[zooropa]

I've been working on this email to T since last week, and I think I'm about ready to send it but I thought I'd share it here first and get some feedback.

you don't need to reply to this, but if you could read it sometime before Wed and think about it, and please give me a chance to talk about it, I'd appreciate it.

these are questions I have, in no particular order. Putting them down here has helped me a lot. Talking about them would help, too. These are the questions that I have that only you can answer.

You said that you know you haven't been pushing me enough because I "check out" too much. I wonder, though. Isn't it possible that having been raped in August could be expected to lead to a worsening of PTSD symptoms such as dissociating? Is it also possible that you being more aware of my dissociating now doesn't mean that I actually am dissociating more, but rather I am better able to verbalize it?

Have you discussed me with your consultation team lately? Have you talked about me with any other professionals recently?

You said that trauma is going to keep happening to me. Do you really believe that? Do you believe I cause that to happen, that I create it?

You said that there is no reason to wait until I'm more stable because I may never be more stable. Again, do you really believe that? Do you think this is as good as it gets for me?

Can you see how the 2 statements above could leave me feeling really hopeless, at a time when I need to feel hope more than ever? How do I separate my reality from yours, so that even if you believe things are hopeless for me, I don't have to believe it, too?

How come losing you feels like losing me? And more importantly, how do I fix it? How do I deal with it? How do I become and feel like a real person all on my own? And how do I become a person that doesn't burn out everyone who gets close? How is it that I do that, and how do I stop?

It seems like this comes from the night ***edited for privacy***. Is it because I called you in the middle of the night? I don't know that I've done that before. Was that the final straw? and if not that, then what was?

If I continue to see you, are there going to be rules about what I can and cannot talk about? Is it possible to set such boundaries in a way that they are clear to both of us, and that those boundaries will be consistent?

Again, if I continue to see you, is it possible to revisit or at least brush up on the distress tolerance skills as well?

Either way, can you refer me to a therapist that specializes in trauma, that knows the DBT skills, and that isn't averse to the idea of long term care if that's what I need? If you don't know such a person, will you help me find someone so that there is some continuity of care? I'm not talking about a DBT therapist, but I think it is important that they are at last familiar with the skills.

Do you have any idea how painful this is for me? How much it makes me question everything you ever told me, and question my own ability to choose who is a safe person to confide in? Isn't there something that you have learned, some training, some previous experience, that could help you make this easier for me? I don't deserve this pain. I deserve for this to be as painless, as gentle, as possible.

I think you have good questions here, but perhaps it would be better to take them with you to your session and go through them together rather than send it in an email. Just a thought.

[zooropa]

I just thought it would be good to give T a chance to think about the questions before we meet, but you may be right. Maybe I can bring it with me and then we can talk about it the next time or something. I think that with the other email I sent, the one with my needs, we may already have more than enough to fill a session anyway.

[Perna]

Originally Posted by farmergirl

I think you have good questions here, but perhaps it would be better to take them with you to your session and go through them together rather than send it in an email. Just a thought.

Yes, I agree with farmergirl; if it has taken you this long to write them out so you feel good about them and know you would do well discussing them, I would use them as a printout to discuss (some of them, not necessarily all) during your next session.

[Ygrec23]

Hi, Zooropa! I think it's an excellent email, but that there are pros and cons on each side: whether to send it or hand it to him or use it as your own prompt sheet at your next session.

If you send it to him he has at least a minimal time to ponder each of the questions, though I'm sure that each of your questions will give rise to a number of questions on his part. Personally, I'm not a fan of ambushes when the discussion of serious stuff is at stake. If you hold off and don't send it to him beforehand, I wonder if you'll get the same quality of answers that you would if you did send it. Particularly since you have many questions.

While I'm impressed by my own T's mental sharpness and speed, I still think there are mental limits that operate on all human beings. Those limits reduce the richness of an on-the-spot answer.

So why hold off? Why not send the email? Well, in some contexts the person asking the questions very much does want to disconcert and confuse the person who's answering, hoping to come up with statements that are in effect admissions of wrongdoing or of other matters negative to themselves.

