In Session Today: Part V

Session today was good. Told T about the psychiatrist appointment yesterday and he said he was sorry that I had such a horrible experience with that lady. We talked about how it felt to be dismissed like that and how it confirms the feeling that I'm too much for anyone to want to help. We talked about past experiences with other Ts and Pdocs and how I was told that I wanted to feel this way before and how I was told that I was being manipulative by coming to the community mental health clinic on a day that I didn't have an appointment and just asked to speak to my T for a few minutes because I was in crisis. .. That incident was about 4 years ago. But we talked about how those experiences still affect me and make me worry about reaching out for help between sessions or saying too much of what's going on in my head. T says that it causes a bit of dilemma for me because those thoughts are why I'm in therapy and holding them in just hurts me. He didn't say it in a judgmental way, more of a comforting way to try go ease my mind that he's not going to drop me as a client because of anything I say. He says he knows saying it doesn't help much and basically only time helps me with trusting someone. He did offer to help me find a psychiatrist if that's what I want, so that is an option if I want to pursue it more. At the end of session he asked me if I would like to come in tomorrow as well with how difficult this week has been and I said I would if it wasn't for the funeral and my daughter's field trip. He told me I could call tomorrow then and he'll see me Friday morning. The only way I could see him tomorrow would be late in the afternoon or evening but I highly doubt he has that but I might text him in the morning and see if he does have anything available. H and I are supposed to have MC tomorrow at 4 but seeing him would be more helpful at this point.

It’s been a while since I have had a therapy session where I felt like I was speaking in tongues. What I wanted to say and what ended up coming out of my mouth were two different things. I had to fend the Critic off even more than usual.
‘The Critic has been very vocal this week. Lots of past stuff coming up about getting close to my emotions and then retreating.’ I wanted to mention P by name, but I didn’t.
‘It seems to me that you have maybe never allowed yourself to get that close to your feelings with someone before? What you experienced last week struck me as really real…not that I experience you as not real…but an authentic expression of your feelings.’
‘True.’

I showed her the drawing, but didn’t say anything specific about her as the symbol of safety. ‘It’s been a while since we had a new one of these.’
‘I remember when you had them spread out on the floor. If I recall correctly, these are all aspects of you and your feelings?’
‘Not all…all except that one.’
‘So, can you talk me through this?’
‘The central figure is sadness and grief.’
‘Yes.’
‘The figure to the side is anger, whilst the figure on the other side represents safety. The figures in the background represent the stuff that is always there.’
I continued ‘Whilst I was tracing the base layer – I trace these because there’s no hope of getting them perfect every time – I felt a wave of…sadness is a small thing, and yet grief…yes, grief. Whatever it was, it was strong enough that I had to get up and walk away.’
We talked some more about this and I eventually said ‘The Critic says I can’t function with that level of vulnerability. I don’t drink alcohol, but this week reminded me of the quarter of a glass of Prosecco I had at friend’s wedding for toasts. It took me the rest of the next day to feel OK, and this week was a bit like that.’
‘It seems as though it takes you physical energy to process emotions.’

There were moments throughout the session where I lapsed into silence and R sensed me struggling to express myself. ‘It sounds as though you don’t know what to do with yourself.’

‘Yes, it’s exhausting, and then there’s still the flaming bathroom.’

We talked about how the Critic needs fear to function, and although there was pain last week, there was no fear. R said that it was triggered when I answered the door to her, which kind of didn’t sit well with me. The release happened then because I felt safe enough. She said that if it had been the postman that knocked on the door, my reaction would have been different.
I talked about how those people kept me scared, to the point that I couldn’t release any of the emotion. R remarked that this sounded like an ‘unhealthy, imposed’ fear rather than a natural fear of something that is unsafe.
‘Last week was the most vulnerable I have ever been, but also the safest I have felt in two years.’
‘As hard as it was, I saw that and felt connected to you. I don’t want to use the word, but it is the first word that comes to mind. You may still feel a little bit traumatised by what happened last week, so be kind to yourself.’
‘I may regret this, but next week I want to go there. [There being focusing on the bathroom scene, that scene…]’
I couldn’t look her in the eye as I said the next bit: ‘If last week taught me anything, it’s that I can feel safe with you.’
R apologised for not giving me more notice, but she didn’t want to spring it on me last week considering where we ended up. Next week will be the last session before Christmas.

T wore a jacket he had worn two years ago. Last year he only wore a T-Shirt even in Winter.
I started by telling him about my trip home last Friday.


We went quiet for a while, then I mentioned having seen my new doctor this morning. She agreed to continue referring me to my T so I could see him. T: "We almost thought that she'd say that!" I replied: "You maybe did, I didn't!" He laughed. I also mentioned starting my job only in February now and asked whether I could still see him twice a week in January. He said yes.

