[East17]

I didn't know whether to just put this in the 'Dear T, I need to tell you something' section, but felt I would like feedback, so am creating a new thread. Please bear with me on the length, I wanted to capture the detail in order to get appropriate feedback.

I finally plucked up the courage to email my T and tell her that ever since we resumed sessions after Christmas, things have seemed very disjointed. The last 3 sessions she didn't seem fully present with me, I felt I've lost the connection with her that I had a few months ago, that I miss it and wasn't sure how to get it back. For a while I thought we were becoming quite close and the trust I had in her was growing, but the last few sessions it's felt like there's a distance between us.

Her reply was that she was sorry I'd been feeling that way, that it wasn't anything I'd done at all, to bring about any change, perceived or otherwise, in our relationship. She said a likely explanation was that I may have intuitively picked up on her change in energy as she is going through some quite serious health problems and has been for some time. T ended by saying that she hoped I didn't feel she had abandoned me, because she hadn't and never would.

My reply back was I was sorry she was going through serious health problems and that I felt bad for not having realised (I was previously aware of an underlying health condition), I felt selfish for having brought my concerns up.

Her last reply was that I shouldn't feel bad, she thought I was brave to have brought up how I was feeling and felt that was progress. But then T quoted BACP guidelines at me, saying that the focus of our sessions should be on me not her and if we find that difficult then we would need to discuss the best way forward and hopefully we can leave judgement and blame out of it for both our sakes. We agreed on a phone appointment next week to talk.

I do understand about the ethical guidelines of the relationship between client and T. That the client isn't supposed to 'care' about the T because they have a duty to look after themselves through supervision etc. But why does it have to be one sided? She's said she cares about me, so why can't I care about her?

I feel almost as though T realises she's overstepped the boundaries in some of the things she's said to me in the past and is now trying to reign things back onto a more professional basis by quoting BACP guidelines to me. Do I try to pluck up the courage to discuss this with her? I guess I'm afraid that all the things she said in the past weren't really genuine and were just said to make me feel better about myself.

[SalingerEsme]

It's to your credit that you're interpersonally sensitive, and she should quote those guidelines only to herself. She is the one who needs to abide by guidelines, and quoting them to you rather than gently steering the ship seems to be much more significant than being human in a few disclosures.

[LonesomeTonight]

Originally Posted by SalingerEsme

It's to your credit that you're interpersonally sensitive, and she should quote those guidelines only to herself. She is the one who needs to abide by guidelines, and quoting them to you rather than gently steering the ship seems to be much more significant than being human in a few disclosures.

I agree that she shouldn't have quoted the guidelines to you for those reasons.

It makes me think of a time with my former marriage counselor, for whom I had strong transference. I learned at one point (long story) that his wife was sick (she eventually passed away during the time we were seeing him). And he'd had to take some time off, like last-minute cancellations, things like that. I think that's what led to this conversation?

But I was expressing care toward him. And he said: "You're not supposed to care about me. Therapy is a one-sided relationship. The care is only supposed to go one way, from therapist to client. If you care about me, then I'm doing something wrong."

And that really upset me. Because it also made me feel like *I* was doing something wrong. I said how I care about a lot of people and how he's helping us, so isn't it only natural that I care about him, too? We ended up having a phone call about it, and he was saying how it's on him, not me. But it still sort of felt like my being caring was bad (which dredged up childhood stuff with my mom saying I cared about certain people too much, but that's too much to get into here). It felt like a mini-rupture in the relationship.

Then there's my current T (Dr. T), where sometime in the first year of seeing him, I said I cared about him (I forget the context, maybe when he hurt his back?) And he said, "How can you care about me? You don't even know me?" And I said how I care about a lot of people I don't know that well, like neighbors, people in general. But it felt very invalidating, like a person had to meet certain criteria in order for me to care about them.

He has since changed his tune on that (I've now been seeing him for about 3.5 years, and he's seemed to grow warmer over that time). I referenced it at some point, and he said how he understands my caring about him and also how I do know him quite well at this point, maybe not who he is outside of therapy, but that otherwise I know him well. And I've expressed concern about his well-being and things like that more recently, and he's thanked me and been appreciative. One comment he even called "heartwarming."

So I think it's completely natural that you care about your therapist. You spend presumably at least an hour a week talking to her. You've shared some of your deepest thoughts and feelings. She cares about you. So caring about her health and well-being seems normal. Honestly, I would almost find it stranger if you didn't care at all. But I get the sense, from what Dr. T has said, that it's more common for clients to be like that, to see their T more of a hired professional doing a service than as a person.

