you can leave if you want to

Hi,

Hoping to get some feedback on an issue with therapist!

Appointments with a psychiatrist and/or therapist have always been extremely uncomfortable for me. I've made a lot of improvements by working really hard to communicate more and better. Still, even with the improvements I'm set back pretty easily (i retreat) but my set backs have mostly occurred outside of the appointments (the anxiety fall out is experienced at home which makes therapy still really stressful but at least more useful).

I made an effort to communicate to both pdoc and t that the appointments are a big deal for me and I struggle with them but that it's something I really want to do.

I've just started seeing the therapist and had a hard time talking in a session. I told her I was having a hard time talking that day and I brought a notebook to doodle in because I was concerned this may happen and have noticed I can sometimes keep myself talking if I slightly distract myself at the same time. T said I could leave if I wanted to. It sort of stung and I asked if she was under the impression I didn't want to be there. She said she was not under that impression and that she had had clients that did not want to be there and I didn't act that way. I decided to view the statement as an effort to help me feel more in control...

Next appointment starts with her saying 'I have to have surgery and will be gone for three weeks' not so great news. I had some disappointing stuff happen earlier in the week and I guess I was especially vulnerable because when she told me this news I just went blank and literally could not speak. It wasn't that there was stuff in my head I wouldn't/couldn't get out, I literally couldn't form words in my head even and it was as if a large ball of cotton was lodged in my throat. I was trying to stay present, trying to find words, trying to say something. I was doing everything I could just to try and stay in the room...
She said, 'you can leave if you want'.
At that moment I couldn't bare to stay another second and left.
As I handed her the check before walking out the door she said 'you aren't
even going to say something before leaving?'

I never threatened to leave therapy or criticized this therapist. I don't understand the line 'you can leave if you want to' as a response to my difficulty speaking. It feels manipulative, it feels like there is a subtext. She said it both times very nonchalantly but didn't seem to like that I left and even emailed me 'checking in' after the appointment. I don't get it???

Does anyone have any suggestions with how to deal with this?

Difficulty speaking and retreating like a turtle are really big issues for me and I need a therapist that can help with this specifically. I thought I made that clear to pdoc when he gave me referrals to therapists.

Do others have similar barriers that they have been working on with a therapist and are there things that helped?

I just think an alternative to 'you can leave if you want to' is needed because I feel really not ok/safe when I think of seeing her again.

this is your therapy and your money, and I think it would be wasted on a therapist who says something ridiculous like that. they are meant to make us feel wanted and heard, not to show us the door.

Yea, I think it's weird and redundant (of course I can leave!?) and it hurt. If she's uncomfortable and can't accept a client that struggles to verbalize thoughts/feelings but is trying, I don't think I should be seeing her. Thing is, I don't know what to ask for, I don't want to keep going through this sort of thing with a therapist...

It sounds like she was just giving you that control, not that she was trying to get rid of you or even wanted you to leave, just giving you the control to leave if being there was too uncomfortable or anxiety-making for you. She called to see check in with you later which shows she wanted to be sure you were okay.

If her giving you that out is bothering you, then you need to talk to her about it, but I think you may be making out to be critical or manipulative, but it seems her intent (just from what you've described) is exactly opposite: she seems to be trying to place the power in your hands.

My T has told me I can leave anytime I wish. I guess I don't see her saying that as a bad thing, she's just making sure I understand I'm not trapped there. Actually, a session early last week, I DID leave early. In 10 months of seeing my T, that was the first time I left early. And I didn't feel bad about it, because she has always made sure I understood that I don't have to stay if things get too hard.

Trying to think of it from a T point of view, I would bet they think many of us feel "trapped" in our lives as it is and they want to make sure we are aware that therapy is a safe place, and we don't need to feel like we're being trapped there, too?

I also retreat, dissociate, so I understand that very well. Once I realized there was actually a word for what I was doing, I was online trying to figure out how to stop myself from doing that. To me, it's embarrassing, and feels like a waste of time if I'm not mentally "there" during a session. Perhaps your T is just trying to help you feel more comfortable....perhaps to say if you start feeling like you're going to retreat, you can always leave before that happens. I know I will be using her offer to leave more often, if I feel like I'm starting to get upset, as I don't want to let myself dissociate, because if it lasts too long, it can cause issues with my leaving. I need to be in a safe place when I leave there. One day, I ended up sitting in a snow bank in a neighboring parking lot, without realizing I'd put myself there. What if I'd gotten in my car and been driving? Perhaps your T is offering this for your safety, and best interest. Just a different way to think about it.

