Too Many Missed Sessions

peaches I am just catching up. I'm sorry you're going through times of infrequent sessions. I think that is unnerving, too!

I like your T's response to your email. What did you think about it?

To me, it sounds like she's saying that she's talking about coping skills so you can feel better now, and that she is there during sessions to talk more about this, as much as you want to.

I'll also say that when I want comfort and reassurance, I don't feel it when T gives the therapeutic response like "I know it is important to you" and "Of course we'll talk about this next sesion, it's important" because what I want to hear in there is that she cares and that will always be implied, and not expressed, so it leaves me wanting.

I think you've done so well staying connected and sitting with your feelings, and articulating so well what is happening for you.

Suratji,

Thanks for understanding why this situation was so painful for me. I'm sorry that you go through similar feelings!

Rainbow,

I think I was angry, but I'm not sure who i was angry at. Maybe at my t and my mom, but also at myself, for having this attachment problem in the first place!! I really hate when these episodes of neediness come over me -- it is SOOOOOOO not the way my parents have ever taught me to be. They have always expected me to be strong, confident, deal with things myself, be always happy, successful, etc. So whenever i get in touch with that hurt child part of me, i have a conflicting part of myself that is very shaming toward myself! So i was mad at me too.

Yeah, i'm sad that t can't be a mom to me. And I'm sad that my mom doesn't treat me more like t does. My mom has never seemed very interested in knowing about the inner part of me, doesn't ask questions to find out how i feel about stuff, rarely compliments anything I do. She can be a fun person, and she'll spend time with me shopping and such. But the focus is almost always on her and her life, her abilities and successess, etc. I feel like the role i play in our relationship is as her cheerleader. But it seems that nobody in my family notices me or what i do. So maybe because t has shown such an interest in me, it has made me feel so grateful that i've gotten really attached to her, probably too much. Even though it's "clinical," it feels like nobody else has ever cared about me as much as t. But I'm just wanting too much from t, i've been so empty for caring like she gives me for so long, that it feels so good and i want to keep it and t. But she just can't be everything i want her to be in my life. . .and it's sad.

Sounds like you just need to put all of these things in perspective Peaches and accept them.

Your mom didn't and won't give you what you need but you can develop a life for yourself where you have people in it who will give you what you need, including yourself. So this would entail processing in therapy what happened between you and your mom (letting out the feelings) and grieving it too. Moving on will require you building up a supportive life for yourself so that you have others besides T.

It seems that you are stuck in between all of this?

Hi Sannah,

Yes, I do need to find acceptance about my mom. I just wish that we could talk -- really talk -- about our feelings with each other. I wish I could ask her why she did certain things she did (or didn't do). I wish she would tell me what she thinks of me, and we could hash out any hurts that have happened between us over time. I have a feeling there have been tons of misunderstandings that have happened since i was a baby that we never shared with each other or worked through. And it just seems that if we could hash things out, like i do with my t when i get hurt feelings with her, then maybe things would be so much better with my mom. But it doesn't seem like my parents are open to it.

i know there is much my parents have mis-perceived about me, just from the little statements that they've made over time. But it feels like there is just no way to "correct" things, to make them right. And that is part of what keeps me stuck and so frustrated. I feel like our whole relationship is built on assumptions and misinterpretations, never on true and solid communication. I don't know them, and they don't know me. I feel like they have me "all wrong," and maybe I do with them also. But they are not helping me understand. And they are not trying to understand. Anytime i've tried to talk about my depression and anxiety problems now, they clam up. Any time I've tried to bring up some painful situation from my childhood, my mom denies that anything bad happened that would have created my problems today. So i just don't even try talking about it anymore. When they come visit, I have to put on the happy face and just have fun. It's the only way I can relate to them -- they won't allow anything different. And it feels so fake. . .and i feel alone with them.

The other problem i face is that i have no close friends in 3D. Not even friends, really. I'd call them acquaintances. Nobody i go do things with socially. Nobody who invites me to do anything with them. I used to have some friends when my husband was active along with me in our religion. We did things alot with other couples. But since he quit going, and since my depression and anxiety problems, I've become isolated. Of the three close friends i had before my breakdown, one of them moved away, and the other two relationships were destroyed over the course of my depression. Long story. I'm terrified to get close to anybody now because of how badly they misunderstood me during my depression, and how terribly things ended with them. So i take the blame for not reaching out and trying to make friends and have a support system. But nobody else in my congregation is going out of their way to try to befriend me either.

