[Leah123]

I have had a few rough spells with my therapist, about which many people here gave me a lot of helpful support and feedback. I heard from many that my therapist might have room for improvement, to put it nicely. Conversely, I've healed a lot working with her, and she has some distinct strengths and skills from which I've benefited.

During the last one, I devalued her in frustration and anger after asking again for concrete tools to help to cope with a difficult, emotional period. I realize I really want her to fairly acknowledge her role in my frustration- that I was hurt, and I struggled, when I asked her several times during the past months for concrete tools to help keep my emotions (anger, fear, wretchedness) manageable, and she told me variations on the themes of: just write to me when you feel bad, there is no way to deal with the pain except go through it, and just accept it. I know therapy is hard, emotional work and painful. HOWEVER, there are breathing exercises, visualizations, coping techniques, and anger management tools that can help me as I work on the larger issues. That's a fact. I've found some of those tools elsewhere and in occasional consultation with another therapist and been so glad for them.

Now, she has finally offered them to me, but told me it was because I exhibited the borderline personality trait of devaluing her the other day when I was so angry that I told her she was lacking professionally. I was rude to her that session (not because I'm borderline, but because I was dealing with way too much stress, I have PTSD, and lost my cool), and I apologized, but it occurred to me, I may have been trying to idealize her in general other times, and I do want to look at her realistically.

So, I wrote her a letter telling her I was sad that it was only, after months of occasional asking, that it wasn't until I got furious that she was inspired to find tools, and that I was not comfortable with her labeling it as a borderline trait when it wasn't consistent and was clearly more situational, etc. etc. Yes, I was rude, and out of line, and I did apologize, but I felt pathologized the way she offered the DBT.

So, she replied that she knew I definitely didn't have Borderline and that many people exhibited the trait during times of extreme stress, especially people (like me) who have PTSD. She said though, maybe I wouldn't have healed so much before if I did have more structure, and to be radically accepting that we can only learn from the past.

And you know what- I wanted to agree with her, and I did, to an extent, but my underlying feeling is: "That's a cop out! You could have helped me, given me what I asked for and you didn't," and the way to get me to real acceptance is for her to say sorry. I wish she would say sorry. I may not get it, and it won't kill me, but I wrote back to her and said (not verbatim):

I know we can't rewrite history, but if you're going to say my healing might have been less with more structure, well, I want to acknowledge the other side of that too, that I might have gotten better faster. I am glad we're going forward with DBT, but I struggled without those tools for a long time and I see that maybe I idealized our relationship, because I'm trying not to exalt you or devalue you, and I see that this lack of tools at key moments is one limitation of our work together. I told her maybe I was just starting to experience the concept of "good enough mothering" where I see she is not perfect, but good enough, a realistic perception. And I ended by telling her all the many things I appreciated about her, so it was not the type of unfair, angry attack I unleashed on her originally, when I was struggling so hard in the wake of my husband's suicide threat and other issues.

Do you all think I'm being fairly reasonable?

I'm sure what I wrote wasn't perfect, but... I think as the client it's fair for me to give feedback at this juncture, and I want her to acknowledge my struggle and that I feel let down, that I am trying to accept this relationship as it is, and for her to admit she fell short in this area.

I know I shouldn't try to force an apology or agreement, but... I just want some type of acceptance of responsibility to move forward. I don't want her to get away with dismissing my requests for coping tools so long and then telling me I acted borderline without acknowledging her part in our longer-term misattunement about how concrete grounding/coping exercises would have been helpful.

Anyhow, I'm afraid she'll be sick of me trying to push her to admit imperfections, but... I'm not sure how to just get past this right now. I've had an ugly few weeks that definitely would have gone much better if she understood what I needed.

[Daisymay]

I think you're being perfectly reasonable to need her to acknowledge how her actions/words caused your hurt and frustration. It's validation of your feelings.

[archipelago]

If you are agonizing about the relationship specifically about doubts you have that she will provide the right kind of care in the right kind of way, then unfortunately I think it may be time to reconsider. At least to be open to it.

I have had many difficult times with my therapist, fighting over things that I did not think were okay for him to do, but these all got worked out, with him really listening, wanting to improve the relationship, which is exactly what happened.

