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Dr. Bob is Robert Hsiung, MD,
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Posted by fairywings on February 6, 2006, at 6:43:58
In reply to Is this the termination phase?, posted by Dinah on February 6, 2006, at 3:46:24
Doesn't sound like termination is a good idea right now. Maybe you should tell him about what's going on and what you're afraid of. When's he moving back? It's got to be hard with him out of town, and your life in flux.
fw
Posted by fallsfall on February 6, 2006, at 8:23:56
In reply to Is this the termination phase?, posted by Dinah on February 6, 2006, at 3:46:24
"stupid" is definately not the right word for you.
I think that you are grieving, quite appropriately. I'm so sorry for your loss, Dinah. I know that this is painful all the way down to your core.
The suicidal ideation seems so understandable to me. You have planned for years to stop living if your therapy ended. It is your "natural" (practiced) reaction to this situation. But please do note that you have already passed the place where you had always thought you would end your life. You have already proved that you can *survive* past where you thought you couldn't survive. I'm not saying it has been easy, it certainly hasn't been fun, but you have survived so far - much farther than you thought you could.
I believe that you will travel through this phase and make it through to the other side. I also believe that this phase will be excruciatingly painful for you. I wish I could make it less painful, but I think that all I can do is sit beside you and hold your hand and tell you that you aren't alone. So, if it is alright with you, I'll sit down beside you.
(((((Dinah)))))
We're here. Keep talking to us.
Love,
Falls.
Posted by pegasus on February 6, 2006, at 9:24:33
In reply to Is this the termination phase?, posted by Dinah on February 6, 2006, at 3:46:24
Oh, Dinah, I'm so sorry. In theory, the termination phase is something both parties are supposed to decide on together. And it definitely sounds like you haven't decided that it's what you want or are ready for.
I wish you could know that your therapist agrees with that definition, and that he wouldn't "terminate you" against your will. I know it's a great fear of yours, from long before Katrina.
many hugs and wishes of support
peg
Posted by Dinah on February 6, 2006, at 9:51:47
In reply to Re: Is this the termination phase?, posted by pegasus on February 6, 2006, at 9:24:33
To be fair, he hasn't suggested it. He'll probably even get angry if I suggest that's how I feel. It's just that every meeting feels like a goodbye. I don't need him the way I used to. I wonder what to talk about in session. There's a bittersweet feel to everything.
Is that what the termination phase feels like?
Posted by annierose on February 6, 2006, at 16:00:52
In reply to Re: Is this the termination phase?, posted by Dinah on February 6, 2006, at 9:51:47
When I have dared to bring up termination, my T said and I quote "It is bittersweet. You will be ready and we will talk about it for a long time. It will not be sudden."
>>I don't need him the way I used to<<<
That sounds like (cover your ears) growth.
Posted by Bobby on February 6, 2006, at 21:44:35
In reply to Is this the termination phase?, posted by Dinah on February 6, 2006, at 3:46:24
you're really worrying me Dinah. Alchohol and suicidal ideation. Doesn't sound like you at all. Hope it's the alchohol and wears off soon. BTW, I had my first therapy session last week. I've always been somewhat skeptical about seeing a T. But, it's my wife's insisting--so I lose. The T wants my wife to come in after one more session. Not real happy about that. I want it to be one on one for a while. What do you think?
p.s.I posted to you on the Health board.
Posted by pegasus on February 6, 2006, at 21:44:51
In reply to Re: Is this the termination phase?, posted by Dinah on February 6, 2006, at 9:51:47
Yep. According to what I've read, that sounds like you're ready to start a termination phase. Although, having known you for a while here, I'm wondering if it isn't just that you're starting to give up, which is an entirely different phenomenon. Which rings more true to you?
At any rate, if you really are getting yourself into a termination phase, I hope it can take as long as you need it to. I think the idea is that you wouldn't actually end until you want to. And even then, an ideal termination apparently includes an open ended invitation to come back now and then as needed.