He said things seem to be going okay at the moment. I agreed with that, since now can relax and since that doctor has agreed to me seeing my T. He answered it seems this still stressed me out. I replied that she could have just said I couldn't see him anymore! He told me that no doctor would do that. I said there's bad doctors out there too. I told him about one time I was at the doctor's with my mom, I was around 13 years old. I kept getting sick and throwing up in the morning, so we wanted to check that out. The doctor took a book from his shelf, read in it for a while, then said he had no idea what was wrong with me and told us to leave. When we were walking out, I told my mom: "Did you see, that guy has the same book as we do at home!" T laughed again. Then he asked why it bothered me that guy consulted a book, isn't that what good doctors do? I agreed, but said if the book doesn't tell you anything, then the doctor shouldn't just say they don't know. He should do tests or something. I even knew at the time that this was happening since I was so stressed. T said maybe the doctor thought it wasn't too bad, feeling a bit sick from time to time. I got a bit upset and asked whether he thinks throwing up once or twice a week is healthy. He said he hadn't realized it was that often and involved throwing up. Then he said but at least the doctor was honest and told you he didn't know. To that I said that he should have given me recommendations for people who could figure out what was wrong. He shouldn't just send me away.

T said how doctors often do that, they do all these tests and can't figure out anything that's wrong, so they tell the patient everything's fine. But the patient still doesn't feel well. Often that for examples with panic attacks, where people think they have heart attacks instead.
He said how he's on purpose arguing with me about this. He said we're trying to think about what this guy might have thought such that I don't always just jump to bad assumptions about people.
Shortly after that, we confirmed we'd see each other on Friday and then said good bye.

T appointment yesterday. I had a mental list of things I wanted to talk about: sui feelings last week, how long its been since I've sh-ed (5 weeks) and how it is getting harder not to and how I usually break down at about 50 days, hallucinations, Christmas holidays, and how I've been coping. We got through the list which was good. She's really proud of me for the five weeks which makes me feel ridiculously good. It's weird, but positive feedback from others helps me not engage in that behavior. Once I had friends text me everyday for two months and I was able to not SH during those two months but of course after a while people have their own lives and can't continue that level of support which is fine. I was glad she was proud of me. T3 had accused me of manipulating her or something like that when I wanted her to be proud of me from abstaining from SH. It was a weird reaction so I'm glad this T didn't have that reaction and she was very positive about it.
She was glad that I talked to the PDOC about the hallucinations, and the PDOC isn't concerned which makes me not concerned so I'm happy about that. She said that if I have more that I need to tell him though. (I'm talking about auditory hallucinations. I get visual hallucinations but those don't bother me all that much usually, unless I'm really unwell, but the auditory ones do bother me a lot.)

We talked about what coping mechanisms I'm using to help me with the depression, sui thoughts, not SH-ing etc. After I talked about what I have been doing, she said I have a really good attitude, that I'm very positive and relatively stable. (I questioned her on that one because I don't feel relatively stable.) But what does "relatively" mean? So this was the first time I had disagreed with her and said so to her in session--which is really big for me because I don't usually disagree with people aloud, even if I disagree with them in my head. So, I deduce, I must be feeling safe enough with her to disagree with her. She said that when she said relatively stable, she meant, I wasn't reacting or acting out in violent or inappropriate ways, or bizarre ways. That yes, I SH which is a problem, but I'm taking steps to deal with it and those steps are productive and positive. I thought she was a little off course here because I have never reacted or acted out violently or anything like that. But I guess she was comparing me to her case load which may include people who do those things. She talked about breaking windows, etc. That's definitely not me. But I could see where she's coming from when she said, "relatively" stable. My mood is not stable but my behavior is relatively stable. I can keep myself safe when I feel unsafe. I will either let my parents know, or I go to the hospital or whatever. That was a good discussion to have. Even though I still sort of disagreed with her, I could see her point and I got what she was trying to get across. It also normalized some of my behavior.
We talked about Christmas and the people I've lost this year that will make the Christmas holidays more difficult. We talked about how my routine will be messed up during the holidays and what I have in place to deal with that. I'm very routine oriented. I need things to be relatively the same everyday. It helps me be stable. I'm going to my sister's for the holiday and that is always stressful being around my brother-in-law especially, and the five children but not as much. I'm just not overly used to being around children. I have a trip this weekend, and Disneyland on Monday so a lot of different stuff happening that can throw me off.

I was worried about this appointment because it had been a month since I've been to Therapy which I'm still getting used to, after 10 years of going once a week. I talked to her about how sad I am that my former T isn't my T, that Thanksgiving was hard because of that and how I anticipate Christmas being hard because of that. She took me talking about my former T very well I thought.
I gave her a Christmas card which she thanked me for and really seemed to appreciate. She wished me a very merry Christmas, and I told her I would see her on the 2nd. Also she commented on my little stuffed animal that I bring with me to therapy. She said it's so realistic (it's of a little hamster). She said something when I was leaving, and I said, "See ya later." It was a good session overall. Thanks to anyone who reads all of this. Kit.

It went so badly today I discontinued services for my own safety. I don’t really want to get into it. But it went very bad today. I’ll be looking for a new therapist eventually in a completely different practice.

