In Session Today: Part V

I view it slightly differently. Like how many times has he said things that 'may' trigger LT but that don't? He may be trying to gently get her out of her comfort zone, from the context of a strong caring relationship, and most times it works - we don't know.

But it seems he's only triggered her 2/3 times (that LT recorded here) and they were, in my view, gently meant as LT has reported them, and they were heard or felt different by her. I see it as giving LT an opportunity to re jig her neurons in the safest of environments.

Agree too. This sounds like a very good T to take the leap of faith/trust/belief with. It's hard though. I'm there now either trying to leap or not scamble back up the cliff!

Gonna resurrect this thread to avoid taking over In Session Today and reply to some people there:
LT's Dr. T Thread

Psychotherapist Diana Fosha PH'D talks about how patients/clients mainly need to know they are being kept in mind. " The Felt Sense of Existing in the Heart and Mind of the Other" . It is about object constancy. I am a big fan of LT's T , but in this case, I don't think she read negatively into that statement bc of anxiety; I think he went way too far to make his point and broke the rapport in a way that wasn't in her best interests. I do think he realized this, and was forthcoming about pushing too hard on a sensitive place. IMO he realized LT had a good point, and was responsive to that. His point that people are often thoughtless and he is too and not to take it personally that he won't likely think of her again that day? Misfire imo. Rupture and repair has its own beauty though.

Repair:

Responded on your thread

Had a Halloween session, brought my dog in costume. (Buzz lightyear) T loved it and took a picture of him.

Had a nice session. Was able to talk about the big issue I was having around halloween. Took a short break from phobia work but discussed the crappy session we had off site the week before. I'm glad next week to be back on my regular day again, October was so confusing

My transference with T is gone for the most part.

He changed his approach which was working as a transference relationship only to working with me as a therapist. He was practicing psychoanalytically, which i knew really intensifies transference. He still uses that approach, but he's not doing that blank slate thing.

It's really interesting and also surprising how much that changes things. It seems i am still talking about the same things with the exception of transference feelings-they just are not there anymore other than subtle more fleeting feelings.

Had my second (third?) session with my new T (M) on Wednesday.

I started out talking about how I'd seen a video of a sea creature called a 'feather star', the day before. I told him how it hovers along peacefully above the sea bed, feeding on plankton and things. How little creatures - shrimp and fish - have developed perfectly matching camouflage and hide safely and securely in their fronds. At one point I stopped and said I regretted talking about it already, and I was worried he'd find it stupid and weird. He said he wasn't finding it stupid and weird and I said "I haven't finished yet!"

Anyway, when I started to talk about the shrimp I started to cry. I said that it had just struck me, watching the video, that I wished I was a shrimp instead of myself. Safely camouflaged in a feather star.

I tried to explain that recently I've been having these occasional attacks of existential crisis, where I feel overwhelmed by all the other people and creatures and things in the world, and often there's a feeling of jealousy... of wanting to be something or someone else. As well as just feeling kind of baffled and/or amazed by it all.

I can't remember what his response to all this was... I think he asked some questions, to try to understand. He didn't appear to think that I am crazy, so that was nice.

I said that shrimp don't have to have heart surgery. I kept crying. I explained that a few years ago I had been diagnosed with 'health anxiety' and sent for CBT... because I was so afraid that there was something wrong with my heart. But it had spread out to many aspects of my life - I couldn't eat most things, because I was afraid they'd kill me, I couldn't take medication and I was terrified of any kind of medical procedure (something I've since had to endure a ton of). I've also always been terribly afraid of needles and/or having anything put in my veins (like cannulas).

(Trigger for medical stuff.)



He said that sounded horrible and terrifying. But he sounded... I don't know... kind of self-conscious? Not quite genuine? I'm thinking now that it's interesting that I felt absolutely nothing typing that out, and I probably didn't feel that much about it whilst relating it to him either. I'm too disconnected from it, it's too unimaginable. Maybe it was unimaginable to him too.

Maybe it was that feeling of a lack of connection from him and between us that made me talk about missing R (my previous therapist). He asked me to tell him more about it and I basically started to list everything I loved about R - his use of interesting long words, his sense of humour, how kind and gentle he always was with me. I also talked more generally about how we'd spent a year building a relationship, and it had finally got to a point where I was really comfortable with him and we really were working well together, and it just bloody sucks to have to start all over again.

I said (hesitantly, feeling pretty bad about sharing this) that I was aware that a part of me hated him for not being R. That I knew it wasn't fair, that he is actually doing me a favour by even seeing me at all and he doesn't deserve to be hated.

He said he was glad that I'd named that, because he'd been having this feeling like everything he said was wrong somehow. And weirdly, or perhaps not weirdly at all, now that we'd both got that out in the open it seemed to dissolve a bit.

I think I talked a bit more about my experiences with C (my first T) and R, the bad and the good. I said how I'd sort of had to 'teach' R how to work with me.

He said something about feeling like he had to earn a relationship with me, and wondered if that might apply to other people in my life too. I said I could definitely understand him feeling that way, and that yes, I suppose I did expect him to earn a relationship with me. But that I didn't think it was that way with other people in my life - just therapists. He asked why and I said something about different parts of me being much more present in therapy and having different needs. Sometimes conflicting needs. He seemed to understand that.

