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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Speaker on April 10, 2004, at 10:15:14
If you have any thoughts or input I would appreciate it!!! I have gone to this new T for about 6 months. I have been having a very painful time remembering past trauma...very scarey. I mentioned to the T that I wanted to call him the other night. I have called once during office hours and left a message...he kindly returned my call. When I told him I wanted to call at night I asked him if it would have been ok. He said yes...but...if it happened too often he would have to talk to me about that!!!! Duhhhh!!! To me that said NOT REALLY BUT IF YOU MUST. I understand boundries and am VERY good at them...but I am sick of living in a "compasson of convinience" world. As long as its conveinent (in your allotted appt. time) I will have compassion and help...BUT...if its not within my boundries of convenience I won't be helping. Am I looking at this WRONG????
Posted by Rigby on April 10, 2004, at 10:40:43
In reply to Compassion of Convenience, posted by Speaker on April 10, 2004, at 10:15:14
Hi Speaker,
The whole boundary thing can be tricky and really off-putting. And therapists seem pretty attuned if not (IMHO) a bit hair-trigger about the whole issue.
I suppose many w/ experience have had clients who do over do it so they feel a need to put that out there. Anyway, I can relate and I would probably feel the same way. Maybe you can bring that up with him at some point--that you "get" boundaries and you didn't need for him at that moment to assert his?
> If you have any thoughts or input I would appreciate it!!! I have gone to this new T for about 6 months. I have been having a very painful time remembering past trauma...very scarey. I mentioned to the T that I wanted to call him the other night. I have called once during office hours and left a message...he kindly returned my call. When I told him I wanted to call at night I asked him if it would have been ok. He said yes...but...if it happened too often he would have to talk to me about that!!!! Duhhhh!!! To me that said NOT REALLY BUT IF YOU MUST. I understand boundries and am VERY good at them...but I am sick of living in a "compasson of convinience" world. As long as its conveinent (in your allotted appt. time) I will have compassion and help...BUT...if its not within my boundries of convenience I won't be helping. Am I looking at this WRONG????
Posted by gardenergirl on April 10, 2004, at 11:05:54
In reply to Re: Compassion of Convenience, posted by Rigby on April 10, 2004, at 10:40:43
I can really understand your frustration. Of course emotions and needs do not follow business hours. In some ways, it makes sense that night time might be worse if during the day there are a number of distractions which keep you occupied.
As a T in training, I remember hearing at a conference a good way for T's to address this dynamic . I think it came from Linehan's DBT approach where there is much more access, but it can also become too much for the T at times. I think they recommend the T say something explaining the after hours access but adding a statement about the T's own needs and feelings. Something like: "If phone calls after hours were to begin to feel excessive to me, I will talk with you about that. I'm afraid that this could make me feel angry with you, and then I can't be effective in working with you. And I don't want that to happen."
Anyway, it sets it up from the start that T's have feelings and needs too, that may at times affect the client. The tough part is that it is really impossible to quantify what might feel like too much.
I think perhaps T's might reiterate about after hours because we want to be available, but we also don't want to get into a What about Bob situation. Which of course is not likely, but there is that tiny fear deep down.
Just my thoughts, although I can certainly feel for your annoyance, especially if you are not one to abuse the privilege and instead use it effectively.
gg
Posted by lucy stone on April 10, 2004, at 12:20:10
In reply to Re: Compassion of Convenience, posted by gardenergirl on April 10, 2004, at 11:05:54
I understand this 100%. It's a huge issue for me, that my T is only compassionate to me because I pay him to be. He shows me in many ways that this is not true, but I don't really trust it. It it is at the core of my issues, that I am forgettable and not really important to the people I care about. He is very good about access and always responds to messages at the office within a few hours. He carries and pager and says that if I need him I can page, but he leaves it up to me to decide if it is necessary. He says that he trusts that I wouldn't page him unless I needed to. I have only done so one time and it didn't turn out very well for me, but I know the access is there. He also gives me the phone number of his hotel when he goes out of town so I can reach him if I need to. I have never done that, and knowing that I can if I need makes it less likely that I would.
Posted by DaisyM on April 10, 2004, at 16:24:20
In reply to Re: Compassion of Convenience, posted by lucy stone on April 10, 2004, at 12:20:10
Adding that sentence would have completely shut me down so I can totally see why you are upset. It is all so confusing. Being someone who really likes rule books, I want to know exactly what exessive is: 2 calls per week? 2 calls per month? Does it have anything to do with how many sessions you've had?
I'm probably not the best person to answer this because it is a HUGE issue for me. I worry all the time about overwhelming my Therapist. I tell myself to stand on my own two feet and deal with it myself. He tells me to call him and when I don't, he is unhappy if he finds out I had a hard time. And of course, I don't want to do therapy wrong either, so if I don't call when I need to, do I get points off? So confusing...
After almost a year, we've developed a pretty good balance. When I'm having a really hard time, he will set up check in calls. That way I'm not tortured about whether to call or not. He also always tells me after we talk on the phone that it was OK. On a few occasions, after particularly hard sessions, he has called me to follow up.
