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Re: Managing a therapeutic relationship

Posted by emilyp on August 6, 2009, at 23:27:46

In reply to Managing a therapeutic relationship, posted by emilyp on August 4, 2009, at 23:00:25

I realize that I posted this thread and never gave my own thoughts. I suspect that was partly because I dont have a great response. But nonetheless, I thought I would give some thoughts.

1. I agree that having other support is critical. It is critical whether one is in therapy or not. Yet even with a strong network (I have many close friends, always have even before I started therapy. It was how I managed because my family was not as supportive as I needed) I found it difficult to manage my relationship with my therapist. I think the reason my friends were not as helpful is that at the same time I was struggling most with the therapeutic relationship, I was also suffering from severe depression. When the depression is really bad, I try not to overburden my friends. So at those times I probably became even more reliant on my therapist.

2. Unlike many others who posted, I did not find it helpful to talk to my therapist regarding my frustrations. In fact, I found it even more frustrating. While my doctor (my psychiatrist is also my therapist) clearly understood my concerns, he could not say anything that made me feel better. Having said that it seems like a few of things that I said (or perhaps more importantly wrote) about my difficulties, stuck with him as from time to time he mentions it.

3. I think the way I best dealt with my frustration (until something else happened, see below) was by putting some space between the two of us. I needed to force myself not to feel overly dependent and control my emotions and actions. And the more I could do that the more I felt as if in some way the relationship was a bit more balanced. It was hard and in the beginning it could really hurt. But over time, knowing that I did not feel so dependent gave me some confidence; it also lead me to devote time in my appointments to issues truly dealing with the depression.

4. Despite my posting, I am probably not the best person to comment on this topic because now, after all these years, my doctor and I have a very special relationship that in many ways probably crosses boundaries. I know a lot about his life and his family. We frequently talk about his family problems (he has a very sick family member). I have helped him with his computer and from time to time, there are some things related to the business part of his practice that we discuss. It is not that all of the boundaries are gone he is very professional (he is a fairly well known doctor and must keep his reputation above reproach). For example, he is now vacation and he is clearly not available even though I am having a very difficult time with the depression). But the change in our relationship only transpired due to some events that we both experienced specifically my father died, then three years later my mother died. In between the death of my parents, my doctors father died. It created a very unique (albeit sad) connection between the two of us. Then we experienced another similar life event. I suspect I would still be struggling as much as I was in the past had we not been through such a tumultuous period.

5. Another reason I think the relationship changed is that despite my frustrations, I never, ever tried to cross the boundaries. For many years, I called him Dr. Smith (that is not his real name, but you get the point). This is despite the fact that every one of his other patients called him by his first name. I was simply brought up to call doctors, Dr.; it never occurred to me to call him anything else. I never asked for hugs (not that there is anything wrong with that) or asked him things that I knew were usually out-of-bounds. I think that he respected that and realized that I was not trying to push him. I also think he learned to respect me as a professional I was a senior executive at a large company. Ultimately he started to disclose small things and one thing led to another in terms of us developing a relationship.

So, thats my experience. As I said, I am not sure it provides much input into the discussion. But nonetheless I thought since I started it, I should at least contribute.




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