[LonesomeTonight]

Curious as to how other people's T's deal with this. I suppose most of this will need to be under a trigger warning.

Possible trigger:

I recently had a discussion with my T about SH. It's not something that I do often, and it's, according to him, not a dangerous, i.e., life-threatening, form of it. However, I do have the urges at times, with the most recent being 2 Saturdays ago after a fight with my H. I told Dr. T in session how I'd had those thoughts (but didn't act on them), and he just seemed rather dismissive. In the past, the most he's generally said if I have SHed is, "I'm sorry."

So I decided to type up, in detail, what it feels like when I have those thoughts/urges in my head. How even if I don't act on them, the feelings suck. That I don't want to have them. I went into detail for a few paragraphs. (If anyone wants to see what I wrote, let me know, and I can PM it. Just afraid will be too triggering here.) But I handed that to him close to the end of the next session to let him read it. He didn't say much about it.

So next session, I brought it up. I said that part of me wanted to know how he felt when he read it, but then I was afraid it would sound like I'd given it to him for the purpose of getting a reaction from him. When I just wanted him to "get it," what that felt like for me, how even if I don't act on it, the feelings can suck. He said how we'd never really talked about how I wanted him to respond to that topic.

And we did. I said, echoing something he'd asked from the previous session, how maybe part of me did want some compassion from him around the topic. Like, I wouldn't want him to start sobbing uncontrollably in session about it. But that it might help if he said something like, "It makes me feel sad that you felt that way." How he'll share other ways I make him feel, like frustrated, annoyed, etc. So it could be helpful to hear that.

Dr. T said that his general stance, with all clients, is to try to remain fairly neutral on SH. To not react too much one way or the other. I said it can be difficult in getting lots of empathy from him on stuff with my D, but then with the SH, I don't get that. How I understand that maybe it's a case of, as a parent, it's easier to empathize about stuff with a child, because he could think of it happening with his own son. Me: "But, and I of course have no idea of your mental health background and am not asking, but if you've never had those feelings before, it might be more difficult to understand someone's feelings of wanting to harm their own body." I don't think he said anything to that.

I said how I understand how maybe some clients would SH (or talk about it) to get attention, but that I hoped he realized I'm not like that. How I'm ultimately a people pleaser and that it can take a lot for me to actually share those thoughts and feelings with him. He said that people can have subconscious motivations that they aren't even aware of. So he feels it's safer to just stay neutral.

I'm debating whether to discuss this more with him in our next session. It's not something that comes up too often for me, but when it does, they're moments when I'm in really intense pain. Like back in the email exchange that led to the rupture in late August. (Though I now understand, from what he said in session, why he didn't show much empathy or caring at that time.)

So, if anyone got this far, how does your T handle these topics? Is it worth bringing up with him more? I feel in a way like this is sort of a reenactment of my parents not giving me the support I wanted/needed for mental health issues. (Like, I started sobbing partway through this most recent session, saying, "My parents didn't give me the compassion I needed.") Do I just try to use the feelings it's dredging up now to explore that stuff? Do I ask my T if he's at all willing to try a different approach with me on this topic, then if it seems to become an issue (like I seem to keep looking for attention), he can shift? Because at this point, I don't even see what the point of telling him about SH thoughts or even actions is. If he's basically going to be like, "Sorry. Well, OK, moving on..."

Thanks!

[arielawhile]

In some senses, our therapists are so similar! I tend to seek compassion or emotional validation, and my therapist tends to remain scrupulously neutral. He offers no physical touch and never any observation about anything physical (hair color change, something major...much less anything wardrobe-related). Anyway...

Does everything having to do with SH need to go under trigger? Then...

Possible trigger:

I have SHed. My T knows, requested to see it. My level of SH is relatively minor. (Nothing requiring stitches. Marks fading after several days). His response was again very neutral. Not overly concerned. I've also had some fairly serious SUI thoughts. He was more concerned about that, but again, fairly detached. He's fairly amazing at threading the needle between being warm and not emotionally charged, if that makes any sense at all.

Your T has been very clear that he wants to remain neutral on this subject. Maybe it's worthwhile to explore why you feel you need HIS (i.e. external) validation and compassion so much? And how to provide that validation and compassion for yourself. (BTW, I don't want to derail your post, but let me say I totally understand not getting what you need from your parents PLUS some.) That might be an interesting road to go down. I get it isn't easy. There are some good self-compassion books by Kristin Neff and Chris Germer that you might read (if you're into doing research on your own). They're on the meditation/mindfulness side though.

