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Default Jan 04, 2019 at 12:12 AM
  #1
I know this topic has been posted many many times, but if you could please help me with it especially if you know my past/current situation.

I don't know what modalities I should be looking for. I'm thinking DBT? But I think my T said something about psychoanalytic or psychodynamic? I know I don't want CBT.

What other questions should I ask?

I should probably bring up that I have BPD? And my extreme attachment to T. Should I say that I don't want to attach to the new T?

I know I should ask about emails and phone calls. I need a T who can be there outside of session. But I don't think I need to ask about hugs. Or should I? What if I do become attached and want a hug?

Should I find someone who I might be able to attach to? This new T will hopefully be my backup T for a long time. A part of me is against attachment, but maybe it could be healthy?

Should I choose a man or a woman? I think I'll get attached to a woman. An older woman would probably create transference which I really don't want. And I'm afraid if I get attached to a man, it will be hard for me to not get it confused with attraction.

I feel overwhelmed with emotions. I don't want to do this. But I have to. I can't survive 6 months without a T. Everyone knows this. Even my dad who somehow thinks there's nothing wrong with me, knows I need a T.

Please, again, keep in mind that this is a backup T, I have BPD, and I get attached to people.

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Default Jan 04, 2019 at 12:19 AM
  #2
On the topic of modalities, you say you don't want CBT. May I ask why? I am pretty anti-CBT myself, so I'm not trying to nudge you in that direction or anything. It's just that CBT has a lot in common with DBT, so I'm wondering if there's something you don't like about CBT that would also be a problem with DBT.
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Default Jan 04, 2019 at 12:24 AM
  #3
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Originally Posted by susannahsays View Post
On the topic of modalities, you say you don't want CBT. May I ask why? I am pretty anti-CBT myself, so I'm not trying to nudge you in that direction or anything. It's just that CBT has a lot in common with DBT, so I'm wondering if there's something you don't like about CBT that would also be a problem with DBT.
I don't like the thought worksheets! Really. I don't like breaking down my thoughts. Pros and cons, okay. Mindfulness, okay. Coping skills, teflon mind, okay. I don't want the strictness of a DBT program either. I prefer talking through things, processing, exploring. However, I don't need to go into my past. I've dealt with my past enough. I need to focus on the present and how to cope with the loss of my T.

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Default Jan 04, 2019 at 12:26 AM
  #4
Hmm. Maybe therapy from primarily a psychodynamic approach, but with a therapist who is also trained in DBT?
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Default Jan 04, 2019 at 12:28 AM
  #5
I'm thinking a DBT T might be good because they usually treat BPD, and they usually do out of session contact. That's what I'm going to need the most. Even if I have to pay per email, it's something that's important to me.

Eta: I don't want a T who is judgemental towards people with borderline. I need someone who can see me as me and not just a diagnosis.

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Default Jan 04, 2019 at 01:30 AM
  #6
If you struggle with attachment to your T, I’d definitely recommend DBT. However, most DBT therapists who offer phone coaching also have pretty strict boundaries and are adherent DBT - meaning they will expect you to fill out diary cards, BCAs (behavior chain analysis), and perhaps even join a skills group. The exercises are very similar to CBT, as DBT and CBT overlap in many ways (yet different in some) My therapist is a bit lenient, which does make me nervous her more lax boundaries may cause me to become attached. Since many DBT therapists do offer out of session contact, I think that’s why adherent DBT is so structured so as to help the client gain skills without becoming overly dependent on the therapist for the out of session support.
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Default Jan 04, 2019 at 02:22 AM
  #7
Yeah, I'm not into the diary cards or such. I'm not really into writing anything out. T sometimes makes me write stuff, but they're usually reminders or mantras. Sometimes she has me challenge my thoughts. So yes, I do some CBT/DBT, but really it's modified. Maybe that's why T didn't suggest DBT.

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Default Jan 04, 2019 at 02:44 AM
  #8
My T is on both the psychodynamic and psychoanalytical registers, but I mentioned a DBT skills workbook someone recommend to me and he was okay to work with it. The one I have is by Matthew Mckay and you can work through on your own too.

