In Session Today: Part IV

That must be tough. Did she give you any feedback as to why she becomes more distant? My T does this too at times. Like he becomes more clinical and cautious.

That was a tough session. R reassured me that we ought to be able to work something out with regard to my meeting and scheduling thereafter. She was pleased that I got through Easter, and said that she did think of me.

Then I told her about the experience on Good Friday, or started to…
‘As you know, where we left it last week, I was preparing for Sunday. I didn’t expect Good Friday.’
‘What happened on Good Friday?’
‘Well, this ties in with my experience…there I go again…’
‘If you want me to, I can be a bit more directive. I don’t really feel comfortable, because I don’t want to be too teacher-like: ‘Lost, you said you wanted to talk about Good Friday, why aren’t you? But if that would help…’
‘Yes, I think that would be useful.’
‘What happened on Good Friday?’
‘I went to pottery class and the morning was fine. It was just me and the tutor. I made a point of not talking about my experience in the lead up to Easter. Then another student turned up and said “I’m just going to use the loo before we start.” She disappeared for about ten minutes and then came back: “I couldn’t use the loo because it’s engaged and the emergency light is on. Somebody must be in trouble.”

At this, an expression of sadness, concern and understanding flashed across R’s face.

‘And I was left fending off you know what.’
‘So it wasn’t anything to do with the present moment?’
‘No, the present moment fell away altogether, and I was in that “She called me into the bathroom…” I wanted to run, but I was sitting there trying to breathe.’
‘Lost, I feel like I am asking a lot of questions today, but it feels wrong to say that I understand. I am trying to – can you tell me a little more about what it is like for you at night? I know you have said it is like a film.’

‘It is like watching a film and being in it at the same time. I experience all of the emotions, but I have no agency.’
‘It sounds as though it always starts from the same place. Can you explain to me what you see?’
‘She called me into the bathroom to help with something, and then collapsed’…and the film starts there.’

‘Do you see the collapse?’

‘I do, and then it gets frantic. I see them working.’

‘Them?’

‘The emergency services. I think there is some stuff from a previous crisis mixed in there…’We nearly lost her three times in the back of the ambulance. Then the rest of that week gets a little hazy until the morning of the 15th, with everyone around the…bed, and her…’ I reached for R’s hand ‘…slipping in and out of consciousness.’
‘There’s a lot of “Nobody in their right mind would subject another human being to that” going through my head at the moment…and especially knowing.’

‘It strikes me that it is the beginning and the end that have stayed with you. As somebody who struggles with medical information – you haven’t really gone into why, and it doesn’t sound as though you have experienced anybody having medical difficulties in front of you – this sounds like your worst nightmare, and there is also the sense of ‘It didn’t happen, so why am I so affected by it.’
R then asked whether there was an ideal response I would have wanted if I had been able to reach out.
I explained that I considered asking for the words, but based on my prior experience I didn’t feel it would give me what I needed.
‘And when I say them to myself, it sounds threatening.’
‘Pull yourself together, you’re safe!’
‘Exactly. I talk to myself the way you’d discipline a dog.’
‘You talk to yourself the way you’d discipline a dog?’ She continued
‘It’s a big idea, but I’m going to own it. Your greatest tool is you . I would ask you to put your LOTTness… I’m making up words today, but put that caring and compassion into practice. How would you react if somebody else was in that situation?’
‘It’s something I need to work on.’
I struggled when asked how I was feeling, as there was a lot going through my head. I am frustrated that I don’t trust myself enough to connect with my emotions. Like I said at the beginning of session: ‘Here I am with an opportunity to talk about it, and yet I’m not.’

Hi Thal, she said at first that she didn’t recall doing it. She reassured me it wasn’t anything she was doing on purpose. Then she said she was likely (unconsciously) being cautious because ‘you’ve been so terribly hurt’ by therapists in the past.

I told her my perception could be wrong. She said, ‘so could mine.’ She totally thought about it and owned it...which was good of her.

