![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by daisym on October 8, 2005, at 20:26:17
I've been researching again -- I do this when I'm lost and looking for answers. I spent three hours in the library stacks today at the University, just reading about suicidal ideation and what the current theories are about it. What strikes me is that a lot of the literature talked about how therapist can grow to resent this aspect of their job and the individual patients who pose a risk of attempt or completion. (God forbid we use the word death -- it is a "completed" suicide.) There was one article that talked about how a therapist might go over board to prove caring because they really feel angry and are masking that. So, how do we (the patients) know which is true? How do you know how honest to really be?
The other thing was that there are lots of theories about what suicide and suicidal ideation represents to the patient. Things like "acting out against the therapist" or "trying to gain the upper hand in the power differential" or "getting and keeping the therapist's attention." Is it not possible that sometimes the world is just too hard to live in? That wanting to die might really be about wanting to escape all the bad things -- internally and externally? Why does there have to be some other unconscious motivation? Honestly, it made me feel like I should never admit these thoughts or feelings unless I was in a very dangerous place. I found it very upsetting and I didn't find the answers or cures or whatever I was looking for.
I wish someone would tell me where they are hidden.
Posted by alexandra_k on October 8, 2005, at 20:55:17
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
> I've been researching again -- I do this when I'm lost and looking for answers.
me too :-)
> I wish someone would tell me where they are hidden.
yes, oh yes.
what i found...
well... i found psychodynamic theorists first. that was useful to me because the first thing i wanted to know was: why the hell are clinicians so damned judgemental? and so i found the answer right there. because of the theory. the intentions they attribute to the client. the 'real reasons' they attribute to the clients words / behaviours.i'm sure that not all psychodynamic theory is like this but i do have to say that based on what i have read... a fair chunk of it is.
i was reading books mostly. and journal articles, yeah, but i wasn't database searching and thus i had to search the stacks manually to find journal articles. what that meant... was that i found books mostly. and they tended to be older... and same goes for the journal articles, i guess.
i hope that current theory isn't as judgemental as i found past theory to be...
but...
truth be told, there is still a lot of judgement and assumptions out there...
with respect to suicide...
i'd say that linehan is a pretty good source.
because she started out being interested in suicide and parasuicidal behaviour (si) and from there became interested in borderline personality disorder because that was the clincial population that seemed to have most of the chronic suicidal ideators.it is my personal belief that she is revolutionary... because she refrains from negative judgement and assumption of malevolent (or otherwise perverted) intent.
and so you might find some answers there...
at least... i did.
> What strikes me is that a lot of the literature talked about how therapist can grow to resent this aspect of their job and the individual patients who pose a risk of attempt or completion... There was one article that talked about how a therapist might go over board to prove caring because they really feel angry and are masking that.
I think that is reaction formation? When people have the opposite emotion to what they are 'really' having?
> So, how do we (the patients) know which is true?
hmm. how does the therapist know which is true?
>How do you know how honest to really be?
well... i would say that if the therapist felt angry with me for being honest then i would pick up on that and i wouldn't feel safe disclosing. if i had the option... i guess i'd find myself another therapist.
i would say that if the therapist seemed very caring etc but really felt angry with me... well... i guess how i'd describe that is to say that they feel angry because they feel POWERLESS. that that is where the anger is really coming from. and that they know that it is inappropriate (and ultimately unhelpful to the client) to express that (and they probably feel a little guilty about feeling that way anyways) and thus they try and help the patient the best way they know how. ie. by caring for them.i had a t once who told me fairly upfront that she was terrified that one of her patients would kill themself. that she was really very worried that i was going to do that. i think i said something like 'well, you should have thought of that before you became a t'. we didn't get on so well... but anyway... she said that she rationally knew that she could only do the best she could do and ultimately she had to accept that it would be the patients decision whether to do it or not - and all she could do was help them and care for them as best she could.
and i guess...
thats all they can do.
i mean... it is hard. when people are distressed. and when people need to talk abotu that distress. and yeah, it must be hard for the t. but that is the t's job. and it is a necessary part of the job. and so... despite how they feel about it the burden is on them to explore their own responses and reactions and to behave in a manner that is most likely to help the client. that is what makes a good t.and you have to be honest...
or there isn't any point in doing therapy.> The other thing was that there are lots of theories about what suicide and suicidal ideation represents to the patient. Things like "acting out against the therapist" or "trying to gain the upper hand in the power differential" or "getting and keeping the therapist's attention."
okay... so imagine you are a t and you are reading that interpretation of what suicidal clients are really up to. now... how are you going to feel? i know that i would feel pretty mad at them for trying to play such games with me. and thus the theory ENCOURAGES therapists to feel angry at their clients and then CHASTISES then for that. Crazy crazy crazy and i do wonder just who are the crazy ones?????
I think that is crap.
in the words of linehan 'intention must be assessed and not assumed'.
and linehan reckons...
and yeah so maybe this smacks of behaviourism or cognitive behaviour therapy a bit
(but they do have some decent stuff to say and best not throw it all out because of some of the crazy sh*t)
but linehan says that maybe we should listen to what the client says as to her reasons.
and believe her.
and believe her.
instead of theorising that the 'real' reasons have just been repressed and are thus inaccessible to the client.revolutionary.
