My Support Forums - View Single Post - For those of you whom have been hurt by the therapist you're attached to...

Calilady · Jul 11, 2017, 12:44 AM

So, in the mean time of making my decision about whether to return to my T or not (I have a Friday appointment), I purchased his book, titled, Attachment To Your Therapist: A Conversation (by Jeffrey Smith). I'm on the third chapter and this passage stuck out to me. It makes it all the more confusing if I am to return to the lone therapist who has brought about feelings of attachment (I'm usually rather aloof)...

I'm afraid that in making an error, inspiring guilt and shame in me as I walked out of the door at the end of our last session, that I'll return to a less empathetic response. There is a fine line here. I'm afraid that she may not know what she's doing and her impulsive speech is inciting and activating things from my past, but will be met with a less than ideal response by her.

How do you feel about the article below? Any comments?

Quote:

Let's go back to the complex moment when M's mixed feelings might intersect. Her therapist calls to say she is canceling a session because of a family emergency. I am guessing that M feels a sudden pang of disappointment, hurt, and anger. At the same time, she feels concern for her therapist. Is she OK? Has something terrible happened to her child? Will the child be OK? Will she be available to help me?

This is not YET a therapeutic moment. According to my guesses, two things take away the likelihood of transformation at that moment. First, there is no time or place for M to linger with her feelings, even for the few seconds or minutes that catharsis requires. This is not a time for new learning but a time for coping with a jumble of feelings. Second, M's conscience says she should be a "good person" and suppress her selfish feelings when someone she cares about is in need. Quite automatically, M shuts down her feelings and stuffs away her disappointment. The opportunity for transformation is not now.
At their next session, let's say M's conscience has relented enough for her to feel her self-centered feelings. She is feeling hurt and anger at the same time that she is feeling empathy for her therapist. Suddenly she realizes that this bitter-sweet mix of feelings is not new. The many times her parents had to attend to her sick sibling while she was neglected (this is my imagination, not M's report) come to consciousness. Now the intensity of the hurt and anger are there for a reason. It is not that she is selfish and immature in wanting her therapist all to herself. Rather, the therapy has brought to the surface some important unfinished business from her past, the inevitable result of her sibling's illness.

Let's focus on the anger. M states that she feels anger towards her therapist at first. But it really doesn't fit, because the therapist did no wrong. This might be what we call "displaced" feeling. It is the right feeling directed towards the wrong person. At least the feeling is active, but without the original context, it can't heal. Then with the realization that she has felt this before, M is able to connect the feeling within the right circumstances. The therapist now provides a safe context in which to feel the anger of a child who has legit needs independent of the sibling's illness. In this new context, the feeling can heal in the same way traumatic memories do. The neural network of anger at parents gets "wired together" with the one representing that it is safe and OK and understandable to feel such things, even when a beloved sibling is sick.

The old association of anger with being "bad" is rewritten and the anger begins follow a natural course of healing. The same goes for the feelings of pain and loneliness when the therapist disappoints. That pain heals by catharsis just like the pain from trauma.

This is how the therapeutic relationship heals. At first the feeling is towards the therapist, and may be uncomfortable and threatening. As the therapist encourages exploration of what is happening, the feeling heals a little and becomes more safe. With safety, the mind is able to furnish the original context involving the parents and sibling or other earlier experience. Now, the therapist is able to serve as a comforting and empathic witness. Those are the conditions for catharsis: Feelings being activated with their original details in a newly safe and empathic context.

There are still a few important points to clarify. First, there is some misconception in therapist circles that having a healthy relationship with your therapist constitutes a "corrective emotional experience" and will heal you. Having a nice therapist who doesn't have children or conflicting needs is not enough for healing and growth to take place. The reason is that "niceness" tends to reinforce or suppression of shameful, immature, or problematic feelings. When feelings are suppressed, catharsis can't take place. The troublesome moments in therapy, whether they involve feelings about the therapist or some other difficult emotions, are the ones that can bring us to a cusp where there is opportunity for transformation.

Second, let's not mix up intellectual clarity with empathic understanding. "Mindfulness" doesn't mean gaining an intellectual perspective. It refers to an emotional sense of being understood and accepted, or perhaps acceptable. It is true that the therapist often has some wisdom about the situation and can share that with us, but the thing that makes for catharsis is the fact that the therapist is in tune with our intense feelings but not overwhelmed by them. It is the therapist's calm empathy that activates neural networks representing safety. Intellectual understanding alone doesn't necessarily mean empathy. Furthermore, "intellectualization" can and often does facilitate suppression of feeling, which, as stated above, means catharsis can't take place.

Finally, what about feelings that come up when the therapist actually does something wrong. Therapists can make mistakes and do have counter-transferences. They can be caught unaware of their own emotions and can say or do things that are not in the patient's best interest. If the error is not so grave as to end therapy, then there is still work to do for both the therapist and patient. Forgiving, too, involves the process of catharsis, whether we are forgiving a therapist or anyone else. Once again, there is a cusp between the feelings of hurt and anger that have been aroused by the error and feeling the therapist's empathy with our hurt.

Now the complicated part. Much of the time when a break in attunement is due to a therapist error, it also arouses feelings associated with unfinished business from the past. Just because the therapist has participated in creating the problem doesn't mean the feelings all stem from the present. It is likely that there are also feelings from the past piggybacked on top of the present ones. How can you tell? When the feelings are out of proportion to what has happened in the present, it usually means that something from the past was activated as well. Unfortunately, in situations like this, when the therapist's role is not error-free or "clean" it is much more difficult to sort out feelings come from where. The rule is this: Therapist and patient will have to first sort through and heal the problem in the therapeutic relationship before clarifying what comes from the past. Only then, when here-and-now feelings are no longer intense, is there a chance to identify and address what comes from the past. If clarity is not possible because of the murkiness of the situation, dealing with feelings from the past may have to wait till they are activated again under circumstances that are less confused.