And about the uselessness of telling your T about the SH thoughts and actions if he's not willing to be compassionate? Well, telling him about them is basically giving him clinical information. Like how often. How severe. He needs to know this to roadmap your treatment. It's like telling a doctor about how often you're having a fever or something.

Sorry if this isn't helpful. I'm only on my first cup of coffee so maybe I need my second. This is really tough, complicated, murky stuff!

[JaneTennison1]

sometimes LT it sounds like you have a script or expectation for him to follow and when he doesnt it throws you off. Maybe it feels like you know how he will react and when he doesnt you worry you dont know him that well.

My T doesnt really respond. She knows I am no severe risk to myself and she doesn't make it a big deal but more something that happened and she wants to explore why it did. My T views self harm as a coping mechanism and would prefer to discuss why someone is feeling unable to cope. I'm ok with that. I dont need or even want a reaction because to me it is just a thing I felt.

[susannahsays]

You say he has been dismissive, and I agree. You also say you want him to be more empathetic and compassionate about it. This all translates to me as you want him to express concern. I don't know if that's accurate, but that's how it comes across. Therefore, it seems fair to say you are talking about SH to get his attention - especially giving him a long, graphic description of what you want to do to yourself. If that wasn't accurate, his dismissiveness wouldn't be an issue. I'm not saying that is bad. Maybe that's the only way you can think of to adequately express the depth of how bad you're feeling - and an expression of concern would be like confirmation that he has received that message. I am saying that what you are communicating to him seems at odds with "not attention-seeking" which might be setting off alarm bells with him because he might be perceiving it as manipulative. You can be worried about being perceived as attention seeking and still attention seek. Clearly he thinks that's what you're doing since he made the comments about subconscious motives.

I once made the mistake of telling the therapist that I liked coming to therapy because she had to pay attention to me. She interpreted that in the worst way possible, it seemed. "Attention" is a dirty word, apparently. I think it's stupid because if you're coming to therapy, of course you're seeking attention. You're paying someone to sit there and pay attention to you.

Back to Dr. T. I wonder if it might be more fruitful to bring up the SH thoughts from a different angle. Maybe instead of focusing on the fact that they are about SH, you could focus on their intrusive nature when you talk about them. It sounds like that's a big part of what makes them distressing. I don't think detailing the exact thoughts is going to get him to provide you with a helpful response. I think he might be more open to being empathetic if you come at it from a different angle. You could also try keeping a log of what's happening before the thoughts start to try to figure out what triggers them and bring that up. If you bring it up as more than just a passive topic that you want him to express concern about, he might be less inclined to withdraw emotionally.

[zoiecat]

LT, first I wanted to say that I am sorry you have those feelings. Emotions can be hard to handle and SH is one way to make them stop. I will start with what you probably don't want to hear first and hope you continue reading to the end where I will make suggestions and describe how my T deals with it. I am saying this from the heart but feel free to disregard anything I say if I am totally off base. A couple things you said struck a chord with me.

"He said how we'd never really talked about how I wanted him to respond to that topic." I am not saying this to hurt you, but it is a pattern of yours that I have observed for quite awhile. Why should your T have to respond the way you want? "But that it might help if he said something like, "It makes me feel sad that you felt that way." You frequently say things like "why can't he say this", "I wish he could just say this." If your T feels he can only respond in the way you want him to, then he is not being honest with you and providing the responses and help that you really need to learn and grow.

"I said how I understand how maybe some clients would SH (or talk about it) to get attention, but that I hoped he realized I'm not like that." I know you are not doing or thinking of SH as a way to get attention, but your words throughout this post strike me as you are telling him to get some kind of reaction; empathy and sorrow for your difficulty with these emotions. Let's say he does these things, will that make them go away? Probably not because life's difficulties are still going to happen and unless you learn how to cope with those emotions in a different way, the SH harm thoughts will still be there. Actually if he responds the way you want him to it may even make the SH thoughts worse. Based on your patterns I would be afraid that would start relying even more on SH in order to get the reactions and empathy from T that you are looking for.

