In Session Today : Part III

LT, if I didn’t know better I would think we had the same T. Reading your sessions, I can hear my T saying everything your t says. It’s so weird, they have the EXACT same style. And it’s ironic because I also switched from a female T (I think just a few months before you switched) with some interesting dynamics who allowed more outside contact to my current T. Current T is male, has very firm boundaries, and is caring in a professional way. And just like you’ve experienced with this new T, I thought I’d be upset about the tighter boundaries at first, but I actually feel safer with him now and it makes it easier to define the relationship in my mind.

today's session sucked. I don't even know that I can properly explain it.

We wound up talking about "parts." I told him how S had really made me feel a lot of shame over the idea of even thinking of myself in different "parts," and so how reluctant I was to ever even speak that way. But, how impossible it also seems to be to truly communicate without talking about it that way.

C was talking about the different parts of me and said "you know how I feel about the little part. You know the feelings I have towards that part." And, that stuck in my mind. I was really uncomfortable asking, but I finally was able to write down "You said you have 'those feelings' (Daddy feelings/protective feelings) towards the little part, but does that mean you don't feel that way towards the rest of the parts?"

He said "no. I feel differently towards the other parts."

Guys, this left me gutted and spinning. I tried to explain to him, but it just seemed to get worse. He said he doesn't feel protective of adult me, and that is really really hurting me right now. I told him how much it hurts and frightens me to think that "my time is up" for anyone to feel protective towards me. He started talking about how "yes, it's painful for both of us to realize I can't ever be your Daddy, you can't ever be my little girl." But, I told him, no, that's not what I'm talking about. I'm talking about adult me -- how I feel like I'm on my own now, children are more important, I approached this from every angle -- eventually literally saying "like if I were to get mugged, I'd be on my own." And "Don't adults protect one another?" To which he said "All the time," but didn't go further.

He eventually said "If we were walking down a street, and someone were to try to attack us, of course I would want to protect you. But the little part of you is the part I would most want to protect."

I eventually just said that I felt like he was talking about another person -- like some other person is who he would want to protect, not me. Maybe the *******ed parts talk was a horrible mistake, because I told him that I felt so much more disconnected now, he feels like a stranger, he feels unsafe. Which, of course, is not what he wants, nor what I want... but that's how we left it.

Oh, and then, at the very end, I asked him "is it a problem that so much of our therapy is focused on our relationship?" I was expecting an easy "no, it isn't a problem; so much of the work we are doing comes from our relationship" or something like that. Instead, he said "I don't know. To answer that, we'd have to go back to what we talked about last week, which is what are your goals in therapy?"

I totally shut down and basically just left at that point, because now I also feel like he's not OK with so much of my focus being on our relationship. And, yeah, logical me says "TMC, relationships aren't built primarily by talking about them; they are built primarily by experiencing them -- perhaps it's time to stop talking about the relationship and open another box, because that's when you felt most connected."

Except I trusted him before we did that, and now I've swung back to "he's unsafe." Or even "this isn't going to work; I give up."

Monday 1/8 - No session, phone call

After several emails on Sunday, we decided to have a phone call at 9:30am and keep my appointment at 3:30pm open for me. At 9:30am, you called several times trying to get through to me saying that you were running late and would call me later. The phone connection was bad so you tried several times. Finally, you got through enough to tell me what you wanted and to hear my response. After that call, I emailed you to say to call the room number, not knowing if the problem was on your end or mine. You called back at 9:45ish to my cell number.

Hi, Hi… Oh I called your cell number not the room… It’s ok… I think the problem was on my end, an issue with the cell phone connecting to a blue tooth head set in bag…. Ok… In office now, is it ok to pause for a moment and put you on speaker phone? … yeah, muttering to myself, I should do the same…. Ok can you hear me… yes, can you hear me… yes…

You said in an exclamative tone “What happened?