I don't look for skills in my therapy, not at least in any straightforward, but I know that many do and there are many therapists who specialize in providing just that.

The fact that she only decided to give you what you're asking for after a rupture that hurt you and threw you into a tailspin is not really a good sign, though that didn't occur to me until now. That is because I didn't realize that she labeled you as borderline. That sends up a red flag for me. I have PTSD too. The two diagnosis share some traits, but are not the same, though I have used DBT worksheet on my own to develop self-soothing. But borderline for many has a stigmatizing effect because therapist do have an aversion to borderlines that I believe is unwarranted, but more common than it should be. And you seem very clear that you don't agree with her assessment.

[Leah123]

Originally Posted by archipelago

If you are agonizing about the relationship specifically about doubts you have that she will provide the right kind of care in the right kind of way, then unfortunately I think it may be time to reconsider. At least to be open to it.

I have had many difficult times with my therapist, fighting over things that I did not think were okay for him to do, but these all got worked out, with him really listening, wanting to improve the relationship, which is exactly what happened.

I don't look for skills in my therapy, not at least in any straightforward, but I know that many do and there are many therapists who specialize in providing just that.

The fact that she only decided to give you what you're asking for after a rupture that hurt you and threw you into a tailspin is not really a good sign, though that didn't occur to me until now. That is because I didn't realize that she labeled you as borderline. That sends up a red flag for me. I have PTSD too. The two diagnosis share some traits, but are not the same, though I have used DBT worksheet on my own to develop self-soothing. But borderline for many has a stigmatizing effect because therapist do have an aversion to borderlines that I believe is unwarranted, but more common than it should be. And you seem very clear that you don't agree with her assessment.

I want to be clear, she did not label me as borderline, though I bristled at even the use of the word, it's associated with some baggage of mine, the fear of being pathologized.

She was very clear to say in our initial chat and in email when I mentioned it again, that I definitely did not have borderline. But I just don't know why she even had to tell me I had a trait of it, why she had to bring that into the conversation. I definitely didn't find it helpful.

Also, ironically, I do believe now that she is willing to provide the right kind of care. Her style of therapy, client-directed, has worked very very well for me for the most part, met a lot of my needs, it is just in this area, of very very difficult emotions and being activated/triggered, I needed something more concrete, and it's been a long time coming, but she showed me the other day, she could do it, and I think if I give her December, I'll be happy with our work, I hope!

[Syra]

I'm wondering if perhaps the obtaining of homework is a real good sign. If I understand it, you have been asking for homework for a long time. And she has resisted, as I could imagine with someone who is PCA/client-directed would do. It's not their way to do therapy. And then you have a huge fight. And she is very very angry - and yet she went out and got you what you wanted. I know when my husband gets really really mad at me, it doesn't make me more likely to want to change and do things his way.

I'm not defending her outburst. I'm just wondering if getting the homework is a good sign.

I completely understand wanting her to acknowledge her contribution. I think it would be nice. I think the outburst was not using good skills. I wonder if she has changing her behavior is close enough for therapy to work? I think of the story of a couple fighting. and the next day, the husband goes out and does what the wife wants. Doesn't apologize. Doesn't say anything. But getting the thing he was resisting the previous day, without complaining, with good will, is sort of the best the guy can do at this moment.

I don't know if it's good enough. I'm just wondering.

[Leah123]

That is such a good perspective Syra, because I've been going back and forth with her about this today, and she acknowledges it's a learning process and says she's sorry I was suffering, but she does not apologize or acknowledge her lack of sensitivity, lack of attunement, lack of ability to meet my request for structure, for a calming tool.

I'm having a very hard time with it!

I feel terribly upset and exposed because I behaved badly and my stress level is extraordinarily high. I hate how hard it is for me to cope right now. I am feeling so resistant to therapy right now.

She's waiting to offer me tools and acceptance, to stick by me, which is all very good, but...

I'm not at the point, tonight anyway, of letting go of my realization that she majorly let me down and I did not want to act so ugly, to be seen so ugly. That is not her fault- my behavior is my fault only, but... it's like... I was bleeding, and she wanted me to talk about the blood instead of give me a bandaid. That's not exactly the kind of therapy I signed up for.