>Is it not possible that sometimes the world is just too hard to live in? That wanting to die might really be about wanting to escape all the bad things -- internally and externally? Why does there have to be some other unconscious motivation?
yes yes yes
i agree 100%
and i dare say that that is what clients think it is about
it is just psychodynamic theory that would have the 'real' reasons inaccessible to the client.>Honestly, it made me feel like I should never admit these thoughts or feelings unless I was in a very dangerous place. I found it very upsetting and I didn't find the answers or cures or whatever I was looking for.
yes.
i understand your response.
that is something that i struggled with for many many years...
and my way out...
was linehan.
even though apparantly the dx of bpd was a mis-dx...
its her theory
the lack of judgement
that is so very refreshing.best have a theory that both patients and clinicians can live with ;-)
Posted by alexandra_k on October 8, 2005, at 21:06:05
In reply to Re: How therapists think or feel (trigger) » daisym, posted by alexandra_k on October 8, 2005, at 20:55:17
in fact...
thats what interests me the most.
the power of theory to offer a conceptualisation of peoples behaviour.
the power of theory to offer a conceptualisation that it is just about impossible to accept without despair...
the power of theory to offer a conceptualisation that is healing to accept. that offers hope. and empathy. and understanding.and it seems to me that linehan is revolutionary there.
and what is left to be done...
is to rewrite all 'mental illness' stuff... in a similar vein.
i don't care how much theorietical dispute remains...
a fair bit of sh*t has been inherited
from clinicians
who reveal more about themselves
and their own insecurities
than they reveal about people with mental illness.and what is so very sad about it...
is that we expect more from clinicians.i really don't think it should be too much to ask them to be empathetic and to attempt to understand...
but unfortunately...
most times it is.and most blunder on oblivious...
Posted by alexandra_k on October 8, 2005, at 21:34:32
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
sorry daisy, i just realised that i was distracted from your concerns onto my particular gripe...
because what you really want to know...
is: does my therapist really care about me through this, or is he angry with me?
so here i would say...
that it depends on how he is seeing the situation.
if he thinks you are attempting to engage in some kind of power struggle or something like that, then i guess he is likely to feel frustrated.(though linehan has a much better conceptualisation of 'power struggles' too imo)
could you maybe have a chat with him?
if he accepts your reasons behind your ideation then i would say that it would be very unlikely indeed that he would feel mad at you.another thing...
i would say that the reaction formation stuff (if that is indeed what it is) is supposed to warn therapists that anger / hostility / frustration might underlie BAD BOUNDARIES. and so here i'm thinking of such things as letting someone call you at any time (even at 4am) or spending lots of session time holding a client or things like that. that those are the kinds of 'caring behaviours' that they are saying might come from repressed hostility.
(though even here i would want to say that it is still more about fear of powerlessness - but try and find a psychodynamic theorist who is willing to admit to that ha!)
sorry...
i think i'm raving more than anything...
Posted by fallsfall on October 8, 2005, at 21:56:04
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
Please call me.
I am not asleep. I have to stay up tonight to keep an eye on my daughter - so you will not be waking me up.
Posted by rubenstein on October 8, 2005, at 22:29:33
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
We are so much alike. I am also a reasearcher and suffer with suicidal ideation. When it is worse I study more. And I have been mulling those same things in my head. Does he resent me. I don't know wy I feel this way. I just do. Sometimes I don't even want to tell him. Last session was good though, it was a crisis session and he said he just hates to see people he cares about in such turmoil. I know he cares. Why can't I just believe it.
rachI've been researching again -- I do this when I'm lost and looking for answers. I spent three hours in the library stacks today at the University, just reading about suicidal ideation and what the current theories are about it. What strikes me is that a lot of the literature talked about how therapist can grow to resent this aspect of their job and the individual patients who pose a risk of attempt or completion. (God forbid we use the word death -- it is a "completed" suicide.) There was one article that talked about how a therapist might go over board to prove caring because they really feel angry and are masking that. So, how do we (the patients) know which is true? How do you know how honest to really be?
>
> The other thing was that there are lots of theories about what suicide and suicidal ideation represents to the patient. Things like "acting out against the therapist" or "trying to gain the upper hand in the power differential" or "getting and keeping the therapist's attention." Is it not possible that sometimes the world is just too hard to live in? That wanting to die might really be about wanting to escape all the bad things -- internally and externally? Why does there have to be some other unconscious motivation? Honestly, it made me feel like I should never admit these thoughts or feelings unless I was in a very dangerous place. I found it very upsetting and I didn't find the answers or cures or whatever I was looking for.
>
> I wish someone would tell me where they are hidden.
Posted by Annierose on October 9, 2005, at 7:28:18
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
I hope you called Fallsfall last night. I am sorry you are hurting so much right now. You are so worth this fight!
You do have the answer Daisy. It's the hard work you are now doing in therapy. It's all muddled under years of abuse, pain and life. You and your T will find it together.