But I have to admit that I found those vignettes in the books where the client has a bitersweet final session, where they recognize all their gains and that they're done with therapy, and everyone cries and hugs to sound a bit pollyanna-ish. It's hard to imagine that it really goes that way very often. I'm picturing a lot of turmoil in the mind of the client, underneath their well mannered goodbye. Maybe those are just my issues. Or maybe the therapists who write the books just think that's how it's going? :(
peg
Posted by Daisym on February 6, 2006, at 22:33:10
In reply to Re: Is this the termination phase?, posted by pegasus on February 6, 2006, at 21:44:51
I think it totally depends on the client. When my son decided he was done (the first time), we scheduled the last session and his therapist had him write down 10 things he "learned" during therapy and 5 things he still felt needed some work. And his therapist did the same. Together they read and agreed on the things on their lists of "need work" and "done with." They put the items on cards and tucked them into envelopes. His therapist gave him the "done with" to keep and said this whole speech about no one ever being able to take those things from him. And then they put the "needs work" cards in another envelope and his therapist kept those, and said he would hold on to them until my son was ready, if ever, to come back and work on them. It was a really sweet way to keep that door open.
And a year later he is back in therapy, though unfortunately, working on things from both envelopes. But it was tremendous that his therapist could create such a sense of open door safety that this 14 year old boy knew when he needed to go back and did so.
So not all pollyanna. Thank goodness.
Posted by Daisym on February 6, 2006, at 22:40:56
In reply to Is this the termination phase?, posted by Dinah on February 6, 2006, at 3:46:24
(((Dinah)))
Not stupid at all. Painful. Tearful. A heart full of loss. Too much for any one soul. You have every reason to mourn your place of comfort and safety that got ripped away so brutally. The unpredictibility of it is flat out terrifying.
I don't know about termination. I haven't done one yet, in the true sense of the word. But we seem to be in similar places of giving up that anyone else can take care of us and that we MUST take care of ourselves. And thus we do. But it is a lonely, scary place to live, full of anxiety and other challenges. It was easier to melt into the security that the walls of the therapy office offered. Or used to offer.
Do we redefine our sense of safety? Do we go through these really painful separation episodes to end up at a place of mature relationship without the neediness? I really don't know.
But I'll listen as long as you need to talk about it. Keep posting. It helps me to think about it too.
Hugs,
Daisy
Posted by madeline on February 7, 2006, at 4:33:19
In reply to Re: Is this the termination phase?, posted by Dinah on February 6, 2006, at 9:51:47
dinah,
It maybe time then for you to bring up the termination yourself in therapy.
Tell your therapist how you feel, and then together you both can decide if the time is right for you.
I have never been through the termination phase with a long term therapist, but there is a lot of work to be done to ensure that both parties (yes, even the therapist) can untangle themselves from each other.
One thing that may help is to remember that there is no such thing as a permanent termination. Their door should be, and usually is, always open for you.
Posted by pegasus on February 7, 2006, at 10:23:24
In reply to Re: Is this the termination phase? » Dinah, posted by madeline on February 7, 2006, at 4:33:19
Sorry to butt in, but I had to comment on the "no permanent termination" idea. I only wish it were so. Unfortunately, many of us here have indeed experienced permanent terminations, where there is no option to come back to the therapist, for one reason or another. But I agree that in an ideal case, it would always be possible to come back when needed. I hope Dinah's case will be more ideal than not, whenever she does end up deciding to terminate.
peg
Posted by pegasus on February 7, 2006, at 10:26:07
In reply to Re: Is this the termination phase? » pegasus, posted by Daisym on February 6, 2006, at 22:33:10
Oh, how beautiful. I'm glad that your son has such a skilled and sensitive therapist. And I'm glad to hear about a positive termination in real life.
I guess my skepticism means that I still have issues around endings that I could work on some more . . .