I talked about a 'disagreement' I'd had with a friend who had stopped talking to me because of it. I said I'd been a d**k to her (and that more generally I keep being a d**k to people). As I described what had happened, getting kind of annoyed I guess, he said that it sounded more like I felt that she'd been a d**k to me. I said no, and started crying again. I said that I felt like she had good reasons for the way she felt and I should have just left it the f**k alone. He said it was like I'd been angry and righteous at first, and then it had quickly dissolved into hating myself instead. I thought that was very astute of him (though I suppose it was quite a straightforward observation), and said yes - that's how it always is. That's very familiar to me.

I feel like I must have missed something out, because that doesn't seem like enough content from a fifty minute session... but I think that's pretty much it. There were fairly long periods of silence/quiet sobbing on my part.

He gave me a five-minute warning, which I find quite annoying, remind me to tell him to stop doing that. Because I'm always keeping an eye on the time. I knew there were five minutes left.

Talking quite fast and animatedly, I squeezed in a description of a dream I'd had recently (it suddenly felt very relevant, I can't remember why). I'd been on the waltzer on the pier, with my mum and my partner, but it started malfunctioning. They stopped it and said they were going to fix it and start again but I was too afraid, sure that something terrible was going to happen, and got off. My mum and partner rolled their eyes and me and scoffed at how stupid and anxious I was being, and stayed on. I couldn't watch, so I walked around the corner, but then I heard a crashing and banging and I knew immediately that something had happened to my mum. She had been thrown off the ride and hit her head and was really confused and distressed.

I told M that when I'd woken from the dream my immediate interpretation of it had been that it was clearly about my mum, and how fragile but confident she is - how I'm afraid she'll hurt herself by being that way. Then I'd spoken to a friend about it which had uncovered more layers. It's about my heart - how I always knew that something was wrong, even though I was treated so dismissively. And when I was younger I used to go on the waltzer all the time - I smiled telling M how (I am from this city and he is not) you could buy a wristband that would let you go on unlimited rides and me and my friends used to challenge ourselves to see how many times in a row we could go on it. But now I wouldn't go on it. Or anything like that. Because I'm too afraid for my heart. I don't do anything fun anymore.

Then, in a lecture that Monday, my tutor - who is very interested in Jung and archetypes and the collective unconscious and symbols - had been talking about dream symbols and had said that a cycle, like the wheels on a bicycle perhaps, might represent life - the life cycle. And I very suddenly started to cry, and said that the waltzer is like that, a circle, a cycle, but it was too fast and too scary and too broken and I needed to get off. So it was like 'stop the world, I want to get off'.

All I remember in terms of his response as I related all that to him is that he'd been sort of smiling through most of it, but his expression changed as suddenly as mine when I started crying again. I think I took everyone by surprise.

When we both stood up at the end of the session, there was this moment where I was suddenly struck by how extremely attractive he is. I mean, I was aware of it already, but I hadn't been looking at him much, and somehow it was just... agh. He's just really lovely. I'm a bit worried about that.

Email exchange between me and T:

I told my t about my obsession with him. of course he knew way before I finally verbalized it. t says he it makes sense I experience this given what I've been thru and that he understands it's intense at times. he's said before that he understands where my need for his attention come from and he wishes he could give it to me

you've been pretty open with your t before about scary feeling things. do you think you could ever vaguely say how often you think of him?

maybe I'm a few days behind tho. I haven't been reading much here. apologies if I'm talking abt things that aren't relevant anymore..

Session yesterday. I talked about grandpa's passing and how that affected me. We talked about death in different cultures and how different people deal with it based on their culture. I'm not sure that was entirely helpful as I was talking about me and how I was dealing with it, but okay, whatever, points to ponder.


We briefly talked about work. This was the first time she didn't tell me to get a new job. That's good. I like my job, I'm not challenged though and I don't make enough money, but I don't have the fight in me right now to go looking for a new job.


We talked about hallucinations and self harm. She wasn't particularly helpful with either. She tends to just ask me what I do to make me happy, what do I do to feel peaceful? Is there music I can listen to that helps? Is there a movie I watch that makes me feel happy? I could get that kind of response from a friend. I'm looking for something more concrete. Like what do I do with this stuff! I was kind of annoyed because she really wasn't giving me good responses. It just felt like "pat on the head" stuff. I talked to her about having SI around the time of grandpa's passing. She skipped right over that.


I think she's nice. I think she doesn't know how to help me though. I think she's just sort of floundering, like pulling out the same questions each time. I'm wondering if it's helping me.


She asked me trigger for SH I don't know. It's just one of those sticky thoughts that won't go away. She didn't have any answer as to helping the thoughts get unstuck. Its like they are velcoed to my brain.


She ended the session by asking me if there was anything else I wanted to tell her but didn't. Nope. I thought that was a weird question as she had said our time was up. Why would I bring up something else if our time was up?


Argh. I miss my former T so much. It's like any progress I was making has come to a complete halt. I think PC is doing me more good than therapy really. Just having people that go through the same stuff. Anyway I see T again in one month. I think she has too many clients. She doesn't seem to remember things from previous sessions. Kit.