I recently spoke to the elders about how isolated and lonely i feel in the congregation, and since then 2 or 3 people have shown more interest in me, even one of them inviting me to a meal at her house. But now i feel like the elders must have asked people to be my friend, so i feel like a pity case! I want people to "want" to be my friend, not to do it because they feel obligated. I'm going to go to the meal anyway, though, because i think it is wrong for me to complain about not having friends, but then turn down opportunities when they arise. But truthfully, i'm really, really scared to start any kind of relationship with anyone. If my former friends, who knew me for years, misunderstood my depression so badly and blamed me for it, then how can i expect anybody to understand me? I mean, i don't have to dump my problems on my friends, and i don't plan to. But i also don't want just another situation like with my parents, where i have to be fake and put on a happy face all the time. i feel like if anybody gets to know the real me, they don't like me anymore.

Peaches, do you think that you will be able to accept that you aren't going to have a healthy relationship with your parents because they are not capable of it?

Yes, building relationships takes time and work (because we have to figure out what isn't working). I have had to do this and still work on it. I'm glad that you are going to go to that meal!

Withorwithout you,

You said that talking to your t about the intense attachment helped you settle down about it. I think that's where I'm having trouble. My t and I aren't talking about it. I'm telling her (in emails) how if feel about her, but she's avoiding those parts of my messages. So it leaves me feeling weird about it. . .like maybe she doesn't want me to feel attached??? I feel a little bit better since my t's last reply, but I'm still concerned about the way she tends to minimize (or what feels like minimizing) the attachment and separation thing i struggle with. It makes me feel a little bit blown off, and more vulnerable than i like to feel. So I'm hoping my t will talk to me about this a little bit when i see her tomorrow.

Hmm, I see where you're coming from. I think the only way to deal with it is to bring it up tomorrow when you see her, right away at the beginning, since she won't address it in your e-mails. I told mine in a letter, but it wasn't addressed to her (I referred to her in the 3rd person) because at the end of the day, I really knew this was about me and not her. We talked about it the next session (over the phone) and she talked to me for double the time, I guess she thought it was too important to cut off at 50 minutes.

I hope for your sake she does not continue to avoid this. However, I would give her the benefit of the doubt until tomorrow. I wonder if she is not acknowledging this on purpose because it's too important to try and discuss in writing. Just a thought. Good luck! I still have to wait 9 more days

I leave in 1 hour for my t appt, and I need to get some thoughts on an important matter. . .

I'm thinking about reducing my sessions with my t. I've already emailed her to let her know that i want to talk about this, and why. Having to miss so many sessions lately has shown me how attached I am to her, and how much my separation feelings get triggered when i can't see her. It's not just sort of hard, i mean it is extremely painful. I think i am too attached to her. Separation shouldn't be this hard, but it is.

I understand that my attachment problems go back to childhood with my mom, but they also very much come into play with my t. Some part of me must be looking to my t as kind of a mother figure. So when she goes away and i have to miss my session, i start feeling the same awful way i did as a child when my mom left on business trips and I wasn't going to see her. No amount of reasoning with my intellectual mind takes away the awful emotions. Of course i know that i'm an adult now, that t is not my mom, and that this is 2011!! But some part of me must not know it!! Or maybe my feeling abandoned was just so bad as a child that anytime anything reminds me of it today, my body just reacts with panic. I suffered a horrible rejection and abandonment several years ago, which seems to have made my initial attachment/abandonment issues twice as painful and embedded.

This "paring down" of sessions, because of my t's taking so much time off, has really been a clear reminder to me of where my therapy is headed, and where it is going to eventually end. The only way to successfully end therapy is to learn to tolerate more and more separation from my t. I'm scared about how difficult it already is for me just to miss a few sessions. As painful as it is, i think i need to enforce these separations by reducing my sessions on my own.