This brings me to my suggestion. Rather than trying to get the reaction or response that you are looking for, why not ask him how to lessen the SH thoughts. Ask him to help you learn better coping skills in order to better handle life's hard times. Also, learning to sit with difficult emotions (not SH thoughts) helps you to build resilience so that they become easier to deal with. Although it took a long time for me to understand this, my T has continued to push me gently toward sitting with my emotions. It is hard and I don't like it. I tell him that every time and he agrees. He knows it's hard. But he also knows that going through the emotions is the only way to get to the other side. SH is only a way to avoid them. I take it day be day and am improving my resilience one baby step at a time.

As for how my T deals with my comments about SUI (I never talk about SH unless he makes me go there because he then makes us do a Chain Analysis which I absolutely HATE doing) it depends on how severe they are and how much of a threat he feels there is at the moment. As you stated, you are not in any real physical danger so he may not respond very much. My T always says these thoughts and feelings are part of my depression. They will improve as the depression improves. He also said it is OK to have the thoughts as long as I don't act upon them. He is actually happy every time I do not act upon them because it means I am learning to better handle my emotions. My T requires me to fill out a DBT diary card every week and it is the first thing he insists on looking at it first thing every session. It tracks my SUI and SH urges every day among other things. When he sees bad days he will comment on how that day was really bad and ask me what caused me to feel so bad that day. This may lead to a discussion on what skills I used to deal with them or what skills I could use going forward to cope in a better way. He tries to normalize the self-destructive thoughts and focus on the resolution.

I don't think T want to make too big of an issue out of SH for fear that the client will increase the behavior. (Unless of course they are in clear physical danger.) It has been my experience that whenever my T is talking to me on a really bad SUI day, he tries to speak as soft and calm as possible. In the long run, he prefers to work on coping skills and reframes, rather than drawing attention to my self-destructive thoughts. He is more apt to not directly respond to my self-destructive ideation at all in favor of pushing me toward ways to improve my life. I guess when you think about it, if a T provides a big reaction the client is going to internalize that as a way to illicit the response again in the future as a way to express how bad they are feeling.

I hope this helps and I'm sorry if anything I said upset you. I hope you can get to a point of peace and understanding with your T on the topic. Keep in mind that their responses are usually the result of many years of experience dealing with these types of issues.

[Mindtraveller]

I imagine a t to stay neutral on this topic as they don't want to "punish" or "reward" a client for doing SH.

They may feel that giving too much empathy and compassion rewards the behaviour and the client may subconsciously repeat it again to obtain the same reaction whenever they're feeling bad and in need of T's attention/empathy/caring etc.

On the other hand, they don't wish to react negatively and therefore punish a client for essentially using the only way they know as a reliable coping mechanism. To do this would only be more damaging for the client and the therapeutic relationship.

It sounds like by being neutral, you t has perhaps unintentionally created the impression of reacting negatively towards your SH and it almost feels a bit neglectful to you.

Maybe he didn't mean for this, who knows, but nevertheless his reaction has had consequences for you. Could tell him how his reaction (or lack of reaction) made you feel and see where the conversation takes you from there?

[JaneTennison1]

Originally Posted by zoiecat

This brings me to my suggestion. Rather than trying to get the reaction or response that you are looking for, why not ask him how to lessen the SH thoughts. Ask him to help you learn better coping skills in order to better handle life's hard times. Also, learning to sit with difficult emotions (not SH thoughts) helps you to build resilience so that they become easier to deal with. Although it took a long time for me to understand this, my T has continued to push me gently toward sitting with my emotions. It is hard and I don't like it. I tell him that every time and he agrees. He knows it's hard. But he also knows that going through the emotions is the only way to get to the other side. SH is only a way to avoid them. I take it day be day and am improving my resilience one baby step at a time.

This is wonderful, you often seem to get caugh in the distraction of your relationship rather than the issue. I do it too so no judgement here. I've started to learn I need to focus on the issue and not the T and it's helping. The issue should not be T reaction but maybe how you felt or why you SH or even drink as coping tools, what tools can replace those?? His lack of reaction reminded you of your parents THAT is the focus not T, he is a conduit for all of this.

