In Session Today: Part IV

That's an interesting point. It's sort of like if the stone represented the therapy space, it was OK, but if it strictly represented him, that made him uncomfortable. I feel like he sends a lot of mixed messages about some of those sorts of things. In fact, the subject line of my e-mail to him was "Mixed emotions and confusing messages."

And then later in his response, he also says this: "I want you to be able to feel cared about and to trust my investment in your wellbeing, and for you to feel a connection to me as your therapist." So then it seems like connection to *him* is OK, so long as it is *him as my therapist* (rather than, say, him as a person). Which maybe is kinda the whole "Dr. T" vs. [T's first name] thing?

Often things are not quite that clear in my brain as to what something represents to me or what exact feeling I have toward a person--for example, fondness vs. affection vs. connection vs. platonic love vs. romantic love. I certainly don't categorize in my head, say, "I like this person as my coworker." It would be more, "I like this person." And, OK, this is going off on a bit of a tangent, but I was thinking the other day that maybe the way I define, say, "love," at least for when I feel it, is different from how someone else might define it. So maybe, for example, when I shared those feelings with ex-MC--and told current T about sharing that with him--they each thought I meant something different than what I did and reacted according to what they would mean if they told someone they loved them. Which might be something to discuss with T...

I have no idea if this makes much sense--only partway through my coffee!

Today’s session encompassed a variety of topics. I had intended on talking about my understanding of ‘breaking point’ and safety, but veered off after talking about The Cherry Orchard.

About to say ‘I demand honesty from other people’, I caught myself and said ‘I encourage honesty with friends, but find it hard to be honest myself.’
‘Why do you encourage honesty in others? Because you want to be that person?’
‘Even though we know that my desire to be that person got me into this situation.’ I talked some more about my frustration with the bathroom scene, and how if safety is equated with the ability to feel, it doesn’t feel very safe. R wondered whether that is because I am alone with it.

I agree, and added that once I have examined the bathroom scene from every angle, it wears me out.

‘The one thing I want to do at the end of the day, like most people, is sleep.’
‘It sounds exhausting. I am getting a sense of how consuming it is for you, which I haven’t had for a while.’
‘Yes. It’s like there’s a wall between me and everything…’ I paused, because I couldn’t speak.

‘Can you explain to me what’s going on? I feel a bit out on a limb here.’

‘The inner critic is disputing the existence of the wall.’

‘I think grief is too small a word for this. What differentiates my experience of grief is that there was movement.’

‘When you talk about Chris, although there is obvious pain and sadness, I have a sense that it is complete. It comes up again around Easter, but that is over there, and this is here. When you talk about Chris, you can say the words [died, the C word, etc.]’

‘I hate making comparisons…I hate making comparisons between Chris’ life, illness and death, but throughout that I felt respected.’

‘That jumped out at me then. Do you think that is part of the issue?’

‘Yes. From ‘Because of all you’ve been through, I didn’t want to tell you this, but…’ to ‘She knows you worry’ with no trace of empathy, to that hideous email…’
‘Most people wouldn’t be as affected by it as I am.’
‘Is that the inner critic?’
R and I had a conversation about how I may never feel fully safe enough to express my emotions, but we can work towards that. She offered that I might spend some time between now and next session trying to name emotions as they arise, after I mentioned my physical resistance to them when I am in that night-time space.

Warning: ridiculously long!

T yesterday. Sat down. He said (as he noted in the e-mail) that he realized last session was rather disjointed, with many topics left rather open, so he knew we'd be coming back to them. I said it was good that he realized that, since he's said before he sometimes has different impressions of sessions than me.

I said I know he prefers meeting in person, but that I specifically wanted an e-mail response for a reason. I know things like body language are an important part of communication. He agreed. Me: "But...I'm not sure how to explain this, but sometimes it's like I can be in here and maybe I'm bothered by something you said, but then by the end we're smiling and laughing, and I'm thinking, 'OK, everything is fine.' And then minutes or hours after I leave, the words you said will come back to me, and I'll realize I'm not fine." T: "Hm." "It was really a big problem with ex-MC, like I could come into session really upset or angry with him, then he could look at me a certain caring way, and it's like I would just be like, 'aww, everything is OK.' When really it wasn't, and I'd be mad at myself afterward. So I just wanted the words this time."

T: "Also, the good thing about an e-mail, is you can go back and look at it, you don't have to trust your memory of what was said." Me: "Yes, and then it gives me something to go back and read later if I'm feeling insecure about the relationship or something. I hope it doesn't bother you that I reread them sometimes." T: "No, of course not. I'm glad that you don't just skim them once and stuff them in a folder or the trash and never look at them again. It makes the time I put into them more worth it."

