Psycho-Babble Psychology Thread 794498

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The Phases of Therapy

Posted by Daisym on November 11, 2007, at 23:23:11

I've been thinking about this lately and it seems like there have been several threads from people in such different phases of therapy - the angst of the beginning, the warm feelings that come when you begin to trust and feel heard, worries about moving into the hard stuff and winding down and even ending.

I think each phase has its challenges and rewards, like any relationship. I'm not sure where I am - which phase this is. My therapist said the other day that we are working in a very deep way, deeper than we ever have before. He was sort of saying that even a few months ago I wouldn't have been willing or able to deal with stuff we are talking about now. I find myself pushing him a lot - I get angry or upset with him and I'm testing him all over the place. He remains calm and available but calls me out on these feelings too. We are very connected, even in the midst of the storm. Last Friday I had a very bad day and when he called I talked nonstop for 20 minutes about all the crud. Then I said (don't laugh) "I'm sorry to have dumped all that out on you." He said, "Is this where I remind you that I'm your THERAPIST?"

I was thinking if I described my therapy and the relationship I have with my therapist to anyone right now, they'd likely wonder why I'm putting myself through this. It is painful. I leave in tears. I need my therapist - a lot. And yet my relationship with him is complicated and painful too. Therapy certainly isn't warm and fuzzy these days.

And yet -- I know we are doing the work that needs to be done. And I know we've built this really strong alliance. Not only do I trust him, but I feel like he trusts me too. He said the other day, "You know me...I want to talk about this, etc." and I *did* know he would say that. It felt good.

I guess I'm just musing here - maybe we should try to name all the phases -- for the book, right?


Re: The Phases of Therapy Daisym

Posted by JoniS on November 11, 2007, at 23:53:52

In reply to The Phases of Therapy, posted by Daisym on November 11, 2007, at 23:23:11


Your post was sweet. I am on the verge of tears. I appreciate what you shared in your post. sorry you are feeling such pain right now, even though I know it is sometimes necessary.

I dont know what stage I'm in right now. I feel liek there is a creek between me and my T and it swells, then goes down a little, then swells. It creates just enough space that we can talk, but not to easily, not too deeply. I am so disappointed. I need the closeness that I have had with him in the past. We have talked about it, and I'm sure we will some more, but so far it hasn't helped. I see him tomorrow and after that, probably not til December. I will probably get 2 appointments in December and then he is on sabbatical from January til March. I know it isn't personal, but I feel so insignificant to him.

Tomorrow I am also going to see another T. My T doesn't know, and I'm not sure I'll mention it. I might see this other one while my T is gone.

So, what stage am I in? The "wait stage"? Or maybe the "reality" stage, or maybe the "end of idealizing your T" stage. It's hard to idealize him when his specialty is Marriage & Family but takes off his wedding ring and claims he's still trying to work through it. Removing the ring symbolizes "I don't want to be married, as far as I'm concerned, this committment is over" - to my way of thinking anyway. Sorry I've "babbled" on. I know we are not all perfect, and T's are not either. But I'm sad. I want my T back!

Hope I didn't hijack your post. I didn't mean to. I'm really sad. Maybe sleep will take care of it.



Re: The Phases of Therapy Daisym

Posted by RealMe on November 12, 2007, at 0:54:32

In reply to The Phases of Therapy, posted by Daisym on November 11, 2007, at 23:23:11


I think we are in sort of the same spot right now. My T has said something similar about how mush work I have done just in the last couple of months, and like you, I am in tears most of the time in therapy. It is so painful, and yet I also feel closer to my therapist and understood. I said to him Friday that I never cry in front of people, and yet here I am crying all the time, and I don't want to. He said maybe I need to cry here. I said I would think you would be sick of it and think, "oh here we go again." I don't remember if he even said anything, but I knew he did not feel that way.

I had some huge insights after I left therapy on Friday, and I wrote them all down and sent it to him in an email. He knows that if I don't write it down, it is gone in a couple of days, thanks to the ECT. Now I will look up his response to my email as I don't remember what it was off hand.

Okay, he said: "It is terrific that you are doing such meaningful self reflection and sharing it with me." I had told him some thoughts I had about how he laughs at my faces and silly comments and how I think that I got comfortable with that and felt more scared of the serious him, I mean really serious--the T who says things like, yes it is true that if you decide you are going to kill yourself, I will take steps to stop you. I told him if I was really going to do it, I would not say anything to him. He said he was sorry to hear that. I felt like sh*t after I said that too him. The insight I had was that maybe this is one way I got people to like me, men in particular by being "impish" as my T has called it. But this always led to relationships with men that I did not really want. Another story and related to the csa. So, I never realized or was aware of this dynamic before. Now what. I wonder what he will be like when I see him on Tuesday as I told him that part of me thought he was "cute" too when he laughed and that I fantasized saying to him that when he is like that I just want to do something with him that I think I will get blocked if I say the word here. Now I am just really embarrassed to even see him.