I think I remember that you stopped taking some meds because of the side affects (sorry if I got that wrong). But maybe you need to try another medication. Give some ADs a chance to help you through this process, to lessen the burden on your brain.
I love Falls post to you on the previous thread. Please re-read it daily. And to quote another babbler friend of yours, you are so worth love.
Don't worry about your therapist. He will take care of his own emotions. His job is to worry about YOU and help you through this journey.
Posted by Tamar on October 9, 2005, at 16:12:17
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
Hey Daisy,
I agree wholeheartedly with what Alexandra was saying about the theory.
And I also think your therapist isn’t angry with you.
But if you are worried, do you think you can ask him? Can you say that you have been reading literature that talked about therapists’ anger towards suicidal patients and you want to know how he thinks about it and what he makes of the theory?
I’ve always had the impression that your therapist is willing to allow you to name your experiences and he’s prepared to accept that your feelings are real and authentic and not some kind of attempt to manipulate him. I do think there are therapists who understand that people are sometimes suicidal because life is sometimes sh*t.
One thing about theory: it’s aimed at therapists, rather than clients; it’s written in textbooks and journals that require a formal academic style; and it pulls no punches. There’s nothing in the style that recognises the extent of the client’s distress (it seems to me). I’m sure I’m not saying anything you don’t already know. But I do understand that it can be very disturbing to read theory when it doesn’t appear to take adequate account of client feelings. I tend to hope that therapists reading the theory are going to examine their own practice honestly and openly to see if, for example, they have feelings of anger toward suicidal patients.
If you want to know where the answers are hidden, I’d suggest they’re hidden in individual relationships between therapists and clients. There’s probably something of the White Knight in every therapist and they probably want to believe they can help even the most suicidal of patients. The good ones know that they can’t rescue us but they can help us as much as possible therapeutically. The good ones don’t get angry or resentful, because they understand that we’re not yanking their chains; we have some seriously bad cr*p to deal with every single day. But it’s all in the relationship. My therapist might not be able to help *you*; your therapist might not be able to help *me*. The important thing is your relationship with *your* therapist.
Your ability to be honest about suicidal feelings probably depends on your level of trust in your therapist. If you’re having doubts about your therapist’s ability to understand you, then I really hope you will talk to him about it. It’s only through that kind of discussion that you can determine whether you can continue to trust him.
I hope very much that you will talk to him, because from everything you’ve said about him so far he has risen to the challenge of therapy. I like Dinah’s term: ‘fighting to relationship’. It is a struggle sometimes. I hope you get through this in a way that you find satisfying.
Tamar
Posted by daisym on October 9, 2005, at 16:59:33
In reply to Re: How therapists think or feel (trigger), posted by alexandra_k on October 8, 2005, at 21:34:32
sorry daisy, i just realised that i was distracted from your concerns onto my particular gripe...
***No, I found it interesting to read -- you've obviously been thinking about this. I want, almost desperately, to debate the theory and find the flaws in it.
because what you really want to know...
is: does my therapist really care about me through this, or is he angry with me?
***I think what I really want to know is how to go forward and use therapy when all I want to do is check out. I think it might be easier to move through my life numb if I didn't have sessions that opened up the wanting and needing. I don't doubt that my therapist cares a great deal, but I'm also sensing frustration and perhaps anger. It does feel like crying wolf, you know?
so here i would say...
that it depends on how he is seeing the situation.
if he thinks you are attempting to engage in some kind of power struggle or something like that, then i guess he is likely to feel frustrated.***I don't know what he thinks. I'm good at setting up re-enactments but I tend not to engage in power struggles, that's not my style. I learned very young to keep your thoughts to yourself and find a way around the obstacles, not to plow over them and prove you have the upper hand. It is OK to have it without the other person knowing you have it. I'm truly hard to read if I don't want to be read.
(though linehan has a much better conceptualisation of 'power struggles' too imo)
could you maybe have a chat with him?
if he accepts your reasons behind your ideation then i would say that it would be very unlikely indeed that he would feel mad at you.***I think he accepts the reasons. He is the first one to say that I'm juggling too many balls at one time. I think it is more the idea that I can't stop bringing the ideation into our conversations. Is this manipulative? Am I trying to communicate something? Am I really seeking his complete attention or control his responses? Most of the time I just think I feel really bad but I am willing to look for other motivations and see if they fit. Am I talking about suicide so I don't actually do anything? I just don't know.
another thing...
i would say that the reaction formation stuff (if that is indeed what it is) is supposed to warn therapists that anger / hostility / frustration might underlie BAD BOUNDARIES. and so here i'm thinking of such things as letting someone call you at any time (even at 4am) or spending lots of session time holding a client or things like that. that those are the kinds of 'caring behaviours' that they are saying might come from repressed hostility.
***Hate those boundaries. He has very good ones, though he is open to me asking for anything and us talking about it. Rarely does he deviate from his usual rules and responses. I do have his cell number for emergency. I've used it once. I think he gave it to me knowing that I would really need to be in trouble to even think about using it. I think I'm wondering if he comes to resent the worry I cause when I talk about this stuff. And I know I should reach out to other supports when I feel like this but I just can't. I pull in and try to retreat from all of my close friends who might notice I'm not OK. So he ends up being my primary support which is really hard on him.
