Playing the Cards Right

Hi all,

I have a kind of complicated issue that I would love to get some insight from you all about. For those of you who do know my history, I'll try to make my summary brief. I was seeing a therapist for about a year, whom I became very close to. I saw her 3-4x a week with lots of out of session contact (via phone, text, email, even snail mail.) I was seeing her for OCD primarily. Last January, my OCD got so bad that I was admitted to a residential program. I was there for about 8 weeks and went through intensive CBT work. The professionals there squeezed every bit of information out of me about my relationship with my therapist as they could (I still don't know why). They deemed her unfit to treat me because of boundary issues. Our relationship was terminated without my consent and upon discharge, I was sent to a new therapist. It was heartbreaking for me to be cut off from my previous therapist because we were so close. That brings us up to the present.

So here's the issue I'm facing. This new therapist and I got off to a very rocky start. I was discharged and came home spitting mad. I was angry and frustrated and not at all willing to see this new therapist. I didn't have a choice though, so I tried to make it work. It's been about 6 months with this new person now and we still aren't great together. I've always felt like she was judging me, judging my old t, and very invalidating of my grief over losing old t. She tends to be very blunt and very vocal about her personal opinions. I always have felt like I have to edit my thoughts around her and what I say in session, and I always feel like I have to stay one step ahead of her ulterior motives (whatever they might be).

A couple days ago, she brought up the idea of termination. Her job was to ensure that I had a successful re-integration into the real world from residential and that job has been done. I was over the moon when I heard that I might finally get to be done with her. She asked me to think about termination (what evidence I have to justify the termination, what I would like to do next, what goals I have for the future, etc.) I was going to just be honest and tell her that she herself said that her job is done, and that I don't feel like we ever really connected, and I would like to terminate. However, I really want to go back to my old t. I have other issues that I want to work on that are un-OCD related and I think that my old t would be the perfect person to help me work through those (since the issues have to do with trust, and abandonment, and other personal issues). I feel comfortable with her. The problem is, new t is very biased against my old t, because she was informed by the hospital that old t had bad boundaries and was "unethical".

My dilemma is this: I need this new therapist to be on my side. I can't go in and say that I should be able to terminate because I don't like her, and expect her to help me by recommending that I go back to my old t. Neither can I go in and tell her that we should terminate because I'm doing so well and don't need her help anymore. She'll say, "If you don't need help anymore, then why do you need me to recommend you see your old therapist?" I need to play my cards just right. Because I'm a minor, her recommendation is going to have a huge effect on what happens to me after we terminate. Any ideas for how I could convince her to let me go back to old t?

I see my t on Tuesday to make my case. I really need it to go well.

Honestly miswimmy... I know how much you were attached to your old T, but I think going back to her is a bad idea... so I can't think of any ideas for you.

But I do also think that leaving your current T is a good idea. But I would suggest finding a brand new T who is not related in any way to either of them.

First of all, do you feel ready to work on abandonment and trust issues? Because those are really big and heartbreaking things to tackle and all that is stirred up in confronting it might trigger your OCD stuff again.
Secondly, if you are ready to really get into that stuff, i think you need to be realistic about whether your old T is the one to help you with this. You might think she is because you yearn the closeness and nurturing that she offered you but trust me, going thru abandonment crap sends you down a crazy road and it is really really important that you have a T that holds good boundaries. I know it's not what you want to hear, cos honestly i don't like the fact either. But constant access to a therapist keeps you in a place of neediness and dependence and never really trying to cope yourself. There needs to be some space in the week where you cope without her, because it is the only way you will learn resilience. And if she can't recognise that and doesn't hold the boundaries it can be really dangerous and harmful for you because what you want to deal with is Trauma. Is she qualified to work in depth with trauma, attachment, and everything else it entails?

If you've truly considered all this and you still think she's best for you, then really isn't it your parents you should be speaking to openly and honestly about what it is you want to work on and why the old T is best for you?

In making your case to new T, you will need to convince her that old T is now right for you. It sounds like this task could be difficult indeed. Besides the fact that you are comfortable with her, what is it about old T's skill set, orientation, experience, etc. that makes you sure that she is right for your current issues? I think it would be wise to be prepared to answer this question.

Miswimmy1,
Have you thought of trying to build a relationship with a new therapist? That way you can build a long term relationship with the new therapist.

I think going back to your old T would be a step backward into a place of dependency and neediness and very loose boundaries. I suspect you would backslide with her. If you still have things to work through, look for a therapist who has some of the nurturing qualities of your original T, but is more able to maintain clearer boundaries with you. That would be a therapy relationship that would have more potential to move your forward.

I agree that this therapist is not the right one for you. I also think that returning to your prior therapist would not be very helpful for you. It seems almost like Goldilocks and the three bears. You know, the first T was too soft, this T is too hard. You deserve a T who is just right for you.