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Default Jan 04, 2019 at 03:46 AM
  #9
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My T is on both the psychodynamic and psychoanalytical registers, but I mentioned a DBT skills workbook someone recommend to me and he was okay to work with it. The one I have is by Matthew Mckay and you can work through on your own too.
I don't really want to work through a workbook. I have 2 I think and have never read either. I just need a T to support me while T is gone. I'm honestly not looking to do any work except processing the loss of T. But thank you for the suggestion!

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Default Jan 04, 2019 at 03:50 AM
  #10
If you're mostly looking for support processing the loss, I would think psychodynamic or humanistic would be fine. Personally I think the most important thing is how the relationship with your therapist feels for you. Try a few of different modalities and see what your gut tells you when you meet people. Remember you can always switch if the therapist isn't working for you.
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Default Jan 04, 2019 at 04:07 AM
  #11
My T does both psychodynamic and CBT. He seems to be reading books on pretty much all modalities though, he knows lots about for example DBT and can work with those things if needed. So maybe if you interview somebody ask them what they know about modalities other than those that they list as their primary ones? I like to have a mixture of different approaches since the T can adapt to what I need in a certain moment.

Having BPD myself, I'd personally bring it up since it affects me a lot. You said the primary focus would be dealing with losing your T, so you will probably have to bring up your attachment. Of course you can also say you don't want to attach to the new T, even though one might argue that you can't just decide that.

Regarding outside contact: plenty of Ts offer that without being trained in DBT specifically. Pure DBT outside contact is somewhat weird as far as I remember. I think I read somewhere that it's for example if you self harm, then it's okay to reach out at any time before you do it, but not after you've done it. So maybe it might be a good idea to ask things like when is it okay to reach out, how often, how fast can you get a reaction, and so on.

Regarding hugs: if you think that'd be something you'd absolutely need in case you get attached, I'd ask. It doesn't hurt if you ask but then don't need it. But if you're suddenly attached to someone who doesn't allow it and it's important to you, that might be a problem. But maybe it would also be good to learn that you can be attached and feel safe without hugs?

I don't think you can decide whether or not you'll get attached to somebody. To me it doesn't sound too bad to be attached to two people though. It might distribute the intense feelings more onto two people instead of one? I don't know whether it would be like that of course, but I certainly don't think it would only be a bad thing to be attached.

Regarding gender, I think go with whatever you feel more comfortable with. My previous experience was always that I fell in love with men who listened to me, but I do not feel attracted one bit to my T. There's also some transference with him that I'm pretty sure comes from my mom, so I think that could happen with both genders too. Maybe don't focus on the gender too much at first and try to find somebody who matches your other needs?

In case a T doesn't specialize in DBT, I think it'd be good to ask whether they've worked with BPD before. I'd also mention what you're there for, what you're looking for and then ask what their general approach would be.
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Default Jan 04, 2019 at 05:27 AM
  #12
I don't think that you will have much conscious control over whether you develop attachment bonds to a therapist.
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Default Jan 04, 2019 at 05:58 AM
  #13
Relational Psychodynamic is what I think. I would definitely not give them a label of any kind about yourself, and tell your story afresh without self- judgment. Maybe someone who doesn't add trigger to the situation accidentally - no babies at home , maybe a different demographic?

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Default Jan 04, 2019 at 06:16 AM
  #14
Personally, I'd suggest letting things flow as naturally as possible and, if it's easier and you're comfortable with it, maybe you could sign a release to have your current therapist talk to this new one.

What about interpersonal?
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Default Jan 04, 2019 at 09:51 AM
  #15
Thank you so much for your advice and opinions. It really does help.

I know I can't control whether or not I get attached. I just don't want to. I actually hated current T in the beginning of our relationship because I never felt like she listened to me, and part of me still was hanging onto ex-T. T kept good clear boundaries, which also slowed how fast I got attached. But in the end, I did get attached. She fit the description of the type of person that I attach to, so it's not really a surprise. But if I'm going to attach to someone new, I'm going to feel like I'm cheating on my T. I know logically, she prefers me to attach to someone else as well as her. She also told me to give the T a chance even if I hate them at first.

