T threatened termination

I haven't been posting here lately - things were just too overwhelming for me for a while. But recently I've been lurking and reading and keeping up with everyone. to you all!

So.............I got dumped by my last T who thought I was 'malingering'.
(I'm not!)

She referred me to my current T who I've been seeing since July.

Last night during therapy, after a conversation about my ED, this T told me that if I didn't want to 'give up' my ED, then she would respect that decision and would terminate sessions with me until I decided I wanted to get better and then I could come back and see her.

I felt so scared when she mentioned terminating sessions, so I back-pedaled and BS'ed my way out of it.

But now I wish I would have told her about how scared, angry and hurt she made me. I wish I would have gotten up and walked out.
I don't want to go back. I don't want to talk to her about this.

I got home and told my H what she said, and he laughed and said, you're getting the boot from ANOTHER T????

How is this possible? It is true that I've been more WILLFUL lately than WILLING (DBT terms) but, aren't T's supposed to work with people to HELP THEM want to get better and give up maladaptive behaviors?
Is it me? Or the T's I've been seeing?

((((((((((((((((((((((((ktgirl))))))))))))))))))))))))))

wow, super sensitive response from your hubby. *hugs*

Wow, the husband comment was really bad!

I don't know how therapy for EDs work. Is there an agreement that unless you try to get better you will stop therapy? Was this news to you? Did you sign a contract to try to stop your ED and your T feels you are not holding up your end of the bargain?

"Malingering" is really different from not trying to get better. Malingering is when you are really better but you pretend you aren't. But your new T seems to think you really do have an ED but just don't want to work on it?

I don't know. It doesn't sound therapeutic or effective to me. How will stopping therapy help you with your ED? Do you think she feels frustrated because she has been unable to help you and so wonders if your problem is outside of her ability to help? When this happens, a T usually will refer you not terminate you.

Maybe it was not a good idea to get a referral from your old T. Maybe your old T's approach did not work but the only Ts she knows take a similar approach so you just got "more of the same"? Would you say these 2 therapists follow a similar treatment plan?

I think it would be really helpful if you had a frank discussion with your T and asked her those questions. If you don't understand the treatment approach, it will be hard to get better.

is this a therapist that you like and want to continue working with? do you want to get better?

if the answer to both of those questions is yes, then i agree you should probably talk to you therapist about whats going on and come to some sort of plan for your treatment.

Can you ask T why she is wanting to terminate you? I know that ED's are difficult for most people to understand, because most people love eating and are overweight! H. sounds like a sensitive sort. I'm sorry you are going through all this. My pdoc wanted to terminate me at one time, but it was a misunderstanding. Perhaps you can clear this up. Best of Luck and Blessings to You ~ billieJ

(((KT)))) You got some good responses. I agree that if like this t and want to work with her that some questions would be in order.

I cannot imagine that an ED therapist wont work with someone who they have only known since July and terminate b/c she has not decided to get better. Sounds like ths could be more of the same in terms of someone not knowing what to do with an ED. I do believe that not everyone can handle ED clients.
If the situation is just as you said, that she told you to decide to get better first and get therapy from her later, Id run for the hills. EDs are notoriously resistant to "getting better." That is what the help is for

Keep us posted.

((((((ktgirl)))))) I know how you feel. My old Pdoc told me if I attempt suicide again that he would terminate treatment. I didn't understand at the time but he used my attachment to him to save my life. I think that T's sometimes give us ultimatums in order to save the treatment and possible our lives. I also have an ED. But mine is in check right now. I think that your T may have talked about termination to get you to stop harming yourself.

Just my 2 cents worth. Keep your head up.

A threatening T?
A T who is a different orientation would not threaten to terminate. If you have to change T's you could research types of therapies and therapistas at www.guidetopsychology.com.
My T is a psychodynamic/psychoanalytic psychotherapist, and I chose this kind of therapy after researching. In this kind of therapy, the therapist would not threaten to discontinue therapy. There is always something to talk about, always something to explore. You will work through things at your own pace. If you are working on changing something like an ED, you will talk about ED, about what you think about it, what you think about in continuing or discontinuing it, how it makes you feel.. There is much to explore.