We had a good couple of sessions this week, talked a lot about trust and reasons for distrust and feelings of being valued. I felt pretty good when I got out. Then when I got back to work I got word that something had fallen through, not a huge thing but a disappointment. I feel much more upset by it than I think I normally would. Sometimes therapy just leaves me way more emotional than usual.

First, I told my T I had realized two more things regarding my doctor's visit on Wednesday. One was that there's a few special characters in our language that you can capitalize on the keyboard by pressing caps lock. T apparently didn't know, since he did it wrong in a report to my doctor, which I received since I received all my medical documents. I said something along the lines of 'you know you can capitalize those, right?' and he said he always had trouble with it and couldn't be bothered to google it. I told him to 'press the key that capitalizes all letters' and he said 'oh, the ca... ca... ca...' until I helped him out and told him it's called caps lock.

The second thing I realized was that I had been kind of irritated by one of her questions. T asked what it was. I said she asked about self harm. He said she probably had read that in his report, but I said that couldn't be since then she would have already known that I do it. She probably just read the diagnosis. And that bothered me as well, first she asked whether he told me at all about my diagnosis and then kind of whispered 'borderline' as though it was a horrible thing to say. He said some people set BPD and self harm equal. That she was probably just interested. He asked whether the question had been too intrusive. I said yes, and he said he would have felt the same way. How you might show normal wounds to a doctor, but if they are coming from mental issues it makes things more complicated. It's very intimate to talk about and I barely even know the doctor.
I for some reason also told him about how I upset her a bit.
He asked me what I could have done in that situation instead of answering with the truth, if I had realized the question bothered me earlier. First, I said I could say that I didn't want to answer, but T thought that was quite harsh. Then I suggested saying that I do it, but it's not that bad (we also discussed that she might have been worried that I'd need stitches all the time). He told me that I didn't want to share anything about it, so I shouldn't. I couldn't come up with anything else, so he suggested to just say I didn't want to talk about it.

He then said something about changing doctors being a part of me moving away from the city I grew up in. That triggered me a bit. I got worried he'd leave me. So I sat there and became sad. He asked me what was happening for me, so I told him I felt sad and also that I couldn't close my eyes since then I experienced too many memories coming up.
He told me that he thinks I can manage to not get sad or have memories. That upset me, so I started crying. Probably with a really painful expression on my face since he asked me what was hurting me so much. I answered that it was upsetting to hear I shouldn't be sad and that I felt like he didn't want to talk to me anymore or have me share anything. He replied that of course I can be sad in his room. But that I could change how I react to being sad, how I regulate. He also said it can happen that he's too harsh and I'm allowed to say when that's the case. I continued crying and he offered me a tissue. We discussed how people can contradict themselves and how it was probably confusing me to hear from him that I should not be sad and at other times hear that I should let myself be sad. He also wanted me to focus on my being angry and to feel that emotion but also let go of it.

After a while I managed to look at him, which he seems to most of the time take as a hint to end the session. We scheduled for next week, after that I left.

HWMNBN asked "how did things end up?" or something, and I responded, "well, my mom is visiting and I feel pretty tightly wound." And he said that what he'd actually been asking about was an email I'd sent him earlier in the week about

Anyway. Then he asked me what I had for the agenda. He said he wanted to talk about the date I'd been on, which was no surprise to me since he has this thing about wanting me to be in touch with the fact that I'd like to be in a romantic relationship (though the prospect also scares the bejesus out of me, in part b/c I am so effing sick). I said I wanted to talk about my mom's visit. He asked me to pick which to start with and I said we ought to start with the dates (in my mind b/c I wanted to get that out of the way. God, I hate talking about dating with him.).

I told him about how I went on a date last Saturday, during which the guy proved himself to have a very specific agenda (that being to get in my pants). I told HWMNBN that once I'd figured that out I politely but firmly left, to which HWMNBN said, "good for you" or something. He also, amusingly, said a shocked/empathetic, "I'm sorry" several times while listening to my story about this very persistent guy... a few months ago he said something along the lines of, "guys will say a lot of things to get sex" which struck me as odd somehow, I suppose since he himself is a guy (and is not *that* much older than me--maybe 10 years give or take). Anyway, I also told him about the other date I went on which was much nicer--dinner and drinks with a very irreverent and funny guy who is getting his PhD in engineering--and HWMNBN seemed pleased. I said that the nicer guy and I are planning to go to a jazz club next week. He asked, "did he initiate that?" and I said yes and he seemed pleased again. (I was a tiny bit insulted by that question, I suppose b/c it makes me wonder if he thinks I am socially incompetent and a terrible date... but whatever.) Anyway he said, "that sounds like the kind of guy you should be involved with. A kind person, who is a bit of a nerd--sorry if that's offensive to you [I laughed and said, "not offensive, just accurate"]--who is looking for an actual relationship rather than just someone to be physically intimate with." I agreed.