Extra session today. Told him why I was there (impulsive actions on Sunday) that led me to finally admit I needed to finish his stupid crisis plan. He said he was impressed with my ability to step away from my actions, really glad I came in. "Can you even imagine having this conversation a month ago?"

So we went through the initial phase of the crisis plan. Didn't have enough time to go into the post crisis phase of the plan. He had some good insights, I added a few things.

Interesting bits:

• In part of the plan I asked him to be willing to converse with any admitting team to collaborate on a diagnosis and possible medications. He said he was cool with that, knowing I wouldn't want to be on anything heavy duty.
• In the event that I were ever admitted, he said he'd write a note for work telling them whatever I wanted to. I paused a moment, giggled and said "butt surgery."
  "Okay, Daisy, but you're going to have a hard time explaining why an LCSW is writing you a doctor's note for butt surgery."
• He explained when he'd want me to call him in crisis (I asked). He clarified his thoughts and was really glad I was at least considering adding that as a tool in my toolbox.

I see him again on Friday.

(((Daisy))) do i see my influence here? Hope im not being cheeky!

Oh my

They say the best middle school teachers are the ones who never matured past middle school age.

T said my mind is not based in reality right now and i need to take my meds

=[[[[
But i got a birthday hug

Happy Birthday, DNA!

Do you believe your T? I would trust his instincts.

I had one of those sessions where I didn't have much to say. T and I talked about my reaction last week, and how I got over it quickly. About thirty minutes into the session, I wondered out loud if I should go. T said it was my choice but not to do something that I would regret (or something along those lines). So, I stayed ten more minutes, leaving five minutes early. It was a good session. For some reason, though, I feel needy right now for no discernable reason.

Okay fuller version here. I went in and said I'd had a tough week missing him. I said I was aware we said at the end of last session that we would discuss holidays at the start of this session, so let's get that out of the way.
He said he was doing something different this year in that he was taking 3 consecutive weeks off in June. We quickly ascertained they come directly after my one week off. So in all i will have a 5 week gap between seeing him. All I could say was "that f***ing sucks" and look at my sleeve.
After a while he asked what was happening and I said "nothing".
He said he guessed I might be cross with him. I said no, I'm pissed off with myself for caring this much and I've run out of patience with myself and this process. T said he thinks on some level this might feel like abandonment, so its worth noticing how i turn that anger on myself. I judt looked at him and wiped tears from my eyes. I looked at his bookshelf for ages. I noticed we have a lot of the same books.
T said he didn't want to distract me from the here and now feelings but he keeps thinking of my mother, my lack of feelings towards her and the intensity of my feelings towards him. He said we don't need to talk about it but he wanted to say he had thought of it. I said I dont have the energy to think about the transference right now.
I said, although I rationally know it's not true, I feel like he should have prepared me better, or he shouldn't have let me become this vulnerable. He said that my feelings that he should have prepared me are as valid as any other feeling, even if there's nothing else he could have done.
I asked him if he was surprised by my reaction. He said no, that my attachment had felt pretty intense recently and he wasn't surprised. I said that I was surprised and it makes me feel woefully underprepared for if we had to stop working together suddenly for any reason. I said I am not sure how I would cope.
I said "knowing you hurts me. I wouldn't be hurting right now if I didn't know you" and he just nodded sadly. I started crying again when I said that.
We talked about object permanence, and how I struggle with believing he still exists sometimes. I said if I could get all of me to believe he still exists and is coming back it would probably be okay.
We hugged which was nice. As we got to the door there was an engine. I said "is that someone arriving or leaving?" He asked me if I wanted him to check. I said yes. He went out and said that it was a car leaving. It was probably a visitor and the car was gone by the time I got outside. He said seeya next week and I left.

Happy birthday, jDNA!

Yes.... I guess so. He texted last night and told me to take my meds n go to bed. He said it will be ok and wjll return to normal soon. So i took my meds n slept and i amdoing ok today so far

Do you love me? Can you email me and tell me you do?