First session of the week today.

T asked how I was doing. I said it's going okay. On the weekend I felt really empty. Now I'm doing better.

I mentioned how I feel less scared than usual. There's things that'd usually trigger me and now they don't. T said it might be due to medication, but it's sometimes hard to tell, we'd have to give it some time. I said there's still things i worry about, like things connected to me moving in with my partner and having to deal with changing adresses. That worries me because of health insurance. The way it works for me, I have to be referred to my T once a year. And since I'm moving, I'll have to see a new doctor who might not do that. T said how he thinks that won't happen and how it probably even be harmful if that happened currently. It also led to a discussion of our health care system, which was funny because T knew about as much about it as everyone else, meaning he's not quite sure how anything works and sounds like 'my wife usually deals with this'.

Then I mentioned feeling a bit sad. T asked me whether I knew what mindfulness is, which I do. We discussed it a bit. After he asked me what I'd like to focus on? Something about my body (meaning breathing or how something feels), a certain topic, something else? I said I'd like to talk. But I wasn't sure whether it could only be about things that are currently happening since he talked about how mindfulness had to do with staying in the moment. He said no, we can still discuss other things.

I told him I'm thinking about getting my parents a book for Christmas about BPD. They know I'm in therapy but don't know my diagnosis. T asked why I wanted to tell them, which I wasn't sure why, I just feel like it. He wondered about what they might think why I'm seeing him. He said they probably noticed something when I was in high school. I didn't really agree, I lied to them all the time about how I as doing. T said how the teachers probably said something to them during those teacher parent discussions they have once a semester here. I disagreed. I started talking more about that time. First, I felt the need to set the scene again so I mentioned again how I wasn't allowed to talk to one of the girls after I told her I had a crush on her. Thankfully, T remembered. After about half a year, I had a meeting with one of my teachers and her. Because my behavior was causing problems. T asked what that meant. I was aggressive, for example when we did those fetch games for physical ed, I'd only chase her. I think she was scared of me. One time for our drawing class we were allowed to draw whatever we wanted to. So I drew skeletons in a graveyard, wearing clothing associated with Punk (they music genre). Because at home I played a video game that contained skeletons and I liked that kind of music, and skeletons live on graveyards. A couple days later my French teacher called me outside to discuss the drawing. I explained what it was, but she said she didn't believe me and said I wasn't allowed to draw such things anymore. So I think there was some kind of fear of me attacking her going around. Although I never did anything.
I got back to that meeting. I said how my teacher told my parents about it, saying I had cried. T asked whether I remembered why I cried. I said it was because I was never allowed to talk to that girl after saying I liked her. She was allowed to set rules like 'don't talk to me', but then I was not allowed to set any rules for myself. She was allowed to do whatever she wanted but I had to respect what she said. She had her parents telling everyone everything, how to act and what to do. And since I didn't want to tell my parents I liked girls, I didn't have anyone. T said how that undermined my autonomity. We talked about this some more. Including the fact that at some points I wanted her to suffer just like I did because she hurt me. T said that's normal.

Then we discussed how I might want to make my parents suffer to. I disagreed again. T said it seems I hate my mom. My dad is usually fine in stories it seems, but I'm always annoyed or mad at my mom. I answered that I think it's normal to be annoyed with your parents sometimes. But I don't hate them. That's also why I'm not sure about giving them a book, since it might seem like I am blaming them. Which I am not. I don't want them to feel bad, I just want them to understand. T mentioned how it might be good to just talk to them for five minutes at some point instead of having them read about it by themselves, but that's kind of hard when your family never discusses emotions.

After some more talking, we had to say good bye. T confirmed our time for Friday and I left.

I ended up with a bonus T session yesterday, but first a post giving an explanation of how that came about. At the end of Monday's session (which I never got around to writing up), I'd said to T how he will say things like "I care about your success" or "I care about your well-being" rather than "I care about you," and it feels like there's a difference to me. I think I expected him to just say something like, "Of course I care about you." Instead, he said he didn't want to respond to my comment right then because it was the end of session. T: "I don't want to give you a half-baked answer. You don't want to eat raw cookie dough." Me: "Yeah, I don't want to get therapy salmonella." T said he liked that one.

So I thought I was OK waiting to hear his explanation. But then I thought about it more and more. I had been out running errands and on my way home, I got really emotional. I actually pulled off into a parking lot and left him a rambling, weepy voicemail about how I want him to say "I care about you." He emailed a reply a couple hours later and also texted to let me know he'd sent the email and that if I wanted a time slot the next day, to text him (since he wouldn't check email till the next morning).

Here's what he said in the email:
"Hi LT,

I'm so sorry to hear how deeply you've been affected by my unwillingness to specifically state "I care about you." I certainly don't want you to feel such distress! I decided to email you a reply, and if you want to discuss this further in-person I could schedule an appointment tomorrow but that's up to you.