I think it's important to let her know how this makes you feel and to clear up her intentions. The one I see now told me early on that she wants to make it easy for me to leave because I've stayed too long with therapists who weren't good for me. Even so, it was hard not to hear it as a rejection, so we dealt with it right there and it didn't come up again. She really was just trying to make sure I knew I was the one in control, not her.

Also, let your therapist know that your throat closes up like that and you can't talk even though you want to. That might help her read your silences a little more accurately.

I agree with lolagrace - it sounds like she was trying to give you some control of the situation by letting you know you were not trapped and could leave if needed. My T will often say the same thing. She's reminding me that I'm not stuck in my seat and can get up and move and even leave the room if I need to. I understand how that could feel like rejection from a new T, though.

Perhaps, at the start of your next session, you could tell T that you understand you're able to leave if needed, but that's not the route you want to take. Before things start to go south, ask T if she can help you stay present in the room if you start to dissociate. I know how hard that is, but I've found that if I can lay the groundwork, then T has a better idea of what I need when I get to the point where I can't communicate it as clearly.

When T says that I can leave if I need to, I usually respond with "I know, but I want to stay - help me, please?" She'll help me get grounded enough that I can be present and stay in the room both mentally and physically. It's taken me a long time to get to this point, and I started it with letting T know at the start of a session what I needed from her when I started to check out.

My T said it once so I knew I had control and a choice in staying or leaving. I told her right off the bat that I hated that as it sounded like she was saying she didn't care if I was there or not, that it sounded so dismissive and that I was trying very hard to stay in the room and it made me feel like I *should* leave. She's never said it again.

My response to such a thing from a therapist would be who the eff are you to think you get to give me permission to do or not do anything? I find it an insulting thing to say to a client, not because they are trying to get rid of the client, but because they presume they have some control over me that they do not.

That is you, but many clients often feel "trapped" and a bit powerless in that room, and be reassured that they aren't, that they have the control and power to stay or leave as needed, would be helpful to many.

Yes, that is why I said "my response..."
I advocate telling the therapist to stop saying such thing no matter what the reason. I advocate telling them not to talk at all when their speaking becomes useless or detrimental.

I can see that this is really bothering you. I suggest you talk with your therapist about it and just ask her for an explanation. If you really just don't like the way it makes you feel when she says that just tell her. I'm sure she will understand.

I also agree with what Lolagrace said "It sounds like she was just giving you that control, not that she was trying to get rid of you or even wanted you to leave, just giving you the control to leave if being there was too uncomfortable or anxiety-making for you. She called to see check in with you later which shows she wanted to be sure you were okay".

In order for therapy to be successful you have to be open and honest. If you keep things like this inside it will get in the way of your progress. Even if you have to write her a letter just find a way to express your concerns. Best Wishes

Wow, thanks all, your responses are awesome!

I see the reasons why a therapist may mean well saying that line but still don't think it's useful with a new client regardless of intention. Explaining that one is in control and if they feel trapped... that I get.

I truly think she would say her intention was only to empower me but I feel like it was really her having an issue with my not speaking. The only way I have ever felt empowered is my ability to leave and possibly the biggest, at least one of the biggest, things I'm working on is changing my default defense and learning to stay.

I appreciate all the encouragement to talk to the therapist because I realize that there's really no way to get past it and for me to grow and change the way I want to without doing so.

Right now I feel a bit stuck tho. I have two potential appointments with her before she is gone for three weeks and that makes me feel way too vulnerable to put myself out there.

I just went through a thing that's still an open sore with psychiatrist. I told him that I didn't like something that happened in an appointment via email. His response was so-so, he said something like, 'I didn't intend to communicate that'. I was really proud of myself for bringing it up tho and figured it would feel more resolved once I saw him at next appointment (I have not had good experiences with telling people I felt uncomfortable/upset with something they did or said before, it's resulted in me being treated poorly afterwards). But, I had a heck of a time making an appointment with him because he was going to be out of town. Finally made one and he cancelled it. When I pointed out that his availability had changed since I started seeing him he basically denied it. It sucks!!! I think that he's got something going on and is totally overwhelmed. I basically like him but I'm really disappointed with the way he's communicated with me lately.

