![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 8 to 32 of 32. Go back in thread:
Posted by Nadezda on October 29, 2008, at 15:05:33
In reply to Rupture in therapy (long), posted by Wittgensteinz on October 28, 2008, at 20:09:25
Hi, Witti.
I'm very sorry to hear about this really painful treatment by your T. As others have said, he seems to have some countertransference issues, and not to be dealing with them very effectively. Obviously, this is a situation that needs to be resolved pretty quickly, to prevent it from becoming a much more serious rupture, which I would hate to see.
I've always thought that a contract not to try to commit suicide, while it might be a useful, or practical thing in some ways, is a bit unrealistic, and--unless the consequences are made very concrete and explicit, is impossible to enforce. Unless your T thinks your ODing a "cry for help" and gives you other, truly helpful things to take the brunt of your despair, and to move you into more constructive actions, I don't understand how he can reasonably expect you to take a contract into consideration when you reach such a level of hopelessness. But it seems that the issue of your OD and his response to it needs to be addressed until he can "forgive" you, or move away from this resentment and need to punish you.
It's not fair to you-- or to his best intentions and caring. I think I agree that he needs supervision if he can't heal the rupture on his own. I do imagine, though, that manyTs, particularly experienced ones, are quite unlikely to seek supervision. It just isn't consistent with their idea of their professional dignity. I hope yours can either see his way to restoring the relationship, or to some realization that he does need a professional consult, at least.
I just feel very badly for you, having to go through this. I can imagine how lost and abandoned you feel, when someone who's been warm and who's encouraged you to trust and open up, turns away, and becomes stony. His lack of empathy at your tears is so awful. I can't imagine how that must feel, to have someone whom you've come to believe in be so rejecting.
As for your asking him about his military service. How absurd that he would respond harshly. There's absolutely nothing wrong with expressing curiosity and desire to know someone so important. Even if he feels that answering the question is not what you needed-- there's no reason for sharpness or any reproof. And his harshness also in telling you to leave was really uncalled for. I can imagine that he might be forced to end the time-- but not to be kind and to express regret that you and he don't have more time-- is positively heart-wrenching. As for his wife coming-- that must have felt shocking and awful. As you know, I have issues with the whole setup-- but still-- I can't believe he doesn't have some privacy around his actual consulting room. I don't mean to criticize your T, but something does seem out of kilter there to me.
So I understand why you're devastated.. But please, try to hang in there. You'll get through this. Ruptures, even deep ones, can be repaired. And you have a pdoc who seems as if he can act as a support in the crisis. Let him step in and provide a bridge, while you sort things out with your T. Even a crisis can be an opportunity to strengthen and deepen things.
I don't know if the day programme would be right for you-- especially as you'd have to stop seeing your T. But if you do feel as if you might harm yourself, I very much hope you do whatever's necessary to keep yourself from that step. If your T seems unrelenting, then I would consider the programme quite seriously- you can't leave yourself in such a vulnerable position until he takes stock of his role.
I'm very happy to hear, though, of your plans for the future. I'm sure you'll enjoy and find so rewarding the career you've chosen. It's great, too, that you're making progress toward your goal. While it's terribly painful to go through this--you have so much ahead of you; please tell yourself the truth-- which is, that however awful the moment feels-- it is temporary. This is a difficult passage, toward much better days.
hugs, Nadezda
Posted by Wittgensteinz on October 29, 2008, at 15:25:49
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by seldomseen on October 29, 2008, at 6:34:17
Thanks Seldom, I read your post several times to take it in. I found it very perceptive.
The problem with his comment about the other 135 sessions is that this sharpness is nothing new. We've had a number of these incidences the last couple of months, and before that maybe 2 or 3 times something like this has happened. This time was somehow worse - perhaps it's a cumulative effect. He has said in the past that I hold him to high standards - and that I have to realise he is only human. I don't want him to feel pressured to be the 'perfect therapist' but my trust is so shaky that any opportunity for me to doubt his intentions and I do.
What I think is important is that I hold onto the many very kind and unexpected things he has done for me - the times he has gone out of his way to support me. He is not a big one for soft words - he is not 'Mr Empathy' at the best of times. That's just not his style and that I accepted from the beginning as I got to know him. Perhaps for a long while I've wished he could be just a bit more soft and compassionate when I'm really having a hard time. His tissues are hidden away in a draw at the back of his office. They only ever come out if I ask - he has never offered a tissue (oh, maybe once he did actually). He doesn't ever say "it's ok" or other things to that effect, but he is a good therapist and very dedicated. It's not his job but his life.
A thought I have at this moment is, am I strong enough for this level of support to be enough? The outbreaks of sharpness are not helping but the pain I'd feel from walking away albeit only for a short time could be far worse. I actually feel very sorry for him that I reacted to his sharpness as I did - I feel bad that he's now having a difficult time with me due to it. My desire is to take him some chocolates the next session as a 'peace offering' - I'm not really sure why I want to do this - I find it hard/impossible to be angry with a person or suppose that my rights should come higher than another's.
