In Session Today: Part IV

Hugs, TMC...that sounds really difficult.

i want to clarify that i did come back to the convo and said

"I don't think I have DID, because I don't black out and lose time."

to which he said "that is also why I don't think you have DID."

WHY does stupid #(*%^ diagnosis words have to even come into play here....

I should've just said outright "DO YOU BELIEVE I HAVE OSDD/DD-NOS OR NOT?"

That is what I'm going to email him

once and for all.

I need it to be clear VERY CLEAR that if we're talking parts, if he's ENCOURAGING parts work, that I mean DISTINCT parts such as in OSDD/DD-NOS without losing time that would push it to DID

T on Tuesday--he'd been on vacation the week before. I was kinda nervous, fearing I wouldn't feel connected to him.
When we got back to his office, I said, "Well, I guess you didn't get trampled by elephants. I'm glad!" He said, "There aren't many elephants in [place where he went]." (I wanted to say, "You know, if you'd just told me before where you were going, that would have helped with some of the issues I had going into your vacation." But I didn't say anything.)

I said the previous 10 days had been fairly eventful, and I was trying to figure out which thing to talk about. He said was up to me. I said how the week had been especially stressful, because H's mom had surgery, so he had to be with her and help her out, so I was on D duty much of the time. How the change in routine (H usually gets her from after-care) seemed to bother her. T asked if she's usually really sensitive to changes like that, and I said at times, but sometimes she's fine. That was a moment where I felt like, "he really understands" because he also has a kid on the spectrum (but of course I didn't mention it in the moment).

I said how even just trying to go out to eat with her the one night (with H meeting us) was really stressful because the restaurant (which I named), was much more crowded than usual. T said, "How dare all those people go to your [name of restaurant]!" I said, "What?" He said, "That's one of your regular spots, right? All those other people shouldn't have been in your spot!" I was like, "Yeah, you're right!" It showed he paid attention, since he recognized the restaurant as one of our regulars.
I then mentioned finding out I'd been rejected by one PhD program (not surprised by it) and suspected I'd get rejected from the other (based on some intel)--he seemed really caring and sympathetic about that. Which surprised me for some reason.

I told him how his advice on dealing with my friend had worked, how he'd really appreciated my e-mail and that we'd ended up talking for a long time the one night. T looked genuinely happy for me. He said, "I'm glad my advice worked--remember that for next time that I give bad advice that doesn't work." I laughed and said, "So will the next advice you give be bad?" He said, "If only it was that easy to know."

I said how we'd seen MC on Monday and how I'd e-mailed him the previous week, pulling the printed e-mail out of my purse. T asked if I wanted him to read it, and I said I wasn't sure (I didn't tell him this, but parts of it were doubts about him). I said I could just share certain parts. That I was happy with MC's response.
Talked a little about the e-mail, but mostly about the session from the day before. I said how I'd felt really connected to MC, which felt good but was also probably bad. He asked why it was bad. I said, crying, that it made me not want to separate from him.

I described what happened at end of session, first asking if he'd seen Good Will Hunting--"a long time ago." I asked if he remembered the "It's not your fault" scene with Robin Williams and Matt Damon. He did. So I described the whole "You're not too much" exchange with MC. And how it had really affected me. How it seems like he has this ability to reach a certain part of me. T asked if I felt other people couldn't reach that part, and I said for the most part, yes. How that's part of why it's hard to leave him. I said I didn't think it was probably T's thing to talk that way (like MC did)--I forget what he said to that.

I said it felt like he could reach my child part. I asked if he believed in parts stuff (I'd been reading some about this, prompted by something a friend shared with me). He said, "You mean, like a child part, and adult part, and...what's the other part--the parent maybe?" I said there were lots of different theories about it (always encouraging when you feel more knowledgeable about psychology than your T!) He asked if I actually meant like id, ego, superego, and I said no. More about there being a child part.

I said I'd talked to MC about some of my fears that he (T) wouldn't be able to deal with my attachment. How I told MC I worried that T wouldn't handle it correctly, and I'd get really hurt. And how MC had said that's exactly why he wanted me to keep seeing T, to show that my fears were unfounded and, even if I did end up getting hurt, that I'd get through it. I forget what he said to that part.