This sounds like a very painful session and I can identify with some parts.

Would your T be willing to do emails or short calls during the break?

I don't know... I don't really want to ask him. I value that he takes care of himself and takes a break and I don't want to impinge on it. There's such a split though because part of me wants him on call all the time. Buy I know he wouldn't be the therapist he is if he didn't take self care so seriously.

I read to T from my teenage diary. It was extremely emotionally affecting for me. We talked about some people from my past, and my behaviour in the past, and my feelings about those things.

He was mostly great but there were some moments of misattunement that really got to me. I did challenge them, sort of, and we did reach a place of understanding. It's just... Ugh, why do the smallest things have to feel so huge? Why can't he be perfect? Why am I so upset by him not being perfect?

I almost went into a hole at one point. I said "I feel like shutting down"... but I didn't. He said he noticed I was having trouble making eye contact (something we've discussed before) and wondered if it was hard because of what I'd just shared with him (honestly my teenage diaries are pretty f***ed up). I said "I don't know" and stared at my toes for a bit.

He's always so nice though. We laughed a lot at the end. I told him I'd seen a bluetit in the tree outside his house and he said "Oh, yes! Did it swear at you? It often gets quite angry with me..." Apparently they have very different noises that they make when they're angry. I said it hadn't seemed angry at me but that I wouldn't care anyway. I'd just be like "whatever, come at me, I'm not afraid of you"...

Then he asked what I'm doing for my birthday on Tuesday and I said I'm seeing my clients. He asked if I'd tell them about it being my birthday and I said no, that could be weird for them... I might just wear a party hat though. He said I could wear a "32 today" badge...

I miss him now. God this is so stupid. Therapy is stupid.

I was so annoyed with T, I was annoyed she cut me off mid thought, I was mad in general and I don't know why. I'm sure she didn't do anything wrong.

Edited to add actually you know what does annoy me? That she literally told me repeatedly that texting was ok, so when I texted her feeling utterly depressed and worthless and she didn't reply it felt horrible, when I brought it up she said she was actually trying not to text anything personal to people. Fair enough

Today I texted something about scheduling and in session told her i was sorry for bugging her to which she replied that she texts with people ALL THE TIME and often about other things or personal things and as long as it's not super long she never minds.

SAY WHAT???

So yeah that does annoy me.

I didn't feel like it was a good session. I dissociated through most of it. He had me sit in discomfort a bit, as another part of what we're working on is building up my window of tolerance toward uncomfortable feelings.

He said I was doing a good job, even if I didn't feel like it. I said that it didn't matter what I was doing it felt like, he'd praise me anyway. He said, "well, you walk in the door every week. That's more than most people can do. Plus, you're really good at looking past surface level issues. That's something that can take people months or years. So yes, you're doing a good job."

I continued to feel like I was wasting my session. He said I wasn't, but what if I was? Made me think of RoboT. Told him about that, and he thanked me for sharing. He doesn't comment much when I bring up RoboT.



He said at one point that I seem good at mentally distracting myself. I said that 85% of the time I just think of cute animals. He said he loves watching YouTube videos of cute animals and asked if I'd seen videos of Fiona the Hippo. She's so precious.

I stayed a few minutes extra to ground; he was mildly concerned that I'd leave and not be okay. I'm not great but I'm okay.

T today (note writeup includes some stuff from Wednesday's MC session that I haven't written up, since I was talking to T about it). As we were walking back, T apologized, saying he had to handle an emergency situation with a client on his phone real quick, that it should only take a couple minutes. I said was OK. He said it was about scheduling, not a long conversation back and forth. Which I understood, but still a slightly awkward start.

When he turned back to me, I said I had a cold and hoped it was OK that I still came. That I could sit in the chair further from him if he wanted. He said it was fine and that I did sound stuffy. I said I'd do my best not to breathe on him. He said, "No breathing--we'll see how long that can last!" and laughed.

