fired by text

I don't like the punishment either and think saying you can't call for a month is infantilizing and quite ridiculous IMO. But I personally understand the hesitation to just dump this program (and the T, since she is part of the program) for simple practical reasons. I would likely do the same in a similar situation, would go back and try to get the good out of it given the investment and how complicated it would be to go elsewhere. And there wouldn't be anything else much deeper driving my decision. If she ****s up again, then I would leave. You can probably feel good about yourself for taking the high road eventually, being more skilled at communication and asserting your needs more effectively than the therapist, including the ability to make compromises.

This is like if a physical therapist got mad and decided they wouldn't do a particular set of exercises with a client for a month. It wouldn't be ethical. She's basically withholding part of DBT treatment. It's not ok that she's withholding treatment for punitive reasons. If she is unable to provide phone coaching, she should not be part of a full fledged DBT program. If that is not the issue, she should not be withholding part of the treatment from you because she is ethically bound to act in your best interests and withholding treatment is not in your best interest.

I don't think it's fair to punish you by not allowing phone contact for a month. I would talk much more with her about all this. When my last t put restrictions on the therapy it felt like a punishment more then helpful The only reason why i stuck through was the day program and i could not afford to pay out of pocket. I truly think you are better off with a better t that wont use punishment in treatment, I am always here to support you, it's very tough. Hugs

I didn't see another thread about this so, for what it is worth:

What would it really take for you to feel really "repaired" and OK about her inside? The phone coaching now seems like. . .something else entirely almost. Her using it -- withholding it -- puts that in another category, to me. It will require that she acknowledge that she did a passive-aggressive, inappropriate thing AGAIN, in punishing you, and what has happened so far is that she doesn't seems very able to do that very well.

She has been disrespectful of you, and your legitimate needs and expectations as a DBT client. That hurts -- for good reason. Would a card telling you what a wonderful client you are really do the trick here? Seems to me that's a surface thing related to what was harmed, but not a repair to the core problem. Like others have said, it just doesn't sound to me like this T has it in her to do much better right now. And NOW is when you need her. This is not a friendship as is repeated over and over in this forum, and it doesn't mean she is a bad person, just. . .limited.

If you can put some limits around yourself, and on your trust in her, and keep on getting some benefit from the program -- maybe that's a kind of "repair" that you can do yourself? IDK. It's the kind of thing I try to do these days sometimes in other relationships. Feel the pain. Accept what seems most likely to be the reality about them. And let it go.

It's great that you have been able to learn skills and handle even this issue skillfully. If you can learn some more, I can certainly see why you would like to try it. But if it turns out there's not much more, and it's hurtful to continue, then that's another story.

@maybeblue raises a good point, however. Although I stand by my opinions and many others' opinions here, maybeblue does point out indirectly that there are differences between therapeutic ruptures and therapy (emotional) abuse. However, the lines are not that clear in such cases, and they can often become blurred. Sometimes mistakes happen, but sometimes they are more than mistakes - they turn into an abusive relationship over time. How can we tell? Would we be susceptible to further emotional abuse in therapy if we allow ourselves to explore the answers? Will the relationship be repairable? Could it be repairable? What does that mean for the client and his/her continuity of care?

For many of us who have experienced therapy abuse, myself included, I recall seeing the warning signs early on but ignored them because I wanted to see if it was just me, if mistakes are repairable, etc. In some minor ruptures, they are repairable. But in others, those ruptures become a pattern and a cycle that does little to help the client; in fact, when it turns into a cyclical pattern of abuse, it is like experiencing intimate partner violence, where leaving becomes even more scary and painful.

As noted under Dr. Grohol's PC article found here: Your Patient Rights in Therapy

Dr. Grohol also includes this bullet point in his PC article:

In another PC article by Dr. Nauert found here:
Strong Therapist/Client Relationship Necessary for Exposure Therapy

Here's an excerpt from Dr. Nauert's article on PC:

In the case presented here, many of us who are supporting or trying to support maybeblue may recognize our own past therapeutic experiences, including therapy abuse and/or non-abusive therapy ruptures. Sometimes we do our best to help, but our own past clouds our judgment or influences our methods for helping. Sometimes our past traumas are so similar to the traumas we hear from those whom we're supporting that we experience "vicarious" or "secondary" trauma, but may not even be aware of it. In my case, I can relate to some of the things mentioned here, and in my experience, it had turned into therapy abuse over time. But that's my own bias. And no one is without bias. It just gets more challenging when we are trying to help someone we know. So, when in doubt, I turn to articles that can shed light on areas I may not be aware of, which helps to reduce bias.