Well, no big surprise there.
peg
Posted by Dinah on February 7, 2006, at 12:11:44
In reply to Re: Is this the termination phase? » Daisym, posted by pegasus on February 7, 2006, at 10:26:07
I think maybe I'm not ready to examine this too closely. Bringing it up at all is traumatic enough. Well, bringing it up in words.
I made the hugely bad choice to call my therapist yesterday. The return of the suicidal thoughts, along with the pain led me to call him for one of the rare times since he returned from his month long trip. I do know better. :(
I clearly can't talk to him about this. Except for telling me he didn't think it was as much about termination as it was about me being unable or unwilling to accept the changes that Katrina had brought, he made it into something totally about him. He capped it off with saying he was sorry if he was no longer the therapist for me.
Which of course not only sent me into hysterics, but was right before he told me he had a client waiting and had to go.
I'm not going to make the mistake of talking to him about this again. I'll deal with it myself.
I started the Risperdal again, at a fairly high dose. It doesn't change the feelings, but it should make me behave better. And that's what counts, isn't it?
Posted by Dinah on February 7, 2006, at 12:24:08
In reply to Re: Is this the termination phase? » Dinah, posted by Bobby on February 6, 2006, at 21:44:35
It's not as bad as it sounds. Suicidal ideation is an old "friend", it just hasn't been around for a few months.
And the alchohol wouldn't be significant by any standards. Maybe an inch in a kitchen glass. But it helps the pain.
Therapy isn't all that bad. :) The last therapist I went to said something along the lines that when she met with couples, she preferred that both parties be involved right away. Maybe if you want individual therapist she'd be ok with you doing that as well.
Posted by fallsfall on February 7, 2006, at 14:04:21
In reply to Re: Is this the termination phase?, posted by Dinah on February 7, 2006, at 12:11:44
(((Dinah)))
No, your behavior is not all that matters. You matter.
Your therapist has never been good on the phone, but this conversation sounds even less good than usual. I'm sorry.
(((Dinah)))
let me know if I can help...
Falls.
Posted by Dinah on February 7, 2006, at 14:46:35
In reply to Re: Is this the termination phase? » Dinah, posted by fallsfall on February 7, 2006, at 14:04:21
Yeah, it wasn't pretty. But the thing is that I knew better. It was stupid of me to expect anything else.
He's got enough troubles that he doesn't need my foolishness on top of it.
In theory it may be true that something other than my actions matter, but in practice that's just not true. I get in trouble whenever I forget that. :(
Posted by annierose on February 7, 2006, at 16:29:42
In reply to Re: Is this the termination phase?, posted by Dinah on February 7, 2006, at 12:11:44
(((((((((Dinah))))))))))))
I wish I knew what to say to make you feel better. I don't think your T meant to hurt your feelings. I don't think he realizes how hurtful his comments are. I would feel so destroyed if my T said, "I'm sorry if I'm no longer the therapist for you." That is not what you believe.
Maybe the struggle is less about termination, because clearly that isn't something you really want, but more about how the dynamic in the relationship has changed since Katrina.
I wish I had more wisdom. I wish I could make it better.
Posted by Dinah on February 7, 2006, at 16:51:29
In reply to Re: Is this the termination phase? » Dinah, posted by annierose on February 7, 2006, at 16:29:42
I think there were a few inklings before Katrina, though the natural course of things would have been to decrease the thoughts of separation under the increased stress. But things just aren't the same. He says that he's not the same person since the storm, and I think he's right. I think he wants me to just put the relationship in cold storage and pull it out and go on as if nothing had happened when things are back to normal for him. Or to accept that everything has changed, nothing will be the same, but think that that doesn't change things. I don't know.
