Couch 226--CCXXVI Couch

There is something about those. I think of ants. Like the symmetry serves an evolutionary function, thats why it appeals to us.

I'm struggling a lot and I hope some of you understand.

Warning: Very long.

I feel like there's a huge inherent power differential in therapy. Especially when the client has a lot of trauma and attachment wounds from formative years. Something my T said a few sessions ago, and another much more long ago incident is really bugging me.

Long ago, I brought up the power differential in therapy using various examples. I said she could involuntarily ward patients, and that she sets the session frequency. She disagreed, saying there isn't a power differential, and patients can ward themselves voluntarily, as well as choose to book her "everyday" (hyperbolic, definitely not possible) if they wanted. False equivalences in my view. Because involuntary warding has been described by many psych patients in my country as traumatic. And there is no effing way I could book her every week, not even every day. I spent an entire year with once a month sessions despite needing to see her more often, as some of might recall.

Anyway, somewhere down the line, she said no to a request of mine, citing it's because patients are vulnerable. Now isn't that a direct contradiction to "we're equals, there's no power differential"? Of course I respected her no, I just wish it wasn't a BS reason. It would have been completely OK if she's just not comfortable. But don't disguise it as for my protection because I'm vulnerable. She even said I could find other therapists who would have said yes (and I know from WordPress and here, some would have said yes.)

Anyway, some time ago she brought up eventually spacing out our sessions more at a certain specific point in time. I reacted badly. She said I'd feel differently when the time came. First, I don't think she ought to assume that even if she does have individual clients in long-term therapy where this was accurate, because I'm not them, and every client is different. For all she knows, maybe some felt rushed out and didn't tell her. Second, if it's true that I could decide session frequency like what she claims, then shouldn't it be wholly up to me on spacing out sessions?

Yeah I'm triggered and angry.

(SD, I can guess what you'll say and I respect it too.)

QM - some thoughts:
There is a huge power differential between parents and children. There is history. But t and client are partners, and really there is no history - to me, every meeting is like exercising or massaging a muscle; it is done, then it is over. The next meeting has no history behind it, therefore no power differential. Each meeting is freely chosen by both partners, or else it doesnt exist.

You have freed yourself of so much of your history (by moving out). What is calling you back to repeat it now, where it doesnt belong?

Hmm, good point. I feel it's because I'm currently struggling a ton with unrelated to therapy triggers, so I've lost my adult objectivity.

Last therapy session was intensely painful as we are working with the alter who holds religious abuse. I myself have moved past and healed this in myself but that alter is frozen in time, as T explained. She gave homework.

I've nothing against religion, it's just that my family twisted religion horribly. To the point I believed g-d didn't just sanction the abuse, g-d approved of it. My dad told me the day I moved out that his abuse is his g-d given right and that he should have been harsher.

I got flooded when I attempted the homework so I stopped. Found another way. Unrelated and related things happened, I got triggered a bunch of times. Everything felt unsafe, I felt I was sucked back into the past.

I caught a glimpse of my innocence as a child. It broke me? (Felt that way) Everything became so sinister, including T. I don't really have words. It's like a horrible nightmare.

Today is a funny day. I am painfully aware that it is my best friend's son's birthday.
I do not know him, and as Chris passed away in 2007...this should not feel like this.

I am all too aware that in the aftermath of hearing about her death, realising that her son would face his first birthday without his mother so soon was the thing that made me/allowed me to cry.

Hugs, QM... I'm sorry you've been so triggered lately.


I agree that there is a power differential in therapy. My T claimed at one point that the client has the power, because they can leave anytime. While I countered that I could also be terminated anytime. He said he wouldn't do that (unless I threatened him). To which I said he still theoretically could. Or he could change the rules (say, regarding outside communication) or how he acted toward me such that I would *want* to leave. He understood my point.

Hugs, Lost...

You hire them, you can fire them. They can quit. It is no different than a dentist or accountant.

Yeah, I get that when I'm in adult mode. Definitely not when my brain gets weird. I have to keep reminding myself I'll be ok whatever happens, if she quits, if I fire her etc.

Hugs. I sent an angry email while crying, which I regret. Don't recommend it. I'm usually careful with my words, and it's not fair to her that I was harsh. Being triggered doesn't excuse me.

She wrote back and among other things (such as pointing out my harsh tone, acknowledging there's a relative power differential), asked me why I'm so suddenly so very upset.

