Psycho-Babble Psychology Thread 811358

Shown: posts 1 to 23 of 23. This is the beginning of the thread.

 

Need a Second Opinion (Big Trigger+ Long)

Posted by mair on February 7, 2008, at 17:53:28

I haven't been around in awhile and it's especially difficult for me to participate now because I can't seem to open any posts (much less actually post) from my home computer. I'm writing this from work.

A few weeks ago, my pdoc's husband killed himself. I found out several days after the fact, and in a somewhat roundabout way. This is not a case where this family was a blank slate to me. I don't live in a big metro area. Her kids went to the same school mine did; I knew her husband by sight and we'd frequently turn up at the same school functions. Hearing this was extremely upsetting and I got even more upset when I figured out that when I had last seen my T, she knew about his death and hadn't said anything to me. As time passed, and I found out more details, I really started to slip. His suicide seemed to rekindle alot of my own suicidal thoughts, maybe because his suicide (method and all) played out in much the same way that I always thought mine would. It's been pretty rough sliding for the last couple of weeks, and it seems that it's all my T and I have talked about lately. I think, fortunately, that the worse is over for me. At least his death and suicide in general have stopped being the preoccupations they were a week ago.

Today our session morphed into an discussion about what I know about my T's life and what I don't - how much she should reveal to me, for instance. (I've been seeing her for a very long time and I know a lot) I brought up the issue of how angry I was for her not telling me about my pdoc's husband. She insists it wasn't deliberate - that she just didn't think of it during the one session we had between his death and when I heard about his death. But she also went on to say that she brought this issue up in her supervisory group, and the other T's in the group opined that even if she had his suicide in mind when she met with me, it wasn't really her thing to tell or talk about unless I raised it as a topic. That it was between me and my pdoc.

She's come around in the last couple of sessions to say that, had she thought about his death in our session, she should have said something to me, largely because she knows how much I struggle with suicidal thinking. But she says this with no real conviction. I told her that I thought the reasoning of the Ts in her supervisory group was way off-base. How could it be just a matter between me and my pdoc? I certainly wouldn't feel comfortable processing his suicide and my reaction to it with her. AS it is, even though I probably won't see her again for 8 months or more, I'm worried about how I'm going to answer the questions she always asks me about the degree of my suicidal thinking.

I go to see this pdoc because she is the one my T recommended. What I've talked about with my pdoc, has been the focus of a few therapy sessions. I know that on occasion, they've consulted with one another about me. It seems to me, that having someone I know commit suicide would always be a legitimate therapy topic. And his death was pretty public knowledge before I ever heard of it. So I just can't understand why anyone would think it would be perfectly ok not to raise it as a subject with me.

Last week when I was in a depressive free fall, my T told me that she wasn't a bit surprised that I was struggling so much with his death. Yet today, she asked me why I was so angry. I told her that I was bound to hear sooner or later, and that it was a saving grace that I heard about it an hour or so before a session - how awful if I had had to live with my level of distress for days before I saw her again.

As I'm writing this post, I'm getting a little steamed about this issue all over again. I know it's not fair to my T, but I really can't understand a line of reasoning which would have her just silently waiting around for me to hear news that so predictably started a depressive swing.

Am I entitled to be annoyed? Is she entitled to withhold information that she knows will be very upsetting to me even though she knows that I'm sure to find out from someone else if not from her?

mair

 

Re: Need a Second Opinion (Big Trigger+ Long) mair

Posted by AbbieNormal on February 7, 2008, at 18:30:41

In reply to Need a Second Opinion (Big Trigger+ Long), posted by mair on February 7, 2008, at 17:53:28

I'm so very sorry for this struggle you are facing. The anger and saddness and what sounds like feelings of betrayal by your T?

And.....I'd have to agree with her supervisor. I think your T needed to wait for you to bring it up. Your pdoc's personal life, no matter if it becomes public, is still really her personal life. And her personal life is off limits as far as the T bringing it into sessions, imo.

My heart aches for your pdoc. It must be particularly difficult for someone in the business to lose someone this way.

Abbie

 

Re: Need a Second Opinion (Big Trigger+ Long)

Posted by raisinb on February 7, 2008, at 18:37:36

In reply to Need a Second Opinion (Big Trigger+ Long), posted by mair on February 7, 2008, at 17:53:28

Oh my goodness, that sounds so hard. I am sorry you have to encounter this.

For what it's worth, I often find myself yelling in my head (or at my T), "you SHOULD have done x, y, and z." Sometimes (not always) I come to the realization that even though she didn't do the right thing, she was *trying* to take care of me with what she did do.

