i find it really hard to express attachment. to demonstrate attachment. apparantly former t's tell me (via email) that they never were sure whether i liked them or were attached to them or not...

i guess i feel afraid that if i show someone i feel attached to them then i am giving them power... they know they can hurt me. and then... if they know they have the power then they will hurt me and take advantage of me and stuff.

i can't seem to express...

i remember reading about how some people need to learn how to take care of their t's. to make sure their t's wanted to work with them. what do other people to to look after their t's? to show them they like them? i'm trying to figure stuff that i could do that isn't too hard... i don't want to push my t away but i think i probably have been...

[EJ711]

Special K -

Attachment disorder typically starts at a very early age.

Without trust, there is very little that can be accomplished in therapy.

I think other than being open with your T, there isn't going to be much to keep a T interested in helping anyone.

Maybe others will have different ideas.

EJ

hey. yeah i've found that with p-docs too. especially when there is an attraction there and it is really so very important to us that they not know that... lol. one thing i did one time... i had this session with my p-doc who i liked very much indeed... but i also had trouble because i would disagree with him a lot and stuff. i remember i was venting about how horrible my week was... and he was trying to be a bit soothing... and i was saying 'no it really is that bad' and i'd keep venting.

i sent him a card after that session. i started freaking that he wouldn't want to see me again so i got him this nice card and i wrote something like 'i just wanted you to know that i really appreciate your seeing me. i'm sorry if you left my last session feeling worse. i left my last session feeling better. i needed to vent. i feel better after venting. but i guess you don't know that unless i tell you and so i'm sorry if you left my last session feeling worse. thanks for seeing me'.

i sent it to him... he actually had slight tears in his eyes the next time i was him. he thanked me so much. i think it is important to do those things... my t who i loved so much... i never told her. i never told her how much she meant to me. i think it is important to try... by email or letter or something. it is hard... but i guess everyone likes to feel appreciated. and i guess... letting them know we appreciate them isn't really giving them power the way that really expressing our attachment is...

hey. sure, i agree. it is just a matter of... how open can one afford to be? and how can one express that? and so forth...

figuring out HOW is the problem...

and also figuring out HOW MUCH...

because the sad truth is... it isn't always safe to express things...

[(JD)]

Once you are having these feelings, odds are the T and/or PDoc are trustworthy in your mind. If they've reached that point, it's good to let them know. They already know how important they are to you, but knowing you've reached that awareness, and trust them enough to feel that way, yes, they need to know that.

IMO, this is good. Another thing to think about: wouldn't you like to know how they will respond to this, before you share big stuff with them??? Plus, their understanding of this transference will help you share in the future.

That depends on what you mean by "take care of" I don't believe its my job in the client therapist relationship to "take care of" the therapist meaning I have to make sure the therapist is happy about me and what I say. If they are in the job to feel happy about everything then they are in the wrong profession. Clients are going to be talking about things that are upsetting and so on for them and some of those things may very well be triggers and so on for the therapist, especially if the therapist has a background of being a survivor themselves. It is the therapist job to "take care of" the therapist. Which is why at certain levels of certification and licensure USA therapists are required to have thier own therapists and attend therapy sessions for themselves.

I also dont have a problem with "transferance" though at times I do have problems with "attachment". Transference and attachment are two different concepts.

Transference is taking feelings and issues from inside the client and out of them and on to the therapist regarding the topic being discussed so that the topic can be taken care of.

For example a client is talking about an abuse situation and they start feeling like the therapist is that abuser that they are talking about, that the therapist wants to hurt them, is being rude and so on. by the client putting those feeling into the therapist they can recognize what their feelings are about that topic. Therapists use this type of transference all the time for example telling the client - "if I was so and so what would you say, do ..." "if I were you what would I be feeling right now about that happening to me? Therapists also welcome transference of the persons feelings into inanimate objects for example "if your abuser was sitting in that chair over there what would you say?" basically transferring the persons abuser from inside the person to that chair where the person can process the feelings without feeling threatened and vunerable.

Another example of transference is role playing... "I am going to be so and so and you be you and we are going to re-enact this situation..."

Attachment is whether or not a client likes their therapist, whether or not the client has a problem when the therapist is out of town or unavailable.

My past therapist knew it made me nervious and so on when she went out of town and state so we started saving workbook activities and so on and I would do them then.

My present therapist always lets me know ahead of time when she is unavailable and I have her voice on tape with the two of us doing relaxation visualizations during sessions.

As for letting her know how I feel about her. I have always been open about how I feel about her right from day one. and she has been just as honest with me about what she thinks of me including how she felt when I called her "a stiff with potential" . she also says I have swore at her and called her clueless. One day she asked me "have I grown on you yet?" I told her you might say that I don't think of her as clueless and a stiff with potential anymore. she laughed and said I hadn't swore at her recently. I first knew she liked me when I had left her office and had turned around to ask her something and she was at her desk smiling and whispering to herself "I think we are going to be able to work together" and that was only a couple weeks of starting to see her during the time Iframe that was calling her "a stiff with potential" and swearing at her.

periodically we do talk about how things are going between the two of us. We both know that we had a rocky start and regardless of if we like each other or not we both have to respect and trust each other judgement in order to do what is best for me. If either one of us feels we are going in the wrong direction we say so.