Me: "OK, good. With ex-MC...there was this one voicemail he left me a few years ago when I was in a really bad place, and he just sounded so caring, like not just being a therapist, but like he personally cared about whether I was OK, his voice cracking and things. I don't even know how many times I listened to it after that, but it was a lot. And even after what happened, I can't bring myself to delete it" (I was full-on crying at this point).

I talked about ex-MC being really inconsistent with me (which I'd discussed some before), how the fact that he'd only reply sometimes made me push him more for e-mail responses and feel more anxious about them. While with T, I know he'll always respond in some way, so it's less anxiety-inducing. T said he tries to be consistent. I said I appreciated that. I said that ex-MC would sometimes be fine with me talking about the transference, including in session, but other times he'd say "we should try to stick to marriage counseling boundaries," so I'd never really know when it was OK to talk about. And how I'd read that parents who were really inconsistent with their kids--I think that leads to disorganized attachment? T said he knew that inconsistent parents tended to be the worst for kids because it's confusing. I said that's how it felt with ex-MC. And I think it made me push more for responses and made the transference more intense.

Me: "I know you're worried about me repeating patterns with you. That you wouldn't want me to have a bad ending again. But the thing is, I almost had a good ending with ex-MC. I was started to pull back from him, feel less connected, less needy." [crying lots here]. "Had I not gone to that concert and sent that e-mail (the "I love you so much" one), maybe I just could have continued pulling back and left fully on my own choice on good terms. I mean, I know he didn't make me leave, but his reaction made me feel like I couldn't have the good ending I wanted. But I was close to a good ending! I could have done it. I don't know, it was like...the feelings were fading and part of me was trying to cling onto them desperately or something, kind of like a college student leaving home, then being like 'wait, no I'm not ready!' Maybe that was a bad analogy. And I'm totally giving this monologue, I'm sorry." T: "It's OK, this is helpful to understand."

I said, since I had gotten so emotional during all of that, I probably needed to address the ex-MC thing with him more at some point, because it still feels like it's affecting me, plus it's making me worry about stuff with him (T), too.

I shifted back to T, saying in the e-mail he'd addressed boundaries some, and I'm completely clear on the ethical ones and why they exist. But some of his other boundaries seem a bit unclear to me, so sometimes I don't know what's OK to share with him. He asked why I was so worried about his reaction. I hesitated, then said, "OK, I know I said I wasn't going to bring this up till you have a chance to get consultation, but I don't know how to explain it otherwise. It's because of the stone, how you seemed so horrified by the thought of my holding it if I associated with you." T: "I didn't feel 'horrified.' Just a bit uncomfortable." Me: "OK, it just felt like a really intense reaction from here." T: "I don't know if that's just something with me, that maybe most other therapists would have been fine with it. Which is why I want to talk to a colleague about it." Me: "Yeah, it could be. And maybe you think that many clients wouldn't have been so bothered by your reaction."

T: "Were you worried I'd kick you out over that?" Me: "Yeah, kind of, I guess." T: "I never would have done that." Me: "OK. But I just worry because, I know you may think your boundaries are clear, but some of them don't seem clear to me. Like saying it's OK to Google you, then saying later that really only the first page of results is OK. When...those results are kind of arbitrary anyway. Some really personal stuff sometimes shows up on that first page, like a person's address." T: "Good point, I guess the page 1 is a bit arbitrary, but it was more the idea of what was OK to search."

T: "I know we've discussed this before, how you think a client should be able to say anything in therapy, but as you know, I don't agree with that." Me: "I just keep thinking that this should be the one place where I *can* share anything, that if I can't share it here... And that I should be able to ask you anything, you can just opt not to answer." T: "I don't really think that you can ask anything. Some things wouldn't be appropriate." Me: "Like if, say, I asked you what sorts of things you like to do sexually, that wouldn't be appropriate?" T: "Yes, exactly."

Me: "But I still want to be able to share anything." T: "I just think there are limits, that you don't have to share everything. If a client told me, 'Wow, I really wish you could come on vacation with me and my husband, you could sit at the dinner table with us, and help us work through everything, ha ha!' That's a totally fine thing to share." Me: "OK, that makes sense." T: "But if she were to say to me, 'I have this elaborate sexual fantasy involving you and my husband, and this is the point where I rip off your clothes,' that wouldn't be OK." Me: "Yeah, OK."