With missing repeated sessions, it feels like pulling a bandaid slowly off of a wound. It's hard to tolerate the lingering pain when my t keeps leaving and i keep getting triggered. Eventually i know she is looking at retiring soon anyway, so it is just a matter of time. It seems like the easiest way to get through this separation pain is to drastically reduce my sessions. Since i am already partway through this separation agony, why not rip the bandaid off quickly and push myself through the pain to the other end? Then it won't hurt me every time my t takes time off and i have to miss a session. I won't keep feeling it over, and over, and over each time. If i can disconnect more now, it may hurt like I%&^(, but it won't hurt so much when the ending comes.

My t has told me before that with enough support from her and hard work in therapy, i won't need her as much, and the ending will not be so painful or feel like an abandonment. But I'm starting to doubt this. She has already supported me alot, and i still feel like i need her alot. We've worked together a LONG time, and i still feel separation pain when she goes away. Termination still terrifies me. I've learned an awful lot over the years, but i don't see myself becoming less dependent on her. Because of the way the therapy relationship is set up, it has to end, and i have to become more independent. There seems no easy way to do this except to endure the pain of separation. I just want it to stop. If i can't avoid it, i want to push myself through it, even if it feels like an abandonment to child parts.

Thoughts anyone?

I told my T in last session that I had become way too dependent on her. I was upset and ticked off and I told her I blamed her for it. I said my life has changed and now all I do is wait impatiently from one session to another. I told her that I have now become needy and I don't like it and she should have prevented it. I was very animated while sharing that with her.

She took it very well and asked me what was wrong with being dependent. So we had a long conversation about it and explored this feeling I had. My understanding now is that it's not so much we're dependent on T but we're dependent on being heard and validated and needing help on the healing process.

Once healed, this dependency won't feel so strong. I do believe that. So, do not decrease your sessions. Continue with the process and trust it. I do, finally. But it wasn't until 5 days ago that I finally believed in it.

But, Suratji, what if you still felt that way after 10 years with your T? Would you still think it unwise to cut down sessions?

Rainbow - I can't answer that since I haven't experienced that length of time with T. Is that something you're thinking of doing? Have you talked to T about it? I suspect that 'time' as we measure it is not the same as 'emotional time'.

Look how childhood experiences so impact us still as adults. Our rational brain tells us "Gee, that was so many years ago. Just forget about it." But our emotional brain will not let go. So, I suspect it's the same in therapy - that 'time' is not the main issue. But I'd love to hear other people's thoughts on this since I do not have direct experience with long term therapy.

Well, as usual, I feel so much better after talking to my t!! She is so patient, and corrects my distorted thinking in such a kind way. She was very reassuring to me that she is not pushing me away or minimizing the therapy relationship. She said she hadn’t even been aware that she was taking more time off than she had in the past, or realized we had missed that many sessions. She put her hand up to her heart and said, “I hold you right here, and our work right here, even when we aren’t physically together. I care about you, and that doesn’t change when we miss a session. The relationship doesn’t change. It stays the same.”

She didn’t seem to think reducing sessions was a good idea. She told me that I was telling her conflicting things, that on one hand, I was telling her that the separations were very painful and hard to tolerate – and on the other hand, I wanted more of the same by cutting down sessions. I told her that it was like taking a bandaid off, if this is where we are at in our work together (me needing to separate), then I want to just rip the bandaid off and get the suffering over with. She told me that she is not trying to get me to separate. In fact, she said, “From my point of view, what I experience is that, just as soon as we develop enough trust and safety to begin using our relationship to start working more deeply on your issues, you get the idea that I want to push you away.” She wondered if it might be me who wants to push her away, due to my fear of feeling attached and fearing loss when she retires? I told her I wasn’t sure.

I said because she didn’t respond to parts of my messages about my attachment to her, and how I feel about our relationship, then I felt like she was discouraging it, and trying to let me know that she didn’t want me to fee attached to her. She said that is not at all what she was trying to do.

After awhile, we figured out that sometimes I just need to hear her “tell” me that she cares about me and/or remind me that we are still connected even when I’m not going to be seeing her for awhile. I just need to hear her acknowledge it, because when she doesn’t respond to how I feel about her, or tell me she cares, I start to get scared that maybe I’m losing our relationship. It all goes back to that thing about holding the relationship inside, and how it’s hard for me to do. I need reassurance that our relationship is solid and she won’t forget about me or stop caring even if we have breaks in our work together.

She told me that she thinks she shows her caring by her actions (and gave some examples). But I told her that sometimes, a part of me needs to hear verbal reassurance. She told me that I have permission to let her know when I need to hear that reassurance. I feel good about that!