My T has another therapist she consults with about me. She's told me a tiny bit about what he says and sometimes I feel I can tell that she's following his advice (I have no way of verifying this, of course). Usually, I feel abandoned and misunderstood. It's like she ignores what *I* say I need (and what she should *know* that I need)to follow some stranger's advice, someone who doesn't know or care about me, and who should not be trusted over and above me. I don't know, maybe that's part of it?

Beyond that, I can see how it would feel uncaring for her not to address something so big and difficult. I'd feel abandoned by that, too, and kind of blindsided.

It sounds like she was worried about it and tried to do her best, though she may not have done what was right in the end. I guess all you can do is keep processing the hurt feelings.

I wish you well in dealing with this.

 

Re: Need a Second Opinion (Big Trigger+ Long) mair

Posted by MissK on February 7, 2008, at 19:52:00

In reply to Need a Second Opinion (Big Trigger+ Long), posted by mair on February 7, 2008, at 17:53:28

> I know it's not fair to my T

That's a start.

>I really can't understand a line of reasoning which would have her just silently waiting around for me to hear news that so predictably started a depressive swing.

I think you can tell her how hearing about his suicide affected you and how it relates to your own thoughts of suicide. Her personal life, however, is her personal life. I don't see why she should have to share her personal life with you. If she was unable to perform as your therapist on account of what happened, then she could say that. Even then, it would be up to her whether she told you the exact reason or not beyond it being a personal matter.

>Is she entitled to withhold information that she knows will be very upsetting to me even though she knows that I'm sure to find out from someone else if not from her?

In my view, yes - if it doesn't pertain to you and the therapy she provides you; her husband is her business. What goes on in her personal life is not what you are in therapy for.

 

good to see you-sorry 4 this-more later when awake (nm) mair

Posted by zenhussy on February 7, 2008, at 22:41:59

In reply to Need a Second Opinion (Big Trigger+ Long), posted by mair on February 7, 2008, at 17:53:28

 

Re: Need a Second Opinion (Big Trigger+ Long) mair

Posted by Dinah on February 7, 2008, at 22:45:21

In reply to Need a Second Opinion (Big Trigger+ Long), posted by mair on February 7, 2008, at 17:53:28

Mair, I can understand feeling upset that she kept it a secret. It never feels good to know that someone else knew something important to you and didn't tell you.

I'm guessing my therapist wouldn't have said anything either, if for no other reason than that he isn't in the habit of discussing anyone else in our therapy unless I bring it up. If I noticed he was upset and if I asked, he likely would mention it. But otherwise I don't think he would. Or if I mentioned the pdoc's name, he probably would.

I think it's a difficult situation and because it is so unusual and so difficult it really isn't easy to know what the right thing to do would be. Not for anyone. Thank God, it's not something anyone prepares for. I'm sure it is upsetting to your therapist. I'd think it would have a lot of mental health professionals putting themselves in your pdoc's shoes.

Is it possible you're feeling more than enough anger to go around right now? Your pdoc's husband committed suicide using the method you've thought about. His actions indirectly had an impact on you, and directly had an impact on your pdoc and your therapist and your relationships with them. Everything's all shaken up.

You don't have to be entitled to be angry. My therapist always tells me to quit deciding if I'm being reasonable in being angry with him. That it doesn't matter if I'm being reasonable. That I'm angry and it's more important to talk about that.

(((Mair)))

You've had more than your share of trouble from your care team lately. I'm so sorry this happened after your therapist's health issues.

 

Re: Need a Second Opinion (Big Trigger+ Long)

Posted by Phillipa on February 8, 2008, at 0:14:30

In reply to Re: Need a Second Opinion (Big Trigger+ Long) mair, posted by Dinah on February 7, 2008, at 22:45:21

I kind of know what it feels like as a psychiatrist I saw killed himself his associate I worked with mentioned it not knowing I'd seen him as a patient. She counselled me on the spot. Yes it tough. Love Phillipa

 

Re: Need a Second Opinion (Big Trigger+ Long)

Posted by Daisym on February 8, 2008, at 0:42:19

In reply to Need a Second Opinion (Big Trigger+ Long), posted by mair on February 7, 2008, at 17:53:28

*****I brought up the issue of how angry I was for her not telling me about my pdoc's husband. She insists it wasn't deliberate - that she just didn't think of it during the one session we had between his death and when I heard about his death*****

Hi Mair,

As much as it is upsetting, I think she probably really didn't think of it. I think therapists are just trained to put stuff out of their minds and focus on their clients. You've been with her a long time -- I think you'd know if she was lying to you.

