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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by deerock on July 1, 2010, at 9:55:11
i took a break from my T for several weeks. i started to struggle and asked her to come back but also said i was not positive about working with her in the long term and needed to see her a few times while i thought about it. i consulted with another T in the meantime to help me make a decision. i saw her yesterday for the second time since taking the break. this is how it went.
me: i left you a message asking you to call doctor X, you did not call him. i need you to speak to him so he can help me make a decision about continuing treatment with you.
T: why am i supposed to call him? why is he not calling me?
me: because im asking you to call him. is there a problem with that?
T: yes. you are consulting with him. he is not consulting with me. you need to ask him to call me.
me: that's fine. no problem. i will let him know. however, it feels that out of the need to maintain some kind of self respect or integrity, you're holding to a conviction that he needs to call you and in fact that is getting in the way of this process. rather than be flexible and just call him youre trying to make some kind of point.
T: youre not my client. we havent decided to work together again. im willing to work with you once you make the decision but until then, i dont owe you anything.
me: (becoming enraged at this point due to her last comment and an overall feeling of her evasiveness being completely unnecessary) I think I want you to call him because he is a real doctor. You're not even a real doctor. (my T is a psyD and the consulting guy is an MD). (clearly I said this just to get to her)
T: i am a real doctor.
me: not in my eyes you arent.
T: look mr rock. if we are going to have a relationship, you are welcome to come in here and berate me all session long. however, you need to determine if this is productive for you and at some point decide to focus on what's good in here and talk about that rather than attacking me and devaluing me.
me: im really sorry. sorry that was so rude. sorry.
t: time is up. have a good weekend and take care and please let me know how you want to proceed in terms of tretment with me.-------------------------------------------
so i think what is going on is that when i told her to call this other T, i said it, in a way that was patronizing to her. i did not mean to do this. but it came across like "call this guy, he will let you know how bad you are, youre being bad." so she felt the need to stand up for herself. i became enraged because i felt this was not necessary for her to do.
now im confused because we often have sessions, many sessions in the last several months that we worked together that i rage at her and its not productive. and it seems like when i get angry, she becomes defensive and my anger escalates instead of my anger being a catalyst for insight and change. this is very unproductive. i dont know how to get beyond this right now.
her telling me to focus on the positive feels like she is telling me to just knock it off and be a good boy. but it feels more complicated than that. because i dont often realize im devaluing her. and once i do it, she becomes defensive and i dont know why she is being defensive since i dont realize i just did something. it seems like there is more to it than just hey rock cmon knock it off and be nice.
but maybe there isnt. wondering what others say to this story. thanks for reading. i appreciate it.
Posted by Dinah on July 1, 2010, at 10:10:10
In reply to blow out session with my T yesterday, posted by deerock on July 1, 2010, at 9:55:11
> now im confused because we often have sessions, many sessions in the last several months that we worked together that i rage at her and its not productive. and it seems like when i get angry, she becomes defensive and my anger escalates instead of my anger being a catalyst for insight and change. this is very unproductive. i dont know how to get beyond this right now.
Perhaps you need a therapist from a different school of therapy. What you're talking about sounds like something an analyst might feel quite comfortable doing, but a CBT therapist might not. My therapist wouldn't wish to work with me with the dynamics you're describing. But a therapist with a psychoanalytic focus might.
I don't really like the responses you reported. And it doesn't sound as if she's really enthusiastic about continuing therapy with the devaluation and anger directed toward her. That's just my take on it from what you said, and I could be completely wrong.
Could you have a conversation with her, talking about how you believe your anger can be a catalyst for change, and asking her if she's comfortable with therapy on that basis or if she thinks you need to find a therapist who works more with that type of material?
It doesn't mean that her point of view is wrong or that your point of view is wrong. But it might mean that you aren't ideally matched.
