[chihirochild]

I had a session over zoom with my T yesterday. We were talking about how difficult it has been for me during this COVID pandemic given that I am a doctor and working on the front lines. He acknowledged that the situation is horrific and that there is some amount of unavoidable suffering that I will experience because of it. But he also highlighted the fact that I was “defending my right to suffer in this situation“ and that there is some avoidable suffering that I am bringing on myself. Specifically, he believes that I have an overdeveloped sense of responsibility, which makes me experience bad patient outcomes as personal failures, that some of the sense of doom and terror I am feeling is because of this fault of mine.

I suppose I should be grateful that he is trying to find modifiable factors in this very difficult situation. However what he said about defending my right to suffer really rubbed me the wrong way. All I really wanted from him was some space to process my feelings and some empathy. I told him that his comments made me angry, that I did not want him to answer the question but what I was wondering in that moment is if he even knew what it felt like to lose a patient and feel like it was his fault. (I did comment on the fact that I hope and expect him to provide empathy on many other fronts with which he could not possibly have personal experience so my desire for that information was likely complicated.)

I’m trying to be rational and remember that his job is to use his unique expertise to help me in the long run, not just to play Mommy and comfort me whenever I am sad, but I’m still pretty disappointed and angry. I don’t know; what do y’all think?

[winter4me]

I think, without knowing anything about your situation (just responding as an RN recently retired who signed up to volunteer if needed during this pandemic)---?"right to suffer" would hit me the wrong way, offhand it sounds a bit cold. (like he may need to distance himself from your feelings/situation). It is common, if not "realistic", for health care workers, especially those on the front lines to take death/bad outcomes to heart, and to wonder if we could have done more or made better decisions. It is a normal human response---and right now, the lack of control over this situation will cause anxiety, sadness, anger, .... Keep talking with him & decide if he is a good fit for you---
(I would recommend setting aside a couple of half hours or hours a day to practice relaxation/yoga/mindfulness/exercise/music immersion And to allow yourself to feel, to grieve, and to ultimately know you are human and doing the best you can in difficult times no matter what your own issues are...) This is also a time that can try some relationships.
Thank you for the work you are doing! Please just don't neglect yourself and your colleagues (do you get time to talk with your team & share experiences? this can even be built into "report" time...) Hang in there, I think your feelings are always valid.
What you do with them is all you can (with practice---and never perfectly) guide/control.

[ElectricManatee]

You're in the middle of a terrifying and uncontrollable situation. That is the definition of a traumatic experience. Trauma Therapy 101 says to support, comfort, and empathize until the traumatic situation is over and the person can start to process the experience (this is the stage when you need basic containment from the therapist). I think his comment about suffering might have been helpful if you had perceived it as such. Maybe it would have felt helpful if it had been a very gentle suggestion instead of a more blunt insight? But "defending your right to suffer" is needlessly critical phrasing. Of course you are suffering! Anybody who has read a news article about what it's like to be in a hospital right now knows that everybody there is suffering, if nothing else from primal fear and dread of what is to come.

I think your disappointment and anger are justified, but I admit I don't always agree with your T's style in the best of times. You don't need to be completely rational when you are overwhelmed by an overwhelming situation. It's okay to feel whatever you are feeling. Stay safe out there. Thank you for showing up and facing death every day while the rest of us get to "help" by watching Netflix at home.

[atisketatasket]

I’ve seen some people who defend their right to suffer in my life, but it is absolutely not something I would attribute to a doctor who takes a negative patient outcome as a personal failure. In fact I think that is a good characteristic in a doctor.

Like you I think I see what he was trying to do, but I think in your current circumstances it’s unempathic and missed the mark of what you need completely. I think he should ease up a bit on you during this crisis.

[LonesomeTonight]

This would really bother me, too. I do wonder if he possibly could be projecting some here, maybe some countertransference? Because he's also in a profession where he's trying to help people suffer less, and he can lose clients as well--and perhaps feel it is at least partly his fault that he couldn't save or help them. Even on a scale lower than dying, he likely feels that he's not doing all he can to help some clients, that some are still struggling despite what he does. Note that some of this is from a conversation I had with Dr. T on...Thursday? (I have no idea what day it is anymore), where I kind of got his perspective as a T on some stuff with clients in general (like suicidal clients and whether he'd ever lost a client to that--answer was yes).

I'm not saying this to suggest that it's OK that he said that to you. Just thinking of where he could possibly be coming from. I've also had discussions with Dr. T about how one of his backup T's said I'd make a good therapist. Dr. T said I'd be great for my clients, but it would be awful for me. Because I'd take too much of it home with me and worry about my clients all the time, if I said the wrong thing in session, if they were OK, etc. At first it bothered me a little, but I realized he was right. I'm not sure how I would handle it if a client died or kept getting worse, despite all my efforts. Your caring so much makes you a great doctor for your patients, much in the way he said I'd be a great T for my clients. I imagine he's worried about the toll it's taking on you right now--really, the toll it's probably taking on most all medical care providers working on the front lines like you.

I hope it's OK to be drawing so many parallels to my therapy right now. But you mentioned how maybe he's looking for modifiable factors, when all you want right now is empathy and support. Earlier this week, I thanked Dr. T for all the empathy and validation he'd been giving me since the Covid effects started, with closures of schools and so many other places. He said he felt empathy can only go so far, that it can feel good in the moment, but he feels it isn't enough. That he wants to help (clients in general) figure out solutions and ways to improve, and he's having trouble figuring that out for people right now with all that's going on. I said for me, all I'm really looking for right now is empathy/validation. That I don't expect him to have some magical solution because this is an unprecedented event. I'm not sure he really believed that, but it really is the main thing I'm looking for right now.