Then we got to talking about my mom. She's visiting and is like interrogating me about my depression (she herself works in the mental health field). I keep telling her I don't want to talk about it (e.g. "Mom, I love you, but I don't want to talk with you about this," "Mom, I know this isn't what you want to hear but I don't have the emotional energy to deal with your reactions to my mental health struggles.") Her questioning feels intrusive to me... somehow feels like it's less about me and more about her need to enact the good caring mother, more about her need to tell me about her own response to my mental illness ("your father and I were devastated"), more about her wanting to tell me about her own suffering ("I have depression and fibromyalgia and know what it's like to have a lifelong chronic illness"). I was trying to relay this to HWMNBN, about how I feel and about how I wonder if the problem is really my mom or really me. I was also trying to explain how the fact that my parents think that I'm a bad daughter makes me feel essentially bad (even though cognitively I don't believe that to be the case). He, of course, took it to a BPD place and was going on about identity diffusion (e.g. "if my mother thinks that I am bad, then I am bad") which is not how it feels to me b/c I am only like this with my parents and I feel like everyone has a complicated and often regressive relationship with their parents... but whatever. I was trying to figure out how to feel less bad about it. He kept saying that, like, it's okay for me to continue to believe what I believe (e.g. that I am a bad daughter) but that I ought to introduce some doubt into that thought. Also he said that it seemed pretty obvious from the way that I talk about my parents that objectively this is their fault not mine. Still, that didn't feel very satisfying to me b/c what I want is to feel differently about all this.... when he asked me how I felt talking about the stuff with me mother I said I felt hopeless and he seemed surprised for some reason. I was also angsting about how stupid it is that what I want, desperately, is to be cared for and held... but I won't tell my mother about my problems and I don't want her to touch me (like, when she touches me I stiffen automatically before I can make myself not do it... and she's always bugging me to give her a real hug or whatever).

We were just about out of time (actually a bit over time) when he asked how it had been talking with him. I said that it felt a bit unsatisfying, as I often wish that I could come into therapy and feel better afterwards, and that did not happen this hour--it felt like we were in a very cognitive place, rather than an emotional one. He said something like, "you often come here wanting some form of holding from me, is that right?" I said yes, that's what I tend to want. He said that if that is what I want, I ought to say that. I argued that I am not sure if what I want is the same as what I need, that perhaps the thing that I want (emotional containment) is not the thing that will make me better in the long run (who the hell knows what that might be). (I don't bloody know if this is the case or not--I am not any kind of expert in this stuff. But it gets into all this business about whether therapy ought to be a place where needs are fulfilled vs discussed etc etc etc.) He asked me to explain, and I was having a difficult time (I often clam up in therapy with HWMNBN)... and eventually I said, "well, I don't know--if you let a five-year-old choose what to eat for dinner, he'll end up eating ice cream night after night, and then he'll end up missing a whole bunch of vital nutrients. Sometimes the things we want and the things we need are not the same." His response to that was that if what I want has a regressive component to it, then whatever we'll explore it (which was not the point I was trying to make, but okay sure). He also said, "you know that I'm not going to hold you, right?" to which I said promptly, "yes." (This also perplexed me a little b/c I thought we were talking about, like, holding in the Winnicottian sense... I can understand why he would say that explicitly, if not only b/c clarity is a virtue (teehee) but also because I once told HWMNBN how my former pdoc sort of screwed up on that front, and with former Ts I have wished that they would give me a hug or even hold me. Even still, a tiny little part of me wanted to scream, "I DO NOT WANT YOU TO TOUCH ME DUDE I JUST WANT YOU TO BE NICE TO ME FOR LIKE 45 MINUTES A WEEK.") He followed that up with a lot of, "nothing is going to happen so it's safe to explore it" stuff, and also "we're never going to understand this unless we can look at it from the inside." The point that I was trying to make was that I oughtn't ask for something if I don't think it is the thing I need, regardless of whether or not it is regressive or appropriate or possible... but whatever. I told him that I would likely need help asking for what I want/need, and he said that was okay.

Anyway, I was late for group so I left.

Damn this crap is exhausting.

How long does a normal therapist try to pound a "technique" into his client? 3 months or longer would you say? How about 10 years? mmm....that doesn't sound normal to me.

First a recap of Thursday's session so Friday's will make sense. Went back and sat down. I complained about how a car had taken forever to get out of its parking space in the lot, making me almost late. That it was a sports car. Which led to brief discussion of cars and how T's last vehicle was a Jeep Wrangler, which surprised me a bit.

Talked about a conflict with a friend I'd had about some stuff discussed in the previous session about autism. And how I was worried I wouldn't be able to discuss it with the friend anymore. He gave some suggestions on ways I could still talk about it.

I described how I handled the conflict. T said he was blown away by how well I'd handled it. And he'd felt that way about how I'd handled some other relationships lately, too. That I seemed to definitely be making progress in that area. Which made me feel good. He said he wondered if it was different because most of these were online relationships. I said I wasn't sure, that I also talked to local friends over text/messenger, and I think I've handled some things with them well enough. But I think it would be different if the conflict happened when I was face to face with someone, that it would be more difficult to just change the subject if I found it getting tense. Or to step away for a bit. Though I had been doing better with that with H, come to think of it.

