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Default May 12, 2018 at 08:43 PM
  #21
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Originally Posted by ByStarlight View Post
I don't agree. The OP is self-injuring to the point of needed stitches (and exploring the option of self-suturing). I believe the OP's therapist has admitted treatment failure and is doing the only ethical thing he can do at this point.
What if forcing termination and taking the decision of out OP's hands ratchets up the disregulation and the SH urges? What if this is a secondary consideration, and the therapist's main concern is avoiding liability or complications?

Also, failed therapy can be traumatic, and just blowing it up and pushing the client to a new therapist could potentially begin the cycle again, and expose the client to the same risks and dysfunction all over again.

I've been in a no-win therapy situation. People said it was ethical for the therapist to bail out. No, it wasn't. Nothing about it was ethical.
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Default May 12, 2018 at 08:53 PM
  #22
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Originally Posted by growlycat View Post
I think your t is putting too much faith in dbt. I don’t think it cures anyone of self harm behaviors, especially intelligent people who may fully understand why they self harm. It isn’t worthless to try but your t needs to temper his own expectations . You ask a great question. What if dbt does not stop your self harm. Will t still see you if after a round of dbt you still sh? Better to know now.

I don’t think one necessarily needs dbt to curb self harm just a skilled therapist
I asked him that question and he said we'd cross that bridge when we get to it and pointed out that I was expecting the worst and catastrophizing (which I was... I was sobbing "what if it doesn't work and I can't be fixed and I'm broken forever" type stuff)
He's right that I need to help with regulating emotions and it's exactly the kind of bpd stuff that DBT is really effective for. There are a lot of reasons for my self harm, it's not one simple answer, but the intense irrational emotional responses to things are definitely a large factor and I'm very aware that I do it, and I knew that well before I started seeing him. Unfortunately being aware of it is not the same as being in control of it (though it is a helpful first step).
I really do think DBT would be helpful and that those skills would be useful for me, or that it's at least worth trying. But, as I said, I have these strong emotional responses and even though I logically agree with him that a DBT program would be a good idea (though I don't necessarily think I should stop seeing him while I do it), and I know that he cares and isn't abandoning me, it still [I feels[/I] like rejection and abandonment and my emotional response is to that, not to what I believe intellectually, and it's a really really strong emotional response, and when I act based on that emotional response I do stupid things like end up in the ER getting 50 sutures.
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Default May 12, 2018 at 09:08 PM
  #23
I'm so sorry this has happened to you, LabRat. If I was in your situation with a therapist I would feel frightened and very frustrated. Therapists definitely won't go past their personal area of experience and professional comfort - at least an ethical one won't. It seems cold-blooded, but I was informed by a therapist many years ago that therapists fairly commonly refer clients out to someone who has more experience in a certain area of psychology and behavior - and is interested in those areas. I could be wrong, but I suspect some therapists just don't really want to work with certain types of behavior, which could be for all sorts of reasons.
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Default May 13, 2018 at 08:39 AM
  #24
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Originally Posted by BudFox View Post
Since he is pretending to be a doctor... if we extend the analogy, this outcome is like botched surgery or treatment failure. But he's off the hook with a referral? I don't see how any of this is ethical.

I got the same "i'm abandoning you because i care" routine. I was told I should get with a new therapist asap and this would help me. And then we'd be able to work together again. And she recommended DBT. All of these things turned out to be lies or just plain nonsense. I dug myself out of the hole. It is possible.
Therapy, the reenactments of unconscious family dynamics, the re-traumatization and new traumatization, and my own possibly deluded determination to "get to the bottom of things" did eventually lead me to the bottom of things, and the pit.

But there, stuck, the T was of no help. In many ways she just kept putting me down when I was trying to get out. It was me in a "role" or something that she didn't want. An authentic if somewhat unsocialized/uncivilized me, when she wanted a "helpee" to help her with her self-image as a "helper"? I don't know, maybe it doesn't matter, she terminated because she didn't have the emotional resources to continue.