Re: The Phases of Therapy Daisym

Posted by twinleaf on November 12, 2007, at 1:02:19

In reply to The Phases of Therapy, posted by Daisym on November 11, 2007, at 23:23:11

That was so good to hear Daisy- that you are working at such a deep level, and still feeling so trusting and connected- no matter what comes up- and you know for certain that he feels that way towards you also. You talked about stages, but didn't identify one. I'm getting the feeling that you maybe feel that you are moving into the last phases of deep therapy work, and that perhaps the stage to follow is termination. I went to a conference just today about termination, and was very reassured to learn how long everyone takes to go through it- about two years seems to be average- sometimes much longer. And, as you know, most therapists don't shut the door in a final way. They expect and welcome "as-needed" contacts. In one (extreme) case, a woman "terminated" seven years of analysis, and then kept on going once a week to the same therapist for 30 years! There was a lot of very interesting discussion about how it is a relationship of lifelong importance- whether one is going frequently, occasionally, or just keeping the memory of the therapist in mind.

By the way, this was the conference at which my former analyst was the keynote speaker. He gave a very abstract, historical talk-mostly about termination boundary violations by long-dead analysts, such as Masud Khan in England, who slept with most of his female patients! That was so extreme that it didn't seem very relevant, although his point was that the threat of loss of the patient can result in very destructive boundary violations by the therapist. It was sad to see him across a room full of people. We kind of avoided looking at one another. Twice, I saw him suddenly look at me, with a grave, searching expression. Perhaps he was wondering what I am doing now (he doesn't know about the new analyst, because the new one says he would be saying something like "what HAPPENED between you and Dr.,,,,,,,,,?!", and he doesn't think there's any possible, useful answer), and perhaps he was wondering, himself, what on earth happened to us. It's awfully hard to go through something like that, and understand it so little. It felt so sad, and like so much love, trust and hard work had just been wasted and thrown aside. I feel like I've been thrown aside myself.

Well, I need to remember that I've got a wonderful new analyst!


Re: The Phases of Therapy JoniS

Posted by twinleaf on November 12, 2007, at 1:20:59

In reply to Re: The Phases of Therapy Daisym, posted by JoniS on November 11, 2007, at 23:53:52

It must be impossible to feel connected and able to do good work when your therapist has essentially abandoned you, and is preoccupied with his own problems. You have had a good relationship with him in the past, and could certainly have one again, but I think it was smart of you to make an appointment with someone new. The new one might turn out to be wonderful, and a wonderful match for you, or he might be more of a temporary help until your therapist is able to resume. Whatever happens, I think it is a very good idea on your part. Good luck!


Re: The Phases of Therapy

Posted by antigua3 on November 12, 2007, at 8:30:16

In reply to The Phases of Therapy, posted by Daisym on November 11, 2007, at 23:23:11

To be honest, I couldn't say what stage of therapy I'm in, although I will agree w/whoever said that termination can go on for years. My T says jokingly it can last 10 years!

I've been through ups and downs, transferences, etc., but I go back and forth through the stages when something big comes up. I don't have a series of time where I delved deeply into all the bad stuff; mine is more sporadic than that.

I'd certainly say I was closer to termination than I had been; but recently I've learned that I'm not as close as I thought.

I envy those of you, knowing how difficult it is for you (I wouldn't ever underestimate the pain), that you are able to go through a stage where it all comes forth. It just doesn't work that way for me. I'll have a crisis, and now that I have better coping skills, they don't last as long, but I rarely get to the emotions. Well, not rarely, I tend to deal with it more head on now, at least with my T. My pdoc is a whole other story.


Re: The Phases of Therapy Daisym

Posted by seldomseen on November 12, 2007, at 8:35:34

In reply to The Phases of Therapy, posted by Daisym on November 11, 2007, at 23:23:11

I'm in the winding down phase of therapy (7 years), but here are the phases that I went through:

INITIATION - for me this was just like a huge emotional dump. I just off loaded all the crap from my childhood. Also involved a significant amount of re-traumatization.

RESISTANCE - Perhaps as the result of the re-traumatization, but I became very distrustful of my therapist, experienced a lot of anger toward him.
TRANSFERENCE - Anger melted into feelings of deep love for and dependence on my T. The relationship I had with him was the most important in my life. Spent a lot of time thinking about therapy. The focus was definately on HIM.

RESOLUTION - This phase was very painful because I began to accept the therapeutic boundaries. However, my T was very masterful and left me in a very good place. I began to internalize the relationship and trust.

THERAPEUTIC WORK - Finally! Began to realize how all of my past survival techniques were impairing my life. Got a glimmer of how good life could be post-abuse.

INTEGRATION - Incorporating the insights in therapy into my daily life, I've developed the ability to make these insights my self. Much more self-reliant and in control.