T asked if I wanted to talk about my session with MC. I said yes. I said that we did terminate, but really only the last 5 or so minutes were about that. How it had actually been kind of a rough session, in terms of marriage counseling stuff. I said H had wanted to talk about some of that stuff, so we did, but then it wound up taking up almost whole session.

I started by saying how MC was late, and it was particularly frustrating because he was talking to receptionist about another client for 5 minutes while we were in waiting room (he knew we were there). And that he was already late before that. T said it would have been good for him to have poked his head out and said he'd be with us in a minute. I said yeah and ranted a little about MC's tendency to be late, then I said, "I'm sorry." T: "Why are you apologizing?" Me: "I don't know...I guess because I was ranting?"

I said how one part was the conflict over my getting a pay cut from one of my freelance jobs, how H had been like, "Well, you should be getting away from freelance anyway." And what H said in session implied to me that he did have an "agenda," as T had mentioned last week. In MC session, H said how he thought maybe it would be the push I needed to get away from freelance. I said (in MC session) how that wasn't what I needed to hear right then. How I was upset about pay cut and just wanted empathy and validation.
So MC had said that I wasn't getting response I wanted, and that H was trying to help, but wasn't being appreciated for it. And being supportive is exactly what a husband should do for his wife. I noted to T today how that had seemed a bit biased. T said how I'd mentioned that numerous times with MC, and I said yeah...and then he was doing it again. MC wanted us to validate each other. I turned to H and said, "I'm sorry I wasn't appreciative of your trying to help." To which MC said, "You shouldn't have apologized there." When I told T that, he gave a little laugh and kinda shook his head, and I said, "Yeah, I can't do anything right!"

I said how H had been talking about "tension in the house," and I'd said much of it was various stressors. How H had said it was like my cup was full, and anything else made it spill over. T said that's a perfect analogy, because it's often referred to as "overflow." I said how some of it was due to work stuff, plus snow days, spring break, etc.
I said how D had been particularly challenging the past few weeks and gave a description of a meltdown yesterday morning. T said that sounded really difficult. I said I'd been considering looking into behavioral therapists again for her. T said something surprising here--he suggested we read a book ("The Explosive Child," plus the related online material) instead of going to a therapist. He said how therapy is a big undertaking, "as you know." But he thought could be better for H and I to set aside time to read and discuss that book instead of paying a therapist. Which...seems weird coming from a T, but OK! (though...I have to wonder now if maybe he tried something like with his son--also on spectrum--and it didn't help?)

He described a concept from that book, how you can't get through to a kid when they're in the middle of a meltdown. He gestured with his hands to show the start, the peak/crown, then the end. And said how you could reach a kid before or after crown, not during. During, all you can do is contain. He mentioned his friend who is "one of the best parents I know" and said she often needs to "take 24," waiting to talk to her kid until the next day about something. How she does it both for her kid and for herself.

I said I did want to get back to the MC stuff. He apologized for getting us off track, and I said, "No, this is really helpful, she's a big source of stress for me right now." I said with MC, near end of session, he'd said how I'd looked upset. I said that I had intended that to be termination session. And that MC had said we could do sort of an open-ended thing or that we could do an official stop, with the option to return anytime we wanted. I said how I felt I needed the official stop, to be able to sit with that a bit. How I'd felt in limbo for months and didn't want to feel that way anymore. T said that answered a question he was going to ask--did I think I'd waited too long to terminate. I said yes.

I said I felt I'd lost the trust in MC. And without the trust, that I felt I could no longer do therapy with him. T said how trust is very important in therapy. I agreed. He was saying something else, and in there I kinda of mumbled "I trust you," but he either didn't hear it or didn't acknowledge it (I imagine the former). I said how it can take time to build trust, and he said not always. He referenced attachment theory, how trust is the big thing in the first 4 months of life. How securely attached people tend to just assume everyone is good and won't hurt them. While insecurely attached ones (like me) meet someone new and might wonder, "How will this person hurt me? Will they abandon me?"

