Attachment theory & premature termination

I think if therapy isn't behaviorally based in some way, it would be nearly impossible for a T to explain "the process". Or if they did different Ts would give different answers.

I think that's the problem- the therapist who doesn't "get it" will also not fully understand the level of emotional pain that certain clients will experience after termination. They are seeing the client/T relationship as far less meaningful than any intimate relationship could possibly be. So when clients experience such strong attachment I think it comes as a surprise. I don't think this is the clients fault but a flaw within the field of therapy. In my own therapy I connect with them, but I don't get attached the way so many posters here do. I think it's too risky and not what I want to use therapy for. I imagine as a T I will do the same - I would never see my self as a replacement for someone in a clients life and don't always agree with Ts who try to do this.

And so it has proven in my experience.

Then what on earth are they doing in that job? This is basic stuff. Any idiot can read a few books on attachment theory and comprehend how this might play out in therapy. I think the problem is more to do with the lack of consequences for the T, and with Ts whose own defenses and wounding get triggered such that they are no longer putting the client's needs first.

Speaking for myself, attachment/dependence was not something actively pursued by me or the T. It just arose, as a consequence of our interactions, much of which was unconscious on both sides. I don't understand when people talk about attachment as something that people "do". In my case my T's behavior did induce attachment and dependence, but it was not a purposeful thing. It was her default way of relating, probably to do with own neediness. And same for me.

My perspective is very different. I can't see going to therapy to work on goals or skills. The very thought of a therapist coaching me or giving advice is frightening. I've never benefitted from therapy, but if I did my guess is that it would be the relationship itself. I don't see much about therapy that makes much sense, other than if you find the right one and have a real human connection there could be healing.

The book I'm reading talks a lot about the brain as social organ, neuroplasticity, and how healthy attachments repair trauma in the brain. The author argues for a "reparenting" approach. The book is called "Why Therapy Works", but ironically I'm reading it to understand how therapy might have damaged my brain (and secondarily to see if therapy could help).

This quote is useful: "When humans are cut off from their primary sources of attachment, we are programmed to whither and die". He also explains that abandonment panic in borderline type patients can trigger flashbacks of life threatening proportions.

When put in this context, not hard to see that premature or imposed termination might be very destructive.

I agree that this is "basic stuff" when reading it in a text book, but it is truly more complicated than a chapter or even an entire book on the subject. The problem is that many, if not most "therapists" are truly NOT trained in the principals/theory of attachment/transference/trauma bonding/betrayal etc. They don't understand or "get" the idea that some people attach to them in a way that creates great pain, anguish and trauma if they push the client away or boot them out the door, telling them to "they aren't the right therapist for them." It is true that a therapist is acting unethically if they continue to treat someone they aren't equipped to deal with effectively, BUT the "ripping off the bandaid and walking away after referring the client out, is not okay.

Therapists in training read about it, talk about it in class, practice it with their classmates in role plays, use it in their short practicums and internships, but the majority of them don't get the extensive SUPERVISION needed to truly handle situations that are difficult, harmful and retraumatizing to some clients. They truly believe that by telling a client that they "need to refer them on" and provide a simple list of referrals, the client will happily or at least contently and obediently go out the door with an appropriate plan to find a new therapist and the therapist never has to think about or deal with the situation again . . .And if the client re-contacts them or makes a stink (files a complaint), the therapist often feels angry, put upon and or singled out unfairly. I have rarely heard therapists talk about regretting how they handled a case, it's always the clients who is a burden or "bad" client who was basically untreatable.

Perhaps the saddest thing in my opinion, is the therapist who don't have the knowledge or understanding to truly consider in any depth or deep feeling how they have in fact harmed clients. THEY. JUST. DON'T. UNDERSTAND. WHAT. THEY. JUST. DID!

Now the good ones, the really good ones, never stop getting supervision/peer group contact about their cases--no matter how long they've been a therapist. They check their egos at the door. They learn and relearn how to recognize and apologize for their mistakes. Because as we say on here often--we're all human and we all make mistakes. . . but along with that statement comes the ability to know how to apologize, to really apologize with feeling and true meaning. A genuine apology without any "buts" is a very healing thing for a lot of clients. And one apology doesn't usually cut it, it sometimes takes a while to work things through to final closure.

