It sounds like it was a really crappy session.
When I began reading this, I suspected being on Skype has something to do with this dynamic, as you mentioned things went sour after starting Skype. Without the eye contact, I think opportunities for missattunement (on both ends) are much more frequent.
Quote:
At first she did not want to give therapy by Skype or call but after one or two crises there she agreed to do it by audio call. That’s when things seemed to break down a bit - I found her dismissive about one of my concerns and slightly patronising over another. I discussed this with her and she said when I was away she became more directive and that she would be more aware of this in the future.
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I couldn't make much of the situation without understanding this. What does she mean by becoming more directive? Is she saying she changed her therapy style? Was she more passive before? What does being more directive look like? I am stumped.