She flat out tells me "don't go there because..." or "I wish you wouldn't go there because..."

I always try something that she wants me to do and if it doesn't work I let her know right away for example the recent situation where her co workers were forcing her to push me into working on a project that neither one of us were completely ready to complete yet. She brought their request to me and we tried it. It was not working for me so I sat down and wrote about it and printed off the journal entry and went into my session telling her flat out when she mentioned her co workers deadline for my project "don't worry about the deadline cause Im not doing it" and handed over my journal entry that went into more detail about my decision to not work on the project under her co workers standards and requests.

The one thing I do do though is try not to move faster than my therapist. That decision isn't specifically taking care of my therapist. Thats taking care of me. LL is on the case after three years of my working with another therapist and add to that the DHS stuff involving my sons case.

Back when I first started with LL, LL and I tried to have her jump right in where my past therapist left off. Without knowing all the information needed it lead to a disaster of LL thinking I said something wrong at a court hearing that both LL and I attended. She thought she was doing what was best by strongly pointing out what I did wrong in the meeting so that it wouldnt happen again.The result was my retreating into la la land for months because I knew I had said nothing wrong and I couldn't understand why she was so upset with me. It took about 6 months to work that one situation out of her understanding how the DHS case and hearings have been run and my understanding that she had just wanted everything to be perfect for me because a DHS caseworker had just gotten fired because of my requesting local, state and federal investigation into that caseworker. Now everyone on the case was going to be seeing me as a troublemaker so to speak because they now knew I was not the normal nieve parent with a child in the system who did not know how to navigate the systems and recognise when the case was not being run ethically and legally correct.

It is virtually unheard of for a parent of a child in the system to win against a DHS caseworker and not only did I win on my complaint and the caseworker had been removed from my case BUT her other cases were put under review also AND she had been fired. Along with that comes removal of her state license which means she could no longer work DHS in the whole state.

So LL had been trying to make sure everything was perfect for me but not knowing everything she jumped in at the wrong time with disaster results of my floating in la la land for months.

Because of that situation LL and I both knew she could not just jump in taking things right fropm where SKR left off. We needed to take time to get to know each other and she needed time to get to know what the case was all about, how it has been run and what SKR and I had been working on.

I knew if I wanted LL to understand things then I had to take it in steps. Break things down into steps that she could understand instead of just lopping everything in her lap and saying ok here you go and hope she didn't make another jump without the crucial information needed. Breaking things down not only helped her but it also helped me because I was able to see other sides of things that SKR and I had already worked on from a fresh angle of what LL saw in it. Which only helped to bring me even more stability and so on.

Just telling LL thank you for things that she does for me shows I like her and what she does for me. Including her in on my projects, artwork and journal entries shows that I trust her judgement. I am always on the lookout for different things to do to help myself. When I find out that LL is aslo interested in something that I am doing I bring it in for her to see, make copies of and so on for example I have been doing Nancy J Napeir relaxation visualizations for years now either from her website or her books. When I entered the depression management group and LL was doing relaxation visualizations in the group and revieled that she does them on her own too. I brought in to my individual therapy sessions my Nancy J. Napeir stuff for her to see. Now not only am I on to Nancy J Napeir stuff but so is LL and three of her co workers and They use them for themselves and their clients. LL says not only does she get to bring me new resourses but she loves it when clients teach her about new things and resourses too.

>That depends on what you mean by "take care of"

Sure it does. I don't mean that therapy is about taking care of your therapist in the sense of listening to them talk about their troubles and supporting them in that. I don't mean therapy is about taking care of your therapist in the sense of not talking about stuff because you are very concerned about how your therapist is going to feel about what you want to talk about.

If those things were happening... Then that wouldn't be so good. Therapy is supposed to be about helping the client rather than helping the therapist. I know that the above features arise as issues for some people. I don't mean to get people feeling worse about those things, that isn't what I meant by taking care of them.

What I had in mind... Was Linehan (the DBT lady) talking about how there are some clients who have a pattern of having burned out therapists. It isn't the clients fault that therapists burn out (therapists should see when they are starting to burn out and it is up to them to take steps to ensure that that does not happen). But still... Blame aside it is a fact that some clients are harder to see than others... And it is a fact that there are things on both the therapists and clients side that contributes to that process.

I have a pattern of burned out therapists. Why? Because I'm not very giving I suppose. Giving in what way? I don't express idealisations (I typically don't idealise or when I do I feel a little embarrased about it so I take pains to conceal it). I don't express liking for my therapist (I worry that that gives them the power to hurt me). I don't say 'gee wow I've gotten so much better in the time I've seen you' because typically I haven't and also because I worry that if I say that then they will stop trying to help / they will terminate me 'cause they will think I'm all better.

So... I guess that makes it hard for them to see me... They don't know if I like them. They don't know if they are helping me. They don't know if I feel like I'm making progress. And those things... Make burn out more likely I guess.

