Hi Freewill,
A T who doesn't hear your pain sounds kinda useless. T is being paid to hear you and help guide you into avenues of healing. Sometimes we have to move on if we no longer feel we can communicate with or learn from our T. Sometimes they also wear out or lose their edge with us and it shouldn't be a bad thing for either side to change if it stops being Theraputic.
Have you been with him the whole 23 years? That's a long time. He may have stopped "seeing" and "hearing" you from over-familiarity. That is not saying anything bad about him or you, its just people.
If he isn't listening and keeps pushing things over and over without accepting what you are trying to say....something is off and needs to change. Don't let fear or familiarity keep you with someone who is no longer a benefit to your healing process!
Leslie and the Pixies