Is that EVER a concern in the therapy situation? I would HOPE not! If your therapeutic alliance has degenerated to the point where you're trying to catch your T out, something's very wrong. Why set traps for T? Really. I think you and I and every patient would like T to spend as much private time as possible simply pondering our situation, our case, calling on their own deep resources to help generate THEIR insight into OUR problems.

So, bottom line? Email it to T and hope that he has enough spare time to focus on it and think about it for an hour or so by himself. I think he'll actually appreciate the lead time you give him. Good luck! And take care.

[elliemay]

I agree Ygrec, if things have come to the accusatory question, then it's time for a major major change.

If we set traps, most of the time people step into them. It feels like a victory, but oh boy! is it NOT.

Zoo, if these are things that you really want to know, then why not just ask. I know if I gave these to my therapist and he answered, there would be no way I could trust the answer. I mean, he would have time to come up with the therapeutic answer - which may or may not be "truthful".

I guess it really depends on what you are hoping to gain here.

[CantExplain]

Originally Posted by zooropa

I just thought it would be good to give T a chance to think about the questions before we meet.

That makes sense to you and me, but somehow Ts never see it like that. It's part of the way they protect themselves, I guess.

Originally Posted by zooropa

You said that there is no reason to wait until I'm more stable because I may never be more stable. Again, do you really believe that? Do you think this is as good as it gets for me?

I'm sorry you see it like that, and I understand why you do. But look closer. There is no reason to WAIT for you to become more stable. That means you might not get better BY YOURSELF. It doesn't mean you can't be HELPED.

I was upset to read that you had been raped. That's something no one should have to suffer.

[zooropa]

yeah, I don't know. I guess there are a couple things on that list that I will want to ask her right away, and I can just ask. But I already sent her an email last week stating what I need in therapy, and I know (or hope, anyway) that she'll be planning to talk about that. There's no way we could address everything in both emails during one session.

So, probably I'll just ask her the most pressing questions, and we can talk about that and about the email I did send her, and if I want to later I can send or bring in the rest of the questions. Or by then maybe it won't matter so much anymore, I don't know. I just know that trying to talk about a whole bunch of things will just lead to not talking about any of them very extensively.

[zooropa]

forgot to say, I know that some of those questions probably seemed like I'm trying to "catch" T in something. I'm not sure what, but I am aware that a lot of it comes from hurt feelings and a lot of confusion on my part, which is why I posted it here instead of just sending it.
It's not that I'm trying to catch her, it's that I desperately want to hear the answers I want to hear. If that makes any sense.
Instead of asking T for that I'm working on providing those answers to myself, and on accepting that T isn't god: her opinion is just that and it is not a FACT.

But I do want to know if she can explain what she said about trauma, because I can't stop hearing that: trauma is just going to keep happening...I can hear her voice and see the sort of dismissive gesture she made while she said it, and the way she seemed to be sort of almost-smiling or smirking. It is just a really disturbing thing that I can't shake loose.

[zooropa]

Originally Posted by CantExplain

That makes sense to you and me, but somehow Ts never see it like that. It's part of the way they protect themselves, I guess.


I'm sorry you see it like that, and I understand why you do. But look closer. There is no reason to WAIT for you to become more stable. That means you might not get better BY YOURSELF. It doesn't mean you can't be HELPED.

I was upset to read that you had been raped. That's something no one should have to suffer.

she was saying that I'm not stable enough to do trauma work, and that maybe I will be in 6 mos or 6 years or never. My problem with that, and what I asked T at the time, is: where does that leave me? So, I can never talk about it? I Just have to carry it alone because I'm not "stable enough", whatever that is? And the way I am right now might be the most stable I ever am? UGH.

[WePow]

(((((Zoo)))) I like that letter. I do think you should take it into session though because it would be very good for you to look at her and watch her as she reads it for the first time.

You are doing great by being honest! And you are right that you deserve to not be in this pain. Good job!