Your T often reminds me of mine, so I'm wondering if he has a similar philosophy on therapy, on trying to find solutions instead of just giving support. When I feel there are different times for each. Right now, I think it's about just getting through, and support/empathy is what many people, you and I included, really need right now. Maybe try telling him that? How you aren't looking for solutions or answers from him, just want support right now to get through this particular very challenging time. Anyway, hope this helped in some way. And stay safe out there...

Ironically, the comments so far are defending your right to suffer. Did he explicitly describe your defense as a "fault" or is that a descriptor you have ascribed? I think you have a right to suffer and I don't think your defence of that right is a faulty characteristic - it is a part of your character and is probably something which has served you well up to this point (if indeed it is a behaviour which you display, no one here can know whether you do behave in that way). Maybe it hit close to home because it is true, or has elements of truth in it.

There are many times that I have reacted strongly against (what I perceived to be) a clumsy or insensitive comment made by my therapist (and there have been many!). However, when the dust has settled and I am less reactive and angry/upset, I begrudgingly realise that she has a point. I don't necessarily accept all aspects of her observation, but both her observation and my reaction to it become pivotal parts of my work.

... Alternatively, he could have been behaving like a provocative dickhead, I wouldn't rule that out.

[chihirochild]

Thank you, everyone, for your thoughts and kind words.

winter4me, I have been working hard to try to build a healthy community at work--bringing in tea, telling people how much I appreciate them, delivering coffee to the RNs and CNAs, even arranging for one of the psychiatrists to hold a weekly process group for us. I've also been trying to take care of myself, meditating daily and trying my best to get in fresh air and exercise, though this is a challenge given that I feel like I am especially high risk to be a pre-symptomatic shedder of virus and do not want to be outside/around people if I can help it.

I sent my T this email:
Dear [T],

I felt angry and disappointed after our session yesterday. I did hear you say that this situation is horrific and that there is bound to be unavoidable suffering. I appreciate that your intent in highlighting the ways that I add to my own suffering is to draw attention to modifiable factors of my mind and experience so that I can address those factors and suffer less.

However, I’m doing work that I find scary and difficult in the midst of a global disaster. All want, all I think I can tolerate right now, is reassurance and a safe place to process. Can we talk about how to find a balance between containment and growth that is acceptable to both of us?

Thanks for considering,
[c]

[ArtleyWilkins]

Sounds like a good letter.

He may be getting to the idea of needing to compartmentalize in your profession for your own mental health, but he didn't seem to quite communicate it that way.

I know you are dealing with being on the front lines of this crisis. I hope you are managing and thank you and your coworkers for all you are doing right now.

[LonesomeTonight]

I agree that it was a good email you sent him. I hope you hear something back from him that's helpful. When do you "meet" again?

[chihirochild]

We’re meeting next over Zoom on Tuesday.

I wish he would answer my email but he doesn’t answer emails unless it is about something logistical.

[sophiebunny]

I don't know what kind of medicine you practice, ER, ICU, infectious disease, family, but I know that hospitals that staff psychiatrists are making them available for their medical staff that could use some compassion and assistance in the face of so much suffering. Perhaps, given the crisis you are trying to manage, it might not be a bad idea to reach out to the psychiatry staff at your hospital. They would be far more empathetic than a therapist who has no idea what being in the trenches with this pandemic is like. It sounds like you are reaching out for some emotional respite and your therapist has no idea the magnitude of what you are dealing with. The truth is, none of us not directly in the trenches, has that kind of awareness. All we can do is give you our profound gratitude and offer what little bit of comfort we can.

Don't forget to take care of yourself.

[Quietmind 2]

Good comments from everyone here. Chiro, I have no words, just a hug if you want one. It's tough and scary and you're doing your best.

[sarahsweets]

I dont like it. To me it shows how removed from the "dirty" work he is to say something like that. You are dealing with an unprecedented human virus that no one in our lifetime ever dealt with. You have a right to feel however you feel about it.

[LonesomeTonight]

Originally Posted by sarahsweets

I dont like it. To me it shows how removed from the "dirty" work he is to say something like that. You are dealing with an unprecedented human virus that no one in our lifetime ever dealt with. You have a right to feel however you feel about it.

This is a really good point.

Originally Posted by sarahsweets

I dont like it. To me it shows how removed from the "dirty" work he is to say something like that. You are dealing with an unprecedented human virus that no one in our lifetime ever dealt with. You have a right to feel however you feel about it.

I didn't understand his comment as suggesting that chihirochild doesn't have a right to feel what she feels; rather that he was exploring what might be informing her response and how this internal experience might be impacting her behaviour. This is not the same as saying she should not feel something or that her response is faulty in some way. The fact that chihirochild did not find that exploration/suggestion helpful and wanted support of a different nature is totally valid, but this does not mean that the therapist's comments were invalid.

[winter4me]

& trust you are on the receiving end of small kindness' from those around you (there is pleasure if giving, so allow others to give to you) And maybe that didn't need to be said. You are doing all that you can. I think it is time for your T to respond by being open to hearing your thoughts and feelings without judgement, without labels, to simply be there and accept, offer what comfort and guidance he can---
You know what you need right now. Your T needs to let you guide the way.