I don't want to switch part-time Ts while T is gone. I want T's blessings for part-time T. I think that would make me more comf with part-time T.

I will be signing a release for the two Ts to talk. I want them to be on the same page. I always sign a release for my T with Pdocs, doctors, and Ts. I also have to if I want a dual session with them.

T has a male T in mind. She's never actually met him, but has heard good things about him from an office mate of his. She says he enjoys working with BPD. I'm going to try him out first. Then my pcp gave me a name of a T who works with a lot of her clients. And worst case, I turn to psychology today. But I don't have a lot of money, so I don't have the luxury of trying out a lot of Ts who don't accept my insurance.

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Default Jan 04, 2019 at 01:00 PM
  #16
It's good your T has a suggestion for you. She knows you and she knows of this other T. I think that is a great place to start. Kit
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Default Jan 04, 2019 at 11:15 PM
  #17
Okay. T gave me possible T's website. He's young! Graduated in 2016. I looked him up on psychology today and he does list borderline personality disorder. His modalities are CBT, DBT, psychodynamic and psychoanalytic. He says his age range that he likes to work with is teens, 20's, and 30's. I'm 36. I wonder if he'll consider me too old? And I'm afraid that because he is young, maybe he'll consider me an experiment? Practice for him? I need someone stable, secure, good but not severe boundaries.

I'm so scared! I don't want to do this! I just want my T!!!!!

But I did fill out an email to the guy. I would post it here, but their site wouldn't let me scroll to see all I wrote. Now I have to wait all weekend for a response.

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Default Jan 04, 2019 at 11:34 PM
  #18
Found his FB page. He's married and has a golden doodle. And supposedly has 4 degrees? Wife looks to be a nurse. No kids yet. His profile is locked down except for 1 picture, but his wife's isn't and has a ton of pictures.

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Default Jan 05, 2019 at 07:38 AM
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Found his FB page. He's married and has a golden doodle. And supposedly has 4 degrees? Wife looks to be a nurse. No kids yet. His profile is locked down except for 1 picture, but his wife's isn't and has a ton of pictures.

Sounds like you are off to an excellent start already ...
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Default Jan 05, 2019 at 08:17 AM
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Okay. T gave me possible T's website. He's young! Graduated in 2016. I looked him up on psychology today and he does list borderline personality disorder. His modalities are CBT, DBT, psychodynamic and psychoanalytic. He says his age range that he likes to work with is teens, 20's, and 30's. I'm 36. I wonder if he'll consider me too old? And I'm afraid that because he is young, maybe he'll consider me an experiment? Practice for him? I need someone stable, secure, good but not severe boundaries.

I'm so scared! I don't want to do this! I just want my T!!!!!

But I did fill out an email to the guy. I would post it here, but their site wouldn't let me scroll to see all I wrote. Now I have to wait all weekend for a response.
I wouldn't necessarily worry about the age range he said he prefers to work with. My T's website mentions teens and young adults (plus couples), and when I emailed him from Psychology Today, I asked if he also worked with "not-so-young adults." He replied and said that he does. And ex-MC specialized in teens, but worked with adults of various ages (his client before us looked to be an elderly woman) and obviously married couples.

If he has 4 degrees and got his psychology degree (a PhD maybe?) in 2016, he might not actually be that young. Also, it's possible he's been working in psychology longer than that (besides his training)--like my T first got a master's in psychology and did some work related to that (not in private practice, but like at a psych hospital, I think) and then later got his PhD and started working in private practice after that. He's 7 years older than me (I'm 41) and I'm finding I like working with someone closer to my age (ex-T was like 30 years older).

If he is pretty new to the field, he could be more up on the latest treatment methods and theories and more enthusiastic about his job (not that T's who have been in practice a long time aren't!), which could be good. I hope he works out! And I wonder if maybe you'd feel less guilty if you got attached to him, because he's a different gender than your T?
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