Posted by deerock on July 1, 2010, at 10:20:38
In reply to Re: blow out session with my T yesterday, posted by Dinah on July 1, 2010, at 10:10:10
she is an analyst dinah. thanks for your input. i agree, it seems like she doesnt want to deal with the anger. the T that i had a consult with told me he would talk to her.
he said that if she means dont get angry with me and only be nice because she cant use the anger in a therapeutic way then she is not the right match for me.i can have a conversation with her regarding using my anger in a helpful way but in some ways it feels like that should go unstated. thats her job. thats what she is being paid to do.
we'll see. she did say several times how committed she is to working with me and how willing but it felt like there is a condition. either be nice or waste your own time. and im not exactly going to her so i can pay someone to beat up on them verbally. i have friends for that. just joking. but seriously. it feels like im getting blamed for something that im there to try to resolve. and its not getting resolved. so therefore i need to stop doing it? that makes no sense what so ever.
Posted by violette on July 1, 2010, at 11:01:39
In reply to blow out session with my T yesterday, posted by deerock on July 1, 2010, at 9:55:11
"...but it feels more complicated than that. because i dont often realize im devaluing her. and once i do it, she becomes defensive and i dont know why she is being defensive since i dont realize i just did something..." Deerock
Hi Deerock,
It seems to me that her being 'defensive' is the means for which she is trying to get you to see her as a person with feelings when you devalue. Since you do not realize you are doing this at times (which could also mean you are possibly doing this more than you think), and considering the length of time you've been in therapy, maybe this is a pattern of relating that she is more aggressively addressing by challenging you with the goal of promoting change in this area?I've been the recipient of devaluing; not as a therapist, but as a gf. When the bf no longer idealized me because I was no longer serving his needs when he unknowingly discovered I had my own emotional needs in the relationship, that bf did not have the ability to see me as a person with needs. He did not have a capacity for empathy.
Well, I'm only relating my experience and intuition here to make a guess about your situation, and I'm not sure how else a T would adress a pattern of objectifying. While my ex could not "see" me as a person and devalued me-he had no clue. The fact you do have empathy being that you do not always do this, and that you recognize it either during or after is significant, and that insight alone is a catalyst for change. Being objectified is probably one of the most awful feelings for me; I am not sure how Ts can handle it repeatedly. But she is willing to do this, it seems, to continue to help you resolve your issues. Often with psychoanalysis, the relationship between T and patient is emphasized. She would likely have to be 'defensive' as her part of the relationship, perhaps if insight alone has not allowed you to progress in this area.
Maybe you are uncomfortable with the way she is doing this, maybe it is only the way she is handling this and not you-or maybe it is just a difficult area for you to work on ("feels more complicated than that") because you identify this with your self-and it is difficult to leave parts of your self behind. It feels like self betrayal, or it could feel like loss, or be confusing and painful. It can be very uncomfortable either way.
I'm not sure if CBT therapists have the knowledge or are trained to address this sort of thing as this is one of those core self issues deeply ingrained and intertwined with how we relate to the world-as opposed to a specific trait. I don't know-but I'd be interested to know if you if could bring this up to the CBT therapist you were considering, and ask how they would address this.
I certainly hope you will be at peace with whatever decision you make.
Best to you,
Violette
Posted by deerock on July 1, 2010, at 11:14:11
In reply to Re: blow out session with my T yesterday » deerock, posted by violette on July 1, 2010, at 11:01:39
thanks violette. sorry you were objectified. i dont know if i ever felt that way. well, wait. my parents raised me that way. thats why i treat others this way. so i know its an aweful feeling. i bet the reason i do it to her is to guard myself from feeling it.
anyways, i think she is willing to keep at it because she knows that i can change this. i had given up on the CBT therapists. i didnt find them to be offering something that i need right now. thats why i went back to my T.
im not sure how much is her trying to change the behavior by being defensive. this is complicated because she tries to be neutral. often. and when i get a reaction out of her, it seems very contained. when i feel something it shows. not so much with her. so when she gets defensive, it gets me riled up because i think she is trying to hide it. i feel like i am affecting her. a lot. i can see her getting uncomfortable when i say stuff to her that is provocative. but i continue to do it because somehow it feels like a game. almost like she is trying to hide that im affecting her and later she will say you impact me i hope you know that.
i wish in the moment, she would say that thing you said right there, that's devaluing etc. etc.