[Omers]

First thank you SO much for posting this, I needed this today. I would be interested in reading what you wrote. I get very strong urges to SH. To date I have only acted on them once a very long time ago but usually I don’t admit that episode as I worry that if I do then it opens an excuse to do it again. Anyway, I have always told T when I have urges and if I have any understanding of where they are coming from I share that too. Often for me it is physical pain I can’t control, feeling invisible, or self punishment for something. It almost always comes from something that open up the wounds of 3rd-8th grade which T and I call the 5th grader... I am not DID but that is one of the places my development clearly stopped. When something opens a wound or re wounds that age the urges are so, so strong.
T has never said much although he has expressed his appreciation of my openness and trust as it is something very personal and sensitive. I have never opened up SH as a topic of conversation in our sessions so part of his lack of response may be that he has not been formally invited to work with that pain, he has only been allowed to see it. He is amazingly and wonderfully sensitive like that for me most of the time.
T has told me from the beginning that our feelings are ALWAYS OK no matter how strong they are and it is always OK to talk to him about my feelings and he will share his as appropriate. The second part of that though is that there are boundaries on how we express our feelings. I don’t think T would put in place some of the boundaries I have read other T’s putting on clients around self harm. I can see T wanting to focus more on the feelings, what triggers the feelings in the moment and what from my past is that trigger bringing up. Because, for me, it is so often linked to the “5th grader” I can see him really pushing to know what she needs, what she wants and how do we make those things happen for her.
I can’t see T focusing too much on what the urges feel like or what it would feel like/do to actually SH. In the grand scheme of things my coping mechanisms to not SH when I have urges aren’t exactly healthy either but they are less unhealthy than SH. I can see T not understanding why I “settle” for a less harmful option (I can actually imagine him saying harm is harm although I am not confident of how accurate this may or may not be). Why am I binge eating pringles and chocolate and not getting out of bed when I *could* be doing “self care”... which, on a day like today could actually get me to cuss at T.

[ScarletPimpernel]

Even though it's been almost 5 years since I sh'ed, I still have the urges. I don't really know how L (or T) react. I guess they're compassionate and empathetic, but not in an overt way. We don't really concentrate on the thoughts themselves because, well, they are just thoughts. We focus on why the thoughts are coming up, how to cope, and how to have compassion for myself.

You seem to keep butting heads with your T. You keep wanting something from him that he either doesn't do or at least isn't natural for him to do. You can keep bringing it up if you feel you need to, but you're probably wasting your time and energy. It's probably best to focus on the why you're having the thoughts and how to cope with them. No one likes having sh or sui thoughts. But they are there for a reason.

[atisketatasket]

I had a couple years where I sh’d. I haven’t now in 2 years or so, but when I was doing it or felt like doing it, Info did not seem supportive. She once told me a bunch of things I could do instead (the infamous “dance with the cat” speech). She said I was confusing the action with the emotion. SH is one way to deal with the emotion. There are others, was her point, and I was an adult who was perfectly capable of dealing with it in other ways. I was massively irritated about “dance with the cat” at the time, but she had a point.

I imagine your therapist might feel the same way. If you were actively SHing so that you needed medical care, he’d probably deal with it differently (I hope). But you have the skills to cope with those urges, and yes, it feels yucky, but that’s the emotion, not the action, and you have the capability of coping with the emotion too.

[satsuma]

My T was always quite calm and didn’t react very much. I think they are trained to avoid allowing SH to be a way of communicating feelings. He was very responsive when I communicated my feelings through words, and also he said that he understood that SH was a coping mechanism but it didn’t make me feel good so it wasn’t very helpful. Which was true.
Only happened a handful of times. I can see the danger that if he had had a bigger reaction I might have either felt that I couldn’t be open about it because it would create drama, or it might have reinforced the idea that through SH I was able to communicate emotions ... which is not very helpful.

[LonesomeTonight]

Originally Posted by atisketatasket

I had a couple years where I sh’d. I haven’t now in 2 years or so, but when I was doing it or felt like doing it, Info did not seem supportive. She once told me a bunch of things I could do instead (the infamous “dance with the cat” speech). She said I was confusing the action with the emotion. SH is one way to deal with the emotion. There are others, was her point, and I was an adult who was perfectly capable of dealing with it in other ways. I was massively irritated about “dance with the cat” at the time, but she had a point.

I imagine your therapist might feel the same way. If you were actively SHing so that you needed medical care, he’d probably deal with it differently (I hope). But you have the skills to cope with those urges, and yes, it feels yucky, but that’s the emotion, not the action, and you have the capability of coping with the emotion too.

Oh, I'd forgotten about the "dance with a cat" suggestion! Dr. T was starting to suggest something with a pet to cope and said, "Or petting the...right, you don't have a pet."

