Psycho-Babble Psychology Thread 900453

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New therapy from PDoc - can anyone explain?

Posted by garnet71 on June 11, 2009, at 7:41:40

I never engage in the discussions here about therapy becaues I could never relate. My past therapists were more "friends" with me than anything else, which I told this new doctor. I liked my past therapists, but I think maybe I've never been in 'real' therapy before, despite years of exchanges w/therapists off/on. I started seeing this new psychiatrist and am sort of confused about the whole thing. I did engage in therapy about 9 years ago for PTSD and major depression with a guy who did a similar approach though not as intense; it only lasted 5 or 6 sessions because he passed away. It seems he was the only therapist in the past who really made a diff. and after only just a few visits, it was noticable.

So this new psychiatrist does psychotherapy, he makes no small talk at all-doesn't reveal anything about himself. As soon as I walk in his office, he starts with intense probing that last till the minute I leave. So this was the 2nd time I visited him, and I thought my reaction and behavior with him was very strange. Can anyone explain this? I think it might be good he's not going to be my "friend", but I'm sort of scared. I called him last night and left a message at his office to call me because I'm concerned about how I felt last night. I had major chest pains when I left his office, a strange sort of awareness of a "hidden/emerging" type of anxiety I felt was buried that I could somehow control. I never had anxiety like that before. Followed by feeling depressed, crying, then becoming totally exhausted. Sorry this is long!!

This is what I wrote about the experience:

In continuing with my history today, I had the most uncomfortable conversation of my entire life with another human being. We didn't talk about medications because he said we still have to continue my background/history next week.

It was scary that he had me feeling like a vulnerable little girl. But yet I was joking or had a nonchalant attitude about everything, not purposely, and I didn't realize I was doing this, until he asked me why I was doing that instead of crying, and I said because my family and life had been so rediculous, there's really no other way to act anymore when thinking about it all. I was just trying to discuss everything rationally so he could get a clear picture, but for some reason had the hardest time articulating things; I couldn't really think and kept fidgeting and playing with a pillow.

I feel very strange for talking to him that way, then I realized it might have been because he had no body language or reaction/feedback to anything during most of the session, and I couldn't sense anything from his eyes-I've never known someone so difficult to read. And it's not that I should be doing that, but it's automatic and I only realized he was like this after I left because I felt so uncomfortable the whole time. I guess it's social anxiety or something, i remember one therapist who I could immediately see in her eyes she was judging me during one conversation, for example....and just notice that stuff with daily conversations I guess.

So when I left i realized his behavior left me feeling totally exposed, in that with therapists I've gone through hisotry w/before never were like that, and I'd never had a psychiatrist probe me like that before. I think that's why I didn't cry, feeling so vulnerable and exposed. What an uncomfortable realization. My communication behavior was very odd. But I think he did that on purpose to get a specific reaction from me?

I don't feel so well and I noticed i had major chest pains after leaving his office and they haven't gone away. It's a different kind of anxiety I've never had before. I feel sort of confused about the whole experience.

I do feel positive because he has referred to wanting to know "everything" several times, and wouldn't knowing everything lead to a much better treatment outcome? I'm a little worried I don't know how long its going to take for him to find out 'everything', and I couldn't remember 1/2 the stuff he was asking me about, but he did say he could understand why I don't remember. His probing just seems so intense and uncomfortable. I guess it's all for the better though.

 

Re: New therapy from PDoc - can anyone explain?

Posted by Dinah on June 11, 2009, at 12:08:30

In reply to New therapy from PDoc - can anyone explain?, posted by garnet71 on June 11, 2009, at 7:41:40

How do you feel about it? I can't quite tell whether you think it's going to be helpful in pulling old feelings out to be examined and processed, or if you think his style is causing you to feel brand new feelings.

I'm not as experienced with blank slate therapists as some, but I suspect that the blank slate is intended to bring about something along the lines of what you describe. Different clients find different approaches helpful. It sounds as if you think this might be helpful for you?

Maybe someone with an analyst could address your question better than I of course. I tend to get wrapped in circles in my brain when I try to think of analytical theory.

 

Re: New therapy from PDoc - can anyone explain?