So, I just do not feel safe. I get the value of saying something for myself (not holding it inside, expressing my needs, changing MY behavior when I have no control over others...) I just don't feel like I can take another 'hit' right now. It won't matter much what the initial response is because what matters to me is if their behavior towards me changes after I say something. I had a therapist go from nicey-nice and validating to curt and invalidating after I said I was disappointed with how a session had gone. I also have a history full of overwhelmed and burnt out mental health professionals that regardless of how well intentioned they were and decent/nice people they were either sloppy or unable to offer the time/situation it would've taken to resolve anything.

Right now, I've decided to email her and tell her I don't like 'you can leave if you want to' and why (acknowledging I think she was well intentioned). And, I will tell her about the big cotton ball in throat feeling, it's a good suggestion to describe what was happening for me. I'm also going to tell her I'm not planning on seeing her before her absence for surgery and that we can start again when she gets back (if I'm around, another thing is how blah this timing is since I may be leaving the area soon).

This could change. Ideally I would try to get something out of the two appointments. I've had a lot of breakthroughs for me lately in terms of communicating and asking for help. I'm really concerned that pushing myself to go to these appointments when there'll be no real follow-up for an extended period and with the pdoc having gone M.I.A. on me is a recipe for disaster.

Hope everyone's day is going alright.

I hope you eventually find a t where you can learn how to have a safe dialogue. These ts you describe dont seem to understand that their number one job is to provide you a safe space. I couldnt even look at my ts bookshelves the first few years, i felt like i was intruding. I get the feeling you feel kinda the same way. Then to be told you can leave is like the opposite of what you want to hear. But the point is dialogue - not hit and run. Stay and listen to the other person. Its very scary.

I think you're telling the wrong person. (us).

Sounds to me like you're telling everyone (us, pdoc) what you need, but you haven't told the person who needs to know- your therapist.

Tell her that you need her to help you speak. Tell her that you've found doodling helps loosen your tongue. Tell her that being told you can leave if you want hurts your feelings and you need her to try something to help you talk. The woman is not a mind reader.

Put yourself in her shoes.You have a NEW CLIENT- someone you DO NOT KNOW-who walks in your office, says nothing to you, and sits down and starts drawing in her notebook.

On yet another session, she comes in, sits down, you start the session by telling her of your upcoming surgery that will keep you away from the office for three weeks (no fun for you), and the client hands you a check and gets up and walks out?

Would you not be COMPLETELY BAFFLED? Wonder WTF is going on?

She's a person. Just like you. She can't read your mind, she can't know what you're feeling, she can't even guess because she doesn't know you yet.

Sounds to me like you're looking for a therapist who is a mind reader and you're mad at this one because she isn't.

Find a way to communicate. Write her a letter, hand it to her in session. Record yourself on your phone ahead of time and play it for her in session. You have to steer your own ship. Your therapist can't help you do that without a little more information.

While therapists are not (fortunately for the one I pay) mind-readers, they should certainly be used to and able to handle clients who are anxious, stressed about being there, and who have difficulty talking. I do not expect that a therapist is all that baffled nor going WTF when a client has these sorts of challenges. Further, it is not the job of the client to worry about or put themselves in the shoes of a therapist. The therapist should be trained to handle such things and no client should have to feel ashamed or worried about the therapist.
Also it is not the same as expecting a mind-reader.

I disagree. I have gone in, not talked, and not been told to leave by the therapist. I did not want mind reading. I had to take time to be comfortable. I would find it most unusual for a therapist who has been in practice more than a day, to not know and be understanding of clients who have difficulty talking.

I think many are inept and can't handle someone not talking, but there are some who are fine with it and even see silence or waiting as perfectly okay and expected.

I would expect them to be gentle and perhaps ask if there was anything they could to help. But to be baffled or WTF over it would seem grossly incompetent to me. And I do have trouble talking and neither therapist has been baffled etc at me.

Hmmm, I think you're actually reading a lot into what I've said.
I specifically told the therapist that I brought the notebook in to doodle and why (how it helped me keep a better flow talking and listening. I even explained how I used this technique in college to maintain an attention span).

Also, I made a great effort to explain that I had these issues and how they played out with my psychiatrist. My psychiatrist is the one that referred me to the t in the first place as has my prior medical records that should illustrate I struggle with this issue but commit to appointments and trying to work on them.
I even suggested to the psychiatrist that perhaps I should see an art therapist because talk therapy may be too distressing.

