In Session Today: Part IV

I started at a new pdoc office yesterday because my old one moved. The first lady took my vitals and entered my extensive med list in a computer system. The second lady, the main nurse practitioner, asked about my abuse history and started to go over meds and enter them in the computer. I asked why we were doing it again because I had just done it with the other lady. She snapped "Because life sucks and the computers are out to get us."

Eff her. How dare she tell a depressed and suicidal person who traveled far and payed a lot something like that. Ever. But especially at an intake meeting?! Shame on that shaggy birch tree.

(((LT))) its not about giving you comfort. Its about his being WITH you in confronting YOUR feelings. I see the feelings as a third entity, and i think you kind of do too. Only instead of him COMFORTING you, buying you another ice cream to replace the one that fell on the ground, or for him to tell you, "oh stop it, you can get another ice cream later", you say, "i always drop my ice cream. I can never have ice cream," or whatever your fear is. That was mine, btw! Whenever things were/are going well, i get a phone call from an aunt "wanting to talk", which just wrecks me.

Ts role was to point out that was magical thinking, and how could i change the outcome, and thereby my feelings? It is not their role to do anything that would change my feelings, per se. Like tell my aunt not to call me. But he could tell me i dont have to answer the phone. Which EVENTUALLY i didnt.

So re the stone - maybe he could delve into why a talisman is important to you? I think its more what other people have mentioned, you have scripts for people. I wonder if thats an OCD thing. Because in the middle of the script, you get a feeling, then if the script doesnt go your way, you postpone the feeling, start a new script, then pick up the old feeling/script later in an email?

Re the aspie/sport/AA - No, i meant his orientation as a t.

I can easily see why that would be the response you wanted.

Except, in like the first or second session, my T said that there was nothing that would make her think less of me. She worked in a prison for some time, so I think that is what she was thinking of. When I sort of talked around my self-harm and why I do it, the first question she asked was "Well,have you ever murdered someome?" I told her "Uhhh...noooo...." and she said my shame seemed so great, that she had to ask.

The thing is, she was genuinely curious. She has told me before that she sees ALL behavior as a symptom (I think she holds a different account to socio/psycho paths), and she finds compassion in all of it.

It blows my mind, bc I can not be compassionate to someone who is in the left lane, driving ENTIRELY too slow for my liking (and the speed limit)

Soo, what my long-winded post is trying to say is, it isn't so unreasonable to find UPR for people. ESPECIALLY your own children! If I had a child and found out they were something that was "un-curable" ie pedophile or something of the like, I would want them to get help. IF help meant prison, I'd do it. That doesn't mean I wouldn't still love my child, bc, he/she is MY child.

Anyway. I am getting too philosophical. Sorry

I took the elevator to the 4th floor right at 8:56. I don't like being early for sessions, or late either. One time when I arrived early, you engaged in a skirmish with the next door office about how their coffee smells came into your office, and it made you seem more fussy and difficult as a person than you come across one on one. Your office smells very warm-masculine, like shaving and cologne. I like it, but honestly the coffee smell I like fine too and I screen it out automatically. Once I got glitter on your couch from an evening gown ( was on a podcast & had to wear it). You were nice about that, you are charmable- just not often.

You asked what I wanted to talk about, but part of my mind kept being distracted by a subtext of the the huge new framed family portraits you placed at client eye level. In talking to you now, you are wreathed in your family members - kissing your wife at your wedding looking off an ocean pier with your kids etc, though you forbid questions about you. It is distracting, especially bc me having ended a marriage over a the loss of a pregnancy( complicated) and now BF and I deep in conversation about me not wanting to adopt kids, makes me feel like you are not on my side whatsoever. Early in therapy, you said women biologically want children more than men, and that was the lowest point of therapy for me and my hope for you to understand my universe. Yes, I love kids, but with my background I worry I would impart some kind of generational trauma as an accidental inheritance, and I wouldn't want to do that to any news life.

