![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 28. Go back in thread:
Posted by slugdoo on August 13, 2007, at 2:58:34
In reply to ***** Long, tedious and triggery *****, posted by Tamar on August 12, 2007, at 21:52:23
Hi Tamar,
It sounds like he needs some stiffer boundries for himself. He is messing up and when T's do that, it caused us to suffer. But I know you know that. He does sound very distracted, so it must be something, but that something shouldn't interfer with his job, at least not this many times.
One thing my old T was good at , he NEVER called to cancel with me in 2 1/2 years, and he is never more than 5 mins late either. It did give me a sense I could count on him. That is so important I believe. I would feel like you if this happened to me with my T. I don't think it is your fault for wanting more, you DESERVE more. Have you ever brought this issue up?It sounds like you have some big issues you are working on and you deserve better treatment, you need to be able to rely on him or the trust will just not be there. (((((Tamar))))))) I am so sorry things are going tough for you.
Posted by Squiggles on August 13, 2007, at 6:37:55
In reply to ***** Long, tedious and triggery *****, posted by Tamar on August 12, 2007, at 21:52:23
I'm not sure about T-vocabulary; what are the
boundaries and the framework for example? Also,
if you would be happy having a loving relationship, is the therapist the best person to have that with? Maybe, a bodyfriend, or a husband? I'm not sure what your needs are, but i have noticed a dependence relationship or bond forming with many patients here and their therapist. What happens, when he's gone; it's one of the reasons i think a dr. and social worker team would be less personally intrusive.
It's just my perspective, i may be wrong altogether about the benefits as i have only been to a counsellor in my life, outside a therapist.Squiggles
Posted by JoniS on August 13, 2007, at 8:58:40
In reply to ***** Long, tedious and triggery *****, posted by Tamar on August 12, 2007, at 21:52:23
Tamar,
You were brave to write this post. You are going through a lot of stuff. I think I understand all of your feelings.
You are working harder to keep the boundaries than your T is. I think common sense and your intuition too is telling you that wont be a theraputic relationship if it continues. You are having to put your needs after your T, and that is very wrong and your T knows that.
>
> "...Anyway, I want to keep working with him because when he’s there he’s brilliant. But when he’s not there, I feel humiliated and rejected. Certainly his absences reinforce all my negative thoughts about myself. And at times I think trying to do therapy in this way is damaging me..."
You see, right there you know that it is damaging to your emotional health.
> "...I can’t talk to him about it because he wards me off at the first sign of discomfort and I can’t cope with it. I dissociate and then cry later. I’m terrified. I’m so desperate to talk but if he keeps hurting me I’m afraid I will kill myself..."I'm sorry I don't understand what you mean by "...he wards me off..." But if you keep getting stuck at "terrified" and then feel like you will kill yourself how can this become healing for you? How long should you wait for his life to get back to normal so he can do his job right?
>
> "...I’ve always believed love is a gift. I’m so ashamed of feeling love for someone who doesn’t want my love. It’s like… making an effort to choose something really nice for him, something I think he’d really like, and giving it to him, and then it turns out he thinks my gift is cheap and nasty; he thanks me insincerely and later, after I’ve left, he throws it in the trash. Why do I want to give him something he has no use for and that isn’t to his taste? ..."I believe love is a gift too. But it's my belief that your perception of your feelings and how he would feel about them is very distorted. I have had similar thoughts and worked through a lot of them with my T. It is so not good for you to have to put off dealing with your feelings because of him. If he is a good T he will listen tenderly (and he already knows how you feel, he's an expert on feelings) and he will validate your feelings of love and help you to get rid of the feelings of shame. He definitely wont throw your "gift" in the trash!
I guess I'm making an assumption here that he is a well trained PhD and experienced T
>"... I hate myself for thinking these things because it seems so overdramatic and irrational, but it won’t go away. I’m certain I’ll eventually talk to my therapist about loving him, and he’ll respond by reminding me of the professional nature of our relationship, and he’ll say nothing about what my feelings of love mean to him, and that will be that..."Please don't hate yourself for having normal feelings . I suspect that he will remind you of "the professional nature of your relationship..." but that does not mean the feelings are wrong or bad. He should let you know that your feelings are valid and the boundary is just a reminder that neither of you will act on the feelings but they are there and need to be dealt with. That is a very healing session - builds trust and helps you to feel better about yourself.
I hope you can work through these things with your T, but in the meantime, I relly believe you need to find a new T that you can build a healthy theraputic bond with. It would be ideal if you could transition from your current T to a new one. Deal with the feelings you have (which are so normal and OK) and move on to a T who will respect the important boundaries of t and help you work on the trust issues.
You can take my opinion with a grain of salt. I hope it's helpful, but if not that's OK. I would like to at least let you know you are supported.
I know what it is like to cry in the bed loving your T but getting no reciprocation. I just did some of that yesterday for a couple of hours myself. I believe they still love us, just in a different way. I think that dealing with all this is a big part of therapy, so I'm looking forward to the day I can deal with this and not cry full of pain and sadness.
I'll be thinking of you and wishing you well.
Joni
Posted by Tamar on August 13, 2007, at 9:03:38
In reply to Re: ***** Long, tedious and triggery ***** » Tamar, posted by twinleaf on August 12, 2007, at 22:43:49
> This sounds so frustrating! I think a good relationship with a therapist- one that doesn't change, and does not ever cause pain, is essential for us to feel safe, respected, cared for and able to deall with the things which are important to us. If we have to worry about the relationship itself so much of the time, there isn't too much time left to deal with the issues we would like to- and, really, only we, as patients or clients, really know what those are.
Yes, and he acknowledges all of this.He apologizes, and he recognizes the need for stability. He just can't seem to provide it...
> This sounds hard, because when he's really with you, things go well. But there do sound like a lot of difficult, painful times. I guess I have to ask: would another therapist be better for you?
That's a hard question. I've been through so much with this therapist and there are things he understands that most people probably wouldn't. And I've looked into other therapists in the area and the only one that appealed to me turned out to be my friend's therapist, so I decided I wouldn't go there, in case it caused problems with my friend.
Like so many people in difficult relationships, I want him to start doing things right instead of my having to leave.