I'd talk to your T more about how you're feeling and how this is affecting you and your therapy. I suspect that what you said might be part of what's going on here, that she realizes *she* overstepped some boundaries, so she's citing the BACP code. Rather than taking responsibility for what she shared. I hope you're able to talk to her about it and come to a good place again in your therapy with her.

[Oliviab]

I don't think she necessarily did anything wrong in quoting those guidelines to you. If she did that in order to hide behind them and justify unilateral decisions, then yes, that's problematic. Or if she expects you to somehow self-monitor so the guidelines are not violated, that's problematic, too, because the guidelines are for HER, not you, to follow.

But I like to be informed of such things, especially if my T is using them to inform decisions about my treatment. I don't think one person in the relationship can accurately determine whether something is useful in therapy or not, so putting the guidelines out there in order to have a conversation about it and to negotiate boundaries is entirely appropriate, in my opinion. At least, that's how I want my therapy to work--more transparent and collaborative and less my T operating with all these secret rules behind the scenes.

I am not a huge fan of the "this is supposed to be all about you, not me" stance in therapy. If it's going to be a real relationship, it needs to be bidirectional (which is not to say there should be an equal amount of disclosure or caretaking in both directions). But, it's ok to care about your therapist. I think it's healthy, in fact. It becomes problematic when you care MORE about your therapist than yourself, when you caretake to the extent that you subjugate your own needs in favor of theirs. Making therapy all about the client is both disingenuous (of course therapists have needs) and it doesn't give the client the opportunity to practice asserting their own needs in the face of another's needs. Some people may need therapy to be all about them in order to do the work, but I don't think that's everybody or all of the time.

In this instance, I think her disclosures were (likely) helpful, although only you can be the judge of that. I encourage you to talk to her about everything above. Working with her to figure out how both of you get to be human and have needs, and yet keep the majority of the energy focused on your needs, could be therapeutic. Caring about your T and also not subjugating yourself could be therapeutic. And as long as you're talking about how all of this makes you feel, then that is about you and your work.

[nottrustin]

I do not understand why a client is not supposed to care about a therapist especially since we see them so frequently. Years ago T want feeling well and I said something and she replied that I was not supposed to mother her, she was supposed to care for herself. I explained that it wasn't that I was trying to take care of her it was just that I care. I saw her more often than I saw anybody else who did not live in my house.

The one time current T has ot cancel because of illness. I told her to take care and make sure to get lots of rest. I prefaced it with I know I am not supposed to mother her and I promise that was not my intent. She thanked me for the non mothering concern. She understood it is because she cares. She has also said she care about me on a few occasions. So maybe it is normal to discuss such things. She is a huge advocate of naming things though.

[Rive.]

You can absolutely care about her but the focus of sessions / therapy ought to be on you. Not her or her health issues. That is not what therapy is about. I guess that's what she was reminding both you and herself

[elisewin]

I think it is a bit weird of her to tell about her health problems (of course you care) and then quote some guidelines. Either or, not both. Such a mixed message. She seems confused.

About the caring.. natural and normal. I deeply cared about my long term T too while in therapy, and I got to know her pretty well.

After the long term T I have had some short time counselors to discuss some limited issues, and to be honest, I couldn't care much less what's going on in their lives. I don't care to hear, I want to use the time on what I want to bring up. It couldn't be any more different than it was with my ex long term T

[Salmon77]

I don't think it's accurate to say you're not supposed to care about your T as a person. A lot of therapy is about having a relationship with a person, and part of being in a relationship is caring about the other person.

That said, the purpose of the relationship is the benefit of the client. Reading you the guidelines was maybe a clumsy way to do it, but I would take that as your T's attempt to let you know that it's not your responsibility to worry about her health or make allowances because of it. Her health is her problem and she needs to do her job well regardless.

Quoting guidelines is crass and unhelpful. As others have said, it is also irrelevant since the professional guidelines are there to guide her practice, not to manage your behaviour. I would challenge my therapist if she did this during a communication with me and actually I can imagine it leading to a rupture. Her referring to guidelines strikes me as a cold and sterile action - a harsh way of cutting away the warmth from the relationship.