Posted by Phillipa on June 11, 2009, at 12:52:20

In reply to Re: New therapy from PDoc - can anyone explain?, posted by Dinah on June 11, 2009, at 12:08:30

I don't seem to do well with therapists as I reveal and look for answers and they always forget by the next weeks what sessions were about. So given up. Phillipa

 

Re: New therapy from PDoc - can anyone explain? Phillipa

Posted by garnet71 on June 11, 2009, at 17:53:34

In reply to Re: New therapy from PDoc - can anyone explain?, posted by Phillipa on June 11, 2009, at 12:52:20

I can see why it would help a person with a lot of repressed memories. I think I like it. It's just exhausting, I have been extremely fatigued all day agian, and strange pains and anxiety. It is kind of scary, he doesn't even pause after i say something-just fires questions at me and never lets up so that I have to be talking constantly. I am concerned if I would be able to handle it while in school.

It's not easy, but I had an overwhelming feeling today that he'd somehow be able to heal me so that I wouldn't have to take psyche meds again. And I've had little to no confidence in most doctors, and all psychiatrists, over the years.

 

Re: New therapy from PDoc - can anyone explain? garnet71

Posted by Phillipa on June 11, 2009, at 21:10:15

In reply to Re: New therapy from PDoc - can anyone explain? Phillipa, posted by garnet71 on June 11, 2009, at 17:53:34

I wonder if accupuncture can help any of us as Daughter just had one session more to follow for weight loss. Well I've strayed. Phillipa

 

Re: New therapy from PDoc - can anyone explain?

Posted by BirdSong on June 11, 2009, at 23:46:05

In reply to New therapy from PDoc - can anyone explain?, posted by garnet71 on June 11, 2009, at 7:41:40

I am assuming when you say psychotherapy, you are referring to either psychodynamic or psychoanalytic (as opposed to CBT or brief or existential, etc)

I am also assuming your pdoc is doing psychodynamic therapy, because in psychoanalytic the T says little, you lie on a couch and it is classic analysis.

Psychodynamic therapy is a method that deals with the unconscious mind. The T relies on a client's free association, fantasies, dreams, the psychological defenses, and transference to work with the client. By working through these various things, a client frees the unconscious into consciousness and thus can gain insight.

What you felt after is common, because the processing of the unconscious continues long after the therapy session has ended.
This type of therapy is extremely exhausting, both mentally and physically. Personally, I need naps after my therapy because of the drain.

Your unconscious mind will also continue to work on it while you sleep and your dreams may reflect this.


Now, as to your "behaviors" in therapy and your communication and feeling vulnerable with your pdoc, I would suggest that the following could have been occurring (1) transference, (2) regression, or (3) suppression.
(2) and (3) are defense mechanisms (unconscious) whereas (1) is a response to something that reminds of you something else (also unconscious).
(4) dissociation is a possibility, however you did not mention forgetting, dizziness, fogginess, or other characteristics of dissociation, which would lead me away from this.

Wow, isn't this fun! Trust me, it is the only way to do therapy and if you have a well-trained T you will learn and grow...but it is SO VERY hard and painful.


 

Re: New therapy from PDoc - can anyone explain? garnet71

Posted by sassyfrancesca on June 12, 2009, at 12:45:13

In reply to New therapy from PDoc - can anyone explain?, posted by garnet71 on June 11, 2009, at 7:41:40

My thought would be to tell him exactly what you said here, that he is too intense and probing for you at least right now in the beginning; he should understand that. He needs to try and follow YOUR lead so you don't feel so overwhelmed.

Hugs, Sassy

 

Re: New therapy from PDoc - can anyone explain? garnet71

Posted by Dinah on June 12, 2009, at 14:40:42

In reply to Re: New therapy from PDoc - can anyone explain? Phillipa, posted by garnet71 on June 11, 2009, at 17:53:34

You sound excited at the possibilities. That's a positive sign. I know it's hard to fall into the process, but maybe you could enter into it for a while and see how it goes?

If you need to pull back if it gets in the way of your life, you could always ask your therapist to slow down a bit.

A good therapist will make sure that you retain enough defenses to function, even if he's carefully disassembling others.

 

Re: New therapy from PDoc - can anyone explain? BirdSong

Posted by garnet71 on June 12, 2009, at 18:24:25

In reply to Re: New therapy from PDoc - can anyone explain?, posted by BirdSong on June 11, 2009, at 23:46:05

You know alot about this stuff BirdSong (I always want to call you SongBird...lol)

Thanks, I looked it up, it seems he was doing psychodynamic therapy. I never really took the time to learn about the different types of therapy. He didn't tell me yet how he'd be treating me-he said that would be after history. I guess he has to first decide whether or not I am a candidate for that type of therapy--to see what my issues are, and to see if I 'take' to him.