I think CBT has a place in working with clients. And I think if you have a specific goal or problem to work on and that's all you want to work on, then CBT is great. But if you're a person who has experienced a lot of trauma in your life, CBT alone is not going to cut it (this of course is my own personal take on things). If a therapist isn't adequately trained in attachment/interpersonal relationships/transference/countertransference/trauma bonding etc. then they are often going to fail to recognize and deal with complicated clinical relationships. Just my take on things.

And just so people aren't thinking that I'm being negative about therapy, that isn't my purpose. I firmly believe that there are excellent, well-trained therapists out there, but I also believe there are a LOT of quacks and damaged therapists out there too!

I agree that none of this is nearly as "basic" as it seems like it should be. Anyone can read books about psychology and think they "get it" but it's quite different when putting theory into practice. None of this is instinctive and people who haven't experienced it themselves are not going to understand the feelings. They can name the feelings, but they don't experience them. The same can be said when working with clients who are in recovery from addiction or eating disorders - it's very hard to truly empathize of youve never experienced what they have. Therapists learn about theory through readings and discussion. They learn how to do therapy by working with clients. Attachment and transference are not always part of the early learning experience.

It's also important to keep in mind that many clients do not experience therapy the same way, so what seems like basic common sense to one is foriegn to someone else. Goals for therapy are different for everyone. Like I said in another post, my goals in therapy is always skill building and changing something in my life. When I've tried traditional psychodynamic with little structure, I got nothing out of it. I've never had t that encouraged dependence and I've never engaged with them in such a way. It's like this even with the my pdoc who I'm attracted to. I obsessed at first, but was able to keep this in check. If I couldn't, the only thing my pdoc ocould have have done was refer me out. Not out of rejection but because meeting with someone that you feel so strongly for in such a pseudo intimate setting is psychological torture. I wouldn't have been something to work through, it wouldn't have just needed to end. In this case the best thing a therapist can do is admit it when they mess up, sincerely apologize and be kind. Consultation and supervision is important of course, although I suspect many terminations are a direct result of consultation and not the other way around.

Jaybird57: Yeah, I don't mean to say that reading a few books on attachment/transference necessarily qualifies a clinician to work with it. But it could equip one to at at least recognize this when it manifests, and not make a total f'ing mess of it, and re-traumatize the client. It would have helped me for sure if T could have given me some basic context to explain my obvious dependency and neediness. Having read some books myself since then, even I could spot the behavior and elaborate the basic concepts.

What are they are teaching these people? My T was good at filling out forms, billing insurance, citing ethics codes, scheduling appts, chatting with me, giving pep talks, dispensing advice, making eyes at me. She was also profoundly good at listening and attuning, hence the transference and dependence.

You bring up a bunch of important issues, things I have been blathering about all over this forum. But the issue of supervision, I agree that is big. My T got supervision one time, when things got extremely painful and overwhelming, but even that was a lot for her fragile ego. Even post-termination when we were locked in an out of control downward spiral with both of us seriously wounded (I much more), she could not deviate from the one course of action -- get rid of me as quickly as possible, at all costs. Just too painful for her to face what a shambles she had made of my psyche.

The other issue I bring up a lot -- no oversight or reporting. Yes Ts need proper training and supervision, but if they are given free reign to abandon clients in distress, some of them will do just that.

Maybe the problem is honestly that therapy is just not real enough. It blurs too many lines between mental health services vs emotional prostitution.

It's like a car repair service where sometimes they let you use a rental while they fix your car and sometimes they don't feel like it. What kind of business model is that? And who in their right mind would refuse to take their car back so they could drive the rental a little longer?

Man... What a strange profession. Doesn't seem like there's any good solution. Personally I prefer to meet therapists where they're at, and don't really talk about my life in therapy, just my issues. But I'm starting to feel like therapy is wrong for me anyway. Too few of them know what they're doing and it's almost a waste of time trying to find one that doesn't have extensive issues of their own.

