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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by Eddie Sylvano on January 28, 2003, at 10:04:23
I've read more than one person here stating fears that their therapist will drop them. Does this actually happen? What kind of therapist (without truly just cause) would do that? Given the situation they chose to be in, it seems very important that they be compassionate.
For that matter, how do most of you feel about your therapists, past and present? Are they generally interested, supportive people, or do they seem relative sterile and "professional?"
On a silly note, does anyone watch "7th Heaven?" There was a pretty funny (silly, rather) therapist bit last week where the father character gets totally berated by his therapist in the first minute of his first session for being a selfish whiner.
Posted by justyourlaugh on January 28, 2003, at 12:59:33
In reply to Fickle therapists, posted by Eddie Sylvano on January 28, 2003, at 10:04:23
hi edd,
i live in ontario and never heard of a therapist.
i see a pdoc.
on occation i have talked with an adult crisis worker at the hospital.
can they prescribe meds?
mabe md"s do not believe in them?ha ha
whats the difference between the two?
jyl
Posted by Dinah on January 28, 2003, at 16:48:41
In reply to Fickle therapists, posted by Eddie Sylvano on January 28, 2003, at 10:04:23
I think a lot of our fears are more metaphorical than actual, although therapists do refer out patients that they don't feel competent to treat. And there are some things that make some therapists feel uncomfortable, and I guess we're afraid they'll feel so uncomfortable that they would feel like they would better serve us to refer us out. There are some therapists who prefer to work with people who are not terribly troubled, and find it difficult to work with, for example, suicidal patients or self injuring patients. So a lot of times we feel things out a bit at a time, to see how comfortable a therapist seems with some information before giving out more.
I worked with a pdoc who was clearly uncomfortable with my self injury and was terribly frustrated that he couldn't medicate it out of me. When I didn't respond appropriately to his meds, he pretty much provoked me into quitting. I can't believe it wasn't deliberate. Needless to say, I did much better once I was away from him.
But I think a lot of our fears have more to do with our therapists being disgusted by us, and rejecting us in other ways than leaving us. Those of us with abandonment issues can see abandonment in just about anything.
How do I see my therapist? Does he see me as a person that he truly wants to help? Does he see me as a walking dollar sign that he'll put up with to pay the bills? Who knows. A bit of both I guess. How much of each probably shifts from week to week. But is that so unusual? Are those of us in the service industry always eager to serve all our clients? Are we happier serving some than others? As long as my therapist does his job with reasonable competence, professionalism, and consistency, I'm happy enough with him. He doesn't have to like me, although it helps if he doesn't dislike me enough for it to show.
Posted by mikhail99 on January 28, 2003, at 17:26:36
In reply to Fickle therapists, posted by Eddie Sylvano on January 28, 2003, at 10:04:23
Hi Eddie
I'm very fortunate to have a wonderful therapist. I had fears he would drop me after I had to confess I had developed some intense feelings for him but he handled it very well. It's a bit weird at times because he also sees me and my husband twice a month but so far, it's been ok. He is compassionate and caring but keeps those boundaries firmly in place. I feel he accepts me and it's probably one of the few places I don't feel like a freak.
Take care,
Mik
Posted by Mashogr8 on January 31, 2003, at 16:00:53
In reply to Re: Fickle therapists » Eddie Sylvano, posted by Dinah on January 28, 2003, at 16:48:41
I was "dropped" by a psy doc who was both medication consultant and psychotherapist. I had been seeing her for about two years. Under her advice I had been admitted to a psychiatric facility to try to determine what was keeping the medication from working (this was at least twenty years ago). I found it very hard to talk with her. I was a professional with children. She was a professional with children. I had been referred to her because I might be able to learn how to balance my life by realizing that she had similar issues. There did come a point when -- and this is what I remember her saying, "This is never going to work. You have frusttrated me so much that I see you as one of my own children. I cannot work with you while I am in that capacity. You need to find someone else as soon as you can. I will neet with you two more times while you locate someone else."
