[daisydid]

So about a month ago, I had a major breakthrough in my work with my therapist. It’s been very trying emotionally, but my therapist and I agreed that this was my brain’s way of signaling that I was ready to delve into some trauma work that I’d really struggled with in the past. My therapist knew the magnitude of the effect this would have on me, so he did many things recently that I would view as beyond the traditional scope of therapy. Here’s everything I remember:

• Proactively offered me an extra session
• Gave me permission to reach out over the weekend if I was struggling
• When I texted him Sunday evening after a breakdown, he insisted meeting with me Sunday night
• Drove me to the hospital when deemed IP was necessary
• Sat with me in the waiting room until I was taken back to a bed
• Drove to my house to pick up my husband and then drove him to our car at the office
• Tried multiple times (unsuccessfully) to try to meet with me while I was IP.
• Once out of the hospital, met with me for two 2-hour sessions to process as much as possible
• These sessions were from 7pm-9pm on consecutive days
• He chose to only bill my insurance for 1 hour for these sessions.
• Followed me home the night that I drove myself to session
• Walked me to my car when my husband drove me the next night

Everything that he did was either his offer or at his insistence. Like I argued against him driving my husband to our car, because I was afraid about what they would talk about and I was unable to be present. Overall, I feel both a deep gratitude toward my therapist for being invested in my safety and success and a profound sense of shame. I don’t feel like I’m worth all of the personal sacrifice on the part of my therapist. He has said multiple times that he isn’t doing anything he doesn’t feel comfortable doing, nor would he do any of what he has were I not clearly dedicated to putting in the work in my therapy.

There’s also an element of this where I’m concerned that my therapist is not taking care of himself in all of this. I know that he doesn’t have a family at home (like partner, children, etc.) so I wonder if he’s more willing to put his work first when someone else might not have that ability. My father was a workaholic and I saw the profound negative impact that had on him, so I don’t want the same thing to happen to my therapist.

I’m wondering if I should bring up my concerns about the situation in session. Up to this point I’ve been continuously appreciative, and at times argumentative that he’s doing too much. We did touch on the shame since this evening, but that didn’t really allay my shame. I guess other than support and understanding, I’m interested how you would handle this situation or something similar. Thanks for reading this novella if you’ve made it to this point.

[Favorite Jeans]

Do you feel like he’s respecting YOUR boundaries?

Like I argued against him driving my husband to our car, because I was afraid about what they would talk about and I was unable to be present.

[He] followed me home the night that I drove myself to session

Because this wouldn’t be okay with me at all.

It sounds like he is insinuating himself into your life and undermining your autonomy.

[Quietmind 2]

While my therapist hasn't done the same things, she works hard with long hours, yet does even more work outside direct client work.

I too have had concerns because of stuff I know about her over the course of our therapy. Plus I've worked really long hours myself out of a sense of responsibility in a demanding field and have burned out twice.

I decided to be relatively blunt about my concerns after prefacing I know it isn't my role to take care of her.

I asked some brief yes/no questions about her supports -- with the disclaimer she can of course not answer.

I explained my thinking, then asked how could I show care since I obviously aren't a friend etc -- she knows I'm huge on showing care and appreciation to friends, and I correctly pinged she has some tendencies towards self sacrifice. She told me the best thing I could do is to take care of myself the best that I can.

Recently, I chanced upon a short interview she did (she's quite well known in my local area, I wasn't hunting for anything) where she had mentioned working long hours out of a deep sense of compassion, although that ups the risk for burnout. She was also explicitly thanked in the interview for using her personal time in her already busy schedule to run some rather time intensive things.

So I saw her for therapy and as we were wrapping up, I briefly referenced the interview and remarked she hasn't seemed to take a break for quite a long while as we've an agreement she'd try to give me some advance notice for breaks. She then told me when her next break would be and how she hopes she'll take the break rather not.

Before my burnout, she would encourage me to take a day off work or even a week off, but it was really difficult for several reasons due to the nature of the job. So yeah, I cheekily quipped she better get that break and rein in her self sacrifice schema.

[unaluna]

Its been almost ten years now, but my t offered to drive me home from a hospital stay that was not t-related. I was like, dude, a taxi will get here faster! But it sure felt good knowing i had options, which i think was the point.

[LonesomeTonight]

I understand these feelings. A couple nights ago, I was in a bad place and texted my T, asking if there was any way we could talk. When I had asked for that in the past (in particular, one time nearly 2 years ago, when I was in a really bad place--though we did have a couple email exchanges then), he'd said no. And he's mentioned in the past that he doesn't do unscheduled phone calls unless it's to briefly assess whether a client may need to go to the hospital. Though one other time he said he'd be willing to speak briefly on the phone sometimes (this was pre-pandemic, so Zoom/video chats wasn't a thing yet).