Posted by Tamar on August 13, 2007, at 9:05:10
In reply to Re: ***** Long, tedious and triggery ***** » Tamar, posted by twinleaf on August 12, 2007, at 22:43:49
Posted by Tamar on August 13, 2007, at 9:16:44
In reply to Re: ***** Long, tedious and triggery *****, posted by slugdoo on August 13, 2007, at 2:58:34
> It sounds like he needs some stiffer boundries for himself. He is messing up and when T's do that, it caused us to suffer. But I know you know that. He does sound very distracted, so it must be something, but that something shouldn't interfer with his job, at least not this many times.
I guess... some things can't be changed. After all, if his partner is ill (for example) it's going to interfere with his work. And I do believe his partner should come first, if that's what it is. At least, I believe it at a rational level. I would find it easier if I knew what the problem was, because then I could meditate (pray, cast spells, or whatever) about it...
> One thing my old T was good at , he NEVER called to cancel with me in 2 1/2 years, and he is never more than 5 mins late either. It did give me a sense I could count on him. That is so important I believe. I would feel like you if this happened to me with my T. I don't think it is your fault for wanting more, you DESERVE more. Have you ever brought this issue up?
Wow, I'd love it if my therapist were that reliable. Twinges of envy... Yes, I DO deserve more, and I do bring it up because every time it happens I feel a little more anger and a little more self-hatred. He can't do very much about it though, except tell me he will be the best therapist he can be (which appears to be a slightly unreliable therapist). I asked him once to reassure me that he still wanted to work with me and he said, "I think you know, Tamar, that I don't think it's helpful to offer you that kind of reassurance." The 'I think you know' part hurt the most. I really resent his refusal to reassure me after letting me down.
> It sounds like you have some big issues you are working on and you deserve better treatment, you need to be able to rely on him or the trust will just not be there. (((((Tamar))))))) I am so sorry things are going tough for you.
Thanks for the hugs. I keep hoping he'll get more reliable. Who knows what the future holds?
Posted by Tamar on August 13, 2007, at 9:20:53
In reply to Re: ***** Long, tedious and triggery ***** » Tamar, posted by Squiggles on August 13, 2007, at 6:37:55
> I'm not sure about T-vocabulary; what are the
> boundaries and the framework for example?I’ve had no psychological training, but here’s how I understand it:
Boundaries are concerned with issues of contact between therapist and client: how much a therapist tells the client about himself/herself, whether there will be hugging, whether the client may call the therapist at the office, or outside of office hours, whether the therapist will accept gifts from the client, and things like that.
The frame is about the environment in which therapy takes place: how long the sessions last, where they happen, when they happen, and how often. I think the boundaries are part of the environment and so can be considered part of the frame.
> Also,
> if you would be happy having a loving relationship, is the therapist the best person to have that with? Maybe, a bodyfriend, or a husband?I have lots of loving relationships with partner, children, parents, friends… But I love my therapist too, because he cares (albeit professionally) for my emotional needs. It’s not the same as the care provided by a GP or a gynaecologist or whatever: it’s much more intimate because of the things I talk to him about.
> I'm not sure what your needs are, but i have noticed a dependence relationship or bond forming with many patients here and their therapist. What happens, when he's gone; it's one of the reasons i think a dr. and social worker team would be less personally intrusive.
Yes, many patients develop a bond with their therapist. Some become dependent. Do you see that as a bad thing? I need to be able to bond with and depend on my therapist because I need to work in transference. The work I need to do is inevitably personally intrusive because it involves my gender, sexuality and body. A doctor and social worker team wouldn’t be able to help me much on those issues, unless they were psychoanalytically trained perhaps.
What should happen (I believe) is that I should be able to work though all that stuff by bringing my transferential material to therapy, and working through that with the benefit of my therapist’s interpretations based partly on his clinical skill and experience and partly on his countertransference reactions. He would work with me to find ways of integrating the different parts of myself until I’m better able to live happily with who I am. And when I get to that point I will no longer feel so dependent on my therapist and I will be able to cope with leaving him.
That’s what I want. I make it sound easy, eh? His apparent resistance to my transference is my first problem, and one I haven’t yet been able to solve.
> It's just my perspective, i may be wrong altogether about the benefits as i have only been to a counsellor in my life, outside a therapist.
Well, I guess the benefits of therapy to me might be very different to the benefits to you because we wouldn’t be working on the same issues, and even if we had similar issues, we’d have different experiences of them. Each person has unique experiences of therapy, so it’s hard to generalize.
Thanks for your thoughts about all this.
Tamar
Posted by antigua3 on August 13, 2007, at 9:28:54
In reply to Re: ***** Long, tedious and triggery ***** » Squiggles, posted by Tamar on August 13, 2007, at 9:20:53
Whoa, you just pretty much described my relationship with my Pdoc. He's never late, but he won't return calls (which makes him unreliable in my book) or get "involved" in our relationship.
What you want to achieve with your T is what I want with my Pdoc. He has very strict boundaries, but I don't think he's holding up his end of the "therapeutic relationship." I tend to think he is afraid of me, can't handle me or just doesn't want to get involved.
I see him tomorrow and I'm going to bring this up again (we've discussed this before). If I don't feel good about how it turns out, I'm going to find another Pdoc. It's interfering with my life and I don't want to worry about this anymore. Sometimes I wonder if I've let myself get into another abusive relationship and if I have, I have to get right out of it.
I need things from him that he either doesn't see or refuses to give.
I'm sorry you're going through this, but I certainly understand. When my pdoc is "on" it's just fantastic.
best,
antigua
Posted by Squiggles on August 13, 2007, at 9:44:33
In reply to Re: ***** Long, tedious and triggery ***** » Squiggles, posted by Tamar on August 13, 2007, at 9:20:53
OK Tamar, thank you for being patient with me and explaining these pesky questions. I really appreciate it, because I don't have a very open mind on this therapy thing, and it may be on account of misunderstandings about what is really going on between therapist and patient.
> > I'm not sure about T-vocabulary; what are the
> > boundaries and the framework for example?