I guess we talked about some other stuff in there. I saw we had 20 minutes left and said I was debating which of two things to bring up. T: "Should I flip a coin?" Me: "Maybe...The first is a dream I had that's kind of screwed up." T: "OK." Me: "The other is kind of about the therapeutic relationship." I started tearing up as I said that. Me: "Damn it...I guess that means I need to talk about that, don't I?" T: "Probably."

I said there were a few areas I wanted to talk about. First "prong" was stuff I wanted to know about his son, but knew I shouldn't ask. Or that maybe I could ask, but that I doubted he would answer, and I understood that. Like I wondered if he was higher or lower functioning, if he was in [our county] public schools, if he had an IEP. Like, part of me wants to be able to talk to you as a fellow parent dealing with those things, but I knew that wasn't his role... T said I was right, that he wouldn't answer those, but understood my curiosity.

Then he asked what exactly ex-T had told me about his son. I said, "All she said was, 'He has a kid on the spectrum, too.' No other details." T said how what ex-T had told me, that had to be 8-year-old information, as that was when he'd last worked in the office with her. How it might not be accurate information anymore. I wasn't sure how to respond to that. Because...what? He hadn't denied it at the time I told him.

Second "prong" was more vague, that I'd felt particularly connected to him the past few weeks. He said we'd talked about topics further out in the circle, where our relationship is the center. How they was less emotionality and intensity. Me: "But they were emotional topics for me, ex-MC and D?" T: "I didn't say they weren't emotional. But not as intense as talking about the relationship." Me: "OK."

I said how I kept thinking "Things are good here as long as I don't talk about the relationship. But I also know that's not a good way to think..." He said that avoiding a topic puts a block in the relationship. I agreed. Me: "But I also feel like any of our conflicts or ruptures have been as a result of talking about the relationship. And if things are going well, I don't want to risk losing the connection." T: "But we always become connected again, right?" Me: "I guess." He said it's important to work through those things in a relationship, to know that it survives them. And that working through them makes the relationship stronger. Me: "I guess."

We were out of time. Confirmed next week, went over and paid. Shook hands as he said, "Have a good weekend." Me: "You too." T: "Take care." Me: "You too."

The stuff from the last part of the session started really bothering me later that evening, particularly about his son, so I ended up emailing him. He sent a long response (that he charged me for) the next morning, then offered me a 10:30 session that morning if I wanted it, as he said some of it would likely be better talked about in person. So I took him up on that (and canceled Monday's), partly because some of what he said in the email upset me even more. Will write that up in a bit.

OK, I was going to try to write about the emails without including them, but I'm struggling with summarizing, so here they are (anonymized):
Thursday evening:
Hi Dr. [T],

Two things from today that are gnawing at me. First, you said how [Ex-T] gave me 8-year-old information about your son that might not be accurate anymore. Implying that maybe he's not on the spectrum. Which bothered me, because if that in fact is the case, then I feel like you've been dishonest with me. You didn't challenge its veracity when I shared what she'd said before, so I assumed it was true and have been going forward with that info in the back of my mind. Like feeling, without needing to explicitly talk about it, that you understand certain experiences and emotions I've had on a particular level. Which made feel safer discussing certain things. And now I feel like you're trying to deny that's the case? I do understand and respect your desire for privacy, for not giving all the details. But if you're now suggesting it's completely different, that bothers me.

Second, it felt like you were implying that discussing the therapeutic relationship would likely lead to conflict. I want to feel like anything I bring up with you will be OK, that you'll accept it not talking about threats). I want the relationship to feel safe in that way. I know you say that we'll get through whatever conflicts come up, but I want to think that such conflicts might not even *need* to come up, that we could discuss the therapeutic relationship without it becoming this big thing. I want you to be able to accept and contain whatever I say. Yes, I know that may not be realistic for outside relationships, but...I'm also paying you. So this isn't the same as an outside relationship, it's a professional one. I'm essentially paying you to deal with my feelings, and to generally keep yours out of it. Isn't that basically what the therapeutic relationship is about, what makes it unique?

Addendum sent at 2 a.m.
I want to make it clear that I'm really struggling with this. It's the stuff in the first half of the email that's particularly affecting me. (Though I suppose it all ultimately ties into the therapeutic relationship in general.)

T's response at 8:45 next morning (yes, he charged me for this)--a few things cut for space/relevance:
[LT],

I'm sorry that you're struggling with questions about my son, and you are correct about my desire for privacy. I'm not happy with [ex-T's] choice to disclose personal information about my family to a client...

It seems you've developed a narrative about my son from whatever you heard from [ex-T], and from things I have said about Autism. Based on your email I'm thinking that you've interpreted my knowledge on the subject as evidence towards this narrative. I'm sorry that you've felt deceived by my failure to correct your beliefs; however I was not aware that you had such a robust narrative. Your observation yesterday was, as far as I can remember, the first time you've made that narrative so explicit. I chose to say what I did because I wanted to be clear that your narrative was not necessarily true - whatever [ex-T] heard had to be at least 8 years old... and a lot can change over the course of so much time when you're talking about the differences between a 4- and 11-year-old. I have not shared anything more about my son, deliberately wanting to protect not just my privacy but his privacy as well.