I don't think I'll ever change to being more expressive... But maybe I need to be a little more expressive. Little things to take care of them in the sense of expressing my liking and appreciation. Don't get me wrong I am polite and I say 'thanks' after sessions but maybe that comes across more as mere politeness than anything...

Transference can also be about... Past people in ones life. For example... If one feels like one was abandoned by ones father then one might start to feel like ones t is going to abandon one. The fears about abandonment are present / intensified because the client transfers the feelings from the father situation to the therapist situation. Emotions that are out of keeping with present circumstances or are out of keeping with respect to intensity with the present circumstances can be clues that there is a transference response.

The converse is counter-transference when the therapist relates to the client on the basis of their past interactions / relationships with people. If the therapist feels that the client is ungrateful, for example then the therapists therapist might ask 'when do you remember feeling that someone was ungrateful before?'

The phenomenon goes both ways.

I find it hard to seperate responses appropriate (in form and intensity) to the present, from responses appropriate (in form and intensity) to the past. The present and the past merge kind of and I can't tease them apart. Hard for me to know whether my responses to the present are justified in the present or not... And hard for me to know whether my t's responses are justified (in form and intensity) to the present or whether they are having a counter-transference response.

Yay isn't therapy fun.

Hrm.

It reminds me of a song by this NZ band 'the headless chickens' (since disbanded)

'if i had vision who would i see?
maybe its you and maybe its me'

maybe thats why therapy with me is such hard work...
it isn't about giving me a mirror...
there can be a hall of mirrors...
and reactions model reactions
and many t's think...
therapy isn't supposed to work that way.

sigh.

i don't think it is.
i don't think it is just defensiveness on my part...
maybe also, but never just ;-)

[(JD)]

Just a note. Transference can also be warm and fuzzy... making the T into someone who cares about you.

No client is to blame for their therapist burning out. I've had therapists burn out on me. I actually asked the last one if it was me. If I was the reason. she told me no. therapists are just like normal people. they have things that happen in their own life that makes it hard for them to work with their clients

for example One of my therapists came very close to burning out. her mom died. She was the executor of her moms will so she had to travel out of state to take care of that. so now not only do you have a therapist going through the grieving process but one with financial problems because it takes loads of money to travel every couple weeks to another state. for court hearings and mediations because relatives are contesting the will. Add to that lets say the therapist was a single parent of a preteen boy who was having problems with the father.and this preteen boy was a challenging child who needed special schools and so on. then you add to that the prospect that the therapy agency she worked for was going through lay offs due to government cutbacks. add to that being a cancer survivor so she has all the worries that come along with going through cancer treatment and surviving and the no guarentee that at any point it can come back. lets also add depression and a survivor of abuse to the mix because alot of therapists go into the business because they have been through what thier clients go through. Now add some clients to this. before the therapist mom dies therapist is seeing clients one a DID sexual abuse survivor who became suicidal because she did not take care of her depression and DID by remaining in therapy and on medication. As a result child is placed in foster care temporarily. and when the child is returned the child is now violent and attacking the client. Top that off with clients lawyer has forbidden the revieling of the DID diagnosis which leads to the client having to lie on what symptoms she has on comprehensive psychological evaluations so as not to reviel her diagnosis but yet lawyer has told therapist and client to just work on the diagnosis and get it in control so now not only does the client have to hide the diagnosis but the therapist is also put through stress because she has to be careful how she documents sessions, therapist now has to keep two separate set of files for this client. Add to that the client is a self injurer and throws a table at the therapist while dissociated. add to that a DHS caseworker trumping up charges against the therapist of such things as seeing the client too much, not seeing the client enough, having an unethical relationship, and so on.

Does this mean the client is to blame for the therapist burning out - no

The bottom line is therapists are in the job of being a therapist to hear about everyones problems and so on..

I don't tell LL every time I dissociate. Does that mean that I am to blame should she ever go though burnout becaus I was not "nice enough" to let her know whether or not I dissociate around her.

No LL burning out would be because LL wasn't taking care of herself by not taking vacation time when she needed to, seeing her therapist to keep her problems in check, staying on her medication if she's has any to take an so on.

LL's burning out has nothing to do with how much I tell her or include her in on as to if she is helping me or not.

I base how mush I tell her on me not on her, I do consider how fast I tell a therapist something but that is based on my 20 plus years of experiencing telling somethings in a too forward way and has gotten me locked in a nut ward or two. so now I take time to explain things in such a way that the therapist doesn't have a chance to yell or lock me in some nut ward because I left out a crutail piece of information. I take time think ok if I walk in to a therapy office with afresh cut bleeding all over the place thats a sure ride to the nut ward but if I walk in and say to my therapistbeen having thoughts agian but I when I think about it anrd wrote about it I know that I am not going to do anything that therapist is going to say ok do you know what triggered that reaction. one situation gets instant ride and the other gets discussion. For my own protection I take the time to find the routes that lead to discussions not the instant rides.

If I do know my terapist is unfamiliar with something and so on I don't take my time because I am afraid they are going to burn out and if they do its my fault because whether or not they burn out is not my fault. I do so because they respect me enough to take their time when they see that I am unfamiliar with what they are doing and saying. You might say I treat my therapists the way I want them to treat me - with respect as a human being.

