In Session Today: Part IV

((TMC)) ...I just hate S so much...

Today’s session felt really hard. I was there, but very much in my head. I went straight into telling R about the Work Capability Assessment, and the mental health conversation that ensued as a result. I expressed my surprise at the conversation taking place in front of a third party, and that the matter hadn’t been discussed with me before. I told her that I had a piece of paper prepared in case I couldn’t say the words. She asked whether that had been helpful, and I agreed that it had.

‘I thought I was coping pretty well.’
‘You mean, you actually thought you were coping well, or you were presenting as if?’
‘Presenting as if. A couple of days later, I went to the doctor to get my knees checked out after the fall.’
‘That was when you fell over in town?’
‘Yes. Mum said she would give me a few minutes with the doctor whilst she was examining my knees ‘in case I wanted to talk about anything else.’ I have actually skipped over an important point here. Mum told the social worker that she had spoken to the doctor, and she said ‘It’s a fine line.’ I am assuming a fine line between normal and pathological…well, not pathological, but you know what I mean.’

‘The word “depression” is coming up for me now, something we have discussed before. ‘A diagnosis of depression’. How did you feel during that conversation? Did you feel heard?’
‘No.’
‘And what happens when you don’t feel heard?’
‘I pull away. I withdraw. I retreat.’

I went on to say that I felt a sense of shock because I thought I had been projecting well.

‘Projecting?’

I explained about the Inner critic and their role in keeping me from speaking freely, and then recognised that we had veered off the subject of the doctor’s appointment. R asked whether I felt that the door to being open with my mother had closed. I said I wasn’t sure, but the last time I mentioned going to the doctor, the week before my experience in the cinema, I was met with a comment about social interaction. I mentioned to R that I worry about the impact that my stuff has on other people, and she reminded me of the work she had to do to convince me that she can take it, and it’s her responsibility to manage it if it affects her.

We had a bit more of a discussion about ‘speaking freely’, and what that means to me; how I find that in session is the only place I can speak freely.

‘I don’t mind if people walk up to my boundaries and nudge them, but stepping over them is another thing.’

‘So, to give an example…you don’t mind if people mention that you seem a little out of sorts, but if it’s more…’Come on! You’re not really here, are you?’, then it’s more difficult?’

‘Yes. And the inner critic was providing a lot of backtalk. I had been considering going back to the doctor’s for a while – and you know that me considering something is like preparing a legal case.’

‘Yes.’

‘But I wanted to talk to you first.’ I’m still not really sure why that was, but it seemed important at the time.

Then we finally got around to talking about the specifics of the doctor’s appointment.

‘As she was examining my knees, which was a painful experience…she asked me how I am in myself.’

‘That’s a good question…a very open question, and open questions are often the best.’

‘I went straight in with “I haven’t been sleeping very well”, and she asked me whether that was due to pain, or something else. If I wanted to completely dismiss my own experience, then what I said next is a good way of doing that. ‘Mental health stuff.’’

“Mental health stuff – was that what you said next?’

‘Yes. I wanted to say more, but I was finding it difficult to keep eye contact, and maintain the conversation, and keep the inner critic quiet.’

‘That sounds like a lot.’

‘It is.’

‘Is your doctor aware of the situation?’

‘Yes, I told her what had happened when I last spoke to her.’

I then decided that I was going to hand R the piece of paper I had prepared in case I couldn’t find the words.
She took it from me, and we continued to talk for a few moments more, and then she noticed the time and said she had better read it, because we only had five minutes left.

The upshot of it all was that I told her I don’t want to be afraid of my emotions any more.

‘And we both know how much I hate those bastards!’

‘So, it is important to me, once I am in that place of speaking freely, to be able to stay there…and you can help me with that.’

I met with t. we walked our route. it was muggy and looked like it might rain. t asked how my thinking is. I said it's obsessive but the biggest problem right now is my mood. we spent the whole session talking about my depression. we came back and played cards and got a bit philosophical. it started to rain and I was crying

we did not talk about payment.