I'm not sure why my caring about your well-being and commitment to your success and growth seems to lack sufficient weight, or why it is so important that you hear me specifically say that I care about YOU (emphasis was what I heard in your message). There is an important distinction there, and I am trying to figure that out. This has the feel of a boundary issue and rather than being impulsive I want to think about the significance so that I can talk about it in a way that is best for both of us. I want to respect your needs, but more important than that I want to support your mental health and emotional growth. I also want to respect what I am comfortable with saying, and understand the implications of what I say before I say it around such a sensitive topic. Your reaction to this makes it clear to me that there is a great deal of emotional weight around this issue. That only makes me more certain that this is very important and needs to be taken seriously. I realize that I am not answering your question and that's because I have no answer - I have not been able to give it the attention it deserves.

Let me know if you'd like to talk tomorrow, or just wait until Thursday. I'd be able to see you at 2:30pm Tuesday. You asked about a phone call - and my policy is to not take phone calls for clinical issues unless they are scheduled in advance during regular hours. I charge my normal rate for that time. I do take emergency phone calls, although these are brief evaluations to see if someone needs to consider hospitalization or other emergency service. For non-emergencies I schedule the client ASAP, and for crisis requiring intervention I recommend either a crisis hotline or the ER. I sincerely hope that you're not in need of such an intervention, but if so I would try to help that process."

I texted to say I did want the slot the next day, but would that give him enough time to think about it? He said he thought he'd be OK to talk about it. He closed that exchange with "I hope you can rest well tonight," which I appreciated. OK, actual session in separate post.

Crosspost from other thread:
Bonus T session yesterday. Went back and sat down. T (in jeans and a striped dress shirt): "I have my coffee and you have your Perrier, so we're all set." Me: "Yes." T: "I think this is going to be a very important conversation." Me: "What we're talking about today, from the voicemail?" T: "Yes." I started talking and he was like, "You have a piece of glitter on your cheek." I frantically brushed at my cheek. Me: "I think it's from my D's Halloween costume, we have glitter everywhere. Is it gone?" T: "Yes, I think so. It was just very incongruent with what you were talking about."

I grabbed the box of tissues and sat it next to me on the couch. I then did something I don't normally do in there. I reached over on his couch and grabbed a throw pillow that had a bunch of fringe on the edges. I sat with it in my lap most of the session, stroking the fringe to kind of soothe myself. I think it also felt like a protective barrier.

I said I'd contemplated coming in and just terminating, that if he didn't care about me as a person, then what was the point? What was I doing there? But I figured I should come in and talk in out instead of just ending it. That I didn't know if it was just me running away from something difficult or if it was a case where he isn't the right T for me. And I didn't know why I was so upset about the caring stuff, but it's clearly really triggering me.

He asked about why it felt so different for him to say "I care about your success" or "well-being" vs. "I care about you." Me: "I think...'I care about you' suggests that you care about me as a human being. And I spend 2 hours a week in here with you, sharing intense things, so I'd like to think you care on that level." T: "OK. I'll explain my thoughts in a minute. What I was thinking of saying at the end of yesterday's session but decided not to was 'I care about you as a client.' But I don't think you would have liked that." Me: "No, that would have bothered me. Because it would have felt like, as long as I'm paying you, then you care. That it's based on the money, not me." T: "But I don't feel that way. I know you as a client, so that's how I care about you."

Me: "I guess I just think of something ex-MC said that stuck with me. Where I said I was basically paying him to care. And he said, 'You can pay me to do my job, but you can't pay me to care.' As in, he was choosing to care. And that felt good." I forget what T said to that.

T: "So for me, the difference in saying 'I care about you' is that it seems to push things beyond the boundaries of the therapeutic relationship. Like more in the sense of a friendship or romantic relationship." Me: "Really? Because I feel like I care about a lot of people as people, including, say, my neighbors who I barely know. But maybe that's just me?"

T: "You've talked about how things ended up going badly with ex-MC. And at times with ex-T. So I'm trying to avoid things going in that direction. I'm trying to look out for your well-being. And not saying 'I care about you' is one way I'm doing that." Me: "Oh... So I wasn't sure if at the end of last session, you needed time to think about whether you do in fact care about me or if you needed time to decide what to tell me. So, I'm guessing it's the second one?" T: "Yes, I was trying to figure out the best way to handle it to serve your well-being." Me: "Oh...OK. I think I was afraid you had to think about whether you cared or not." T: "No." T elaborated more on how I'd said that both with ex-MC and ex-T, things had crossed over a line at times (like ex-T admitting she'd gotten too close to me), which affected the therapy. And he's trying very hard not to do that here, that he's trying to be very careful in how he's handling things with me so that it doesn't go down the same path. I didn't say this at the time, but after the session, I thought how in a way, he's not saying he cares about me not because he doesn't care but because he *does* care about me...

He asked if I wanted to think I was special, different from his other clients, and that's what part of the caring thing was about. Me: "No, I want you to care about all your clients as people, not just clients. I don't expect you to care about me any more than them."

Somewhere in there we talked about therapy being one-directional in terms of caring. Me: "I know this sort of got me in trouble with ex-MC, but I also cared about him. And I care about you." T: "How can you care about me? You don't even know me!" Me: "But I spend 2 hours a week with you. I can still care about you without knowing all about you." T: "I mean, I understand you don't want me to get hit by a bus, but I don't think you can really care about me." Me: "But I do. Maybe I'm just weird like that...I care about a lot of people."

