My Support Forums - View Single Post - Dear T: I Really Need to Tell You Something...Part XXXIV

Lemoncake · 02:18 PM

Dear T,

Maybe you should refer me out to someone else or I should split the transference .

Quote:

Often, in early assessments, someone with a borderline trouble brings a false demeanor. They're on their best behavior. So you start a therapy without knowing what you're getting into. Then something goes wrong, and they need an extra session. And then another. The therapist sees it's too much, but doesn't know what to do. And sometimes they just go with it. But more becomes much less. There is an escalation of the craziness but nothing useful happens. It's as though the therapist is supposed to meet every need, and of course, they can't and shouldn't.

If one person in the patient’s life has become so important that you’re going to feel so devastated when they leave you, you’re always in danger of destroying the relationship you most need, as these escalations often do. In therapy, that’s transference — transferring to the present something about the critical relational moments from your past. We’re fortunate here in that the intensity has a chance of being managed through the clinical team.

Eventually, if things go well, the feelings do get centered on the therapist, but the therapist must have help with this. For a while, the intensity of the transference can be distributed — to the nurse, who bridges the gap between therapy sessions and manages troubles between peers; to the internist, who manages the patient’s physical health; to the patient community. And the patient’s psychopharmacologist is also helping to take the edge off of the most intense feelings. So you have many people bearing bits of the feeling, and the patient begins to feel safe. The eggs are not in one basket, so to speak, and if one part of the human environment is endangered by the patient’s intensity, there is always another, who can help both the patient and the other staff member.

But more than anything I wish I was physically sick with an illness that could be quantified by a simple lab test. I'm so tired, in a lot of pain and so weak in this need for you. Is that therapy?