It was the b est thing that ever happened (well not really) but we were going NOWHERE and I was afraid of her and was definitely afraid to tell her what I was really thinking. She often said why do you wait until the last ten minutes to tell me you feel so badly or are suicidal? Truth be told, I was actually afraid to tell her. I would only bring it up at that time because if I didn't, I would have to hope I could last unntil the next session.
I think there are some good reasons to be dropped. At first, I was repulsed, disappointed, furious, scared...... In the long run, she was right, darnit. I jsut wish she didn't make me feel like I had flunked therapy big time!
MA
Posted by mair on January 31, 2003, at 17:10:27
In reply to Re: Fickle therapists, posted by Mashogr8 on January 31, 2003, at 16:00:53
I think it's pretty typical to worry about whether your therapist will drop you. I was initially referred to my therapist for very short term directed CBT. I think she figured out pretty quickly afterwards that my need for therapy was considerably greater than that. Forever after that I worried that she was resentful for having ended up with a patient who was so much more challenging than initially represented. We've addressed these fears numerous times in the past and I'm pretty sure it will crop up again. It seems to go with the territory.
Mair
Posted by Eddie Sylvano on February 3, 2003, at 10:24:37
In reply to Re: Fickle therapists, posted by mair on January 31, 2003, at 17:10:27
>I worried that she was resentful for having ended up with a patient who was so much more challenging than initially represented. We've addressed these fears numerous times in the past and I'm pretty sure it will crop up again. It seems to go with the territory.
-------------------I've noticed that a lot of people here are afraid to tell their therapists/pdocs/etc their true feelings and concerns. Is that fear unique to each therapist (some are more intimidating than others), or just a general desire to avoid voicing your problems to anyone? It reminds me of being in Catholic school, and going to confession. I got the impression that no one ever actually confessed their darkest issues, but just gave the priest a few bones for the sake of the system. I was probably the only one telling him all the really bad stuff, and he handled it very well.
An intersting question would be, Has anyone told their therapist something bad that they thought/did, and had the therapist openly criticize or judge them? As far as I understand, they should never do that. Their role is to question, not claim.
Posted by noa on February 3, 2003, at 19:24:14
In reply to Re: Fickle therapists, posted by Eddie Sylvano on February 3, 2003, at 10:24:37
I feel I am quite open with my therapist. In fact, I don't feel that I can lie to him. The only time I withheld important feelings was one time when I was suicidal. Before that time, I had been honest about my suicidal feelings. But that time, I had told myself not to tell him because if I told him it would be harder to go through with it. But the entire therapy session that day, I was sitting there totally conflicted because it was hard to lie to him and withhold my suicidal intentions, but on the other hand I was trying to keep to my plan not to tell him.
Well, I ended up telling him in the last 10 minutes of the session--I just could not continue to decieve him. He was angry that I withheld it until the end, but we went into crisis mode and did a safety agreement verbally. I actually was kind of relieved in a way. I still felt suicidal but I kind of let myself accede to his judgement--kind of suspending my own because my judgment was pretty bad at the moment.
We set another appointment up the next day, and during that appointment, after checking safety, etc., he told me he had felt angry at my waiting until the end of the session and that if I am feeling suicidal I must tell him right away. He also kind of read me the riot act, telling me that if I cannot keep myself safe, I would need a higher level of care, whether hospitalization or day treatment, but that he felt he could not provide enough structure for me in outpatient care while I was that suicidal.
I agreed to continue the safety agreement and not to pull an end-of-session bomb on him again.
Anyway, that is the only time I was purposely deceptive with my therapist. It was a few years ago.
When I avoid topics or feelings it is not because I am afraid to tell him, it is because allowing myself to think/feel certain things is highly uncomfortable for me.
When I was younger and first started therapy in another city, I was very scared and embarrased to bring up difficult things, even things that don't seem so hard to me now, like anger, especially anger at the therapist. I took to writing my therapist letters to raise issues. Then, once the ice was broken via the letters, I could tolerate talking about the feelings. This was also because it was easier for me to express my thoughts and feelings in writing than in person, especially when I was feeling flooded by my emotions in the therapy sessions.