At one point, we were talking about some of the harsher truths he's said and how that can be difficult for me. T: "Do you think that therapists shouldn't tell their clients things like that? The more negative things that could hurt them, even if they're the truth?" Me: "I mean, I guess it wouldn't be helpful, but..." T: "Really think about it. I'm curious about your answer." Me: "Maybe part of me wants that, but I feel in the long run I need to hear some of these harsh things. Like if I really do think differently from most people, then I guess I need to know that." T: "I would agree." Me: "I figured."

Talking more about the "I care about you" and why it was important to me. I said something like, "You've known me over a year and spend 2 hours a week with me. I've confided many things in you. I'd certainly like to think you care about me as a human, not just as your client. Like if I left, would it just be like, 'well guess I have two other slots to fill now?'" T: "If, say, you were to die tomorrow, I'd be very affected. I wouldn't just think 'Now I have to fill some time slots.'" Me: "OK, thank you, that's good to hear."

We ended up going over by a few minutes, but he didn't seem to be looking at the clock at all. He seemed very engaged and thoughtful the whole session, doing things like closing his eyes while he thought about something and at one point covering his face with his hands. It seemed like he was really trying to understand me and also say what he felt was the right thing for me. I was crying quite a bit throughout and sometimes hiding my face, but still making a fair amount of eye contact.

As I was going over to pay, he said, "I am going to have to charge you for the email." Me: "You mean the one from the voicemail?" T: "Yes, it did take a bit of time." Me: "Uh, OK." T: "But if you can't pay it all right now, like that and the extra session, I can bill you for it later." Me: "No, it's fine." I guess I wish he'd told me before that there was a charge for that voicemail/email (even though I'd suspected), since it felt a bit like a slap in the face at the end of the session. He said I could let him know if I wanted to cancel Thursday, just give him 24 hours, preferably sooner. I said I would. Shook hands as he said "Have a good few days." Me: "Thanks, you too."

I talked to t on the phone. he asked me to catch him up. i told him everything. there's a lot of stuff going on, some of which I haven't rly written abt on here. anyway t mostly asked a lot of questions abt what I was saying. last time I saw t in person which was a few weeks ago, he was angry with me. and I could tell. immediately I noticed his body language and I shut down. i ended up leaving after maybe 7 minutes. it was terrible for me. I am acutely focused on any and all changes in t and his affect and personality and mood...... I feel that I pick up on things that average ppl dont... maybe because we've been working together for 8 yeArs

anyway my session on the phone went okay.... it felt good to talk about stuff... thAt's really all that happened

I brought the Russian dolls to show him. I haven't finished but I have done 4 layers (3 left to do) so I talked him through what I had done so far. The most affecting part to do so far was the older man part. I said that this part was a source of a lot of my confidence and self-belief but also the source of a lot of feelings and behaviours that I have trouble accepting about myself. I know it's because this part is an introjection of a lot of male figures, both loving ones and abusive ones, so it's a confusing and difficult part of my internal makeup. Talked a lot about the feelings that come from that part and also about gender, my feelings about my own gender. It was a good discussion.

We also talked about another part whose role seems to be to contain the other parts. I depicted this part as faceless on the dolls. T asked me if I had any idea who this part was. I said no. T asked me if I can think of any person or character that is like this part.
I said that the only thing that comes to mind is comical scenarios. I described a scene in Frasier where Frasier is pretending to be Jewish to please his girlfriend's mother. He is pretending he isn't cooking ham, concealing the Christmas tree delivery and hiding Niles, who is dressed as Jesus. T said he knows what I am describing - the desperation not to be seen as you really are. That was and accurate description of both Frasier in that episode and also of this part of me.

I told T that someone (also a T) had said to me "parts of you are in love with him, probably" and that I think it is true, parts of me are in love with him. T said that had occurred to him a couple of weeks ago but he thought he had better not say it. I said "Well J said it". T said "I'm glad he did". T asked me what being in love meant to me. I said it feels more passionate than just loving someone. T said it made him think of wanting to merge with someone. I said it reminded me of the Winnicott quote "there's no such thing as baby, only mother and baby" or whatever it is. Like it's a young desire to merge with a caregiver.

I told T I had had and told him details of that.
He was quiet and I asked what he was thinking. He said he was wondering what it was like for me to tell him all that. I said it felt a bit awkward but basically fine. But all the humiliation type feelings aren't present, they are kept away by the containing part (number 3 in the dolls). I said it's weird because I always endeavour to be open with him. T said sometimes number 3 is stronger than my openness. I said yes and sometimes I don't even know. Number 3 keeps it from me. T said it's part of its strategy.

T said he was also relating what I was saying to parts 2 and 4 (2= anxious part, 4=older man) and there seemed to be some interplay between them in the anxiety/control battle between me. I agreed with that.