Looking back, I think that he was being defensive. He has been having a lot of trouble lately separating what I'm trying to say about myself from what he thinks I'm trying to say about him. I have to fight with him to get him to drop his own person out of the equation to hear what I'm saying. And I'm not sure I succeed. So he was hearing that I was telling him that his efforts weren't enough. And I was trying to tell him that I was afraid of my own feelings. I heard his statement as a veiled threat that if I didn't like how things were, I could find another therapist. But I don't *think* that's how he meant them.
I need to try to stop conveying any feelings about therapy or about anything that could remotely be connected to therapy. Even though those things are uppermost in my mind. Even in the permutations of wondering whether we'll have to move, or about my job, therapy concerns run through all of those things, and I just can't talk about them with him. He says I can, but if I believe him and try, I get punished for it.
I think our relationship will at least be smoother if I start lying like crazy.
Posted by madeline on February 7, 2006, at 19:19:01
In reply to Re: Is this the termination phase? » madeline, posted by pegasus on February 7, 2006, at 10:23:24
I'm really sorry to hear that a lot of people have suffered permanent terminations. I worry from time to time about that myself, but my T always says, "only when we are both ready and it is never permanent".
I hope he means it.
Posted by 64bowtie on February 8, 2006, at 14:56:39
In reply to Re: Is this the termination phase? » annierose, posted by Dinah on February 7, 2006, at 16:51:29
(((Dinah)))
>...if I start lying like crazy.
<<< Scott Peck, ""A Road Less Traveled", calls the therapy process "The Lying Game", until the client decides to make the necessary changes in habits, behaviors, and beliefs... Sounds like your pains and sufferings have driven you backwards several steps in your recovery, if you find a need to rekindle "The Lying Game"... No matter... I'm still here for you....
Rod
Posted by Dinah on February 8, 2006, at 20:22:46
In reply to Re: Is this the termination phase? » pegasus, posted by madeline on February 7, 2006, at 19:19:01
My therapist called me this afternoon to tell me that he was in town and could see me this evening. So, feeling somewhat selfish for it, I inconvenienced my husband a bit and took the appointment.
And everything was ok! I just can't keep up with what goes on. He admits that he was probably defensive, but asked me how I would respond if he started talking about termination. I reminded him that I was *supposed* to respond that way; I'm the client (who wouldn't be there if I didn't have some difficulties). Plus I am so emotionally engaged that I couldn't possibly be objective.
Anyway, he sat and listened. And while I'm not sure he understood, well no one really does. At least he tried, and he didn't take it personally.
It's so hard to explain how even if I don't need him as much, I still need to need him. And feeling like I don't need him terrifies me because of the intense need to need him.
It all came down to growth of course. And how most people just don't realize why it's such an incredibly negative thing. That what you lose is so vastly more important than what you gain. That all I want, all I've ever wanted (aside from stuff), was to feel safe and secure.
Posted by annierose on February 8, 2006, at 21:16:17
In reply to Up and down and up and down and..., posted by Dinah on February 8, 2006, at 20:22:46
I do understand. Feeling safe and secure is a wonderful thing. Who would want to give that up? But I'm not sure you have to. It will become a part of you.
Don't get me wrong. I am still fully engaged in the therapy process and termination seems extremely scary to me.
I'm glad you were able to see him tonight.
Posted by Dinah on February 8, 2006, at 21:43:55
In reply to Re: Up and down and up and down and... » Dinah, posted by annierose on February 8, 2006, at 21:16:17
I'm not really finding I've internalized that. :( I may feel more confident that I can handle things without needing him. And I might not feel the intensity in sessions and I might wonder what I'm going to talk about. But that doesn't bring any feelings of safety or security. Just loneliness.
I am glad I went today. I now remember something that kind of slipped past me during the session because we were in the middle of something else. He told me that he had somewhere along the course of our therapy figured out that he was never going to terminate me for any reason and that therapy was only going to end when I ended it.