As I progress through to termination, I will post my feelings about that as well, but it maybe years.



Re: The Phases of Therapy

Posted by Poet on November 12, 2007, at 9:28:35

In reply to The Phases of Therapy, posted by Daisym on November 11, 2007, at 23:23:11

For me it's been

Learning to trust (five years)

Realizing I'm making progress

Accepting that its okay to call T when I need to

Accepting that its okay that T cares about me

Starting to work on the hard stuff (CSA)



Re: The Phases of Therapy

Posted by Dinah on November 12, 2007, at 10:00:29

In reply to Re: The Phases of Therapy Daisym, posted by seldomseen on November 12, 2007, at 8:35:34

I'd say that roughly my phases were the same as seldomseen's. There was certainly overlap between them as well.

I think my Initiation period was different. I wasn't really an emotional dumper and in fact I think I relatively deliberately misled him in some things when I first started because I didn't feel comfortable admitting them (probably as much to myself as to him.) And since he does a lot of CBT work, the first several months were spent with the "Anxiety and Phobia Workbook" and learning relaxation skills. He also tried to work with my cognitive distortions, but I wasn't too cooperative there.

Then it took five years to trust him, another two years for him to trust me, and at ten years I trusted my trust in him. Who knows where it would have gone if it followed the natural progression there, but it didn't. We were really doing very important work at that point, although I don't now recall what it was.

I have a hard time identifying where I am now. There is a better understanding of what he can and can't be to me, which left me both more trusting and less trusting. And he doesn't seem as magical. There's a warm comfort. I reflect a lot on how I have changed, and wryly accept those areas where I still need to change. I almost always know why I do the things I do. I sometimes recognize that my priorities have changed and that what I wanted in the past is not what I want in the present, and that my change in priorities really needs to result in a change in how I spend my time and money, including my therapy money.

But in reality termination is not even on the horizon, although where I'm at may sound like a termination phase. It's just not going to happen.


Re: The Phases of Therapy twinleaf

Posted by Wittgenstein on November 12, 2007, at 10:06:16

In reply to Re: The Phases of Therapy Daisym, posted by twinleaf on November 12, 2007, at 1:02:19


It interested me to read what you heard about termination and how long this process can take. I asked my T at our last session how long the therapy would last and how it will end (although I'm in the early stages of therapy at the moment) - he said that a year isn't a long time in this type of therapy (PA) - so I assume by that he means it will likely take some years. He also said that the impetus to bring the therapy to a close must come from the patient and can be tapered off or can continue less frequently as a form of maintenance i.e. that there will come a day when I feel ready to move on, and only then begins the termination process. I was pleased to here this - very relieved. I guess I was worried that after a few months or a year he would be the one bringing up termination.

Is this the norm for analytic therapy, to take a number of years? How long does it generally last?



Re: The Phases of Therapy

Posted by Wittgenstein on November 12, 2007, at 10:17:36

In reply to The Phases of Therapy, posted by Daisym on November 11, 2007, at 23:23:11

Thanks for this thread - it's really interesting. I don't have much to contribute - still in the early stages - not even sure if I'm done 'offloading' yet but at the same time my fear of him and the hatred I perceived he had for me has eased and I'm feeling closer and more attached - warm feelings, love. Working on getting more secure, trust, feeling safe - that will take time.

Reading about others' experiences gives me a sense of optimism.

Daisy, you mentioned 'the book' - what is this??



me'n'Poets bout the same (nm)

Posted by Muffled on November 12, 2007, at 12:33:35

In reply to Re: The Phases of Therapy, posted by Poet on November 12, 2007, at 9:28:35


Re: Phases of Therapy (mention abuse, no details)

Posted by sunnydays on November 12, 2007, at 14:19:33

In reply to Re: The Phases of Therapy twinleaf, posted by Wittgenstein on November 12, 2007, at 10:06:16

I don't know about phases. I can't think clearly enough about where I was at the beginning. But I definitely know I have improved a whole lot. I feel like I can talk about myself so much more deeply and insightfully and confidently now, whereas before I could barely talk at all. I also am grateful that even though I am graduating this year, if I don't stay in the area I can talk to my T on the phone as long as I want. He said I could get married and have five kids and be ecstatic all the time and still come and see him. It was totally my choice how long our therapy lasted. That even after he retired I could talk to him if I wanted to. He said it was a lifelong commitment, which was just really nice, and so important for me to hear when he said it a couple weeks ago.

But phases... well that would require remembering the painful parts and since I'm in a painful part right now I'd rather just remember the pleasant parts in the past. Right now we are dealing intensively with how much I get scared he's going to leave me and abandon me and really working with connecting those feelings back to what they are really about - my parents, who were verbally abusive, and my mother was physically abusive.

I think you're doing good work Daisy. And I think your T would make a lifelong commitment to you too. I'm glad you feel your trust is growing some.


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