T said I keep mentioning how he doesn't work with attachment, and how it seems I tend to take one comment that people make and get sort of hung up on that. When it's just one piece of things. He said he does work with attachment. That many of his clients have attachment issues, with people in their lives, such as caretakers. The difference is, their attachment isn't to him. So he does work with attachment. I wasn't sure how to explain to him how it was different and why this still worried me...(that's for tomorrow's session!)

He said how some schools of therapy believe that the healing is in the relationship, how the therapy relationship can serve as a model for real-world relationships. But he didn't really ascribe to that. That he wasn't sure how I'd react to this word choice (he knows me well!) but in some ways, the therapy relationship is "fake." In the sense that it's different from real-world relationships. I said, "It's OK, I know what you mean. About the one-sidedness of it." He said yes and expanded a bit more on it.

Then I said, "I've heard people say that a therapist is like an emotional prostitute. That you pay for them to spend an hour listening intently to you, then they move on to the next person. Which I suppose could be rather offensive, but..." T said, "I could see that comparison, actually. Though I'd say, 'Highly skilled emotional prostitute.'" Me: ...(because "highly skilled...prostitute...") T: ...

I then moved it along. It was near the end of session, so of course the perfect time to bring up something that had been bothering me since last session (the Saturday one). I said I kept thinking about how he'd said my texts the night before that session had been "intrusive." How I thought I'd been following the "rules," but it still bothered him, and I was worried I'd mess up again. How I thought texts were for scheduling, and that's what I was trying to do, though with a phone call because he isn't normally in office on Saturdays and was going out of town the day after, so it didn't occur to me to ask for session.

He said he could see what I meant there, how it was partly the time of the text, though he said he didn't recall what time. I said 9. He said that was kind of on the borderline (I know he'd said 10 before!). But it was more that it wasn't just asking for an extra session, it was that I was saying I was upset. Because he sees the little number showing he has a text on his phone, and he feels he has to look at it (I wanted to say, "OCD much?" Note: I also have OCD, and for me, constantly looking at e-mails/texts/other notifications is a thing of mine). And then he feels compelled to respond. I said I felt like, had I not said that I was upset with his e-mail response, it wouldn't make sense why I was asking for phone call (not knowing session was option) since I'd just seen him the day before. He said that still kind of took it from being a straight scheduling text. How if I'd just texted him, say, "Do you have any sessions available tomorrow? If not I'll e-mail you," that would have been fine. Because he could have quickly written back and put it out of his mind, either given me a session or looked at my e-mail at his leisure.

(I didn't say this, but it just seems so ridiculously nuanced, how a few words of explanation take it from being fine to "intrusive..." I feel like he needs an interactive "Should I text? E-mail? Or wait till next session?" flowchart on his professional website...)

I said I worried that he would think of this as "strike 1," how I was afraid of messing up again. He said he didn't think of it that way. He wasn't mad, annoyed maybe, but people get annoyed all the time (channeling MC there...). He said he told me it bothered him, then that put it out of his mind. I said, "Maybe I'm just not used to people being so direct with me?" (which certainly applies to my family of origin...) "So it worries me?" He said that could be part of it.

Knew we had to stop. I said I'd been debating asking him if he had Friday slot. He said he had one opening, let's schedule for next Tuesday (usual time), then either I could wait to tell him about Friday--though no guarantees on it staying open--or I could schedule and let him know if I wanted to cancel. I said I'd rather schedule, since I wanted time for this session to sort of settle in my mind to figure out what I wanted. If I was going to cancel, could I let him know by 1:30 the next day (yesterday), which would give him time to fill it? He said sure. So, seeing him tomorrow (now nervously worrying about whether we are in fact scheduled, or if he was waiting for me to confirm, but he put me in his calendar, so...)

Went over and paid. I was commenting how I'd seen a friend and her son the week before, how the weather had been so nice we were able to hang out at the park. He said the weather was nice in [place where he was], too, so apparently not an accidental slip that he'd mentioned it at start of session.

He shook my hand, but didn't really say anything (normally says, "Good luck out there" or possibly "take care" or something). I opened the door and looked back at him, and he said, "See you soon" (which made me feel better). I said, "See you then" and left.