[ChickenNoodleSoup]

My T sometimes tells me that it's a 'bad' coping mechanism/that he'd rather have me not do it. Other than that, sometimes he asks to see the wounds, might ask how I did it, then pretty quickly focuses on why I had felt the urge to do it.
At some point I told him that he sometimes sounds dismissive when talking about the topic. While he agreed with my criticism, he also explained that he can't just go and say it's a good thing to do. He usually shows a bit more compassion now though, but we still focus a lot on the 'why did it even happen' as well as working on better coping skills. Since in my opinion those two things are the most helpful in ultimately not reacting to the urges so strongly anymore.

[LonesomeTonight]

Thanks for everyone's replies. I may reply in more detail to some of them later. But many of you mentioned T talking about other coping skills with me. That's actually what we'd spent most of the previous session doing.

Basically, the urges were triggered by a fight with H Saturday that left me feeling bad about myself. When I saw him Monday, I told him about some of the feelings I'd had, including the urges I discussed above (don't feel like putting all this in a trigger box!) He seemed to ignore that aspect entirely and talked about how H and I could have communicated better, to the level of actually drawing a diagram (he never does that). And much of it seemed to be about me listening to H more and asking what was going on with him (though he agreed that H had, as he put it, a "case of asshole-itis").

What I'd been wanting in that session and had explicitly asked for was help in dealing with was the feelings in the aftermath of the fight, where I spiraled downward quickly. (Like, how I could handle them better in the future.) And at the time, he was just talking about how I could have handled it differently *during* the fight. Which I let him go on with, because I knew that had value, too, but wasn't what I was seeking.

So I ended up asking for an extra session. At the start, T didn't seem to be getting what I'd wanted at all and I was going to leave. But then he finally got it. Then it seemed like he was repeating the generic coping strategies that he'd listed before. (Like, "Go for a walk." Well, I can't do that at 11 p.m. That's just one example.) I said I imagined he was frustrated that he was listing the same coping skills and that I wasn't good enough at using them. He said that he wasn't and that we hadn't talked about them recently, that maybe I needed more details/a plan.

Then he got into more details about how if I hit a certain threshold of emotions (another diagram!), those strategies might not work anymore, and how my threshold may be lower than many people's. Then he started giving descriptions of how I could be aware of my emotions, feelings in my body, etc., to identify when I'm heading in the direction of that threshold and how I could come up with things to do at different levels (like try x, if that doesn't work/isn't available, try y, etc.). I asked if it might help to write down what I'm feeling (emotionally and physically) at those times, and he agreed.

It was around there that I showed him what I'd typed about the topic of this thread, but he didn't really say anything after reading it. Talked a bit more about coping stuff. Right at the end, he said, "You're not allowed to beat yourself up over being bad at the coping skills. Not when you're sitting here with me, at least." Which made me feel better.

But anyway, so, yeah, we did discuss them a bunch. Thursday (regular session) was sort of the loose ends of the extra session, where we kinda talked about what I'd showed him.

[LonesomeTonight]

Also, I know many people commented here (or on past posts) that I try to dictate what I want from my T, or get upset if he doesn't give me/say to me exactly what I'm hoping he does. The thing is...if something he's doing isn't helping or working for me, what's wrong with asking him for what I feel I need? He's someone I hired to help me. If someone was redoing my kitchen and I hated the paint color, I wouldn't just go along with it because it's what the worker thought was better. Why should it be that way with a T? In some ways, this is also me standing up for my needs. And the same could apply in other relationships. If something my H does when I'm upset makes me feel worse, wouldn't it make sense to tell him about it? And suggest ways he might be better able to help me? Note that I'd expect the same from him. Because for me it *is* progress to ask for what I feel I want or need after many years of being a people pleaser.

Originally Posted by LonesomeTonight

Also, I know many people commented here (or on past posts) that I try to dictate what I want from my T, or get upset if he doesn't give me/say to me exactly what I'm hoping he does. The thing is...if something he's doing isn't helping or working for me, what's wrong with asking him for what I feel I need? He's someone I hired to help me. If someone was redoing my kitchen and I hated the paint color, I wouldn't just go along with it because it's what the worker thought was better. Why should it be that way with a T? In some ways, this is also me standing up for my needs. And the same could apply in other relationships. If something my H does when I'm upset makes me feel worse, wouldn't it make sense to tell him about it? And suggest ways he might be better able to help me? Note that I'd expect the same from him. Because for me it *is* progress to ask for what I feel I want or need after many years of being a people pleaser.