I realize this is the type of therapy I need-yes, it is wonderful (fun? lol). You are right about the insights--I have a load of them from the past 2 days now that I have composed myself! Insights that articulate things I've wondered about, but never knew (like my defense mechanisms), especially how I just compartmentalize scary emotions. I realize now I just put them aside somewhere, and never look back...when I felt the anxiety wanting to emerge after talking to him, the different type of anxiety I just noticed, I realized that's exactly where it comes from. I think I have 2 types of anxiety though. This one comes from my spleen area, I felt it and knew it was there, this is the one I've had forever; so odd that I have a place in my body that refers to it. I never noticed this before.

I'm fascinated with this whole thing. I've never felt transferrence like that with anyone, rarely felt strong emotions with any therapist before.

But he was only "getting my history", so it's strange I took to him so quickly. I think part of it is that I feel 100% trust in him. I already had preconceived notions about him before we even met. His son, also a doctor, left a lasting impression upon me (2 years or less ago). I realize he is not his son, but the whole situation led me to the father. I'm so lucky I found him and I believe his is very skilled and he has been a psychiatrist for 40+ years, so very experienced.

Yes, so exhausting. And I bombed my first assignment today-3 weeks into the semester. Bombed it really bad. I've had it all together, so far, despite panick attacks and anxiety. I'll have to talk to him about that. No disassociation though.

Question: I know when I see him next week, he's going to ask me how I felt about last time. So I'll have to tell him I feel a strong attachment to him. Do you think he'll say he can't treat me because of that? I'm just afraid he's going to say that while I think this is totally what i need. I cannot not tell him. I can't even think in the room with him. He called me back about my concerns and didn't say much. He said we went through a lot, and we will see how it goes next time. The word 'reassurance' keeps popping up in my mind. I think that was the motivation behind my calling him. I crave reassurance from him.

How long have you been in this type of therapy?

 

Re: New therapy from PDoc - can anyone explain? Phillipa

Posted by garnet71 on June 12, 2009, at 18:25:19

In reply to Re: New therapy from PDoc - can anyone explain? garnet71, posted by Phillipa on June 11, 2009, at 21:10:15

I always wanted to try accupunture too Phillipa! I highly doubt that is what I need though. lol

 

Re: New therapy from PDoc - can anyone explain? sassyfrancesca

Posted by garnet71 on June 12, 2009, at 18:29:25

In reply to Re: New therapy from PDoc - can anyone explain? garnet71, posted by sassyfrancesca on June 12, 2009, at 12:45:13

thanks Sassy. I don't want to lead anymore. I'm tired of it. But it was only our second appt; i'm sure he'll realize this when we discuss my reaction. I'll certainly bring that up, but I do trust his judgment.

 

Re: New therapy from PDoc - can anyone explain? Dinah

Posted by garnet71 on June 12, 2009, at 18:45:36

In reply to Re: New therapy from PDoc - can anyone explain? garnet71, posted by Dinah on June 12, 2009, at 14:40:42

Thanks for talking with me, Dinah. What do you mean disassembling functions? How could he go about doing that from just talking about my history for 45 minutes?

Although I couldn't process thought at the time, I felt like he put a wall in between us, despite feeling overwhelming emotions that were repressed. An invisible wall that had somehow become visible to me--I can almost see it. But I felt like HE did it and not me. But if he put a wall between us, or if I did w/o knowing it, why would I feel overwhelming emotion? Does that make sense? He had a short and tiny coffee table between us-I was sitting on the couch, and him on a chair directly across from me and facing me. I wonder if he somehow positions things that way to get an effect.

Now I understand why you guys talk about this stuff all the time. lol

 

Re: New therapy from PDoc - can anyone explain? garnet71

Posted by Dinah on June 12, 2009, at 19:28:39

In reply to Re: New therapy from PDoc - can anyone explain? Dinah, posted by garnet71 on June 12, 2009, at 18:45:36

I tend to experience the blank slate approach as a wall of sorts. I'm not sure if that's how I am supposed to feel it. I know I'm very sensitive to any screen or wall or distance with my therapist, but I tend to appreciate it with some of the therapists I've consulted with for a particular reason over the years.