But as far as me telling them things and including them in on things so they don't burn out no matter what I say or do... if they are going to burn out they will even if I am the queen of manners and the best client on earth. Therapists are human and they have their problems just like I do.

So I don't take it on to myself to keep them f4rom burning out. thats their job as a person in the field of therapy work.

hey, i think there is a middle ground with respect to therapist burnout in the sense that there are things the client can do to help, and there are things that the therapist can do to help as well.

sometimes there are external things that are going on in the therapists life. those kinds of things... well they aren't so much the kinds of worries i'm having... i don't think that there is much i can do about what my therapists life is like outside therapy.

but what i do has an impact on how much my therapist looks forward to / dreads seeing me. if my therapist dreads seeing me then it is more likely that she is going to want to terminate me / give me away to someone else. if my therapist likes seeing me then it is less likely that she is going to feel burned out with me and want to terminate me / give me away to someone else.

throwing tables at therapists... probably doesn't help them look forward to seeing you...

yeah there is positive transference responses as well. there is also idealisation (which can be a concern 'cause it can turn to disillusionment and devaluation when the idealised object fails to live up to the ideal). but positive transference responses... tend to make burnout less likely too...

;-)

anyhoo not that it matters now. she can't fit me in until the 20th and then she said she would try and schedule that as our weekly time until we move to fortnightly sessions.

so i guess now i know what the plan is.

goodo.

crap. i don't want to do this anymore.

like sux

sometimes i wish one could will oneslef out of existence
kinda go to sleep and never wake up

break out the valium...

jeepers am i in a foul mood today...

grr

I've been thinking... And I realise... I push people away. I push away... Most people. Everybody really. Sometimes I long for connection but in general I'm too frightened. And so I push people away. People I live with. People I work with. People on boards. My family too I guess (though that one is complicated).

I think...

Maybe this is about her testing how important therapy is to me. It is so tempting for me to say 'fine then' and withdraw at this point. But maybe it is about her testing how important therapy is to me. Maybe... If I don't tell her then I'll lose her.

I am sick. Terribly sick. Feel like I'm going to die kinda sick. I've been sick (like this or nearly like this) about four times since late Feb. I'm thinking... It is psychosomatic. Or has a psychosomatic component. Any social thing that I really should go to... Well I just happen to get sick and then I can't go. Typically it is a social thing that I'm dreading, but I appreciate it is important for me to go.

Part of pushing people away. %#@&#! %#@&#! %#@&#!. What the hell am I going to do??

((((((special K))))))))))))

Yea throwing the table scared her and me too. but no it did not make her dread seeing me. in fact she spent more time with me helping me to get it into control. and now that she is no longer my therapist and we have completed the ethics law time frame which turns client -therapist relationship over into friendship one year from the date of the last therapy session, we are now friends.

[(JD)]

I'd share my valium if I had any T's have to learn self care..and perform it!!! Each T needs someone THEY confide in, confidentially, a mentor or colleague in the field. (not the corn field btw lol) They have to limit their practice to what they can do... emails or not? late calls? T to fill in... yeah... work load and hours... they also have to plan in the CEUs they need each year to stay current for their license. So much! But..it's part of the job... Most importantly, they need to be qualified for the cases they have, and keep from taking OUR problems personally Yay T!

Hey. Sorry, I most certainly didn't mean to imply that throwing the table at her would make her dread seeing you. I just meant that those kinds of things... Most certainly CAN make it more likely that they won't look forward to seeing you...

> in fact she spent more time with me helping me to get it into control.

Interesting response... Still if it worked for you guys more power to the both of you! Seriously though, there can be all kinds of things going on...

I'm glad you still keep contact with you sometimes. I keep contact with a couple past t's too. It is kinda nice :-)

Hey. Thats okay I have some valium. Don't take it very often (maybe once per month) but I take it when things feel really very very bad and I'm feeling really anxious and stuff... Just to help take the edge off it and help me get to sleep. Damned sickness made it hard for me to get to sleep. 'Cause I kept needing to blow my nose... Once I fell asleep I was okay but getting off to sleep was a nightmare. Took a little to help me get to sleep. Think that lack of sleep (and sickness induced misery) meant I was getting a little wound up...

Yeah you are right. It is up to the t to make sure they have appropriate supervision and that they set appropriate boundaries to PREVENT burnout. Some therapists are better or worse at doing this, however. I guess they are only human... Sometimes they give too much... Can't put stuff away... They are only human I guess.

I still keep contact with a t that terminated me. I went off at her for terminating me out of the blue and she emailed me: I was making myself sick worrying, worrying, worrying, because I didn't know what to do to help you.

And I thought: %#@&#!. %#@&#! %#@&#! %#@&#!.

I said: You don't need to do anything. Just listening to me... Just accepting me for who and what I am... That is what I need. And you have been doing that just fine.

She went off about how she couldn't do just nothing!