>
> I’ve had no psychological training, but here’s how I understand it:
>
> Boundaries are concerned with issues of contact between therapist and client: how much a therapist tells the client about himself/herself, whether there will be hugging, whether the client may call the therapist at the office, or outside of office hours, whether the therapist will accept gifts from the client, and things like that.
>That I understand. My doctor has very tight boundaries; even backed off on sensitive issues like how often do i have sex, and what people have hurt me in my life etc. It has if anything been voluntary information and as soon as he sees me wince, he stops questioning. I think that shows great respect for the individual and I am very fond of him for that. That's because he knows that i am a rational being and will not change just by being told you should have more sex, for example. That's a personal thing and decision depending on life circumstances.
> The frame is about the environment in which therapy takes place: how long the sessions last, where they happen, when they happen, and how often. I think the boundaries are part of the environment and so can be considered part of the frame.OK- that sounds like the plan in which the therapy will take place-- money, time, structure, intensity, etc.
>
> > Also,
> > if you would be happy having a loving relationship, is the therapist the best person to have that with? Maybe, a bodyfriend, or a husband?
>
> I have lots of loving relationships with partner, children, parents, friends… But I love my therapist too, because he cares (albeit professionally) for my emotional needs. It’s not the same as the care provided by a GP or a gynaecologist or whatever: it’s much more intimate because of the things I talk to him about.
>
> > I'm not sure what your needs are, but i have noticed a dependence relationship or bond forming with many patients here and their therapist. What happens, when he's gone; it's one of the reasons i think a dr. and social worker team would be less personally intrusive.
>
> Yes, many patients develop a bond with their therapist. Some become dependent. Do you see that as a bad thing?Answer:
Well, I might be afraid that if it is deep enough, and a foundation for personality support, that taking it away, may leave you without that support, maybe with separation anxiety.
--
I need to be able to bond with and depend on my therapist because I need to work in transference.A:
That sounds Freudian. I am not sure that if you transfer you actually attain catharsis or rid yourself of things bugging you for good. I just don't know how that works.--
The work I need to do is inevitably personally intrusive because it involves my gender, sexuality and body. A doctor and social worker team wouldn’t be able to help me much on those issues, unless they were psychoanalytically trained perhaps.A:
Well, i only mention them because much of emotional strife is partly medical and partly contextual in a social setting. Another advantage might be that as i said before, you would be able to leave the situation once your problem is resolved without having formed a dependence. But, how benefitial the personal interaction with a therapist is something that is up to you and i cannot say truthfully that it is better or worse than a less personal relationship like the one i have with my doctor. To me a less personal relation implies freedom. I would want a very personal relation if the therapist actually could solve a problem practically; to give you a hypothetical example-- if you are a victim of abuse the therapist calls in the cops and puts the abuser in jail or keeps him or her in therapy for the rest of his life, preferably in mental hospital. (i am exaggerating:-))
>
> What should happen (I believe) is that I should be able to work though all that stuff by bringing my transferential material to therapy, and working through that with the benefit of my therapist’s interpretations based partly on his clinical skill and experience and partly on his countertransference reactions. He would work with me to find ways of integrating the different parts of myself until I’m better able to live happily with who I am. And when I get to that point I will no longer feel so dependent on my therapist and I will be able to cope with leaving him.Would like to tell me more about transference? I can look it up but it would be interesting from someone who has been there.
>
>
> Well, I guess the benefits of therapy to me might be very different to the benefits to you because we wouldn’t be working on the same issues, and even if we had similar issues, we’d have different experiences of them. Each person has unique experiences of therapy, so it’s hard to generalize.
>
> Thanks for your thoughts about all this.
>Thanks for being so tolerant with my questions.
For each individual, whatever works for them is whta count at the end of the day.Squiggles
Posted by Dinah on August 13, 2007, at 9:55:17
In reply to ***** Long, tedious and triggery *****, posted by Tamar on August 12, 2007, at 21:52:23
I happen to have a fair amount of experience with this. My therapist is unreliable at best, and when stressed, he is horrible at providing a consistent frame.
He told me when it was happening that he knew he was not at his best, or even good enough, that he was trying his best, and to please stick with him until things got better. Of course, he's ok with offering me reassurance so it was easier, and even then I had a horrible, horrible time of it and nearly quit because he really wasn't there in session and quitting wouldn't have been a big difference.
My therapist allowed workarounds on the reliability issue. Such as reminding him when he didn't do what he was supposed to do. And I still ask him at the beginning of each session if he has anything to tell me, because he's not good at remembering to tell me about things that he thinks I'll be upset about.
I'm not sure if your therapist, upon recognizing his shortcomings in the area, will allow you to get your own needs met to some small degree by such workarounds.
Posted by Dinah on August 13, 2007, at 10:58:57
In reply to ***** Long, tedious and triggery *****, posted by Tamar on August 12, 2007, at 21:52:23
I broke this down into three parts, and took advantage of the rule of three, because each part seems important to me, and I wanted to think clearly about it.
I know you know that the reception of a gift has nothing do do with the gift, and everything to do with the recipient. I know you know that in your mind at least.
I think a reasonably close analogy to your therapist would be if you picture a little girl with her family out in the countryside on a picnic. The little girl carefully creates a beautiful crown of wildflowers for her mother. She's careful not to bruise the petals, and she takes her time, and the result is beautiful and every reasonable person who sees it would see not only the beauty of the crown, but the love and care that made it even more beautiful. But the little girl's mother was raised by rigid parents who believed that giving children praise and attention would spoil them. And she read lots of child rearing books that would reinforce that position. She's packing up the car to go home, and when the little girl brings her the crown she fusses at her for not helping with the packing and thanks her for the crown briefly before leaving it in the grass. The little girl is of course crushed.
If you saw this, would you think the crown was bad or ugly? Would you think the little girl was revolting for crawling about in the grass to pick flowers? Would you think she was bad? I doubt you would. You would more likely get angry with the mother, or feel sorry for the mother that her upbringing and training caused her to lose such a precious gift that her daughter offered.
Your caring for, and trust in, and sexual feelings for your therapist are as absolutely perfect as a gift can be. All the more precious for growing out of your heart and soul.
You do not sound at all as if you are pushing yourself on him, or expecting that he reciprocate your feelings, or demanding that he do something sexual with you.