I'm not overly familiar with the terms, but I think the idea behind psychodynamic therapy is that we've built up defenses against old pain that cause us problems in life. The therapist deconstructs the defenses to reach the pain, and help build healthier defense systems. But good therapists make sure that the client is not so totally stripped of their defenses that they aren't able to function. It's been a while since I read psych books, so I can't remember the right way to put it.

I do know that my therapist was careful to build up coping skills, relaxation techniques, etc. and tried to pace the therapy so that it didn't outstrip my ability to cope with my life. There were times when it didn't work so well.

 

Re: New therapy from PDoc - can anyone explain? Dinah

Posted by Phillipa on June 12, 2009, at 19:45:01

In reply to Re: New therapy from PDoc - can anyone explain? garnet71, posted by Dinah on June 12, 2009, at 19:28:39

Dinah how long's the drive from Charlotte to New Orleans think I need your therapist. Love Phillipa

 

Re: New therapy from PDoc - can anyone explain? Phillipa

Posted by Dinah on June 12, 2009, at 19:48:13

In reply to Re: New therapy from PDoc - can anyone explain? Dinah, posted by Phillipa on June 12, 2009, at 19:45:01

His style wouldn't be right for everyone, but I suspect you would find him helpful.

I wish I could share. Well, as long as I didn't know about it. I prefer not to think too much about his other clients. :)

 

Re: New therapy from PDoc - can anyone explain? Dinah

Posted by Phillipa on June 12, 2009, at 20:04:03

In reply to Re: New therapy from PDoc - can anyone explain? Phillipa, posted by Dinah on June 12, 2009, at 19:48:13

Dinah I won't tell. Just have looked to much here. Good thing Charlotte wasn't in you plans a few years ago. Horrible here. truly it is. Love Phillipa

 

Re: New therapy from PDoc - can anyone explain? Dinah

Posted by garnet71 on June 12, 2009, at 20:18:44

In reply to Re: New therapy from PDoc - can anyone explain? garnet71, posted by Dinah on June 12, 2009, at 19:28:39

Oh-I found out all about it-it's called self-disclosure now. It's used either for specific results or by more conservative analyists to avoid unplanned counter-transferrence and violation of patient boundaries.

http://www.psychservices.psychiatryonline.org/cgi/content/full/52/11/1489

I haven't had the opportunity to give him feedback yet, other than a quick call, so I'm sure he'll adjust his methods-pace, etc. accordingly. He's probably just trying to get a feel for my response and all, which I didn't yet have the opportunity to convey.

Thanks--I would have never learned this had you not said anything.

 

Re: New therapy from PDoc - can anyone explain? garnet71

Posted by Phillipa on June 12, 2009, at 21:02:28

In reply to Re: New therapy from PDoc - can anyone explain? Dinah, posted by garnet71 on June 12, 2009, at 20:18:44

Garnet boy it's expensive to join and get copies. Phillipa

 

can someone tell me how they felt -experience

Posted by garnet71 on June 13, 2009, at 20:18:04

In reply to Re: New therapy from PDoc - can anyone explain? garnet71, posted by Phillipa on June 12, 2009, at 21:02:28

I realized what happened and am really blown away by this whole thing, so I just want to hear from someone that's been there, done that.

Now that I've processed this whole thing, I understand what happened. So new PDoc dissasembled all my defense mechanisms and regressed me to a child. I think I was about 4 or 5. I felt emotions I never consciously recognized. I felt like a vulnerable little girl. And I remember making these childlike movements, while I could not think, only feel, while he watched me. I felt like he removed my ego and exposed the unconscious part of my mind.

My defense mechanisms were intellectualizing everything that's happened to me all these years, and never feeling any of the emotions. I realize I never felt any bad emotions from childhood trauma-since I can remember. That's my defense mechanism. Also making humor out of all of it. All I remember 'feeling' as a child was feeling like an adult.

I am so fascinated and shocked because nothing like that ever happened to me before. I did not know another human being could to this to another person. I though I was just narrating my history of childhood trauma. lol.

Can someone just write-someone who had experienced this? It's so powerful but I'm still a bit confused. If I don't remember emotions, how could I know this is what I was feeling? I just know, but I can't explain rationally how I know.

And-am I going to feel dependent upon this doctor forever? I feel so needy with him. I am so attached. What happens when he decides to retire?

I already knew this was meant to be before I even met him.

 

Re: can someone tell me how they felt -experience garnet71

Posted by antigua3 on June 14, 2009, at 11:14:30

In reply to can someone tell me how they felt -experience, posted by garnet71 on June 13, 2009, at 20:18:04

You're going to be OK. Repeat over and over again.