LT-- Glad it went well and hope tomorrow does too!

LT, I think I understand his point about texts, probably because I'm the same way. If you ever have a doubt about what to text, maybe it would help to ask: Can my text be replied to with a yes or a no, or a suggested appointment time (or, I'm running late because of traffic)? Because texting something that dangles out there that you are upset or wanting a phone call is more of a quicksand kind of text. You might know that you want a call because you didn't think he could schedule to see you, but he doesn't know that you're thinking through his availability. So there was a lot more on your end that you left out. To me, it would have come across as the start of a thread that would turn into a rope that would pull me into texting quicksand.

If texting is a concern or uncertainty - why not just email?

Hm, true. My thinking at the time was that it would seem random to just be like "Can I have a session tomorrow?" when he had just responded to my e-mail and presumably thought everything was fine. (Plus I assumed he wouldn't have sessions because he doesn't usually see clients on Saturdays--he does on some Sundays, but he was leaving town that Sunday--which he had specifically told me in session, because he was saying it was OK to contact him.) Though...I suppose he could have always asked why if he was wondering. H says I tend to overexplain.

Well, he'd said before he uses text for scheduling, and I thought a phone call would count as "scheduling" (in lieu of a session because I didn't think he would be in office next day).

And I'm not really looking for input on the texting thing--I was just sharing stuff from my session and my thoughts.

Fair enough. I was just giving my perspective as someone who uses it in a similar way to what you describe with your therapist. I understand how that's not helpful. It sounds like you had a good session. I'm glad for you.

For me I would not use texting if I had the idea that it was unclear. The point I’m trying to make is instead of trying to figure out the seemingly bizarre, unclear, byzantine rules around texting, why not just take control and not do it? Instead of spending energy and agonizing trying to figure out whether something is text worthy or time appropriate or whatever, when that whole piece could just be gotten rid of by simply emailing or calling the office is how I would see it

Not doing it seems like giving UP control, not TAKING control.

This is an example of how you and I don’t understand each other. I’m talking about control over one’s own energy and time and effort. To me spending my time and energy worrying about and trying to figure out some therapist’s bizarro rules about **** I just wouldn't do. The control over my energy.

But I’m not a big texter to begin with and I don’t text with my own clients or with students. I don’t like texts interrupting me and I don’t feel a need to answer them immediately unless it’s somebody I know and like who’s a friend. Texts feel intrusive to me. I don’t like setting up a dynamic of expectation of immediacy on the part of those I don’t think really it fits for. I would hate if a therapist started texting me for no good reason except in a major emergency

It's OK--thanks! I'm just extra sensitive about outside contact stuff, especially since what happened a few months ago with MC...And I hate when it feels like I understand the rules and think I'm following them, then apparently I was wrong. (not just with T's, with anyone, really...pretty sure that comes from childhood.) Like...it might seem I was pushing boundaries, but it wasn't my intention. (Are there times when maybe I do push boundaries? Sure, but this wasn't one of them, so I felt bad that it may have seemed like one to T...)

I miss my t

Among other things, we discussed today that if I remember something from childhood, and have that memory since a young age, it probably happened. Even if my parents tell me it didn't. Seems like a weird concept to me, but still somehow feels good to hear...

Thats a good way to describe what happened in the fateful football phonecall! MC certainly pushed a boundary when he said okay i got two minutes or whatever, then you just pushed back.

But it was all about boundaries and power and control and anger and emotion and i dont know what else . We all keep trying to define rupture - i think that was it.

In your last writeup of your mc session, it sounded like he was aware of the need to repair the rupture, whether or not he continues as your mc.

Also, in another thread, somebody asked if it was kosher for a t to put off working on a rupture? I think this shows, sometimes these things just take as long as they take. Its been my experience that it changes over time. Altho i agree the client shouldnt just be disregarded.

I was snowed in so missed my appointment yesterday. I had a lot I wanted to get out so now I feel dreadful with a perpetual headache I just hope I can get out next Thursday.

It was weird today. The power was out in the clinic. Another therapist who was leaving said a transformer blew, but thankfully the offices get a lot of natural light.