(though even here i would want to say that it is still more about fear of powerlessness - but try and find a psychodynamic theorist who is willing to admit to that ha!)
***Mine did. When we went through this before, we had a session where he pulled out every thing he could to knock me upside the head, including "in your religion this is a sin, and the boys will never get over this." He even told me he might have to turn over his notes. I was so upset. He called later and said he knew he was rough on me and upon reflection it came out of his own anxiety about what was going on. He tried to talk me into the hospital and openly said not only would I be safe but he wouldn't be so worried because as things were right now he felt powerless. Since I refused, he then asked for daily check ins, again saying partly they were for his anxiety. I did appreciate his honesty and I felt horrible for making him worry.
sorry...
i think i'm raving more than anything...***No -- it is totally OK. I started it...
Posted by daisym on October 9, 2005, at 17:00:38
In reply to Re: How therapists think or feel (trigger) » daisym, posted by fallsfall on October 8, 2005, at 21:56:04
Posted by daisym on October 9, 2005, at 17:03:05
In reply to Re: How therapists think or feel (trigger), posted by rubenstein on October 8, 2005, at 22:29:33
I think you can feel caring if you let yourself. I don't think people can do this work if they don't care about their patients. BUT...I do know how hard it is to trust that the caring can't be destroyed or doesn't have to be paid for with "good" behavior. I'm glad you can be open with your therapist. That is important.
Posted by daisym on October 9, 2005, at 17:09:42
In reply to Re: How therapists think or feel (trigger) » daisym, posted by Annierose on October 9, 2005, at 7:28:18
Annie,
I called Falls. She extracted promises. She is tough sometimes. I love that about her.
I'm back on wellbutrin and have zanax as needed. I'm resisting taking the sleeping medication for lots of complicated reasons. I need a new pdoc but haven't pursued it. Perhaps it is time.
I think I'm wondering just how much of this is really supposed to be part of "his job." When it spills over into evening and weekends, aren't I being intrusive? It feels so bad on top of already feeling bad -- you know what i mean? But even more important I have to figure out how to stop talking about these feelings unless they are immenient. It feels manipulative even if it isn't meant to be.
thanks for saying I'm worth it. It is really hard to believe.
Posted by daisym on October 9, 2005, at 17:36:26
In reply to Re: How therapists think or feel (trigger) » daisym, posted by Tamar on October 9, 2005, at 16:12:17
And I also think your therapist isn’t angry with you.
But if you are worried, do you think you can ask him? Can you say that you have been reading literature that talked about therapists’ anger towards suicidal patients and you want to know how he thinks about it and what he makes of the theory?
***I'll tell him tomorrow. And I have had several dreams I need to tell him. I'm cataloging in my head things he is doing different and I'm applying them to my "he's upset with me" theory, so I do need to check all this out with him. Don't anyone say "negative transference!"
I’ve always had the impression that your therapist is willing to allow you to name your experiences and he’s prepared to accept that your feelings are real and authentic and not some kind of attempt to manipulate him. I do think there are therapists who understand that people are sometimes suicidal because life is sometimes sh*t.
***I think the origin of the feelings are easily accepted. It is the ongoing need to keep talking about suicide -- why am I doing this? It seems to me that I should either act or shut up. Am I keeping it going for some unidentified reason? (I don't think so but does he?)One thing about theory: it’s aimed at therapists, rather than clients; it’s written in textbooks and journals that require a formal academic style; and it pulls no punches. There’s nothing in the style that recognises the extent of the client’s distress (it seems to me). I’m sure I’m not saying anything you don’t already know. But I do understand that it can be very disturbing to read theory when it doesn’t appear to take adequate account of client feelings. I tend to hope that therapists reading the theory are going to examine their own practice honestly and openly to see if, for example, they have feelings of anger toward suicidal patients.
***I've been trying to put myself in his place with my own clients. If I had a mom in trouble, would I get upset? I want to say "no" -- but if it was chronic, I can't help but feel that I might get tired of it. The bluntness of it all doesn't bother me, it is the assumption of negative motivation that seems to permeate all of the theory. I think Alexandra named it: it all feels judgemental. But how could it not be? If it wasn't negative, it wouldn't be pathological.If you want to know where the answers are hidden, I’d suggest they’re hidden in individual relationships between therapists and clients. There’s probably something of the White Knight in every therapist and they probably want to believe they can help even the most suicidal of patients. The good ones know that they can’t rescue us but they can help us as much as possible therapeutically. The good ones don’t get angry or resentful, because they understand that we’re not yanking their chains; we have some seriously bad cr*p to deal with every single day. But it’s all in the relationship. My therapist might not be able to help *you*; your therapist might not be able to help *me*. The important thing is your relationship with *your* therapist.