I proceeded to tell you as I often do in reverse order. I told you about Saturday and how at some point in the afternoon I started feeling very tired and cold, not well at all. I started having the feeling behind my eyes that you do when you have a fever so I took my temperature and it was 102. Backtracking I said well really, I started feeling really cold on Friday and unable to get warm but didn’t feel like I was running a fever then. I told you that like I had said on Thursday, it was already acting odd, redder and back [the seromas] so I had contacted the doctor and sent them picture. They had said to stay the course, no aspirating at home and compress as tight as I could handle the wrappings. So, I had been doing that. I said that I wasn’t sure that it was an infection – I thought the coloring might have been from bruising because of the aspirating done by the doctor at Wednesdays appointment and the pain from the tightness of the wrapping. I told you that it just continued to get redder as the week continued. I was trying to get to Monday to contact the clinic again, but when I spiked the fever, I thought it best to call the on-call doctor. The doctor suggested/encouraged me to go to the ED. I thought then that I’d be going in to get drained and oral antibiotics. I shared with you that I asked them about the 4 hour ED waiting time (which didn’t look like that once I got there regardless of anything). She said that she’d let the service to be on the lookout for me and if it seemed to be taking a long time to call her back.

I continued with the story saying that once I got called back to triage, we went through the checklist and took the vitals, there I was only 101.8. As we wrapped up the checklist, I asked the nurse if she wanted to see a picture of my leg as it was still wrapped. She said yes, I pulled it up on my phone and told her that it was taken 2 hours earlier. She said ok, and got up, said she’d be right back. A few moments later, another nurse came to room me. We ran into the first nurse in the hallway as she was coming back to room me also. I got roomed and changed.

I told you that people would come into the room, grab gloves, look at my leg and leave.

The ED nurse came in and took some more information down, heard the story all over again, unwrapped my leg and said ok, be right back and she left. At some point, I got some heated blankets because I was freezing.

Next was the plastics surgeon. She popped her head in and I said, hey I know you. I told you that I couldn’t remember which surgery she was part of but that I recognized her. She said she was the one that was in on the leg surgery. Then I remembered that she was one that had come and checked on the drain when it wasn’t working. She did some pressing and checking on things before leaving. At that time, she said that she’d cut a small opening to try to drain it completely, and probably an admission.

Then an ultrasound tech came in to try to get a picture of what was going on there. He kept getting paged to come assist with another patient that was a safety risk. When he came back for the 3rd time the plastics doc had returned and was starting to set up for the procedure. They decided on no ultrasounds as she was going to cut open anyway. I wished they would have done the ultrasound because I would have liked to have seen what that cavity looked like on the larger seroma.

She finished her procedure and told me at some point that she’d ordered IV antibiotics, admitted me, and put an order for me to have surgery. She tried to reassure me that the surgery order was just in case. I said that later when she came in, she still tried to say it was just in case; I took it as, ‘you are going in for surgery, I’m just trying to ease you into the concept of it’. I told you that I was not prepared for that, that I had thought I was coming in for a drain and oral antibiotics, possibly a onetime bag of IV antibiotics.

We talked a little about the frustration of being NPO every night when being an addon case. I told you that I had started thinking of it as being on standby. I told you how the night before I had ordered an extra dinner before the kitchen closed so I could have a midnight snack before I was unable to eat. You thought this was a good idea. I told you I had mac and cheese. I informed you that the surgeon had cases until 2-3 in the afternoon so I didn’t want to wait that long without food. Again you supported my decision here to eat a late night meal. I said the night before I had eaten dinner at 5pm and it wasn’t until 10 am the following day before I found out that I would not have surgery on Sunday and could eat. You commiserated with me around that. I said that if I could stop eating at midnight and have surgery at 6am, why then could I not eat up until 9am (if I was going in at 3pm). I guess it was a good thing after all because they came to get me at 11:45am not 3pm.

