he was telling me about dissociation...

him: 'i know you have been reading about this stuff... i guess i assume you know less rather than more because i don't really know what you know'.
me: 'thats ok. it is good to learn about what you think about it. i mean, there are a lot of theories out there'.

then he kind of recoiled a little...

how come?

i assume you know less rather than more

Hmmm. Maybe he was surprised, caught off guard by the fact that you are well-read on "the different theories out there."

Like "Hmmm. She probably knows a lot more than I thought she did."

[sunrise]

Maybe, it means he's realizing he's going to have to be sure and do his homework if you're his client. That's not a bad thing! Good for you to challenge him.

hmm. i didn't mean it as a challenge...

i didn't mean to turn it around and make it about what he believes rather than what is the case with me, either.

i guess... i meant that it was okay for him to do that. he can't know what things i accept if he doesn't ask / suggest. and i can't know what things he accepts if i don't ask / suggest.

i guess i thought of it as building up a common language and common background assumptions and conceptualisations.

thanks guys. i might try and say what i meant to do with that next week.

[LMo]

I can see how he would have taken it as:

"she's not going to consider me to be the expert here. I may hold just one of many 'theories', which she may or may not accept"

I'm thinking he might have recoiled a bit because sometimes therapists are:

1. Surprised when their clients know a lot about psychological terms/situations.

2. Don't always want to let clients know what they think about subject. They have to try to be objective.

3. Would rather talk about things in terms of feelings and emotions, rather than hard facts about what something means.

There's many things it could be. But like you said, just mention it next week!

[LMo]

I had a doctor (not a T) once get really irritated that I had 'read up' on a possible dx. She said that there is so much misinformation floating around that she would really prefer it if her patients would simply as the doctor right from the beginning, and seek a second opinion if need be. I guess she thought that it was more work to sort through misunderstandings rather than just to let her take the lead on doing 'her' job.

wow LMo. i guess that patients reading up on their condition can be something of a mixed blessing. i see how uncritical acceptance of unreputable sources is problematic, but i don't see that as inevitable...

i do have concerns about paternalism vs autonomy. there are ethical issues about the patients ability to give 'informed consent' and just how informed you need to be in order to give 'informed consent'. i'm sure there are a lot of doctors out there who just want to prescribe their course of treatment and see it followed... but different doctors could well prescribe different courses of treatment. to sort the issue out you would need to consider the pros and cons of the different options and sometimes when that happens people converge on an optimal course of treatment.

my getting better... i'll be damned if i'm going to throw myself to the mercy of another person if i can take a more active role in my care. basically... i care a lot more that i get the optimal treatment rather than getting some treatment because the doctor had had a busy day and other options simply didn't occur to them. or because that drug had the prettiest advertisment or whatever. if they are making rational decisions... then give me the reasons... i'm well aware some clinician's find this annoying... but tough %#@&#!. you can keep the paternalism thanks very much. (anybody guessing my father was fairly incompetent around about now)?

regarding therapy... hmm... i've talked to my t before about how i have read a lot on this issue. i also told him that i researched it properly at one point and wrote something on it. so he knew that already...

but i guess... egos are fragile. i really didn't mean to be condescending.

what i was getting at was more... if you have BPD some theorists think it is an excess of innate drives of agression. other theorists think the agression comes of frustration of innate libidinal drives, however. these are both views that are on the table. don't much like the innate drive of agression view myself (i don't think there is evidence that is enough to establish the existence of the death instinct). i think that the frustration of libininal drives view promotes sympathy and compassion in a way that less clearly follows from the innate drive view.

if i was seeing a psychodynamic theorist for BPD i'd want to know about their view of it. it would help me make sense of their interpretations / what they were saying.

same here, i guess.

i guess... yeah, w. isn't going to be uncritially accepting what he says anymore than w. would uncritically accept what advertisements and politicians and theorists in general say.

k. idealises... but... there are limits.

is that what this was about? failure to idealise?

hmm... maybe we are getting to know each other after all.

i think... sometimes i think... that i need to be careful with him. is this about my dad being so vulnerable / fragile? perhaps. also thinking back to the transcript of the coroners inquiry i found online (he had to testify as to why he discharged this boy who went on to committ suicide). he was breaking up... he was... he gets a bit rambly / garbled.

is this a defence? (he can't hurt me if he is weak)
i kinda hope he pulls though...
but...

i don't want to have to look after him.

idealisation feeds the ego huh.

i feel sick.

groan.

okay. so the last two sessions i had (prior to this one) were fairly intense. talked a bit about interactions with my mother when i was a kid (she was very emotionally intense and focused on her needs and mostly i experienced her as being invasive and i developed a sense of shame in my own thoughts feelings opionions and desires like the desire to be more independent). i felt the feelings a little. and in the next session i felt shame. and he kind of sat there and held it okay for quite a while and then helped ground me.

so... little kid feelings i guess. primitive feelings. vulnerable feelings.

then i needed to focus on my work. it was hard recovering from those sessions enough to refocus on my work and get into that. so last time i saw him i guess i needed a little more space. needed space from those feelings. needed things to be a little more rationally focused. lighter. problem solving or whatever. and he kept trying to bring things back to where they had left off... and i was trying to resist that.

so instead of talking about j or k (the emotional ones) i wanted to talk about w (the rational one). and what is he to do? doesn't want w to feel rejected... but he really wanted to access k. but no, that is not okay. and w did feel that he would rather access her than him. so maybe... there was a little bit of condescendingness to what i said... maybe... i really didn't mean to be... but maybe there was... and that came through.

dammit.

back off mr.

i'm not really sure why i'm so afraid of intimacy. maybe 'cause my parents hurt me a lot. and i've been going around doing the repetition compulsion thing so have other bad experiences with intimacy that i could add to those...

i guess i'm scared that i'll destroy someone 'cause my emotions can be so very intense. and i'm scared that someone will come to care about me and that i won't be able to reciprocate. i'll just feel cold. because that has happened before. or that i'll care about someone and they won't care about me. they will hurt me or whatever.

but i didn't want to talk to him about vulnerable feelings.

i don't want to regress. dammit. i read about treatment of narcissism and so forth and i think 'i could do that' but he keeps asking about them. whether they have been very active. what they are feeling. i don't want it to be about them. i don't want it to be about my made up stories. i want it to be about me. in the present. not regressed.

what am i afraid of?

feeling vulnerable. i've expressed dependency once in my life (explicitly). and a day or so later that person hurt me very much indeed. i'm still not over it.

thats what you get for expressing dependency. repulsion. or abuse. not that the person was repulsed or abused me exactly... but sent me away for a very long time. hard to explain... hurt me a lot. because... he could. don't give people the power.

life sucks.

don't give people the power

whine whine