either way, if i work on it with her or with someone else, i know there are ways in which i affect people that is hurtful that i am not aware of in the moment. its not my intention to harm people. somehow it turns into a game. a game of do i matter to this person and am i being seen by this person. when i do something to the T and she tries to hide her defensiveness, i think it makes me feel like im not being seen and my attacks get louder until i know im being seen and then i stop.
i dont know really why this is a game to me. it makes me feel pretty disturbed.
on another hand life will be pretty lonely if i dont find a way to stop doing this.
i totally get though, how your ex turned on you. i mean, i get it in the sense that once the novelty and needs being met wears away, its time to get real and time to go through some challenges...why would someone want to do that? they would rather devalue, cut town, get a rush and bolt.
its no recipe for happiness and hurts people quite badly but i can completely see why someoen would operate this way. hell ive done it to every woman ive ever dated.
its amazing that most of my exes are still my friends. i think its because they know i do it for reasons other than the fact that i really dont like them. i hope that makes some sense. have a good one. thanks for sharing your thoughts. it was helpful to me. and even if it wasnt, id hope that id be nice and not devalue you. youre valuable. you deserve to be loved.
Posted by violette on July 1, 2010, at 11:16:07
In reply to Re: blow out session with my T yesterday » Dinah, posted by deerock on July 1, 2010, at 10:20:38
" can have a conversation with her regarding using my anger in a helpful way but in some ways it feels like that should go unstated. thats her job. thats what she is being paid to do."
That's a point I was trying to emphasize with the analytic relationship. It's more than that with psychodynamic therapy-because therapy is a two-way relationship, she has to do more than "just her job" and interact with you relationally.
While it is a therapeutic relationship, and it is her job, she has to play the part of the other half in the relationship to allow you to experience insights, to challenge you, to promote change, rather than only 'listen'. She has no choice now but to channel the insights for you to see by directing you to see how she feels emotionally in the relationship, her emotional reactions to the devaluing--which could be necessay for the devaluing to stop. It is more than generalized anger-it could be anger in recognizing that she has emotional needs, rather than only you. Imo, that's what she is trying to address here. If you did not get your emotional needs met as a young child, if a parent did not recognize that you had emotional needs, you could have developed a pattern as a defense against feeling the pain.
I think the challenging is difficult for many of us patients. But it is, in my view, her 'job' to not just observe the anger-but to interact relationally. At least during this point in therapy. On the other hand, ruptures can sometimes permanently disrupt the relationship and trust is never regained. If you are still having difficulties with trust, that could be problematic when she is challenging you like this.
Posted by violette on July 1, 2010, at 11:35:01
In reply to Re: blow out session with my T yesterday » violette, posted by deerock on July 1, 2010, at 11:14:11
Deerock,
The last post was sent before I read your last response..
"im not sure how much is her trying to change the behavior by being defensive. this is complicated because she tries to be neutral. often. and when i get a reaction out of her, it seems very contained. when i feel something it shows. not so much with her. so when she gets defensive, it gets me riled up because i think she is trying to hide it. i feel like i am affecting her. a lot. i can see her getting uncomfortable when i say stuff to her that is provocative. but i continue to do it because somehow it feels like a game. almost like she is trying to hide that im affecting her and later she will say you impact me i hope you know that."
Yeah, this is really complicated. My guess is that just being neutral isn't enough. I'm not sure about the game playing, i guess that's known as manipulation in psychodynamic therapy. It could be testing her...it could be impusles..When I do subtle things with my T for manipulation, I always tell him right away. Maybe that makes me more boring as a patient (?). But instead of acting on the manipulation, I'll tell him what I wanted to do to manipulate him. For example, I wanted to send him a text message about an appt. as an excuse to contact him and say I missed him. Although the message related to an appointment, could have called his office manager, but had strong urges to text him instead. Just an example. So, maybe try to talk about your desires to provoke her with 'games'? My T and I laugh about it, but our relationship is much different and he doesn't seem as orthodox with psychoanalysis as your T; plus, I have mostly a PTSD construct, which calls for different therapy frame--although I've only been with him for a year so I can't directly compare my stuff with yours. Just a thought-tell her of the urges of wanting to play games rather than doing it. It's easier said than done!
