So upset after my session I purged, need advice

OK long story short, when I came to my therapist it was originally for an ED and I was also taking these ADD meds that were not prescribed for me called Vyvanse that helped me control my apetite and gave me a lot of energy to concentrate in school. My therapist helped me so much with the ED and helped me get off the pills. This fall semester was my first one completely without pills. I am currently in an MA program and hope to apply for my PhD next year. Anyways, I got a B+ in one of my classes, and I completely freaked out and couldn't call my therapist b/c of holiday, and ended up buying more pills.
So today was the first day I saw her after the holiday break. I had emailed her after break to let her know about the B+ and the pills. So our session went completely horrible. I could tell she was so disapointed in me, and she told me that if I needed pills to be in graduate school then maybe I shouldn't be in it. Then I got very quiet and didn't say anything, and then she backtracked and said that she didn't feel like that was the case with me, that I was smart enough to do it without them. But it hurt me so so bad that she would say that, and it doesn't help that she has her PhD from an Ivy League school. I could just tell she was so disapointed in me, and she said that the smart thing to do would be to learn from my B+ instead of taking the easy way out and buying pills, and that that way was the not smart way. That also hurt. When I left I was miserable and felt like I was going to cry the whole day.
A couple hours ago I ate some seafood soup and then purged it up. This has happened one other time after session, that I got very upset about something and purged, but it was a different scenario. This is the first time I have felt my therapist be truly disapointed or upset with me, and I feel like she doesn't even want me as a client b/c I bought those pills. I don't know what to do. I don't want to go to session on Friday b/c I feel like a failure, and she hurt me a lot. And part of me wants to tell her I purged, but the other part feels that would be vindictive. Like "Oh, look how much you hurt me, now I"m gonna make myself throw up." I don't want to be like that. I just don't know what to do, but my first inclination is to email her and ask her not to respond, then to tell her I am not going to session on Friday and that I also purged and that she hurt me. But I don't want to make her feel bad. That is a big part of why I don't want to go to session, b/c I feel like I am too troublesome. I don't know, some advice please!

Sounds like you've regressed into some old bad coping mechanisms. So, would cancelling your appointment to avoid discussing these issues with your T just be another bad coping mechanism?

I have absolutely no experience with ED, so I'm just taking a stab in the dark here. If you want to turn things around so you can get back to handling life without pills or purging and so you can continue to be successful in school (a B+ is a respectable grade by the way), you are going to have to bite the bullet and talk about this with your T and get things back on track. Otherwise, isn't the danger that you continue to slide?

I think you need to go in and ask for help. Take what she says and use it to turn the behaviors into good ones.

I damaged my esophagus from purging. I use to purge and SI after sessions because I always left so frustrated and didn't know how to cope.

EDs rear up at times. I've gone back and forth for 8yrs now, was in treatment for 9mos after 6yrs of struggling in silence. It's something you need to continue to work on and keep in check. Hang in there.

Hi Franki, this is an opportunity for growth here. Feeling that someone is upset or disappointed with you sounds like a big trigger? There must be some history with these issues? Definitely something to go back and talk about so that you can resolve this and grow from it. Can you tell her how you felt in response to what she said to you? Your reactions to her are very valid. Please keep us posted on how it goes?

Have you overtly been dealing with issues of "failing" and "smartness" cause just to add a little perspective here, had I gotten a Bplus in school, I would have been thrilled.

