In Session Today: Part V

I had a T session yesterday. I was sitting in the waiting room, and I realized it was 15 minutes past when the session was supposed to start and 15 minutes before the office staff leaves for the night. I thought if she hadn't shown up by the time the office staff left, I would leave too. I see my T at an office where there is a bunch of T's and PDOCs and they share an office and office staff. My T works late though so usually she is the only T there after 7 PM and that is when the office staff leaves. So eventually T came to get me, before the office staff left, and she asked how my Christmas was. I said, "Good." Kind of shrugged. I wasn't there to talk about my Christmas per se. When we got to her office she wanted to know how the hallucinations were, particularly the auditory hallucinations, so I told her that I had heard voices but not that frequently since I had last seen her, but that I had more trouble with visual hallucinations in the past month. So we talked about that and about what I "see" and whether or not it scares me. I told her that it had been (trigger for mention of SH) she seemed pleased that it wasn't too frequent. I forgot to tell her that I was upset about it, because I feel sort of defeated by it. We talked a little about why I did it, and I explained I have been feeling more depressed and how it helps lift my mood for a while. We talked about the Christmas and New Years breaks and how I do better when there is a routine and how I need to plan things next time to help me not get so depressed. We talked about (mention of Christian religion) We talked about my depression and my former T and how I miss her and how it was worse over the holiday. She asked me if I had been in contact with my former T which made me feel weird. Like I was betraying new T if I had been in contact with former T. I told her that I had emailed former T at the beginning of December and had texted her Merry Christmas with a picture of my kitty on Christmas Day and had received a text back the next day saying that former T had a good Christmas and kitty was growing. We talked about the progression of former T's illness and the T that I saw during the summer that did CBT Therapy and how it didn't really work for me because I don't have a lot of negative self talk for one, and two, being on an anti-psychotic is a very powerful sedating sort of medication so my mind usually feels blank and I have trouble recalling my thoughts. And new T said yes, she didn't think CBT would be very helpful for me. We talked about why I thought I was depressed and I couldn't really say. So it was time to go and I was putting on my jacket and she said next time we would try some eye movement technique. And I couldn't really think at the time, but I wanted to ask her if it was EMDR or something else because I think you have to be thinking about something troubling you to do EMDR. But I just said, It might not work, and she said, it might. And we left it at that. Kit

The therapist retrieved me. She asked how I was. I said I was grumpy. The therapist said she was feeling a bit grumpy, too. She said I was the first person to actually show up for my appointment today. This surprised me and I made some comment about rudeness. She said thank you and agreed. We sat in silence. I complained about how my sister didn't come to stay with me since she was off work, and that she had instead stayed home to enjoy her roommate's guest dog.

We sat in silence.

The therapist finally asked me what I wanted to talk about today. I decided against anything major. I told her I want to make C let me get the ear piercings that I want. We talked about that a little. The therapist said maybe I'd be allowed to do this since I'd been helping out with stuff and had stopped doing a central problem behavior. I didn't say anything, which I guess made her suspicious. She asked for confirmation that I had been behaving. I said kind of.

She seized on that and questioned me until I admitted that I had been engaging in part of the problem behavior, though not the worst part. The rest of the session was spent on this issue, with the therapist repeating her typical refrain that we need to figure out a better way for me to manage my anger.

I told T that needing reassurance as we enter some hard things is part of who I am. She told me that she wouldn't always reassure me the way I wanted. I said this felt hard to talk about and she replies boundaries always are, as soon as boundaries were mentioned I floated off in my brain somewhere and it was time to go.

T didnt so anything wrong but I had a childish impulse to throw her "you are enough" rock on the floor. I wanted to tell her just to eff right off. I'm not sure what all of this means. I'm sure it's fine but I stress ate half a pint of ice cream anyway.

Feelings suck

AND she inadvertantly called me dumb.

*sigh* I'm sure I'm just getting angry to avoid talking about things I need to talk about

Can you say, "I want to throw this rock on the floor"?

Yes and she would respond nicely I'm sure. It only increases the urge lol

We arranged session times for the rest of the month.

Me: "That's 7 sessions in one month"
Her: "I know"
Me: "Will you be able to stand it?"
Her: "I don't know, we will have to wait and see"
Me: ...
Her: "See you next week"

She is a very rude old woman.

T yesterday. I was really nervous because a few days ago, his wife's post showed up in a Facebook group I'm in (related to kids with special needs). I'd emailed T about seeing the post and said how I hadn't clicked on her profile. His response praised me for my restraint, how he really appreciated that I hadn't clicked on her profile or looked at her past posts in the group. I initially just thanked him for understanding, but then yesterday, I felt this overwhelming guilt because I *had* looked at her past posts in the group. So I'd emailed T admitting that and asking him to please not terminate me. He replied last night saying we could discuss today and "Of course I'm not terminating you." Which made me feel a bit better.