KGal, Echoes is spot on. Also what I felt as I read your post was that more than the actual events that took place, ie T acting like a critical parent, and husband acting like an non caring father, that perhaps you feel you have no options but to become helpless and powerless, i?? So these things have happened, what can you do about them?? You can tell you husband not to be so uncaring and grow up and you can go find yourself a therapist that will work with you and not expect you to jump through their hoops. These are things you can do, you can't change them but you can change you, you can break your own pattens and allowing others to drown in their own. Good luck.

The more I think about this, the more uncomfortable it makes me. It seems like by threatening to terminate you, your T is setting up a really unhealthy dynamic in your therapy. Unless you engage in behaviors that please your T, you will be dumped. I can see that would make a person very scared to be their true self in therapy, and to share openly about what they need help with. There would be this pressure to toe the line or else get dumped. I don't think that is good for the relationship at all, and not productive for your growth either. It does not sound like a good situation. I hope are able to talk about all this freely with your T.

Thank you all SO MUCH for your responses and thoughts.
I feel encouraged.


No, we have never made an agreement, or a contract.

I've been in treatment for it twice for my ED (hospital and residential). -the last time was in June/July. I was really motivated when I got out of residential, but now I am really struggling. I told T that now that I have a full-time job which I start in 2 weeks, my H will not send me back to treatment no matter what, so I am tempted t totally give up on recovery. (yeah, very willful)
That's when she said she would respect my decision but would terminate treatment.

I AGREE with all of this. I think maybe she did feel frustrated. I don't really blame her......and I guess I wouldn't blame her for not wanting to work with me. She never mentioned referring me. It seems she thinks unless I want to get better, any kind of treatment is useless.

[quote=sunrise;1159857]
Maybe it was not a good idea to get a referral from your old T. Maybe your old T's approach did not work but the only Ts she knows take a similar approach so you just got "more of the same"? Would you say these 2 therapists follow a similar treatment plan? [quote]

You may be right about this, but I really didn't have a choice about using the referral from the last T. There aren't a lot of T's in my area that specialize in EDs. My old T was psychoanalytic with a splash of EMDR, which we never got to try b/c I was never 'stable' enough.
New T is majorly CBT, with a bit of spiritual counseling thrown in.
So really different treatment approaches. I am starting to really think it must be me....hopeless.

Yes, you are right. I know you are right, but my first instinct is to shut down and run away....if she doesn't want to work with me, I don't want to work with her. (immature, I know)
I will seriously consider this, though. Thanks for your advice Sunny.

I don't know if I want to continue working with her.
I'm not crazy about CBT, but I kind of feel like there's no other option. She's my 3rd T since last year (besides the ones I've had in treatment), and there aren't that many that specialize in EDs around here.

Ahhhhh - that is the million dollar question.
I kind of compare my ED to alcoholism or smoking. Yes, I want to give it up....but it is SOOOOOO hard to do it. I need the "fix", just like someone needs a drink or a cig.
So a big part of me is saying I'll give it up next week, or next month.....I just need to be at "such and such" weight, and then I will stop. It's like an obsession, no matter how low it goes, always wanting to see a lower number.
I'm sure that's part of T's frustration.

Thanks BillieJ.
She said she would terminate because I am not making the right choice, that is to give up the ED. I guess she has a point, what is she supposed to do if I refuse to be open and willing, if I don't even have the slightest motivation to recover. She asked to talk to the "healthy part of me", the part that does want to recover. I told her.... that part doesn't have too much to say these days.

Blue Moon said: I agree with you Moon! And she has always seemed to understand the difficult nature of EDs. She has even said that most T's will not take ED clients because they are so difficult to treat. She told me about one of her client's who said her total identity was the eating disorder, and she felt like if she gave it up she would cease to exist. My point is, T sounds like she has a good understanding of all of this! I think that's one reason why it is hard for me to not take it personally.