***It strikes me that I need to examine what that relationship is right now. I know I'm pushing him away, but maybe it is time to do that. I'm just not finding therapy helpful right now and yet I can't seem to give it up either. I know enough about myself to ask if I'm shielding myself from him to protect him. If I can't hang on, how do I make it "not his fault."Your ability to be honest about suicidal feelings probably depends on your level of trust in your therapist. If you’re having doubts about your therapist’s ability to understand you, then I really hope you will talk to him about it. It’s only through that kind of discussion that you can determine whether you can continue to trust him.
***I trust him. Like I said before, I don't want to hurt him. I know I'm not in charge of his feelings but I'm not nieve enough to think that I don't have an impact on him.I hope very much that you will talk to him, because from everything you’ve said about him so far he has risen to the challenge of therapy. I like Dinah’s term: ‘fighting to relationship’. It is a struggle sometimes. I hope you get through this in a way that you find satisfying.
***Interesting choice of words -- satisfying. I don't know what I want anymore. I'm so tired... But I know I need to talk to him about all my concerns. the one thing I know I can still do is push myself in therapy. STill -- Monday seems so far away.
Posted by muffled on October 9, 2005, at 18:22:31
In reply to Re: How therapists think or feel (trigger) » Tamar, posted by daisym on October 9, 2005, at 17:36:26
> ***I think the origin of the feelings are easily accepted. It is the ongoing need to keep talking about suicide -- why am I doing this? It seems to me that I should either act or shut up. Am I keeping it going for some unidentified reason? (I don't think so but does he?)
For me, it cuz I'm still hurting. Something still hurts inside and won't go away. Maybe talking about it shows the seriousness of the hurt?
> If you want to know where the answers are hidden, I’d suggest they’re hidden in individual relationships between therapists and clients. There’s probably something of the White Knight in every therapist and they probably want to believe they can help even the most suicidal of patients. The good ones know that they can’t rescue us but they can help us as much as possible therapeutically. The good ones don’t get angry or resentful, because they understand that we’re not yanking their chains; we have some seriously bad cr*p to deal with every single day. But it’s all in the relationship. My therapist might not be able to help *you*; your therapist might not be able to help *me*. The important thing is your relationship with *your* therapist.Thats way cool. I'm gonna show this to my T.
> ***It strikes me that I need to examine what that relationship is right now. I know I'm pushing him away, but maybe it is time to do that. I'm just not finding therapy helpful right now and yet I can't seem to give it up either. I know enough about myself to ask if I'm shielding myself from him to protect him. If I can't hang on, how do I make it "not his fault."
Ah. The damn problem about suicide. Its so not just about us. It ends up affecting SO MANY others, in a ripple effect. There is no denying this fact.
> ***I trust him. Like I said before, I don't want to hurt him. I know I'm not in charge of his feelings but I'm not nieve enough to think that I don't have an impact on him.
>
> I hope very much that you will talk to him, because from everything you’ve said about him so far he has risen to the challenge of therapy. I like Dinah’s term: ‘fighting to relationship’. It is a struggle sometimes. I hope you get through this in a way that you find satisfying.
> ***Interesting choice of words -- satisfying. I don't know what I want anymore. I'm so tired... But I know I need to talk to him about all my concerns. the one thing I know I can still do is push myself in therapy. STill -- Monday seems so far away.
>
Tomorrow is Monday. I guess you knew that. Take care, you teaching me lots.
Muffled
>
>
Posted by terrics on October 9, 2005, at 19:52:43
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
I love my p-doc. she told me that she won't take borderlines. She diagnosed me as chronically depressed. I told her that I had been previously dxd with borderline pd. She was ok with it. She told me how hard it was to lose a pt. to suicide (first watching them drink, drug and self-destruct). I attempted suicide twice since I have been with her and after the attempts all she said was 'I am glad you are ok'.
She is sweet. A pt's suicide probably hurt her soo much and left her with so much guilt that she protects herself now. I asked her why she does'nt usually do therapy and she said that most people really don't want to change. Sorry i got carried away. terrics
Posted by Tamar on October 9, 2005, at 20:01:47
In reply to Re: How therapists think or feel (trigger) » Tamar, posted by daisym on October 9, 2005, at 17:36:26
> ***I'll tell him tomorrow. And I have had several dreams I need to tell him. I'm cataloging in my head things he is doing different and I'm applying them to my "he's upset with me" theory, so I do need to check all this out with him. Don't anyone say "negative transference!"
OK, I won’t say it! Yeah, do check it out with him.
> ***I think the origin of the feelings are easily accepted. It is the ongoing need to keep talking about suicide -- why am I doing this? It seems to me that I should either act or shut up. Am I keeping it going for some unidentified reason? (I don't think so but does he?)
Well, I don’t know as much about suicidal feelings, but I know I wanted to keep talking to my therapist about my desire to injure myself. For me there were two reasons. First, I felt if I talked about it I was less likely to injure myself seriously. Second, I really (quite desperately) wanted him to understand how severe my pain was. And I thought he would understand best if I told him how much I wanted to hurt myself. I really don’t think shutting up is the answer. If it’s how you feel, then he needs to know. He wants to know how you’re feeling so he can do everything in his power to support you. I think it worries him much more if you don’t tell than if you do. Hasn’t he said as much?