I don't want to change my seat and send all kinds of messages, but I also resent how the space feels different and so much more about you and your biography, a biography forbidden to patients.

We have a mutual college friendly acquaintance , so I know a good deal more about you than you would prefer, but I will never disclose that to you. The reason partly is bc while they are very personal things, they aren't the things I want to know and don't really make a difference to me. I know you though would be extremely uncomfortable. There is a sense of "touche" about this- you don't disclose- fine I won't either.

After reading LT's post, I decided to "link " you on Linked In. This is an experiment, bc I am tired of being so good and solicitous of your rules that wall you off from your patients. Also, I don't really use linked in. I have 1669 contacts who just sit there , I guess bc I am not looking for a job. you have like 22 contacts and are far more new to this community. If you think you are too good for linked in with a patient ( who happened to have a thriving job) then so be it. We will see what you do. You seem to be independlty affluent and don't work many days, and once joked about yourself that you are Doctor Dad in your house, so it all comes down to me resenting that- resenting that you will empathize with your deep blue eyes and say how you never dealt with a worse situation even in the military and that I have been brave and made a good life against odds, while you dismantle the defenses that keep my life going until 45minutes and then you say bye mid tear, mid sentence and are gone into the ether of I Am A Doctor Do What I Say until the next appointment.

I don't think this is wrong. I am just learning to hate therapy bc it is so much less compassionate than real life relationships. I have given unstinting time to teenagers as have my colleagues, so I guess you seem to miserly as the one singular person I have asked for help.

These aren't fair or right feelings. I am angry and sad, and feel like you care a little but not that much. Is that accurate mentalizing or inaccurate mind reading. You were a genius in school back in the day, and I think there is a part of you that knows your own insight is stellar and your metaphors creative and compelling. You think you give a superior performance in session, and how dare anyone want to leave at 9:51 to be a little more pulled together for the street than at 9:45 when you brilliance shuts off like water from the tap when I turn the handle.

You dislike dogs. My mistrust started there, since you pretended to like them for the first four months just to get along with me.

There was a time I loved you and loved therapy. It seemed like a journey of self discovery, though with dragons to fight . We felt like a team.

You repeated so many times it is a patient's relationship with herself that is all that matters that I have come to believe you. You facilitate people's relationships with themselves, you think psychoanalytic theory is hopelessly old fashioned. I adored you for a long time, but now you seem spiritually stingy hough yes your mind is exceptional, you are witty, clever, insightful- all those qualities. How much heart do you have though?

My best friend is a psychologist, though with a psychoanalytic post doc focus. Her theory is possibly your boundaries were maybe violated in an early life situation, and so you are a little compulsive in the exercise of rules for their own sake, butting boundaries before empathy. Once you described how your kids go in time out if they choose to take a cookie they were told not to. I asked" well, do the get to take the cookie to time out? I was joking, but man you were outraged by the thought lol. No OF COURSE no cookie in time out .

SE, the value I would find in therapy with a guy like would be in working out why I was so drawn to, sucked in, by a sociopath.

It's times like that I wish I'd thought to record an office visit. People like that get away with mistreating people all the time until they are caught out.

I wish you could go with me, and tell me your reaction. I have a sociopath parent. I don't know how to judge the situation. There's so little context.

I think his red flags come through even in the observations you share here. He makes me nervous for your stability and welfare. Cleverness and skill aside, his need for total control is disturbing. The things that make me uneasy go beyond "oh, he wouldn't be a good fit for me." Often the trickiest people are also the most charming.

Esme - it took me a loooong time, with a few missteps on both sides (he would make a joke and i would freak out; i could be ten times as seductive as his joke and be completely blind to it), but i think what i finally wanted to know was (and i did ask explicitly), was i safe in his presence? Could he love me without taking advantage of me? I am starting to detect these messages between you and your t. And LT's t. This is what the wedding ring means, the family pictures - that they are safe for us to be around. At least, that is their intended meaning (by them or their wives?).