Emily Jeanne said:
Thanks for sharing this, Emily. It is interesting that you had a similar experience. I am particularly struck at what you said about pdoc using your attachment to him to save your life. I'm glad that his approach worked for you (and VERY glad you didn't complete the sui)....how long were you seeing him before he threatened termination? I've only been seeing my T for 3 months and I wouldn't say I'm 'attached' to her yet. But for some reason I am scared she won't see me anymore....so maybe she is trying for the same result your pdoc got. I just have really mixed feelings about it right now.

ECHOES said:
This makes a lot of sense to me. Thank you for your input Echoes.
I agree - there is a lot to explore. And it makes me wonder why it has to be so black and white? In fact, she is always talking about 'black and white' thinking as a cognitive distortion (CBT). So why is she using an all or nothing approach here? Seems a little twisted.
I think I do prefer the psychdynamic approach, but this T seems to think CBT is the best treatment for EDs.

Melbadaze said:
Interesting insights, Melbadaze! I never thought about it that way, but I think you're right that I am reacting to T as if she is a critical parent. My mom is like this, and I am constantly trying to please her and I feel very uncomfortable if I don't have her approval. That is EXACTLY how I felt when T threatened termination. I never would have made this connection.
I'm SO afraid to find yet another T. I think the fear is because I am afraid to find another person who is unable/unwilling to help me. I am already nearly convinced that it is a lost cause, and I don't want to have it proven again.

Sunrise said:
THANK YOU for understanding so well, Sunrise! You have put it in terms that I felt but could not quite form into thoughts. I think I might be able to talk to my T about it using your exact words (if it's ok with you).

I'm sorry for this annoyingly-long post. I really appreciate everyone's thoughts and questions, and responding to each one has really helped me think things through. SO THANKS everyone!

Oh, and just a side note, I know my H's remark seems insensitive, and when he said it I was hurt and angry.
But I should have clarified that his remark was made out of disbelief and shock that another T seemed to be giving up on me, and he wasn't laughing to be mean. Once he explained this to me, it felt more like he was on my side....... he said, "is this NORMAL for T's to do this?" - he kust couldn't believe it. And he even got me to laugh about it a little bit too.

Hi KT,

I'm sorry to hear you are going through such difficulties with your t. I'm still trying to figure out why your t feels you are choosing not to get better. In reading what you wrote, it sounded like you're saying that you are taking a full-time job and dropping out of treatment. Is that what's making your t angry? Does she feel that if you really want to overcome your ED, that you would find a job that allowed you to stay in treatment? Could that be it? Sorry if I'm dense. I'm still trying to figure out why she thinks you don't want to get better after only seeing you for 3 months.

Hi Peaches - that's a good point! Maybe she does feel like I am dropping out of treatment because of the job.

Initially she was positive about the job - because she said that having too much free time isn't a good thing for humans - but it was after I told her that having this job would make it easier for me to use ED behaviors that she mentioned terminating.
I am planning to continue treatment even if I am working - the job won't interfere with that because I see her once a week in the evening and I plan to continue.
I think that is why she thinks I don't want to get better. I was honest with her, and it feels like my honesty just got me in a lot of trouble.

do you want to get better, though, (((kt)))?

it sounds like you have vague ideas of wanting to 'get better' (whatever that means), but you don't want to give up your ED behaviours and, in fact, you are assessing potentially benefical strategies to help give it up (e.g., taking up work to reduce free time) in terms of how you can continue your ED behaviours within those.

i am interested in what 'getting better' means for you, if it doesn't mean stopping your ED behaviours. i used to self harm (a LOT), and 'getting better' meant... being able to continue the self harm, but choose when i did it, not be controlled by my body continually craving it, needing it, feeding into that addiction cycle. an important thing for me to work on in order to achieve that modified goal (not quitting altogether) was being able to feel happy/stable enough to not feel like i needed it to cope emotionally.

i don't know if you address other things in therapy, but i'm confused about why you would go and invest time, effort and money into something you don't want to achieve any time in the near future.

doesn't your T "threatening" termination kind of let you off the hook? isnt that a good thing for you? it seems like good sense to me - to delay engaging in therapy, until you actually want change this stuff.

or are there other things you wanted to work on, which would ultimately make this ED easier to let go of? that healthy side of you that you said is quiet these days - is that the part that is reacting to the threatened termination?

ktgirl, in your original post you said yout T threatened termination. Your subject line even says it. Later i a reply you say....