T said how I've mentioned numerous times how someone (like H) hasn't given me what I was looking for. And how that probably feels like a threat to me. I said yes, "it's like, we've been married almost 10 years, shouldn't he know what I want/need by now?" T said it might feel to me like a step toward abandonment. But that H probably has no idea why it feels that way to me because he's more securely attached in general. I said that made sense, that he tended to forget about those things shortly after they happened. T said, "Yes, because they aren't a big deal to him." I said how I felt marriage counseling had helped in the manner of MC being able to explain my anxiety issues to H, but then it was like H understood them cognitively but didn't put them into practice.

I forget why, but ex-T came up, and I'd mentioned the length of our relationship. T said that 6 years is a long time with a T. How a T only has so much in their bag of tricks. I said I hoped his bag didn't run out at 6.5 months (how long I've been seeing him). He said, "Tomorrow, actually," and we both laughed.

I'd mentioned earlier sending MC an e-mail, so T asked me about that. I read him excerpts--at one point, T said, "That's very poetic." I shared MC's response, saying how final it felt, how I kinda wish he'd said he had enjoyed working with us, mentioned his door still being open, something like t hat. T said maybe he's being more reserved in showing his feelings. I said, "To me?" He said maybe with his clients in general. I said how MC had said at very end that my subject line of the e-mail, "coda," was a good word. T: "What's coda?" Me: "Oh it was the subject line of the e-mail." T: "No, what does coda mean?" I gave brief explanation, can be end of a musical piece that's kind of separate from the rest of it.

Was end of session. He confirmed Tuesday, put me on schedule for Friday. I was like, "Oh, Friday the 13th." He said, "I hope you're not superstitious!" I said not about that, about other things. He said, "Ladders, black cats, broken glass?" I said yes, and I'd just seen a black kitten by our house. He was like, "ooo."
I went over to pay. I offered to let him pull the card from my wallet to avoid germs, but he said, "It's OK, I'll just wash my hands. I should be doing that anyway." T ran card, then said I didn't have to sign slip. I said I could use my own pen, he said was OK, he didn't think I'd contest the charge. Skipped handshake. He stood up (usually stays sitting), and I think he was going to open door for me, but I did it out of habit. Then I said, "Oh, sorry, germs!" He said it was OK. I said, "You're going to cover this place in Lysol after I leave, aren't you?" He smiled and said, "Have a good weekend." I said "you too" and left.

It was a good session yesterday. She threw out some ideas that made me think, or reframe. It's funny how a simple statement can be a catalyst for a cascade of new insights.

I was (again) questioning my decision to stay, to keep my home intact, to work toward peace and healing. She suggested that perhaps having the opportunity to process and grieve in this environment is allowing me to fully process some of my grief and anger without getting distracted or overwhelmed by a "new" life. I hadn't really thought of it like that. She said she sees clients who think they've moved on and something happens later, and they are hit out of the blue with all of the feelings with no idea where it all came from. She's seen me process living this life on a regular basis. She's certainly on target--I chose to stay and face all of this, and there is no getting away from processing it here and now.

I also realized after our session, thinking about what she'd said, that I kept prefacing talking about my grief or anger with, "I know I chose this life," and I realized I don't feel that I deserve to feel sorrow or anger or violation or betrayal or grief, because I chose to stay and be faced with it every day. I don't deserve to whine because I made my own bed. What an ugly thought.

I don't know any personals about your situation, but the line I bolded...YES. This is how I feel about my life, and it has been very difficult to get around. My T tries to convince me that it isn't "my" fault, but as I always tell her, it IS! I am the one who got myself to where I am...as an adult. Not as a child, but as a rational adult who knows better.

So, I get it. It sucks, and I think (for me) it is a hard thing to get over. My T keeps trying, and I keep shutting her down. But, there is a reason I show up every week, so I hope she "wins" in the end.