Thats why its The Relationship, isnt it? Cuz my t was JUST SITTING THERE. Im the one who tied myself to the chair. Im the one who was afraid of my own life.

Im the one who had nothing to post except jokes, until i freakin left!

We left 3 minutes early and I am wondering if this is a harbinger of doom, as in, he's sick of me. How many times does he have to tell me we are okay before I completely believe it?


We talked about things that happened at home, the ending of work, what next year might look like. T brought up the previous session which I had forgotten. But it was a good session now that I remember, and he helped me feel a lot better.


I feel like there is something inherently wrong with me, and that I am not okay as I am. T tells me it is okay to be me, I'm not sure when or if I will ever be able to consistently feel that way. Sometimes I don't even know/like who I am. All of this is so painful/excruciating. I am going to spend this Summer trying to do things I like to do in hopes that doing this will lessen my anxiety.

I've felt I have a chameleon soul, just blending in very well to my surroundings. I can pick up on very subtle things and be who ever they want me to be. I've mimicked postures and accents without actually realizing what I'm doing. I can pretend that I'm interested in football when I could care less or laugh when I really don't want to. It's like watching everyone from behind a wall of glass. I can't get closer. I can hide the real me behind make up and bold red lipstick on the wards, but I've felt the same way:

"Can someone please tell me who I am. I haven't recognized myself in a while."

I am just a bunch of fragments my T is trying to integrate. But "I" come out when I've spent a lot of time alone away from others. I would recommend journaling too.

(((Lemoncake & anastasia))) i was just googling books on listening to myself. Not a lot to choose from.

Una, I understand your posts lately in a way I never have before. This really resonates with me. Like, a lot!!

Cuz I'm starting to more fully live my life like going back to school and stuff. But using t as an excuse to not fully commit to school, or whatever else I'm starting to do. You know? Like "I can't because...." Or something.

Cuz it's scary being an adult?? I dunno.

Today's T session might make more sense with the e-mails from Monday/Tuesday. Warning: these are really long!
Me (Monday night):
Hi Dr. T,

I have really mixed emotions about today's session--unfortunately, the negative ones are winning out at the moment. I feel like on the one hand, you're saying I can share anything with you, that it's safe, that you'll be accepting, that you're not going to reject or abandon me for any of several possible reasons I listed today (not getting better fast enough, not having enough problems in the first place, etc.). All of that feels very reassuring.

Yet on the other hand, I'm getting a very different message. That I shouldn't rely on you for support, that it's not OK to feel attached, that I need to keep my distance. Confusing things like: page 1 of Google is OK, page 2 isn't. Finding comfort from a stone I bring into the office and sit on the table for a bit is OK (I opted not to do that today, despite your offer, since I didn't want to take a chance of it becoming uncomfortable); finding comfort from a stone that you already have in the office and hand me isn't OK.

I have no idea when I'm going to cross a line. I know you said you'll be honest with me, but that's not particularly reassuring when I feel at any moment I could break one of your rules that maybe you don't even realize is a rule until I break it--the stone, for example. And I have no idea what else will potentially be an issue (and maybe you don't either.)

Or like today, at a few points (and then riding home) I felt fairly connected to you. But then I thought to myself, wait, that probably would not be OK with you, so I tried to shut it off. Because you say I'm supposed to connect to other people, not you. Even though you're the person I'm spilling all my darkest secrets to. How am I *not* going to feel some emotional connection there? And maybe some attachment/transference stuff? Yes, it's a professional relationship, but I feel therapist/client is unlike any other professional relationship out there in the sense of emotional intimacy (albeit one-sided).

It's like if I'm feeling things, then trying to suppress them...how is that so different from some stuff I dealt with from my parents? I'm afraid some of your reactions are just reinforcing some of the negative messages I got as a kid/teen.

