Aphrodite on November 26, 2004, at 7:30:19
Argh. That sounds awful. I guess it's the particular battle you and your therapist need to face in fighting to relationship.
I wish it were in all the therapy manuals, though, that emotionally charged subjects should be strenuously avoided before a holiday or vacation.
Posted by fallsfall on November 26, 2004, at 9:37:17
In reply to The Dance of Empathy (long), posted by Aphrodite on November 26, 2004, at 7:30:19
Wow. Where did you find the article? That is amazing stuff. I'm rereading "The Dance of Anger" right now (well, I'm trying to read it, but for some reason my comprehension is really nil...).
I'm so glad that you kept calling back and moving through the dance. That would be a horrible place to be stuck over the long weekend.
I continue to be amazed how things we do "make" our therapists do certain things back (and vice versa). And it is mind boggling to think that all of this stuff happens in all our other relationships, too.
Thanks for telling us about such an interesting time.
Posted by Daisym on November 26, 2004, at 12:45:01
In reply to The Dance of Empathy (long), posted by Aphrodite on November 26, 2004, at 7:30:19
I think one of the key things is that you both hung in there, trying to figure all this out. What did you need? What was he able, and willing, to give, within the boundaries of therapy? And most importantly, why are you acting out in this manner?
I suspect faking it to meet someone else's needs is an old, very strong defense devices. If they are getting what they expect, or need from you, they don't push pass what they see. So you can control things better. I'm a real pro at this. In therapy, I've made a commitment to be honest about what I'm thinking or feeling, but sometimes that is so hard that I end up wordless, in this jumble of feelings. But I haven't just "made nice" for a while. You used the word "empty" and that is how I feel if I can fake something and get away with it. It is almost like, "Hey, you know me better than anyone. You are SUPPOSED to be able to tell..." Not very realistic, I know. I guess it is all tied up with wanting our therapists to be magic.
As far as reading articles meant for clinicians, I research when I'm overwhelmed. I look for answers in the books, on my own. I guess I think I can "cure" myself enough so that he won't get frustrated with how much work there is to do. I'm impatient too, so I keep thinking I'll find a shortcut.
All in all, I'm sorry things are tough. It certainly is an ebb and flow -- feeling better, feeling worse again. Be nice to yourself and let it go for a few days if you can. There are some really great shoe sales going on. :)
Take good care,
Daisy
Posted by Toph on November 26, 2004, at 14:57:44
In reply to The Dance of Empathy (long), posted by Aphrodite on November 26, 2004, at 7:30:19
I'm don't have much expertise in treatment Aphrodite, but I'm struck by the metaphor. There are dances where someone leads and dances where two dancers compliment each other in harmonious movement. Your dance seemed to start as the former and progressed through the night into something approaching the ladder.
-Toph
Posted by Dinah on November 26, 2004, at 18:16:15
In reply to Re: The Dance » Aphrodite, posted by Toph on November 26, 2004, at 14:57:44
Posted by Toph on November 26, 2004, at 18:20:10
In reply to I like that :) (nm) » Toph, posted by Dinah on November 26, 2004, at 18:16:15
Posted by Toph on November 27, 2004, at 6:55:23
In reply to The Dance of Empathy (long), posted by Aphrodite on November 26, 2004, at 7:30:19
To further develop the metaphor, empathy then is the music or rhythm providing the thematic framework, if you will, of your therapeutic pas de deux, adagio in this case.
-Toph
Posted by Dinah on November 27, 2004, at 7:28:06
In reply to Re: The Dance » Aphrodite, posted by Toph on November 27, 2004, at 6:55:23
I really do like that metaphor, Toph. It makes me wonder what rhythm or music is the framework to the dance between my therapist and me. I don't think it's empathy in our case.
Posted by Aphrodite on November 27, 2004, at 7:36:33
In reply to Re: The Dance of Empathy (long) » Aphrodite, posted by Dinah on November 26, 2004, at 8:31:08
> I wish it were in all the therapy manuals, though, that emotionally charged subjects should be strenuously avoided before a holiday or vacation.Amen! I think you just gave me an idea for a new thread . . . Be watching;)
Posted by Aphrodite on November 27, 2004, at 7:42:00
In reply to Re: The Dance of Empathy (long) » Aphrodite, posted by fallsfall on November 26, 2004, at 9:37:17
You are right, Falls, that we do have this going on in our other relationships. The difference is that I don't sob on other people's answering machines!