With apparently the marked exception of Bubbles' office. So we were in someone else's room. The chair was more comfortable than his loveseat so there was that. He said that it was good to see me as he collected me from the waiting room, and again as we sat down. I laughed. He said no, seriously, because the alternative wouldn't have been good. I said that wasn't true. That I could have chosen to reenact past patterns and never come back. He said he was glad I hadn't done that.

He said that he wanted to keep it light today, which I thought was a good idea. He said that eventually he'd want us to do a "formal" safety plan in light of our last session, but that didn't need to be today. I said I'd rather just get it over with.

The plan took most of the session. He made some observations about my behavior when I'm activated. That when I'm distressed I don't make eye contact. I said, and I do when I'm not distressed? He laughed and said some, but obviously was a struggle for me. He also said I was engaging in a lot of concrete thinking. That there was only one solution to a problem.

At some point the topic of deescalation came up, and I said it took me until the next afternoon to settle down. "Was there something tangible where you are able to say that this was the moment you calmed down?" I said it probably sounded psychotic, but I felt a weight lift when I stared my period. That the 24-36 hours directly before I'm a lunatic. He said that obviously he'd never experienced that, but it sounded awful. Was I on birth control to help? I glared at him and he said, oh, of course not. He took notes of all of this. Well, he's just a note taker in general.

I don't remember around what, but I was starting to get anxious and said "I don't want to think about this anymore." He replied, "okay then, what do you want to think about?" Before even thinking, I blurted out "PUPPIES." We talked about puppies for a couple of minutes, which led to me talking about graduate school and the importance of mental health services within the school environment.

Time was almost up, and he asked me if there was anything about our last session that I wanted to talk about. I said that I still feel deep shame about the whole thing. That I felt like he didn't have a good impression of who I was as a person, but probably had an accurate impression of my disease. That it was unfortunate that we couldn't meet last week to discuss this all because it'd probably be helpful, but right now the whole thing has been beaten to death.

He replied that he was glad I have a good support group around me who was able to support me through all of this. He reiterated that he was glad I came today. I said that part of me was afraid he was going to terminate, but I'd felt assured that he wouldn't. He said he was happy he was able to convey his willingness and desire to work with me.

I joked that I was getting a lot of my usual BS out of the way early, and he said if that's the case then we might be able to do some good work quickly. That this was the beginning of a long journey, but that he was hopeful I'd be able to do this.

Scheduled for next Friday, paid, and left (on time!)

T again today. I'm not including the whole session today, just one particularly important exchange. After exchanging some small talk, I said I had something I wanted to share with him and pulled out my printout. He asked if I wanted to read it to him or have him read it. I said either way was fine. He opted to read it while I stared out the window at the tree branches blowing in the wind. I was scared of what he'd say, that he would say he couldn't say or do what I wanted. That it just wasn't him.

Here's what I handed him:

"So, with the attachment stuff: I need you to understand that this is going to be a difficult process for me that's going to necessitate a lot of talk about and focus on my relationship with you, as part and parcel with the other work.
Here's a quote from a therapy book my friend shared with me that seemed to ring true: 'Rather than feeling comforted by the therapeutic relationship or by the growing closeness that usually occurs as a natural, healthy outgrowth of psychotherapy, the attach parts can often have the opposite reaction. As they feel “closeness” at long last, it is both a relief and a trigger. Their fears of abandonment and sensitivity to empathic failure typically intensify, often leading to increasing demands on the therapist’s time and energy.'

I think that also helps explain why I keep shifting back and forth between feeling more secure with you and then more doubtful. I'm sure the December rupture with [MC] contributed to those feelings of insecurity, too. The whole authority figure/nurturer thing.

Part of me wants reassurance, but I get the sense that's not your style, and I know it also doesn't tend to be as helpful in the long-term. But it's like I want validation that I want that. Does that make sense? Like: 'I understand what you're looking for here, that you want reassurance. I'm not going to give you that. But I do understand where the want/need is coming from.'