> ***I've been trying to put myself in his place with my own clients. If I had a mom in trouble, would I get upset? I want to say "no" -- but if it was chronic, I can't help but feel that I might get tired of it. The bluntness of it all doesn't bother me, it is the assumption of negative motivation that seems to permeate all of the theory. I think Alexandra named it: it all feels judgemental. But how could it not be? If it wasn't negative, it wouldn't be pathological.
Yeah, judgmental is the word. And yet, even if you have a mom in chronic trouble, wouldn’t you find it easier to understand her if she was honest with you about her situation and her feelings? I had a very difficult student once; he really p*ssed me off… and eventually I learned that he was going through a huge crisis with his sexuality. As soon as I knew what was going on with him it was easy to be sympathetic. And it was so much easier to support him because I knew what kind of help he needed. I think it’s similar with therapists. When they’re good therapists, compassion comes easily. And if they know how we’re really feeling, it’s really an outpouring of love; it’s not judgmental at all.
> ***It strikes me that I need to examine what that relationship is right now. I know I'm pushing him away, but maybe it is time to do that. I'm just not finding therapy helpful right now and yet I can't seem to give it up either. I know enough about myself to ask if I'm shielding myself from him to protect him. If I can't hang on, how do I make it "not his fault."
If you’re not finding therapy helpful, perhaps you really need to talk about that. It does sound to me as if you’re trying to protect him at the moment. And I suspect there’s something very profound there. Something you need to work out with him. If you can’t hang on, it’s nobody’s fault. Not yours; not his. There’s no blame in not hanging on; there’s only intense sadness. But he can help you hang on if you keep talking to him.
> ***I trust him. Like I said before, I don't want to hurt him. I know I'm not in charge of his feelings but I'm not nieve enough to think that I don't have an impact on him.
I agree. You certainly have an impact on him. And you’re a good person; of course you don’t want to hurt him. And yet… since you’re thinking of it from his perspective… He spends his life working with people who are hurting. His pleasure in his work comes from being able to support people who are hurting. But he can’t do that work to the best of his ability unless people are honest with him.
I know he’s been fairly honest with you about his concern for you. And maybe that engages your transference in a way that’s not ideal for you, so that you feel the pressure of responsibility too strongly. Do you think it would have been better if he’d never admitted that he cares about you so much? Or was it always inevitable that you would feel some responsibility for his feelings, no matter what he said?
> ***Interesting choice of words -- satisfying. I don't know what I want anymore. I'm so tired... But I know I need to talk to him about all my concerns. the one thing I know I can still do is push myself in therapy. STill -- Monday seems so far away.
Monday… still many hours away. Yes. Can you get some sleep? I really hope things go well for you.
Tamar
Posted by alexandra_k on October 9, 2005, at 21:39:49
In reply to Re: How therapists think or feel (trigger) » alexandra_k, posted by daisym on October 9, 2005, at 16:59:33
> I want, almost desperately, to debate the theory and find the flaws in it.
LOL! You have just described my favourite pass time ;-)
>Is this manipulative? Am I trying to communicate something? Am I really seeking his complete attention or control his responses? Most of the time I just think I feel really bad but I am willing to look for other motivations and see if they fit. Am I talking about suicide so I don't actually do anything? I just don't know.
I went through something similar a while back. About SI. Reading... Reading that people threaten to SI as an attention seeking, manipulative gesture.
And so I had a good hard think...
I didn't think that was why I did it... But maybe I was in denial. Because the literature was saying that was why people do that. And so I must be in denial. But I really didn't think that that was why I was doing that...
And round and round I would go...
And that kind of theory does not help.
It harms.
I do not see how it is possible to internalise that and think positively of yourself.
I do not see how it is possible to internalise that and be able to live with yourself.I do not see how it is possible for a therapist to internalise that and feel well disposed towards their client.
I do not see how it is possible for a therapist to internalise that and refrain from judging and being mad at their client.But the theorists don't seem to think of that...
They don't care.
Or... Something...
(I find it hard to be charitable here)
Maybe...
They really are oblivious.
Maybe...
They have to put the blame for failed therapy back onto the client because that is the only way they feel able to carry on.
I don't know.
I would like a better explanation
A more charitable one
One that has me feel sympathy for them...
But I can't think of one.> it all feels judgemental. But how could it not be? If it wasn't negative, it wouldn't be pathological.
What is wrong...
Is that you are feeling distressed.
It doesn't help you feel any better to judge you for the distress that you feel.
To blame you for the distress that you feel.
To attribute all kinds of malevolent / perverted intentions to you for having the distress that you feel.In fact...
Coming to accept that it is okay to feel distressed at times.
That the feeling itself won't kill you.
That you can get through the feeling.
That people care for you whether you are feeling happy or whether you are feeling distressed.
That people do not blame you for feeling distressed.
That people do not judge you for feeling distressed.That other people would feel just as distressed as you do if they were to have those events happen to them, if they were to see the same situation in the same way, if they were to have your inherited sensitivities.
All that...
IMO
All that is what heals.
But first...
People need to learn to lift the judgement.