I think I need to ask him to be honest about his mistrust - my mistrust is obvious, but what about his?
As for the question of forgiveness, this is interesting. I'm not a religious person, but after the OD, that next session, one of the first things I asked him was whether he could forgive me for what I did. He said yes, that that wouldn't be difficult, but that things wouldn't be the same now. Obviously, something like that can't just be ignored or forgotten about, but things aren't the same now but in a rather negative/worrying way.
Regarding the rules - I'm not one to test the rules - and he has said as much in the past. I know the boundaries are there for a good reason and I appreciate the boundaries.
It was refreshing to be honest with the Pdoc about having fantasied about hanging myself. He asked how much I had planned - asked if I had a place, such as from a tree outside and I laughed - there are always children playing outside, the idea of doing such a thing there seemed absurd. I would never have such a conversation with my T - I'd seen him just some hours earlier and didn't mention anything of having felt suicidal - it would have seemed mean to have admitted that - "look what you went and did to me this weekend!". The Pdoc said "what an awful thought, how awful you are feeling this way" - again this astounded me somewhat. I can't imagine my T ever saying something like that. At most he'd say "well these fantasies don't bring us further" or "well you cannot act out on that", if even that.
I agree, it was not about the military service (or at least not for me) - well perhaps in retrospect, it was something sensitive for my T. He was born just at the end of WWII and was a little boy in a Dutch city that was badly effected by the bombing. I doubt he was old enough to remember that though, but maybe his father was active in the war.
Anyway, thank you for your very thought-provoking response.
Witti
Posted by Wittgensteinz on October 29, 2008, at 15:31:32
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by Nadezda on October 29, 2008, at 15:05:33
Posted by stellabystarlight on October 29, 2008, at 17:39:49
In reply to Rupture in therapy (long), posted by Wittgensteinz on October 28, 2008, at 20:09:25
Hello Witti,
I ran out of coffee today, so my thoughts are a bit disjointed and incoherent from the withdrawal, but I wanted to reply to your post...so I apologize for not being helpful to you as I'd like to be. I understand the pain and the confusion of various emotions and thoughts you must be going through. It' s excruciatingly painful when the rupture feels like an emotional reenactment of the original wounds. I was sorry to have missed your earlier post when you needed to chat...I felt your pain and it would have been mutually helpful. I've been going through a painful rupture of my own with my therapist for the last month, and although we got through the most difficult part of the repair yesterday, I'm still left with the resentment of having to go through a rupture which I feel was brought on by his "stuff" or counter-transference. I won't get into my rupture right now as I don't want to impose on your post.
I read your posts so I'm very aware of how insightful and intelligent you are about therapy, and I don't want to further upset you with my anger towards these therapists, but I feel your T was being selfish and insensitive! You did absolutely nothing wrong...you're in an immense amount of pain, and he should have shown more empathy! Whether he is disappointed over a broken pact or not, or needing to keep to his rules, or not wanting to talk about his past, etc., the bottom line is you are the "wounded" and he is the "healer". Yes, they're flawed and make mistakes like everybody else, but just 5 minutes of kindness and understanding on his part when you're going through an especially difficult time would have helped you toward healing and not furthering damaging you. Again, I hope I'm not upsetting you with my point of view, but I just spent 4 hours in session and 2 hours on the phone for the last 2 weeks telling my therapist exactly how he made me feel and what I needed or didn't need from him in order for us to continue. I surprised myself with my directness with his mistakes in our rupture as I'm also very attached to my therapist and fear abandonment, but it came down to not being able to do therapy without at least a certain amount of trust. Trust that he won't further damage me - intentional or not.
Every therapy pair is very different so I'm not suggesting you confront yours the way I did with my T, but he ended up respecting me for having the strength to confront him yesterday, and we ended the session on a warm note. He teared up and told me that our therapeutic relationship is very important to him. Is is scary to risk possible abandonment(real or not), but I find it healing to stand up for myself - without attacking him and also acknowledging the other "135" good experiences I have had with him. Repairing ruptures for me are like going into a war, and I thoroughly look at both of our point of views and plan out everything I want to say to him in advance....without putting him on the defense. It's worked for us so far and we've been able to come out with better understanding of each other.