I don't understand why you need this therapist to go along with seeing your first therapist, though? If she feels her work with you is complete, why is it up to her who you see next, whether that's your previous T, a new T, or no T at all?

I think you can find a therapist who is more nurturing than the current one, but that doesn't encourage so much regression as the old one (regression as in seeking and receiving reassurance 24/7, I believe this can maintain someone at a very young age, emotionally).

It may seem counterintuitive, but I think in some ways your old T (unintentionally) encouraged your abandonment fears. She didn't give you space between sessions to learn to trust that when someone you are attached to (friends, family, boyfriends) is not with you, they have not abandoned you. Since she was always 'with' you, there was no way to learn this essential skill. And since others are not and cannot be there for you and reassure you in this idealized manner, I imagine that, in comparison with the T, it may feel that everyone else is abandoning you. In the end, for various reasons, the therapy worsens the abandonment issues it was supposed to heal.

Resilience comes from managing your mood and fears and other things on your own. The therapist needs to help with this, but if they manage these things *for* you, you never learn to do so yourself. Resilience is what will help you get through real life, to be able to count on yourself, trust in your abilities (and from there, trust others).

People talk about 're-parenting' in therapy -this can be healing, it can also go very wrong. One way it can go wrong is if the T doesn't allow the patient to grow, to handle things on their own (over time)

I think this dependence, often need for reassurance, etc. is a necessary *stage* in some therapies, but what if the therapy gets stuck at that stage, because of the lack of skills and/or willingness to let go on the part of the therapist?

And, I'm sorry, but I think some therapists who keep their patients at this stage, that don't allow them to grow and progress from this, do so in an (unconscious) attempt to fulfill their own needs (to parent a young child, in the sense of someone relying on them entirely?) rather than with the needs of the patient in mind.

Therapy is a delicate dance, and it needs to be tailored to the needs of each individual patient, but my impression of your old therapist is that she (unintentionally) instilled the belief in you that you cannot handle things on your own, or at least not without her.

I am sorry youre in such a hard situation.

Thanks you all for the replies- Maybe seeing someone entirely new would be a good thing. I just don't know if I can start all over again. Maybe if old t straightened up her boundaries?

You really should find a new T. You could always write a brief history and give it to the new T so you are not starting new exactly.

I doubt that would work. You can't unring that bell.

Old T almost certainly won't tighten their boundaries.

And if she did, you would get upset and push at her to loosen them again.

You can easily start with a new T - just ask your parents to find you a T who does not work in the same office as either of your past Ts.

You started all over again with new T. It was a rough road but you persisted. It feels dreadful to imagine doing that again, but you have demonstrated your resilience many times. I think you can do it!

I have seen you be tremendously resilient and actually quite mature for your age in some ways. I do admire you for this, I really think you can do it!

I feel like old t filled some hole inside of me and I can't bear to lose her It may have been an unhealthy relationship but I can't change the fact that it was a relationship that we had, and that I enjoyed. I can't deny those feelings. The idea of not seeing her ever again is unbearable to me How am I supposed to just move on?

I don't know. It's hard and I understand.

I feel like that about my exes. I still miss them, each of them. But I move on, and eventually meet someone else who I care a great deal about. But that only happens because I recognize that it's over, and that even though I care, it's time to move on. I have to make myself be open to letting someone new in.

You don't have to stop caring about your old T, and you don't have to stop missing her. Those feelings will fade into the background as time goes on - and those spaces will be filled by new people. But only if you let them. Which is why your old T is a toxic relationship for you - you were content to just have your Old T and you were not growing.

You can honor those feelings you have for her and the relationship. I personally don't think it was very healthy for you, but I also don't think there's any reason to feel shame about it, I hope you don't.

I feel like old t filled some hole inside of me

I feel like this is significant. Maybe you need to work on this emptiness you feel (if this is what you experience); perhaps you will better be able to fill it yourself if you gain a better sense of self and the space to discover that self. I don't think you will have the space to do that with that T -I can't see her giving you the emotional space to find yourself and solidify it as your own, as opposed to a self dependent on others to exist.

If you don't learn to fill this hole, you may also end up looking for others -significant others- to fill that hole for you as you have your therapist, leading to immense dependency on that person -the fear of losing someone who is providing this vital function must be terrifying; if you're able to yourself, you don't have to live in that terror that if you lose x person, you will be lost, empty, alone.

You won't always feel like this --and I think with good therapy, you will be able to feel good, about yourself and your role in the world, in a far more solid, stable, and lasting way, than the feel-good moment-to-moment dependence on this T. You'll find that you can count on others in your life, to help you, to love you, without expecting them or needing them to also take care of you. You'll actually *want* others to treat you as the strong, intelligent, resilient young adult you are, rather than rather helpless, which is I think how your old T treated you sometimes, in subtle ways.