(I realized later that I need to clarify this with him next week. Did he mean she was actually trying to seduce him in session, rip off his clothes right then? Which, OK, yeah, that's crossing a boundary. Or was it that she'd had just had a sexual fantasy about him and shared it? Because that's a really common transference thing and seems like it should be something that's OK to talk about.)

I said I felt like maybe we were straying too much from what I had intended to talk about. He said I could look at my notes if I wanted. I glanced down at my notes and immediately started crying. T: "What just happened there? What's going on?" Me: "I was just thinking about something I'd written, about what you'd said Monday. How you'd said you had no intention of rejecting or abandoning me. And ex-MC had said basically the same thing, except more of a promise. And so maybe that was kind of triggering for me." T: "OK." Me: "And I know he didn't truly abandon me, but..."

T: "Let me ask you a question. Thinking back on relationships that ended in your life, are they any that you would *not* classify as an abandonment?" Me: "Well, yeah. I mean, like losing touch with college friends, where it's more of a mutual thing. Or leaving co-workers if I'm leaving a job. Is that what you mean?" T: "Yes those are good examples. Since some relationships come to a natural end" Me: "Are you trying to figure out what my definition of 'abandonment' is?" T: "Yes, to get a sense of how you see relationship endings." Me: "Well, I guess if it was a romantic relationship, it was either me breaking up with him or him breaking up with me, so someone was abandoning someone. And I guess I still feel kind of abandoned by my ex-best friend because I never knew what happened there." T: "OK, but you don't think that all endings are necessarily abandonments though." Me: "No, just certain ones."

I forget how this came up, but I said something about trusting ex-MC more at first, since he mentioned dealing with anxiety. How ex-T had always seemed so pulled together and like she had no problems, so it was harder for me to trust her in some ways. I don't think I realized I felt this way before regarding current T, but the following just tumbled out of my mouth: "You're a pro athlete, you have a PhD, a successful career, are married with a kid--well, I guess I'm married with a kid, too, but..." He said it was like Facebook syndrome, where people assume everyone else's lives are better than they really are because of what they post. I said yeah, I guess maybe it's like that. How it's something that often comes up in the forums, how someone will say how their therapist is leading this seemingly perfect life, then leaving for a 4-week yacht tour of Europe--then I said, "well, i guess you can't really take a yacht tour of Europe, but you get what I mean." T laughed and said "Yes, I understand."

Boundaries came up again and my fears of sharing something that would bother him. I said the problem is, if I keep stuff inside because I feel I shouldn't share it, then it's sort of the "don't think of a pink elephant" thing. (where if you tell someone/yourself not to think of a pink elephant, then what are they going to think of? A pink elephant.) How I feel that keeping stuff inside intensifies it. I asked T if he thought a boundary could be violated by feelings, or if it was just behaviors? T said he didn't think you could violate a boundary with a feeling, because you can't really control those. I was like, "Yeah, ex-MC was always big on how you can't control your feelings."

I said I just worried I'd break a rule with him that I didn't even know was there. Or that he didn't even know was there. I reluctantly mentioned the stone thing again as an example. He said he hadn't anticipated how he would have reacted to that either. I said, "So how do I manage it then, if you don't even know what you're react to? What if I cross another line?' T: "Then we'd work through it. We'd process it. I wouldn't kick you out the door." Me: "But how can I really know that, if you don't even know how you might react to something?" T: "Like I said, it would be OK, we'd work through it. It wouldn't threaten the relationship. Again, I have no intention of rejecting you or abandoning you."

I said I guess this is something I struggle with in all relationships. How once I'd said in an ex-MC session that I wish I had a sort of book of rules for each person, where as long as I follow the rules and don't break any, then the relationship is OK and I can't get abandoned. But those don't exist. T: "No they don't." Me: "Hm, I guess that sounds sort of OCD-ish, doesn't it? Or maybe anxiety?" T: "I was just thinking, that seems a way of trying to keep control, like OCD or anxiety." Me; "I guess this is something we need to discuss more, isn't it?" (I saw we were out of time), "In a future session." T: "Yes, I agree." Me: "I feel like maybe I didn't get to all the topics I'd intended to talk about today, but I think this was productive." T: "I'm glad you found it productive. I agree."

Confirmed Monday, scheduled for next Thursday. Went over, paid, as I said, "Right now, I feel like today's session went well and I feel OK about things here. Hopefully that will hold, but it's hard to tell." T: "Well, life is messy." Me: "Yeah, it is." Shook hands as he said "Have a good day." Me: "You, too." I sort of glanced back at him and mumbled "Thanks," then walked out.