I had to tend to something for awhile, and noticed you had posted a follow up....I understand your feeling responsible for his "bad" feelings and wanting to take chocolates to him, because I have taken "peace offerings" to my T during our ruptures. Part of the reason why I did it was to show him that I am grateful for the kindness he has shown, and also my tendency to value him above myself, but it's mostly that I wanted him (my mommy or daddy) to see me as a "good girl" and love me again, and not abandon me. Because if I'm a good girl who didn't cause any trouble for him, then everything would be "alright" with us. I almost took treats to yesterday's session, but I stopped myself when I realized that I would be doing disservice to both of us, and possibly sabotaging my therapy. I wanted to give us a chance to work through the rupture without reacting to my fear by appeasing him and making him "love" me again. I have taken all the responsibility for some of the ruptures in the past, because it was easier than confronting him with it, but it's a temporary band aid and the ruptures come back bigger and even more painful the next time.
I hope you try to work through your rupture with your T, before going into a day program. I don't have any experience with it, but it sounds like something to try if the repair fails(although I'm sure you'll succeed in repairing it.) I'm glad you have your pdoc's support. Take care, and I apologize again if I haven't addressed everything in your post properly. Please let us know how you're doing with the repair.
Stellabystarlight
Posted by Sigismund on October 29, 2008, at 18:01:02
In reply to Re: Rupture in therapy (long), posted by Wittgensteinz on October 29, 2008, at 15:25:49
When I did therapy there was a belief, accepted all round, that 'acting out' was definitely a thing to avoid.
But I have some kind of difficulty (what I'm not sure) understanding a no-suicide contract.
Your relationship with your psych sounds so much better than the one with your T.
I am lucky I had a female T and wonder if they are better. Older women.
Posted by Wittgensteinz on October 29, 2008, at 18:01:23
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by sassyfrancesca on October 29, 2008, at 8:16:57
Thanks Sassy,
I see him this Friday so will have to talk more then. I'm sorry about what's happened with your T recently regarding e-mail. That must have come as a big blow. I'll post more on that tomorrow, but wanted you to know I'm thinking of you.
Witti
Posted by Wittgensteinz on October 29, 2008, at 18:24:42
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by lucie lu on October 29, 2008, at 11:55:02
Thanks for your understanding Lucie Lu. In reality I feel a lot of anger toward him, helplessness and grief. The suggestion of entering a day programme also scares me - it makes me realise how badly I'm doing - the pdoc was strongly suggesting it - I almost wonder whether he has his own opinions about my analyst. The first time I met the pdoc he asked among other things how I found my analyst and whether I found him too cold. He also said he knows him from conferences etc. My analyst is pretty well known in the Netherlands. He is a professor and has published a list of titles.
So now I come to the question of consultation - he is a supervisor of other analysts - the idea that he might seek consultation is one I wouldn't dare ask him.
I'll see how it goes this Friday with my T. There's already another matter to catch up on. I agreed some time ago that he could contact my new pdoc and discuss my case with him. My previous pdoc was not very involved to be honest. I asked T a while ago if he had spoken yet with the new pdoc and he said at the time "no but I'll certainly tell you when I do. I like to keep things completely transparent". So I go to my appointment with my pdoc on Tuesday afternoon. That morning I even mention I have the appointment to my T who doesn't give much of a response. At the afternoon appointment the pdoc says he spoke with my T a week ago and seems to have a good picture of how things are (of course he doesn't know about the rupture). I don't really mind T not telling but it doesn't help my trust - I sent him a mail asking him why he didn't let me know he'd been in touch with the pdoc and he wrote back and apologised and said this mistake wasn't helping things. Spot on!
Anyway, I'm going on :( - there's some work for me to do. In a way I feel I should schedule extra sessions as it's difficult day-to-day at the moment, but the idea of me paying out extra because of this seems a bit unreasonable too.
Thanks again LL.
Witti
Posted by lucie lu on October 29, 2008, at 18:35:57
In reply to Rupture in therapy (long), posted by Wittgensteinz on October 28, 2008, at 20:09:25
I was just about to post another response but Stella said some of the same things I was going to say. You may have some great things with your T but I was still struck by his coldness and lack of empathy. I find it very hard to see how this can possibly be of benefit to the client, and quite to the contrary - aren't ALL healers completely foresworn to the "do no harm" dictum? I don't remember there being exclusions for things like personal style or office particulars.The other thing is that maybe it is not a bad thing for you to talk to other therapists and healers who have a warmer way about them. You don't have to irrevocably break the tie with your T, but maybe you really need something different, a higher level of support right now. My goodness, it was not so long ago that you felt enough despair to OD... I would think that comfort and empathy were certainly called for right now and in ample quantities! You sounded so wistful to me when you describe how startled you were at your pdoc's warmth that it actually made me feel sad for you. I think this may be telling you something very important, Witti.
Lucie
Posted by Wittgensteinz on October 29, 2008, at 18:42:41
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by twinleaf on October 29, 2008, at 12:42:31
Twinleaf, thank you for your strong reply. These replies have really helped me - it's a great support to have the views of others who know the inner workings of this sort of therapy.