I think you should call if you need to talk to him. And then check it out with him later if it feels weird in anyway. I would also ask, if you don't know, if he charges for phone calls. I remember a thread here about that, it seem to be a 50/50 split of those Therapist who do and don't.
Posted by mair on April 10, 2004, at 21:48:11
In reply to Re: Compassion of Convenience, posted by lucy stone on April 10, 2004, at 12:20:10
I agree with what the others have said. I think alot of T's stumble on this issue because they really don't want any single client deluging them with phone calls, and yet probably until you start calling, they have no idea what category you're going to fit in. I went for a long time (over a year I think) with my current T before the subject of phoning her came up. I think she just assumed that I would call her if I felt I needed to and I think she assumed I knew how to reach her. I could figure out how to reach her; her home phone number is listed, but I took the lack of an offer of a home number as a message that she didn't want to ever be called. Since the issue first got flushed out, we've probably spent many sessions discussing when it's ok for me to call. Once she realized that I was pretty much incapable of ever declaring any state an emergency, her rule for me got to be that i should call without reservation whenever i felt like it (which of course has been pretty much never). But I think it impeded progress for me to float along for so long thinking that she was so uninvested in her clients that she looked at phone calls as being a real nuisance. It would've been better for me if she had raised the issue early on, but I'm sure the danger from her perspective might be that I was the sort of person to call too frequently.
Mair
Posted by 64Bowtie on April 11, 2004, at 1:09:59
In reply to Re: Compassion of Convenience, posted by gardenergirl on April 10, 2004, at 11:05:54
>
> Anyway, it sets it up from the start that T's have feelings and needs too, that may at times affect the client. The tough part is that it is really impossible to quantify what might feel like too much.
>
>
<<<Thanx, gg! You said it so I didn't have to.Rod
Posted by Dinah on April 11, 2004, at 10:12:19
In reply to Compassion of Convenience, posted by Speaker on April 10, 2004, at 10:15:14
I brought it up with my therapist. He's had cases in the past where clients really abused the privilege. When I told him I was willing to pay for the time, and shoved payment on him a few times he didn't ask, he quit being scared of that, and started to encourage me to call if I needed him. But he's lousy at the phone anyway, so I don't call all that often anyway and don't speak long when I do.
Posted by pegasus on April 11, 2004, at 15:27:13
In reply to Compassion of Convenience, posted by Speaker on April 10, 2004, at 10:15:14
This is such a hard one, isn't it? Sometimes I feel just like you describe, too. And your T didn't really help that with her statement, which maybe could have been phrased in a more supportive way.
Although, I can also see why a T might feel the need to explain some of those conditions. I know there are people who really make their Ts lives miserable by calling them with "emergencies" day and night. And that has got to be hard. The Ts that I have had have dealt with it in a way that I really like. They only checked messages during the day. But they encouraged me to leave messages at night, if I needed to. That way, they got uninterrupted sleep on a regular basis, but I also felt welcome to call.
My current T says that I can leave her as many messages as I want, and she will only call me back if I specifically ask her to. She made it sound like that was a big favor to me: this way I don't have to worry about her calling back unless I really want her to. But it also kind of feels sometimes like I would have to beg to actually receive any help. I brought this up with my old T once, and he got very uppity about it, saying that that was *not* what it was about. It was about setting realistic expectations, and considering his pragmatic limits - not the limits of his caring. This was a really big deal to him. And I'm sure it's a tricky thing to balance for all Ts.
just my 2 cents.
pegasus
Posted by lucy stone on April 11, 2004, at 16:51:01
In reply to Re: Compassion of Convenience, posted by pegasus on April 11, 2004, at 15:27:13
I said in a past post that I can page my T after hours if I need to talk to him. I did this once on a weekend and it didn't turn out well. He didn't call back as quickly as I expected I got very angry. My anger is a huge issue for me and something we work on all the time, so he consideredit an opportunity. It scared me, though, so I never paged him again. We talked about it again last week, and I said that I was afraid that he would get angry at me or irritated if I called him when I didn't need to. He said that if that happened we could talk about it and work it out. Perhaps this is what Speaker's T was talking about in a not very clear way, that if Speaker called too often it would be something they would talk about, not that Speaker shouldn't call.
Posted by Joslynn on April 11, 2004, at 20:36:45
In reply to Compassion of Convenience, posted by Speaker on April 10, 2004, at 10:15:14
This whole issue would be so much easier for both therps and their clients if the therps would give you a little written pamphlet. It would include basic things like payment, phone call policy, when to cancel, etc.
Both my pdoc and my therp have voicemail at their offices, so I use that knowing that I am not bothering them personally at home. (In spite of previous posts, both my pdoc and therp will call if I am obviously losing it a little, like if I am crying. I will usually call my therp for those kinds of things but if she is on vaca, I call my pdoc. If I am really losing it, I leave msgs with both of them. They almost always call back the next day or later in the evening in those cases. I guess I have used the vmail thing in a crisis about, hmm, maybe 3 times a year?)