Digging myself out of the pit, I have gotten a lot from social support on occasion. But I haven't needed it from just one person to whom I was "attached".
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Default May 13, 2018 at 08:42 AM
  #25
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Originally Posted by LabRat27 View Post
Trigger warning for self harm, mention of suicide

A month and a half ago I wrote this on here:

"I've been seeing my T for a few months now and was getting to the point where I was going to be talking about things I've never talked about before. I knew that if I did that and then he referred me out, it would feel like a rejection and I would be devastated.
So I pretty much told him that. I said that if he thinks there's any chance that he could come to realize that I'm "too much" for him to handle, I would rather that he refer me to another therapist now, because if he did so now I'd be able to work with another therapist in the future, but if he did that after I started talking about the most painful and shameful things then I don't think I'd be able to ever open up like that again.

It went well and I felt a lot better having gotten it out in the open and having been reassured.


I should have known better. It happened. He said my self harm was worrying him and that he doesn't have the skills to help me with my emotional regulation. He gave me a referral to someone who does DBT. He said he had an obligation to refer me out to someone who could help me because he doesn't have the skill set. He said just like a GP would refer someone to a cardiologist if they had a heart problem, he needs to refer me to someone who is trained in DBT. He asked the head of a program he works for who to refer me to, and he gave me that name and phone number.

This past weekend I ended up in the ER getting stitches for self harm again, and I told him about how I'd learned to suture and had started suturing my own cuts. Apparently that was too much for him. He isn't a medical doctor and he's seriously overestimating the risk of accidental death from it. I wouldn't advise anyone else to do it, but I'm a biologist with enough background in anatomy and enough training in sterile technique that the risk of accidental death is practically non existent.

He promised he wasn't abandoning me. He promised he cared about me. He said he wanted to continue to work with me after. That he wanted me to go do DBT and then come back to work on other things with him after doing a DBT program. He told me he cared about me and that if he didn't want to continue working with me he wouldn't be saying he wanted me to return after doing DBT.

But what if the DBT doesn't work? What if this is just who I am and I can't be fixed? What if he doesn't want to work with me when it turns out that he can't just ship me off to be fixed and then work with a less screwed up version of me?

This is exactly what I told him would happen. That I'd be too much for him to handle.

He said he wants me to have an initial appointment with someone whose name he gave me who does a private practice DBT program and then call him after to update him because he cares and wants to know that I'm doing the program or help me get into a different one if I don't like the therapist. But I looked her up and her program has mostly terrible reviews by people saying she's condescending and that the billing department is awful and sends bills for things that were already paid and bills things incorrectly and all kinds of stuff. I know every practice will get some bad reviews, but these were all terrible reviews with similar complaints over several years.
So there's no way I'm calling her. Plus she's really far away from where I live and work.
I don't want to be open and vulnerable with someone else only to find out that they can't fix me either and get pawned off on somebody else yet again. I've had so many awful therapy experiences. This was me giving it one more final chance.

I asked him if he'd care if he never heard from me again. He said it would upset him. Then he asked if I was suicidal and I said no, and then he asked about why I would ask about him never hearing from me again and I told him I meant giving up on therapy, not killing myself.

He said he really believed he could help me with other things but that I needed someone who could help me with emotional regulation and not self harming, and he didn't have the training, and that he really did want to continue to work with me after I did DBT.

I told him I'd consider it. I do believe him about everything he said about why he's doing this and that he does care. I believe that he believes he's being honest with me. But it still feels like rejection and abandonment. And it's still him saying that he can't help me. He wants someone else to fix me so he can help some other hypothetical version of me who is a less awful and screwed up person.

Part of me wants to just give up. I was handling things before I started therapy. I can go back to handling things on my own. I gave therapy one last chance, and I really did try. I made myself vulnerable. I may do a lot of stupid things, but even I eventually learn from my mistakes. Therapy has failed enough times for me and it just failed again. Why would I try yet again and expect something different? This time really really hurt. I should have known better.
LabRat, I'm sorry that the rug has been pulled out from under you this way. I'm sorry you tried therapy and got hurt again, especially as you just put yourself in such a vulnerable place.

You seem very logically minded to me, and someone who likes to make decisions off the best data available (like you looking at reviews for this other therapist).

So while you're deciding your next move, would it be worth asking why he wants you to see him after DBT, and not during? And if he says it has to be after, ask why you can't do both at the same time? You could also ask him if he had other recommendations for DBT practitioners. That may shed some light on his thinking and intentions and give you more peace of mind if you decide to stop therapy.

You wouldn't be begging -- you'd be asking a very reasonable question. You could even email him if you don't want to ask him face to face or worry about getting emotional -- you could see it as admin. You're not making any decisions about what to do next, or asking him to continue seeing you, you're just gathering information at this stage.