R:I don't want fight or hurt you.

S: Loving you already hurts me.

Sigh...

My session was... ok

But I feel I've messed things up

The S stuff... then I told him about the session I'd scheduled with J (edit to add: J is the T I saw right after S left, and he's my "back-up" T but I haven't seen him again since starting to see C... but C can't see me for a session coming up, so I scheduled a session with J....) AND mentioned that Group T had asked about part mapping, which C didn't know anything about and seemed reluctant to consider doing...all of this has led to him feeling some insecurity.

Email from C:

I feel kind of awful, and I've gone ahead and cancelled the session with J, but that does mean yet another week of only seeing C once...and I just feel really...idk...shaky right now. With all the death stuff and the insomnia and the S stuff...

I pretty much just want to dig a hole and hide in it.

And I can't stop EATING EVERYTHING.

I don't understand why he would say those things to you. Of course it makes you feel bad. His insecurities should not be your problem.

Our therapy has always involved him sharing his responses to the things I say and do. His insecurities aren't my problem, and he's definitely not telling me to change anything because of his insecurities... he is responding because I asked him point blank how he felt because I sensed his insecurity.

Sounds like he and my T would get along swimmingly!

God forbid.

I've never hears of a T admitting attachment to a patient/ client like that on such an even playing field. I really like it in one way, though I completely agree hs feelings are not your job, especially when he did have the time open for you.

Lol well... do imagine him saying it in a very intellectual tone, because that is how he talks all the time (suuuper intellectual...speaking of feelings but not typically WITH feeling...it takes getting used to).

I see my t again on sunday. I guess I have to be the one to bring up payments. and how I owe him more than $500. and how I don't know how to pay it. and that life is SHYT

I had an extra session because I felt really crappy and disconnected after Wednesdays session.
I started by telling him why I'd asked for an extra session, that on the face of it the session seemed fine but I still felt awful afterwards and disconnected from him.
He said when he read my request for an extra session he tried to figure out what it was about but drew a blank, so he decided to just follow my lead.
He asked what I thought the disconnection might be about. I said it occurred to me that it could be something going on in his life outside of the room. He said there's nothing major going on in his life that would be distracting him. He said a couple of minor things occurred to him but he'd be "very surprised" if they were distracting him in session. I felt reassured by that and more connected because I knew he wasn't withholding anything and he was being honest with me.
I told him someone had played "everything reminds me of my therapist" by Nancy Tucker yesterday and I felt really sad. He asked why I felt sad. I said because everything does remind me of my therapist and it's because I don't know him, I'm creating him, inventing him. He asked if it's true that I don't know him. I said it some ways, yes it feels like I don't know him. He said he doesn't know all of me either. I said "but you have more to go on."
He asked what questions I could ask that would make me know him. I said nothing would be enough and I'd always want more. It's an insatiable hunger.
He said at his core he's the same person in the room as he is everywhere else.
He asked if it was about knowing things about him. I said no, it's that he can never fully relax because he has to think so carefully about what he says. He's always in role. He said that's true.
We speculated a bit about what might be causing the disconnect. He said "are we missing an elephant?". I said i think so but I don't know what it is. He said where is it? I said it's between us. He asked what it looks like. I said it's more of an absence, a void. He asked what it's made from. I said dark matter. He asked me if black holes are made from dark matter and I replied "You're the scientist!" (because he has a science degree).
He said he was thinking about how this might relate to what we talked about with the connections between him, my mum and my deceased ex. I talked a bit about my ex.
And then I talked about how the version of my mum in a sort of visualisation we've been using is a younger version of her. I said I wondered if that's because when I knew her, the person she was was kind of masked by mental illness, but I know from her writing that she was a very different person when she was younger. Very witty and clever. So maybe it's about knowing/not knowing someone, and missing out on parts of someone.
I said I was thinking of my sadness that he's retiring from public speaking and teaching. It's kind of like mourning the loss of a part of him I never knew.
Now that I reflect on it, I think that perhaps I felt disconnected from him because I have clearly seen that he is in role on a couple of occasions recently. Firstly when he felt unable to talk to me about a professional issue I was having for fear of "coming out of therapy mode" and again two sessions ago when he said he was quiet because he was worried about accidentally saying something that might hurt me. It's like catching a glimpse of the sharp edges of the therapeutic frame. I think it's helped me to make sense of what was going on and I feel a lot better.