Hopefully some of these articles found on PC help not only maybeblue, but also the rest of us who struggle or have struggled with similar issues in treatment. Many times, we learn by example, and we're hoping that the examples shown on here or elsewhere are positive outcomes, even if that means ending a potentially toxic relationship (emphasis on potential, because nothing is always 100% absolute or predictable).

Anyway, I'll get off my :soapbox and end here. I won't post anymore under this thread unless addressed directly. I just wanted to help.

((safe hugs to all))

I wouldn't stick with her.

She messed up (firing via text) and didn't make amends in session. This makes me wonder if she even knows what she is doing. Is she experienced or relatively new?

Anyway, I wouldn't feel it my duty to teach her how to do her job properly. You expressed your needs. IF she had an issue with it, she ought to have addressed it with expertise and maturity. Instead, she got defensive. I would use my wise mind to advocate for myself. So no, I would go to that second other nicer DBT T. Why? I would like to work on myself and help myself, *not* try to teach T1 how to be a decent T. Not on my buck!

This is not taking anything away re how useful she has been to you in the past. But maybe she can only help you up to this point. It is okay to leave a T who is no longer useful, rather than stay and keep trying to recapture... what used to be.

Lillib - I think what is experienced as harm or abuse can be quite subjective and personal, depending on many factors including our individual histories, sensitivities, personality, emotional style and so on. I am not sure it is a good idea to overemphasize one's own experiences by projecting it upon others' - it can actually create anxiety and self-doubts that are not necessary and can sometimes be more harmful than the suggested "harm". I'm just saying this because I have seen reactions like that many times on PC and also in my everyday life. They are usually well-meaning and protective but, IMO at least, it can be more effective to just share our own experiences as our own and not interpret others (especially people on the web), using factual statements like this means X, something is because of Y, especially in very complex ways. It's exactly what some Ts do and it can be pretty counterproductive when it implants something into the client's mind that does not belong there. I think the stories and interactions on a forum like this are, by definition, lacking tons of information about us and our experiences, so I personally prefer to refrain from treating and analyzing them as some sort of exact science. I know I fall in that trap myself because that's how my mind works naturally and automatically, but probably better to be careful with too strong interpretations.

Maybeblue - thanks for posting the update! I was really curious to see how the meeting would go.

I think you're being very thoughtful (in the sense of thinking things through, not just reacting) and doing a good job of advocating for yourself, while also looking at other options (the other program) and behaving more skillfully than your T. Good on you!

And, even though I really don't like what your therapist is doing, I understand that there are all kinds of other constraints in play here. It sort of sucks, and I'm sorry that there aren't more programs easily accessible to you. Even with the 2.5 hour drive, I don't know how you do it. That's like... road trip territory

So, I wanted to say, I respect your ability to decide whether to try again with this person or move on. You're clearly a competent adult, and you get to make your own decisions, using whatever criteria are important to you. Staying *might* be a mistake. But, so might any decision we make. And, in the end, it's your life... you get to pick.

That said, I'd be a tiny bit worried at this point that this T may not have a lot more to teach you. Didn't she admit that you acted more skillfully than she did? Maybe you're bumping up against the end of her capability to actually be helpful?

I'd also worry that removing phone coaching will make it *harder* for you to learn what you need. It seems like an integral part of DBT? And, won't it slow down your learning?

Do you think there's any other Ts in this program that you could use as a "phone coach" instead? Since it's just skills coaching, and not support, any DBT-trained T should be able to step in to that role, right? Would that work for you?

(Honestly, I kind of wonder why they don't have it set up so that one T is acting as a phone coach at any given time, and the other Ts get a break... like they should have a shared cell phone, and Ts get assigned times to take it home and do the coaching. That way, they all get plenty of breaks and "time off" from essentially being on-call.)

I'm also really confused/surprised by the fact that she admitted she needed to make a repair, which sounds like she's admitting she did something wrong, but then followed that by punishing you (which sounds like she still thinks YOU did something wrong.) That's confusing and seems really weird to me.

Good luck with whatever you end up doing!