I have enough pain, enough blood to work through without feeling comfortable just letting that artery spout without having her help me put some pressure on it. Sigh, I am SO conflicted right now.

Too stressed. I hope tomorrow is better, just don't know how to move forward feeling I am looking more volatile to her by the minute and fearful of seeming so.... dysfunctional. It didn't have to get this bad. I wish I did not have to get so far off balance before she heeded my request for support.

It's not that she's never offered me anything, but it was in a crunch, in the darkest place, where I felt the lacking in our relationship and her skillset the most.

[CantExplain]

Hi Leia!

What you describe is fairly typical of my complaints against Madame T. In the end, it is easier to change Ts than to get a T to change.

Sorry!

[tametc]

Originally Posted by Leah123

That is such a good perspective Syra, because I've been going back and forth with her about this today, and she acknowledges it's a learning process and says she's sorry I was suffering, but she does not apologize or acknowledge her lack of sensitivity, lack of attunement, lack of ability to meet my request for structure, for a calming tool.

I'm having a very hard time with it!

I feel terribly upset and exposed because I behaved badly and my stress level is extraordinarily high. I hate how hard it is for me to cope right now. I am feeling so resistant to therapy right now.

She's waiting to offer me tools and acceptance, to stick by me, which is all very good, but...

I'm not at the point, tonight anyway, of letting go of my realization that she majorly let me down and I did not want to act so ugly, to be seen so ugly. That is not her fault- my behavior is my fault only, but... it's like... I was bleeding, and she wanted me to talk about the blood instead of give me a bandaid. That's not exactly the kind of therapy I signed up for.

I have enough pain, enough blood to work through without feeling comfortable just letting that artery spout without having her help me put some pressure on it. Sigh, I am SO conflicted right now.

Too stressed. I hope tomorrow is better, just don't know how to move forward feeling I am looking more volatile to her by the minute and fearful of seeming so.... dysfunctional. It didn't have to get this bad. I wish I did not have to get so far off balance before she heeded my request for support.

It's not that she's never offered me anything, but it was in a crunch, in the darkest place, where I felt the lacking in our relationship and her skillset the most.

You are very good at explaining this in the way you write. The analogy of wanting her to help you put pressure on the artery is powerful. Is there any way you can share this post with her? I think a T that doesn't acknowledge her shortcomings is probably insecure.

[unaluna]

I think generally speaking, in therapy, it is up to the client to reach across the aisle. The t provides the environment, but i dont think they should insert themselves into that space. That might be the expectation in a normal relationship, but in t, i think we are pushed to extend ourselves more. It's not punishment or to teach us anything - i believe its really just to give us enough room to find our true selves in. Without them interfering. I cant really tell if this applies to you because i dont remember you talking about the holding environment etc.

[Leah123]

Originally Posted by hankster

I think generally speaking, in therapy, it is up to the client to reach across the aisle. The t provides the environment, but i dont think they should insert themselves into that space. That might be the expectation in a normal relationship, but in t, i think we are pushed to extend ourselves more. It's not punishment or to teach us anything - i believe its really just to give us enough room to find our true selves in. Without them interfering. I cant really tell if this applies to you because i dont remember you talking about the holding environment etc.

Yes, I reached far across the aisle, so far, I felt myself falling. I felt like retreating when I was triggered, but I did not. I showed up, pushed through, and got worse. She tried to help but really missed the mark. I do understand about us finding our true selves, and do not shy away from pain or working through my issues, but the point of a therapeutic relationship is to do that with support, the theory in my psychodynamic therapy being that I can have a corrective experience, a supportive experience, a safe holding space, and I needed my therapist to be assertive and offer me the right tool, and she came up mostly empty handed. She says she is willing now to provide the tools, but not without telling me I have a borderline trait, which is unhelpful, not without me having to get to an escalated point before she could apparently think of the right tool for the job.

It seems like the offer was a long time in coming, and I wish she would say sorry for not properly helping me sooner. I just wish for that.

[Leah123]

Originally Posted by tametc

You are very good at explaining this in the way you write. The analogy of wanting her to help you put pressure on the artery is powerful. Is there any way you can share this post with her? I think a T that doesn't acknowledge her shortcomings is probably insecure.