Did she explicitly tell you that you aren't supposed to care about her? I don't recall reading this in BACP guidelines and since she seems so fond of using them, I wonder how she came to this conclusion. If she didn't explicitly tell you this, it might be that you are responding to something which she didn't actually say. I can imagine that in your position, I would feel scolded and infantilised and so I might hear her telling me that I shouldn't have needs or feelings (a common message from my mother). As such, I would be caught in a transferential exchange where I am not hearing what she is actually saying, but rather what I am used to hearing.

So, it might be worth checking out with her what she meant. I often say to my therapist something like, "When you said abc, I heard xyz" and this helps us to work out how, and to whom, I am responding. After all, there is a big difference between "the focus of our sessions needs to be on you and your needs, East17" and "you should not care about me".

I would also tell her that if she needs to revisit guidelines, the place for her to do that is supervision or CPD sessions.

[Brown Owl 2]

It seems strange to me that your T quoted those guidelines at you. Her serious illness has impacted your sessions, sounds like she hadn’t realised that was happening, but she apologised to you when she realised it was, and explained to you why she hadn’t been her usual self, and you gave a normal human response to her. I would have expected her to reply to your response something like: no need to feel bad or selfish that you brought it up, let’s see how we can move forward and regain our connection, let’s be reflective together about this. I think a more relevant bit if the BACP guidelines is her responsibility to know when she’s not fit to practice.

[corbie]

Originally Posted by East17

Her last reply was that I shouldn't feel bad, she thought I was brave to have brought up how I was feeling and felt that was progress. But then T quoted BACP guidelines at me, saying that the focus of our sessions should be on me not her and if we find that difficult then we would need to discuss the best way forward and hopefully we can leave judgement and blame out of it for both our sakes. We agreed on a phone appointment next week to talk.

I do understand about the ethical guidelines of the relationship between client and T. That the client isn't supposed to 'care' about the T because they have a duty to look after themselves through supervision etc. But why does it have to be one sided? She's said she cares about me, so why can't I care about her?

I think that therapy guidelines are often used by therapists for their own protection, while being able to pass it off as being in the client's 'best interest'. Or used in otherwise misguided ways. Like, conflating 'care' with 'take responsibility for'. I agree the latter should be discouraged (not in a way that implies the client is doing something wrong, mind you), because feeling responsible for things that are in fact established (in therapy guidelines in this case) to be someone else's is generally not good for one's mental health. But caring for people important to us should be a normal part of human existence, and I don't see how trying to keep it out of the therapeutic relationship would be in the clients best interest.

Likewise, yes the focus should be on the client, but once the therapist's **** does leak into the relationship (which I don't think is entirely avoidable, unless maybe it's one of those therapists consistently pretends to be a piece of talking furniture), I don't see how subsequent attempts to deflect discussion are in the client's best interest.

If my therapist is acting in weird or hurtful ways, I want to have some sort of an idea why that is, and I want to have some degree of agency in the situation (other than escaping it altogether). Obviously, endlessly venting about stuff is not OK, the depths of the therapists psyche aren't the client's business, but to the extent of 'yes there's this thing going on' or 'yes that stuff is difficult for me to hear, which is fine but maybe give me a warning before you bring it up' or stuff like that, that'd seem only natural to me and could be helpful in a therapeutic way I think.

This is of course largely based on my experience with my ex-T. She'd insist that I'm not responsible for her feelings and that it's good when I'm angry and whatever, yet whenever I tried to bring up that something she did or said was hurtful, she'd get defensive and shot back with 'but you', implying that I also said something hurtful or it's otherwise so difficult with me. But then when I'd ask her to explain what exactly was setting her off, because maybe I can do something different if only I knew what the problem was, she'd go back into hiding behind 'it's not your responsibility'. Which simultaneously made me feel like a foolish little child, and stripped of any means of defending myself. Which is why she's not my therapist anymore. And no, it wasn't my responsibility, but I was still the one getting hurt, and it'd still have been worth trying to see if the relationship was fixable, and it would have been infinitely more helpful to have specific and so easier-to-change elements of my behavior pointed out than being left with the knowledge that something in how I came across was so off-putting that even this person who claimed to want to help and was supposedly equipped to handle anything couldn't cope with it. Of course, especially that last assumption clearly wasn't true, and she did share some, so I do have some theories as to what might have been the problem, but not knowing still sucks. But of course understanding her point of view was 'not what I needed' because it was all just transference. Grrrrrrr, still angry when I think about it.