Thank you everyone. It has been very helpful to get validation here. I'm really stubborn about trying to make relationships work, but I can promise that if something this horrible happens again I will not stay. The whole thing still seems weird to me, and it really sucks but it is giving me a chance to practice skills. It's a private DBT program and there is only one other therapist. I think that's got to be a really difficult way to do it. I wrote a DEAR MAN (actually just DEAR since the MAN part is how you do it.) And do I think that a note will "make it all better?" No. If that is possible it will take time. But it's a symbol and an insistence that she actually do something to make a repair. She said that she needed to make a repair in the same tone of voice she uses for group when she says she has to be gone for a week for a conference.

Describe: A couple of weeks ago you sent me a text message terminating therapy with me. I texted back asking for a session so we could discuss your decision. You agreed. During that session you said that you had accidentally reinforced a behavior in me that you didn’t believe was effective. You also said that you were getting burned out with my text messages which is what caused you to send that text. At no time prior to that text did you ever directly tell me that I was contacting you too much. In fact, every time before that week when I had contacted you said things like “Thank you for asking.” You apologized about the text and reinforcing the behavior and said that you needed to do a repair. Then you also said that I couldn’t use coaching for a month.

Express: When you sent me that text, it caused me a great deal of harm. It hurt tremendously. It was our 16th anniversary and my husband and I were on vacation. Since I was quite upset and preoccupied it hurt him too. During those five days between the time that you decided to send that text and the time that you actually explained why you did it, I spent every waking moment trying to figure out how I could be such a difficult client that even a DBT therapist with all of your experience couldn’t handle me. I questioned every time that you praised me and told me I was doing well. I went over everything I could remember saying in group and individual therapy to see if I could figure out what I had done wrong. I don’t think that therapists always understand the power they have over clients or the capacity they have to hurt us deeply.

I have had to rely on a lot of resources to be able to get through this period and I’m OK with that. I’ve talked to several people about it, including several of the suicide hotline people and another certified DBT therapist in another state to see if I was over-reacting to this, and without an exception they all said that in this case my instincts are correct. This was a violation of trust. And it wasn’t DBT. Just so you know though, I gave nobody your name.

I appreciate you admitting that you made a mistake. But I’m not satisfied with the repair you made to me. To me it seems like setting the boundaries around contacting you is your responsibility and that you owed it to me to be explicit about them. If you had, I would have respected that. I am good at boundaries, but only if I know where they are. So it seems like you made the mistake, but I’m the one being punished, and I feel resentful and angry about that. I’m also worried that there is some other line that I might accidentally cross without knowing it is there and you might again decide to dump me. I also think that by eliminating coaching entirely you are not giving me an opportunity to demonstrate that I can and will respect reasonable boundaries. You went from one extreme to the other instead of finding a middle path.

I am also worried that your team made you take me back and that you don’t actually want to work with me.

Ask: I am requesting that you reinstate coaching. I would propose a limit of no more than one call a week, but I would like you to call me back. There is too much opportunity for confusion with texting about when the conversation is finished and wondering how many texts are too many. I would like to be able to use that call for questions about skills, the diary card, homework, or a brief (5 min) relationship repair. But not for asking for reassurance. And if it is a repair, I’ll wait at least 24 hours to make sure that I’m calm enough to discuss it and that it is really an actual problem and not me being impulsive.

I would also like a more meaningful repair because your behavior resulted in significant harm to me. I would like you to write me a note telling me things that you like or appreciate about me, but only if you mean them and if this relationship is important enough to you to repair. In return I will write one for you. Because there are many things that I like about you.

I know that confrontation is difficult, but if you do not want to work with me, or can’t handle me for whatever reason I just want you to look me in the eye and tell me and explain why, so that I can learn from it. I would much prefer you were just honest and told me that directly instead of doing something indirectly later that hurts me again.

If you do decide that you want to be my therapist, then I am probably going to need some reassurance from time to time that you do still like me and that I haven’t hurt or offended you. I don’t think that it is unreasonable or unskillful for me to occasionally need to find out or “check the facts”, especially while I am regaining trust. But I can do that in session.

As long as we agree on the targets, I am willing to follow the DBT structure. However, if I do a target behavior, I propose that I do the chain analysis and bring it in and go over it with you. That will save a lot of time and I won’t be frustrated that we never get to the solution analysis which has been my previous experience with chains.

One more thing...if I come into a session extremely depressed, I might need more compassion and understanding and I will certainly need you to go more slowly. I also believe that doing a chain about something that happened the previous week would not be nearly as productive as helping me with the current emotion.

