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Old Dec 15, 2010, 07:54 AM
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sugahorse1 sugahorse1 is offline
Upwards and Onwards!
 
Member Since: Mar 2010
Location: Kent, UK
Posts: 7,878
Just to repost the correspondence that happened between me and T, between last session and today's:
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Here is the conversation between my T and me; comments and thoughts are much appreciated. I must admit I surprised myself at being able to be so open, adn her reply surprised me positively. I think she may have skirted some questions, but that's what she has to realise herself, and deal with herself. She got angry with me yesterday about having to ask a question for a 4th time, and I was avoiding it. Now the tables are turned. I'm sure I'm not an easy patient and of all her patients, probably the one that makes her think and question herself the most

Hi,

I know your policy on e-mails, but I NEED to get this out. No, I do not think I can discuss with you face to face, but no doubt it’ll eventually get there.
Yesterday’s session was probably one of the hardest for me ever. I was looking forward to a neutralplatform to be able to talk. To be open and honest, to talk about my deepest and most hurtful feelings; to be in a safe environment, where no immediate demands are placed on me, to feel there was at least one person out there that cares. I thought 3 weeks were a LONG time for me to cope on my own. I’m not sure you understand how much I value my therapy. For the reasons listed above.
I hate feeling like a number, instead of a patient that is unique and vulnerable at the same time. I hate thinking that as soon as I leave your rooms, you forget everything to do with me,and only remember me again when you open your diary to see our appointments. I understand these are my perceptions and may be false.
I am someone who requires constant reassurance– I know you told me about the progress you feel I’ve made. But sometimes I just need to hear it over.
Your voice and presence is very comforting me– probably the reason I have managed to talk as much as I have. In the last few sessions I’ve been more and more open, telling you things that really are hard for me to say. But I’m finding this so hard. I need to feel safe and cared for, I need to be able to trust and connect with someone, in order for these deep things to come out. I really appreciate you as my therapist and can see how I’ve come on in leaps and bounds. I now feel that our therapy needs to go to another level, to really dig deep. I know therapy is painful– maybe I’ve kept coming back because the pain I was enduring was actually rather minimal. But once those issues have been dealt with, it’s time to get deeper and more serious.
There were a number of things yesterday that hurt me:
1. The fact that you feel helpless towards me– this makes me feel guilty (you’re my therapist and want the best for me, and are doing the best you can for me)
2. That you feel I ignore your advice a lot of the time (I’ve only come this far by taking to heart what we have discovered in therapy)
3. That you take me at face value– as a hard-core and angry person, when I’m actually very emotional, sensitive and soft.
4. That you say there cannot be an emotional connection (I understand the client/therapist protocol, but surely there has to be some connection to make the other open up and trust)
5. I still need to really talk about my suicidal thoughts– it continuously plays on my mind that I actually don’t have a crisis plan in place, or an understand of how to measure the severity.
You presence and voice has a very calming influence on me, and to a certain extent I feel some form of reassurance. I would really appreciate the opportunity of having a voice message on my phone (Whatever the words are) to listen to and find comfort in your voice (During those times when I cannot be in session with you) to help me through the difficult times.
I really sometimes feel you are not hearing me when I try and explain the level of pain and anguish I am in.
So, right now therapy is very painful for me. I appreciate you as my therapist; I believe I’ve made some good progress. But I am battling to get to the deeper bits.
I’m sorry I wrote such a long mail, but I needed you to know. Even if for the sake of my therapy. I want to get better, but I do need your help. I have not stopped thinking about our session, drove to see my horse afterwards and totally broke down. My stomach has been in knots and I have felt terrible. Please take my mail in the right context.
I am just not secure enough in myself to bring this up in a session– following this mail, I am actually very anxious about coming back to any session. Please consider the pain I am currently in, and how vulnerable I am.
Regards,
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Jackie,