But I can see why you'd be upset. The connection is too close and your reaction what she expected. I don't disagree with Dinah - there is a lot to be angry about and your therapist is a safe place to put some of it. The whole situation is just so awful. And in a supervision group there is too much time to pull apart all the possible ramifications of a decision. In the moment, there can't be as much thinking, analyzing or second guessing.

I'm glad you are feeling somewhat more stable. Sounds like a very tough couple of weeks. Hang in there.

 

Re: Need a Second Opinion (Big Trigger+ Long)

Posted by mair on February 8, 2008, at 7:36:09

In reply to Re: Need a Second Opinion (Big Trigger+ Long) mair, posted by AbbieNormal on February 7, 2008, at 18:30:41

Thank you Abbie

" And.....I'd have to agree with her supervisor. I think your T needed to wait for you to bring it up. Your pdoc's personal life, no matter if it becomes public, is still really her personal life. And her personal life is off limits as far as the T bringing it into sessions, imo."

My T said as much too - that even if she had all this in mind when she first saw me, she may not have said anything out of a respect for my pdoc's privacy. I'm ok with that. It's just in this case, it was very public and I hated the way I actually did hear.

>" My heart aches for your pdoc. It must be particularly difficult for someone in the business to lose someone this way."

I totally agree. My pdoc, unlike my T, is a very very nonrevealing person. When I first heard this (and still now) I was furious with her Husband for doing this to her and to their children. I have a very hard time imagining how she will feel when she goes back to seeing patients, particularly those she also sees for therapy.

mair

 

Re: Need a Second Opinion (Big Trigger+ Long)

Posted by mair on February 8, 2008, at 7:44:28

In reply to Re: Need a Second Opinion (Big Trigger+ Long), posted by raisinb on February 7, 2008, at 18:37:36

I read this book once where the author said that a trait of many depressed people is that they essentially want people who are close to them to be mindreaders. I've seen that in myself. I'll get angry with my husband for seeming so insensitive when really he has no idea when I'm in a bad place and when I'm not. My T frustrates me no end sometimes by the way she finishes my stumbling halting sentences. Or when she might anticipate what I'm about to say. All too often, she's totally wrong and it makes me feel either that she can't possibly be listening that well or that she just doesn't get me. I guess it points to how poorly I communicate.

I'm sure part of my frustration arises from my thought that she knew how upset I'd get so why let that happen to me in isolation.

mair

 

Re: Need a Second Opinion (Big Trigger+ Long)

Posted by mair on February 8, 2008, at 7:56:56

In reply to Re: Need a Second Opinion (Big Trigger+ Long) mair, posted by MissK on February 7, 2008, at 19:52:00

I didn't want to give the impression that this was my T's husband. I wouldn't be talking about this with her at all if it was.

I have no problems with boundaries. Few Ts could construct as firm a boundary as I've constructed for myself. I struggled with the issue of whether I should even send my pdoc a condolence card - knowing how private she is. I thought there was a chance that she would hate getting notes from her patients. Ultimately, I decided that acknowledging it now might mean that it wouldn't have to be acknowledged all over again when I next see her. My sending her a card allowed me to say what I felt I needed to in a way which didn't demand a response.

Unlike my pdoc, my T falls somewhere in the middle of the spectrum when it comes to self-revealing. She'll bring up her own experiences occasionally to make a point to me. She'll answer personal questions I've asked from time to time. It's ok because I'm very careful not to ask too much or too often. However, I've felt great sympathy for her when she was forced to process with her patients how they felt about things that affected her - like her divorce and more recently her cancer. These were events that she chose not to keep private, but I thought it was pretty crummy that she felt she had to share them with people she sees in therapy.

 

thanks zen (nm)

Posted by mair on February 8, 2008, at 7:58:04

In reply to good to see you-sorry 4 this-more later when awake (nm) mair, posted by zenhussy on February 7, 2008, at 22:41:59

 

Re: Need a Second Opinion (Big Trigger+ Long) Dinah

Posted by mair on February 8, 2008, at 8:08:49

In reply to Re: Need a Second Opinion (Big Trigger+ Long) mair, posted by Dinah on February 7, 2008, at 22:45:21

Dinah - I think sometimes you get me better than I get me.

I was pretty horrified that his death triggered some of my own suicidal thinking. I was so upset that he would hurt his wife and kids in this manner. I had the reaction to this event that any normal non-suicidal person would have. I didn't envy him that he was no longer in pain; I felt no particular sympathy for whatever drove him to this. And I truly bled for his wife. It was so easy for me to imagine all the many different awful ways that this will affect her life and their children's lives.