I spent an entire session with therapist talking about how talking can be difficult for me and how I try to cope with it. I'm sure this also came up in our initial meeting since it is such a prominent issue.

I never once thought the therapist should read my mind. I reacted to her comment negatively and I came on here to explore that negative reaction. If you re read my initial post I think you may also see that I asked for suggestions/alternatives to 'you can leave if you want to' in dealing with me. I asked for what to look for in a therapist, ask from a therapist in order to better deal with this.

It's funny, your replies felt like an attack but now that I'm writing this I find myself laughing because it it's really obvious to me that you are waaay off the mark and maybe even trying to read my mind!

I came back here now to say I have emailed therapist. I went out of my way to express that I believed she had good intentions to be helpful, offer me an 'out' if I felt trapped and so on. I also told her how the statement made me feel while fully acknowledging the difference between what I may think she was meaning to say and how it felt to hear it. I even made a point of telling her that my comfort in writing her was, in a way, a compliment from me. And, I apologized if I was taking too much liberty in sending such a detailed email (tho she did seem to encourage a response earlier).

I don't chose not to speak, it happens and it sucks and I'm doing everything I can to stay. She said it was ok for me to leave. If that is the case WTF is not an appropriate response and it's too bad you have that take on it.

I came here to process what has been a difficult situation for me. In doing so I was able to work through things in likely not just a more healthy manner but a more timely manner and I THANK everyone on here for being so supportive because it has really made a difference.

So, uh, get off of my cloud.
I'm feeling pretty good about handling this situation differently then I would have in the past, changing, growing in this moment.

Okay. Good for you. It's a step in the right direction. It's unfortunate you're offended by my being blunt. My apologies. Hope you can begin accepting responsibility for your own reactions in therapy in the future.

PS glad I could make you laugh!

Llleeeee, i think and hope i understand. It is amazing how different we all are. If an offer or invitation like that were made to me I would immediately believe i was being told to get out.

If i am being quiet i am fighting so hard to get an answer out that my body and mind says should be kept inside and i wish my t would just repeatedly ask our keep pushing until i get it forced out. Telling me i have the option to leave would be telling me to quit wasting his time and i am useless like that. Even when he says is OK and to think about it and moves on, that is now still just stick inside. My silence would never be a signal of wanting to leave.

We share so many similarities and differences here. We have to have compassion on our T's imagining what it must be like knowing each person could take the exact same action or words he/she makes and it could be taken as attacking and insulting by some and needed, wanted and necessary by another. Wow

Llleeeee, I'm coming a little late to your thread but I did want to comment. I personally believe that the only time a statement such as "You can leave if you want to", is appropriate is if the client is extremely anxious and asks how long they have to stay or if they can leave. I think it's appropriate in those situations for the therapist to reassure the client that they are never required to remain in a session unless they want to; that the client is always in charge of how long they want to stay in a session or even come to a session.

I too would have been annoyed or frustrated if I was having trouble speaking and the therapist immediately jumps to the "You can leave if you want to" statement. To me, it would feel as if he/she was saying that I was only welcome if I comply with some rule that states that I MUST talk and silences are not tolerated. I'm not saying that's what your therapist meant by her comment, but it could very well feel that way when you're already frustrated and anxious about having a productive session. It's like a parent saying to a misbehaving child, "You can go to bed right now if you don't shape up!" In other words, the person withdraws their attention and empathy if you're not performing up to standard.

I'm glad you were able to write her an email and explain what was happening for you in the session and how her statement about leaving made you feel. Excellent example of you taking charge (being responsible) for yourself!

I also would have found the statement 'you can leave if you want to' hard to hear. It is inconceivable that my T would ever have said that to me. I would have found it discouraging and rejecting.

InRealLife45,
These are all really good ideas for things I can suggest a t do with me if I'm having a lot of difficulty talking in the future, thanks!

"I would bring in letters for her to read, if I still couldn't talk she would do some kind of activity that didnt require me to speak -sand tray, mindfulness, relaxation, whatever -sometimes she'd sit by me and we'd write each other notes on a piece of paper or a whiteboard- but I did talk a bit, most times. The times when I would say absolutely nothing she would either sit with me in silence or she would talk to me,"