It was coming to the end of the session. T said he hoped it was okay if he brought a practical question up now. I said yes. He said that he wondered whether we should talk about our plans for holidays next year, because "while we aren't organising our lives round you...." he said he wanted to make sure we didn't get a repeat of last year where our holidays were consecutive. He wanted to make sure we tried to coordinate them. He said if he had known when my holidays were he would have booked his differently. We agreed to tell each other when we book holidays so that we can coordinate them. I thanked him. I was a little taken aback, honestly.

We stood up and hugged. He commented on my shoes which are sparkly and we joked about that. We said goodbye and I left.

I had second therapy appointment of the week, we meet Monday, Wednesday, and Friday. It's a good thing I like him. Haha.

I got there ten minutes early and posted on Psych Central obviously.

He came out to get me and commented on my shoes, he always does when I wear heels. He doesn't understand why women want to torture their feet. I always laugh and say they are actually comfortable otherwise I wouldn't wear them to work. He always laughs and says he'll stick with sneakers. it's kind of a running joke.

I take a seat on his super comfortable couch, either that or the chair I'm using for training is a piece of garbage which it is. We discuss my new job; which is going great I like that the Practice Manager has taken me under her wing and is letting me be Junior Practice Manager why I do referrals. This led to a discussion about the old job which caused me to develop PTSD. I can't hear the name of the hospital, I can't hear their names, I can't watch the Big Bang Theory because of a name of character being shared with a former coworker. I wanted to type something much ruder than coworker, but I don't think PC would like my language. I'm kind of scared that my PTSD will make this new job harder. I'm doing and feeling fine and maybe even stable.

We talked about what caused the PTSD and how I wasn't able to take a job as a drug sales representative because they were in the service area I would be assigned. Ironically I still see one of the providers associated with this place he just practices at another location and he's the only doctor I've ever been able to trust. Sometimes I question why, but I still trust him; he's the only one I've seen that treats me as a person instead of illness. I also see him tomorrow and have to take off work early to see him since his hours don't coincide with my work schedule. I also have a huge paper due for my Bachelor's degree so I can use that time to make sure it's perfect before submitting.

We also talked about trying to make friends with the new colleagues since I'm mostly dealing with Doctors, Nurse Practitioner's, Physician Assistant's, and of course their nurses. One of the Physician Assistant's wanted to do lunch with me; which was fine up until I went to grab my wallet from my purse and a letter from the Cardiologist office fell out, and unfortunately for me the place I am going has Cardiology in the name so I couldn't play it off as something else. He got worried and wanted to take my pulse once we got back to the office. I politely told him I had a doctor and he shouldn't worry. He insisted he worry since I'm the only one that hasn't been scared to approach them about either a Referral problem or a Practice problem. With as much as I've seen doctors this year I'm no longer scared. My pulse was 150 resting, he of course was worried. I told him it's lower than normal, when in reality it usually runs around 130. He wanted to order a Holter Monitor, and I told him that I wouldn't be receiving medical care where I work, made that mistake the last time and I payed the cost of being terminated since they knew everything about me. I felt bad, but why I like him; I have my own doctor and if he wanted to he would have ordered one himself instead of sending me directly to a Cardiologist. We talked about how I need to address the referral nightmare with my doctor, because someone made a mistake and I want to know who it was, because they scheduled me with a Cardiologist affiliated with my demonic former workplace. I can't because of anxiety and PTSD. If I see them I will probably say something I'd regret.

We talked about how I'm afraid this Cardiologist is going to write my case as being psychiatric in nature since I do have a Generalized Anxiety Disorder, and he could just call it anxiety when it reality it's probably something since I've had four EKG's since April of this year. I'm terrified of him just seeing me as a Mental Illness and not a heart issue. I hope he doesn't, but it's still something I think about. I'm also super young to be having heart problems, so that might be another strike. I know realistically it's my anxiety making me think worse case scenario.

We talked about maybe discussing my PTSD diagnosis with my doc, since even though he's just a primary doc he's my pdoc as well since I've seen both in my area and walked out of both their offices because they refused to diagnosis me and just put me on the newest medication a drug rep bribed them with lunch, and I had a terrible reaction too. So he deals with my psych issues too. He's never said a cross word about it, besides my therapist is also in Medical School to become a Pdoc, so if I have a drug question I'll asked therapist and then talk to my doctor about it. I don't want to tell my doc since he is still employed there and I don't want to cloud his judgement, same reason I want to show him my paper, since this place is growing so rapidly that it's going to fail and I want him to at least know. I don't know if I tell him about the PTSD, surely he has seen the signs and just doesn't know how to address it, at the same time I don't want him to drop me as a patient since it could be seen as me trying to be vindictive since I was rudely terminated, when in reality I want to help him. Therapist thinks I should tell him about the diagnosis, but in reality I'm on the right medication and seeing a therapist.

At that point of going back of forth of do I tell or not tell my time was up, we hugged and I told him I'd tell him how the appointment went when I saw him Friday.

First time I've ever posted about therapy discussions and that actually felt really satisfying to type.

We talked about so many things. And the last trauma uncovered from dissociation somehow feeling like 'the end', since it answered so many questions.

T was kind and caring, which left me with feelings that he is so cute and lovable. 🍯

What a difference it makes to have a relationship with him as a therapist instead of just a transference relationship.