You came through big for me in session, because with the 18 hour work day, bad dreams so I can't sleep, and doing trauma processing, the tears just wouldn't stop, and it rips my pride to shreds to be that way. You said that the water kept rising and I didn't notice it until it was mouth level, and then I just try to breathe through my nose and pretends it's all fine, until it is a fact of drowning. You are a very strict T, and very boundaried, and at times that feels dismissive. On the other hand, I feel in good hands when I am scared and I could feel the wave of trust and you "lending" me strength . I love when you say that- that you are lending me anger bc I don't have enough of my own etc.

E-mail exchange with T (he embedded his responses, so posting it like a conversation):

Me: Wanted to update you on my thoughts since session. If you could respond to this in some sort of detail, that would be good (charge accepted). I'd like to try to get back to regular work with you Monday (maybe some childhood stuff?) so a longer response could save another full session of therapeutic relationship talk.

Me: I want to address the "feeling judged" thing, since you asked me in session to explain it. I know you say you're just being honest, not judging. But as I said, I'm not used to that sort of brutal honesty (from almost anyone ever). So it's jarring to me. I need you to understand that and that I may react strongly to comments you think aren't a big deal.

T: I do understand that, and hopefully you are able to see that I make an effort to be caring while also sharing my thoughts and opinions. I'm confused by what you define as "judgment" so maybe in the future you can point out when it's happening so I can get clarity. Also, I do see my honest observations as a big deal and I try to be very mindful about how I express it to you. It's interesting that I reflect on our sessions as having been far more positive than you seem to. We must be either remembering different things or having vastly different reactions to what's happening and I'm not reading you at all during those moments.

Me: From what you explained Tuesday, I get what you're trying to do with sharing your reactions with me (and I know it's your style as a therapist). However, I may need you to be a little more gentle about that for a bit, if that's OK. I think we need to spend some time examining where my general shame and feeling judged are coming from (see: childhood). And find ways for me to deal better with that. (And then you can fully unleash on me!) Are you open to doing that?

T: I can certainly make an effort - and I'll do so. I appreciate you sharing this as a request. Hopefully you do not see me as having been deliberately shaming, since that was not at all my intention.

Me: I'm at a certain place now with things like transference, how I felt about the stone (it hurt to give it back, but I felt I had to, because of how it made you feel), how much I think about the therapeutic relationship, etc. I know you think many of those things are unhealthy for me and apparently uncomfortable for you as well. But the fact is, it's just where I am right now. And I need you to first accept and join me where I am in order to help me move forward into healthier relationships--with you, with others in my life, and with myself.

T: This is an interesting observation, and I'm going to have to think about it. I do think that it is unhealthy for you. It's hard for me to know how to keep our work from going in a [Dr. Ex-MC] direction, which I absolutely 100% don't want to happen for you. And you are correct - if that were to happen it would be uncomfortable for me, although I don't believe that has anything to do with you personally. My overall goal in therapy is to help people feel well-balanced, strong, healthy and able to live loving lives - and therapy is a way of getting people to that point while also not creating dependency on the therapy/therapist. I'll try to be more comfortable with the idea that we will have to spend time in session talking about things like transference. I'm going to have to trust that it will lead into a place where it can have a positive impact on the relationships you have outside of the therapy office.