It's amazing that you realize this after such a short time with him. You must have been really ready for this.

While it may feel like how could this be? it can be. You can regress like that and tap into the exact feelings you experienced as a child. Often they come about through flashbacks, but you seem to have been able to let them surface more neutrally, which is a great thing. Don't doubt the feelings, just recognize them and feel them because as you said, you've been intellectualing and using humor to keep them at bay.

Maybe you will experience transference with this doctor, maybe you won't. Try not to worry about it yet. Try not to put up those defenses yet. Your pdoc seems very skilled at dismantling your defenses, but remember to hold onto your self, too, and make sure you have adequate skills in place if tearing down your defenses becomes too anxious for you.

If you do experience transference, you will get past it. I know this from experience. It's not easy, but for some therapeutic orientations, it's a natural part of the the process and you will have your doctor's help getting throught it. Trust, for me, has a lot to do with it.

Just try not to get overwhelmed by the whole thing, although that is easier said than done.

I'm just so impressed at the immediate progress you've made.
antigua

 

Re: can someone tell me how they felt -experience antigua3

Posted by garnet71 on June 14, 2009, at 18:41:05

In reply to Re: can someone tell me how they felt -experience garnet71, posted by antigua3 on June 14, 2009, at 11:14:30

Thanks antigua, you are sweet :) I think I need my doctor's reassurance, similar to what you said.

The transference is so overwhelming, I can envision a concrete physical manifestation of it as it takes me over. I also could envision a physical manifestation of the wall he put between us because of his self-disclosure style and also have a concrete picture of my unsciousness being exposed. Did that ever happen to you? Is that normal?

Yeah, I'm so ready-I can't wait to go back. I'm so intrigued by all of this. Not overwhelmed anymore-just fascinated. i don't want to hold onto myself though, just want to let everything go. I trust him completely.

I'm afraid that when i tell him about the overpowering transference, he will say he can't treat me.

 

Re: can someone tell me how they felt -experience

Posted by backseatdriver on June 15, 2009, at 8:38:57

In reply to Re: can someone tell me how they felt -experience antigua3, posted by garnet71 on June 14, 2009, at 18:41:05

You know what? I'd tell him about the transference. I am absolutely sure that he knows what it is like, and what to say and do about it. This is also a good moment to evaluate *him* a little. He should make you sufficiently comfortable with the feelings so the work can proceed, and he should be able to help you use the feelings to deepen the work that you are already doing.

Congratulations on your progress!
BSD


 

Re: can someone tell me how they felt -experience garnet71

Posted by antigua3 on June 15, 2009, at 12:31:07

In reply to Re: can someone tell me how they felt -experience antigua3, posted by garnet71 on June 14, 2009, at 18:41:05

Yes, I've felt that concrete wall, but I've learned that most of that wall was put up by me and not him. He does play a role, but I tried to keep him at arm's length as long as I could, but that wall is crumbling. It's scary and very painful for me, but it needs to be done. He's not the warm and fuzzy type, either...

A good therapist knows about the overpowering transference and recognizes that it is a huge part of therapy. Yours really should understand this, with all of his years of experience. But, of course, nobody can predict what another human being will do, but I would tend to think you'll be OK. I really hope you'll be OK.
antigua

 

Re: can someone tell me how they felt -experience

Posted by garnet71 on June 15, 2009, at 16:49:04

In reply to Re: can someone tell me how they felt -experience garnet71, posted by antigua3 on June 15, 2009, at 12:31:07

I am going to tell him all about it. I also think he did all that last time to induce the attachment, so yes, I'm sure knows all about it. I'm really awed by it all.

So its up to the patient to remove the wall? I don't see how that could be possible with the blank state, but you had me interested in thinking about the possibility..

Do you guys call your T in between appointments? do they usually encourage that w/this type of therapy?

Well I'll find out this week if he will decide to treat me or not. I think this was a preliminary assessment.

It was interesting how I was just giving him my history but all this stuff happened and I gained so many insights. And after I left his office, I had new types of anxiety and could also picture it concretely like all the other emotional feelings. And the anxiety turned to grief and left my body, and that I even knew it turned to grief is really interesting.

did you ever feel that strong ache in your solar plexus when someone you were close to has passed away? Well what started out as anxiety and strong chest pains turned into that ache, that feeling of grief, then left my body. Maybe if this keeps happening I will rid myself of anxiety permanently.


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