Toward the end of the session, she asked me if there was something I was needing at the end of sessions that would help me keep the connection with her. I wasn’t sure what to say. Sometimes, I think I need a hug, but other times, that would feel too close. Sometimes, I just need to get a feeling inside of her caring. Maybe just the verbal reminder of the connection at the conclusion of the session would be enough?

I know that when I feel sure and good about her caring about me, then I leave feeling stronger and don’t need as much contact between sessions. It is like the insecure child part of me is warm and satisfied. I guess I need to figure out how to leave my sessions feeling connected. Then I won’t feel insecure or desperate for connection in between. I will know that nothing is going away during that time. I told R. I would like to be able to bring up that warm safe feeling on my own when I am not with her. But sometimes it just won’t happen. So we are going to try to figure out how to help me leave my sessions feeling that way.

I can totally see how, in the long run, the goal is for me to internalize that caring inside of me, so I can carry it around and let it sustain me, even when we aren’t meeting anymore. I truly “get” the concept, and that is where I hope to be when we terminate. But the many missed sessions was starting to interrupt the connection too much (in my mind) and I think I was trying to tell R. that I needed reassurance from her that all was well with us. It wasn’t so much that I needed coping skills – because I knew logically that I could get myself through the week without her. The problem was that I needed help to know that, in the absence of the sessions, I wasn’t “losing” anything.

I know it sounds crazy, but a part of me has a really hard time realizing that my connection with t is not dependent on constantly seeing or hearing from her. That it just “is.” R. gave me that reassurance yesterday. I think if I can remind myself of that when I get these separation triggers, then maybe I can calm myself down and not freak out. I need a way to remind myself that the awful internal feeling that R. is gone, or the relationship is gone, is coming from the past, and my body and mind are reacting with that same “panic” I used to feel when my mom went away. But it’s not really happening in the present moment. R. hasn’t gone anywhere, or the relationship with her. It stays intact despite the breaks in our sessions.

My t also told me that when she suggests me using coping skills, she is not saying "Just go help yourself, and don't expect my help." She is emphasizing that, yes, she knows missing sessions is hard for me, and that it triggers my separation feelings from childhood. . .and so using those coping skills will help me learn to tolerate the pain that comes with the separation triggers. It's not an either-or thing (either she helps me, or i am on my own completely trying to help myself). It's not black and white. But that's the way my mind works!!

For example, if my t suggests I use coping skills, i assume she is dismissing the relationship factor of therapy. If she is physically there with me, a part of me assumes the relationship is intact -- but when not with me, it is in danger of disappearing. (Very distorted thinking, since we have worked together 10 years!) It's like, when my separation issues get triggered, my cognitive reasoning doesn't work! I seem to be able to only understand a matter by forming a contrast or polar opposite. Or i understand one situation is being true by assuming that some other situation is false. I'm finding it to be very odd, and I'm not sure that i think this way normally, when i am not triggered!!

Sorry this is so darn long. . .I'm kind of thinking out loud.

I feel like i learned alot from my session.

I'm so sorry! I don't know why my message is so small. Once i saved it, I tried to go back and edit, making it larger. But i didn't see a way to do it.

SORRY!!!!

Peaches - I am so so so happy that you had such a good session. You prove how important it is to be honest with T. I really appreciate how you went into detail. Never apologize for message being 'so darn long'. It helps others learn to relate to their T's too and how to cope with the attachment to T's

I think it is starting to sink in why my t says that my reactions are based on the past with my mom. It is because something gets me triggered. . .then i start thinking my t is doing the same thing my mom did. . .which then causes me to react to t the way i reacted to mom. But in reality, t is not doing what my mom was doing. So my reaction to t does not "fit" the situation with t.

1. As a child, my parents work all day, then go out often at night, leaving me with babysitter. I beg mom not to go, but to stay home with me. Mom goes anyway. I cry and feel separation pain.

2. My parents call to say they stopped at a bar on the way home from work and will be home in an hour. 3 hours go by, and i am at the window, stomach in knots. I think they must of had a car accident and are lying there dead somewhere.