I think I understand his therapeutic reasons for that, what with my abandonment issues and all. But hearing him say it so starkly does give me a feeling of reassurance that discussing this frankly won't cause him to agree with me and terminate me over it. :)
Posted by fallsfall on February 9, 2006, at 7:57:43
In reply to Re: Up and down and up and down and... » annierose, posted by Dinah on February 8, 2006, at 21:43:55
(((Dinah)))
The up and down could be because he keeps vascillating between being the therapist and the patient. You were so right to tell him that you would be allowed to be devistated by termination BECAUSE you are the patient.
While I understand your peace at knowing that he won't terminate you for any reason, he is being unethical. A therapist is REQUIRED to refer a patient on when the therapist is no longer able to help the patient (and "not hurting" the patient doesn't qualify). He is abdicating his responsibility and asking you to be the therapist, just like your parents asked you to be a grownup.
This reminds me so strongly of my first therapist - I believe that she was *afraid* to refer me on. Afraid because of what my reaction would be. Therapists *hurt* us when they are afraid of us. I hope that you can stop being hurt.
Dinah, it is time to figure out how you are going to get out of this therapy. He is not going to help you do this - in fact he has shown that he will make it more difficult for you. I know that this is an impossibly hard thing for you to do, but you have already come an awfully long way in the healthy direction. I think that you know that this is what you need to do. Can you start to shift from "how can I stay in this therapy" to "how can I plan for the future"? Can you start to envision how your life could thrive without this therapy?
I'm so sorry, Dinah. But you need to take care of yourself, because he isn't taking care of you.
Posted by Dinah on February 9, 2006, at 12:19:19
In reply to Re: Up and down and up and down and... » Dinah, posted by fallsfall on February 9, 2006, at 7:57:43
I have to admit that he hasn't been himself since Katrina. And I do understand that, given what's going on in his life. I think he'd be the first to agree. And there are times when that's hurting me.
But I also have to admit the possibility that I may be distorting things. It certainly wouldn't be the first time I did that around emotionally charged situations.
If we can ever manage to get on even keel, I think that his style of therapy *is* right for me, as evidenced by the fact that I'm worrying that I am growing out of needing therapy.
A lot of what he does with me is based on what he knows about me and about how I react. He always has been a strong believer that a message needs to be delivered in such a way that the intended recipient can hear and accept it. He knows, based on ten years experience, what helps with me and what causes me to dig in my heels and resist. I've always thought that was either part of his genius with me, or an unnaturally fortuitous coincidence, that he takes the strategy of letting me learn on my own. Of letting me lead in some ways in coming to interpretations of my behavior, although of course I'm sure he leads me in his own way with small comments and suggestive statements. But mostly his strategy is radical acceptance of me. He knows me well enough to know that I'll resist that acceptance enough to make changes, if that makes sense.
And thinking back over my entire life, and how I learn, and how I reacted to various teachers, I'm struck again with how brilliant that is of him. Now, whether he realizes that or not, whether he just intuitively acts that way based on my reactions, or whether his natural style just meshes well with mine, I'm not sure.
But (and you may have recognized this in me), I'm rather naturally a contrarian. Not a rebel. Oh no. But being contrary is rather oddly one of my greatest natural skills. And as much as I hate to admit it, I also inherited a modicum of my mother's will. Just a small tiny percentage, mind you. I won't admit to more than that.
So his genius is in giving me nothing to push against. No matter how ridiculous something I say might be, he takes it at face value and accepts it. Then I have to admit how ridiculous it is myself.
I don't know. At our best therapy with him is this wonderful alchemy. It helps me transform myself into something better.
Now isn't our best. And I careen between thinking it can never be our best again, and thinking that just maybe it can be. He has faith that it can be. The cockeyed optimist. ;)
I happen to think he's right about the termination though. Coming from me, it would be traumatic to me. Coming from him, it would confirm every suspicion I've ever had about what happens when I care about someone. It would have hugely negative influence on my already shaky ability to trust. I can't see how that would be therapeutic.
This is the end of the thread.
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