A day later, I do still feel OK to good about the session and relationship with him, no crying, no e-mails. I'm sure some of the conversations will be ongoing on certain topics, but some stuff feels more settled, at least for now.

A lot was discussed but this was the main thing:

I came into session telling t that I yelled at my mother and unfairly took out my anger on her and that I know I shouldn’t do this but I’m convinced I’m going to Hell anyway so I don’t see much reason to change my behavior. She asked why I thought I was going to Hell and I told her (I’d rather not share here). She said she doesn’t think I’m going to Hell for that but she’s not very religious so she may not be the best person to talk to about this. She said maybe there is some way to make it up to God so I don’t go to Hell. She told me last week to pray. I told her I did but I told her it gave me flashbacks because . I told her I found a t that did Christian counseling however her profile only said heterosexual clients under populations served so I’m not going to go there and have someone tell me not to be gay because that’s not how it works and that has nothing to do with why I think I’m going to hell. So we figured out I need a female LGBT affirming religious person to talk to. Then I said I can’t really go to a church even if it’s LGBT friendly because I’m afraid of crosses as well due to what happened to me. So we said maybe something online so there would be less religious symbols. I told her I had found a few Christian groups online but they were also against homosexuality but that I may see if there is some female LGBT friendly religious person I can pay to Skype or something but I’m not getting my hopes up too high.

Hey, though I'm not religious, I used to be Christian. And I'm LGBT and my parents used Christianity to abuse me. I have a queer affirming theology list - would you want a link?

I don't know how I missed this, and my response is well. . dual. First of all, the thoughtfulness and care with which he explicated his ideas about bonds in therapy says many good things about him in my eyes. Caring for you as a client rises from the email like fog from the river outside my window right now, burning off before the sun rises fully. He is engaged in his work with you.

There isn't however any give to caring about you the way that you might want to be cared for- he said the best boundaries support BOTH people and are understood by both. This is problematic bc you are right now in a discovery process trying to suss out what exactly are the boundaries so you don't cross them, but that is for his sake and not really yours. You dot want to ask for anything that will get you punished or rejected, and are playing defense to his offense. He is the chairman of the boundaries, if not the dictator . The boundaries he says support both people. This is the rub- Do they boundaries meet the client's needs or are they there primarily for the T to be safe in doing the work without getting too personally involved?

For me personally, the bond between me and my T isn't always healthy and reasonable from my perspective . His expectation for me to pick the thing I most don't want to talk about and share it openly with him, then leave mid sentence without feelings of protest or disruption violate my sense of what is a safe way to speak to another human. He doesn't care about that. On the flip side, I would never call him on the phone or go to his house- that isn't bc he told me not to or set that boundary, but it is bc it would violate MY sense of appropriate for the relationship. So our negotiation about what's healthy and good for both people lies in the country between session ending on the dot and what could happen to make things better between us would be less than a phonemail. I want my T to check on me after a harrowing session( maybe once every 6 months) , and I want my T to email with me like your T des with you. To him these are boundary violations into his persona space. Ugg. The bottom line is, we feel differently, but we do it his way. My option is to leave for a different T or have no say in the boundaries.

LT,
I appreciate your concerns. Even while our session was happening I had expected that there would be a lot of loose ends and unclear issues that we would need to come back to either by email or at our next session. Regarding your other email about the stone, I'm sorry for the confusion and if my picking it up was hurtful to you. Not my intention, but I can see how you may have expected me to give it back to you at that moment as I reflect on the conversation with hindsight - which is, of course, 20/20. At this point the whole stone-as-a-connection concept has become muddled to me and I think I will need to talk to a colleague or two as a way of helping me make sense of my thinking and your needs/request.

In reading your thoughts on attachment/connection, I think that you're taking a black and white mindset to something that is more nuanced. Of course you are allowed - and in fact supposed to - develop an attachment, bond, connection, and/or feelings towards our relationship. That happens in all relationships. How that connection plays out and gets expressed, and the boundaries of what is or is not healthy, appropriate, and/or reasonable in that relationship, is profoundly important. The roles that each person plays in the relationship in some ways dictate those boundaries. For example, the attachment of a teacher to a student has different rules than that teacher's relationship to a spouse, his/her boss, or the doctor that is treating him/her for a medical condition. Those relationships can be closer or more distant depending on a lot of factors, but that is independent of the fact that there are boundaries/rules. Those rules are sometimes simply understood or unspoken - for example the relationship between a server and a customer - but in other contexts parts or all of the boundaries are rigidly articulated - like doctor-patient. Some of those roles allow for dual relationships, some do not, and some only under certain circumstances. In almost all cases dual relationships can be problematic.