And I said that acceptance... Sometimes acceptance is the key to change. She trained as a DBT therapist but I don't know that she got the hang of the acceptance part. She didn't need to do anything. In fact... Her trying to change me just made me more resistent and if she had just expressed acceptance... Well I would have resisted that and pushed for change of course :-)

I'm contrary like that :-)

We keep in touch now. But yeah... She had trouble setting personal boundaries and confining her worrying time and trouble expressing that stuff to me. We could have talked about it instead of letting it build up to that point. Ditto for t's who terminated me 'cause they thought I didn't like them. I guess... t's are people too :-O

Yea for some therapists encountering a piece of memory where the memory content is anger and throwing things CAN make them dread seeing the client.

But therapists here in the USA have been trained to work with such clients. Working in the mental health business is not easy. they encounter all kinds of clients from addictions straight on through to violent clients.

for therapists having a client go off during a session is just normal and part of the job.

if they didn't want or expect clients to let loose and release their emotions no matter what that emotion is then they would not be in the profession as a therapist.

Therapist spending more time with the client - interesting response -

For me and I have seen 19 different therapists and the one thing that rings true with each one was that if a client is in crisis that is the time when they need the therapist so the therapist ups the sessions in order to focus on what is going on and get it into control.

Now what kind of upping the sessions varied from moving monthly sessions to bi monthly or weekly or twice a week right on up to hospitalizing a client that needs 24 hour 7 days a week care.

All the therapists I have had contact with say that depending on the problem depends on how often they see a client.

For example LL sees me twice a month unless I am experiencing an increase in flashbacks and self harm urges. Then the sessions go to weekly until things calm down. I control for the most part of the two and a half years that I have been seeing LL. When setting the appointments she usually asks me if I want to come in the next week, two weeks, or the next month. I pretty mush stay at two weeks unless I am having a problem. on that two and a half years hisory LL and I have had to move my sessions to weekly on only two occasions.

I have been in therapy on and off for over 23 years and it has always been that therapists see their clients more during times of crisis then they do when their clients are on track and so on. so the fact that SKR upped my sessions after I got triggered into switching into the memory piece of Margo isn't an out of the ordinary response for a therapist. Its just the way therapy field works here in the USA.

> But therapists here in the USA have been trained to work with such clients.

all or some? in other parts of the world as well?

> for therapists having a client go off during a session is just normal and part of the job.

right. maybe we have different notons of 'going off'?

> if they didn't want or expect clients to let loose and release their emotions no matter what that emotion is then they would not be in the profession as a therapist.

maybe i'm getting the wrong idea about the thowing table incident. i probably am. i'm thinking more along the lines of damage to property / therapist feeling threatened. but maybe you mean the incident a little differently...

> so the fact that SKR upped my sessions after I got triggered into switching into the memory piece of Margo isn't an out of the ordinary response for a therapist. Its just the way therapy field works here in the USA.

on one model of therapy, yes. one model. and that is why some people have been led to say that 'switching into memory pieces' becomes more frequent. because the therapist responds positively / reinforces / gives more attention to clients who do that. and then... surprise! clients start to do that...

i found that interesting, was all...

Other parts of the world I don't know I live in the USA and my post specifically stated USA therapists. If you are in another country your areas board of certified and licenced clinical social workers can tell you if it is a part of the training process there.

When I was checking in on the training and so on when I was a vollunteer on a hotline and taking psych courses in college. I also went through some of that training as a part of my orientation for woring at a crisis center as a vollunteer and it was the counselors that trained us. While I was going through the orientation to work at the crisis center we had guest speakiers from the local mental health agency and they handed out some stuff about basic training for therapists in the state I was in and nationwide because therapists can move from state to state and practice, in case any of us wanted to use our college psych courses to go on into the field of mental health. One of the standard protocals is for becoming a therapist is doing internship and working with a variety of clients under supervision and during the college class work and during orientation we had to role play working with various types of clients including self injurers, suicidals, violent adults, violent children with mental problems. The reason their training is so diverse is because a therapist unless they are worknig a private practice and can choose the type of clients that they see, they work in agencies who assign them their clients. Therapists work with who ever the supervisor who hands out the caseloads tell them too, and alot of times people are not going to admit to being a violent type person right on intake so the therapists must be ready to handle situations when they spontaniously happen, and people working at crisis centers don't pick their clients either we got what ever sitation and who ever walked in the door or what ever situation or person the local ER called us about. If we felt we were not capable of handling a situation a superviser stayed in the room with us.

i myself had to deal with an escaped prison inmate who showed up on college grounds and I happened to be working the college office and taking classes that day and when I sent a student to put a call in to the crisis center and the police the local on call person with the center that night was in the ER with a rape victim. and the next one was a 15 minute drive away. That standard training for therapists and crisis intervention came in real handy that night. Luckily I didn't find out the guy was an escaped prisoner from a downstate prison. I probably would have passed out instead of sitting there keeping him calm and focused on me instead of the students and classes going on upstairs in the classrooms,until help arrived.