Me: I feel like I'm taking this huge leap of faith in continuing to work with you, in trusting that you will ultimately help me more than hurt me. I need you to understand and respect and be mindful of that, the trust I'm putting in you right now. That's really what it all comes down to. Because I do want to try, and hopefully to find that greater peace you've talked about.

T: I appreciate that trust. All I can do it give you my best effort, [LT]. If it's OK, can we talk more about this last paragraph on Monday?

Emails, me to T:

T to me (5 minutes after I sent mine)

I had a pretty rough session the week before, and was worried discussing it would in some way destroy everything I managed to achieve so far in therapy, so I was pleasantly surprised when that wasn't the case.

First, I told T I was hurt by lots of things that he did last week. I reminded him of what had happened: first, he made another comment on how he thinks me sitting a certain way and not looking at him meant I was not engaged in the process and forgot everything we talked about as soon as I left. Then, he also said that he deliberately only gave me short phone calls when I asked for extra support in between sessions. And finally he ignored a question I had completely and just kicked me out.

He asked what I wanted to focus on, which I didn't know. So he started with the first point. He explained that it made him feel very insecure that I never look at him, and I sit differently than all his other clients. That he felt maybe he's doing something wrong. But that he of course couldn't tell what was going on inside me, that he could barely even tell what's happening for himself sometimes. That nobody could really tell that, not even the best therapist in the world. I said it was especially hurtful that he brought it up all the time, then agreed I was indeed engaged, and then two weeks later brought it up again. He agreed that sometimes he needs to be told something a couple of times before he can remember.

He asked me what I thought, whether it was not good for me to sit like that? I told him how I usually write down everything we have discussed for 50 minutes on my train ride home, about 3 pages each time. I also think about what we have discussed and try to apply it whenever I can, plus I talk to other people about therapy in general. He said that made him feel at ease that I was indeed not just ignoring everything I said. He also told me that some people do not do anything like this, he once even had a guy come in and listen to music instead of talking to him.

He then went on to the second thing, the fact that he said he was limiting outside of session contact to short phone calls on purpose. He agreed that he worded it way too harshly. I mentioned that he once told me we were a team, but that in a team you'd inform the other person of your decisions regarding the team, you'd not just do whatever you thought was best. He said 'well, I can't really say anything to that... you're completely right'. He aplogized that he worded it like he did, and reassured me that it wasn't the case that I could never get extra sessions, I'd just have to ask for them.

Then, we also shortly talked about what I should do when I get flashbacks during sessions, since that happened last time, but I wasn't able to tell him. He said it would be very important to mention it when it happens, and that I can just tell him to shut up because this is more important.

I managed to look at him once during the session, which made him very happy. And when saying good bye we smiled at each other. I feel much better about our relationship again, and I think he does too, which is nice.

LT: how do you feel about his response?

CNS: i also am T’s only client who not only sits as far away as possible from her, but am usually turned away as well as curled up in a ball/covered w a pillow. She’s talked about it a few times, but has never made a huge deal out of it.

So, Piaf yesterday.

I went in meaning to talk about No. 3, because that’s bugging me again. So I already wasn’t in a great mood to start with, and when we sat down and she asked if I had an agenda for today, I froze up and spent the next ten minutes looking around her office in an unsuccessful attempt not to start weeping.

Trying to get myself back on track, I asked why there was a Bible on her bookcase (“It’s a good book, and it’s helpful when I have Christian clients.”) and what was in her mystery cupboard (her lunch and her purse) and if one of the certificates on her wall was new (no).

I asked if she was getting tired of playing patience on a monument. She said she could wait, she just wanted to check nothing specific had happened (no).

I also mentioned somewhere in there how I didn’t like how the last session ended (the “Go!” with a pointing at the door when I said I felt like going home and writing). She said she’d thought about it after I left and felt she shouldn’t have done it as it might seem “rudely dismissive.” I asked why she hadn’t mentioned that when I came in today. “It didn’t occur to me.”