I think that the most successful therapy outcomes are only possible when a client feels that their therapist cares deeply and take a serious investment in their problems. There is a closeness and intimacy that can develop within the confine of the therapy room. Some people find the limits of the therapist/client relationship frustrating and will invalidate the connection because of the limits placed on it by the clear boundaries expressed in our ethic codes for the protection of both the client and the therapist.

It's been my experience that you can have both - closeness and also boundaries. In fact, I'd argue that all healthy relationships have both closeness and boundaries. Actually, I think boundaries help with the closeness when those boundaries are thoughtful and support both people mutually. For example, I have a client with opposing political views to my own, and he will sometimes try to engage in discourse on the subject. I hold a strict boundary with him not to participate in that conversation, although he is welcome to share his beliefs if that's how he wants to spend his time. It is my belief - and the belief of other therapists - that the boundary protects both of us. I think there are - or will need to be - boundaries over what you share with your mother, or at least boundaries within yourself when it comes to your expectations and how she responds to you. Those boundaries would help you feel less hurt/rejected, and as a result would make it easier for you to feel emotionally close to your mother. She then benefits from feeling closer to you.

My concern for our work together has centered around some of your past relationships that have ended badly. There seems to be a theme of boundaries getting blurred, or perhaps the closeness you feel becoming complicated in a way that ends up unraveling the relationship. I very much want for this therapy experience to be different in that regard. I want you to be able to feel cared about and to trust my investment in your wellbeing, and for you to feel a connection to me as your therapist. I also want you to be able to feel good about the boundaries of our relationship and for your attachment, bond, and expectations to comfortably stay within those rules/boundaries. Additionally, I want you to be able to have full, rich, close, loving and dependable relationships with the people in your life outside of the therapy room - and most importantly with yourself.

Hopefully this makes sense to you, and when we talk more about it later this week we can continue to gain clarity. If you want to meet earlier than Thursday I do have time on Wednesday - right now I have 12:30 available.

(I ended up taking today's slot and canceling tomorrow--will write up today's later, but think it generally went well.)[/QUOTE]

Sorry to hear about your parents. Yeah, the link would be great.

I just emailed this to my T:

I literally wrote 'me' instead of my name.

I giggled when I read the "me" bit. I think it's cute.

I didn't use a comma at first and it just said "love me". I thought well that's my unconscious talking.

Had a very productive session today, I think. I was able to tell t honestly how everything’s getting worse at the same time: depression, anxiety, OCD, and trauma memories. And how I’m restricting a lot but it’s somehow not helping to suppress all this s***. I even disclosed the nature of the OCD symptoms, which I’ve never done before. I was so afraid he’d think differently of me, but I don’t think he did, though I guess I can never really know. I admitted that my next step will probably be fasting because I can’t handle all of this and just want to feel nothing. I cried more than I’ve ever cried before in session today. Ugh.

I'm proud of you! You did it

Response from T

At 3am:
And at 5am:
So I know he exists, I know when he's home, and know he's thousands of miles away. Who knows where. Maybe West coast of America, or Canada or New Zealand or something.

He wrote you back, that's great!

Thanks! Yeah, I hadn't realised that it was the feeling that he was unreachable that was causing me the most anxiety, so it's a good feeling that he is reachable.

Ya know, canada IS part of the west coast of america

https://giphy.com/gifs/XJCL959KwYbE4

LOL. thats as good as his "smell a fart" acting lesson, or "Supposably"!

Yesterday. I don't have much to say, honestly. Due to the content that we discussed, I was very emotional. There was a moment where I said none of what was happening felt real. So he was saying it sounded like I was dissociating, which made sense given the context.

Trigger: CSA



It made me so sad. But I'm okay. I'm glad I get to see him on Tuesday instead of waiting a week.

I'm glad he checked with you. He sounds good. Sorry it's so difficult right now

Yay! I'n glad he finally got back to you.

Thanks velcro! I appreciated the help

I had a really crappy and inappropriate experience at my new psychiatry office, but my T has been amazingly supportive! She is very frustrated with their behavior, but is advocating on my behalf to switch providers and fully supporting my decision to report the poor level of care I received to higher-up folks. It's so awesome to have a caring advocate. I never had one growing up and it's really cool to experience it now. Thanks T!! <3

In my last session, T told me she's disgusted by me and doesn't care about me or my problems.

Or that's how I remember it.

What a load of old shite.