[dizgirl2011]

Hey Zoo,

I agree that with so many questions that are important for you, it may be better to take it with you to a session as it is likely your T won't reply to those questions via email.

You said "these are questions that only you can answer" but that's not true and I don't think your T will think it is either. I know it may feel like she has the answers to what you need to do to make things better but as a Therapist they can really only help you to come to a decision on what you think is the best way forward.

I think are probably some questions in there that she can answer because you are just asking for clarity on what she said.

I want to put a few ideas out for you on your email and I want you to know that I don't expect you to take them on board if they don't feel right to you because only you and your T knows what goes on between you

I am a bit confused on what you said about PTSD and disassociating. When you said how your T has said she hasn't been pushing you too hard because you dissociate a lot - I'm just wondering if you see that as a bad thing on her behalf, rather than her thinking that pushing you would not help and may not help if you are dissociating. Did your T say that she didn't think your assault in August would have impacted your PSTD as I think most people would realise it was likely to have an impact on you, as its a very traumatic thing to go through and something no one should have to experience. I just wonder if your T is trying to say that she doesnt want to push you and make things worse, as you might not be ready to deal with it at this stage? A T can often see the signs or feel a change in the room, when a person dissociates, they often don't need the person to verbally say it, so perhaps your T feels she knows when you are dissocating?

I don't need to know the answer to this but I think your T will want to know what makes you concerned about if she talks to other professionals about you? I'm not sure how your T works but there would only be certain people she would be allowed to discuss your case with due to confidentiality agreements.

I can understand that you want to know what your T meant when she said that trauma is going to keep happening to you. I hope she can give you some clarity on this

You went on to say in one of your posts that your T said that you may be ready in 6 weeks, 6 months or perhaps it may never really be the right time to do trauma work. Would she have said this as a way to try and encourage you to try some trauma work or is it that she doesn't feel you are ready for it and that you feel you are?

I'm afraid that when you ask her how do you seperate your reality from hers or why it feels you are loosing yourself when you think about loosing her...she probably won't be able to answer these huni. I can hear your pain in these words, a desperate cry for help because your hurting but I think you have as much information to answer them, if not more than she does, which I know is a scary feeling

Even though she may not be able to give you answers to the questions, hopefully she can help you explore ways you can make things better.

I'm not sure what happened with the call in the night but it sounds like you feel something may have changed in the way your T responds to you and you are wondering if that night was the cause of it? That is probably such an emotionally charged question that you need to talk to her about it in person really.

I would be very concerned to hear any client feeling that they had rules to follow in their therapy about what they can and cannot talk about because that really defeats the purpose of therapy, so I would hope that was not the case for you.

Boundaries may need to be set further but it shouldn't be with regards to what you are or aren't allowed to talk about hun . I would also like to think if a client wanted to go over some skills that might help them, then a therapist should be willing to do this, even briefly.

Is your T ending your therapy with them? I am just wondering as you have asked for a referal?

The last part of your message is full of pain and I see that definately and although your T probably would too, it does have an accusitory tone to it ...sort of like - do you realise what you have done? type vibe to it and your T may feel it is a bit like a guilt trip in a way because you go on to kind of doubt her training ina sense by asking if she learned anything to make it easier on you- make the pain that she has inflicted on you easier. Again this is just a perspective on how she MIGHT take that, she may not see it that way at all.

I agree you don't deserve to be in pain but it sounds like you believe its her fault that you are and maybe that is how you feel, is it?? If it is then you have every right to express that but just be aware that she will most likely not see it the same way.

I hope some of my thoughts have helped in some way, again I dont know the full details so I am only working with what you have said and I could easily be wrong.

I hope you get some resolution for all that pain you are feeling as I can imagine it is very, very hard to deal with

[zooropa]

hey, diz. thanks so much for your well thought out reply.
I really agree with pretty much everything you said, and I thank you for your perspective. I'm just trying to answer a few questions.

My T was saying that she hasn't been pushing me enough, the proof of that being the fact that I still dissociate, and so she's going to start pushing more. I don't want to be pushed by T, at least not more than I feel she already does.