Thank you for your email and your openness. I understand that the session was painful for you, still I feel we did some important work that we will carry on with in the next session. We should definitely discuss the different perceptions we seem to have of the sessions and our relationship to discover what is going on. It is in investigating this that our best work gets done. How you relate to me gives us important imformation about how you are relating to the world. What is called transference is essential to therapy. Transference is the attitudes toward the therapist that are transferred from earlier attitudes toward important figures in your life. These feelings are new editions of old impulses. Sometimes the feelings you have towards me are based on reality (things I have done or said) and at other times they are based on ideas or attitudes developed from other relationships. I strongly believe we should discuss all of this. I don't feel able to engage in a proper exploration via email and sms. I will bring this to our next session and believe it is an important extension of what we discussed last week. Your resolution of these feelings will be of extraordinary value to your life.
In terms of the suicidal ideation, there is no quick fix, when you are feeling suicidal, distract yourself, play music, blog or journal. if you become overwhelmed and are not able to control the impulse to hurt yourself, go to your nearest hospital. The suicidal ideation is partly due to the bipolar (which we are managing with meds) and partly due to interpersonal and occupational difficulties that result in you feeling helpless and hopeless; we need to spend time working through them, as we have been doing and as we will continue to do. Therapy is frustrating and painful but it is worth it in the end.
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Well, today's session was very different. I'd say, WOW, hard, deep, connecting, insightful, provoking.....

In response to the mails we had sent, we've now left with in the following conclusions:

1. I battle to put my thoughts into vocal words. Paper, and writing things down, I can do. So, T say that seeing as it works for me, I can work through things from the previous session on my own, and then send her a mail of what I'm thinking/feeling/conclusions I've come to... She will then use it to prepare for our next session and prompt my interaction in our session. I just need to be prompted, because I'm not brave enough to say it. But going into a session, where T knows what I want to discuss, and possibly even remember things I may have forgotten by the time I get there, will make it a lot easier. I hope to eventually be strong enough to bring these topics up on my own.

2. T asked about my request for a voice message - something to hold on to. I told her right now I felt strong enough to walk on my own for a while. She wanted to know how it would help me - to feel cared for when no one is there, to have something to listen to when I'm lonely... So, because I said I was ok for now, she said that if I felt I needed it at some time, we would discuss it again. Yay

3. In my mail I mentioned I was scared I was just a number; someone she forgot after I walked out of the room. So she was pondering whether or not to tell me, but finally did. Around the time I first contacted her to set up my first app with her, she had been considering closing her private practice, concentrate on furthering her studies (I think a thesis?!?) as well as continue her work in the state hospital. After she met with me, she realised I really needed someone to talk to, someone to help me, and not be let down/feel abandoned. So, she decided to continue her private practice, but limit it to a few clients only.
It struck me that she went out her way and CARED enough about me to make this decision.
I feel a little bit of guilt that I've influenced her life in this manner, but at the end of the day, it was her decision. And I appreciate it.

4. We've been working on me not sending her mails between sessions (Other than the scenario above) or sending her texts - her life between sessions is her life, and she has a family and other patients too - so that is basically her reason for enforcing this boundary - definitely not to hurt me.

She is working on my perceived NEEDS - they are unrealistic and cannot be met. The logical me understands this, but the emotional side doesn't. And right now my emotional side is more prevalent than my logical side.

She took everything I wrote in my mail to heart, and touched on each and every point.

Wow - I'm feeling emotional (Especially as we discussed what things make me feel cared for), right now things haven't quite sunk in, but I think my last 2 sessions have been very different, deep and moving forwards.

Am I unique in the following: T asked me today what I was feeling after every emotional point we touched on. I told her that during a session it was just like I was in a two-way lecture. Everything was just words. I remember about 1/2 of that, take it away with me, and after a while I start to internalise and feel.
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"I'd rather attempt to do something great and fail than to attempt to do nothing and succeed. Robert H. Schuller"

Current dx: Bipolar Disorder Unspecified

Current Meds: Epitec (Lamotrigine) 300mg, Solian 50mg, Seroquel 25mg PRN, Metformin 500mg, Klonopin prn
Thanks for this!
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