I was sorry to learn that you are tired of holding the responsibility for my mental health. I was not aware that this dynamic was present in our therapeutic relationship. It hurt to hear you say that.


I feel angry, in part because that’s my knee-jerk response when I feel hurt, and in part because a part of me is going, “isn’t it a therapist’s job to hold some of the responsibility for the mental health of their patients? How was it therapeutic for him to share his resentment towards me? Isn’t this why I am paying this man so much money, much of which is not reimbursed by my insurance?”


Maybe there’s something I can learn here about how to be in relationship with someone when I feel hurt by them (i.e. how to maintain one's sense of self when the other reflects something other than complete approval).


(As an aside, I can’t help but wonder if there’s a part of you that is trying to get me to fire you so that you can get rid of me without having to endure any guilt related to initiating termination yourself — like you’ve said to me before: you’re intelligent; you knew how that comment would land with me.)


I think you were getting at the fact that you continually re-direct me to discuss the difficulties that come up with my BF. Maybe I’m not ready to do that work? Maybe that work is difficult for me because I have BPD? I heard you say that this latter explanatory model is a “cop-out,” but I’m not so sure. Do you get to be annoyed at me for having the very problem for which I’ve come to you for help? Do you get to tell me that there is a right and wrong way to engage with therapy, and that I’m doing it wrong? Christ, T; I’m doing the best I can.


Or maybe I just don’t know what the hell to do with the advice that you give me. When you say things like, “it is important to be curious,” or “you have a habit of engaging in black-and-white-thinking“ I hear and understand those concepts but don’t know how what to do about them I do not feel curious about areas of vulnerability in my relationship with my BF because those areas feel scary and threatening. I can't spontaneously generate curiosity — I know this from my time as a medical student; some topics are just not inherently interesting and I can’t make myself feel interested in them no matter what I do. When I felt like this in medical school, I’d force myself myself to engage with these topics anyway by erecting external scaffolding, creating structure. Should I set a reminder on my phone? Pause at the end of the day and write down three things that went badly in my relationship with my BF, three areas in which I engaged in black-and-white-thinking? I could sit down and make a list about all of the things I like and dislike about my BF and bring that list to session? I am not being sarcastic here; I literally do not know what the f*** to do.


I feel quite bad. My limbs feel leaden and I want to cry all the time. I am trying not to fall apart because my BF doesn’t understand why a disagreement with my therapist would make me so upset. Maybe it shouldn’t. Maybe he should f*** off. I don’t know.