I'm aware that you will probably be dissatisfied that I am not going to share anything more about my son's situation. I am also aware that this is a profound difference from Dr. [Ex-MC]. Hopefully we can talk about what that means to you, and how to best cope with the ambiguity. Your curiosity is completely understandable and I'm quite sure I'd have an interest were our positions reversed. We can talk about how important or necessary it might be that a therapist have actual, personal experience with an issue in order to understand or empathize with a client, as well as how important that had been to you in this specific instance. I would like to hear more about how you are reacting to all of this and what impact it is having on you, but I think that's best shared in person....

You also raised the issue of conflict being likely in the discussion of the therapeutic relationship. At our session I was trying to emphasize that it's not conflict - it's intensity and emotionality. Discussing the issues that arise between two people directly is, more so that other things that can be discussed, likely to be intense and emotional. Conflict can arise because of that, but it's not necessarily going to. I think that discussing the therapeutic relationship is a big thing for you, in addition to the content naturally having intense and emotional impact. You make an interesting statement when you say "I want you to be able to accept and contain whatever I say." This reminds me of other conversations we've had, where I've stated my position that there are things you can say that I may not accept. I'm not sure what you mean by 'contain'. If you mean that I will do my part to have a civil, caring, appropriate, and hopefully therapeutically healing conversation with you than yes - you are 100% correct that you should expect that from me and any therapist. If you mean that I should have no reaction or feelings of my own, than I disagree with the statement.

There is a lot to talk about from your email. If you want to address these issues ASAP I could see you at 10:30am today...

LT-
I applaud your ability to honestly express to your T how you are feeling regarding the therapeutic relationship (I wish I could do more of that myself). I also think your T's email reply was generally thoughtful and non-defensive. Just my opinion from the outside looking in. Thanks again for sharing your story. I hope you had a good session yesterday.

Boy does he ever profit off of provoking insecurity in you. I hope your session at least helped.

Warning, this is really long, and I still feel like I left stuff out.
Bonus T session yesterday. He retrieved me, and I had trouble looking at him as I walked past and sat down. He was wearing his glasses--he's usually in contacts. After I sat, I realized the sun was streaming onto my face and asked if he could close blinds up there, and he did. Then a few minutes into session, the sun had shifted, so I asked if he could close the next one, too (he did). T: "Ah, you're a two-blind client." Me: "I guess so."

I started crying and picked up the box of tissues and put it next to me, noticing it was almost empty. Covering my face with my hand/a tissue, I said that I felt bad about things. T: "What do you mean?" Me: "What I'm expecting of you. It's not fair for me to expect you to share that stuff about your son." I forget what he said to that.

Me (still hiding face, unable to look at him, which is unlike me): "And some of what you said in the email bothered me. Like what you said about the 'narrative,' like I'd just made up some story out of nothing. But it wasn't from nothing. If I'd told you what ex-T had said about you're son, and you'd said she was wrong, then I'd have just put it out of my head, and it would have been nothing. But you didn't."

T: "I'm not saying if what she said was correct or incorrect." Me: ??? T: "She shouldn't have said anything at all." Me: "I know. But she did. And then you didn't say it was wrong. So I assumed it was accurate." T: "Again, I'm not going to say whether it's accurate or inaccurate, just that it was 8-year-old information." Me: "OK." T: "I guess I'd almost put it out of my mind that you'd told me. Because you hadn't brought it up. And until you were talking about it yesterday, I hadn't realized how much it played into things for you."

Me: "Yeah, I guess...I never really mentioned it since then. But I just assumed it was true. So when you were talking about things with autism...I assumed it was partly coming from your personal experience. In additional to professional. I guess it felt like you understood. That it was...I don't know, a connection we had." T: "I can understand that, where it felt like we were going through the same thing, maybe kindred spirits in a way?" Me (crying): "Yes...like that. Like...you were talking to me not just as a therapist but also as a fellow autism parent. And maybe like...I don't know, almost like you might possibly have been getting something out of having that shared experience with me, too. Or something. I don't know."

T: "I get that. But do you feel that someone needs to have experienced the same things as you to understand and feel empathy?" Me: "I guess not. I mean, with ex-MC, with him saying early on that he also had an anxiety disorder, it made me feel like he understood me more. While with ex-T, she seemed all pulled together, so I figured maybe she was less likely to understand me. And I guess I thought the same about you, but then with your son..."

T: "OK. I obviously haven't had all the same conditions and experiences that my clients have." Me: "If so, you'd probably be on a lot of meds..." T: "Right. But I have almost 20 years of talking to people about their experiences. Plus my training. So I feel like I have an understanding of most all of those experiences. That I get it. Without necessarily having to have experienced it myself." Me: "OK, that makes sense."

