![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by DaisyM on November 26, 2003, at 19:08:48
We were talking today about how strong my need to "check in" can be sometimes. It isn't always but there are weeks when I feel really emotionally raw and needy. I said I assumed he would tell me when it was "too much." He clarified that I have a fear that he will get fed up and terminate. Well, yeah.
"What if," he asked, "I just said that I can't be there for you this one time, or around this one issue, but I'll be there the next time. Or around the other issues. Or what if I said, maybe you should only call 1x between sessions, instead of 10." (He was using an extreme example, BTW, I've never called 10Xs!) He clarified that right now he couldn't really project what an issue would possibly be that he couldn't be there for me, but...how would I feel if he "gently" needed to set limits or say no.
I guess what he was getting at was: "Is it all or nothing with your Therapist?"
My answer was that intellectually I could probably understand a good reason given for a "let down", for lack of a better term. But emotionally I have no experience with there being a next time. In my life, once I have been stomped on, I'm done. Or their done.
And as far as limit setting, since I usually set and keep my own, I would be mortified and it would be a complete shut down for me. Not that I wouldn't want to know, though. I think. :(
So, PTC members, how would you deal with this one?!
Posted by shar on November 26, 2003, at 19:23:41
In reply to New Question from a Therapist, posted by DaisyM on November 26, 2003, at 19:08:48
This reminds me of my expressing anger at my therapist. It was very important for me to learn, that with at least one person, I could be angry at them and they wouldn't go away. Or, vice versa.
It doesn't always feel good all the time, but, to have a continuing relationship, sometimes we may ask for and NOT get what we want...and still have all of the good things that exist within that relationship.
Or...something like that. I hope you get the idea. If my therapist said 'only call once between sessions' I would respect that (as I'm sure you would!), but I would have a ton of questions...Like what about flexibility--what if I need to talk to you twice? Or three times? Or, what if it's a second call but more serious (like I feel suicidal)? I guess I'd want to know where I stand.
Shar
Posted by Dinah on November 26, 2003, at 19:58:34
In reply to New Question from a Therapist, posted by DaisyM on November 26, 2003, at 19:08:48
G*d, I'm with you. I'd be utterly mortified. I have checked with him many times over the years, and he's said I've never come close to the boundaries. And I've gotten better, not worse, so I haven't checked with him for ages.
For what it's worth, it did come up a few times. I used to call and leave a message for him to call, then cancel, then cancel my cancellation, maybe a few times. He brought it up once (this was within the first few years of therapy) and I asked if it annoyed him. He thought before he answered and said that if I had spoken to him that many times it would have annoyed him, but that since I spoke to his machine and he listened to all the messages at once that it didn't really annoy him. And that it was an interesting view into the workings of my mind. Which was a very gentle way of saying what wouldn't be ok. And I picked up on the clue and worked out with him that it was better to just ask him to call me and let him do it, rather than fight with myself over it. So I gradually learned to do that.
It also came up in another way. I was remarking about how distant he seemed on the phone, which generally made me feel worse than when I called. And he apologized, and said that perhaps he had learned to do that (not with me, but in general) because he didn't want to encourage long calls that he wasn't paid for. So we worked out that I would pay for calls over a couple of minutes. And from then on I offered to pay for several calls. He generally turned me down, but I think it reassured him. So now he's warmer on the phone than he used to be. Still not his best, but better than he used to be.
But a direct limit setting? I think it'd make me nuts and clingy and self hating and totally annoying to him. :(
A major flaw on my part.
Posted by fallsfall on November 26, 2003, at 20:15:22
In reply to New Question from a Therapist, posted by DaisyM on November 26, 2003, at 19:08:48
I called my therapist on a Saturday a couple of weeks ago. I really, really wanted to see him. This was the first time I had asked for an extra session (either during the week or on a weekend). He has a pager and called me right back. I told him the jist of my problem and that I could either keep thinking about it, bury it, or could I see him. Turns out he was at a conference that weekend an hour and a half away. So he said that he couldn't see me - BUT he made sure that I believed that he wasn't abandoning me - that he did want to talk about it on Monday, and the implication was (though he didn't say) that if he was local that weekend and didn't have major plans that he would have seen me. He asked me to bury the issue, but dig it up for our session on Monday. He told me I could call again that weekend if a 5 minute call could shore me up for a little more time - so I knew that he wasn't mad that I had called.