Though I still felt nervous for session. In part because he tends to share what he's feeling about things I say or do--he says to help me understand how other people in my outside life might be reacting to me. So I worried what he'd say about this, even if he wasn't going to terminate. So I had trouble looking at him as he retrieved me and when I first sat down. I thanked him for email reply the night before. T: "I was hoping you'd be able to get some sleep." Me: "Well, I got some but was still awake a lot." T: "I'm sorry."

Me (crying a bit): "I feel almost like I should apologize for my email to you--it probably seemed so pathetic. I just had sort of this meltdown yesterday. Your first email to me, you were just praising me so much for my restraint, and I didn't deserve that. I just got consumed by guilt. You gave me much more credit than I deserved. You thought I was better than I am, and I couldn't deal with that." T: "It's OK, you didn't really do anything wrong."

Me: "But I feel like I did. And that email I sent you, I know it was coming from a very young place. It was like...OK I feel this is an extreme comparison because my parents never did this, but the best way to describe it is:

I know that probably seems like a screwed-up thing to joke about, but I think it helped kinda break the ice and make me feel less scared.

Me: "I guess in a way, it's like something got put right in my lap" (referring to his wife's post). T: "I agree." Me: "But I feel like I should have been able to put it to the side and walk away from it." T: "It would have taken Herculean strength to have done that. I probably would have done the same thing in your position." Me: "OK, thanks, that makes me feel better." T: "And people, including my wife, should realize that nothing they post online is truly private." Me: "Well, this was in a closed group, so not totally public, but yeah I understand what you mean."

Me: "Also I was honest with you that I didn't click on her profile. I'm worried you won't believe that." T: "I believe you." Me: "OK, good. I mean, I don't even know if there would have been anything in there to see, or if she had most set to private." T: "I don't know. I'm not on Facebook." Me: "I know, you've said that. I also worried you wouldn't believe that I got the notification in the group, that I didn't go looking for it. But I checked, and I've been in the group 3 years." T: "I believed your account of what happened." Me: "OK, good."

T: "Just so you know, my wife decided to leave the group." He said he'd just told her that a client had seen a post. I made sure he hadn't said anything identifying about me, and he confirmed he hadn't and wouldn't. I said I was wondering if he would have told her to block me. T: "No, I couldn't do that." Me: "Because it would require revealing my name and that I'm a client?" T: "Exactly." I said I felt kinda bad if his wife had to leave a group she was involved in because of me. He said she told him that she wasn't really that active in the group anymore, so she just opted to leave. That I don't need to worry about it.

I saw we had 20 minutes left and suddenly started sobbing. Me: "So I know you probably have anger or frustration to express to me. I don't want you to do that in the last 5 minutes of session. So, just go ahead and have at me, lay it on me." T: "But I'm not angry with you." Me: "You're not?" T: "No. I have no reason to be. And I think you've beat yourself up enough already." Me: "Yeah...OK, good." He said he wished he hadn't seen what I had, but wasn't angry about it.

Me: "Do you want me to share what I saw?" T: "You don't need to tell me. Most of the posts were older, like from a few years ago, right?" Me: "Yes, so I know, any information might not still apply. And like, if certain diets or supplements were tried, that could have been for multiple reasons, like allergies or something. OK, I guess that gives a suggestion of something I read. I mean, some of it was just things she'd shared from other groups, so no information there. But if you want me to be specific about what I read, I can." T: "Why don't you just see how you feel going forward?" Me: "Like if I think something could be affecting our relationship, then I could share it?" T: "Exactly." Me: "OK."

I did say how I'd been worried before talking about certain possible treatments for my D, worrying he'd think they were kooky or something. Then I saw his wife was in a biomedical treatment group. That if I'd realized they supported that beore, then I'd have felt more comfortable talking about it. T: "Didn't you realize by my comments about it that I was OK with it?" Me: "I guess, eventually. But at first I was concerned. Like this was a case where having a bit of information would have helped me."

T said how some of this is about protecting his son's privacy. I said it's not like I'm going to tell people about his son. T: "Well, you already have." (referencing a few people I talk to from PC nonanonymously). Me: "OK, good point, but the chance of any of those people having anything to do with your son is extremely slim." T: "You never know." Me: "True." T: "I do choose to have his picture on my desk, so clients see that I have a son. And that he's 11. And that he needs glasses." Me: "But he could just be wearing glasses for the look." T: "Well, that would say something about him, too!"

He said whatever is shared in therapy is mine to do what I want with. I could share all kinds of negative things about him, give him a 1-star review on Yelp if I want. Me: "I kinda doubt people trust Yelp for therapy reviews..." He said how he has to hold my confidentiality, but I have no similar obligation to him.