Like 15 minutes in I finally got out the rest of the story (she’d heard about the session where 3 and the copy-paste apology 3 gave me for that. So we went through Smaug, then how everything finally seemed to be tied up when we had closure sessions last June until 3 contacted me against my wishes last fall and increased the downward spiral I was in then over work and the divorce. And so now nothing feels tied up and I am angry, hurt, and completely uncomprehending of 3 and her loose behavior around boundaries (which can then lead back to anger etc.).

It’s a long story even though I skimmed the Smaug/No. 2/DBC bit, so even though she’d come out to get me a few minutes early we were knocking up against the hour (she does a full 60 minutes). She asked a couple questions (why did I think this woman was so important to me? Well, because I saw her at truly the lowest point in my life and she helped me get through it, and hypothetically, would you ever want to see 3 again, even just passing in the street? No). I did tell her sometimes the way she and I talk reminds me of 3 and me, which after she confirmed this wasn’t a problem, led to her suggesting I might always find therapy hard and painful because of various bad experiences. (I didn’t tell her it’s always been hard and painful.)

Then she asked if there was anything I needed before I left. I said it seemed like a big high school drama to me and I hated that. She shrugged. I cracked, “not into reassurance, huh?” And she shook her head, and said, “I would tell you what I thought, but it would seem condescending, so I won’t.”

Which hit me completely the wrong way, probably because the 3 saga is easily the most personal thing I’ve told her and it hurts to tell it. Either tell me or don’t, don’t leave me wondering. I snapped at her, “but you can tell me it’s condescending?” and got up and left.

Which meant she didn’t get to fill out her little piece of paper with services rendered and the next appointment she does at the end of session. So I emailed her last night, confirmed the next appointment, and added I would mail her a letter (Piaf is old-fashioned) explaining what went wrong and we could talk about it next time. She wrote back:

Mostly OK, I think. In order: I'm still puzzled that he doesn't seem to comprehend what I mean by "feeling judged." It makes me wonder if he's never felt that (or shame) in his life...in which I'd consider him very lucky, very arrogant, very mentally healthy, or probably some mix of those. I suppose I'll attempt to explain again Monday (almost tempted to start a thread about it, like "how do I explain what 'feeling judged' means?")

Apparently he reflects on our sessions, which is good--though I'm not surprised he comes out of some with different impressions than me, especially as I might seem fine in there, but then start to get upset in the car or later than evening. I appreciate that he's willing to maybe tame his honest comments to me a bit for now at least.

I struggle with the "unhealthy" and "uncomfortable" stuff regarding transference. Especially since I shared that possibility from the start and he knew many details about the ex-MC stuff and have asked him repeatedly if he would be OK working with me if it developed. But in the e-mail, it seems like he's trying to look out for my best interests in not having me repeat what happened with ex-MC--because I certainly don't want that either. And he seems willing to work on his discomfort and try to meet me where I am. I just hope he can come through on that.

So what I just wrote probably doesn't sound like I'm "mostly OK" with it... But I guess it's not just about the words themselves, it's the sense I get that he's looking out for my welfare and that he wants to understand me better. He seemed to really be considering what I said and thinking about it, which means a lot. Especially since I don't think ex-MC really considered the effect some of what he did and said (and his unclear, shifting boundaries) had on me, until the end when it all blew up. So I'd rather have a T who is giving thought to such things and considering how what he's doing will affect his client. Even if he's not giving me all the answers I want (and even though part of me wished he had said I could have the stone back...)

I had a difficult time remembering session, which is rare. What I remembered today was when T told me, "You don't have to have reason for how you feel, you don't have to explain who you are. It is okay to be you. It might sound like common sense, but to me it was very powerful. I used those thoughts today toward myself when I was having a difficult time, and they seemed quite profound.