The article was by McCann in a book called "Countertransference in the Treatment of PTSD"
Posted by Aphrodite on November 27, 2004, at 7:43:23
In reply to Re: The Dance of Empathy (long), posted by Aphrodite on November 27, 2004, at 7:42:00
Posted by Toph on November 27, 2004, at 7:48:53
In reply to Re: The Dance » Toph, posted by Dinah on November 27, 2004, at 7:28:06
> I really do like that metaphor, Toph. It makes me wonder what rhythm or music is the framework to the dance between my therapist and me. I don't think it's empathy in our case.
My interaction with my therapist, is less of a dance and more of a cage match, I'm afraid, Dinah. A cage, I suppose, because I have to see him for my meds, and a match because I'm too damn vain/afraid/stubborn to really submit to the process. My loss, he says.
Posted by Aphrodite on November 27, 2004, at 7:50:43
In reply to Re: The Dance of Empathy (long) » Aphrodite, posted by Daisym on November 26, 2004, at 12:45:01
Where did you shop yesterday? I just didn't see any good shoe sales at all! I really wanted some brown, dressy boots. They were all either the 5 inch spiky heel kind or hiking boots. No good sales, either.
Anyway, I've read yet another article about this "faking it" thing I sometimes do. It says that we "test" our therapists to see if this relationship will be different and safe. If there is concern or worry that the T will behave like other relationships, trauma patients will preserve the relationship at the expense of expressing an authentic self. At this point, I am never sure how he will respond to my raw honesty. Sometimes he is incredibly understanding, sometimes he becomes angry, sometimes he gets very upset with me. So I believe I do comply -- I like people to be pleased with me! -- in order to preserve this much-needed relationship.
We started the conversation the other night when I was crying and saying I couldn't be honest with him. He acknowledged his inconsistency but countered that I don't let him in. True enough. I'm interested to find out if things will change with either of us.
Thanks for your support.
Posted by Aphrodite on November 27, 2004, at 7:53:23
In reply to Re: The Dance » Aphrodite, posted by Toph on November 26, 2004, at 14:57:44
I really like your analogy. Sometimes, when I am stuck with something he said, he'll say, "Were my lyrics right but the music was not?" That is often the case.
And I think "ladder" may not have been a typo! Yet another good analogy, climbing to the top of a precarious ledge. ;)
Posted by Toph on November 27, 2004, at 8:39:02
In reply to Re: The Dance » Toph, posted by Aphrodite on November 27, 2004, at 7:53:23
Yeah, I thought about that slip, too. But, what's with your T calling you at home, doesn't that break the sanctitiy of "the room" and all? If my shrink were to call me it would be to complain that I'm late with my check.
Posted by Aphrodite on November 27, 2004, at 8:47:53
In reply to Re: The Dance » Aphrodite, posted by Toph on November 27, 2004, at 8:39:02
My T calls me at home and on my cell phone a lot between sessions to check-in when I'm having a hard time. He usually calls late, after his evening appointments. He's a worrier, which is sweet. It's not unusual to get calls at 10:30 or later. (He asked if it was OK to call late since he's a night owl.) My husband asked if my shrink was a vampire;)
Posted by Toph on November 27, 2004, at 9:05:33
In reply to Re: The Dance » Toph, posted by Aphrodite on November 27, 2004, at 8:47:53
Therapy is what you make it, I suppose, and I'm sure there are various styles, techniques, and environments that are effective for different people. I'm glad that yours is so open, caring and familial, Aphrodite. But considering the issue of treatment boundaries, what if some of the work of your therapy involves relationship issues in your home, couldn't there be a problem if your T is calling you there and sort of injecting himself into the problem either literally or psychicly?