He said again the thing about what I thought about his son felt to me like a connection between us. I said yes. And that I struggle with the therapeutic relationship at times because it's so one-sided, it's unnatural. T agreed that it's not a natural relationship, but said it's important for it to be that way to keep the focus on me and my issues. How, if I know too much about his son, that I'll feel I should ask about him, and that takes the focus off of me.

T: "I'm just going to use a random example. Say, I get migraines." Me: "I do too, I mean, I don't know that you do, you're just using an example." T: "Right, but if I tell you I get migraines, then you might feel obligated to ask how I'm feeling. You're a nice person and if you don't ask, you might worry I'm thinking, 'What a b****, she's not even asking how I'm feeling?'" Me: "But if I get migraines, too, then it might be easier for me to talk about them, knowing you have them." T: "But me talking for 20 minutes about my migraines isn't going to help you. I can talk about yours and support you with that whether I get them or not. I hope you don't end up getting a migraine from this..."

Me: "Me, too. OK, I see. But I know you said before that I can't care about you because I don't really know you. Yet I feel that I can care about you in terms of what I do know of you, of who you are to me." T: "Yes, I agree with that." Me: "OK, good."

We were almost out of time. I started crying again. Pointing to him, then to myself, I said, "So, we're OK, right?" T: "Yes, we're OK." Me: "Good. I think so, too. I was just really worried that I'd messed things up." T: "You didn't." Me: "OK. Thanks for understanding."

Confirmed Monday and Thursday, and went over to pay. Shook hands and he said, "Have a good weekend." Me: "Thanks, you too." T: "Take care." Me: "you too."

LT--I'm glad T session went so well and that he was understanding and not hurt or mad. I didn't think you did anything wrong and it sounds like he doesn't think so either. Well done! Kit

Thanks, Kit! I think I was mainly worried because we'd just recently had the conversation about his son and he was saying how what ex-T had said might no longer be accurate. And then I saw previous postings by his wife that suggested how, at least at one time in the not-too-distant past (like a few years), it may have been accurate (based on what his wife had posted and what I know about biomedical treatments for autism and other conditions). So I felt I had violated a particularly touchy area for him. But like you and he said, I didn't really do anything wrong. If his wife posts in groups like that, there's always a chance a client could see it (including a particularly curious client like me...) I really appreciated how he handled it.

That was a touching session write up, LT. He handled it really well, and seemed to zero in on how scared you felt. He seemed to give more ground to your bond- that you can care about him .

Did he actually use the word "*****"? This would really bother me. I seem to remember him referencing "blue balls" recently as well, in relation to your partner's "need" for sexual contact. For me, this is acutely patriarchal and misogynist language and indicates a male-centric/female-marginalising approach. This would be a deal-breaker for me, regardless of his other significant failings.

I appreciate that you will probably feel differently, but I don't want this kind of de-valuing language about women to go unnoticed, even if others don't baulk at it.

He did use that word, but I wouldn't be surprised if I'd used that word with him at some point as well. I feel maybe it's more common in the US? I mean, I use it at times (though...I don't know, is that different because I'm a woman?) I didn't personally feel offended by it because of the context in which it was used. And in terms of cursing, I didn't include this in the writeup, but I used the F-word like 5 times that session, to the point that I said at one point, "Wow I'm cursing a lot today."

I'm not sure I see the blue balls as necessarily being particularly sexist, as he said it's not like H was dealing with that effect. He wasn't all "Oh, you're giving him blue balls!" He was supportive of my being in control of how often I want/have sex and basically being like, "Eh, H will be OK, he can take care of himself." It would be completely different if he'd acted like I owed him sex or something.
So I can see where it would offend some people, certainly. And it might be different if I'd just started seeing him. But I feel we're at a point in the relationship where I've shown to him (again, partly by things I've also said) that I'm OK with it. Should some of those words maybe not be part of the language in general? Sure, OK. But I feel in the context and limited times my T uses them, it's all good. If others would choose not to see him because of it, that's fine, then don't see him.

Yeah, I feel like he's understanding and becoming more comfortable with it lately. I think he now understands that he may need to take a different approach with me than with most of his other clients. He's seen what helps me and what hurts me and is adjusting accordingly. I feel that's a sign of a good T.

I'm "feeling congested"!

LT, I admire you for telling the T all this. I know I never would and would just look up anything I want on the public web. I hope his feedback has helped a bit for you to see/accept that your curiosity and using the web is okay!

It is always interesting to me that some other members here see your T as failing in many things. To me, he still seems like the best T I can read about here regularly and your progress with him is pretty visible. Of course these things are subjective.