Granted yes there are clients that attempt to use crisis situations as an attention getter and therapists in this country have strict mental health ethics laws and rules surrounding the client therapist relationship and working with clients to promote independance not dependance for this reason and and each agency has set protocals of what to do when they see a client using therapy time for attention instead of work on their problems.

for starters here in the USA the first few sessions are used for getting to know each other and filling in paperwork as to why the person is entering therapy, what their problems are and what goals they want to accomplish while in therapy. Usually this goal sheet is done every 6 months especially if the person is paying by some form of medical, mental insurance polocy. (medicaid, state, blue cross and so on) Then the sessions after that are geared for working towards accomplishing those goals set down during the first few sessions. When the therapist notices the client is using therapy time for gaining attention through creating crisises instead of working on their problems and goals the therapist either informs the client what the agencys protocal is concerning extreme crisies (self injury, suicidal or whatever beintentional behavior is happening) protocal is. usually the protocals include referring the client after hours to the local ER instead of taking their calls after hours. During hours the therapist no matter what problem the client comes in with, stays focused on solutions for their problems or decreases their sessions if the client repeatedly does not work on their goals and solving their problems, or transfers the client to another therapist so that the client cannot continue to manipulate the preferred therapist for attention.

Going off - there are a lot of therapy techniques geared towards the client expressing the extreme emotions that they have locked in side for example punching pillows, hitting a chair with a bat, screaming or yelling at their abuser if needed and so on.

Yes they are supposed to be controlled going off situations but I have witnessed many times when those techniques have been used and the therapist has had to follow the training protocal of leaving the room and calling in reinforcements of co workers, supervisors, or the police..

Table throwing situation SKR happened on to that piece of memory without realizing it was there. I am an amnesia DID which means I have no idea what and how many memorys were separated and stored at my unconscious level (repressed memories). (A typical person with Dissociative Identity Disorder can have a minimum of 2 repressed memories being acted out unconsciously and over 200 hundred for maximum number of repressed memory pieces being acted out unconsciously spontaniously when triggered) which is what DID is - a person who when triggered switches into acting out repressed memories unconsciously while they are mentally unaware of what is going on.

Since my memories have been separated and stored at my unconscious level of thinking I can't tell my therapist what they are so my therapist finds out when I act the pieces of memories out.

With DID there is no warning. You want an idea of what its like have you ever saw the movie "Sybil". Its a bit over dramatized for getting people to watch it but it does represent the unpredictableness of "switches" as in a person can switch in a snap into acting out any number of pieces of memories.

I am a rapid switcher and I switch give or take 5- 10 times a day. I can be doing something while fully aware one second and then next from my perspective I am floating in my mental safe place but what people around me see is my physically acting out a memory. I can be talking to a friend one minute and then next standing there with her telling me I just beat up her boyfriend, or one minute making dinner and then next sitting in the bathtub taking a bath and so on.

In the situation of the table getting thrown one second I was talking about my child who is in residential treatment facility right now and the next second I was feeling far away and floating in my mental safe place and the next SKR was not in the room and the room was a mess, the next second SKR was sitting in front of me asking if I remembered throwing the table.

After I told her I remember talking about my child and then being far away and then she was gone and then she was back she told me that she had set up the table because while talking about my child I got up and looked out the window then I sat down and she asked me if I could draw her a picture because I could not tell her what I was seeing. I apparently told her yes so she set up the table and crayons and markers, I drew a picture and then I threw the table. the table was flying along with the crayons and markers and sketch book.

When I had come aware and she was not in the room it was because she went down stairs for help and to call the supervisor. When I became aware and she was in the room she said that was when she had been in the room about 5 minutes trying to talk to me to find out what memory piece I was in at that moment. Then she got permission from me to call a friend and the friend was going to come pick me up to take me home She wanted me to have some time to calm down and relax and because of what happened we needed to slow down on my therapy program and instead of focusing on my nightmare we had to meet more often to work on gaining control of my dissociating into that one piece of memory because if throwing things while I was dissociated happened again we could not work together and I may have to be hospitalized. When I asked SKR if I had hurt her or broke anything in the office because at home things do get broke sometimes when I dissociate. she told me she was fine a bit scared the table had hit her knee but that was not going to scare her away from being ny therapist and as for room damage therapy agencys carry insurance to cover damages when unpredictable things like this happens because in the business of mental health there is no predicting when a person is going to get triggered into going off let alone to my extent. A certain amount is expected which is why therapy agencies the insurance policys . going off to my extent is expected with DID clients because there is no predicting what the repressed memories are until the person with DID gets triggered into acting those memories out.

TRUE DID switching is trigger related not based on getting attention which is why switching increases with seeing a therapist. The therapist and client are working on remembering the abuse situations that the person cannot remember.

Can a rape victim control a flashback - (Ok Im not going to have a flashback until I see my therapist.) No flashbacks happen when the person encounters a situation that reminds them of the abuse they went through. what are flashbacks memories of traumatic events.

Same with DID switching. When a person with DID encounters a situation that upsets them the piece of memory that is related to the topic or situation replays.

DID's can't say ok Im not going to dissociate until I see my therapist. Dissociation is a part of their life in every aspect of their lives.