I'm just wondering if she talked about me with her consultation team, because her change of tactics (for lack of a better word) sort of seemed to come out of the blue, unless as I mentioned later it was because I called her in the middle of the night one weekend. I think when I wrote that I was really caught up in WHY? but now it doesn't matter as much. The why isn't as important as the what of what's happening now.

I think the trauma work conversation went something like: T said we would do more trauma work someday, then she said we won't. I don't WANT to do trauma work, but I want to carry the trauma alone forever even less. It is hard for me to think about opening up that much with another T, but that's something for me to work on.

and yes, she has said that we need to set and end date and stick to it. I haven't talked to her directly about referrals yet, but I'm going to have to.

And you're right, there is probably a part of me that feels like T is causing my pain. I don't really understand why I have to stop seeing her, and I feel like if I could keep seeing her then everything would be fine. Which, of course, it wouldn't be, but losing T just makes me feel so...alone. Abandoned. Worthless.

so, I won't share that email with her in its entirety, because a lot of it came out of raw emotion and I've worked through some of those emotions. I also agree that when I said "these are questions only you can answer," that wasn't accurate. There are things in there that only T can answer, and those are the things I'll ask her. The rest of it...well, just the act of putting it into words seems to have started some process of resolving those feelings within me.

[mixedup_emotions]

(((( zoo ))))

I love how you put your stuff in writing to T....and shared it here to get feedback, helping you to see different perspectives that may or may not fit...that is the beauty of PC....

I am sorry that you're going through this, but I do think it's an excellent start to a much needed open conversation. I hate that you're having to deal with this.

[CantExplain]

Originally Posted by zooropa

I'm just wondering if she talked about me with her consultation team, because her change of tactics (for lack of a better word) sort of seemed to come out of the blue.

Every therapist has a supervisor, a more experienced therapist they can go to for advice. In my experience, Ts never mention their supervisors, and certainly never say, "My supervisor says..."

[zooropa]

Originally Posted by CantExplain

Every therapist has a supervisor, a more experienced therapist they can go to for advice. In my experience, Ts never mention their supervisors, and certainly never say, "My supervisor says..."

not my experience, at all, and certainly not with this T. It may be an aspect of DBT, I don't know.

[CantExplain]

Originally Posted by zooropa

not my experience, at all, and certainly not with this T. It may be an aspect of DBT, I don't know.

You mean your T does mention her supervisor?

[zooropa]

Originally Posted by CantExplain

You mean your T does mention her supervisor?

yes, she does, quite a bit. Just last week she said she had talked to her supervisor (not sure she used that word, she may have said "person I consult with") about me, and told me what they talked about. Is that unusual?

[CantExplain]

Originally Posted by zooropa

yes, she does, quite a bit. Just last week she said she had talked to her supervisor (not sure she used that word, she may have said "person I consult with") about me, and told me what they talked about. Is that unusual?

Come to think of it, I've only ever had three proper Ts, so maybe they are unusual. Time for a new thread!

I'd say that you're right on, Zoo, that this is an aspect of DBT for your therapist. In manualized DBT (in other words, following the protocol set up by Linehan & associates), therapists who are practicing DBT need to function within a team, and each member of the team uses DBT skills with each other while consulting about clients. The belief is that you live, eat and breath DBT and the way you do that is by teaching and helping your clients to use the skills and using the skills in your own life, especially within your consulting team. That said, not all therapists using DBT actually function within a team.

The team approach helps therapists recognize when they might be blurring the boundaries or not adhereing to strict DBT protocol, it's support for the therapist while doing difficult work. When a person is involved in difficult and sometimes emotionally charged material, he/she might find themselves functioning with tunnel vision. A DBT team approach allows a therapist to widen their perspective by consulting about their individual cases and/or groups. Personally, I think that when a therapist draws a "new" boundary or adjusts the boundary, he/she needs to own that boundary and not cope out by referring to their supervisior or consulting team as suggesting the change (just my own bias ). It is important for all therapists to define the degree to which he/she gets "supervision" or takes consultation about your case. It should not ethically be a hidden subject.