T: "Plus, if it was something I experienced myself, that can be more different, because I'd be seeing it partly through the lens of my experience rather than just the client's. Say, for example, back surgery. I haven't had back surgery, but if I had, and a client came in who was going to have it, I'd likely be thinking of my own experiences with it and talking about that instead of focusing completely on my client's experience with it." Me: "OK, I see. And I think maybe that was an issue at times with ex-MC and my anxiety."

T's son came up again. I said in a way...it reminded me of the stuff with ex-MC's wife (who I figured out--via a mix of something I overheard, something ex-T said, and a story ex-MC told--was sick), with the uncertainty there, with wanting to know more but ex-MC being reluctant to share, even though he disclosed about so many other things. How it was hard for me to know something was going on but I didn't have all the information. That I understood why he didn't tell me, but was hard.

T said with his son, he was concerned that if he did share about him, then, I'd be worried about him. And to be nice, I'd ask about him in session, and he didn't want me using my session time for that. Me: "It wouldn't just be 'to be nice,' it would be genuine care." T: "I know, that's what I meant, because you're a nice person, you would ask. I didn't mean that it wouldn't be genuine." Me: "OK." T: "Again, I'm not going to say whether he's on the spectrum or isn't." Me: "OK, I know."

Around that time, I pulled out the last tissue. T: "It's OK, they're included in the cost! You're on the Silver Plan here: unlimited tissues!" I said it was a good thing, as he walked across the room to get the other box, which he handed to me (he usually just lets me get them).

We shifted to talking about therapeutic relationship. He reiterated what he said in the email about how talking about it doesn't have to mean conflict, but that it just brings up emotionality and intensity. How I can talk about an emotional topic with him or, say, H, but if I'm talking about just my own experiences, or else an experience with someone else, it's still not going to be as intense as talking about the relationship with the person in front of me. T: "Like you talking to me about ex-MC could be very emotional for you, but it's not going to be as intense as you and I talking about us." Me: "OK, I think I understand."

I tried to explain the "contain" thing from the email. He said that made him think of a container, like, say, a beaker, where I might pour acid in it and just expect it to sit there, unaffected. But he wasn't going to be like that. I said it wasn't that I didn't expect him to react to things I said, more that I wanted him to deal with them on his own time, rather than necessarily with me. Me: "Like...if I got angry at you, maybe you'd feel anger in response, but you wouldn't yell at me." T: "That's what I meant in the email about responding therapeutically and safely. I wouldn't yell at you, but I might tell you how I'm reacting." Me: "OK." T: "Remember, one of my things is to help you understand how people in the outside world might react to things you say or do. If I don't let you know what I'm feeling, that doesn't help you with that." Me: "Yeah, I guess. I just get scared of your reaction and it makes me not want to share things sometimes. Like now." T: "It's always OK to talk about them. We've always worked through it before, right? We've gotten through it." Me: "Yes."

Me: "I guess just sometimes I wonder...therapy brings up a lot of turmoil for me. Like last night, I was awake in the middle of the night crying because I was upset about things with you. Had I not had a session, or I'd opted to talk about the dream instead, I likely would have had a good night's sleep. OK, not good night, as my D was awake, but a better night's sleep." T: "I haven't gotten the sense you've had as much turmoil regarding therapy lately, unless there's stuff you haven't been telling me." Me: "I guess...maybe I haven't told you all of it. Though there was the thing maybe a month ago where I called you because I was upset about you not saying 'I care about you.'" T: "OK, but it seems like since then, things have generally been calmer, and I sort of wondered what had changed." Me: "Well, until this." T: "Well, OK."



Me: "So I guess at times, I wonder...is it worth all the turmoil? Are the gains worth it? Is it all part of the means to get to the end? Or am I just causing myself additional pain?" T: "I can't answer that question for you." Me: "I know...I don't know how to figure out the answer. I mean, I think I've made progress lately. You even mentioned that yesterday in terms of relating to my friends." T: "Yes, I was impressed by that." Me: "But I don't know...I mean, I feel like I drink more on the days I have session, too. Maybe it's partly the topics, but...I feel like that can't be a good thing. I just don't know. And do I need a different T, or do I just need to take a break from therapy in general?"

T: "I don't know. There are a lot of warm and fuzzy therapists out there, if that's what you feel like you need." Me: "I don't know...I mean, at one time I thought I did...but wouldn't I probably just become really attached to them and not want to leave like with ex-MC?" T: "I don't know. But if you want to try one out, I understand." Me: "I don't know...because I also feel like you're helping me. Maybe I need an approach more like yours to make progress."

T: "And know that you don't have to worry about hurting my feelings if you want to take a break, either from therapy entirely or to see a different T for a bit. Remember, I'm not going anywhere. If you walk out the door, I'm not immediately throwing your file in the trash and shutting the door on you. You could come back whenever you would want whether for a longer-term or a single session." Me: "Thanks, I know. I just don't know what to do sometimes. And this would be a bad time to take a break with the holidays coming up..." T: "It's probably never an ideal time." Me: "Yeah...I'll think about it more."