I then joked about having spent my annual out of pocket max for medical this year within the first week of the year. You said, way to look at the bright side. I told you I was a little afraid of insurance not covering this bill because of the issues coming as complications from an elective procedure. You responded with support. I shared with you that I talked to the on-call doctor about this as a concern for coming in and that they said that it should be covered and something about complications from an anesthetized procedure but that I might have to fight the insurance. There was some discussion around it all being in how the hospital coded things. You agreed that it could be a stressful situation depending on how it works out.

I told you that it was weird being in the hospital for as long as I have been (at this point I was at 60 hours). I said that through all my procedures and everything I had never stayed more than one overnight, so no multiple overnights experiences other than maybe my tonsils when I was 4. I told you about my experience on Sunday about walking up from a nap, going for a walk, and being a little disoriented about my surroundings. You said it was common (or not that uncommon). I proceed to say how I was walking around in a gown and scrubs and it felt like all there was was being on this unit/in the hospital. Like there wasn’t a real world out there, that this was my world, would be my world. In fact, I had walked passed the door to the outside several times and just did not even see it. I didn’t feel like you understood what I was trying to describe early on. I do think you caught on some by the end of this topic.

I thanked you for holding my session today. I said that I had a topic I was nervous about but thought it would be best handled in person. You respected my thoughts around this and did not push or pry on it, like usual.

It was time to wrap up, I knew we’d talked a long time. I wanted to tell you “love you”. This reminded me of my mother’s call on Sunday and how she said, “love you” in the closing [I have no memory of the last time my mother verbalized the word love in either love you or I love you. She always signs her cards, "Love, Mom"]. You asked me how I felt about (maybe how was it for me). I said I didn’t like it at all. I said that it would be another thing for our session (again aware of the time). You said ok added to the list – I felt like you were joking around with me on this, it felt good.

I commented that I thought about that call because I wanted to say I love you to you and it brought up that memory.

We started to wrap things up, saying good byes, thank yous for this and that. You commented again about hoping to see me and also hoping that I have the surgery because either one is taking care of me.

We hung up without me telling you I love you. It felt weird to try to say it after the connection to my mother’s call. I was sad for a short period after our call. I didn’t want to go back to work. I wanted to curl into a ball. I did curl up some for a few mins maybe 10, doubtful more than that. I don’t think I cried, if I did it would have been only a tear or 2. Then I returned to work.

Emails after surgery -
Hi Dr. S, Still in post op waiting for transportation. They found the infection and took sample to culture. I can't get discharged until the red is gone. Hopefully that will be quickly.

I'm feeling youngish and connected to the mommy part in you.

Phone almost out of battery.

Love me

Dear Me!
Thank you for touching base! Hang in there. Know that I am sending thoughts of rest and healing and comfort! And may you rest peacefully in the thought that I know!
Faithfully,
Dr. S

It's one of those days that therapy seems a bit out of reach of my capacity as a person to weather the line between how highly personal it is, yet how it is a professional relationship.

My T worked really hard today, and kept reaching out in kind ways. He is very aware he is a male T treating a female trauma person( he insists patient not client) , and he also knows he pushes hard much of the time. Today he seemed a bit concerned , and talked about how we could take a breather and discuss a lighter subject, and not get more bleary-eyed and so sad bc he realized I am exhausted.

Then, right at the end of session he cancelled Friday by saying. Oh, I'm out of town on Friday". Last ten seconds. . . .

This is where I get so frustrated with myself. He showed me such attentiveness and caring all session, but I still felt kind of put in my place and dismissed with that .

I know it is bc it was just the holidays and the session schedule was not as reliable, but it was also bc he insists on so much confiding from me and talking about secrets on and on. . . couldn't he at least say hey I am going to . . . my kids soccer game, a conference. . . I guess I am confused about myself, and why this hurts my feelings.

I think it is likely bc it calls attention to the part that this is a doctor -patient relationship only even though it feels personal. I have plenty of good friends, a BF, and a busy full life, so I cant understand why the psychologist mesmerizes my attention so much. It doesnt really invoke or call to mind my behavior outside of session, and it takes so much will power not to overreact to these little things.