"I just don't know what to do, but my first inclination is to email her and ask her not to respond, then to tell her I am not going to session on Friday and that I also purged and that she hurt me. But I don't want to make her feel bad. That is a big part of why I don't want to go to session, b/c I feel like I am too troublesome. "

First - you will not be making the therapist feel bad. A therapist that feels bad based upon a client's feelings needs to go get themselves fixed, but it is not a client's fault. I suggest you go tell her that you were hurt by her and your way of dealing with hurt is to purge. Are you looking for other ways to cope with being hurt that she might could help with? Do you want her to feel bad that you purged? Do you just want her to know how bad you are hurting? Or are you expecting her to reject you? I think all of these are fairly usual responses to therapists when they do hurtful things (intent on their part does not really matter). The bigger part is to tell her and not try to take care of her - that is not the job of the client. (at least not in my opinion)

Hello everyone, thank you all for the advice and sorry it took so long to get back. Anyways, I ended up throwing the pills away and emailing her. I told her that she had hurt me and that she had made feel horrible and that I had purged. I also told her that I felt like I needed help (this is the first time in therapy I have ever said I have needed help with something) in not beating myself up for things so much and in feeling like I deserve praise. Because at present, I truly do not feel like I deserve to tell myself I did a good job or anything like that. But I also told her that the only reason I threw away the pills was b/c I felt that she was disappointed in me and b/c I felt that I would not be able to go to therapy b/c she would be too disappointed in me and I would feel ashamed, which is true. I did not throw the pills away for myself, I threw them away because of her, b/c honestly she is the one person that I will really listen to. I told her if I had to move away, then I would go right back to taking the pills b/c she would not be there, which is true.
She emailed me back and told me she was sorry I felt so badly, and that she truly did not mean to be hurtful, and she told me three times in the email that she thinks I am extremely smart and capable, and that she was trying to get me to see that I do not need the pills. She then said that we need to find out the reasons why I think so badly of myself "in the face of so much contradictory evidence."
It made me feel better, but I also hate admitting to her that she hurt me, which makes me vulnerable to her. I feel like I sound like a mess, like waayyy too dependent on her. Sometimes I feel like it would be better not to go to therapy and just not have her there, so then I could just do what I want to do instead of having someone there to stop me from taking pills or engaging in other not-so-great behavior. Like I already feel way too dependent on her and like I rely on her too much, and now I basically admitted it. I don't want her to think I am a freak or a cry-baby and that every time she says something I don't like I am going to go and make myself throw up. But most of all I hate hate hate admitting that I am vulnerable to her. Like sometimes I just feel like maybe I shouldn't be in therapy and just deal with things on my own.

Not overtly, no. She just pretty much lets me talk about what I want to talk about, and I usually don't really see that as a problem, so I don't want to talk about it, but I guess it is.

Were you hurt in the past when you were vulnerable to others?

I just like to be the one in control and therefore I don't risk getting hurt. I also don't like to talk about things that happened in the past b/c I feel like I would be being too self-indulgent or dwelling on the past, so it's hard for me to talk about things like this. I am just used to being very independent and never relying on anyone, so it is hard for me to admit to my therapist that I do rely on her and that I am dependent on her, and that what she says affects me a lot.
However, I know what she is thinking when she says that we have to talk about why I think so badly of myself, which probably relates to Sannah's question. When I was younger, I did not have a good relationship with my dad and occasionally he would hit me and sometimes leave bruises. Over the summer, I was visiting home and he told me that he thinks that women, including myself, should not be able to vote.
I have briefly mentioned these things to my therapist, but I get very upset about them and don't like to talk about them. The one other time I purged after session was when she made me talk about my dad and didn't expect me to tell her that my dad had hit me sometimes, b/c I kept telling her it was stupid and not worth mentioning. And she kept pushing, b/c she didn't think it would be anything that bad, b/c I kept telling her it was stupid, so when I finally did tell her, I freaked out and purged after session. I don't know. I guess maybe that is why I don't like feelikng vulnerable to other people. Because when I was younger and my dad would occasionally hit me or just not be nice to me, I would feel stupid and disgusting, and I never wanted to be in that position again, where another person could make me feel that way.
WOW that was a lot right there.

This stuff is hard but it is really important to get out. Can you tell your T that you purged after that session and that maybe she shouldn't push you as much?????



Try to remember that your T is on your side and that she isn't your dad. I had to do this a lot during my healing, tell myself that the healthy people in my present were not the people from my past.