My 14 y.o. has been making su statements at school so I've had him to the local psych hospital 2x for intake but he has not yet been admitted (spent several hours there yesterday). Today he and I went to talk to his t, and she wanted all three of us to talk for a bit, which turned into 30 minutes. I feel so raw trying to reach my son and tell him I know how loud and overpowering the depression voice can be while also trying to maintain my composure and not let him know how much it pains me to see him in such pain. This is all on top of my dealing with my own issues with my own t. After our 30 mins meeting with 14 y.o., t and me, since my kiddo wasn't talking, she sent him to the waiting room (it was empty) to write about his thoughts while she "checked in with mom."

I'm glad that she checked in with me. I was able to tell her how hard it was to hear my son talk about sui given my experiences with the topic. I feel relieved that she thinks he is just using words to get attention - like he'll make a threatening to self statement to a teacher, I get called in, I take him to the psych hosp, he says he doesn't want to go inpatient because he has plans with his friends this weekend (good friends).

It was weird to be weepy in front of his t, but then again, it isn't because I'm used to being weepy in front of t-type people.

My t had asked me to email me yesterday in response to the topic I am discussing, so I did but mentioned how I spend the afternoon (with son). She said she was sorry to hear about (son), and "I wish I could help." Ah - the challenge of interpreting a single line of email!

Anyhow, thanks for listening.

well it didn't go well

I sobbed and hid my head in my shirt

t didn't bring up payments again

I guess he's waiting bc I am horribly depressed.

I feel so lost. a shell of a person

Jdna, I think your T just wants there to be a plan other than to continue to rack up debt. If he was planning on terminating you over the money, he wouldn't allow you to evade the subject.

Edit: What I mean is, maybe he just will have you pay a small amount each session and forgive the debt or something.

Blondie tonight.

She said she’d been expecting to talk to me Friday and had wanted to be there for me emotionally (I’d blown her off Friday am). I just repeated that I was exhausted — truth but not the whole truth. I’d also been a bit hurt that when I’d texted her post my procedure (at her specific, repeated request that I do so) with a short summary of what it’d entailed, all she sent back was a robotic two short lines that basically gave me an appointment time (as if all that was standing between me and my fate was a precious therapy session with her).

I wouldn’t have bothered texting if I’d known that’s what she’d do — I was exhausted as it is. And, this isn’t the first time she’s gotten weird and squirrelly about any out-of-session communication — she did equally weird stuff when I was in the hospital and at other times as well (even when she has initiated contact). So, I guess she’s clearly ambivalent and concerned about my breaking boundaries, which just feels really hurtful given that I’ve been seeing her all this while and (hopefully) haven’t given her any reason to feel like I would. I also know (from random remarks) that she does exchange emails / texts (not just for scheduling) with others but somehow gets really weird when it comes to me. However, I do know she’s gone out of her way to do a whole lot of stuff for me and so, I didn’t want to nitpick and be an arse about it — so just dropped it.

I also told her a bit more in detail about my mom’s response when I came out to her. Blondie told me she was sad for me (I am actually okay with where my mom is at) and so, I told her that I do understand that it can feel like the loss of a dream for a parent when their child comes out to them. So, she told me that she’d have no problem if her sons chose male partners — I looked at her quizzically (I don’t think she’s homophobic but I also don’t think she’s so very progressive that she’d totally be cool if her kids show up with a partner of the same sex).

She finally said that she thinks her kids don’t have to make that decision now and there’s plenty of time (her older kid is 16 or so). I was really tempted to challenge her and ask if she’d say the same thing “They don’t have to decide” if they came home with an opposite sex partner? Or, is this homily of not-deciding-now only to be given at the prospect of facing a queer relationship of some sort? But, again, I just don’t think she has the depth to sort it out — I suspect she’ll be hurt if I asked her this stuff and anyhow it’s not my business to change her mindset, as long as she remains generally okay with me.

Gah.