Perhaps the amount of trust there was - especially his trust toward me - is part of the problem. My OD came as a great shock to him. He did not expect it - it came as a "cold shower". I had said I felt suicidal when I saw him the day before it happened but for some reason I am unable to convey to him how serious things are when they are - perhaps he doesn't want to to hear this. It wasn't a cry for help. It was however an act of compulsion rather than a carefully calculated thing.
You've written about how you and your analyst work on ruptures. How sensitive and perceptive he is to the very smallest cracks appearing in the blanket of trust. How you are able to talk about things in that moment before they become something consuming. I think this is a real gift in a therapist - and also a gift in a patient to be able to succeed in this.
I have always asked him if he is angry with me - perhaps my favourite question (!) and his answer has always been no, but lately I don't trust him as much. He said, and again somewhat sharply, the other session "Your thinking I am angry with you is just another of your fantasies" - which to me confirmed my very fear!
I really really want things to be repaired. I really hope he can say what I feel.. *know*? to exist in the room but which he denies. I'd rather him say "yes I am angry with you for x,y,z" than feel his anger through his coldness and then have him deny it. It won't be easy to hear it, but then there is a way forward at least. I would be the first to admit how selfish I have been and how likely the action is to have had effects on those that care about me.
Many thanks again for your reply.
Witti
Posted by Racer on October 29, 2008, at 19:44:42
In reply to Rupture in therapy (long), posted by Wittgensteinz on October 28, 2008, at 20:09:25
Witti,
This will be short -- at least by my standards ;-) -- because I think most of what I have to say has already been said. And said quite well by others -- even I am wise enough to know that I can't improve on any of it.
What I will say is pretty simple: although we have rarely interacted, I admire your wisdom, and the support and empathy you offer others. I'm terribly sorry that you have had this painful experience, and wish I could comfort you in some meaningful way.
In my not-at-all-humble opinion, you deserve better, from your therapist and from life.
Posted by Phillipa on October 29, 2008, at 20:22:40
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by Racer on October 29, 2008, at 19:44:42
Witti I was married to a man from the Netherlands and visited there when married to him. I was under the impression that the Netherlands also had socialized medicine so theraphy isn't free? And sounds like the pdoc is more receptive to your needs and feeling. Sounds like a great one. My ex was a young boy in Holland when World War II happened and they hid people in their home. He had to try and find food during the night. Potatoes was about it and at the end of the War had to be sent somewhere to gain weight as they were starved and his family was wealthy. And my ex was so strong willed maybe that is why he's not that empathetic. I don't know. But I wish you the very best and hope you resolve your conflict and find peace. Phillipa ps by the way my ancestry is Dutch also.
Posted by Wittgensteinz on October 30, 2008, at 4:35:35
In reply to Re: Rupture in therapy (long), posted by Phillipa on October 29, 2008, at 20:22:40
Philipa, I recall you mentioning something of this before - that your ex was Dutch. I'm not Dutch by my partner is.
Really I know nothing about my T and his background - or at least very little. All I know is his date of birth and his birth place, and that was because it was on his page of a university website. He has never made any sort of reference to his childhood. All I know is that he was born something like 5 years before the end of WWII - so he really was young. As far as I know, although some Dutch people were kind enough to hide Jewish people in their homes, it is widely believed and accepted that they for the most part were rather co-operative with the Gestapo on this matter. My partner's father was also alive and a young boy at this time and he didn't have the experience your ex had - incidentally he lived on a farm. To be honest I don't really care what the reason is why he is or is not empathic - the fact of it is the same whatever the personal reasons.
Thanks for your kind words.
Witti
Posted by Wittgensteinz on October 30, 2008, at 6:13:14
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by Nadezda on October 29, 2008, at 15:05:33
Nadezda, my apologies for a bit of a slow reply. Thank you for your candid response.
I also find the no-suicide contract something absurd. It was not a matter of crying for help in my case and although I can, while in a fairly good state, agree not to do something like that again, when it comes to it, such an agreement does not hold much weight. If I really feel like doing it, and then it feels an absolute need, then I'm not going to sabotage myself and intervene to stop myself doing so - that's just absurd. So in a way I have had to agree to the impossible. I am trying to be wise, I try to avoid a situation that would put me in such a state and take measures before it gets to bad but you're right, he needs to play a role in that too. It was an agreement made with little disucssion - frankly he made it clear that he cannot work under that pressure/with that responsibility. He told me that when he came to the hospital and I begged him at the time to let me continue seeing him. I wonder in retrospect whether that was his sole reason for coming to the hospital and not for the obvious reason of being concerned. Maybe I am too doubtful/cynical in my current state.
This question of professional dignity is an important one. He is a known superviser. He is a retired professor - and a 'honored' professor at that. He has a list of books published in the field. In the analytic community he is very well known and often the key speaker at important events. So it is a difficult one. To whom could he turn, even if he would be willing to?