T said something that made me think he wanted to wash his hands of me after sessions. I sat in silence for a long time. I asked him what he was thinking and he said

"I am sad that you immediately go to that place, that you think I want to wash my hands of you. That's not how I feel about you. At all. But I can't convince you of that. It's a wound in you that feels like I would feel that way about you. And I don't know how to reach that part of you. I think that's part of our work together. To reach that part of you and say you are loved, you are lovable, and it's okay."

First, we talked about how I played tourist guide for a friend from the US over the weekend. On Monday we decided to get drunk and high, which ended in me throwing up for the whole night. Then we shortly talked about an event on climate change I had attended yesterday. I didn't feel any kind of anxiety, which surprised me a bit.

T asked about my medication. Whether I take it regularly and what dose. He asked about side effects, I said I think it makes me a bit sleepy. He said that usually it makes people more awake, but that some also feel sleepy. He said normally that stops after a while. I mentioned how I sleep well, just get sleepy in the afternoon. He asked about feeling sick, headaches and trembling. I don't experience any of that, which is nice. He wanted to know what I think of the med so far. I said I feel a lot less scared. Things that used to trigger me just a few weeks ago and gave me panic attacks now barely bother me. I might get a bit worried, but not like before.
He mentioned that people usually only start to feel effects after a few weeks, but also said how he had the impression for me it was already after a couple of days, which is correct. We decided that I'll stay on the dose I'm on now for the time being.

After some silence, T asked whether I had started reading a book on mindfulness I mentioned last session. I replied that I didn't find time yet, I was busy with the tourist friend. My partner and I met him online and have never met him in person before. T said how that sounds exhausting, to hang out with somebody like that for almost a week every day. I agreed, but said how it got better after we got him high the first time. T wanted to know about some of the substances I mentioned offering the friend, he had never heard of it.

Then we switched to discussing job applications. I have three more interviews coming up and it's exhausting to constantly thing about these things. He wanted to know what kind of things I might be doing and how I feel about it. I said the only thing that worries me is that I'll only be able to come to therapy once a week after I start working. He said we should figure out when we can meet, but I told him I had already told all possible employers that I'd have to take Fridays off. I can't work before or after therapy, before I'm nervous and after I'm tired. And on Friday it's much quieter in his office than on Wednesday.

I rolled up in a ball. He asked what was going on. I replied that I'm sad. I'm scared I couldn't see him anymore. He told me to remind myself how that won't be the case. I did and it helped a bit. He asked about reasons for thinking like this. Are there any evidence that this might happen? I said no, but when I'm sad then people get angry... He asked whether there's any reason he should be angry? I said no, and that he doesn't seem mad either. I cried for a while and managed to calm myself as well. He asked whether there are any feeling besides sadness. I said now I don't feel anything and he replied that nothing is also something, that I should describe it. I said it's emptyness. He asked what's going on in my head, is it empty as well? It wasn't, I was thinking about how I'd like to be able to talk but couldn't, which I told him.

Then I got sad and scared again. I was scared he'd leave. He asked whether there's any evidence for that. I replied that he could die at any time. And then I'd have nothing, no reminder of our time together or anything. He said how I think about the future and past too much. How it would be beneficial to stay in the moment more. We practiced that for a bit and he connected it to mindfulness. He told me to start reading my book.

After calming down a bit, we confirmed our time for Friday and I left.

I had an intense session today – began with a bit of a laugh, as R nearly arrived three hours earlier than scheduled. I began by saying:



‘If last Thursday was the lesson, then Friday was the test,’ before changing tack and inviting her to read the new poem.

She said that the piece was beautifully written, and she could almost take it line by line and ask about each one.

‘I postpone my own howling and shaking…’ She highlighted again how my poetry goes against the grain of me saying that I cannot express my emotions.

We moved in the direction of talking about the Friday, and I really struggled to explain what had happened. Eventually, I said that ‘I lost control…I cried.’ I talked a lot more about it, but couldn’t word it well or look at her. ‘There I go, trying to out-logic emotions.’ In the end she said:



‘You’ve gone away again…this is a bit directive, but can you look at me and try to help me understand?’

She offered her hand, which I grasped as I tried to look at her.

‘Too many words, not enough meaning.’



‘It doesn’t matter to me. That’s The Critic…you’re safe.’

‘You talked about crying as a loss of control. For me, it’s a release of emotion. There are many types of crying.’

‘I think that’s part of it – I never got any release from this.’ I waffled about how a ‘normal’ response would have been to walk away.

‘Normal?’

‘Normal and logical are the same to me.’



We talked about my urge to take off the mask, and R said that she sometimes sees it come off slightly ‘but as soon as I go out of the door’, it goes back on.

‘The only release would be…’



‘Stay with it…’

‘The only release would be her death.’



‘You struggle to even say the words ‘death’ or ‘die’. When you’re expecting somebody to pass or to die, there is a sense of relief…I might be bringing my stuff into the room, sorry.’

We did some somatic stuff, when she asked me to name what I felt in the present moment, and I ‘drifted’ into naming some emotions relating to the previous experience.

‘My shoulders are heavy.’



‘By heavy, do you mean tense? Can you release them? Sometimes we hold our shoulders around our ears without realising.’ I released them a little, but they’re still pretty tense as I write this.