There is nothing ugly about your feelings, or about you as a person. I wish you could see yourself as others see you. And yes, I do realize there is a cost to pay in being love-able. And I hope that you realize that you don't always have to be wonderful here or anywhere else to be loved. You are love-able even when you're feeling at your least lovely. Or even if you aren't always as wise and patient and insightful as you so often are.
I'm going to use a theological concept here in a nontheological setting. Your therapist has trouble accepting the grace you are offering him. That's his issue, and his loss. He's so wrapped up in fears and reminders from his training, and likely NHS standards, that he has no room in his heart to accept grace, not from clients anyway. I feel sorry for him.
And I'm going to go out on a really long limb here and say that I don't think the most important issue in this is your therapist's response, as unfortunate and sad as it is. I think the real issue is your view of yourself, your feelings of self worth. And that's what you're in therapy for! I hope that even if he can't accept your gift graciously or tenderly, that he at least is able to help you learn to value yourself and not have the knowledge of your worth affected by the insensitive responses of others.
Easier said than done, I know. And likely the responses of others will always shake you, and everyone else. And warm you and reinforce your positive feelings about yourself. That's natural.
Posted by Dinah on August 13, 2007, at 11:35:52
In reply to ***** Long, tedious and triggery *****, posted by Tamar on August 12, 2007, at 21:52:23
I'm not going to tell you you should find another therapist or leave this one. I know to my toes that sometimes the "correct" answer isn't the right one for any one person at any one time. And that decisions are usually based on what's right for a person at this time, in a pragmatic sense. There is a right time and a wrong time for everything.
I think if I were you, I would bring your post into your therapist. And maybe some responses that feel like they might help convey to him what you're trying to say. I think I would ask him to read it in its entirety, to think about it as a whole instead of jumping on particular words and phrases, and to consider it before responding.
Your post was perfect. It explained your feelings, your reactions to his behavior, and made clear that you didn't expect or need him to respond sexually to you, but rather to accept your feelings as your feelings in a therapeutic way.
You might also suggest that he seek out information on the ways therapists can respond therapeutically to clients feelings if he's uncomfortable, while acknowledging that training is sparse in the area and it isn't really his fault that he doesn't feel equipped to handle it. The APA has some materials on the topic. A video and perhaps a training guide as well. You know your therapist better than I do. My therapist would probably not take my suggestion, but he'd be amused not defensive or angry, and he'd take my point. Your therapist might be inclined to get angry or defensive, and it might not be beneficial.
In an ideal world, showing him your post would be enough to shake him up into realizing what harm he was doing.
But this is not an ideal world, and people tend to stick with the flaws they have. Your therapist was rigidly trained, and he doesn't appear willing or able to shake off that inflexibility. Honestly, I don't see that changing. Anything is possible of course.
This is entirely my own conclusions, and not based on any brilliance of any sort, but just my experiences. I find that in any relationship of any sort there comes a point where you discover that what you want and/or need and what you're getting don't really mesh. It's usually a good time to figure out strategies to change the relationship to better suit your needs. I think you've done that, and maybe you're at that point again.
What you want and need from this relationship and what you're getting and likely to get don't really mesh. It's not necessarily anyone's fault. (Although I blame the NHS training system in this case.) It's just what *is*. (At least that's my take on it. I could be completely wrong, but you've known him a year, and then some before then right?)
You have a lot of choices at this point. You can continue as you are, hoping things will change and doing your best to make him understand. You can change your response to him and hope that it will lead to changes in his behavior, perhaps.
Or you can accept that this gap will probably always be there. It might be too painful to be in the relationship where he is willing to offer less than you wish, and you might wish to leave. Or you might decide that even though what he offers is less than you need, it's better than not having him in your life, and reduce your expectations and hopes so that you don't feel like you're butting your head against a wall.
If you aren't ready to make that decision yet, you can choose to stand on the cusp of making a decision with options open in either direction but on the relatively firm footing of knowing what you're doing and choosing to do it. This makes it a choice, and empowers you in a way that not choosing doesn't. If that makes sense. I've realized this lately about my work. Yes, every decision has consequences I'm not ready to accept. But instead of being frozen by the impossibility, I'm recognizing that for now I am making the choice of balancing on the fine line of no decision.
I don't think the therapy relationship is unique in this. I think all relationships (even relationships with intangibles such as work) come to this point, perhaps time and time again. It's not fun, it s*cks, but it's reality I think.
Or I might be completely wrong and skewed in my viewpoints, which were after all forged from my own experiences. If they don't resonate, just ignore them. :) It was still a helpful exercise for me to write them down.
Posted by JoniS on August 13, 2007, at 12:04:15
In reply to Gifts » Tamar, posted by Dinah on August 13, 2007, at 10:58:57
Dinah
You have wonderful way of putting things. I admire that. Your post was tender and non-judgemental.
Posted by Dinah on August 13, 2007, at 12:25:35
In reply to Re: Gifts » Dinah, posted by JoniS on August 13, 2007, at 12:04:15
Thank you.
I really appreciate that.
Dinah
Posted by Tamar on August 13, 2007, at 12:49:24
In reply to ** Long, tedious and triggery ** » Tamar, posted by JoniS on August 13, 2007, at 8:58:40
> You were brave to write this post. You are going through a lot of stuff. I think I understand all of your feelings.I like being understood :)
> You are working harder to keep the boundaries than your T is. I think common sense and your intuition too is telling you that wont be a theraputic relationship if it continues. You are having to put your needs after your T, and that is very wrong and your T knows that.
Wow, I hadn’t thought of it like that. But I did have a dream a few weeks ago in which he said to me, “Well, I think our therapeutic relationship is effectively ruined,” and then he put his arms around me and hugged me, and then some sexual stuff happened, which felt ok but a but weird… So if dreams are any kind of window into the unconscious, I guess some part of me thinks that.
> I'm sorry I don't understand what you mean by "...he wards me off..."