This sounds sort of like your therapists "I can't help you with this one, but I'll help you with others in the future". You may need to experience it before you will believe it - but I think it can work that way.
Posted by Elle2021 on November 27, 2003, at 7:12:33
In reply to Re: New Question from a Therapist » DaisyM, posted by Dinah on November 26, 2003, at 19:58:34
>And he apologized, and said that perhaps he had learned to do that (not with me, but in general) because he didn't want to encourage long calls that he wasn't paid for. So we worked out that I would pay for calls over a couple of minutes. And from then on I offered to pay for several calls. He generally turned me down, but I think it reassured him. So now he's warmer on the phone than he used to be. Still not his best, but
better than he used to be.Dinah,
He was making you PAY for phonecalls? I can't believe that. If my pdoc said that to me, that would be the END of our therapy. He always tells me I'm free to call him anytime. BUT the thing is his secretery answers the phone and gives him messages. I have NO WAY of getting a hold of him on my own like calling say, a pager. It really irritates me. He isn't ever there for me, like now when I really need him to be. I even emailed him like three days ago and NO REPLY. I am more convinced than ever that he is trying to get rid of me, so why won't he just come right out and say it?
Elle
Posted by Dinah on November 27, 2003, at 7:59:05
In reply to Re: New Question from a Therapist » Dinah, posted by Elle2021 on November 27, 2003, at 7:12:33
Why would that bother you? If I scheduled a fifteen minute session I'd pay for it, so if I talk to him on hte phone for a total of fifteen minutes over a bad week, for example (or ten even) I offer to pay for it.
It's no big thing to me, and it keeps him from feeling resentful. And like I said, he usually turns it down when I offer.
Posted by DaisyM on November 27, 2003, at 12:45:56
In reply to Re: New Question from a Therapist » Elle2021, posted by Dinah on November 27, 2003, at 7:59:05
I think there is a difference between you calling for "business" type stuff and needing to talk. I agree with Dinah that it is appropriate to charge for phone sessions. It keeps it professional also, you aren't "chatting" on the phone with a friend.
It should also help relieve some of the guilt about "bothering" them -- but for me, it doesn't!
Posted by crushedout on November 27, 2003, at 22:12:06
In reply to paying for phone calls, posted by DaisyM on November 27, 2003, at 12:45:56
But what if it's just a five-minute check-in kind of needing to talk? Do you pay for those, Daisy?> I think there is a difference between you calling for "business" type stuff and needing to talk. I agree with Dinah that it is appropriate to charge for phone sessions. It keeps it professional also, you aren't "chatting" on the phone with a friend.
>
> It should also help relieve some of the guilt about "bothering" them -- but for me, it doesn't!
>
Posted by DaisyM on November 27, 2003, at 23:36:37
In reply to Re: paying for phone calls » DaisyM, posted by crushedout on November 27, 2003, at 22:12:06
I don't think you should be charged for that but what kind of check in would "only" take 5 minutes? I mean, I guess you could call and say, "I'm not doing well", and they could say, "well, then come in" but I don't think you should get charged for that. On the other hand, if their response was, "tell me what it going on" and you tried to sort it out on the phone with some strategies for coping, this I would expect them to charge for.
I think this is a fairly common practice these days. I often wonder how email will play into this at some point. My Therapist does not have email but my son's does and we often send notes back and forth this way.
Posted by Elle2021 on November 28, 2003, at 1:22:02
In reply to Re: New Question from a Therapist » Elle2021, posted by Dinah on November 27, 2003, at 7:59:05
> Why would that bother you?
I'm sorry, I was upset when I was writing posts yesterday. I think *everything* was bothering me. I do see your point about paying for the phone call.
Elle
Posted by Dinah on November 28, 2003, at 2:27:13
In reply to Re: New Question from a Therapist » Dinah, posted by Elle2021 on November 28, 2003, at 1:22:02
I hope you know I didn't mean that in any negative sort of way. I do understand I think. The only time my therapist requested to add a quarter hour to the bill for a phone call, I actually was upset. I guess I hadn't kept time of the call. But since them I've been really really careful to always offer.
So I guess that for me it doesn't bother me at all unless he's the one suggesting it. If he suggests it then I feel I've done something wrong or something. As long as I keep track, it doesn't bother me at all.
Posted by Elle2021 on November 28, 2003, at 2:43:28
In reply to Re: New Question from a Therapist » Elle2021, posted by Dinah on November 28, 2003, at 2:27:13
> I hope you know I didn't mean that in any negative sort of way.