Quote:

so I am tempted t totally give up on recovery. (yeah, very willful) That's when she said she would respect my decision but would terminate treatment.

First let me say that at one point in my therapy my T told me he didn't want to continue to see me if I wasn't going to work on the problems that brought me to him. It scared the bejeebers out of me. I completely and utterly freaked out. It brought up all my abandonment issues. It scared and angered my inner family. Once I got overr the original terror though it was VERY therapuetic for me. I had been stuck. I was talking about the same stuff every session and not making any progress. The thought that he would no longer see me motivated me to start working on what I needed to work on. It got me unstuck.

Second, therapists have an ethical obligation to appropriately terminate clients who are not willing to work on what they came to therapy for. Like deliquesce, I wonder what your definition of "getting better" is. You said you are tempted to "give up on recovery". Why would you want to continue therapy if you are willing to give up on recovery?

What does getting better mean? - I guess working toward a healthy body weight instead of wanting to waste away.

You guys asked great questions, and they are valid....why would I want to continue therapy if I am not willing to try? I think maybe I am scared of what I will do to myself if I am left with myself.

The eating disorder started as a response to trauma. The trauma took away a huge part of my life. My eating disorder has replaced the part I've lost, and I don't want to give that up now too. It feels like it would be another loss when I haven't even dealt with the first loss.

If being in therapy is the only committment I can make toward recovery right now, does it make sense to give that up too?

Or should I hang on to it with everything I have because that's ALL that I have. I don't know.

Deli and Lizard Lady, thank you for your input.
You've both given me a lot to think about.

This is an excellent comparison because they are all addictions. The best way to give up an addiction is to figure out why you are doing it and then work on that. It seems that this therapist just wants you to stop your ED because she is asking you. Well, duh!

a couple of thoughts....

How about starting your next session telling your T how you feel about the "threat" to terminate? It could be an opportunity for some great therapy.

Are you dealing with the first loss in therapy? If not, it might be another good topic to bring up to your T.

trigger warning.....



Lastly, what can you do that's not harmful to yourself that would help fill the gap caused by the loss? Again, back in the day I used to self-injure. Initially I didn't want to give it up because it filled a need for me. I found a safe alternative that got me through until I not longer needed to self-injure (used markers to simulate cuts instead of actually cutting).

Sannah - you are right! And I know why I am doing it (trauma), but my T thinks I am not ready to do trauma work until my ED is under control. It is like a catch-22, which came first, the chicken or the egg. Trauma stuff causes the ED, but can't work on the trauma stuff until the ED is better.

I think this is part of her frustration. I guess I am just an exasperating, willful, pain-in-the-***** client.

yep, you're right, I should def. talk to her about it. When I first posted this I felt like NO WAY would I ever talk to her about it. But now because of everyone's feedback I am starting to feel more like it is a possibility. I see her on Wed evening, so I have some time to think about it.

Not yet.... T thinks I am not ready to work on the trauma stuff because she doesn't want it to make the ED get worse. I think she might be willing to go there if I brought it up, but my instinct is to bury the topic b/c it is so painful. So she is not bringing it up, and I am not bringing it up, and we just stay on the surface stuff, ie, eating disorder.


Great question, and I wish I had an answer. I don't know how to get to the point where I am ready to use healthy coping skills. The ED behaviors/habits are so ingrained now and it is so easy and effective to use them.
I'm so glad you were able to find a safe alternative to SI. It must have been really hard to fight those urges. I wish I had your strength and motivation!

just a thought - but can you not do both? ie, work on the ED stuff AND do trauma work at the same time? not in depth trauma stuff, but yknow... at least acknowledge it etc.

i started doing a bit of processing with my pdoc, and of course my ED stuff popped up again. he was ok about it though, because i was getting a lot from the trauma work we were doing. he did tell me however that if i reached x weight that he would stop the trauma work and we would look only at the ED. i hate looking at the ED stuff, so it was a good incentive for me to make sure i didnt deteriorate that much. so it was like... engaging in the same control behaviours, but preventing the actual weight loss.

Have you talked about this with your T?