Today was really really hard. I was already feeling down by something I'd failed to accomplish today, and I was glad I had an appointment with T right after this 'failure'. I still feel like I've been hit by a truck, but T helped me ease my nervousness.

I just am... what?

So in the middle of a month-long hospitalization (which ended about a week ago), t told me she thought we ought to find me another therapist. Her arguments were not unreasonable (e.g. I am quite sick but she can only see me once a week reliably b/c she works for a public clinic, she I work for the same small hospital system which has occasionally led to s**tty/awkward moments, etc.) but it still felt really awful.



But during our session today she said, “I’m having a very difficult time finding someone who is able to see you 2-3x/wk and is reasonably close geographically and is willing to work with your insurance/HR department to make a single-case agreement... so how do you feel about us returning to our former frame and continuing to work together?"

I had not been expecting that at all... and after sitting quietly for a while I said, "I'm not really sure how to respond to that." I told her how even though cognitively I understood her arguments about why switching providers could be a good idea (and even agreed with some of the arguments), emotionally I experienced her suggestion as rejection/abandonment and felt angry/hurt in response. (It also stirred up this thing I have about feeling like I'm too needy or "too much" for people.) And those feelings are still there--it feels like there's a crack in the foundation, and I'm not sure about what to do about the crack. (We were going to have to deal with the crack whether or not I switched ts, but it's gonna be more important and more difficult if she and I stick it out.) I had expressed snippets of these thoughts and feelings to her over the phone in the hospital but it had been hard to have a real conversation (in part because our phone calls in the hospital were never very long--she always had to go after 5-10 min).

I felt like she was able to hear and understand that. She said something like, “when I was considering making this suggestion to transfer your care--and talking with your inpatient psychiatrist and my supervisor about it--I lost sleep over it. And I don’t lose sleep over patients--I can’t, as a trauma therapist, if I want to continue to do my job. But I knew that no matter how I presented it, you would experience it as rejection/abandonment. I would've experienced it that way in your position. Ultimately I decided to push it forward as an option because I truly do believe that you would benefit from more frequent therapy than I'm able to provide. I hope that you can hear me when I say that, as much as one person can empathize with another, I understand how this has felt and continues to feel. I'm hoping that with time you might be able to learn to trust me again." So that made me feel like she understood and cared about my hurt/anger, and that she was able to tolerate my negative feelings towards her.

[I'm getting real tired so this might start making less and less sense going forward]

Interestingly, she also said that she believed that some kind of break was inevitable between us, that we were always bound to come to a point where I felt like she wasn't giving me enough. I disagreed in part b/c the emptiness inside me feels less like "I need a larger amount of the affection/attention/love that you are already providing" and more like "you have not yet figured out how to solve the lock/find the key and get close enough to the vulnerable part of me to figure out what is missing and how to provide it." [Side note: we had a laugh when I said, "I'm uncomfortable with how phallic that metaphor came out... didn't realize it 'till it came out of my mouth, but there it is."] Anyway... ultimately I quirked a smile and asked, "you think I was always bound to feel that way because I have holes in my pockets?" (A phrase stolen from Yalom re: patients for whom no amount of love and affection will ever be enough; I'm pretty sure t and I have used it in the past.) She corrected, gently, "because you have holes in your heart."

We also talked about how part of me wants to stay sick in order to punish her (and/or to keep her around--sh**'s complicated). How sometimes when I SH it feels like I am doing it not to hurt myself but to hurt her. (Admitting to that part made me squirm--I think I said, "I know that's super ****ed-up--very cluster B.") She had an interesting take on that which I'm not sure I agree with--she said, "I think it means you've internalized me, at least somewhat. It means that in those moments you're not alone, that someone is witnessing your pain." That just seemed sad to me, and I said so. In part because we are all alone, ultimately.

Anyway. I am now quite tired and need to sleep but wanted to get down the bones of the thing before time swept them away.

Chichi: That is an interesting session, and sounds good? How do you feel about it?