Sometimes others can't or won't meet our needs. Part of understanding our needs is knowing how to manage the associated feelings when we are faced with the reality of unmet needs. "People pleaser" or "telling someone what to say" are binary positions on the same spectrum of mismanaging your own needs. There are other positions you can learn to occupy, such as meeting your own needs or being able to tolerate the pain of other people's boundaries.

[atisketatasket]

Originally Posted by comrademoomoo

Sometimes others can't or won't meet our needs. Part of understanding our needs is knowing how to manage the associated feelings when we are faced with the reality of unmet needs. "People pleaser" or "telling someone what to say" are binary positions on the same spectrum of mismanaging your own needs. There are other positions you can learn to occupy, such as meeting your own needs or being able to tolerate the pain of other people's boundaries.

This, and also want vs. need. Like when you wanted him to stand up at the end of session, that was a want. It might have been the way you articulated a need, but was the actual standing up necessary for your therapy?

[LonesomeTonight]

Originally Posted by atisketatasket

This, and also want vs. need. Like when you wanted him to stand up at the end of session, that was a want. It might have been the way you articulated a need, but was the actual standing up necessary for your therapy?

It wasn't, but he was also really harsh in his reaction to me, and it made me reluctant to express any wants for a long time. But he stands up at the end now, and it has actually made a difference to me (along with the paying at the start of session instead of the end). I feel different about leaving session now.

[LonesomeTonight]

Originally Posted by comrademoomoo

Sometimes others can't or won't meet our needs. Part of understanding our needs is knowing how to manage the associated feelings when we are faced with the reality of unmet needs. "People pleaser" or "telling someone what to say" are binary positions on the same spectrum of mismanaging your own needs. There are other positions you can learn to occupy, such as meeting your own needs or being able to tolerate the pain of other people's boundaries.

I guess I don't see these on the same spectrum. I don't see what's wrong for asking for what I want or need? Trying to meet my own needs is something I'm working on in therapy, as is the pain of boundaries.

[ElectricManatee]

I think this is another side of Dr. T not having expertise in relationship trauma/attachment issues. I am thinking in particular how Amy (EMDR/DBT T) responds to this kind of thing because her main specialty is working with people who have intense emotions and trouble with self-soothing (which can lead to destructive behaviors like SH). We have talked about how the neutral stance often doesn't work for people with borderline traits (which I have and many other emotionally neglected people do, even those without a BPD diagnosis). The classic neutral stance just heightens the sensitive client's distress because we tend to assume on some level that the T is either reacting negatively to what we're saying or doesn't care.

I don't self-harm, but I do sometimes have trouble with suicidal ideation. I fill out an abbreviated DBT diary card every day and show it to her at my sessions. My card just lists the five emotions (shame, sadness, anger, fear, and joy) and then any problematic behaviors I am working on taming (just suicidal ideation for me -- with intensity of urge on a 1-10 scale and any steps I took toward the action on a 1-10 scale -- but you can also track SH, drinking, etc.) I hand her my card at the beginning of each session, and she comments on patterns or asks about hard days in an empathic way. (Like, "The urge was much higher than it has been in a while Wednesday, and it also looks like shame peaked. What was happening that day?") Sometimes it's just a brief answer and sometimes we talk more in-depth. I like that she is monitoring how I'm doing, and I like that I can just show her the card instead of having to bring it up.

I don't think there's necessarily anything wrong with "wanting attention." My other T reframes that as "asking to be attended to." It would be one thing if you went around trying to drum up support from every stranger on the street. It's quite another to want a significant figure in your life (especially a therapist) to understand you deeply and care about you and your well-being.

Ultimately I think the key is to learn how to regulate your emotions and self-soothe (alongside asking for support from others). Feeling ignored seems to lead to the opposite thing in my estimation. Your uncomfortable emotions just fester and grow until they threaten to consume you, and then you engage in the maladaptive coping strategy to get some relief. I think getting support and coaching from a therapist can help you figure out how to support and care for yourself, which just makes everything go more smoothly. It helps when a therapist has a developmental/attachment orientation to help guide you through this. I'm just not sure that Dr. T is in touch enough with working with the inner experience and with attachment issues to know how to handle them in this way. His approach seems more based in problem-solving and working with interpersonal relationship issues.