Thank you. I sent her the analogy, telling her as she encouraged me to 'vent' and explore my husband's issues and my marriage while I was severely triggered, instead of addressing my being triggered, that I felt she was more focused in watching the blood spurting than in staunching the flow. It was not until, in my extreme frustration, fear, and struggle that I actually lashed out at her that she finally decided I might need the tools.

I believe in exploring my issues and I know it will be hard. I've been doing this work intensively for months now, three or more sessions a week, so I'm not shying away from the pain, but I was really triggered, extremely anxious, fearful, etc. and it was time for some pain management to get me feeling more myself, more centered, more capable, more sound, before doing further work. Sigh.

[CantExplain]

I wanted Madame T to meet me halfway. When I reached out to her, I wanted her to reach out to me.

[Leah123]

Yes, exactly!!! I just wrote this to my therapist, after the metaphor about the artery:

"I'm thinking about 'water under the bridge' - that's how you see it. I should accept this difficult time as a learning experience, no matter that it was so painful for me, it's a bit easier for you than for me to talk about radical acceptance in this case I imagine.

To me though, it's blood, not water.

I reached out, and I fell. I was not caught, I was dropped into the void.

And you're "sorry I feel that way," as if you weren't there, missing me!"

---------------------

You know how I'm feeling right this minute? I'm feeling like my seven-year-old-self. When I was six or seven, my father (an asshole) took me to the monkey bars. I was determined to try crossing them, but I was scared. He promised to keep me safe. I got halfway across. I started to lose strength in my arms. He was supposed to be right there to hold me, but.... he was my father, an alcoholic, adulterous, abusive prick, and he had stepped too far back and I fell.

I fell the six feet to the bark surface and hurt my back. I cried and cried.

Was it good for me to learn to be self-reliant? Yeah, I guess. But you know- I don't need to be paying Madame T for lessons in self-reliance.

[archipelago]

I know exactly how that feels (I think). It's happened in therapy too. I feel like I'm being dropped into a void. It's awful. I'm sorry.

And your story of your father…sad. It is close to a story in my own childhood. Once I was trying to learn to play baseball. My father stood around me, helping hold the bat, but when the ball came, he just forgot that I was there and swung hard. I went flying across the pavement since I was very skinny, got all scraped up, and never played again. He was just too much into himself and his ego to actually help me or even be "there" or realized that I was there at all.

[Leah123]

Thank you for sharing that, what a terrible story, I am sorry.

When you felt like that in therapy, did you work it out? Did you stay with that therapist?

Mine is mostly very very kind and devoted and does have some good skills and experience, but I'm really hurting right now. Not all her fault, it's my life being chaotic right now and me being super-stressed out, but I'm having a hard time finding any peace with her right now.

[archipelago]

It happened more with another shrink, who was too withholding and reserved. I often felt abandoned and alone. I would act out feeling triggered. It was awful. I actually switched shrinks due to an impasse, that required a consultant, who happened to be a colleague shrink and I ended up going with him instead. He is more warm and present so that didn't happen anymore. Still we have had rough times in our relationship and that feels awful. And I have felt "left hanging" with a sense of urgency about doing something about it, when he wasn't willing until we formally had session. The waiting was so painful and I felt like hitting a void, but eventually we talked it out.

By the way, each time we do this our relationship gets stronger so though a painful process it has worked out to be beneficial. But then again I do psychoanalysis, a type that focuses on the relationship itself as one of the most important healing factors so the interpersonal workings are much more in central focus than in other types of therapies.

[Leah123]

I can not at all, in good conscience, say my therapist is withholding and reserved. She's so warm, comforting, and will be there day or night for me when I reach out to her. It's kind of amazing, how devoted and motherly she acts. She will share things with me and give me feedback about her perceptions so I do not feel too alone or unsure of where I stand. It's been very very wonderful (and challenging) - our relationships been getting better, but I just feel everything's a mess now. She says it's because I don't feel safe anymore, anywhere, now that my husband has been acting out so much. When she & I worked through the past trauma, she says I could feel safer in the past, but focusing on the present so much, is harder.

Only thing is, if she knows all that, I wish she woulda been more attentive and gentle, but it's probably harder than I think it is. She did a lot of things, just not the right one, she didn't get what I needed, maybe she does now, but the waiting was so scary and painful.