Given that, you'd think that one of my reactions would be that I'd never think about committing suicide again - that I'd never consider putting my family through that. So when the initial shock wore off and when I launched myself into suicide-obsession mode, it felt selfish and certainly inappropriate. Having my T tell me that she was actually not surprised at all with how much I was struggling was reassuring and helpful, if not illuminating.

mair

 

Re: Need a Second Opinion (Big Trigger+ Long) Phillipa

Posted by mair on February 8, 2008, at 8:10:06

In reply to Re: Need a Second Opinion (Big Trigger+ Long), posted by Phillipa on February 8, 2008, at 0:14:30

That does sound awful. Was this someone you saw for a long time?

 

Re: Need a Second Opinion (Big Trigger+ Long) Daisym

Posted by mair on February 8, 2008, at 8:29:29

In reply to Re: Need a Second Opinion (Big Trigger+ Long), posted by Daisym on February 8, 2008, at 0:42:19

You know Daisy, her explanation as to why she didn't think to tell me actually rang true to me although a friend of mine scoffed at it when I tried to explain it to her. My T's explanation was that she was so upset herself and was focused on her own hurt. She explained that when she's doing therapy, she very good at totally pushing aside personal thoughts and thus forgot all about it during our session. This is believable to me because I, too, put therapy in a different box when I'm not there. I compartmentalize therapy to such a degree that I'm sometimes incapable of remembering what we talked about from one session to the next. I think it hinders therapeutic progress, but it also allows me to function outside of my T's office.

I guess it hurt a little that she never drew a connection with me - not just when I saw her, but for the next couple of days afterwards. When I brought it up, the look on her face told me that in that instance, she immediately saw that this would be very upsetting to me.

Beyond that, I was sort of ok about her role in this until she started telling me what the reaction was of the other T's who are in the same supervisory group. Their opinions and her seeming acceptance of their point of view felt invalidating.

I have to say, I sometimes get very tired navigating discussions about the unique differences between a therapeutic relationship and an IRL one. I can't seem to process my feelings about those differences easily or competently. I start feeling like the relationship is too complicated for me (maybe not for others) and that I'd be better off (certainly no worse off?) if I didn't have to juggle it at all.

That's where I am right now.

thanks

mair

 

Re: Need a Second Opinion (Big Trigger+ Long) mair

Posted by MissK on February 8, 2008, at 8:59:06

In reply to Need a Second Opinion (Big Trigger+ Long), posted by mair on February 7, 2008, at 17:53:28

oops, I re-read that it was you pdoc that had this happen. My comments would remain the same, however, whether it was your T or your pdoc.

 

Need a Second Opinion (Big Trigger+ Longer Even) mair

Posted by Dinah on February 8, 2008, at 9:28:16

In reply to Re: Need a Second Opinion (Big Trigger+ Long) Daisym, posted by mair on February 8, 2008, at 8:29:29

You know, Mair. I think it's perfectly reasonable for you to be upset and wanting to throw in the towel. Your therapist and pdoc, through no fault of their own, have been the source of so much distress lately that they'd be a reason to send someone to therapy.

The husband of someone you care about committed suicide. Your therapist had months of chemotherapy for cancer. Your therapist got divorced. And even before that you were upset about knowing things your therapist didn't know you knew, right? In a normal relationship it would have been distressing processing those things. In a therapeutic relationship, where you feel uncomfortable about turning the focus on her, and where you make sure to keep firm boundaries, it's even harder processing these things. You've been traumatized by your therapeutic relationships lately, through absolutely no fault of their own.

During Katrina, when my therapist went away to Europe for what amounted to six weeks of no therapy when I needed therapy most, when he needed therapy maybe even more than I did so wasn't at his best, I had an interim therapist I call T3. I was telling T3 my hopes that when he came back we could get back to normal again (even though he had moved three hours away). What she answered felt more like a curse than an intervention. And I am not sure I'll ever forget it for my entire therapy life. She said "But you will always know it happened."

If you stop and think, do you find yourself angry about all these things? About therapists who are mortal and imperfect. About pdocs who weren't able to help their husbands so how can they help you? About what has happened in the past and what might happen in the future? If you are angry about those things, I'd say go ahead and get as angry as you want. Is it fair to your therapist? It doesn't really matter. Therapy is a place where you don't have to check to make sure you're responding in a mature way. It's more important to respond with truth than with correctness.

I hate it whenever my therapist talks about me in a group setting. She probably ought to have left that out in discussing it with you, even if the group was a general one, not a specific one. Maybe especially. You have a specific relationship, not a general one.