For example - Just today I was sitting in an eye doctors office for my routine check and the assistant put eye drops in my eyes and the next thing I know the appointment is over and the doctor is telling me what the test results were. From there I went to the local library. I was in an elevator and a drunk got on. The next thing I know I am sitting in the bathroom and one of the librarians is asking me if I need any help because I had been screaming while sitting on the bathroom floor. I told her I was fine and went to the computers. then I went downstairs and had lunch with a friend the next thing I know Im sitting at my therapist office for my normal session. Then I biked home I stopped to draw some ducks. The next thing I know I am in my grocery store. then I went home and watched some tv. The next thing I know I am taking a bath. I got out and made dinner and ate it. The next thing I know I am sitting on the floor coloring in a coloring book -

Where is the attention - I live alone, I do my own grocery shopping, I do my research and write my books at the library alone, When I talked to my friend to fill in my dissociation log she told me that what I couldnt remember was that we had coffee and ate sandwhich and talked about a book that both of us were reading. She didn't even notice I had dissociated until I swore a specific word which when I am completely aware I don't use a particular word. my therapist had wrote my appointment time down wrong so we never had the session just rescheduled. and I make up my own therapy projects and do most of my therapy work at home when I am alone such as drawing and other artwork, dissociation logs, depression management logs, anxiety managment logs, journaling, awareness therapy, stimulating my senses therapy work all most of which my therapist never sees. My therapist constantly asks me if I am still aware because I switch so often that she cannot tell from one second to the next if I am fully aware or answering her questions from memory pieces.

If I was switching to gain my therapist attention I would only be switching with my therapist and my switching would be over dramatized so that I gain her attention and my therapy work would only be worked on with my therapist.

DID does not work on the realm of gaining attention unless the person is not a true DID. DID starts in childhood and is in every aspect of the persons life not just in the therapy room.

> Granted yes there are clients that attempt to use crisis situations as an attention getter... When the therapist notices the client is using therapy time for gaining attention through creating crisises instead of working on their problems and goals... the therapist no matter what problem the client comes in with, stays focused on solutions for their problems or decreases their sessions if the client repeatedly does not work on their goals and solving their problems, or transfers the client to another therapist so that the client cannot continue to manipulate the preferred therapist for attention.

I'm wondering how the therapist decides whether to judge 'attention seeking' or 'DID'

> Table throwing situation SKR happened on to that piece of memory without realizing it was there. I am an amnesia DID which means I have no idea what and how many memorys were separated and stored at my unconscious level (repressed memories)...

> unconsciously spontaniously when triggered) which is what DID is - a person who when triggered switches into acting out repressed memories unconsciously while they are mentally unaware of what is going on.

> Since my memories have been separated and stored at my unconscious level of thinking I can't tell my therapist what they are so my therapist finds out when I act the pieces of memories out.

> In the situation of the table getting thrown one second I was talking about my child who is in residential treatment facility right now and the next second I was feeling far away and floating in my mental safe place and the next SKR was not in the room and the room was a mess, the next second SKR was sitting in front of me asking if I remembered throwing the table.

> instead of focusing on my nightmare we had to meet more often to work on gaining control of my dissociating into that one piece of memory because if throwing things while I was dissociated happened again we could not work together and I may have to be hospitalized.

Right. So your t did indeed state clear consequences if it happened again.

Linehan takes pains to distinguish between someone intentionally manipulating their therapists, and someone not intentionally manipulating their therapist. She says that when therapists judge a client to be manipulated all they are really entitled to is 'I feel manipulated by you'. That is typically because the client doesn't know how to obtain the attention and care that they need. I'm an advocate for clients who are typically judged to be 'attention seekers' and 'manipulative' for the reason that it says more about the therapists limitations than it does about the client. We knew the client needed help already (that is why they are in therapy). The therapist on the other hand... We hoped they could help... But sometimes therapists would rather blame / judge clients than admit that they don't know how to help some clients.

> going off to my extent is expected with DID clients because there is no predicting what the repressed memories are until the person with DID gets triggered into acting those memories out.

Sounds to me like DID patients get treated differently (in the cases when they do) because people say 'I wasn't aware of doing that' and thus they are absolved of responsibility. Griffiths considers it to be an example of 'disclamed action' comperable to 'the voices made me do it'. Lets say someone kills someone else and they 'don't remember'. Does that mean they should be let off, or should they still face consequences so as to prevent their reoffending?

What is interesting about what the behaviourists learned was that if a behaviour is reinforced then it is more likely to recurr (whether people were aware of the reinforcement / the reason for the likely recurrence or not). Similarly if a behaviour is punished then it is less likely to recurr (whether people were aware of the punishment / the reson for the likely non occurrence or not). What that means... Is that ones behaviour can come under the influence of reinforcement contingencies without one being aware of it (thus I say it is pointless to blame the client / victim though it is indeed something that therapists should be aware of / should consider).

> TRUE DID switching is trigger related not based on getting attention which is why switching increases with seeing a therapist.

Do you mean by definition? Thus if the therapist judges the client to be 'faking' to 'get attention' then they don't really have DID whereas if the therapist is sympathetic to the 'I lost time I don't remember doing that' claims of the client then they are taken seriously thus they have DID?

> Can a rape victim control a flashback

To some extent. Also the flashbacks can come to be elicited by... Reinforcing their recurrence...

