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Default Aug 31, 2019 at 11:14 AM
  #121
Oh what a difficult decision to have to make. I know it will be exceptionally hard. Have you got any sense intuitively of what is the right thing to do? I say this because when my alliance with one T turned sour, I knew in my heart it was time to leave. It was only my mind/thoughts trying to justify it.

It does sound like a good session but you're wise to question whether deep issues would re-emerge with this T later and cause friction again. One session doesn't mean a lot in the long run. I had many satisfying discussions with an abusive ex husband whilst trying desperately to make it work. He said what I needed to hear, but sadly deep routed patterns always took over.

Listen to your gut feelings if at all possible. How did it feel being with the new T? Sometimes the unfamiliar is more scary, but ultimately more right.
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Default Aug 31, 2019 at 11:15 AM
  #122
The trauma bond is strong. It feels real. Maybe, it is real, but. . .traumatic, too.

My forays into therapy did, maybe, help me find my "parts" and the dissociation and some forgotten traumatic memories behind them. But my last T, and others before that, didn't help me integrate them, didn't help me become a whole self, if there is such a thing.

I came across an older book I have yesterday, called "Leaving Home". Lots I don't like about it but the general idea -- that someone who has had their needs met can then "leave home", separate from the parents (or in this case, parent substitute) is a good one, I think.

Not that you might not need some help with that separating and establishing yourself, as yourself, if that makes sense. Adolescents have peer groups, and this forum has been one for me, I think. I still feel a need for some additional help, but my forays into looking for another T have all been awful. Not for me, is my guess.

Thanks for the update. Please continue to keep us posted?
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Default Aug 31, 2019 at 01:14 PM
  #123
Thank you for posting an update SE. I was thinking about you yesterday.

I would echo what the others have said. Always trust your gut instinct.

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Default Aug 31, 2019 at 06:12 PM
  #124
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Therapy helps me but it could also have been fatal . It’s powerful , and when gone off the rails can do the damage it is chartered to heal. I do believe in therapy, both that it can heal or endanger when the client is fragile. I hope I am less fragile for having advocated for myself, and I would have done that without PC.
this ^^^^ right here....so eloquently summed up

thanks for the update SE. what ever you eventually decide to do, i feel humbled for you and have the upmost respect for your insight and courage
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Default Aug 31, 2019 at 07:12 PM
  #125
To comment on what Koru_Kiwi did--yes, I agree. I don't think T's realize how much power they can hold over us, particularly clients with attachment issues and transference. How much their words and actions can affect us. Because it's often not just a "professional relationship," but calls back to wounds from our past. So something they say or do that might seem minor to them can be extremely painful or extremely healing or anywhere in between.
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Default Sep 01, 2019 at 07:07 AM
  #126
I avoided these kind of twisty, painful relationships in real life, so I can’t fathom how this one developed in therapy of all places. The psychoanalyst told me to read up on Kohut’s “ twinship” concept . It is like my T and I enact rather than process, and we might unfortunately have related areas of weakness / wounding and trigger each other . I don’t know. I am almost addicted to my T, like we are not just looking back at trauma but also recreating a version of it in real time. Like a car accident can be hard to look away from, these conflicts feel extra mesmerizing to something sick inside me that I never knew was there. It isn’t a premonition so much as intuition that things will likely come to a destructive end with my T despite good intentions on both sides and true care. The dynamic has a tidal pull. Right now, I have a viable option of a really suited older T to help, but he won’t likely be an option next time. However, I genuinely can’t afford him no matter how I run the numbers . I also don’t have the will power to be the one who looks away first. A great outcome would be this moment of hardcore standing up for myself creates a lasting sea change as our session was a sea change. I don’t truly believe entrenched dynamics can change radically, but unwisely I am goi g to see it through. It is wrong to say I love my T, but it is not romantic . It is bc he speaks my language.