And there is still too much of it out there :-(
And it doesn't help
It hurts
And it is unnecessary
There are alternative explanations out there...From what you have said about your therapist...
Sounds like he is a good one.
I think most theories have problems...
But it is probably helpful to remember that even within one theory (such as CBT or psychodynamic) there are still one hell of a lot of theorists working within that one theory - and not all of them agree.Just because your t is of one theorietical orientation... doesn't mean he is guilty of buying into all that crap by association.
:-)
Sounds to me...
Like your real worry is how you see yourself...
And fear that he sees you the way you are afraid you might be.But it can be so very hard to learn not to judge oneself...
When theorists model judgemental attitudes for usWhat do they expect us to do?
Sigh.
I don't think I will ever understand...
Posted by gardenergirl on October 9, 2005, at 22:23:35
In reply to Re: How therapists think or feel (trigger) » daisym, posted by alexandra_k on October 9, 2005, at 21:39:49
Daisy,
I think that maybe you keep talking about it because maybe you still feel that rotten? If it's not getting better, then it's still present, and that's what's on your plate, so to speak.As far as the literature you were reading...keep in mind it was written by therapists. I don't know how much input they got from clients. And I absolutely agree with alexandra that Linehan's view is so much more humanizing and effective. In fact, I wonder if some of her skills stuff might be helpful for you. It can seem very basic at times, and certainly you have skills. But there are useful ideas in there for distress tolerance and managing very painful emotions.
I've been thinking about you and your T. I don't know what he might be feeling. I do know that it's not your job to protect him from feeling mad, or anxious, or frustrated. If the reality of your situation is that you are still struggling, and maybe he's feeling less effective than he would like, well, that's the reality. Protecting him from those feelings isn't going to change the reality. And it's going to make both of you less able to make things better if you are not honest.
I know you know these things. And I'm glad you are still going to go in there and talk to him and check out your worries.
(((daisy)))
Try to get some sleep tonight. I'll be thinking of you.
gg
Posted by fallsfall on October 10, 2005, at 9:21:27
In reply to Re: How therapists think or feel (trigger) » Annierose, posted by daisym on October 9, 2005, at 17:09:42
>But even more important I have to figure out how to stop talking about these feelings unless they are immenient.
I disagree. The feelings are there for a reason. And you need to talk about your feelings. If they are intruding on your life, they should intrude on therapy. Perhaps you can ease your conscience a little if you can clearly differentiate (both for your therapist and us, and for yourself) when they are thoughts and when they are intentions.
(That is what the "promises" are about, you know. When I ask you to promise to talk to me the next day, I'm asking if you can be sure that you won't act on the thoughts. The days when those promises are hard for you are days when the intentions are creeping up.)
When I was released from the hospital for the first time 10 years ago, I told my pdoc that I was still having suicidal thoughts (hoping that he would keep me longer...). He told me that I would probably continue to have suicidal thoughts, perhaps for years, but that I needed to find a way to live with them (as long as I wasn't going to act on them). Now, I can differentiate different levels of suicidal thought, and I can articulate where they are on the spectrum. But it wasn't easy to get to this place. So have patience with yourself.
I think that the first step is to stop fighting the fact that you have these feelings. Accept that they are part of who you are. Then you can try to understand WHY they are part of you. But denying the feelings won't help. It just makes them one more secret - and we know how dangerous secrets are.
Posted by orchid on October 10, 2005, at 14:27:23
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
Daisy,
Therapists are quite wise. And especially yours is even wiser. If the therapist feels the patient is being genuine and wants help, and is just admitting their feeling, they will definitely not take offense. Some patients do try to manipulate their therapist with suicidal ideas, but even then, therapists are trained to understand that it is the patients own mental trauma that is beign displayed in that fashion. My first T once said, he really won't worry even if his patients commit suicide and he won't feel guilty if he knows he has done his best. I am sure all therapists are trained to understand that and that ultimately, the patients are responsible for their actions, and therapist are not God.
I am sure your thearpist understands the intense pain that you are in, and wants to help you. He definitely is not going to take offense if you want help. Just like transference, suicidal ideas probably will take lot of time talking about it to make it go away. I am sure your T understands this.
Even we understand it here, so I am sure your T understands it 100 times more. Please feel free to talk about it as much as you want. Talking about it really really helps.
Posted by Poet on October 10, 2005, at 19:34:38
In reply to How therapists think or feel (trigger), posted by daisym on October 8, 2005, at 20:26:17
Hi Daisy,
This is what my T said to me last year when I was suicidal.
*It would hurt me in a deep place if you killed yourself. I would work through it in time, but I would always miss you. I could possibly help your husband work through it, too, but again there would be this hole where you used to be.
I know, big deal, I would miss you.*She said no note, no matter how well written could make anyone understand why I did it.
I told her that she was just afraid of being a failure as a therapist if one of her clients killed themself. She said that isn't it at all, she would miss me and mourn the loss of me as a person.
I think your T would feel the same way.
BTW I found babble when I was searching on the internet for ways to kill myself. That was two years ago. I'm still here even with the horrors of last year. You're still here, too. Stay here.