I feel that whenever I want to talk about something particularly sensitive about our relationship he closes down the conversation in one way or another. For example, a couple of weeks ago I was telling him about some pictures of myself that I sometimes bring to therapy with me but always leave in my bag. I didn’t have them with me when I told him about them. He asked me if I wanted to show them to him and I said I wasn’t sure; I said I didn’t think so because there’s a lot of skin in them, although they’re not porn or anything. He responded by saying he didn’t think it was appropriate for him to see them “because therapists aren’t supposed to see their patients with not many clothes on.” It terrified me. I have no intention of talking off my clothes in therapy! Pictures that involve some nakedness are not the same thing as actual there-in-the-room nudity. And in any case I’d already said I wasn’t sure I wanted to show him. But I did want to talk about what they mean. However, after he’d refused to look at them (even though I didn’t have them and wasn’t asking him to look at them) I felt it was impossible to talk about them any more. To be honest, I kind of feel as if he pissed all over them.
Now if his first response had been a bit more sympathetic, I’d have felt able to continue the discussion. If he’d said something more accepting, like maybe that he could understand why I might want to bring representations of my pain to therapy, I’d have felt understood and, well, accepted. If he’d drawn me into a conversation about what it means to allow my vulnerability to be seen, or what the pictures might convey that I can’t express in words, that would have been helpful to me. But I can’t have that conversation with him if his first response seems to convey his fear that I might get naked in therapy. I can certainly understand his discomfort: of course he doesn’t want to look at pictures of me that show my breasts or my *ss. But I wish he could tolerate that discomfort a bit better so that we can talk about the symbolism or whatever, instead of responding only to the boundary issues.
> I believe love is a gift too. But it's my belief that your perception of your feelings and how he would feel about them is very distorted. I have had similar thoughts and worked through a lot of them with my T. It is so not good for you to have to put off dealing with your feelings because of him. If he is a good T he will listen tenderly (and he already knows how you feel, he's an expert on feelings) and he will validate your feelings of love and help you to get rid of the feelings of shame. He definitely wont throw your "gift" in the trash!
I wish I could believe he will validate my feelings of love. But I think he’s more likely to feel uncomfortable and make it clear that my feelings are a boundary issue.
> I guess I'm making an assumption here that he is a well trained PhD and experienced T
He’s certainly well-qualified and well-trained. And he has years and years of experience. He’s also extremely clever: the man has a brain the size of Kentucky. I know he’s got experience both with psychoanalytic psychotherapy and with CBT, and possibly some other approaches. I’ve sometimes thought he’s using the techniques of the psychoanalytic stuff that emphasise boundaries alongside the techniques of the CBT stuff that de-emphasise the relationship, so I’m all transferred up with no place to go. But I’m probably being unfair to him.
> Please don't hate yourself for having normal feelings . I suspect that he will remind you of "the professional nature of your relationship..." but that does not mean the feelings are wrong or bad. He should let you know that your feelings are valid and the boundary is just a reminder that neither of you will act on the feelings but they are there and need to be dealt with. That is a very healing session - builds trust and helps you to feel better about yourself.
I’d like to have that kind of healing session. I certainly don’t want to act out, at least not consciously. And my unconscious desires ought to be material for therapy…
> I hope you can work through these things with your T, but in the meantime, I relly believe you need to find a new T that you can build a healthy theraputic bond with. It would be ideal if you could transition from your current T to a new one. Deal with the feelings you have (which are so normal and OK) and move on to a T who will respect the important boundaries of t and help you work on the trust issues.
Hmm… a new therapist… I dunno. I don’t think there’s anyone else around here. Or maybe I’m just desperate to fix the relationship with this therapist.
> You can take my opinion with a grain of salt. I hope it's helpful, but if not that's OK. I would like to at least let you know you are supported.
Thanks, Joni. It does feel nice to be supported, and your opinions are very helpful.
> I know what it is like to cry in the bed loving your T but getting no reciprocation. I just did some of that yesterday for a couple of hours myself. I believe they still love us, just in a different way. I think that dealing with all this is a big part of therapy, so I'm looking forward to the day I can deal with this and not cry full of pain and sadness.
I don’t really expect him to love me. I think I’d settle for the idea that he cares about me as much as possible under the circumstances, whatever those circumstances may be. But if he could accept that I love him without feeling uncomfortable or disgusted or violated… that’s what I want most.
Posted by Tamar on August 13, 2007, at 12:57:49
In reply to Re: ***** Long, tedious and triggery ***** » Tamar, posted by antigua3 on August 13, 2007, at 9:28:54
> Whoa, you just pretty much described my relationship with my Pdoc. He's never late, but he won't return calls (which makes him unreliable in my book) or get "involved" in our relationship.
Ouch. That sounds hard.
> What you want to achieve with your T is what I want with my Pdoc. He has very strict boundaries, but I don't think he's holding up his end of the "therapeutic relationship." I tend to think he is afraid of me, can't handle me or just doesn't want to get involved.
Yeah, I know that feeling all too well.
> I see him tomorrow and I'm going to bring this up again (we've discussed this before). If I don't feel good about how it turns out, I'm going to find another Pdoc. It's interfering with my life and I don't want to worry about this anymore. Sometimes I wonder if I've let myself get into another abusive relationship and if I have, I have to get right out of it.
I know what you mean about abusive relationships. Every time someone suggests I should leave my therapist, my first response is, “But I love him,” which I’ve heard so many times from women in abusive relationships. And there is something about the way *some* therapists exercise power that mirrors the way abusers maintain their control of the relationship.
> I need things from him that he either doesn't see or refuses to give.
I reckon that if he refuses to give you what you need or want, he ought to be able to help you with those feelings of needing and wanting. If he can’t help you with that, what can he do?
> I'm sorry you're going through this, but I certainly understand. When my pdoc is "on" it's just fantastic.
Yeah. Just when we’re at the end of our tethers, the bastards do brilliant work with us. Can’t live with them, can’t live without them…
Posted by Tamar on August 13, 2007, at 13:01:32
In reply to Re: ** Long, tedious and triggery ** » JoniS, posted by Tamar on August 13, 2007, at 12:49:24
Some months ago I used to write stuff and hit 'submit' and all my bad language would be slightly cleaned up by the auto-asterisking thingy. But that didn't happen in my above posts.
I apologise sincerely for any offence I've caused and will put in asterisks manually from now on.