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Default Sep 01, 2019 at 07:20 AM
  #127
I know you've probably thought of this Esme but have you approached the issue of money with the new T and asked if he could make some allowances for your situation? Here at least, many Ts do. If you felt that this T was a viable option perhaps it could be easier in the short or long term to consider leaving the current T (I know it's hard though). All credit to you anyway for being aware of what's happening.
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Default Sep 01, 2019 at 08:47 AM
  #128
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Originally Posted by SalingerEsme View Post
I avoided these kind of twisty, painful relationships in real life, so I can’t fathom how this one developed in therapy of all places. The psychoanalyst told me to read up on Kohut’s “ twinship” concept . It is like my T and I enact rather than process, and we might unfortunately have related areas of weakness / wounding and trigger each other . I don’t know. I am almost addicted to my T, like we are not just looking back at trauma but also recreating a version of it in real time. Like a car accident can be hard to look away from, these conflicts feel extra mesmerizing to something sick inside me that I never knew was there. It isn’t a premonition so much as intuition that things will likely come to a destructive end with my T despite good intentions on both sides and true care. The dynamic has a tidal pull. Right now, I have a viable option of a really suited older T to help, but he won’t likely be an option next time. However, I genuinely can’t afford him no matter how I run the numbers . I also don’t have the will power to be the one who looks away first. A great outcome would be this moment of hardcore standing up for myself creates a lasting sea change as our session was a sea change. I don’t truly believe entrenched dynamics can change radically, but unwisely I am goi g to see it through. It is wrong to say I love my T, but it is not romantic . It is bc he speaks my language.
No, no, no! OK, I understand the pull is enormous. I didn't get in close relationships in real life, either. I saw it "through", not with any particular T but with the idea of therapy in general, until the last T stopped it. We we were stuck in some sick dynamics, too. But I was determined not to quit. There was something there that was a key to who I am/was. . .I couldn't let go, until forced to. . .Maybe haven't let go entirely yet.

I think it does have to do with ego -- yours and your T's. And I think twinship may be a key to getting beyond that -- but not with a T still stuck in bad ego-s..t dynamics. Does no one here speak your language? Or somewhere else in your life?

Also, if the alternative T is that great, I don't know why he has to work only for an exhorbitant fee. Either -- he really isn't such a great alternative or maybe he might be willing, like Lonelyinmyheart said, to consider. . .well, alternatives there, too. Stand up for yourself and ask? What's the worst that can happen? He will say no -- maybe ridicule you for asking? In which case, no matter how wonderful his reputation and status is . . .I'm not so sure that idealizing him would be a good idea anyway.
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Default Sep 01, 2019 at 11:42 AM
  #129
SE - There are many parallels between your experiences with your T and what I've experienced with mine. Things came to a head at the end of April when my T told me he could no longer be my primary therapist because we couldn't seem to stop the re-enactments and there was too much risk of me being retraumatized and getting harmed by our work together. That was absolutely devastating to me and I was hurt and angry and felt helpless. Therapy itself felt retraumatizing, and yet an abrupt and involuntary termination was also most definitely re-traumatizing--either way, staying or leaving--I was in for a world of hurt.

We were both aware of the re-enactments, could see them and name them, but that didn't stop them. I could see my own role in them, but was helpless to change things, and my T could not seem to see his own role in the re-enactments, nor respond differently to me in order to stop the cycle. I don't want to put all the gory details out there, but am willing to share my experiences with you via PM if you like--just let me know.

P.S. We seem to be working through things towards a happy ending. It IS possible, although I think the vast majority of the time, the Ts are unable or unwilling to see or own their part in things and change their reactions/ways of working, and most of the time, we clients can't change our reactions even if we're aware of them (duh, that's why we're in therapy). So "working through it" in a way that is healing and empowering to the client is possible, although not very common, I don't think.
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Default Sep 01, 2019 at 01:34 PM
  #130
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. . .. We seem to be working through things towards a happy ending. It IS possible, although I think the vast majority of the time, the Ts are unable or unwilling to see or own their part in things and change their reactions/ways of working, and most of the time, we clients can't change our reactions even if we're aware of them (duh, that's why we're in therapy). So "working through it" in a way that is healing and empowering to the client is possible, although not very common, I don't think.
That's the thing -- it is NOT under our control, as clients, no matter how hard we try. The T may get to a sticking place, for them, and stuck there they stay, perhaps even with the best supervision they can find.

And when it doesn't work, when it can't be "worked through" -- for me, it left me in a very much less empowered place than when I went into therapy.