‘Instead of being allowed to grieve, they gave me their grief.’

‘They gave you their grief and left you overwhelmed and depleted. You suffered, and continue to suffer.’

She asked me how I felt at the end of the session, and the only word I could reach was calm.

‘A complex calm.’



She asked me what my plans were for the rest of the day.



'I had a work meeting via Skype that was supposed to be on Tuesday, one of my colleagues emailed and cancelled with two hours' notice, mumble mumble, so now it's tonight, mumble mumble...'



'I'll interpret the mumble mumble for myself...I hope you have a good week.'

Brief recap of T session from Monday: Sat down, he said, smiling, "You decided to come back!" Me: "Yes, for now at least!" Talked briefly about some stuff that came up in PC thread.

The main topic we discussed was my leaving Sunday's 5K race after a mile (1/3 of race). T: "Tell me about what happened." I said it was a mix of the cold (temperatures right at freezing--32 F), extreme difficulty of the course (cross country, some really steep hills), and my having trouble breathing. I said how at first, when I got back to the car, I was crying and really down on myself, texting H to apologize for being a quitter and a failure. H was supportive. Then I said how I started trying to reframe it to myself, to think, "OK, this was a case of me realizing that something was too much for me and taking myself out of it. I didn't fail." Me to T: "So I think that's progress, right?" T, looking pleased, "Yes I'd say so." He said how I'd used some physiological coping skills with crying, then getting myself to stop. Then I reached out for and received social support from my H. Then I used more cognitive sort of skills in the self-talk. Me: "Also, even a couple weeks ago, I most likely would have contacted you to look for reassurance. But I didn't feel I had to do that. Plus I figured I'd see you today." T seemed to think that was good, too.

He said I should see what I can take out of what happened with the 5K. T: "There's a saying that 'experience is what you get when you don't get what you want.'" I said I wasn't sure I'd heard that before. So he talked about what I could take away from it. I said partly that perhaps cross-country courses aren't for me. Or that I need more training in cold weather. He was saying could go beyond that. He asked if he'd talked to me about "fixed vs. growth mindset" before. I said I didn't think so.

So he went on to explain how a fixed mindset means someone might think they do or don't have natural talent in something and that's just how they are. While a growth mindset, they feel they have the potential to improve in something, even if no natural talent. I said the fixed mindset resonated with me--I'd always thought and been told I was no good at athletic endeavors. So in my head, I'm just not an athlete. And for example, that 10 years ago, I took a karate class, which I felt was a great physical workout. But I wasn't picking up on skills as quickly and felt like I was holding the class back and ended up quitting. T said was interesting that I was also worried about the other students being annoyed with me. I said was reason I felt I could never do a team sport.

I said was kind of like that with art, too, was told at one point as a kid that I was "terrible" at painting, so I just assumed I sucked at it and didn't try much after that. I said how my mom said if I encountered something difficult, I'd often just give up instead of continuing to try. How I stuck with things that came more easily to me, like academics (English and math particularly). T said that's a form of fixed mindset, too, assuming I'm good at certain things, rather than having to make an effort. So then it was probably jarring for me if I encountered something more difficult in that area. I said yeah, with math.

He said with a growth mindset, then one thinks that they can get better at most anything with practice. He said even if someone has natural talent in an area, if they don't practice and work at it, then someone without natural talent who *does* work at it will most likely surpass them. Which I found to be interesting. So we talked about ways I could try to apply the growth mindset to my life, including in terms of running/walking but also beyond that.

It was a session that really made me think about some of the patterns I had throughout my life and also how my parents had contributed to them. Scheduled, I went over to pay, he shook my hand and said, "Good luck out there today." I turned to leave, he gestured at the couch and said, "Would you mind throwing away those couple of tissues?" Me: "Oh sorry! I didn't realize I'd left them there." T: "It's OK." I grabbed them and threw them in trash." T: "Take good care." Me: "Thanks, you too."

(((LT))) My parents were always encouraging me to quit stuff - but i think it was stuff that affected them, like if i talked to them about it. If they didnt know about it, i just went ahead and did it. Like i just went ahead and did my homework by myself all thru school, because the "prime directive" had been just to do whatever the nuns and teachers tell you to do. Once i started talking to them, like about boys and friends and life, thats when i got into trouble. They had no good advice. This "fixed vs growth" is very good for me to hang onto right now. Hey its never too late!

(((LT))) and (((unaluna))) I think for me, my parents were so adamant that I didn't quit anything that I've stayed at jobs far longer than was healthy for me, etc. My parents were of the mindset that once you start, you never quit, even when there's good reasons to. I took piano as a child and have no aptitude for it, but my parents made me stick with it for 10 years even though I wasn't progressing much as a student, and I didn't enjoy it. I wasn't getting anything out of it, but there's a stick-to-it-ness in my family that can be overdone. I think it's good sometimes to know that just because something is begun doesn't mean it has to be completed. I guess my parents were just on the extreme end. Never quit. Be better. An A isn't enough. Why didn't you get an A+? They just wanted what was best for me, but didn't allow my input into what was best for me. Sigh. Kit