I probably will not mention it to him, bc it seems like nitpicking when he is generally so tuned in, and even to myself it seems like an unreasonable thing about which to be upset. Still, three hours after session, I feel it snubbed.

It was kind of the T version of the Doorknob Topic, and it was in such distancing language after he coaxed me all session to be connected and present- seems hypocritical(?).

Sorry such a long post- I'm frustrated and puzzled by myself.

Completely a doorknob method. Vacations and changes in schedule/routine, if they affect you, affect us for a wide range of reasons. Your feelings are valid and ok. I would recommend talking to your T about how it felt like a doorknob topic and would appreciate more notice and time to process out your feelings around the changes.

My T disclosed several weeks throughout the year where she'll be working Monday but leaving before Thursday for conferences. The first one coming up in February. We've already started to process this missed session. I don't know how frequently you see your T; however, given he is talking about this Friday, it is a good chance you won't see him before he leaves, by not bringing it up early in the session, he effectively forces you to either use out of session contact to work through it with him or you deal with it on your own.


Have you asked him in the past what he was doing or where he was going when he's had a vacation? Will he disclose at all if you ask? And yeah it can be hard to deal with not knowing things about our T and the onesideness of this type of relationship; especially after we share so much of ourselves. My T will share some with me but usually I have to directly ask. So, if you can, you can directly ask him what he'll be up too. Maybe it's not a secret, maybe it just didn't occur to him to tell you. Again, not knowing the type of dynamic you've had with him and your therapy process.

This is a big one for me. Anything that reminds me of the business side of this stuff can set me off and set us back. I know it's a business. I know my T is a paid person in my life and if I stopped paying her she would eventually cut me completely off. I don't believe she'd stop caring about me and I do believe she would be generous in trying to work with me.

I don't have plenty of good friends, I do have a wife, and a few good friends that are not geographically near me. I have a somewhat busy life. So there is that difference for me than what you describe.

For me, there seems to be the need for an illusion aspect to the relationship in order for me to feel her caring and love. I can deal with the business side of things if it is done outside the therapy room. I think it has something to do with once in that room, then we are on me time. It is the time in my life where everything can be about me and the business side of this activity is not about me unless I have a problem with it, like when waiting for her to get in network with my insurance or when there was a coding issue and I needed her to address how her billing people did something. I am so glad she has a billing service that takes care of her billing for her so I don't have to deal with any of that directly with her unless I have a problem with them.

I also have a MC and with him, none of these things bother me - we pay each session a copay and talk about schedule stuff frequently. So I don't need this illusion with all mental health providers.

PS - don't worry about the length of your post, it's all good. I do mini novels.

Thank you so much Elio, for understanding. My T really regards himself as a professional like a medical doctor, and I dont think he understands how much the session times mean to me symbolically and in other ways. I am frustrated with myself too bc I dont usually have problems with separations etc, and am usually easygoing. Therapy, with its constant requirement of honesty about secrets v being a resistant PIA makes me crazy I guess.