The T really should be the one to meet the client where they are at to some extent, but not if it leads them to an uncomfortable place. The problem I see with a lot of Ts is they list every disorder under under the sun as an area of "expertise". That of course is bull, since no one specialized in everything. When I was looking for a marriage counselor my pdoc said to be sure that I find one that lists only a few specialties. Too many is a red flag. I think many Ts want to build a business and may think their schooling was enough to prepare them to work with certain clients. These are a lot of the Ts that end up retraumatizong people.

Budfox - I've been thinking about this same thing recently, that is whether therapy is actually harmful. Although I was not terminated, I have been "triggered" by my attachment. In my last session I had a flashback like episode where I couldn't talk or feel anything at all, left and was in total panic and despair for several days after my therapist said something relatively benign about not sharing my feelings. Maybe that's not benign, but my emotional fall out was definitely over the top.

I am very fortunate I guess that when I wrote my therapist a long email he took the time to respond. It seems like he has to walk a very fine line with me for me to not be re-traumatized. I've discovered I am very sensitive, touch with kid gloves. It is magnified in therapy, but it is sadly true of me everywhere.

For people like us, I think therapy is dangerous. But when you have child abuse you really have psychological cancer, and maybe the "cure" has to be radical and equally powerful like chemo? All I'm saying is, I am holding out hope that therapy and or just me alone can cure this thing, and I think overall my therapy is helping although it has also been very painful.

I do think that treating people like us, who by the way are not your most common client I'm sure, isn't something for every therapist. Like I said mine seems to be well attuned to when to get close and when to back off. He has somehow left me feeling loved in a non-sexual way while refusing to say it. And while frustrating, my therapy has become barely tolerable finally. We hug, we text minimally, I guess the relationship is starting to feel close enough more often.

Anyways, it is always more than just your therapist, even if you are madly in love. For example, I place these demands on my husband, and various other people in my life. It is convenient to know that about myself, and sometimes now I can rationalize myself out of hurts, but this has taken a long time and come at a cost.

Yes, it's a grieving process. Very unpleasant, possibly very distressing but possible to come through it as people do with support.

Yep. Needle in a haystack. Have no idea how to find one I like, trust, who doesn't charge outrageous fees, has solid theoretical foundation, sufficient experience, and is not a narcissist or sociopath or too fragile. If I could find one who checked all the boxes, I'd give it a go.

I sorta dont trust any of the MFTs and LCSWs etc anymore. Couple years of school and they're welcoming in clients with god knows what sort of deep trauma or disorder.

And you might not know till quite far into it that they have extensive issues. You place your trust in a professionally constructed persona. They are trained to conceal.

True but then doesn't that apply to any issue a client brings in? My point is just that a T should be able to at least identify what is going on.

I don't get it. Seems we are all a product of earliest attachment relationships, and this is the source of much of our struggles. If a T is seeing clients without a basic understanding of this, aren't they like a "child playing with a live bomb"?

But what if in parallel with attraction there is intense attachment and dependence? And the client has regressed, become destabilized, re-traumatized? It's not always so tidy or easy. Abrupt termination might itself be the most damaging move of all. For me also the attraction/rejection thing was at the very core of my deepest wounding. The very thing that was most likely to destroy me was precisely what I got in therapy. If that is not worked through, but rather T just bails out with the hope that some other T will dig the client out of a massive hole, could be disaster. Especially if you are deep into the process, now the client must search out another T, start over at great expense and risk. For me it was a nightmare either way. I should never have been put in such a position. And I aint taking the blame. This was a failure of my T and of the system.

I didn't mean Ts don't learn about attachment in their coursework. You're right, attachment forms the basis for all of our later relationships. My point was that many therapists in training don't often work with clients struggling with the most complex attachment issues. Your T handled it poorly, there's no doubt about it. And I'm not fond of therapists who promise to "correct" insecure attachment in grown adult clients. Ts who really think they have this ability are the ones who foster dependence - their egos need it. Of course, they inevitably become overwhelmed and when they can't handle it, blame the client. This type of therapy is irresponsible in my opinion and is practiced by Ts who are very damaged in their own right.

Well said, like the rest of your post.

You raise some good points. Yes not for every therapist. The problem for me though is that my therapist announced this after some 35-40 sessions. Bit late. With serious attachment/dependence (addiction even) already in place, pretty dangerous to bail out.

