[CantExplain]

This isn't a new idea of course, but I don't think we've ever spelt it out in exactly those words on this forum.

What a therapist does as a doctor (referal, termination, strict boundaries) is abandonment and betrayal as a parent.

Much, perhaps most of the distress posted on this forum comes from therapists behaving like doctors and not like parents. Many therapists seem very callous in waving off their patient's parental expectations.

On the other hand, a therapist also has a duty to be a good doctor. There is an inevitable tension here and sometimes it reaches breaking point.

[stopdog]

Or it may be the medical model does not always work for either therapist or client. There are therapists who reject the medical model.

As a client I reject the parent model for myself.

[Asiablue]

wow, i've never thought of it like that. But that is why it's so hurtful when termination happens especially against the will of the client. For people with abandonment issues or who were emotionally neglected, part of the healing process is often learning to attach to your therapist and naturally you come to see them as a parental figure. So if therapy ends before a client can learn to wean themselves from their therapist then natural they are going to experience flashbacks of the original real parental trauma.

[UnderRugSwept]

I guess whether or not you view T as a parent could depend on your experience as a child, of course. I was emotionally neglected as a child (two very narcissistic parents, one terminally ill). For whatever reason, I don't see my Ts now in a parental framework at all.
I know when I saw my first T at 7 years old I really wanted her to be my mother...I grew out of that somewhere along the way as I saw her until I was 18 and realized she wasn't helpful anymore at all!
The best T I have ever had had strict boundaries and he was really excellent for me; I made more progress with him in a little over a year than I think I have with anyone else.
I do like thinking about my Ts as drs....that means they will (hopefully) be a lot more competent than my parents were!

[willowbrook]

I don't see my Pdoc as a parental figure, that being said I would be pretty devastated if I lost him in anyway. I don't know how to describe my relationship with my Pdoc - it's definitely Doctor/Patient, but it's also not entirely clinical and detached, we're friendly, we joke around with one another, but we're not 'friends', sometimes it reminds me of a brother/sister type dynamic, but then I don't really feel that way either. I guess to me he's a Pdoc with boundaries that are firm enough for me to feel safe, and loose enough that I don't feel like I'm being abandoned or turned away when he's all cold and detached like other Pdocs I've been too.

If that sounded confusing, it is to me too. I do (platonically) love and respect my Pdoc, but to me he is still first and foremost my Doctor and I am his patient, and everything else I guess just stems from there.

[feralkittymom]

I just don't think the analogy holds up as firmly as you seem to want it to.

I think using extreme examples of actions--terminations--as reflective of the entirety of a complex relationship skews its character. And the assumption seems to be that good Dr/parents don't have firm boundaries, always meet their patient/child's expectations, never "fail" in multiple ways.

I don't accept the inherently opposing nature of Dr and parent. In fact, I think that in the appropriate circumstance, a good Dr and good parent have much in common, both in attitude, approach, and behavior.

Seen through the lens of Object Relations (which you can accept or reject as you wish, of course) , there is a stage of development in which the child perceives the parent (usually mother) as split: the "Good" mother, who fulfills all needs and provides good feelings; and the "Bad" mother, who is the source of unfulfilled needs and bad feelings. The child's perception shifts back and forth according to circumstance: while sensing uncomfortable sensations of hunger, the "Bad" mother is perceived; when food arrives, the "Good" mother is perceived.

Eventually, the two merge, if all proceeds in a healthy way, and the child learns that the "Good" mother and "Bad" mother are woven together as one. And finally, that the now "Good and Bad" mother has an identity separate from the child self and not wholly characterized by the "goodness" or "badness" of the actions.

I think these binary analogies result in an undermining of the essential acceptance of the mixed nature of identity, whether that identity is of Dr/T/Parent/Mother.

[unaluna]

Fkm, you make me feel so lazy!! But thats okay Thanks for taking the time to compose such an excellent answer.

[feralkittymom]

Oh Heavens, don't feel lazy! I write stuff for a living, so it isn't that much of a stretch. My current research involves OR theory as a perspective on politics as reflected in popular film/literature. Yeah-- real "best seller" material!!!

But thanks.

[elliemay]

If a patient has parental expectations of the therapist, then that likely is the work of the therapy.

Our therapists are not our parents, nor are they our lovers, or friends. They have unique role for sure as sometimes we transfer the expectation of those persons to them, but they aren't. They help us to stop bringing those expectations to our relationships, which are usually not helpful to our relations with others.

On this, I definitely agree with Freud - the therapist shouldn't oblige the transference of the client, but remain steadfast as they and client resolve that misplaced expectation.

[Perna]

I don't think either, therapist or parent, can be held responsible or accountable for another person's expectations, they have their own. Good parents DO refer, terminate, have strict boundaries! You go away to school all day at 6 whether you like it or not, referred to the teacher; at bedtime you are terminated from staying up and being part of the nighttime excitement and you can cry all you want but it won't get you out of it; good luck getting around a good parents' curfew or "rule" as a teenager or not getting punished for breaking it.