Mostly talking about transference again. I said I want him to be okay with my feelings. He said he does feel okay with my feelings but he knows there has been times in the past when he has been 'knocked off balance' by my feelings and he can't promise that won't happen again, but that he feels confident he can steady himself again if it happens. I said I don't want to step on any landmines. I feel scared of being hurt. He said that's a powerful image.
A few minutes later I was looking deeply into his eyes and I said something to him, I can't remember what but I felt some kind of pressure and I commented on my feeling. He responded that he had recently watched a film about landmines which he had found disturbing and after what I said those images were in his mind. I continued to look at him. He said "what's happening?" I said "I feel better now you told me that. I felt there was some pressure there and it feels like we found the valve".
He cocked his head as I continued to look his eyes and said "you're highly intuitive, aren't you?" I replied "I feel it right now".
We were silent for a few more minutes and I asked him "how does it feel to be seen like that?" He said he felt a bit self-conscious. I said I understand that, being seen can feel good and bad.
We talked about how my deep connection to him and sensitivity to his emotional responses probably comes from having to gauge my mother's response because whether I was safe one day to the next depended on her moods. So I learned to pick up on things.
We went on to discuss what the transference feels like and what I do with the feelings. I said there's a particular song about absence which is not my genre and not something I would normally listen to but I have been listening to it a lot recently and thinking of him. Thinking of missing him when he's not there and having nothing without him. I said I know it's not true but in the moments I am listening to that song I could believe it's true. He was curious about that. How the fantasy and the reality coexist. He asked if that fueled the fantasy. I said that sounded pejorative. He apologised and said it wasn't meant to. I said I allow myself to feel the feelings that want to be felt. The erotic transference particularly comes from a teenage part of me and I allow those feelings the outlet they want, which means listening to sad songs, joking around with friends about sexual innuendo relating to him (I told him some sexual jokes I had made about him which was quite funny) and I alluded to sexual fantasy too without saying it.
I said that it occurred to me that the song I find myself listening to was released when I was a teenager and when my mother was sectioned. I said though I didn't have any conscious thoughts about it at the time, I wonder now whether the lyrics about somebody being gone had actually spoken to my feelings about her absence at that time.
We were almost going over time by this point so I paid him as we were still talking, we briefly hugged and I left.

I broke a toy in Ts office and thought he was mad and started crying

I'm sorry. That is one of my biggest fears. How did your T handle it?

He asked if I broke it i said yes. I told him I'm sorry he said it's ok I didn't buy it ...its (another client name)'s. I said are you mad at me? He said no. He said go clean that up so it doesn't get everywhere (it was like gooey slime). I washed my hands . He teased me saying I broke it on purpose bc I don't like that client. I said that's not what happened ! I started to tear up and I don't even know why. I said now I'm crying! He said im just teasing you junkdna. I knew he was teasing and wasn't hurt about it but I really thought he was mad at me. It felt overwhelming and I cried. I think he felt bad about teasing me and sat with me over time, telling me it's okay and he knows it was an accident and that everyone's been trying to break it

I feel bad about it still and embarrassed that I broke it. I'm having a strong reaction to this and am not sure why.

I spilled my soda once in T's office and just HATED myself for it. Really. I started to cry because I'd never hated myself so much.

I think it's related to feeling that it's somehow unacceptable to 'make a mess' - which is a terrible feeling to have in a T's office, where we just get our messy feelings everywhere.

I'm sorry the thing broke, and that your T teased you. It's okay - it's even okay to make a mess. These things happen.

I know for me it goes beyond "make a mess". I won't even touch things in my T's office for fear of breaking or somehow damaging it/them. I will look at things, not just at T's even at a store, longingly and not touch it for fear that I will break it. It's not an all the time thing (well at T's it is) but elsewhere, sometimes it is strong and other times no big deal.

Wow well my T got really mad, like a normal person mad and lost his T costume . He said that reading into or trying to figure out why he said I will Be Out Of Town at the doorknob was setting hm up and shutting him down and reactions I didnt understand. He is usually very composed and thoughtful in every response. I am worried I hurt his feelings, and I have no clue what transpired and escalated.

Even though Elio sees my point, my T absolutely doesnt, and he won't back down even a tiny bit to see any part of my viewpoint. It is very unlike him.

Those guys can get very very defensive when someone points out something they are sensitive about. I would not worry about hurting a therapist's feelings. I would confront the therapist about their response. And keep in mind, sometimes (in my belief most of the time) they defend themselves about doing this sort of thing by telling the client they intended it as an "intervention" for the client's sake - not they just went batshit crazy and forgot their job.

Wow, what an odd thing to get angry about! Now I just want to analyze it even more. I'm sorry he had this inexplicable reaction. I don't think it's the client's job to worry about the therapist's feelings, and I'm sorry he put you into that position. My T would absolutely want to talk about her timing (she wouldn't have done that in the first place) and my feelings about what happened. So odd that he got defensive. You really didn't deserve that response.

jDNA, can you replace the item you broke? That might make you feel better by doing something to fix what happened.