My pdoc also has a beeper for emergencies. I used it one time when someone I knew died and I was hysterical (my therp was on vacation). Pdoc called me later that evening and was very nice to me . He listened to me cry and helped me feel a little better.
My therp has an answering service for emergencies. I think I called it 2-3 times in the past three years. One time there was a mix up and she did not return an emergency msg from the answering service! That did not go over well with me. However, she was just so pleased that I was angry with her! She likes to see me angry and says that is something I should show more, even if it is towards her.
I have had to feel out the boundaries though, neither of them ever spelled them out to me.
How hard would it be to prepare some written guidelines?
Posted by Dinah on April 11, 2004, at 22:50:39
In reply to Re: Compassion of Convenience, posted by Joslynn on April 11, 2004, at 20:36:45
Maybe because like it or not, their policies are probably different for different patients. My therapist has moved to a "call me anytime" policy because he knows it keeps me calm and keeps me from either calling him too much or having crises.
I don't think he'd urge the same thing for a client who would call him anytime. I remember once he was leaving town for business (yet again) and gave his standard offer to meet me on the weekend before he left if I thought it was needed. As it happened, I was mid-meltdown and thought it might be needed. The look on his face was priceless! As it happened, his out of town trip was cancelled so so was our Saturday session. But I'm not sure he's made that offer since. lol.
Posted by platinumbride on April 12, 2004, at 13:27:36
In reply to Compassion of Convenience, posted by Speaker on April 10, 2004, at 10:15:14
Speaker,
I think your T perhaps made a slight, but forgivable error by mentioning that while you were feeling very vulnerable. Perhaps HE has had trouble in his own experience as a T with setting and/or maintaining boundaries with clients and just gave a little speech that he has taught himself or has been advised to give. Many compassionate people do have that as an issue, as I am sure many of us can attest to.
I think, however, that if you don't address it, you will feel impeded and angry at him...and those feelings won't help at all...especially if you "forget about them". Because even if you do choose to just let it slide, it will always be present on a subconscious level.
My guess is that he has to know that you are not one who abuses priveleges, but that he made a faux pas. And he only made a faux pas because he is human. So if the relationship, on the whole, is really pretty good, it is worth forgiving but only after addressing. The addressing has to do with YOUR needs and YOUR progress. I imagine that issues similar to this bare present in your "real life", and when the day is done, it will probably be of great help to you, both in your therapy and your day to day dealings with people.
If I am way out of line in making suggestions, I apologize. Of course I don't know you and am just making guesses. (That's my little disclaimer in case my two-cents are way off base or in a currency different from your own ha ha).
Good luck....because this could ultimately orove to be a good thing. :-)
Diane
Posted by Speaker on April 12, 2004, at 20:03:59
In reply to Re: Compassion of Convenience » Joslynn, posted by Dinah on April 11, 2004, at 22:50:39
I went to my appt. this morning and had a good talk with the T. about this subject. He stated that I mentioned I wanted to call him but wouldn't want to ever call too much. THAT'S why he said I could call and if I called too much we would have to talk about it!!! Sorry you guys!!! When things get intense I don't always remember everything EXACTLY as it goes. It is terrible trying to trust a new T when I really didn't want to leave the old T. Finding all the boundries is difficult and yet I do want to get help. I realized today that I want help without the risk of a relationship...I don't really want to get to know this T because I know it will end....OK so ABANDONMENT issues might be at hand :). Thanks to all of you for your response as it was so helpful knowing I wasn't alone.
Posted by Speaker on April 12, 2004, at 20:10:03
In reply to Re: Compassion of Convenience, posted by platinumbride on April 12, 2004, at 13:27:36
Diane,
Thanks for your input! I agree that my T is human and have no trouble forgiving him for his insensitivity (or lack of ability to read my mind :). If you read my post about my time with him today you will see it was resolved and actually my fault or misunderstanding. I have gone through a lot of what I call drama and trauma and the compassion stuff really pushes buttons for me. I will admit I feel sorry for my T at times because I know I'm not an easy client. I'm nice but not always easy :). Thanks for taking time to reply.
Posted by Fallen4myT on April 12, 2004, at 20:20:02
In reply to Talked with the T., posted by Speaker on April 12, 2004, at 20:03:59
Cool Speaker your T sounds like he may be a keeper :)
Posted by fallsfall on April 13, 2004, at 7:58:11
In reply to Talked with the T., posted by Speaker on April 12, 2004, at 20:03:59
Good for you, Speaker! It really is amazing how there are so many things that we "hear" that just aren't quite the way they are. At least we find out about them in therapy. How much do we do this in the rest of our relationships? Scary thought.
I can really relate to the abandonment fears. I'm sorry that you have them too. I think that they take an awful lot of work (with a lot of pain) and a long time. But I do believe that it can come out that we can stop fearing abandonment as much as we do now. Remember, you aren't alone.
Falls.
Posted by platinumbride on April 13, 2004, at 18:05:30
In reply to Re: Compassion of Convenience » platinumbride, posted by Speaker on April 12, 2004, at 20:10:03
This is the end of the thread.
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