Posted by Tamar on August 13, 2007, at 14:17:40
In reply to Re: ***** Long, tedious and triggery ***** » Tamar, posted by Squiggles on August 13, 2007, at 9:44:33
> OK Tamar, thank you for being patient with me and explaining these pesky questions. I really appreciate it, because I don't have a very open mind on this therapy thing, and it may be on account of misunderstandings about what is really going on between therapist and patient.
Hey, I’m no expert on what is really going on between therapist and patient! But I’m happy to describe my understanding of it.
> That I understand. My doctor has very tight boundaries; even backed off on sensitive issues like how often do i have sex, and what people have hurt me in my life etc. It has if anything been voluntary information and as soon as he sees me wince, he stops questioning. I think that shows great respect for the individual and I am very fond of him for that. That's because he knows that i am a rational being and will not change just by being told you should have more sex, for example. That's a personal thing and decision depending on life circumstances.
It’s great that your doctor is sensitive about what you feel able to talk about. I agree that it shows great respect for the individual. My therapist, similarly, makes sure he never pressures me into talking about things I don’t feel ready to talk about.
> Well, I might be afraid that if it is deep enough, and a foundation for personality support, that taking it away, may leave you without that support, maybe with separation anxiety.
Yes, and that’s a really important point. In an ideal world, that kind of support would never be taken away suddenly, or without appropriate alternatives put in place. But this isn’t an ideal world, and sometimes therapy ends in unhelpful and very painful ways. And of course patients in that situation might wish they’d never gone into therapy in the first place. On the other hand, having that support when you really need it can make a huge difference to a person’s ability to be able to cope with life.
> That sounds Freudian. I am not sure that if you transfer you actually attain catharsis or rid yourself of things bugging you for good. I just don't know how that works.
I guess it is Freudian (although Jung also used ideas about transference), and I’m not Freud’s biggest fan, but my therapist uses Freudian and post-Freudian theoretical approaches, so I’m willing to go along with it to some extent!
I’m not completely sold on transference: for one thing I’m not sure it’s always *transferred* feelings that happen in the transference. Sometimes I think there are new feelings that still need to be accounted for in the transference. And I take your point about catharsis, although I often see it as some kind of eternal debate between Plato and Aristotle. Do we ban poetry from the ideal society, or do we accept that it can provide catharsis? Or, if transference doesn’t provide catharsis, should we take a Platonic view and prevent it happening? (I’m probably being too simplistic.)
And I don’t think therapy can rid a person for good of the things that bug them. What it can do is to help people to learn better coping mechanisms, and to identify support structures. For example, I have been talking in therapy about the long term effects of several sexual assaults over a period of many years. I don’t think a time will come when I completely get over it. One of the things I’m working on in therapy is to stop blaming my body for what happened, to find better ways of coping than binge eating or self-injury, and to rely on my friends to be supportive when I’m feeling cr*ppy about it. I find it very emotionally exhausting and frightening, and the things that go on in my transference are bizarre: fears that my therapist will assault me, fears that I might *want* him to assault me (I don’t! I don’t!), and a strong desire for him to rescue me sexually in various ways, ranging from beating up my attackers to more intimate things. Meanwhile I also project my pain onto him, so that I imagine him as a victim of sexual assault, and myself as the rescuer. The belief that he can heal me with his touch is particularly powerful. I want him to unrape me; to restore my sexuality so that I can have the sex life I want to have (i.e. free of fear, dissociation and feelings of being violated again). And sometimes these thoughts and feelings make me feel insane. I want to talk about them because I believe my therapist can help me to make sense of them, and that he can be a witness to my pain and distress, and that by working on these thoughts and feelings I can find ways to achieve reasonable goals. He can’t rescue me or unrape, but he can be an agent is restoring my sexual response to some extent: not directly, but through discussion.
> To me a less personal relation implies freedom.
I think that’s very interesting. I’m not sure I feel any lack of freedom in a more personal relationship. But I guess it depends how you define freedom.
> Would like to tell me more about transference? I can look it up but it would be interesting from someone who has been there.
I think the idea (very basically because I’m not an expert) is that patients in therapy transfer old feelings that they have for significant people in their lives onto their therapist. For example, I felt neglected by my father when I was a teenager. I’ve always reacted strongly to feeling neglected in other relationships since then. I know that my response to my therapist’s unreliability taps into that sense of neglect, and we’ve talked about that when we’ve talked about his unavailability. When I was a teenager I was very angry at my father, but after talking it through with my therapist I’ve come to accept that my father’s illness was a major factor back then. I feel more forgiving towards my father, and working on it in therapy has improved my relationship with him: the anger I’ve been carrying for years is less acute (although not altogether gone). I’ve presented it all very simplistically: it’s actually very complicated, but that’s the basic idea.
> For each individual, whatever works for them is whta count at the end of the day.
I totally agree.
Tamar
Posted by Squiggles on August 13, 2007, at 14:42:58
In reply to Re: ***** Long, tedious and triggery ***** » Squiggles, posted by Tamar on August 13, 2007, at 14:17:40
Strangely enough, i understand much of what you
say on an emotional level. There are some
vague similiarities in our background. But my
desire for facing fears and conflict on that level is completely different. You notice what i said about freedom; well, that means that what I would want for help in similar situations would be an authority, or help which would be more powerful than the situation which put me in vulnerable position.Hence the survivalist from Alberta with a yellow pick-up truck, a pit bull, a license (for hunting:-)) and complete devotion and protection for me. That's a joke of course, but also kind of a fantasy. I figure if i had a guy like that, I would fear no evil. I guess he would be my therapist.
Squiggles
Posted by Honore on August 13, 2007, at 15:26:15
In reply to ***** Long, tedious and triggery *****, posted by Tamar on August 12, 2007, at 21:52:23
Hi, Tamar. Your T sounds extremely unreliable, and I'm really surprised that you feel as accepting as you do of his very negligent and IMO unacceptable treatment.
I'm sorry to be harsh, I just feel strongly that forgetting appointments, being very late to appointments, or omitting to tell you that he was moving to another office are all actions that are beyond the pale. I can't imagine ever being able to feel trust, security, and confidence in the ability of a T to be consistent and self-disciplined if he did any one of those things-- much less all three.