"but i continue to do it because somehow it feels like a game. almost like she is trying to hide that im affecting her and later she will say you impact me i hope you know that."
I think she has to hold out until you feel/experience it, rather than pointing it out right away. Maybe in getting you to see her feelings, she waits-but if you don't get the insight, she has to say "this is how you impacted me"..etc.
"i wish in the moment, she would say that thing you said right there, that's devaluing etc. etc"
Again, I am not sure if you will get the full insight if she just pointed it out-she is trying to get you to see it BEFORE she points it out. If you do see it-I think she's trying to get you to change. She can't ask you to change-that comes from you. As opposed to CBT, the insights, those 'aha' moments, are the precursor to change.
Hey, thanks too for the sweet comments. :)
I know you mean well. My T and I talk about how important intentions are. He doesn't associate psychosis or schitzophrenia, for example, with being 'crazy'; instead, he said what is crazy is when people are totally unaware....like my mother, for example...oblivious to how their emotional issues harm others. Or blame everything on others, never acknowledging that they themselves can possibly impact their situation or affect others.
Take care :)
Posted by Dinah on July 1, 2010, at 11:45:25
In reply to Re: blow out session with my T yesterday » deerock, posted by violette on July 1, 2010, at 11:01:39
That's a really good point, Violette. I hadn't really considered it. Although my therapist works with the therapeutic relationship, he's not an analyst, and his style of working is way different.
Posted by violette on July 1, 2010, at 12:24:06
In reply to Re: blow out session with my T yesterday » violette, posted by Dinah on July 1, 2010, at 11:45:25
Oh Dinah - I read what I said; I didn't mean to say CBT doesn't involve insights (is that how it came out?). I think it was that psychoanalytic therapy (or at least how I see or experience it) the therapist is less directive in pointing things out, challenging in ways that enable the patient to get the insight. Anyway, it is my experience that CBT therapist in the past have told me my behavior and underlying motivations rather than let me see/feel it first. So, I never got the insights.
With psychodynamic therapy, the insights come when the feeling is integrated with the thought. With my personal experience with CBT, it didn't happen that way--the Ts pointed things out rather than letting me experience them...so that approach didn't work for me with several types of therapist, over several years. :)
Though many therapists are eclectic, I know. And i don't represent the field of CBT or any other type of therapy; just my opinions and experiences.
I have to go run an errand now and will probably come back later after I knock off some things from my to do list. I've been so much more productive lately. Take care!
Posted by deerock on July 1, 2010, at 12:56:16
In reply to Re: blow out session with my T yesterday » Dinah, posted by violette on July 1, 2010, at 12:24:06
rock on violette...you and your productive self.
:) enjoy.
Posted by violette on July 1, 2010, at 18:14:21
In reply to blow out session with my T yesterday, posted by deerock on July 1, 2010, at 9:55:11
Deerock, is it possible for you to turn your babblemail on temporarily? I want to send you a link with some information but I can't post it here since we can't edit or delete anything we say in our posts here.
You could turn your Babblemail back off right away. However, if you don't want to accept a message from me, I won't be offended.
Violette
Posted by deerock on July 1, 2010, at 20:42:39
In reply to Re: blow out session with my T yesterday » deerock, posted by violette on July 1, 2010, at 18:14:21
thatsno problem. let me try to do that now. thanks violette. hope your day is going well.
d
Posted by violette on July 2, 2010, at 9:22:02
In reply to Re: blow out session with my T yesterday » violette, posted by deerock on July 1, 2010, at 20:42:39
It just occurred to me that it's possible you might be moving from a more dismissive attachment pattern to an ambivalent attachment with your T. Which leads (eventually) to a secure attachment...or so I think. (?)
Don't know, just crossed my mind...Maybe the attachment related material we talked about earlier would help make more sense of the situation with your T.
Ambivalance with an attachment figure could possibly explain how you want to continue with her but don't at the same time..Looking at this from an attachment perspective could help you straighten out your thoughts.
Talk to ya later.
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