Poet
Posted by daisym on October 11, 2005, at 19:51:33
In reply to Re: How therapists think or feel (trigger) » daisym, posted by Poet on October 10, 2005, at 19:34:38
I told my therapist what I've been researching and what my questions were. He said he does the same thing when he is worried about something, though he did point out that he would rather I was researching trauma therapy instead of suicidal ideation. I get what he was saying.
He asks really hard questions, like: "are you needing something different from me?" I don't know how to answer that. I told him flat out that I wanted to be rescued and I hated that I already knew that he couldn't do that for me. Only I can do that for me. And I hate that I know the answers are: "you have the power to make choices" and "some things are not in your control, only your response is in your control." I guess I don't want to grow up and be in charge of my life right now. I wish there was a life swap site, like the partner swap ones. He agreed that he couldn't rescue me but he also said that just because I couldn't get everything I needed or wanted from him didn't mean I couldn't get any of it from him. I've never been an all or nothing kind of gal so I don't know why I'm doing that now.
I think I'm still scared I'm going to overwhelm him or disappointment him with my lack of strength. And then what? He says he has no expectations or timelines and I don't need to take care of him. Yesterday he talked about the hospital and I flatly refused. He talked about taking some time off and I refused that too. He pointed out that I'm in the middle of a major depressive episode, I seem to have lost confidence in his ability to help me and I won't tell my friends or family I'm in crisis. So, what was my next move? I couldn't answer that either. I threw it back at him -- "isn't it your job to know what to do now?" He said he thought we should focus on why I had pulled so far away from him and why I wouldn't let him help me. Because usually I feel better when I feel connected and cared for.
Today he let me talk for a while and then he asked why I had shut down the younger parts of me. I told him he had heard the stories and I needed to focus on solving problems not reliving old ones. He looked sad and said he felt them in the room and he thought little daisy might have things to say today. I couldn't help it -- I started to cry and out she came, I completely regressed, told him about the flashbacks and continued to cry. And then apologized all over the place. He said it was OK, "she needs to cry with me" -- and pointed out how intensely I still tell the stories. "We aren't done with this and you need to tell me over and over and over, as much as you want or need to. It is OK."
I came home and fell asleep on the keyboard. I'm so tired but at least I feel connected and safe with him again.
Who said it? Therapy is REALLY hard work.
Posted by orchid on October 11, 2005, at 20:03:00
In reply to How My Therapist thinks (update), posted by daisym on October 11, 2005, at 19:51:33
Your therapist does sound really awesome !!!
There was something Karen Kay used to do a while back. She used to be extremely explicit with her therapist about all her needs, fantasies with him etc. And her therapist used to respond very openly to her too. She was quite very attracted to him, and I remember she used to be extremely explicity about her attraction with him. And he used to be quite open to her also. To my surprise, she got better and moved on faster than others who were not so explicit with the T.
I think you perhaps will heal a lot more if you adopt the same attitude with your T. Be completely open and honest and maybe even completely explicity with all your longings and needs with him/from him. I think that might be the best choice for fast recovery for you, especially, since your T seems to be able to handle any amount of challenge and openness and neediness on your part. Tell him everything you want from him. In all explicit details. And maybe talking about it repeatedly very openly might make you grow faster.
((Daisy))
Posted by Poet on October 11, 2005, at 22:17:58
In reply to How My Therapist thinks (update), posted by daisym on October 11, 2005, at 19:51:33
Hi Daisy,
I don't know who originally said it, but I'll second, third, fourth, etc. that therapy is hard work.
You had a rough sessions, you deserved that nap on the keyboard.
Glad you're feeling cared about and safe with your T. Allowing yourself to feel that way is hard work, too.
Why is it so easy to be hard on ourselves, but so damn impossible to be easy on ourselves? Guess that's why I'm not a philosopher.
Many safe cyber hugs to Daisy little, big and in between.
Poet
Posted by Tamar on October 12, 2005, at 5:35:38
In reply to How My Therapist thinks (update), posted by daisym on October 11, 2005, at 19:51:33
It sounds like a hard session, but a good one.
I really think your therapist is right: sometimes things need to be told over and over and over. And it’s not easy. But I’ve felt it too… Sometimes I simply repeated things I’d already told my therapist, just because I needed to say them again. Sometimes I still need to say them (seven months after terminating)… so I do it in my imagination. It’s not as good as real therapy though.
And I’ve come to the conclusion that it’s not really about repeating the same thing: every time we tell it it’s slightly different. Every time we tell it there are slightly different nuances. And as therapy progresses we sometimes come to see things slightly differently, or notice things about past experience that we weren’t entirely aware of before… and then it needs to be told again.
When I was doing short term therapy I didn’t want to ‘waste’ precious time repeating myself, so I didn’t do it as often as I’d have liked; I wanted to cover as much new ground as possible. If I ever get around to doing long term therapy, I think I’d like to talk every session about the most painful stuff, for a while at least (for as long as I can keep it up). Well, that’s my current fantasy… maybe I’m deluding myself…
I’m glad you feel connected and safe with him again. It sounds like a good place to be.
Tamar
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