When I asked him why he reacted so sharply, and later why he was so cold to me at the end of the session, he simply said that he had 'reached his limit' - this I really can't fathom. It wasn't a particularly trying or taxing session. What made him 'reach his limit' - what did I do to bring that about? It was almost given as a justification - like "we all have our limits and you found mine and there's nothing I can do about that". It leaves me at a bit of a loss.
Thank you for all the reassurance - it goes a long way. I do have plans but my confidence is low and I swing between giving up on life and daring to embrace it. That's the one thing I like very much about my T. He truly believes in me. No-one has ever been so strongly encouraging as him. Also his life-story parallels mine in one important way. He too didn't find his career path until his late 20s - yet he still succeeded and became a renowned analyst. For me that gives me hope. The pdoc on the other hand I think sees more the harshness of my situation - I'm visually impaired - he made a big thing of the the realistic possibility of my becoming a doctor - rather than saying "why not? go for it!" he was more "is it worth the effort?". Now I know it is possible as there are other qualified doctors with my level of vision or worse but this fact didn't convince him. I suppose this is a question of realism and bias. On paper I have 10% vision - sounds like very little - my pdoc was wondering how I can manage to read his e-mails - yet he doesn't know I have done paid work with web-design and animation, played ice-hockey on the team at university and was the photo-editor of the main student magazine. I think he wouldn't believe me if I mentioned this.
Thanks again,
Witti
Posted by lucie lu on October 30, 2008, at 8:14:08
In reply to Re: Rupture in therapy (long) - p.s. » Wittgensteinz, posted by lucie lu on October 29, 2008, at 18:35:57
>right now and in ample quantities! You sounded so wistful to me when you describe how startled you were at your pdoc's warmth that it actually made me feel sad for you. I think this may be telling you something very important, Witti.
I was reading the updated thread and realized that my comment above was poorly worded. I feel very sad at how much you have been suffering, both from the rupture and from the events leading up to it. It was just the wistful tone in some of the things you said that made me wonder whether it reflected unmet yearnings for warmth. And if so, these feelings might be important to pay attention to in addition to those so powerfully coming to the fore right now for you. This led me to wonder if these needs for comfort and warmth might not be met productively short-term in a good day program.
Sorry - I will stop posting now!
L.
Posted by Wittgensteinz on October 30, 2008, at 11:40:19
In reply to poor wording, posted by lucie lu on October 30, 2008, at 8:14:08
Lucie,
I'm sorry but I don't understand why you find your other post poorly worded. I don't. Your post was validating - it voiced something I feel. I've told myself until now that I wouldn't do so well with someone being too nice to me - that I wouldn't know how to deal with someone being too kind and sympathetic - that I simply wouldn't believe their concern to be genuine. But maybe that's just my way to feel better about the absence of sympathy and comfort in my interactions with my current T.
I suppose I have to think whether a warmer approach would be more therapeutic. I never got that warmth or sympathy when growing up. I think deep down I am not really deserving of it - that's something reserved for other people but not for me.
But how can I change that aspect of things with my T? I mean, would there be any value in asking him to be more comforting/sympathetic. Last time I did say to him "why can't you be a little softer with me? It's a real pity." - he didn't give an answer but I'll ask again tomorrow.
I think I have a need for that comfort. From the age of 5 my father never touched or hugged me anymore (I should say he never mishandled me in any way before that). My mother did touch me but it was on her terms, forced and unpredictable. When someone physically hurts you, you don't instinctively want them to hold you. It's something I've yearned for ever since - my father did nothing in the face of my mother's words and actions, even if he was standing there watching. Now in a way it feels like a repeat of that - this time my T is sitting there listening and mostly I just get a 'ah-ha' if that, sometimes an interpretation. I've told him in the past that he feels distant like my father. I've said I wished he would hug me and he says that wouldn't help me, which is fair enough - but could he not hold me with his words? When I imagine him outside the therapy room, I imagine him as more caring than he is. After a time away from therapy, for example after returning from holiday, I'm always confronted by how matter-of-fact he is - there's a shift from my internalised/imagined version of him and the real him.
I shouldn't have made this reply about me - it worried me that you criticise yourself and write that you will stop posting. Please don't be so hard on yourself. You write such valuable things on this board. I must admit I too often say or write things in life and then think to myself "hmm, in retrospect I wish I could press a 'DELETE' button and change that".
Please keep posting - I'm certain a lot of people would miss you deeply, me included, if you stopped (but no pressure of course!!).
Witti
Posted by Wittgensteinz on October 30, 2008, at 11:42:49
In reply to Re: poor wording » lucie lu, posted by Wittgensteinz on October 30, 2008, at 11:40:19
I'm sorry I didn't reply personally to everyone. All of your responses are much appreciated. I feel a bit bad for having written so much on this topic but it's helped me to get it out there. It's made me think about things from different perspectives.