When I texted him Wednesday night, I said how if the answer was "no," that was fine, and I understood. (And that I knew I'd be charged for his time.) Maybe 15 minutes later, he texted back and apologized that he'd been away from his phone. He said, "Zoom?" I said that worked. A few minutes later, at around 8:45 p.m., I was having a Zoom session with him. We ended up talking for more than a half hour. He really helped me to get into an OK place and I was very appreciative.

But in thinking about it since then, I feel sort of weird that he was willing to do that for me, when it normally would have gone against his boundaries. He has loosened some boundaries in general since the pandemic, like he's said he isn't charging for any client emails, no matter the frequency (he generally charges for long replies, like more than a paragraph or two). So maybe this is just something he's willing to do now but wasn't willing to do before. Or it may have been because he knew I was alone (out of town) vs. at home with my husband and daughter, so was more concerned about my safety.

What's sort of ironic about it is that in our previous session, the topic of therapists who work in the evenings came up briefly, and my T said he doesn't know how they do it and that he wished he had that sort of stamina. Well...

I think I may need to address it with him briefly today (I did email him a thank you after the Zoom call, and he responded kindly to that). Daisy, I think it would be good for you to bring up as well.

[ArtleyWilkins]

I've had periods of crisis when my therapists or my pdoc went above and beyond their usual. It was only for those brief periods of time, and I appreciated their concern for my safety and well-being in those moments.

My guess is that it is a temporary additional attention/help that he is willingly offering. Sometimes it's hard to just accept that support with a simple "thank you" because we so often put ourselves last.

[daisydid]

Originally Posted by Favorite Jeans

Do you feel like he’s respecting YOUR boundaries?

Like I argued against him driving my husband to our car, because I was afraid about what they would talk about and I was unable to be present.

[He] followed me home the night that I drove myself to session

Because this wouldn’t be okay with me at all.

It sounds like he is insinuating himself into your life and undermining your autonomy.

Oh hmm this is a really interesting perspective that I hadn’t considered. I guess there’s an element of all of this that’s important for consideration that pretty much everything that happened was while I was in crisis. My therapist (and I) knew that I was going to be admitted when he drove me to the ER. So in a sense I guess my expectations for honoring my boundaries were diminished versus what I would normally find acceptable. Before I agreed to the arrangement that evening the other very real possibility was that my therapist call the authorities to have me put under an ECO. Logistically what happened was better for all parties. I did make it explicitly clear that if my therapist talked about anything related to my care with my therapist that he’d be losing his license. My husband actually tried (without malice) to talk about me and my therapist didn’t engage so while I didn’t love the situation, it was nice not to have to spend $20 on an Uber, which is what the norm for my husband and I in this situation.

As far as following me home, I did not argue this. We had agreed on a safety plan prior to that session and my therapist felt like I didn’t follow what we agreed upon by me driving myself to session. Overall, though, I feel like at minimum this would be a good conversation to have with my therapist. Thank you for your perspective.

[*Beth*]

If I were in the position you're in, daisy, I would feel like all sorts of boundaries are being crossed. I would be concerned that so much extra time and attention outside of the therapeutic environment would be causing dependence - ultimately, possibly resentment - for both of you.

[nottrustin]

I am so thankful you therapist made sure you were safe and made sure there was no added stress for you. I would have felt awkward and probably tried to resist because I would feel horrible for causing her extra work and feeling like an inconvenience. However, I would also be appreciate and cared for.

Long term T once offered that was WAY beyond normal boundaries and it is felt awkward. She talked me into it and told me why. She also reminded me that she had always said if she offered something, she wanted to do it. She would never offer something that she did not want to do. So we took her up on the offer. We were really appreciate and it made a very difficult situation much easier for out family.

[LonesomeTonight]

So, following up a little on my post because I met with T today. I asked him about why he opted to do the evening session with me, if it was because I was away from home and by myself. He said that was part of it, but also that I didn't usually reach out like that. And in particular, the fact that my last text to him just said, "Help?" made him concerned about me. So it made sense why he opted to do something he might not normally do.

So I didn't further address the fact that I felt awkward/uncertain about his going beyond what he would normally do. Because it seemed like he explained the reason. And it didn't seem like he was put out by it at all. In fact, he seemed warmer to me today than usual. I did thank him again at the beginning and end of today's session, too, and said that it meant a lot to me.


I'm trying to think of it as, maybe he was glad that he was able to be there for me and help me through a difficult evening. So maybe you can try to look at it that way, Daisy? That maybe he's happy to provide the support, to feel like he's helping you?