Posted by Aphrodite on November 27, 2004, at 10:17:46
In reply to Re: The phone » Aphrodite, posted by Toph on November 27, 2004, at 9:05:33
You raise a very valid point and concern. However, one of the things I used to never do is call him or respond to his phone calls. At one point, when I was having a very hard time, he said that considering I don't have meds or adequate social support and refuse to use his phone support between sessions, we were at an impasse and it was against his treatment ethics and philosophy to continue to let me discuss trauma, do EMDR, or anything else "uncovering." He said I could, under those circumstances, come for general support, but no hard work until I was able to receive help in some form. So, I being Ms. Little Independent all my life, began by allowing phone support which has, for the most part, been tremendously helpful once I went back into discussing trauma. It makes both of us feel safer about the process, and it helps me feel more stable between sessions. He has also commented on the fact that I disclose more on the phone than I do in his office, and he uses the phone when he feels like he needs more information about something difficult for me to discuss. I guess it's because I'm not inhibited about the tears falling down my face or trying to read his body language.
I've recently shut down again (my choice) until I get on meds and allow for some social support. He thinks that all of these things in place will help the trauma work go more smoothly.
Of course, my cyncial, non-trusting side says I've just become a nice part-time job for him since I pay him for any phone call over 15 minutes! ;)
Posted by Toph on November 27, 2004, at 11:23:17
In reply to Re: The phone » Toph, posted by Aphrodite on November 27, 2004, at 10:17:46
I wasn't being critical, I think flexibility is good. Who am I to talk, when I was in graduate school I took a hard to engage adolescent client fishing!
Posted by Dinah on November 28, 2004, at 9:42:52
In reply to Re: The Dance » Dinah, posted by Toph on November 27, 2004, at 7:48:53
For a long time, ours was the dance of intimacy/attachment/dependency I think. My therapist admitted to having problems with dependent women. I was a totally independent person who was struggling hard against my feelings of attachment and dependence on him. And I was also the needy little girl who needed to attach. It was quite an intricate dance, with a fair amount of anger thrown in.
I think lately the dance has changed quite a bit. We're like two old married people who know each other so well that we take shortcuts with interaction. It's comfortable. Pleasantly unexciting. So maybe that dance has ended.
If there's any conflict in our relationship right now it's over expectations. He gets angry that I don't do or think or feel what seems perfectly logical to him. And maybe a bit too much honesty that comes from the fact that he feels comfortable with me.
Hmmm... Maybe the same dance but on the other side. The dance of too much intimacy?
Posted by Toph on November 28, 2004, at 18:02:38
In reply to Re: The Dance » Toph, posted by Dinah on November 28, 2004, at 9:42:52
Your dance gives me the feel of human development. Your work seems to change, but in the main, mature to the next stage. I envy you that, if this is the case. My relationship with various thearapists have always seemed to stagnate at father-son, brother-brother, shrink-adolescent. Hey, who said old people can't dance? Is their some kind of dance card, turn-about, line dance that you can propose with your therapist?
Posted by Dinah on November 28, 2004, at 20:15:41
In reply to Re: The Dance » Dinah, posted by Toph on November 28, 2004, at 18:02:38
When things settle down for me personally, maybe I'll suggest it.
At a time when I'm being a mother to my parents, and my marriage is on shaky ground, and my whole world seems in disorder, it's kind of nice to have that slightly boring old shoe relationship.
Yeah, I guess it has matured in a way, and is still maturing. Relationships tend to do that, dont' they? It may take a while... (grin)
Posted by Toph on November 29, 2004, at 14:39:06
In reply to Re: :-) » Toph, posted by Dinah on November 28, 2004, at 20:15:41
I reread your previous post about the dance of intimacy. It's a word that I wouldn't use for my therapy probably because it's not the kind of relationship I find easy to have with a man, especially my father, my son or my friends, let alone my shrink.
Etymology: from Latin intimus
1 a : INTRINSIC, ESSENTIAL b : belonging to or characterizing one's deepest nature
2 : marked by very close association, contact, or familiarity <intimate knowledge of the law>
3 a : marked by a warm friendship developing through long association b : suggesting informal warmth or privacy <intimate clubs>
4 : of a very personal or private natureSo looking at the definition, intimacy seems the perfect word in this case. Perhaps I should explore more the barriers that keep me on the side watching others sway with the music.
Posted by annierose on November 29, 2004, at 17:17:55
In reply to Intimacy » Dinah, posted by Toph on November 29, 2004, at 14:39:06
I think therapy is indeed an extremely intimate relationship. And even though it is one-sided, the T does give so much of themselves (time, patience, caring, empathy, understanding, thoughtfullness .... frustration). I liked the thread and the analogy.
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