I wonder what'd happen if therapists stopped buying into their own ********. They are only human, which they're fond of reminding clients mostly when they've undeniably ****ed up (a lot of them not even then, as I gather from these boards). But it's just as true the rest of the time. So maybe show some respect towards clients and be upfront about that from the start. I reckon most clients could handle that better than being let down (and then maybe even blamed for having unrealistic expectations ).

[stopdog]

I agree. The guidelines are more to protect therapists than clients no matter how those people try to sell it

[Favorite Jeans]

Sometimes it’s helpful to imagine how they could’ve said it better.

I think her disclosure about her health issue was important because it tells you that you’re not imagining things, you are perceiving this change for a reason.

The refocus to your needs is also appropriate, that’s why you’re there.

Reading the guidelines was clumsy, as others have observed. They’re there for her, not for you.

However she can explain that while the feeling of care can go both ways, the preponderance of the session time and the focus topic-wise is always about you and your needs. Since you’re both human, her issues are necessarily going to surface sometimes. Sometimes your feelings about her issues (eg if now you’re afraid she might die) might need time, but that’s still really about your feelings, not her issues.

If you feel chastised by her sharing the guidelines (as though she was reminding you not to step out of line) you should probably tell her that and clarify that the guidelines are not meant to direct the client’s behaviour.

[East17]

Thank you all for your responses. It's all academic now.

Today I received a message from T cancelling tomorrow's session and saying she wasn't able to offer an alternative at the moment. T did say she'd be in contact when she was able to offer support again (but didn't say how long that was likely to be).

We'd been working together for just under a year. I swapped to her after my previous long term T also abruptly stopped working.
Beginning to think I'm some kind of curse, or my issues are just tfm.

I'm gutted.

[SlumberKitty]

HUGS @East17 that's horrible. Your T shouldn't be able to just up and say the appointment is cancelled and no idea of when she is able to pick up the work again. That's ridiculous. I am outraged on your behalf. And I'm so sorry you are going through this.

[East17]

Originally Posted by SlumberKitty

HUGS @East17 that's horrible. Your T shouldn't be able to just up and say the appointment is cancelled and no idea of when she is able to pick up the work again. That's ridiculous. I am outraged on your behalf. And I'm so sorry you are going through this.

@SlumberKitty Thanks for the kind words. Maybe I will feel better about it in time, but right now that message coming so soon after an email saying she hoped I didn't feel she'd abandoned me, because she hadn't and never would - has just left me feeling so worthless.

[Favorite Jeans]

Originally Posted by East17

Thank you all for your responses. It's all academic now.

Today I received a message from T cancelling tomorrow's session and saying she wasn't able to offer an alternative at the moment. T did say she'd be in contact when she was able to offer support again (but didn't say how long that was likely to be).

We'd been working together for just under a year. I swapped to her after my previous long term T also abruptly stopped working.
Beginning to think I'm some kind of curse, or my issues are just tfm.

I'm gutted.

Is she cancelling because of her health problem, do you think? It doesn’t feel less horrible but you can feel assured it’s really not about you or your issues. That would be my read here. Sometimes you think you can work through an illness and suddenly realize that you just cannot.

Whatever the reason, I’m so sorry this is happening to you.

[elisewin]

Could it be her health that she has to cancel? She has probably cancelled all her clients. I'm so sorry for you.

[confused_77]

To me her reaction was actually quite appropriate. She might have mentioned something about her health before without realising it will impact you. When you approached her about the connection with her being lost she was being very honest with you and explained why her behaviour was changed. She assured you it had nothing to do with you also quoted bacp to explain that the goal/focus in therapy is on you and she has her ways (ex supervision) to get her needs met. I think all she was saying is that you don't have to be mindful of her health because this is your time and while she might be more withdrawn/changed she doesnt want you to compromise your therapy because of that. Obviously its very natural to worry about someone we care about but to me all she was saying was: 'its your safe space, time and i am here for you'... 'and if you worry about me too much it takes away from focusing on yourself'

[nottrustin]

I just reread the original post through a different lense than I did the first time. I wonder if the reason she cited the regulations because you were blaming yourself for not knowing about her medical issues and bringing it up. Perhaps it was her way of saying that you would know because the "rules" of therapy are such that she would not tell you she is sick. To tell you she is sick would make the appointments about her. So she doesn't want you to feel sorry for asking.

As far as now canceling your appointment maybe she realizes that she wasn't able to conceal her issues as much as she thought she was so rather than allowing it to effect everybody's therapy she is taking time to heal.