I really appreciate all the support you have given me. It's hard to express what that means and what a comfort it is to feel 'heard' by others.
So, thank you.
Witti
Posted by lucie lu on October 30, 2008, at 14:46:34
In reply to Re: poor wording » lucie lu, posted by Wittgensteinz on October 30, 2008, at 11:40:19
Witti,
The phrase that made me wince was saying that "it actually made me feel sorry for you," as if I didn't already have a great deal of sympathy for you. So thanks for letting me off the hook ;-) And I didn't mean so much stopping my posts, just stopping loading up your thread with my posts! (Although I should be working because there is a lot to do this time of year, but that is my bad and not yours.) But thanks for your kind words.
Since you bring them up, there are still a couple of things that I thought of before but didn't go into. The first is your question of how to get such warmth from your T? Well, you can ask but even if he agrees in principle, it sounds like you just cannot get something from him that he cannot give and remain authentic with you. But you can have your cake and eat it too - you can keep your T and get the warmth from elsewhere. Either your pdoc or someone else whose job may not be to understand you on such a deep level (and after I read about some of your history I can see how such a deep understanding would be such a precious thing to you) but just to be empathic and supportive. Maybe Daisy can comment more on this, but it is clear that babies need the different sorts of interactions that they get from different important people in their lives. Father might be stimulating, bouncy, playful, exciting, and Mother, soft, comforting, nurturing, soothing. Baby needs both and behaves quite differently with the parents. I originally hesitated to go into this because I could see you'd had some very painful experiences in this area, but I really think there is a point here that is worth making. So the fact that you need, and receive, one important set of interactions from your "Dad" (T) doesn't mean that that's all that you need; nor that he has to meet all of your needs; nor that he is the only one who can meet your needs. Given what you describe as your family history, it is not difficult to guess where some of those ideas might originate from. Anyway, why not look for that "softer" interaction from someone else, just for what it is - comfort and empathy? And get the other from your T.
It is possible, particularly when you have such a background (I know from my own experiences as well), to have such low expectations of having your needs met that you conclude that either you have none (or not the full range), that even if you do you can live without them, or that you are simply unable to have them met by other people because of some limitation within yourself. So maybe to pursue this angle would be therapeutic in its own right (and then more to analyze with your T as well).
The other thing I wanted to raise but didn't because it still seemed very hazy and vague in my mind is whether there is not only countertransference that is potentially interfering with the analysis but perhaps some sort of enactment going on? This is not really my area, but I just had that feeling when I first heard the story, and the feeling came back again with your subsequent posts. It is almost like there is an unacknowledged sub-plot to the interactions you've been having with your T. I can't be more specific than that, so I'll stop here.
Thanks again for the kind words.
Lucie
Posted by twinleaf on October 30, 2008, at 17:35:39
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by stellabystarlight on October 29, 2008, at 17:39:49
rupture also, Stella. From what you write, it sounds like it's been mended, at least in part. I know what you mean about feeling resentful to have to do so much of the repair work yourself. I hope your relationship goes on getting better, as, when it's good, it seems to be very helpful!
From time to time my analyst and I revisit the disastrous rupture that occurred with my previous analyst. After we have gone through all the high emotions and pain that caused, he sometimes points out that I was doing what I was supposed to do- recreating my troubled relationship with my mother in my therapy. He feels that if my then-analyst had been more aware of that, and had been able to talk it over with me as much as we needed, that no such painful rupture would have occurred. He does believe in the power of shared words and understanding in healing ruptures, and begins doing it the moment he feels things are somehow "off". It seems as though we have a number of very intelligent, intuitive babblers, like you and Witti- others, too- who seem more aware of transferences, countertranferences and ruptures than their therapists are!
If you feel like it. perhaps you will tell us more about what happened.
Posted by Wittgensteinz on October 30, 2008, at 18:51:32
In reply to Re: Rupture in therapy (long) » Wittgensteinz, posted by stellabystarlight on October 29, 2008, at 17:39:49
Stella,
I must apologise for somehow managing to overlook writing you a personal reply. Of course this matter is raw for you because of your recent rupture with you T. You sound strong and wise in the face of it but all the same it must have hurt you dearly to go through. I'm glad things are on the mend - I hope that continues. I hope something good can come from it or at least that your T learns and such similar ruptures are avoided in the future.
I would also like to invite you to share about what happened, if you would like to.
You absolutely didn't upset me with your post - this need to repair the trust is perhaps the biggest issue. If he 'reaches his limit' now then how do I know he won't in the next session or the next? The problem with the T relationship is that we become so entrenched in it - so attached to our T's that on the one hand they have a great potential to help us but on the other hand we become utterly vulnerable to them and their failings. When things go wrong, they can go terribly wrong, as in Twinleaf's case with her former analyst. I can't begin to imagine how that must have felt.