Our therapy is definitely relationship-focused also, and usually I'm fairly clear on most of the influences I bring to it and can communicate clearly with her, but right now, feel a bit more like I'm communicating in a hall of mirrors. Not as fun as in the carnival.

She told me to come to therapy today and we'd focus on helping me deescalate my stress response with some tools, because it definitely has the better of me right now. I could lead the session and she'd help me settle. It sounds so good, but I do not know. Twice burned, thrice shy. I'm not sure if she has any idea how hard it is to show up lately.

[archipelago]

Could you tell her that last thing? that you don't think she has any idea about how hard it is to show up these days. That might do something, let her know something before you start working on skills. You could even add that you need some reassurance, but that may feel risky, I'm not sure.

[Leah123]

Yes, I can tell her that. I've been expressing a lot of my pain and frustration and desire for an apology in email, I'll see this morning how she replies, prior to session or in session, one way or the other.

I was just already having *the* hardest time showing up last week, and now I don't even know where I am. Last week, it felt dangerous to show up being so triggered and wanting to just hide. So... where am I now... how stupid will it be for me to show up again. We could say it was just my PTSD talking, but it is so hard to go into that space where I have to be open, self-examining, share all my deepest issues, when I'm like this. Everything can go wrong so fast.

Maybe today I don't talk about anything, I just let her show me the exercises and stay away from issues, but it's hard. One of our worst sessions last week was me trying to have a nice calm chat and then take 15 minutes to talk about an issue, and she didn't handle that well enough, to the point I felt way too challenged to manage.

[Syra]

I've been in the place you have been. It's hard to know what the right thing to do is. I didn't want to start all over again finding a new T, and lots of good things had happened - but I didn't want to continue with the way things were. In the end it wasn't a cognitive decision. It was a gut decision. I just couldn't do what she required for the next step. I kept going until I just couldn't do it anymore. That's how it was for me.

[archipelago]

I have PTSD too so I think I understand. It is such a difficult thing to feel so vulnerable and triggered. My heart goes out to you. Perhaps it is wise to back off for a while and just learn some soothing exercises. I've used the DBT workbook on my own and found it helpful. Also I back off with my therapist. He does too. He realizes that there needs to be down time in between things for people to calm down and start letting their defenses come back together. We have even had sessions where we don't really talk about me most of the time, for that very reason. The analogy I use is that you can't dive deep all the time. You need to come up for air and sometimes just float.

[Leah123]

Right, I just want to come back together.
I can't imagine she understands this feeling of extreme tension, reactivity, fear, hyperarousal, etc.

I don't know if she even *can* be gentle enough with me right now, maybe she can, but the last couple times didn't work. I think she gets it now, but it was SO hard to make her see it.

I did tell her a couple weeks off from therapy and some TLC, I could regroup and get back to my normal on my own.

I usually crave contact with her so much I'd never take a couple weeks off, and I probably won't today, if the past is any indication, but I feel downright burnt.

[archipelago]

I hope she can realize that gentleness is the right way right now. You don't need more to be stirred up. It can be so exhausting. PTSD is like that. And your body is trashed by all the chemical releases that happen when you have a stress response and go into that state.

For that reason I do take meds to help with anxiety. Then it doesn't get as bad. I can find peace from it for a while, just enough to start feeling like I'm not all like a turtle without a shell.

[Leah123]

Yes, you know just how I feel, I can tell. That's nice to know. It is the chemical reactions getting me lately. I feel it everywhere, am getting so run down. Everything firing off. Closer to meltdown, much closer than usual or comfortable.

Thanks.

[archipelago]

I do know of a breathing exercise that was taught in the hospital so is based on science. It works to calm down the vagal nervous system which is partly responsible for the sympathetic nervous system reactions to stress. And it feel like you just took a med to calm down.

It is really simple. Just three deep breaths, but done in a particular way. You breathe in through your nose leaving your mouth slightly open. Pull the breath deep so that your diaphragm reaches down into the pelvic area and then squeeze the pelvic muscles at the very end. Slowly blow out the air through your mouth until you are almost out of breath and repeat two more times. Be careful because it can make you dizzy sometimes, but I have found this to work and it is so simple to do.