Maybe, if you're prepared in advance and know about that as a possible outcome, though. . .
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Default Sep 01, 2019 at 02:32 PM
  #131
Little things are unclear. For example , my T changed from in network to out of network on my insurance bill, plus the fee per session went from 150 to 200. Since I had just met my deductible, I didn’t notice for several weeks. When asked, he said since he is not charging me more , why does it matter if he told me. This is the kind of example about which I am unsure whose reality is reasonable. To me, since I trust him with my cc on permanent file, I think an FYI would be reasonable. Your bill is different and here is why . This is just bc as an adult, I like to know the practicalities of my insurance etc. we’ve never had any money problem, and I would have taken an FYI in stride. His take is he is honest and ethical , and since it didn’t affect what he is charging me for sessions, it didn’t occur to him to mention it.

One extra concern here for me is I think he might be getting paid less now per hour for me, as I read the billing. I want to pay what I should pay.

This is a tiny example of a larger friction centered around communication. We did talk about this, but I was just as low grade uncertain after as before.

Would your T let you know a fee change or network stays change? Maybe not?

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Default Sep 01, 2019 at 03:13 PM
  #132
My deductible is only $500, and I hit that within one month since I see the therapist 2x/week. Once I meet the deductible, I have to pay $25 + 10%. My plan actually specifies +20%, but I noticed the therapist isn't charging that. She didn't say anything about it, though. I hit the out of pocket limit about 1.5 months before everything resets. At that point, I don't have to pay a copay anymore and insurance pays everything.

Insurance never pays what therapists actually bill. Additionally, there are all sorts of weird intricacies to billing that can sometimes change the rate. For example, we had insurance previously that would start paying the therapist more after a certain number of sessions every year. I don't think it's your responsibility to worry about your therapist's billing. Your responsibility is just to render payment as agreed.

I would expect a therapist to inform me if they were planning on not taking my insurance anymore. If I was paying out of pocket, I would expect to be notified a couple months in advance of any change in fees. When I was seeing a psychiatrist who didn't take insurance, that is how it was done at the agency where she worked. If I was just paying a copay, I'm not sure if I would expect to be informed. On one hand, I really wouldn't care because it wouldn't affect me. However, for people who have really high deductibles, a change in fees is something they might want to know about - even if they've met the deductible for the current year. I am a student and don't have a lot of money. Even though my deductible is really low as deductibles go, I still have to plan for it, since $500 is unfortunately about half a month's income for me. So I think there could be good reasons to let clients know about changes in fees - maybe not small $10 ones, but $50 is a 30% increase from your therapist's previous fee.

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Default Sep 01, 2019 at 03:29 PM
  #133
If he's gone out of network, he could be much more expensive for you starting next year. Actually, it could even affect you this year, depending on how your insurance works. Mine reimburses 60% for out of network, which my T is, but I have to pay him his full fee upfront first, then submit to insurance (which can take forever--like months--to process and pay me). We've met our deductible (which is much higher than yours, Susannah, wow!), but there's a separate in-network out-of-pocket max (which we'll meet soon) and out-of-network out-of-pocket match (which I doubt we'll meet). Meeting the deductible for us just means that insurance starts paying 60% rather than nothing (well...the first chunk of the deductible is covered by H's employer--it's complicated!) In other words, I'd pay close attention to your insurance statements to make sure you aren't going to be responsible for more payment even though you've met your deductible. And to see if you'll need to submit bills to insurance for reimbursement (or maybe he'll do that for you--ex-T and ex-MC's office had a receptionist who took care of that; current T does not). If you will end up paying more if he's out of network, I'd talk to your T about potentially reducing your rates.


To answer your question, I'd definitely want to know about a change in fee. I think they're technically supposed to give a certain amount of notice as well. I'd expect at least a month.
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Default Sep 01, 2019 at 08:19 PM
  #134
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Originally Posted by SalingerEsme View Post
I avoided these kind of twisty, painful relationships in real life, so I can’t fathom how this one developed in therapy of all places. The psychoanalyst told me to read up on Kohut’s “ twinship” concept . It is like my T and I enact rather than process, and we might unfortunately have related areas of weakness / wounding and trigger each other . I don’t know. I am almost addicted to my T, like we are not just looking back at trauma but also recreating a version of it in real time.
yes, this is exactly what was going on in my own therapy as well. i never experienced such drama with others in my life as i did with ex-T. it's like we fed off each others triggers constantly and neither of us knew how to put an end to it. as much as i tried, i don't think T really fully comprehended what exactly was going on until after i ended therapy and we discussed it more later upon meeting a few times.