A couple of things strike me 1) that your T would speak with you for 2 hours on the phone. My T is especially cold on the phone. I only phone him if I really need to (or if my partner pressures me to, such was the case last Friday) plus I have a bit of a phone aversion. 2) that your T teared up - how moving and what a clear way to show his connection to you and his caring. I'm glad he can commend you on your ability to deal with the rupture. I think you deserve that.
I'm relieved you didn't take your T treats (keep them for yourself instead!) :) - and although I have a similar desire, I will not act upon it - maybe I will ceremoniously eat some chocolates myself after seeing T - there is a nice chocolate shop close by, where I sometimes stop for a hot chocolate. I might tell him of my desire though but maybe at a later point if if if.
Maybe my mentioning the day programme suggests otherwise, but I do really want to make things work with my T. Who knows, perhaps when he hears of the pdoc's suggestion he'll sink into his chair in a big sigh of relief!
Good luck with the continuing restoration work.
Witti
Posted by Wittgensteinz on October 30, 2008, at 18:55:21
In reply to very sorry to hear that you are struggling with a, posted by twinleaf on October 30, 2008, at 17:35:39
Twinleaf, this may sound corny but I'll write it anyway.
I'm so glad you had the courage to 'go back' to therapy after the horrific experience with your former-analyst. I very much appreciate reading about your therapy. It sounds so rich and positive - and nurturing. I'm very happy for you that you now have such a good therapist to accompany you on your journey.
Witti
Posted by Wittgensteinz on October 30, 2008, at 19:05:19
In reply to Re: poor wording » Wittgensteinz, posted by lucie lu on October 30, 2008, at 14:46:34
Lucie,
Maybe I should be starting a new thread but your mentioning of 'enactment' has me intrigued. I did a quick search and only come up withstuff about marriage/family therapy.
When you mention enactment do you mean that in the therapy the therapist and patient inadvertently take on the roles of that of the patient to an important care-giver in their earlier life? I bring my troubled past relationships into the room and I project them onto my therapist - the idea is that we analyse them of course, but would an 'enactment' be that somehow my therapist ends up re-enacting them with me, repeating aspects of the role and failings of that earlier care-giver, and thus reinforcing the impact/trauma of them in the first place? I'm a bit worried this explanation might be embarrassingly off the mark but never mind.
Don't worry to be specific about me and my history/case - but could you give an explanation of enactment per se?
Thanks,
Witti
Posted by twinleaf on October 30, 2008, at 19:41:34
In reply to Re: very sorry to hear that you are struggling wit » twinleaf, posted by Wittgensteinz on October 30, 2008, at 18:55:21
Thank you for those tender and encouraging words, Witti. I really do appreciate your saying that to me, and especially now when everything must feel very very painful about your own therapy relationship. One thing struck me- your pdoc asking if you found your T "cold"- perhaps he has been known by others in the field to get that way under extreme emotional pressure?
As to "enactments", we (T and I) were just talking about them. Patients are expected to have them, as they begin bringing their original familial relationships into the therapy relationship. But Ts also have them; it's considered a sign that the T is well-focussed on the patient's real problems when he/she begins to feel pulled or pushed into acting like one or both of the parents. But that's where he has a unique job: he needs to know what it felt like to be you, and he also needs to understand something of what the parent was feeling, but he has to, sometimes, work very hard not to go too far into the enactment. He needs to truly understand how bad it was, emotionally, but to also be able to offer us a newer relationship- not perfect- but different and healthy enough so that our brains can take that information in, and rewire some!
One of the most tragic things about the times when therapists go too far in their enactments is that it seems to almost always happen when the fit is good, when there is a lot of mutual warmth and regard. Often, there is mutual sexual desire, which can be so healing and helpful if the boundaries are kept, and so damaging if they aren't. You don't hear of it happening in so-so humdrum relationships. I don't think I would have noticed this if it weren't for Babble. Somehow, despite all the hurt, it's better to know that, at least, strong and not just negative feelings were involved!