It's not just the issue of forgetting appointments, etc-- it's the issue of how someone gets to the point where they are so lax, self-indulgent, or subject to unresolved (and apparently unaddressed) countertransference that they can act as a reliable person on any level. There's something in allowing yourself to do those things that's more disturbing than the things themselves.
What a rigid or firm frame has to do with resolving these very serious derelictions, I have no clue. People usually invoke a firm frame or boundaries when a patient is asking them to do certain things that might threaten the frame. I see no indication that you've done that-- or that that's the problem.
It's easy for us to get caught up in liking and admiring, and trying to "help" our T, if he's in trouble (eg you imagine that his partner is sick, and therefore not only would understand his actions, but be worried and want to do something to support him through this). But that's understandable, but so unhelpful to you right now.
I guess if I had a T who did all those things, I'd be feeling so awful about myself, a lot of the work would have to be in addressing my issues of feeling put down, etc-- which, if he weren't in fact doing provocative things, might be legitmate-- But when someone is actually mistreating you, the beginning of the solution is in their treating you differently, not once or twice-- but all the time. And their doing some work on themselves-- perhaps with another therapist or in supervision-- on how they could have let things get so out of control.
Barring that, are you sure you're safe in the hands of this guy-- however brilliant he is when he's there?
Honore
Posted by Tamar on August 13, 2007, at 17:41:40
In reply to Relationships » Tamar, posted by Dinah on August 13, 2007, at 11:35:52
Gosh Dinah, I’ve been crying and crying reading your posts (in a good way). I want to respond to you in words, but I’m feeling so emotional… it’s hard to articulate it. I remember what you and your therapist went through after Katrina and how awful it was for you. Thanks for reminding me that it’s possible to keep going. You are an amazing person.
And thanks also for saying all those kind, wonderful things. I’m so touched.
I know you’re right about the real issue being about my self-worth rather than about my therapist’s response. I hope he can help me with that. I know he’s trying.
And I really liked what you said about making decisions. The idea of standing on the cusp of a decision instead of being frozen by impossibility is really helpful.
(((((Dinah))))) Thanks for everything you said. I’m going to print out your posts and keep reading them. There’s so much in there. You’re so wise.
Love,
Tamar
Posted by Tamar on August 13, 2007, at 17:58:54
In reply to Re: ***** Long, tedious and triggery ***** » Tamar, posted by Squiggles on August 13, 2007, at 14:42:58
> Strangely enough, i understand much of what you
> say on an emotional level. There are some
> vague similiarities in our background. But my
> desire for facing fears and conflict on that level is completely different. You notice what i said about freedom; well, that means that what I would want for help in similar situations would be an authority, or help which would be more powerful than the situation which put me in vulnerable position.Yes, that makes sense. It sounds to me as if you value practical assistance very highly - like getting an abuser removed from the situation. And I agree. It’s hard for a therapist to do that; it’s often outside their remit, unless they’re asked to go to court to help put an abuser behind bars, for example.
> Hence the survivalist from Alberta with a yellow pick-up truck, a pit bull, a license (for hunting:-)) and complete devotion and protection for me. That's a joke of course, but also kind of a fantasy. I figure if i had a guy like that, I would fear no evil. I guess he would be my therapist.
I can identify with fantasies of having a devoted protector! And yet… I still want to be able to feel safe enough to manage without one…
Posted by Tamar on August 13, 2007, at 18:51:08
In reply to Re: ***** Long, tedious and triggery *****, posted by Honore on August 13, 2007, at 15:26:15
Hi Honore,
> Your T sounds extremely unreliable, and I'm really surprised that you feel as accepting as you do of his very negligent and IMO unacceptable treatment.
I guess I accept it because I know he doesn’t mean to hurt me. Don’t get me wrong; I’m often very angry about it. And he listens to my anger and handles it well.
> I'm sorry to be harsh, I just feel strongly that forgetting appointments, being very late to appointments, or omitting to tell you that he was moving to another office are all actions that are beyond the pale. I can't imagine ever being able to feel trust, security, and confidence in the ability of a T to be consistent and self-disciplined if he did any one of those things-- much less all three.
I will admit that trust has become a problem…
> It's not just the issue of forgetting appointments, etc-- it's the issue of how someone gets to the point where they are so lax, self-indulgent, or subject to unresolved (and apparently unaddressed) countertransference that they can act as a reliable person on any level. There's something in allowing yourself to do those things that's more disturbing than the things themselves.
I tried to lay a countertransference trip on him. I’m not sure he took my point. I’m pretty sure his view is that the unreliability is a feature of his ongoing personal difficulties and that it isn’t influenced by the work he’s doing with me. I don’t entirely believe that… But then when I think about it, I suppose I want to believe that I’m important enough to him for him to have countertransference reactions to me, and in fact I’m probably not; it probably is just his personal sh*t. And that feels awful too, because I would like to be important enough to him for our work to be meaningful to him.
> What a rigid or firm frame has to do with resolving these very serious derelictions, I have no clue. People usually invoke a firm frame or boundaries when a patient is asking them to do certain things that might threaten the frame. I see no indication that you've done that-- or that that's the problem.
That’s an interesting point. I think he believes that keeping the frame and the boundaries secure is even more important after he has been unreliable, because he doesn’t want to compound the problem. I’m not aware of anything I’ve done to threaten the frame or his boundaries, but maybe he sees it differently.
> It's easy for us to get caught up in liking and admiring, and trying to "help" our T, if he's in trouble (eg you imagine that his partner is sick, and therefore not only would understand his actions, but be worried and want to do something to support him through this). But that's understandable, but so unhelpful to you right now.
Well, I know there’s something going on because he told me. And I guess something so serious that he would be so unreliable looks like a personal or family health problem. Interesting that you picked up on the idea that perhaps it’s his *partner* who is unwell, because I said ‘his own health or someone in his family’. But you’re on the money: it’s often his partner I imagine - maybe because I know he has a partner, whereas I don’t know whether he has kids. But actually I quite often imagine it’s his own health, or perhaps one of his parents. I’ve gone through all the other possibilities too: financial problems, work problems, substance abuse… everything I can think of. Sometimes I wish he’d tell me so that I can concentrate on worrying about just one thing and score the others off my ‘list’ of possible catastrophes! And yes, I’ve told him that I worry about him and he apologised and admitted that it isn’t helpful to me.