Quote:
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A great outcome would be this moment of hardcore standing up for myself creates a lasting sea change as our session was a sea change. I don’t truly believe entrenched dynamics can change radically, but unwisely I am goi g to see it through.
this definilty is not an easy situation to get one's self unstuck from, but i have hope for you because you now are more aware of what really is taking place that knowledge definilty will help aid and empower you to not become so entrenched in this situation any further. i reckon you will start experiencing a sense of control returning to you and your therapy.

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It is wrong to say I love my T, but it is not romantic . It is bc he speaks my language.
i don't think this is wrong to say...i loved my ex-T and still do to this day. he has a good heart and good intentions as a human being, but in all honesty, he is a mediocre T for me. it's taken me a while to get to this stage, and i'm fortunate because my T has been willing to remain in contact after i left so we have been able to smooth and repair things out between us. if he hadn't, i reckon that i would be incredibly hurt, bitter, and angry still to this day and that's a dismal place that i don't care to be struck in any further due to a therapeutic relationship and therapy gone wrong.
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Default Sep 01, 2019 at 08:34 PM
  #135
Mine is really low right now because it's student health insurance. It's not bad, although going to any doctor outside the student health center is too expensive for me thanks to the stupid coinsurance I have to pay on top of the copay.

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Default Nov 10, 2019 at 07:55 AM
  #136
Update and thank for all the support. Without PC, I would not have been able to stand up for myself, and I was unraveling in a dangerous way out of character. Your feedback helped me find a voice and resolve:

Today,Dr. M said he was sad he can feel my perciptious loss of trust in him after we spent years building this. I can see how hard he is trying to go back and compare notes on various past events, so that we share one reality. He used to employ his modality as a way to privilege his experience of a session over mine. He even admitted the times he flat-out lied to me, explained why , and said he understands what mistake that was and that he is sad he did it.

We've been trying hard to repair our relationship; At its worst, it became what my T called an impasse . He said I must confide vivid, visceral details of childhood s abuse to move us forward, and i said I could'nt when the 45 minute session ended, and then I cried in the stairwell for 90 minutes plus in some weird regression of being a small kid hiding in my closet for days ( thank you LT for being better than myT!).

Eventually, I caved in and spent three sessions giving what was asked while shaking and reading notes to keep myself present , but feeling forced ( not as forced as in the original scenario, but still forced). The aftermath was horrible , and it didn't heal the feeling of impasse. I simply lost trust that my t cared about my wellbeing , was properly trained, or maybe was even bit sadistic.

I then went to see/consult a master therapist who retired to my small city, whose book I read and loved. He thought my T cared, but was not trained to "take care" of a capital T trauma client, bc his experience with exposure therapy with soldiers in Germany in a controlled hospital setting and being high on a chain of command did not translate totaling care of a peer by himself.

He thought my T emailed with me bc it filled a need in my T, and that we communicated better in writing that speech, and did not talk to each other in real time about difficult things ( like my T writing about me on Reddit), which just recapitulated both our FOO systems, and created powerful enactments bad for both of us. He thought my T was irresponsible and in over his head, but with his charismatic leader personality, was used to getting away with this.

He thought I should terminate with my t, and work with himself. I actually did this for a week, and told my T that while I was terribly attached to him and grateful that he had basically cured my need to dissociate as a first defense, and been loyal, creative, and challenging in our work, and that I was addicted to his crackhead brilliant insight, that I was terminating bc i felt he was too busy and used a cookie cutter modality on me even when it caused harm.

My T then did something so far out of character it changed my mind and I stayed with him. . He came and sat with me in that stairwell, a place where he said ethics would never let him go, and smelled the industrial carpet, saw the door lock automatically so he couldn't get back to his office easily, and realized i spent 4x as many minutes recovering from seeing him than actually seeing him. We talked about how in a fantastic hospital where he used to practice, nurses took care of this, and that in private practice it really is negligent if patient leaves regressed and crying every session and topics are forced ala Exposure Therapy without resources to cope with that aggressive method. He was in tears, he said he never wanted to hurt anyone and he had hurt me, and that in his heart I was family.