I feel the same way. I was afraid to use my t's drum on more than one occasion when she offered so I could calm myself down by drumming. I finally did the last time she offered and realized I wasn't going to hurt it. I guess I was afraid I would somehow sully it I dunno.

Hes probably going to have some man parts or his butt checked. My ts "colonoscophy" - as he calls it - is practically a national holiday. He always gets pizza after. But people here often say our relationship is unusual, so maybe your all's ts dont share that info with you? Idk.

Eta - im sorry, i didnt meant to kill the thread. But as freud said, sometimes a cigar is just a cigar.

That is so funny, and cheers me up.

Wow, that is a bit defensive. For me it wasn't about what he was doing or trying to figure why he said at the door knob, it was all about him not giving you the appropriate time and space to process the change in routine and the loss of "you" time with him; and maybe you asking him to give you more time to process these changes, even if that means just talking about it at the beginning of the session rather than the end. I'm not sure why he'd say it was setting him up and/or shutting him down. Very weird indeed. I am sorry that he was not able to keep the experience about you and how telling you at the end of a session impacted you.

I meant to type this earlier and forgot. I tend to forget what happened in session as of late for some reason. It went well. T told me to look for clues as to what was causing me to lose the positiveness I hold for him throughout the week. So, I noticed that sometimes I would say something and he would be silent. It happened two to three times today and it has happened before. So, since I figured this out on the way home, when I got home, I texted him. I told him about how his silences were deafening. And I told him that this happens at work. It feels like he is not responding to me like he usually does, and in my mind, it feels as if he is doing this to help me deal with the silences better. I don't know, something like that.

MC tonight - fairly light night. I updated him on my medical adventure. We talked about what started me on my physical transformation. He asked if we wanted to return to the topic of the hurts from this past summer. I said that I didn't think it would be a good night for it. Wife then brought up a discussion that we'd had in the early mornings about worry. She'd had a rough couple of nights worrying about things with me in the hospital. One of the things I bring to the relationship is ownership of worry for her, me, and the guy down the street. I worry and solutions engineer the situation. She doesn't deal well with worry, so for our relationship, she's been able to just hand that over to me (or I've taken it from her). It worked for us pretty well until the life altering event that lead me to therapy. So, it worked until it didn't. Somewhere in there we talked a little bit about our childhood family dynamics some. We talked about how the summer hurts are going to be one of these things where we touch on it and then take a break and then return to it. That it is not going to be a rip the band aide off kind of deal. Wife would like it to be like that for several reasons, I think she understands why it can't be that way. We booked out Feb sessions.

Typically I have my second session Fridays, so we texted instead because he wants me to try to get used to going weekly again

It was fine, but it sucked, got cut a bit short cuz he had a meeting to go to or something. I'm at least glad he is acting as he was before and I did not ruin everything with him.

I'm preparing for some tough topics to bring up Tues.... including one I have avoided for 9 months and shut down if he even tried to mention it....

I told T something dreadful and now I can't stop obsessing about it. Particularly hard because we have an extra day between sessions. Trying to remember her reassurances, but it's hard.

Your t had two choices for your session that day: announce at the beginning that he would be gone, in which case you would lose your time because you would be focused on him. Or announce at the end, and let you have your normal session.

So why are you afraid to continue to focus on you and not on him?

Or - can you use this time now to "have that session" as if he had announced at the beginning, and given you no more further information about it. Just, its a personal day, period.

Which was the point i was trying to make before, that it was just a personal day for him, and he didnt care to expand on it, for whatever reason. Im sorry i sounded like i was making light of the situation.

I think he thought you would not be this affected by it, which was a mistake on his part, and your reaction may have taken him by surprise?

Its taken me by surprise because we usually understand each other. I apologize for adding to your pain on this.