> DID's can't say ok Im not going to dissociate until I see my therapist.

Do most people with DID clearly dissociate before therapy? Kluft (advocate for DID says 'no'). He says therapy makes it more likely to happen as client becomes 'more in touch' with trauma. Sceptics say therapy makes it more likely to happen as client gets reinforced by their t's.

> If I was switching to gain my therapist attention I would only be switching with my therapist and my switching would be over dramatized so that I gain her attention and my therapy work would only be worked on with my therapist.

If overdramatising would have the effect that she would conclude you were faking then it would be in your (unconscious) interests not to dramatise. Sounds like you have her attention already... Behaviours learned in therapy (such as coping skills, such as switching) can indeed generalise outside the therapy setting over time...

I'm just saying... I think there is a middle ground. Nice that your t let you know the table throwing was unacceptable (so if it happened again you would be terminated). If she didn't say that... If she just expressed concern and didn't state a likely consequence... Then... Table throwing would have become more likely in the future.

Dissociative symptoms / flashbacks can be shaped...
And I don't think some t's / clients realise this...

Just like hysterical paralysis (which doesn't really happen anymore). That was shaped too...

It is interesting to me that some theorists (who work with DID) consider BPD to be a dissorder that is best thought of on a continuum with DID (so that BPD is thought of as a dissociative / trauma disorder) e.g., Colin Ross. While other theorists (who work with BPD) consider DID to be a disorder that is best thought of on a continuum with BPD (so that DID is thought of as a disorder of emotion dysregulation).

One could say that they are both right in the sense that they are indeed on a continuum.

People on the BPD end of things are likely to consider alters the product of therapy, however. People on the DID end of things are likely to consider alters to have been present before therapy.

Dennett (interestingly enough) looks at what a self is supposed to be... Seems that the self is a social construction. The social construction is shaped by models in our life, the narrative stories we tell ourselves, reinforcement from others. He considers alters to be narrative stories comperably to how a single self is a narrative story.

Whether the notion of multiple selves / personalities / alters occurs to the client at the suggestion of an abuser, at the clients own suggestion, at the suggestion of movies or books, at the suggestion of a therapist doesn't really matter. He thinks it is hopelessly arbitrary to consider some of those aetiologies to be somehow 'legitimate / genuine' while others are not.

What it does draw ones attention to, however, is the notion that behaviours are indeed (unconsciously) under the control of reinforcement contingencies and therapists are the source of reinforcement contingencies.

IMO... There is an unjustifyable difference between therapists considering some clients to be 'attention seeking' and 'manipulative' in a disorder that is likely to last a lifetime while therapists consider other clients to have a disorder that is 'more severe' yet the treatment outcomes are thought to be 'much better'.

IMO 'attention seeking' and 'manipulative' are expressions of a therapists lack of understanding / feelings of inadequacy.

IMO 'alters' are narrative constructs that are employed to 'make the best sense of behaviour' where behaviour comes under the control of reinforcement contingencies that therapists do indeed have a significant role in shaping.

I advocate a middle ground... Selves just are narrative constructs so there is no metaphysical puzzle in the notion of many selves that isn't already present in the notion of a single self. Punishment isn't particularly effective in shaping behaviour, but teaching legitimate alternatives that have the same function (much needed attention and care) is much much better in shaping behaviour so that a single systems (self) interpretation is more appropriate.
Disclaimed actions should not absolve someone of consequences for their actions. Inappropriate actions need to be dealt to to make their reoccurance less likely.
But the latter point probably follows from my notion that just because we 'could not have done otherwise' (in the sense that determinism could well be true and even if indeterminism was true then the probabilities of different actions could not have been otherwise) and hence justice / moral responsibility is about delivering consequences to make future problem behaviours less likely.

[PasDeDeux]

Hi Special K thats some very deep stuff I have been reading in your thread. You seem to really think it out from all angles.
Do you still see the T I read about a while back in the thread?
You may never find a T that holds the exact same way of looking at all the ways like you do. You are very bright. But I think maybe trying to work it out with a T would still be of benefit

Thanks. Yeah I saw my t today. She mentioned about fortnightly sessions again (in fact she mentioned about monthly sessions too). Next time I'm going to talk to her about what we are doing in therapy because I think we have very different ideas... I think that she is seeing it as brief supportive to help me adjust to having moved countries. I see it as... A way to talk through some of the past stuff that is still impacting on my life. My relationship issues (issues with trust and intimacy and attachment), my trauma issues (issues with flashbacks and ruminations), and so on and so forth. Maybe she doesn't really do that kind of stuff... I don't know. I don't know that she knows what to do with me. I don't know that the public service here is geared toward that at all. I guess they look at my functioning and it is arguable whether I qualify. That being said she said that she was concerned about how I was last week because she didn't think my mood could have afforded to dive anymore. I agree, my mood couldn't have afforded to dive anymore. Trouble is I don't just want therapy to be about helping me through crises. I want to deal to the underlying issues that resurface over time as crises. But... Maintenence... I don't know. Yeah I want therapy... I'm just not sure that this particular variety is going to be what I'm looking for / wanting / needing...

But I shall talk to her next week.