[atisketatasket]

Originally Posted by LonesomeTonight

It wasn't, but he was also really harsh in his reaction to me, and it made me reluctant to express any wants for a long time. But he stands up at the end now, and it has actually made a difference to me (along with the paying at the start of session instead of the end). I feel different about leaving session now.

I’m not talking about the aftermath, I’m talking about the build up. It wasn’t a need, but to you it seemed like one at the time, and maybe trying to figure out what need it was actually a request for would have spared some pain.

Sort of like someone suggested above, approach the sh discussion from a different angle. It’s the underlying cause, not the obvious symptom, that might be more important. You ask why you behave in x way when triggered and you want to investigate that—it’s the same idea here.

I am only saying, there is a difference between wants and needs and figuring out which is which is part of navigating relationships.

[susannahsays]

It's good to be able to ask for what you want or need. The next step is probably learning to accept that your ability to do so won't necessarily mean you always get the results you want. People can still say no even if you ask, even if you don't think they have good reasons for doing so, and even if you feel entitled to receive certain things. I get the feeling that there is an undercurrent of logic that since you are/were a people pleaser, that means it's more reasonable to expect people to bend to your will for a change. And if they say no, that it's more acceptable to push because you're just making up for being a people pleaser. Probably important to make sure you don't overcorrect and go from people pleasing to pushy.

As for the comparison to hiring a painter... I don't think that's very apt. No professional allows the customer to dictate how they do every aspect of their job. For painters, if the customer wanted them to rush and apply a second coat before the painter, in their professional experience, deemed it prudent, the painter would say no. It doesn't matter that the customer is paying the painter; certain professional standards would have to be upheld and the painter gets to decide what those standards are for them personally. The customer is free to seek out a painter who will give them what they want or accept how that particular painter works. I think this is true in therapy, too. Some things may be negotiated, but some may not be.

[WarmFuzzySocks]

Originally Posted by LonesomeTonight

I guess I don't see these on the same spectrum. I don't see what's wrong for asking for what I want or need? Trying to meet my own needs is something I'm working on in therapy, as is the pain of boundaries.

LT, there's nothing wrong with asking. And I can see a pattern that's not so much about proactive "Here's what I want/need" as retrospective "Here's what I wanted/needed. He should have done x but instead he did y."

Your post-session response was quite positive (so much so that you described it as better than your sessions with the mc), so presumably you were receptive in session, and your t likely took that as a sign that he was headed in the right direction. That's a normal thing to happen, not anyone's fault. It's just that there was a second need that didn't get addressed and you didn't realize the distress you were feeling over it until you left still holding it.

I guess I wonder (and more than this one session) how the same thing might have played out...recognition of the distress, need to meet an extra session to address it...without the "should have said/done/happened"? Your relationship with him gets all mooshed into the distress feelings and you end up focused as much or more on him and his words and his behavior and what he should have done as you are on what's distressing you. It gets so tangly.

[JaneTennison1]

Originally Posted by LonesomeTonight

I guess I don't see these on the same spectrum. I don't see what's wrong for asking for what I want or need? Trying to meet my own needs is something I'm working on in therapy, as is the pain of boundaries.

there is nothing wrong with asking for what you need, however, there are several outcomes to this. One of which is he may not be able to meet your need. When this happens though instead of accepting and discussing why you need what you do you seem to put all your energy and focus into getting him to change, making him follow the script and if he doesn't - rupture.

It's ok to ask the person doing your kitchen to install a dishwasher but if he is not able to then it is ok to find someone who is rather than spend hours explaining to him why you need the dishwasher.

People are imperfect and will do what they want. They have free will. expressing your needs doesnt mean you get it from Dr T. Getting louder and rupturing means you take all the focus off you and why you need or want things and puts all the focus on him. This does not seem to help you at all hence needing 2 or 3 sessions and going round, feeling terrible until he either gives in or you move on.

What is playing out here about your unmet needs that needs to be resolved? Patterns are usually our brains way of trying to fix a problem.

[unaluna]

Hey, i thought standing up was going to be the absolute last thing you were going to ask him to do. You were ready to quit him over it. If we look back, you probably brought up some form of the kitchen painting deal back then, too. Doesnt that concern you, that you keep upping the ante? Or repeating the pattern or whatever? The standing up was supposed to be the last thing. You promised!! So whats reeeeeally going on? Thats what i would talk to him about. Thats what i think your other posters here are saying.