It is a real relationship you know. How can it not be after so much time? Even if youve dealt with someone for years on a professional basis rather than in a friendship, there is a layer to the relationship that is real and human. Think back to professional relationships youve had on either side. There might be some that are purely professional, especially if you dont see the other person often. But if you work closely on a professional basis for a long period of time, its impossible for a real relationship not to develop. I guess its the curse and gift of very long term therapy. The trick is that the professional (and you) are supposed to put that aside to concentrate on your issues in the sessions because that *is* the work. Gardenergirl once wrote a post to me that really clarified what was very jumbled in my mind at the time, and causing me a lot of distress. It gave me a framework to think about what was bothering me, and to discuss it with my therapist.

http://www.dr-bob.org/babble/psycho/20040303/msgs/321437.html

I can see why it would be tempting to leave therapy. But Im not sure this is the right time to decide. It might be a better time to talk to your therapist about how tired you are of navigating discussions about the unique differences between a therapeutic relationship and an IRL one. And how you feel the relationship is too complicated for you and that youd be better off if you didnt have to juggle it all.

And how it would be so d*mn much easier to keep to the pristine lines of a clean purely professional therapeutic relationship if their d*mn lives didnt intrude so much on it.

As far as the obsessions go, they arent terribly logical. The very fact that it happened at all and the graphic images evoked by your knowledge of what did happen will trigger obsessions whatever your feelings about what he did may be. Linehan has a section about watching thoughts go by like leaves on a stream. Ive found it very useful for dealing with obsessions that dont really match what Im thinking and feeling.


 

Clarification

Posted by Dinah on February 8, 2008, at 9:43:28

In reply to Need a Second Opinion (Big Trigger+ Longer Even) mair, posted by Dinah on February 8, 2008, at 9:28:16

I didn't mean that these particular obsessions aren't logical. I mean that the obsessional process is not logical.

 

Re: Need a Second Opinion (Big Trigger+ Longer Even) Dinah

Posted by mair on February 8, 2008, at 21:38:02

In reply to Need a Second Opinion (Big Trigger+ Longer Even) mair, posted by Dinah on February 8, 2008, at 9:28:16

Dinah - I'm sorry. I responded to you earlier today but I must have hit the wrong button.

Your post was so on point. I do feel pretty unsettled about everything that's happened and the therapeutic relationship isn't feeling very stable at the moment. At the beginning of the year, I was feeling like I needed to take a break from therapy and I started having that conversation with my T. Then I began to slide(even before my pdoc's husband's death), and it clearly wasn't the right time for me to talk about quiting or scaling back. I like it when I can feel that my T is taking care of me, and then I hate it when she expresses all of her strong reservations about having me even start coming a little less. I recoil from the notion that I need to be therapy-dependent. Life ought to be simpler.

BTW - my daughter had a great time in your fair city. And, much to my surprise, it sounds like she actually did a few things that didn't involve parties and alcohol.

Thank you

mair

 

Re: Need a Second Opinion (Big Trigger+ Longer Eve mair

Posted by Dinah on February 9, 2008, at 11:21:22

In reply to Re: Need a Second Opinion (Big Trigger+ Longer Even) Dinah, posted by mair on February 8, 2008, at 21:38:02

I'm glad she had fun here. :)

 

Re: Need a Second Opinion (Big Trigger+ Longer Even)

Posted by Daisym on February 9, 2008, at 20:45:06

In reply to Need a Second Opinion (Big Trigger+ Longer Even) mair, posted by Dinah on February 8, 2008, at 9:28:16

It has always been one of the things I struggle with - there are times when the therapeutic relationship is the cause of your distress - and I'm not talking about the vacations or separations. If the relationship with the therapist gets so complicated - how do you know when it crosses over from being helpful to you - working out your old stuff - to "simply" being the cause of upset and distress? Even if you've working with this person a long time. Maybe especially if you have.

Because I think Dinah's right. A real relationship forms - you have a history with this person. They have curiosity about events taking place and how things turn out. You know what they were like five years ago - and how things have changed for them - they change their hair, move offices, get married, get degrees...all kinds of things that interrupt, disrupt and change therapy.

I don't know what the answer is. There are certainly plenty of benefits to long term therapy. And I can't imagine working with someone else. But I really feel for you Mair - it really has been a tough year or three for your therapy team. It is a lot to cope with.

 

Happy Valentines Day!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! (nm) mair

Posted by zazenducke on February 14, 2008, at 8:10:00

In reply to Re: Need a Second Opinion (Big Trigger+ Longer Even) Dinah, posted by mair on February 8, 2008, at 21:38:02

 

Gee Thanks!! (nm) zazenducke

Posted by mair on February 17, 2008, at 21:35:05

In reply to Happy Valentines Day!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! (nm) mair, posted by zazenducke on February 14, 2008, at 8:10:00


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