Thank you. I admit he has his flaws, but I do feel he's really helped me. Other people have commented on that progress as well. My relationship with my H is better. I'm more social in general. I mean, I didn't include this in the writeup, but the only reason I'd recently turned on all notifications in the group that T's wife posted in? It's because I'd gotten together with someone I met in another autism parents group recently for coffee and was asking about local groups. She was going to add me to that one, but realized I was already in it (and clearly wasn't seeing the posts). So I turned on notifications. So it only happened because I was trying to make more real-life friends (and I'm seeing her again later this month). As an introvert with social anxiety, this is a big deal to me. And my H was ambivalent about going to his friend's party tomorrow, and I convinced him that the three of us should go. When in the past I might have been like "Sure, we can skip it!" and been secretly relieved. But...I want to socialize (sure I want to come home and curl up in a ball afterward, but still...)

What you are describing reflects my impression from a distance quite well. Your T definitely has a strong tendency to keep you focused on real life goals and progress and a bit away from diving too much into what goes on in your therapy (between him and yourself) - this is what I like best in his approach and it sounds like your benefit from it significantly. I was just thinking of your therapy again reading another thread about unethical therapists who promote (or even just allow) too much idealization and attachment and how that can be detrimental sometimes, especially on the very people who are most prone to those things. Not sure I would classify that as unethical necessarily but definitely not practical. And exactly what keeps clients in that transference hole for way too long and away from actually improving everyday life. So it's kinda ironic that you wanted so much to work on your transference and attachment patterns with this T but his way not to let it take over too much within therapy is what seems to be helpful now. At least this is how I see it, I am sure different people have other views.

This is a very belated "in session Thursday" because I took notes on my phone right after but haven't typed it out until now. Some things that happened, not in any particular order:

awkward few minutes of silence when I was unable to bring myself to say what was going on and he wouldn't ask questions because he's stubborn

I brought up him being affected by the stuff I said in the previous session. I asked "why"
he answered slowly and thoughtfully, saying he has a visceral reaction to seeing someone being abused, went on to say I was abusing myself. He said he told me because he thought it would be helpful for me to know.

I brought up that he cares about me. He confirmed this. I said I felt like he shouldn't, that I shouldn't be allowed to have a therapist who cares about me. He kind of half jokingly said that's a problem then because he does.
I said I felt like I'd tricked him into caring. He said he didn't think so, didn't get the impression that that was my intention. I tried to explain that it wasn't, but I still wanted him to care about me, and he was like "so then you feel that you must have tricked me" and I said yes.

I tried to explain that wanting to be cared about feels "dirty" and disgusting and shameful and wrong. I prefaced it by saying I don't mean the word with the usual connotations, there's just no other good word.
He said it's natural and normal to want to be cared about. He said that therapy is being really vulnerable. Then he started to bring up that usually as adults the level of vulnerability or whatever is associated with romantic relationships and it's natural that... and I was like, that's not what I mean. That's what I meant by not the usual connotations.
He was confused.
Eating disorder tw:

He kind of started going down the road to that topic and I redirected/refocused saying it wasn't really the point, my point was just about using the word "dirty" without the usual connotations. I told him that it feels like there's a moral element to not needing things.

At some point when I was saying I thought I was faking my reaction or exaggerating or being melodramatic or whatever he said he wished he could videotape me and show me how I looked at that moment, curled up in a ball, unable to even look up. He may have had a point there. I was actually kind of shaking by the end of the session :/

I asked about him thinking I had been weak. He said he thought I'd actually actually been pretty damn strong for standing up to my father.

I pointed out, once again, that so many other kids had it worse and I'd never even been hit. He said that what my father did hurt just as much as being hit but didn't leave bruises or broken bones. Said that my mom's emotional distance compounded that effect.

We danced around the word trauma. He'd made some comparison to PTSD and I said that was different because in that case there are actual real measurable physiological changes. It's involuntary and hard wired in the brain. He said he thinks this stuff probably caused permanent physical changes in my brain and things like elevated cortisol levels (I didn't correct him that actually people with PTSD/trauma tend to have lower baseline cortisol, it's about reactivity and return to baseline and whatever...)
I asked him if he really thought so and he said yes.
He still didn't use the word trauma though. So I don't know whether he adheres to a narrow definition of it, and I'm afraid to ask.

Extra session. I wouldn't say the issue I am having with my therapist is resolved but at least after that session I have more clarity on what actually needs resolving. I asked him if he was uncomfortable when I said that I felt he likes me and that has helped my self-worth in the rest of my life (i said it last week) He said he was because he felt I was projecting something on to him. I said it seems like I was expressing internalising acceptance, how is that projection? He said he thought there was an element of my idealising him in there, and he doesn't want to "fuel the transference". I was pretty angry, not because I feel he should fuel the transference, but because he's said LOADS of things more transference-fuelling than liking me. Like "I'm not ready for you to leave" and "of course I feel love for you" so why the **** is now the moment to start worrying about fuelling transference? I did manage to express some of this. But then I let him off the hook bit. But there's still a lot to resolve.