Alternatively, it's OK to press pause on everything. If you're not in a place where you could deal if you got an answer from him you wouldn't like, you're OK to take time out until you are, however long that might be.
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Default May 23, 2018 at 11:29 PM
  #26
So I'm asking him to take me back. I'll find out tomorrow.

I'm doing a DBT IOP, but their first opening isn't until June 11th. One of the requirements is that I have an outside therapist, because they do groups but only a few one on one sessions.
I've looked around for a DBT therapist who might be a good match, and I haven't found anything promising.

If his rationale for not continuing to see me was that he thought that I needed DBT/skills that he couldn't teach me, then if I'm getting that from the IOP then maybe he'd be willing to see me again because it wouldn't be keeping me from getting DBT.

I can't imagine going through the entire process of revealing all my vulnerabilities and shameful feelings with another therapist. And I want the security of having a therapist I've built a relationship with and who feels (felt?) safe.
He actually works in the CBT IOP at the same hospital. I saw him when I was checking in for my intake but I didn't look up and make eye contact. I think he saw me, but I can't be sure.

Someone who's in charge of some stuff, I don't remember their official role, is going to be asking him tomorrow on my behalf (there's no way I could bring myself to ask him).
I don't know what I'll do if he says no. I'm making myself vulnerable by admitting that I care and asking him to be there. If he says no now, I don't know if I could ever bring myself to ask again.
I just want to feel secure again.

I feel lost and having to wait three weeks to even start the DBT program is making things really hard. I feel like I don't have anyone to turn to, and I keep ending up in the ER because the only way I know how to ask for help is to hurt myself.
They said there's a waiting list and they'll call me if anyone drops out of the program and a space opens up. And they said the waiting list order is based on severity/need, not on who was on it first, and according to the person who did my intake, I will almost certainly be first on the list. So at least I'm the best at something?

I don't have anyone I can talk to about this, because if he says no I'll feel so ashamed that I wouldn't want to admit it to anyone. And I don't want to admit how much this means to me. I almost want to call back and ask them not to ask him because I'm not sure I could handle a no, even if I completely understood his reasoning rationally.

And I'm worried he'll say yes out of a feeling of guilt or obligation, if he knows how painful a no would be for be. I'm kind of putting him in a difficult position by asking him to either say yes or no.
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Default May 23, 2018 at 11:38 PM
  #27
I don't think you should feel bad for asking, or worry about putting him in a bad position or something. And I hope he says yes!
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Default May 24, 2018 at 12:20 AM
  #28
But if he says yes I won't know if he said yes because he wanted to say yes or if he said yes because he'd feel guilty about saying no. I won't know if I'm actually unwanted and he's just putting up with me out of a sense of duty or obligation.
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Default May 24, 2018 at 12:26 AM
  #29
If he has healthy boundaries as a professional, he will have the capacity to say no without feeling guilty. That's not for you to worry about.
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Default May 24, 2018 at 02:12 AM
  #30
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Originally Posted by fille_folle View Post
If he has healthy boundaries as a professional, he will have the capacity to say no without feeling guilty. That's not for you to worry about.

Thank you. I needed to hear that.
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Default May 24, 2018 at 05:56 AM
  #31
I hope he says yes--and because he wants to! Because you are doing what he asked you to do. Will the person in charge let you know today after they talk to him? Hugs...
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Default May 24, 2018 at 07:56 AM
  #32
I wish you luck and him wanting to continue working with you. It would make sense as you seem to need a T while on the program anyway.
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Default May 24, 2018 at 03:57 PM
  #33
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Originally Posted by LonesomeTonight View Post
I hope he says yes--and because he wants to! Because you are doing what he asked you to do. Will the person in charge let you know today after they talk to him? Hugs...

I think/hope so. I'm trying not to think about it but I've been anxious about it all day.
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Default May 24, 2018 at 04:45 PM
  #34
I am so sorry all this happened. It sure seems like you are doing absolutely everything that you can to take care of yourself. It seems so logical that he would take you back. It makes absolutely no sense that he wouldn't. And if he does, I'm sure it won't be because you made him feel guilty. I'm not sure those guys work that way. And if he doesn't, I bet it will be because of some kind of external pressure like a supervisor. I hate, hate, hate medical bureaucracies.
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Default May 24, 2018 at 05:04 PM
  #35
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Originally Posted by LabRat27 View Post
So I'm asking him to take me back. I'll find out tomorrow.