I know! You aren't that type of person. :)
I agree with you though, I would be a little caught off guard over being asked to pay for the phone call. But I get upset over little things like that instead of big things...
Elle
Posted by geramiemonkey on November 29, 2003, at 11:32:40
In reply to New Question from a Therapist, posted by DaisyM on November 26, 2003, at 19:08:48
This is only my third post here, so I hope I'm doing this right...
Hi Daisy,
I sometimes used to call my therapist two or three times in between appointments. He didn't mind, but I did. I hated "bothering" him. Recently we had a huge misunderstanding b/c of one of those calls. So he put a huge limit on the calls by telling me he will not respond to any calls unless I can tell him how, exactly, I expect him to help me. Well, just calling because i need to be reassured won't cut it. Now I am very afraid that whatever I say,he will not think that it is worth calling me back, something like that.
When I first starting seeing him about 4 years ago I was a whole lot needier than I am now. I told him that I couldn't go one entire week in between appointments (i hate the word-session). So we had a set up where he would call thursday nights at 9:00. We'd usually talk for about 30-40 minutes. He would end the conversations with a story. Those phone calls were life savers. He did, however, charge me for them :( But that was ok because he really wasn't calling socially.
Anyway, just my two cents worth...
geramie
Posted by judy1 on November 29, 2003, at 11:58:11
In reply to Re: New Question from a Therapist, posted by geramiemonkey on November 29, 2003, at 11:32:40
I had a therp who charged $25 for intersession calls that lasted more than 15 minutes. I guess I thought that was reasonable, I did take his time and it was in fact therapy. Now my pdoc basically has an open-door policy, I have his home phone # (which I have probably used 3 times in 3 years- one a suicidal call at 2am) and he has never complained. What has really helped is e-mail, I go through periods where it's almost daily, but I know he can read it at his leisure and I don't feel guilty. They are all so different, I think it's crucial to learn their boundaries and work within them.
take care, judy
Posted by geramiemonkey on November 29, 2003, at 12:59:25
In reply to Re: New Question from a Therapist, posted by judy1 on November 29, 2003, at 11:58:11
Hi Judy,
omg!! i can't even imagine NOT being able to email my therapist!!! i email all the time, and i sooooo look forward to his responses!!
i work in a customer service center of a newspaper that my t subscribes to. Accidentally, I came across his account one time. So I know his address and phone number. I would never, ever call him at home. I just call his cell. When he goes out of town, it helps to lessen the pain of his being away by pulling up his account and seeing the date of his return.
ok, that's all for now...
geramie
Posted by noa on November 29, 2003, at 20:31:01
In reply to Re: New Question from a Therapist, posted by geramiemonkey on November 29, 2003, at 11:32:40
Did you and your therapist ever consider increasing the frequency of your appointments?
I see my therapist 2x week. Not so much because of having a hard time waiting in between sessions, but because it helps me feel safer to talk about hard stuff, knowing there won't be so much time in between.
Posted by DaisyM on November 29, 2003, at 23:51:43
In reply to Re: New Question from a Therapist, posted by noa on November 29, 2003, at 20:31:01
We went to twice a week a couple of months ago. I think the intensity of what we have been discussing is the issue. But the bigger question for me is WHY the dependency...what need has been touched off and why can't I, an incredibly self-sufficient person and admitted control freak, control this need? My Therapist tells me it is "part of my therapy" to learn to be OK with calling (needing) him. That doesn't mean I don't hate it!
Posted by fallsfall on November 30, 2003, at 10:46:05
In reply to Re: New Question from a Therapist » noa, posted by DaisyM on November 29, 2003, at 23:51:43
Ah, Daisy,
Self-sufficient control freak. You have described me to a 'T'. But I am so dependent that my therapist thought that my previous therapist had me diagnosed with Dependent Personality Disorder (I don't think I am). I live for my therapist's approval.
And this is why I am a control freak. I need approval so much that I can't take any chances of doing anything wrong and losing that approval. So I am hypervigilant about everything. I trust only myself with the imperative task of keeping myself "perfect" - what if someone else was in charge, but they did something wrong and I could have done it right? I can't take that chance. I have to oversee everything myself and do it MY WAY.
All of this it so that I can feel sure that I won't do anything wrong. Because if I did something wrong, the person I need so much would leave me and I couldn't depend on them.
I don't depend on many people (mostly just one at a time, dad, then a boss, then therapists). The rest of the world sees a rock.