Client's with developmental trauma or PTSD presumably have suffered damage to brain, nervous system, and more. If there should be one goal in therapy above all others, it should be to avoid compounding this damage. And offering powerful attunement to the client, then withdrawing it abruptly or prematurely for ANY REASON, is likely going to be quite damaging.

Where once there was attunement and acceptance, there is now only gnawing silence. A more effective and horrific psychological torture I cannot imagine.

What my T missed amid her desperate attempts to avoid further "failure", was that it wasn't about skills or training or modalities or progress, it was about the attachment bond. And if the T lacks the skills, get supervision and keep the alliance from imploding, at all costs.

Thats just my take...

I very much wanted to file a complaint against a T about 15 years ago and decided against it. "Probably wouldn't do any good" was my self-reflective argument.

But that was a different time. Now the boards listen, sometimes, maybe? And it seems to me that the only way the system and incompetent (poorly trained) therapists can get the message is if people who have been harmed do complain. That seems very unfortunate and short-sighted by the therapy profession, but reality is reality.

Eventually I went back to therapy, and 5.5 years ago lucked into my current T. Luck. She and her trauma + psychodynamic therapy HAVE helped. Luck. Luck. Luck. I hope luck finds you, too.

I think what she did was awful. If my therapist terminated me I'm not sure I could survive it. Well, I probably would, but it would seriously unhinge me.

My advice to you would be to keep writing your feelings and mail/ email them to her. Maybe a bad idea, I don't know, but I think that's what I would do. At a minimum it would be a lesson for her in the after effects of her termination.

I agree with your whole post, but this part in particular. My T has been a therapist for at least 13 years, and I know she still gets supervision, and occasionally still sees a T. She has told me that she gets supervision to keep her own emotions out of our therapy.

I am SO lucky I found this T. I know it, and I've only seen her for 6 months. She's not perfect, and does things that I find less therapeutic than it could be, but overall she is a great T. I haven't had any major problems with her, and avoidance is my M.O, but I think if I did and was brave enough to bring the issue up with her, she would apologize without any "but's."

Ok, I hear you. Kinda seems like there needs to be better screening up front to determine therapist-client match. Probably not always feasible or easy though.

I do think my T was intent on fixing or rescuing me, and yes this induced dangerous dependence, and yes she got overwhelmed and blamed me, and yes her ego badly needs to believe in this. And I think when it failed catastrophically, she was crushed. Train wreck all the way round.

However, I've read things from well known psychologists who do seem to advocate some form of healing of insecure attachment by creating a secure attachment in therapy. Maybe not "correcting" but counteracting or something.

Wow that is scary. Sorry to hear. Strange how our bodies/brains hold to on to past trauma or distress and then it manifests like that. I have flashback like feelings too, especially in the face of any abandonment. I assume it is early life stuff, because there is no mental response, it's all in the body or in implicit memory i guess.

An interesting thing I noticed is that post-termination if I had positive contact with ex-T, I could feel my whole inner chemistry shift toward well being. Even just initiating contact with the expectation of a response made a difference. And being refused or cut off conversely was like taking poison.

They say the body never lies. I tried to tell my T about this but she didnt even hear me.

We're still at the "herbs and leeches" stage when it comes to mental health.

At least they've stopped drilling holes in our skulls.

Thanks. Uhinged, yes. I think this has literally driven me semi nuts. It was psychological abuse in a very real way.

Emailing my feelings to her… that is what i've been doing. This would get an occasional response when I pushed the right buttons and guilt would impel her to act. But always it was on her terms, and always she could cut me off again, completely and forever.

Most people would say let it go, cant you see you are making it worse. But I think so many wounds were exposed and so many were inflicted that it was a total overload of the system and to go forward with this level of injury is just too much. She killed a part of me and I am trying to recover it i guess.

About a month ago on the anniversary of termination, I sent her a "one year status report". Made allusion to SUI thoughts. No response.

I know she has definitely received a painful lesson from this. I know because of her emotional breakdown during out last phone call. But even that was followed by denial and a redirecting of blame back on me.