FAST FORWARD to NOW:

1. T goes on vacation.

2. Adult me knows everything is fine. But child part of me feels separation pain and anxiety.

1. T goes to see family.

2. Adult me knows everything is OK. But child part of me feels separation pain and anxiety.

1. T takes several weeks off in a 4-month span.

2. Separation anxiety reaches panic level. I lose my adult thought process. I think my t is wanting to abandon me and i'm losing the relationship. I feel all kinds of emotional pain and suffering and decide i need to reduce sessions and pull away.

But in reality, nothing bad is happening.

Hmmm. . .so maybe this is why my t keeps saying that we need to address the early separation traumas with my mom.

I keep telling t, "But i don't feel separation pain with my mom! I feel it with you! So it can't be about mom. I don't feel anything emotionally when i think about mom."

But the separation pain and anxiety that keep getting triggered by what t says and does. . .that pain and anxiety is an automatic reaction that i learned way back then with mom. The reaction started in the past. And every time in the present that i get a reminder of something that feels similar with t (rejection, abandonment), I react the exact same way!

Now it really falls into place with me why part of my diagnosis is Complex-PTSD. Think about a war veteran. They've been in battle and faced situations where they thought they were going to die. Now fast forward into the present. They hear a car backfire, and they automatically react in great fear, ducking down, hiding, crying, etc. Something in the present (the car backfiring) triggered the earlier trauma (facing possible death in combat). But the reaction of fear doesn't fit the present. They are not in danger now. But it "feels" exactly the same. It "feels" like they are in danger all over again. So every time anything happens that reminds them of the past trauma (such as car backfiring, fireworks, etc.), they react with the same fear.

I really get it. I understand why my t says my reactions are linked with my past triggers. But it's weird that it doesn't feel that way. I don't feel those intense reactions when i think of my parents. Maybe it is like the war veteran that feels numb when he thinks about the war he was in. He doesn't really feel anything because his mind has somehow disconnected his emotions from it. But when something happens in the present to trigger the past fear, it all comes bursting out.

I'm so happy for you, peaches. I'm glad all your preconceived notions about T's behavior turned out to be false.

I'm still counting down the days for me....we're at 7 now.....

My husband says maybe just as my t and I make some progress, I find a way to sabotage the therapy by finding a reason to get upset with her. Usually it's because i think she is pushing me away when she is not doing that. He says maybe i sabotage myself and the therapy because i know that getting better means i will lose my relationship with t. So a part of me doesn't want to get better.

Hmmm. . .I have to think about that some more. I know that I DO want to get better. Never would i have spent so much time and money pursuing painful therapy if i didn't want to get better. I really have and do work hard at it! But I also know that sometimes, when my h and t talk about how good I'm doing, my feelings of being proud of myself soon turn into feeling depressed and anxious.

Maybe i am really scared of moving forward because moving forward means moving through the separation stuff with t -- which is where my traumas with mom came from. Only this time, t wants me to go through the attachment and separation stuff with her and have it go right, so when we terminate, it feels good and healthy and i can go and still feel connected, instead of feeling abandoned.

It's just SOOOOO HAAAAARD because relationship with t brings up so much old pain and anxiety. . .stuff i don't want to feel or face!!! Every time i have any tiny inkling that t is moving away from me, i freak out and want to reduce sessions or stop going. I keep seeing abandonment where it isn't. I keep suffering the pain of it, when there's no abandonment going on in the present!! It's like my mind has to keep re-creating the abandonment and then suffering about it. . .but it's not happening.

So weird. . .

Excellent work Peaches!!!!!!! Maybe thinking about your parents doesn't trigger you because it is only thinking. What triggers us is when something makes us feel. Triggering is all about feeling not thinking.

You need to do the healing work to move forward. If there is no healing work going on there won't be any forward progress.

Sannah,

How do i link the emotional pain that gets triggered by t in the present with my experiences with my folks? When i think about what happened with them, i don't usually feel any pain. I feel numb.

I don't think that you have to link them. I think that you have to talk about what happened between you and your parents in therapy. You need to process it and let those feelings out in therapy. You need to release those stored feelings that you have about your parents so that they won't trigger you anymore.

Sannah,

But I'm not sure how to do that. . .let the feelings out in therapy about what took place with my mom. When i talk about it, i usually don't feel any emotions. . .

The only time i usually feel the emotions is when my t says or does something that triggers me. Then, i feel the emotions. But those emotions don't feel like they are related to mom. Am I making sense?