> I guess if I had a T who did all those things, I'd be feeling so awful about myself, a lot of the work would have to be in addressing my issues of feeling put down, etc-- which, if he weren't in fact doing provocative things, might be legitmate-- But when someone is actually mistreating you, the beginning of the solution is in their treating you differently, not once or twice-- but all the time. And their doing some work on themselves-- perhaps with another therapist or in supervision-- on how they could have let things get so out of control.
Yes, we have done a lot of work on my feelings about all this. And again, he admits that it prevents me from getting on with the stuff I come to therapy to work on.
> Barring that, are you sure you're safe in the hands of this guy-- however brilliant he is when he's there?Ooh, ‘safe’ is a powerful word! Many months ago I used to think of him as some kind of embodiment of safety. That’s harder now. But I don’t think he’s in any way unsafe. I mean, I know he wouldn’t do anything utterly outrageous.
Y’know… despite his shortcomings, his integrity as a person is obvious. I don’t know much personal stuff about him, but what I do know indicates that doing the right thing is important to him. So I think he’s probably quite distressed at his inability to be more reliable. If I weren’t so sure of his integrity I’d have left a long time ago, but I’m confident that his unreliability isn’t just carelessness or self-indulgence.
Thanks so much for your thoughts about this. You are right about so many things. I feel a need to shout at him…
Tamar
Posted by DAisym on August 14, 2007, at 2:04:37
In reply to Re: ***** Long, tedious and triggery ***** » Honore, posted by Tamar on August 13, 2007, at 18:51:08
You know, your posts are neither tedious nor too long...
This is hard for me because I wish for you something so different than what you have. But I'm also glad that you love your therapist - and I think one of the gifts of therapy is feeling love, of really knowing inside yourself, "I can love." Because being able to love someone else, shortcomings and all, is an immensely healing thing to do.
But when the love binds us to someone or something that consistently causes us pain, then I think we have to ask ourselves if this is how God intended love to be spent.
And despite what you said about not being an expert, you have a pretty good grasp of the concepts Transference and countertransference, so much so that I wonder if you aren't really too busy "curing" yourself to see what the reality is. It *sounds* like it isn't good for you. It sounds like the whole thing is painful. I think you deserve better.
And I'll ask a question based on historical knowlege of your journey -- are you asking him to be something he isn't? Didn't he not do this kind of therapy and you talked him into it? You were in therapy with him before and didn't go deep. What made you think it would be different this time?
My final, and harsh question is: what are you getting by remaining locked into this battle of wanting relationship discussions from him? What are you able to avoid talking about?
Posted by Tamar on August 14, 2007, at 5:39:13
In reply to Re: ***** Long, tedious and triggery ***** » Tamar, posted by DAisym on August 14, 2007, at 2:04:37
> You know, your posts are neither tedious nor too long...
Thank you!
> This is hard for me because I wish for you something so different than what you have. But I'm also glad that you love your therapist - and I think one of the gifts of therapy is feeling love, of really knowing inside yourself, "I can love." Because being able to love someone else, shortcomings and all, is an immensely healing thing to do.
Yeah, although I often worry that my love is dangerous or contaminated.
> But when the love binds us to someone or something that consistently causes us pain, then I think we have to ask ourselves if this is how God intended love to be spent.
That’s an interesting idea. I don’t know why, but I feel an inclination to react against the idea that God intends me to do anything. I don’t trust God at all. But I take your point.
> And despite what you said about not being an expert, you have a pretty good grasp of the concepts Transference and countertransference, so much so that I wonder if you aren't really too busy "curing" yourself to see what the reality is. It *sounds* like it isn't good for you. It sounds like the whole thing is painful. I think you deserve better.
Thanks. I think so too!
> And I'll ask a question based on historical knowlege of your journey -- are you asking him to be something he isn't? Didn't he not do this kind of therapy and you talked him into it? You were in therapy with him before and didn't go deep. What made you think it would be different this time?
Ah, it wasn’t quite like that. I did short term therapy with him originally, then didn’t see him for a year, then went back to him. It was his decision to use a more psychodynamic approach this time; I didn’t even realise he was doing things differently for a while. But even so, I think you may be right that I am expecting him to be something he isn’t. It’s just that I don’t know whether he realises he isn’t the thing he’s expecting to be either. If that makes sense.
> My final, and harsh question is: what are you getting by remaining locked into this battle of wanting relationship discussions from him? What are you able to avoid talking about?Again, it doesn’t feel quite like that. I don’t feel locked in a battle of wanting relationship discussions. In fact, we usually only have relationship discussions after he has let me down. But he lets me down so regularly that relationship discussions have become a frequent feature of our work. And when I think about it, I hardly ever start the relationship discussions (I’m too scared). He usually takes the discussion there by asking me something about how I feel about therapy. For example, I started a recent session by talking about a book I’d been reading about therapists’ mistakes, and I was telling my therapist how angry I felt about one chapter. My therapist responded by defending the author and then asked me if I thought he rejected the things I offer him. I pointed out that I haven’t ever offered him anything (I try to avoid his boundaries) and he said he meant the material I bring to therapy: my issues. And then it became a relationship discussion. And then I try to tell him something I feel sensitive about and he runs away.
To be honest, the thing I most want to avoid talking about is the relationship. I managed to do it last week. We had a really fun session with lots of laughter, some good work on my maladaptive coping mechanisms, and not a relationship issue in sight. I prefer it like that.
But if the subject of the relationship comes up I feel unequipped to handle it and unable to tell it like it is. Also I really wish I could talk to him about the bizarre images and thoughts I have about him (like imagining him beating me and assaulting me) because I think talking about it would make it less powerful. But I just can’t get the words out.
But maybe I haven't given an accurate description of what happens. And maybe I didn’t understand you properly. I don’t seem to understand very much these days :(
It’s all too hard. I just want to give up on everything.
Thanks for your thoughts about this. I’ll keep thinking about what you’ve said.
Tamar
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