I think I feel powerless relative to her. That I'm "too attached" and "too dependent/needy" even though I know I'm an adult. I know of course she is within her rights to terminate me, and it's also true I can choose to leave... but yeah I get horribly dysregulated when I think about spacing out sessions etc. Then I am flooded with shame because that's proof I'm too attached, already too dependent and needy etc. So I then feel anger at my emotional powerlessness, so more shame. Horrible loop.

I've always been ashamed of coming across as "too dependent" in therapy especially since I'm not just an adult, there's a stigma on needing any therapy, much less long term therapy.

I was feeling bad and asked BF for reassurance. He said confidence is sexy. I told him that wasn’t helpful. He told me that I am smart and pretty and am full of potential, that I should be happy. I told him it doesn’t work like that.

I’m afraid he’s never going to get this.

I’m afraid that one day I’m going to get seriously depressed and he won’t be able to tolerate it, that he’ll say I should have warned him even though I have.

Hugs, QM. I'm glad she acknowledged the power differential. I've sent angry/harsh emails before, too--and my T has responded...harshly at times, so I've learned to do my best to avoid them. But it can be difficult when you're feeling dysregulated to just sit there with the feelings.


I get what you mean also in the fears of being too attached and too dependent. I'm intending to go back to twice a week sometime in the next couple months, and it scares me a bit. And I know Dr. T is going to go on vacation (or at least take time off) at *some* point, likely in the next couple monts, so I worry about that. He's learned to never bring up reducing sessions to me (even something like, "When you're ready to reduce sessions," as he did a couple years ago when I was twice a week) because it really triggers me. Could you ask your T not to mention reducing sessions, that you'll bring it up when you're ready?

Hugs. Sounds like he doesn't understand, but is trying to be supportive if what he said wasn't in a dismissive tone.

I'm wondering if he would be willing to read up about depression, as well as how to validate and support.

Hm, yeah, I wouldn't find those things to be helpful either. Because then it implies that there's something wrong with you for not feeling happy.

I think it's really that he just doesn't understand depression (and other mental health issues), not that he's intending to be critical. That he thinks he's being helpful and doesn't understand how he isn't. If you had a different therapist (who wasn't negative about your BF), I'd suggest considering taking him with you to a session. But pretty sure that would be a disaster with this T...

I wonder...is he the type who would be willing to read up on something? Could you find, say, an article or two online, maybe even a book, that help describe what you're feeling? That how it's not like you can just snap out of it because someone compliments you or says you should be happy? Just a thought...

I really find it tough to check my tone when dysregulated. I was also attempting grounding, chores etc and it was like wave after wave of distress. What I felt to be "blunt without my usual extensive caveats and disclaimers" was definitely not how it landed. She said it was harsh and can trigger defensiveness in people. I wonder a bit if she thinks I'm this way with everyone... tbh no, only with her.

About therapy breaks, does Dr T do anything to help you with them? I'm glad he's learned not to bring up reducing sessions.

I think I can ask my T to avoid bringing it up, though I don't know if she'll agree. She wrote something about how session frequency needs to depend on if it is helpful or if that is reinforcing dependency. Which I agree, but you know, the dreaded "am I too dependent already?" I think I'm capable of bringing it up when I'm ready but what if I never am ready? I guess part of my issue is how I've pervasive self doubt.

It does sound like a mismatch. Tell him what you need when you want reassurance. What does that look for you? A hug or hearing " it's going to be okay" .

I was also going to suggest maybe he could read up about it too or watch a video- I love Andrew Solomon's. "Depression the secret we share" on youtube.

You could be happy. It's okay if you don't feel like a perky cheerleader right now.

Hugs, QM. I so relate to this that I bolded. I'm pretty sure that's a big part of why I'm so stuck on the whole possibility that L thinks I'm stalking her because of the psychtoday profile thing I've been on about. I'm afraid she thinks I'm overly dependent, far too needy, etc etc and feel ashamed that I do rely on her/therapy and also feel a lot of shame that I haven't "got myself figured out yet" at going on 59. Shame at feeling so broken this late in life. That I can't just magically be some better version of myself. Like I'm doing life wrong.

I got some lemoncello (that is how the package spells it) almonds at costco today -they are okay. I would like them tart-er -they are a little too sweet for me. They have a cult like following and I wanted to see what the fuss was all about.

Do you find "it's going to be okay" reassuring in areas where the person has absolutely no idea whether it will be or not?

When that has been said to me, by someone who would hardly know whether things would be okay or not, it hasn't been reassuring about the situation. It's been reassuring more as an expression of caring or confidence in me.