Reinforcement: I recognize that you have more power in this relationship than I do in that you could more easily replace me as a client than I could you as a therapist. You would probably get an easier one if you do. But there are advantages to working with me. I’m interesting and funny. I’m determined and intelligent, and if we work together instead of at odds with each other, you will get to see progress. And I will challenge and push you into being an even better therapist. But it’s totally up to you. This relationship is important to me, but not as important as my own self-respect.

@maybeblue that is really well thought out. HUGS I hope it goes well.

Agree, you did a great job explaining what happened, how you felt, and what you need to move forward. I think any T would be lucky to have you as a client! Good luck!

I am so sorry this happened to you! Very painful especially with the way it happened.

Thanks. I have to admit though that I might have a few personality quirks that could get annoying to therapists. Usually this one has just laughed when they come up. I have *mostly* resisted the urge to quote the treatment manual at her because I bet that would be irritating. She did laugh once when I told her "look, I practiced skills, that means you need to reinforce me." The first one got grumpy when I'd say things like that.

OMG, the energy expenditure in this thread alone.

I am so glad to be free of this kind of drama.

The incessant analysis. Everything under a microscope. So draining. So pointless (for me it was)..

Having your life turned upside down by a crappy relationship with an emotionally unstable low-awareness know-it-all and compulsive rescuer.

It was self-abuse.

The horror.

I think you did an awesome job, maybeblue. The way to show how a DEAR is done!

Whether the T can deal with that is another matter. But being clear that your self-respect is the more important thing -- after laying everything out so clearly, too -- whatever happens it seems like you have gotten your money's worth from this therapy !

An appalling and unprofessional therapist imo, completely unskilled at communication, grrrr.
I'm sorry you were subjected to the bs from this person.

I'll be honest - and I won't pretend to have any experience of DEAR MAN letters - but I doubt this will have a favorable response when the text that kicked this whole thing off didn't. This letter will likely cause her to be even more defensive because you mention having to call suicide hotlines and basically call her out for being a ****** therapist. Saying you didn't tell anyone her name almost sounds like a threat.

To be clear, I definitely don't think you are wrong for saying anything you wrote. The tone and content just seem at odds with your stated goal of making it work with this therapist. If that's definitely what you want to do, I would probably edit it to be less accusatory. People who feel guilty are unpredictable, and being confronted about ruining your anniversary, making you suicidal, etc. etc. could just make her lash out against you. And making a comment about not having shared her identity with the people you talked with can actually be interpreted as a passive aggressive, manipulative tactic even if that's not what you intended - so I definitely wouldn't use that to curry favor or expect it to be perceived as a gesture of good faith.

Anyway, not trying to be critical, just giving my feedback based on how this therapist has already behaved and also because you say this is an area you are working on. I don't know if your issue is that you are usually a people pleaser and avoid conflict, and maybe you are trying to learn how to confront someone in a productive way, or what. But what I do know is that unfortunately, being as direct as you are in this letter is rarely rewarded - especially when the recipient is in a position of greater power.

Thank you. I actually really appreciate that advice. Writing the letter did make me feel better. So in that way it was very helpful. Fortunately I can't contact her between sessions so I haven't given it to her. I'm right. I wouldn't fire a plumber by text message, much less a client who might actually commit suicide. But being right doesn't necessarily get you what you want. So I should focus on being effective.

Maybe I should let the text go? She did apologize...sort of...for it. And based on what I know of her, she probably does feel guilty. I think she might be more of a people pleaser than I am. She certainly knows I was hurt. But I do think that I want to ask for something. Honestly, I have no desire to call her for coaching at the moment. But it is still a part of DBT and it does feel like a punishment.

Anyway. Thank you for the direct and honest feedback.

In therapy, you're supposed to be able to "come as you are". So if the text is bothering you, I'd bring it up.

With my Ts, both allow me to talk about anything and everything and as often as I want (with the main exception being no T's personal information).

I thought I was supposed to be able to come as I was in therapy but I was wrong. I was terminated, after 6 years, because the therapist "didn't have the emotional resources" to continue.

Seems to me, finally, that some people like honest and direct feedback and some people don't. I don't know any therapy, DBT included, that can help with learning who can tolerate it and who can't. Some people seem to have a knack for picking up on things like that and some people don't. (I'm one of those who don't) So, I think it would it would be a helpful addition to what is offered people who are having mental health issues (depression, anxiety) from social situations. But It's not here yet.

From my experience, it may or may not be helpful to talk with the therapist. The DEAR protocol did at least seem to help the OP to clarify things for herself,. But, yeah, trying to assess what the therapist's response might be seems like a different kettle of fish. Though important, too.