Since then, we have implemented a few talking rules: "Intentionality before instinct" and "coherence before intuition" as rules for talking, He has dropped much the neutral stance and also allowed a double session to ease the immense pressure on each session, and explained he is a "let's go" psychologist by style and likes to move fast. The double session he doesnt believe in, but he sees I gave my all to fix the impasse , and now he is giving his all in his way.

Time will tell if we learn and grow from this as we both want to, or if the bad dynamics are more powerful than intentional change. There is therapy love without therapy trust, there is the real world of our small city creating dual connections and problems to solve, highlighting that therapy love is not real love but a state of suspended animation. I can see things ending badly with M in the future, and I can also see us now being this vulnerable to each other, and making the unlikely come-back..

I am left ambivalent. I love my T deeply, and have told him secrets no one knows in my real life. But he has gazed into my eyes and lied like a champion of lying in the past,and now admitted this and explained why ,saying he will never do it again. And I love him but I dont trust him. And I trust he cares about me but not that he knows or is trained to take care of me. His saying I am family in his heart is loadecd and laden with meaning to me. if he said that to retain me as a patient, bc he is the talented mr ripley then I am doomed.. If he meant it from the heart, I am lucky. The sad thing is I give it 50/50.

And I am scared for the future , but unable to leave . I have some hope for the future turning out right with M ,bc much has changed now , but have to let go of the hurt and let us start fresh . That is hard to do.

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Last edited by SalingerEsme; Nov 10, 2019 at 08:12 AM..
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Default Nov 10, 2019 at 10:17 AM
  #137
I don't have any advice Esme as you're the only one who can make a choice. But I did want to refer back to the title of this thread and say that rather than being unjustified, your anger at your t is incredibly justified and always has been.
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Default Nov 10, 2019 at 10:45 AM
  #138
Thanks so much for the update, SE. Hope things go well, and I understand your feelings about how that might not be the case.

If it doesn't work out well -- and I know this won't help the pain that much -- the future for you may be OK anyway. And his future, too, in a way, but maybe a different way. It sounds like he still has stuff to deal with himself? (As, maybe, do we all.)

I think there's a lot about therapy reactivating old unhealed, unresolved development issues -- and one of those can be "Leaving Home", as is the title of a book I like. And when you leave -- who knows what is out there? But maybe we can't stay "at home" forever?

My 2 cents anyway.
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Default Nov 15, 2019 at 08:06 AM
  #139
I'm sorry you're struggling so much right now Esme.

I know this isn't exactly the same thing but I caME across this video:

YouTube

You are so much stronger than you think you are.

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Default Nov 15, 2019 at 09:22 AM
  #140
Thank you for the prompt to look back at the title. I am so relieved that the things I worried about were not distorted thinking by me or a grievous lack of trust stemming from childhood damage that cannot be cured the way I had feared.

My T did lie to me , he did overcharge by several thousand dollars, and he did make a really big mistake framing the sharing of charged and visceral details from my memory as a way of saving us both from "failing" one another and ending in an impasse.

I'm grateful to my T for stepping up in a way new to him and his modality/ training, to admit I had things about which to be angry in the here and now that were legitimate. He has really tried to repair things, and made palpable changes. Mostly, I learned that he has a real horror of hurting someone or doing harm, and he never wanted to force me the way I felt forced. He was stricken by the aftermath, and the sudden idea he had been negligent. That I believe.

This is a tough relationship, bc this T is very charismatic and bright in a way that answers something in me. I do believe in him, that he has and can help me. However, I also have a gathering awareness I can trust myself rather than take his word above my own the way I used to. He will try to spin doctor reality or privilege his own reality over mine at times- he just is that bright, competitive, know-it-all, Ivy league white male you read about. He is clever, and can debate for the sake of debating or the sake of winning, slipping out of therapist role. However, he has a crackhead capacity for empathy that is redeeming and unexpected, and he has a world-weary wear and tear sorrow in him that does bely some of the nonsense. Complicated human . I guess we will see what happens.



Quote:
Originally Posted by Lonelyinmyheart View Post
I don't have any advice Esme as you're the only one who can make a choice. But I did want to refer back to the title of this thread and say that rather than being unjustified, your anger at your t is incredibly justified and always has been.

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