I generally like working with you. But I hate dealing with some of these fears and emotions with regard to you, then not knowing how you'll react if I talk about it. With Dr. Ex-MC, I often felt I couldn't talk to him about transference/attachment stuff because he was my marriage counselor (yet for the most part, when I did talk to him about it, he was very accepting--until the end). With you, I feel like I can't talk about it because it seems you're more comfortable talking about [gross bodily functions] than about transference and attachment...

Can you work with me through some of this stuff? Can you make it feel more OK to talk about? Can you help me feel safe with you? I feel like that last question was part of what my last e-mail asked, but to me, we never fully addressed it today (though maybe you think we did, since you reassured me about a couple things?)

Charge accepted if you opt to respond in detail (slightly preferred, but if you'd rather talk in person, could either do that Thursday, or if you have something earlier, let me know.

Thanks,
LT
Also me, later that night: Sorry, just one last thing. I think maybe your holding up the stone to me today to verify which one it was--that may have been kind of triggering. This stupidly hopeful part of me thought for a split second maybe you'd offer it back to me, especially because you said you didn't recall how you'd acquired it (so you had no particular emotional connection to it). So it sort of felt like you were dangling this potentially comforting thing in front of me, then taking it back again. I'm sure that wasn't your intention, but it felt that way a bit.

Dr. T (Tuesday morning):
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.)

Be afraid. Very very afraid.

On the couch, no one can hear you scream.

What stands out to me is that what stands out to you (and is keeping you enthralled) are the qualities of a sociopath. He may or may not be one, but these are the qualities that you are drawn to with an intense attraction and admiration. I would not be able to tolerate that kind of therapist, so it strikes me as meaningful that his inflated narcissistic ego is your siren song. Your parent groomed you well. Question is, do you break free by leaving this therapist if he is, indeed, as you perceive him? Or do you say to him, I am drawn to your approach to therapy because it feels abusive. What are your thoughts on that, Dr. T.?


I say this with a lot of care and understanding because I can relate (not that my therapist is like this, but that I was once drawn to charismatic sociopaths).

I really like his response, and also DANNGG does he write long emails! I know he charges for them, but wow!

Also, you amaze me with your introspective abilities, but more because you are extremely honest and vulnerable with your T.

About a month or so ago, I got really upset and angry at my T bc she cancelled a session on Monday in an email on a Friday night--but as a "PS: BTW, I have to cancel" I was not sober when I read that email and spiraled down, quickly.

I have been writing in myjournal and bringing it in for her to read, and while I did write about that incident in my journal, I just wrote that I was really upset. I did not tell her I was angry. Who knows if I ever will. I also know it was an extreme overreaction, so I felt less compelled to tell her my over-reacting feelings.

But that is small potatoes compared to what you talk about!
LOL. I literally snort-laughed when I read this.

My response, exactly

((((Lemoncake))))I'm sorry that you also struggle with who you are. It is painful to have to pretend. I know from your posts here that you are kind, caring, and thoughtful.


I am off for the Summer, so I will have a lot of time to myself and I might go back to writing a journal.

As I was reading your emails, LT, one thing stood out to me.
That seems like an odd thing to say. Like you're not allowed to be attached to him, but to the relationship is ok. I'm not sure where I was going with this because my brain is all fugged up today.

I hugged T and she thumped my back! I hugged her twice and she did it both times. Even after I said "I love you."

I know! The first time he sent a long reply, I was like "whoaaa..." This is why I'm OK paying for the handful of longer ones--because he writes so much and clearly takes the time with them. (Shorter ones--like if he just replies with a few sentences--are free.)

[quoteAlso, you amaze me with your introspective abilities, but more because you are extremely honest and vulnerable with your T.[/quote]

Thanks! Sometimes I think maybe I'm being *too honest*, but like I've said to him, if I don't feel like I can be honest in there, then where can I be? And he's honest right back, which is both good and bad...

I remember that. It's still good you were able to tell her you were upset. And I likely would have reacted the same way to such an e-mail. I do still have trouble telling people I'm angry at them. Even when being so open with current T, I don't think I've really shared anger with him, or at least not labeled it in that way.