Could it be this way with you?
Posted by noa on November 30, 2003, at 12:34:01
In reply to Re: New Question from a Therapist » DaisyM, posted by fallsfall on November 30, 2003, at 10:46:05
Maybe the goal is to bring both sides into a more moderate middle ground with less rigid boundaries between the two---able to flow between dependency and independence smoothly as needed?
I have similar issues, only I've been in therapy so long that I manage the dependency stuff better now. But still working on it all both in therapy and in real life. I tend to stay away from the deep down dependency feelings now, although when they come up, I am better at putting them away when the session is over vs. how hard it once was for me.
Posted by fallsfall on November 30, 2003, at 15:41:51
In reply to Re: New Question from a Therapist, posted by noa on November 30, 2003, at 12:34:01
That sounds like hope for the future!
Posted by DaisyM on November 30, 2003, at 23:13:54
In reply to Re: New Question from a Therapist » DaisyM, posted by fallsfall on November 30, 2003, at 10:46:05
This is totally me! Occasionally I have this discussion with my husband that sort of says I'm really starting to fall apart with *all* of this, all being his illnesses, 3 kids, one with an illness and one with anxiety, 32 employees and government funding(Arnold!), and he usually says something like, oh, you'll be fine. You always are. Like you said -- the rock!
I have 3 friends who knew how bad it got last year and my son's Therapist who "pushed* me into therapy for me. I don't depend on any of these people. I'm trying not to depend on my Therapist. And I'm trying really hard to understand why this particular issue has taken center stage.
Here is another idea I've come up with: The age I've really been dealing with is around middle school - transitioning from a child to a woman -- *needing* my parents yet pulling away. I HAD to grow up really fast and rely only on me plus take care of siblings. So maybe it is a regression thing - needing my therapist yet pulling away to maintain adulthood. I haven't brought this up in therapy yet, what do you think?
Posted by DaisyM on November 30, 2003, at 23:23:13
In reply to Re: New Question from a Therapist, posted by noa on November 30, 2003, at 12:34:01
I think this is totally the goal. Part of depression is isolation and lonliness, even in the midst of a really busy life. Allowing yourself to depend on other people to fill some of these needs would be real progress. It scares me to death. I'm usually the one picking up everyone else, giving them the advice that works, solving problems. I often think of myself as the glue that fills in the cracks that keeps it all together. To have someone "be there" for me means allowing someone to see the need, the imperfection. I don't do this. Not even with my husband -- who, of course, doesn't think I'm in anyway perfect!! Just his rock.
My guess is that your balance suggestion is exactly why my Therapist asked his question. I'm sure he must feel enormous pressure from me not to "let me down." I don't mean to put that on him. I just can't seem to help myself right now. We've been talking about him as my secure base, like a child who keeps checking in. I discovered several books at the library this weekend about Attachment and Adult Psychotherapy so I'm reading up on it. I actually did part of my thesis on infant attachment but never considered the implications for myself until very recently.
I'm glad you found the balance. Any tips on how?
Posted by fallsfall on December 1, 2003, at 7:08:34
In reply to Re: Dependency conflicts with control » fallsfall, posted by DaisyM on November 30, 2003, at 23:13:54
I can relate to trying to break away from a parent. But I feel like I'm more like 2... I used to manage a group of 42 engineers, and I have 3 kids. I was 38 before I realized that I had limits - honestly, I thought I could do anything I wanted - and I did.
I don't know if I would encourage you to melt into a dependency with your therapist. I did, and I've been out of work for 7 of the last 9 years. Everyone's different. It is awfully lonely, though, when you are the only one who knows that you aren't strong. You were good to share with your friends - I didn't do that until much later. My (separated) husband still thinks I'm perfect.
Posted by judy1 on December 1, 2003, at 9:11:36
In reply to Re: Dependency conflicts with control » DaisyM, posted by fallsfall on December 1, 2003, at 7:08:34
I have a similar history to yours, a stressful professional job, 2 kids, and a rep that I was a 'rock' until my early 30s. I've also been on disability for about 5! years, but I'm not at all dependent on my therp. I was dependent on the one who terminated me and I guess I can see where he enabled me to 'stay ill', but since I no longer have that relationship (and it has been 3 years) and still don't work I don't see the correlation. I think I'm a type A perfectionist who can't live up to former expectations, and that feeds the affective cycles I have. At least that's my theory :-), and I'm sticking to it.
take care, judy
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.