Maybe then or at another point, he asked if this tended to be an issue with me with T's in general, and I said it had seemed that way, with ex-T and ex-MC. That there was a lot of turmoil with ex-MC. How I think some of it for me is dealing with the limitations of the therapeutic relationship. That it's a struggle for me. Wanting the connection and closeness, but then...I mean, I probably can't ever get what I'd want from that because of the nature of the relationship. So maybe would always be a struggle."

Also somewhere in there, we ended up talking about therapy clients (like, not his clients, just in general) with childhood trauma (I forget why). And T said the way I was talking about it, it sounded like I felt that other people's trauma made them more worthy of care than me. And that it bothered him that I seemed to feel my experiences weren't as important. Which felt caring to me.

It was 11:28. I feel like he gave me some sort of final thought, but I forget now what it was. Talked about scheduling, I said would just email him (I ended up canceling Monday and taking Wednesday instead of Thursday, but that's partly because I'm Christmas shopping with my dad Thursday and didn't want to be an emotional wreck).

Went over to pay. Me: "I guess you're charging me for the email..." T: "Yes, it took me some time." Me: "I wish in the future...maybe we could have some agreement that you'd only do a paid response if I asked for it explicitly?" T: "Well, other emails you sent me recently, I didn't get the sense you were looking for a longer response. But this one, i felt like you were." Me: "Yeah, I guess, but then sometimes you've offered me session instead before replying." T: "Maybe I should have done that in this case." Me: "We can discuss more next session. I"m fine with paying now, just for future." Shook hands, as T said, "Have a good weekend." Me: "You too."

Bottom line: I feel OK about the session and about T. Not fabulous, not terrible. He seemed very caring and engaged throughout the session, like he was really listening to me. I'm not making any changes before the holidays (only seeing him once next week to make up for extra session--see, he doesn't get as much profit!!!) in terms of a therapy break, trying a different T, or continuing with my T, but will reevaluate after the holidays. I mean, not necessarily precisely on Jan. 2, but I'll be thinking about it.

LT

I admit I didn't read it all, I am only skimming, I'm too sad to read recaps from others right now... but I know I saw stuff about anxiety again and while my T has never really been insightful, he did surprisingly say something interesting to ponder with anxiety...

"Sometimes, it's a good thing to try and see if the situation has a volume knob rather than a switch" and I was confused and he said "With volume, you can go up/down and stop at many spots in between, with a switch--its on or off" This was in relation to anxiety related stuff I was panicking over.

And no one can decide what is best for you going forward, but I know for me.. No T is the only choice. I can't do this to myself anymore. You kinda gotta decide if it's worth all the added stress and anxiety it causes you or not, good luck

i love your recaps, lt.

LT i like DP's idea of a volume knob rather than a switch, but i would take it a step further. I think my therapy was like the song, "The Lion Sleeps Tonight." Multiple themes playing, some verbal, some not, slipping in and out at different times, all coming together at the end, but no single one defining the therapy, and not clear how each line affects any of the others.

I canceled my session with t for Tuesday

I started harassing him via emails again. so I feel ashamed and worried he's mad. I think it's best to not go. I don't want to wind up in more distress

First of all, I tend to like your T, and I am not being negative about him overall. I just don't think this is his shining moment

He keeps the focus too much on himself, what he will and won't do and it is defensive.

On the other hand, you were amazing, honest and vulnerable. I am keeping in mind it is him to whom you feel you can be so honest, and he is good that way.

T: "I'm not saying if what she said was correct or incorrect." Me: ??? T: "She shouldn't have said anything at all." Me: "I know. But she did. And then you didn't say it was wrong. So I assumed it was accurate." T: "Again, I'm not going to say whether it's accurate or inaccurate, just that it was 8-year-old information."

This is why I think it is more an enactment than therapy- his final comment here should have been exploring you, what it all means to you. Instead he doubles down on his own issues.

There's no sense of the mystery of otherness here, the wonder of other people and the need to listen, explore, keep myriad theories open ended to learn experientially in this comment. He is really needing authority , even though you came in apologizing and trying to appease him by saying you asked for too much( which you didn't)

T: "OK. I obviously haven't had all the same conditions and experiences that my clients have." Me: "If so, you'd probably be on a lot of meds..."
T: "Right. But I have almost 20 years of talking to people about their experiences. Plus my training. So I feel like I have an understanding of most all of those experiences. That I get it. Without necessarily having to have experienced it myself." Me: "OK, that makes sense."

Through this post, it is like role reversal- you are validating him, you are listening, you are putting his perceptions first over your own, and you are very insightful .

He is not validating, empathizing, intervening, exploring, attending etc.

T: "Plus, if it was something I experienced myself, that can be more different, because I'd be seeing it partly through the lens of my experience rather than just the client's. Say, for example, back surgery. I haven't had back surgery, but if I had, and a client came in who was going to have it, I'd likely be thinking of my own experiences with it and talking about that instead of focusing completely on my client's experience with it.

This is wrongheaded Imo. Substitute csa for back surgery. He is too uncurious, and too comfortable right here. You talk about SH and SUI- that is not a correlative of back surgery and is dismissive/ invalidating .