Does your T have rules... (Trigger maybe)

Hi i have another question for you all. My T used to let me discuss anything i wanted in our sessions. Now she has a new rule. I am not allowed 2 talk about when i want to or have cut or made myself puke. She says it is old news to her and i am not the only patient she has that does these behaviours. She wants to know what feelings are underneath the behaviours. I told her that I thought she would want to know when i was doing these things. She said no, If i say I feel like cutting/puking it tells her nothing because feeling like cutting and feeling like pking are not accurate statements because they aren't feelings just actions. All she knows from that is that i am not ok and not doing well. In not telling her i don't think she will ever know the frequency or severity that it is happening. Given that she ran an eating disorder clinic for sseveral years i don't understand why she wouldn't want to know when I am doing any of these things. Do any of you have a T that has rules like this? similar or not? Any ideas why she would start this rule after 7yrs of letting me talk freely about anything? Any feedback would be appreciated, Thanks

That does sound odd... I do understand that she would rather focus on feelings rather than just the fact that you did or wanted to cut or purge, but the way she went about it seems a little off.

Like it is old news for her and she has other patients who do it? Did she really say something like that? How have you been getting along with her otherwise? Aside from this instance, what is your general opinion of her?

Like it is old news for her and she has other patients who do it? Did she really say something like that? How have you been getting along with her otherwise? Aside from this instance, what is your general opinion of her?[/quote]

She really did say that. Other than that we get along reeally well. She has been very helpful to me for the most part and i have been seeing her for over 7yrs and continue to see her.

The only rule my therapist has is that she has agreed to keep seeing me as long as I agree not to kill myself. Seems like a rather odd rule if you ask me, sort of hard for her to enforce.

My T hasn't made that rule, but he has said something similar and if I talk about self-harming urges, he does not linger to discuss that, but moves on to focus on the feelings. He has even said something like "Knowing you want to cut doesn't help me as much as knowing what you are feeling and thinking." I think this approach is not uncommon.

I wonder, though, if you might feel pushed to have these behaviors more right now to 'prove' you are in need of help? Sometimes I have felt that way. Maybe it would be helpful to have another conversation with your T about *why* you want to talk about those urges and actions. Her rule will only help you if you both are on the same page, so to speak.

Hang in there, it sounds like you both are invested in this therapy and trying to help you.

My first thought was that she may be trying to change your behavior. Not acknowledging the behavior in order to stop you from acting out. If she were to talk to you about the behavior it would be a positive reinforcement and therefore you may do it again.

Did I express myself alright?

yeah, it sounds like she's trying to get you to use descriptive words that actually describe how you feel, not what you're going to do about it

This is common in DBT or CBT. In other words, the T does not permit discussion of the behavior once it has occurred. You can discuss your feelings, thoughts, plans, etc before the behavior, but once you have acted, it can be seen as trying to gain sympathy and not using your skills or whatever you have learned to help avoid the behavior.

What she is doing is forcing you to look at the feelings and stop focusing on the behaviors. You are ignoring the reason for your behaviors and she is trying to stop you from focusing on the act.

Some studies have shown that when the focus on the act is removed, the behaviors improve. For example, a T no longer pays attention to the "acting-out" so a client has to get satisifaction from the T another way... by talking through the feelings.

good luck. try journaling.. it helps with feelings.

from a client stand point my therapist did start making rules like this, her reasonings were why bring it up if Im not going to address why I do those things and the feelings from before, during and after it. Bringing it up and then not discussing those underlying things was telling my therapist I was just telling her to brag about it, She demonstrated by hiking up her sleeve and saying "hey look at me, look what I did, I got your attention now dont I"

I got the point real fast. therapy is for working on feelings not just the fact and sight of what I was doing. and cutting and other self harm behaviors were not meant for doing just for attention because there is the threat of very real danger.

she also informed me the next time I did something like that - cut, brought it to her attention then dropped it by refusing to discuss feelings and all she would have no recourse but to hospitalize me, because that kind of thing needs more intensive treatment than outpatient can give at that point.

After that any time I did self harm I had to be prepared to discuss it fully feelings and all or not bring it up at all. therapy is for working out my problems and if I wasnt prepared to do that t hen there was no sense in bringing the issue to my treatment providers attention.

From a treatment providers point of view I do agree with my therapists actions and have since worked with other mental health agencies that carry the same boudary. the crisis center where I work now uses the internet as an example of this with their clients.

being a therapist and a client comes in all cut up saying I did this and then not discussing feelinngs and all that the cutting entailed is like being on the internet when someone comes on and posts a suicidal thread.. everyone in the on line group is left feeling helpless because theres nothing they can do and it upsets those that have developed a relationship with that person who is actively suicidal. When someone tells a therapist they cut then slams the door shut the therapist feels helpless and has no other recourse but to either place boundary's of no bring that up or hospitalize the person. the therapist cant force a client to deal with things but they can say hey, if your not ready to deal with this then dont tell me what you did, I dont want to know unless you are ready to work on it.

Thank you all for your feedback and support. I really appreciate it. I did talk to my psychiatrist about it again when I saw her yesterday.

OMG i dont think i will ever let my T know i hurt myself this all seems so harsh