Posted by Dinah on February 3, 2003, at 19:48:56
In reply to Re: Fickle therapists, posted by noa on February 3, 2003, at 19:24:14
There is still a part of me that is terrified of being angry with my therapist. Not just afraid of expressing it, but afraid of feeling it. Of course there is another part of me that feels free to tell him off soundly.
I am pretty much honest with my therapist in most things that I'm comfortable being aware of myself, although I may dance around things sometimes and hopes he gets it. And I do use writing. Sometimes I read him my posts from here and he'll say they help him understand things he hadn't realized before. Even if they're things I've tried to explain. Either I write better than I speak (and I think I do) or he reads better than he listens.
Posted by bpdzone2000 on February 3, 2003, at 22:42:21
In reply to Re: Fickle therapists » Eddie Sylvano, posted by Dinah on January 28, 2003, at 16:48:41
I have a great fear that my therapist will leave me. I posted last week on abandonment and I took your advice and talked with my therapist about some of my fears with her. It was something that bothered me for a long time, and that it was not unsusual to have these feelings. But I was amazed to find that it was o.k. and I was not alone.
I feel very lucky to have a wonderful therapist but I can't stop the feelings of what she might think of me?
I know that's something I have to work on... the self esteem thing... but how long do we have to get beat up before we say enough is enough?
It sometimes gets to a point that you just don't care anymore and then you get into the old habits, bad thoughts, then isolation... then the mind starts to race and then crash and the cycle begins to not knowing or caring and then welcome to existence. And I thought you were suppose to live life not exist.
Sorry for the blabbing...
I got some big changes a head of me...
I've made a committment to my therapist... Now isn't that scarey!!! I'll do it for her before myself...
thanks for your posts everyone!
Posted by Dinah on February 4, 2003, at 6:08:58
In reply to Re: Fickle therapists , posted by bpdzone2000 on February 3, 2003, at 22:42:21
> I have a great fear that my therapist will leave me. I posted last week on abandonment and I took your advice and talked with my therapist about some of my fears with her. It was something that bothered me for a long time, and that it was not unsusual to have these feelings. But I was amazed to find that it was o.k. and I was not alone.
That's great! I'm not surprised of course. But it's great that you got up the courage to talk about it with her. And now you've started talking about the tough stuff, it won't be so hard the next time. Congratulations on crossing a trust/intimacy hurdle!
> I feel very lucky to have a wonderful therapist but I can't stop the feelings of what she might think of me?
Well, I suppose that's natural. But as you keep telling her things, and she keeps communicating that she accepts you, those feelings do get less.
> I've made a committment to my therapist... Now isn't that scarey!!! I'll do it for her before myself...
> thanks for your posts everyone!Not scary or unusual at all (ok, maybe a bit scary, but not unusual). That's what positive transferences are for. :) My therapist always says that he'd rather I not self injure for myself, but if I do it for him, that'll be enough until I can do it for myself.
Thanks for the followup.
Posted by Mashogr8 on February 4, 2003, at 16:41:19
In reply to Re: Fickle therapists » noa, posted by Dinah on February 3, 2003, at 19:48:56
I have rarely used letters to my therapists primarily because I was afraid they wouldn't say what I wanted them to say or they would be nonsensical. However, things got so bad that I recently woulnd up writing a letter both to therapist and pdoc (mostly because I was afraid I would not remember what I had been thinking). It was kind of interesting as my pdoc said, "the letter didn't really say anything I didn't know. What I did need to hear was how intensely you felt." I think there must be some sort of energy or passion that appears in the written word which may not come through in a face to face encounter. (I am definitely more reserved, less prone to dramaticize, become hysterical or even appear to need more to get a point across than I was in that letter).
So maybe there is a better way to say the same thing when it is written and read in front of a client. That to me makes "writer and listener" equal not necessarily one being better.
MA
Posted by Dinah on February 4, 2003, at 18:21:38
In reply to better reader or better listener/Dinah, posted by Mashogr8 on February 4, 2003, at 16:41:19
Yes, perhaps just different. As a matter of fact, my therapist makes me read my more emotional writing aloud so that I can integrate emotion. It's amazing how different it feels to read it in front of someone as opposed to writing it. I often break down in tears reading what I have written myself dry eyed.