I know this isn't your intention. But when you talk about things like my attachment to you compared to other clients--even with you saying it's just an observation, not a judgment--it brings up feelings of shame in me. Like I'm feeling/doing something inappropriate. Like I'm being "bad" almost. I assume those feelings are coming from some other place, likely childhood. But that's part of why I react so strongly to certain things you say and why they keep flying around in my head. I don't think we've talked about this much--it will definitely come out more as we delve into parents/childhood stuff--but shame and guilt are big issues for me. This is something that [ex-T] pointed out multiple times, and she felt badly about it, but it's like she didn't know how to address it. Or maybe I wasn't ready to address it then?

I feel like I'm looking for you to say some magic words to make me feel secure and OK about the attachment stuff. Because I think I need to feel fairly secure to delve into other stuff (childhood, etc.). But I don't know what those words are (which doesn't seem very fair to you...). I think it's something to the effect of, 'I feel confident in my abilities to handle this and work through this with you. I can't promise I'll always understand or that I'll say and do the right thing, and of course I can't promise not to hurt you, but I'll do my best. I want to work with and help you.'"

He finished reading it and said it all sounded reasonable and made sense. I said OK, that was good to hear. He said he felt comfortable with the last sentence, like he felt he could say it to me. I wasn't sure if he meant just last actual sentence or last part. But I said OK. Then he said that he wanted to say it to me. I said OK, still unsure of what he meant. He went on to say: "I feel confident in my abilities to handle this and work through this with you. I can't promise I'll always understand or that I'll say and do the right thing, and of course I can't promise not to hurt you, but I'll do my best. I want to work with and help you." He made lots of eye contact in the last part.

Then he said again that he wanted to work with me. I said how in the past, he'd said that he couldn't ethically abandon me. He said, "I said that, really?" I said yes, in one of our first sessions. And that it made me feel like he was saying, "Well, I started with you, I'm stuck with you now!" He said he felt bad about that impression. And how if it was a case where he didn't think he could help me, he would have said that and referred me elsewhere.

Rest of session was about various stuff, but that's what stuck with me. That he read what i said I needed and...said he could give me that. Which...I was just expecting him to say he either wouldn't or couldn't. So in a way I'm confused, and in another way I'm really comforted. I'm just having trouble processing it all, I think. Like, wait, maybe he is ready and willing to deal with this stuff? Maybe he is in it for the long haul? (However long that is...) I just...in some ways I feel I should be doing backflips. But it's like I'm equal parts comforted and terrified...The joys of insecure attachment, I guess?

LT--- glad he seemed to handle it well.

I relate to a lot of your feelings with it overall. I truly hate it, it's terrifying to me but I also have no idea what else to do besides experience it.

This gave me hope with his response. I am glad you chose to go again today!

I get what you're trying to convey in your replies to OP
The constant turmoil over texting/emailing/phone calls/extra appointments/how long a wait is reasonable to expect a response/quality and length and tone of response is exhausting just reading about it
In uk this level/flexibility of outside contact is extremely rare and for me is restricted to scheduling and twice in 4 years when I felt that a rupture needed describing from my perspective so that my therapist had an idea of how the following session might go where I was coming from etc like preparation for many other situations in life
I do feel it would be good to be able to contact outside session often but I know that I would either receive no response(for days if it was a Friday)or a formulaic unicorn fart of a response or a sorry to hear that we can talk about it next session -he just wouldn't engage with me-but I know that if I really needed help he would offer to call me (once in 4 years) as I don't ask or expect anything outside of session
It seems that therapists who encourage /foster the degree and variety of outside contact that is discussed on the forum are causing untold misery dependence and unrealistic expectations from their clients and I may get shot down for this but the extreme cases might be borderline abuse

It may be that between session contact is problematic for some, but it is not the case for everyone. In my case, it's been helpful, without causing any of the untold misery and unrealistic expectations you claim. Oversimplification and broad judgements about other people's therapy don't really help anyone.

I agree... I have cut back a ton on out of session contact....I rarely email because it just makes me crazy more than anything for some reason.

I text but usually it's only when we schedule it, I try to keep the other stuff to a minimum, but he has no rules on how often I can.

For me, it's helpful, having that connection in some way. It's so hard to keep myself going to therapy or moving forward if I lose that feeling... so it's very important to keep connected and if outside contact is a way for me to do so, than so be it... even though many people don't like my T's boundaries... not really up for discussion LOL

In my experience outside contact in the UK isn't "extremely rare".