Posted by lucie lu on October 31, 2008, at 11:32:05
In reply to Enactment in therapy » lucie lu, posted by Wittgensteinz on October 30, 2008, at 19:05:19
The process is described very well in Nancy McWilliams' book: Psychoanalytic Psychotherapy: A Practitioner's Guide. I love reading her work, she describes processes like this very clearly and compassionately. You can search inside the book for 'enactment' and there are many references to it that might be useful/interesting. It need not be sexual although when sexualization of the relationship occurs, it's often attributed to enactment to at least some degree. Twinleaf describes the enactment process so beautifully in her post. (Twinleaf, I often feel that your prose borders on poetic!) Here's the link;
The way I look at enactments (this is my lay interpretation of the process and any mistatements are mine and not McWilliams!) is in the context of the analytic or therapy space between the T and the patient/client which contains the relational elements and dynamics between them. The patient is expected to bring key elements of his/her inner life into this space for the T to interpret and the dyad studies it together. They are not supposed to "do" anything about the material, just examine and discuss. As Twinleaf expressed it so beautifully, when a dyad is highly attuned, there is more pressure for the T to not only observe but to enter into the "as if" space as a participant by introducing his/her own material. This pressure can become irresistible if the T's inner dynamics mesh compellingly in some way with those of the patient. Since this is unconscious for the T, he/she is unaware of his/her participation in the enactment. In some cases, the two then act out these dynamics in real life, collapsing the analytic space. Since such enactments may be outside the T's awareness, his/her control of the therapy is lost, hopefully temporarily, and ruptures or other consequences can follow. Enactments, like ruptures, can be extremely subtle. An alert T can recognize the enactment quickly and can often pick up useful information for the therapy this way. The important thing is for the T to recognize the enactment and take immediate steps to contain or repair it or whatever the situation warrants. Nancy McWilliams points out in her book that common roles that get played out in enactments include not only the "seducer and the seduced" but also the "uninvolved nonabusing parent and the neglected child," "the sadistic abuser and the helpless, impotently enraged victim"(p. 18) and others. McWilliams explains it all so beautifully. I love her books.
My T and I have had enactments, at least one of which he became aware of as it was happening and drew my attention to it, which was both instructive and very interesting to me. Without knowing your T's contribution there is no way for me to know if any enactment(s) are involved in the rupture, but elements of what I was reading in the posts made me wonder, especially the "cold parent/neglected child" sort of scenario. It seems unlikely to me that your analyst would be completely unaware of potential for enactments around the rupture but it might be interesting to raise the issue. Maybe something in his past replays the dynamic? Of course his material remains unconscious, in which case you may not get far. Or maybe there's simply no enactment going on at all. I don't know, just thought I'd raise it in the context of what looks like his strong apparent countertransference and the persistence of the way you two seem to be relating to each other throughout. As others have pointed out, I think you are doing everything you are supposed to be doing, which leaves your analyst's contributions.
Take care,
Lucie
Posted by rskontos on October 31, 2008, at 18:42:07
In reply to Re: Rupture in therapy (long) » Nadezda, posted by Wittgensteinz on October 30, 2008, at 6:13:14
Witti,
The thing I find astonishing is that this no-suicide contract puts the burden of not committing suicide more or less right back on your shoulders. I thought the goal for therapy was to help you not want to try it? I am confused with that contract bit. Was it something to get the monkey off his back. This is what I am struggling with.
I feel strongly after reading most of the posts and yours, that your T is feeling too strongly his feelings and not yours. It sounds too much like this is all about how he feels not you.
I know the day programme seems scary but maybe a break for you and your T is what is in order. And a new perspective from being with other T's for now would be a good thing. And it isn't like you are breaking with him permanently. You can say your p-doc thinks it is necessary so that it is not you deciding completely. And this way both you and your t can have some breathing room to get things back into place so to speak. Maybe he needs a break to figure out what an *ss he has been. Pardon my language but he has.
He is trying to absolve himself from all responsibilities of helping you with your feelings around suicide. Unlike the p-doc who saw the elephant in the room and discussed it your T is running from the issue.
Just my 2cents. But I am sorry you are having such a rough time.
I care about you sweetie.
Please be safe.
rsk
Posted by stellabystarlight on November 1, 2008, at 18:09:31
In reply to very sorry to hear that you are struggling with a, posted by twinleaf on October 30, 2008, at 17:35:39
Hi Twinleaf,
Thank you so much for your kind reply to my post. It's always great to read your enlightening posts, and especially wonderful to interact with you here. Yes, my therapist and I've been going through a very complicated rupture which has been testing both strengths and weaknesses of our relationship in many ways. I've been wanting to write about it, but I don't even know where to begin as our relationship keeps evolving - very rapidly. I'm sorry I'm not being specific, but this rupture has touched on so many wounds...I'm still very confused about everything.
However, I wasn't too confused to know that his counter-transference was basically the culprit for this rupture and I had him credit me a session for the repair, and told him he's also responsible for the long phone calls! It simply came to a point where I couldn't stomach paying for a painful rupture/repair that I didn't cause, and I needed him to take resonsiblity for his part in a tangible way in order for me to maintain my self-respect. Even though the fear of abandonment was hanging over my head like a black cloud the whole time, I was empowered by speaking up for myself.
Maybe this is an ususual exhange between a therapist and a client, but we closed the session with a better understanding of each other, and perhaps him respecting me more. I will definitely post after I get all this sorted out. Thank you, Twinleaf, and I'm glad you're still doing so well.
Stellabystarlight
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