Posted by mashogr8 on February 4, 2003, at 21:32:43
In reply to Re: better reader or better listener » Mashogr8, posted by Dinah on February 4, 2003, at 18:21:38
Medication has dried up all my tears. I just wish meds would sop up the depression. Crying would be such a relief.
MA
Posted by bpdzone2000 on February 5, 2003, at 18:41:54
In reply to Re: better reader or better listener/Dinah, posted by mashogr8 on February 4, 2003, at 21:32:43
dry eyes too.. Actually emotionless with lots of fear if that makes sense. Wanting so desperately to let it all out!!! yet frieghtened I won't be able to handle it. Afraid to hurt the ones we love. The sad thing is that they really don't get it as much as they try. It kills me that I can't explain without them worrying. You always hurt the ones you love. That's the hardest!
Posted by noa on February 5, 2003, at 19:03:34
In reply to Re: better reader or better listener » Mashogr8, posted by Dinah on February 4, 2003, at 18:21:38
> As a matter of fact, my therapist makes me read my more emotional writing aloud so that I can integrate emotion. It's amazing how different it feels to read it in front of someone as opposed to writing it. I often break down in tears reading what I have written myself dry eyed.
Sounds like your therapist has hit on a good technique for you. You have mentioned before how cut off your emotions can be.
Posted by heather66 on February 7, 2003, at 2:03:12
In reply to Re: better reader or better listener » Dinah, posted by noa on February 5, 2003, at 19:03:34
Thank you to everyone who wrote about their experience with their therapist. Your words helped me tonight - as I decided this week not to go back to mine. I was/am thinking that the therapist is just putting up with me to "make the big bucks" and that he doesn't really care to help or is incapable of helping me because I am hopeless... maybe only I can help myself. I also feel EXTREMELY frustrated by the way that therapy sessions are scheduled and only last an hour. I can't just schedule to get emotionally involved at a certain date and time. Most of the time I try to pretend everything is okay and then I show up at therapy - knowing that right now, this minute, I must stop pretending and I must be open with my feelings. I can't do it. It takes me 45 minutes to feel like being honest - at which point there is 10 minutes left and then I am cut off. No more talking now. Go back to pretending for a week.
Posted by heather66 on February 7, 2003, at 2:05:16
In reply to Re: better reader or better listener/Dinah, posted by mashogr8 on February 4, 2003, at 21:32:43
> Medication has dried up all my tears. I just wish meds would sop up the depression. Crying would be such a relief.
> MAMedication has dried up all my tears too. But the depression is bad. Very bad. I don't know what to do.
Posted by mair on February 7, 2003, at 8:00:19
In reply to Re: fickle therapists, posted by heather66 on February 7, 2003, at 2:03:12
Heather, I don't think you should give up on therapy, particularly when you're feeling as bad as you are. I think the 50 minute hour gets more productive as time goes on. I, too, used to avoid bringing things up until the hour was almost over. It used to take me that amount of time to screw up the courage to talk about some of the harder stuff. I've gotten considerably better but I still feel like I lose alot of time talking around things rather than about them. One thing I've done which has worked for me a few times is to mention to my therapist at the very end of the session whatever topic was most on my mind. At least she then knows to bring it up at the very beginning of the next session. Somehow it's easier (less risky?) for me to do something like virtually as I'm walking out the door, yet keeps me from never addressing it - again, it's easier for me if I have to answer her questions.
I guess what I mean to say is that learning how to use those 50 minutes is part of the process of learning to trust your therapist and with alot of people (definitely me), it's a process that can't be short circuited.
I've gotten very frustrated at times by the fact that I sometimes spend more time talking about the process of therapy than I do about whatever is happening in the rest of my life. I don't address things very directly so it's not an easy topic for me. Now, however, I can look at those sessions as building blocks, and not wasted time at all.
Mair
Posted by Dinah on February 7, 2003, at 9:51:29
In reply to Re: fickle therapists, posted by heather66 on February 7, 2003, at 2:03:12
Heather, Admittedly it's frustrating. And perhaps you don't have the right therapist for you. But there are things you can do to make it easier.