I'm doing a DBT IOP, but their first opening isn't until June 11th. One of the requirements is that I have an outside therapist, because they do groups but only a few one on one sessions.
I've looked around for a DBT therapist who might be a good match, and I haven't found anything promising.

If his rationale for not continuing to see me was that he thought that I needed DBT/skills that he couldn't teach me, then if I'm getting that from the IOP then maybe he'd be willing to see me again because it wouldn't be keeping me from getting DBT.

I can't imagine going through the entire process of revealing all my vulnerabilities and shameful feelings with another therapist. And I want the security of having a therapist I've built a relationship with and who feels (felt?) safe.
He actually works in the CBT IOP at the same hospital. I saw him when I was checking in for my intake but I didn't look up and make eye contact. I think he saw me, but I can't be sure.

Someone who's in charge of some stuff, I don't remember their official role, is going to be asking him tomorrow on my behalf (there's no way I could bring myself to ask him).
I don't know what I'll do if he says no. I'm making myself vulnerable by admitting that I care and asking him to be there. If he says no now, I don't know if I could ever bring myself to ask again.
I just want to feel secure again.

I feel lost and having to wait three weeks to even start the DBT program is making things really hard. I feel like I don't have anyone to turn to, and I keep ending up in the ER because the only way I know how to ask for help is to hurt myself.
They said there's a waiting list and they'll call me if anyone drops out of the program and a space opens up. And they said the waiting list order is based on severity/need, not on who was on it first, and according to the person who did my intake, I will almost certainly be first on the list. So at least I'm the best at something?

I don't have anyone I can talk to about this, because if he says no I'll feel so ashamed that I wouldn't want to admit it to anyone. And I don't want to admit how much this means to me. I almost want to call back and ask them not to ask him because I'm not sure I could handle a no, even if I completely understood his reasoning rationally.

And I'm worried he'll say yes out of a feeling of guilt or obligation, if he knows how painful a no would be for be. I'm kind of putting him in a difficult position by asking him to either say yes or no.
You are acting out of a sense of clear planning and intention. You sound much more clear and purposeful now. I have my fingers crossed that your plan will go forward!!~
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Default May 24, 2018 at 05:29 PM
  #36
Even better than him just saying yes!

He called me. He said he'd seen me at the intake yesterday and assumed I was doing the DBT IOP (there's just the CBT IOP and the DBT IOP, and he works at the CBT IOP) and he wanted to see if, now that I was getting DBT treatment, I'd want to continue meeting with him. I was kind of confused because he seemed to be asking me and didn't mention anything about me asking.

I asked if they'd talked to him and he was like well I talked to my supervisor when I saw you yesterday. And I told him that someone else was actually supposed to talk to him about it yesterday and that was news to him. He called to see if I wanted to go back to seeing him without knowing that someone was going to be asking him that on my behalf.
So it was completely because he wanted to call me, not him saying yes to my request.

And, just now, while I was typing up this post, I got a call from the DBT IOP saying a spot had opened up to start June 4th instead of waiting until the 11th.
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Default May 24, 2018 at 05:31 PM
  #37
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Even better than him just saying yes!

He called me. He said he'd seen me at the intake yesterday and assumed I was doing the DBT IOP (there's just the CBT IOP and the DBT IOP, and he works at the CBT IOP) and he wanted to see if, now that I was getting DBT treatment, I'd want to continue meeting with him. I was kind of confused because he seemed to be asking me and didn't mention anything about me asking.

I asked if they'd talked to him and he was like well I talked to my supervisor when I saw you yesterday. And I told him that someone else was actually supposed to talk to him about it yesterday and that was news to him. He called to see if I wanted to go back to seeing him without knowing that someone was going to be asking him that on my behalf.
So it was completely because he wanted to call me, not him saying yes to my request.

And, just now, while I was typing up this post, I got a call from the DBT IOP saying a spot had opened up to start June 4th instead of waiting until the 11th.
You're rolling now!!!
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Default May 24, 2018 at 06:01 PM
  #38
That's all great news, labrat!
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Default May 24, 2018 at 06:19 PM
  #39
That is such great news!
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Default May 24, 2018 at 06:31 PM
  #40
That's all great news, happy for you!
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