Between sessions you can keep a journal. That can help you figure out what's on your mind that week. You can bring entries from your journal to the therapy session to help you start talking earlier in the session.
I have trouble accessing my emotions, and I also have trouble turning them off. So I always try to prepare myself mentally before the session. My ideal strategy is to keep calm and open as long as I can before the session, then arrive a few minutes early to focus myself and empty my mind of the rush rush of everyday life. I focus on whatever is on my mind. My therapist helps me out there, as he is usually at least ten minutes late. I usually arrive five minutes early, so that gives me fifteen minutes to prepare.
When there is five or ten minutes left, I start to lighten things up, so that when I leave I'm more or less together. Of course, it isn't always that easy, and I sometimes leave while I'm still upset. If that happens, I'll sit down in the car until I feel safe to drive home.
But again, the problem might be that you don't have a good "match" to your therapist.
Good luck with whatever you decide.
Posted by noa on February 7, 2003, at 11:56:46
In reply to Re: fickle therapists » heather66, posted by Dinah on February 7, 2003, at 9:51:29
I watch the clock, too. My therapist has one situated where he can see it and one right over his right shoulder, where I can see it.
Lately, I'm ok if I'm upset at the end of the session, but there are times when I do say that I need help "wrapping up" so that I can leave ok.
I go twice a week, which helps a lot. I also like Dinah's idea of writing down things as they are more active in your mind, and then you can bring your writing with you to therapy. Sometimes, I start off therapy by saying I know I have things to discuss but they are not on the surface right now, or I am afraid to bring them to the surface right now, or can you help me talk about them but not so deeply that I'll get overwhelmed, etc. etc. But sometimes, a session is rather superficial and that is ok, too.
Posted by bpdzone2000 on February 8, 2003, at 13:44:57
In reply to Re: fickle therapists, posted by noa on February 7, 2003, at 11:56:46
Don't mean to get too far off the topic but my therapist is out of town right now and it's like all of my symptoms have heightened. As I've stated in an earlier post, I have abandonment issue's. What's worse is my secret disturbing thoughts. Those thoughts of being abused someway and having my therapist see me in this condition and just feeling so bad for me and wanting to RESCUE me... That's so hard to say and I can't believe that I just typed this. I'm very ashamed of these thoughts.
Anyways I'm in a fst forward mode and thought I'd spill a little bit on the board.
Posted by Dinah on February 8, 2003, at 21:12:59
In reply to Re: fickle therapists-on vacation, posted by bpdzone2000 on February 8, 2003, at 13:44:57
There's nothing to be ashamed of.
But perhaps you could take this time that your therapist is off to write a letter to him/her describing your fantasies and your shame about them. In fact maybe you could write a few letters about issues that have been hard for you to discuss. That will give you a way to "connect" with your therapist while she/he is away, and you can take the letters one at a time to session to get some of those tricky issues opened up.
Posted by bpdzone2000 on February 8, 2003, at 21:43:29
In reply to Re: fickle therapists-on vacation » bpdzone2000, posted by Dinah on February 8, 2003, at 21:12:59
Oh I wish I could. I suppose writing about it might help me to get it out and at least on paper. Bringing it to session and actually sharing it with her would be so embarrassing. I'm sure she has dealt with that before. And I'm sure it would do me a tremendous amount of good to share it with her. I just can't!!!
I thought about maybe her reading the letters? but then I would still be embarrassed. You know I say that she'll understand, I say that she won't abandon me, I say all those right things, yet I can't seem to muster up the courage to tell her this. Maybe if I write about it enough I will get the courage.
Has anyone else had this experience and what did they do and how did the therapist respond?
Thanks Dinah...
Posted by noa on February 9, 2003, at 7:10:47
In reply to Re: fickle therapists-on vacation, posted by bpdzone2000 on February 8, 2003, at 21:43:29
Well, in any event, you have your PB posts to keep as a kind of journal of how you are feeling. If you feel up to it, you could print them out and bring them in to discuss.
I'm glad you felt ok letting us know. It isn't shameful, although I understand that it feels that way. I've had similar feelings at times.
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