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Default Sep 18, 2020 at 09:11 AM
  #1
Hi all!

I've been a member here for years but haven't been here much in the recent years. When I was an active member, I desperately wanted to start therapy and in the past 10 years I've made a few attempts to start the process, falling short each time. Last year I finally managed to get all the paperwork done, and searched for a therapist for 8 months until I found one who was able to take a new client. He also had experience with eating disorders, which was what I was most concerned with at the time. Over time, it turned out the eating disorders were likely a response to the traumatic events I have endured growing up. So we've attempted to start processing this stuff. I've been in therapy for about 10 months now and I think I've made a lot of progress.

I've found I dissociate on a daily basis. We have thought of a few grounding strategies I am employing when I notice I'm starting to feel out of it, and I've been self-studying DBT skills to soothe myself when experiencing anxiety or other strong feelings which tend to trigger the dissociation. We have deduced that the dissociation happens due to an inability to cope with unpleasant feelings.

A few times in the past month, my therapist has made comments that make me think he is doubting my willingness to work, and that I'm trying to use dissociative episodes and me being exhausted all the time as excuses to stop working on whatever we are trying to work on. My last bigger episode was after a session where we started mapping out the earliest events I can recall. This felt fine and I was proud of myself to have remembered some events which clearly indicated childhood neglect. It made me a little anxious, but I was able to stand it. Still, afterwards I dissociated.

I brought this up because he has asked me to report these episodes when I remember. However, he only asked a little about the triggers and what happened that led to the dissociation before starting a monologue on how it is my responsibility to keep myself grounded and not dissociate. I didn't say anything because I felt he was a bit annoyed when I came in, so I just nodded and said I understood. And it is good to remind the client that the therapist can only do so much. I understand this. I don't even remember everything anymore, but he said we can't stop the life history work because I dissociate. I did not bring this even up because I wanted to postpone it. If I did, it was unconscious. He also asked me if I'm using my dog's illness and my life obligations as excuses to not progress in therapy. I feel like I have a lot on my plate, and he has asked me to be forgiving of myself in terms of life obligations because therapy is hard.

Then he said, "I know I'm saying this in a provoking manner, but if you're not ready to do the work, then why are we even here? Maybe you need a break from therapy to sort your things out." For some reason I responded I had thought of the same thing - which I have not! - I don't know why I said it. But I said that I know therapy is good for me and I am tired of my situation. This seemed to diffuse the situation and I thought I sensed a bit of a shift in his energy, and we ended on a good note. I felt crappy because it is clear to me that I escape my feelings so often, like my parents. It makes me feel unable to cope with life in general. He suggested to do a grounding exercise, but I just wanted to go home and it does help me to just walk and breathe the air. I took extra precaution to take the shortest, most familiar route to my bus stop, to prevent dissociating.

Now a day has passed and I sit here alone, thinking of a few sessions prior.... we were supposed to work on a ton of different things, but something else came up. I know in the past month I've said a few times I'd like to have a shorter session because I was sleep-deprived and the other time I was on overdrive from having to take my dog to the ER the previous day. A few times I've had something on my mind that I wanted to talk about, but when I tried, he started asking me questions about the first thing I said, which caused me to forget the thing I wanted to talk about in the first place.

One time I wanted to thank him for telling me that I have the power to stop an exercise any time I feel it is overpowering, but he stopped me when I said "It didn't even occur to me that I could that" and started lecturing about how I cannot always decide what we do because I'm going to choose the easier way.

I feel slightly offended. How does he know that? Is that a provocation technique? How much provocation is ok? I don't feel it is fair to ask a provoking question but not tell the reason for it at the end of the session, for example. To me, that feels like manipulation or pushing me to do or say something. Thinking of that session, I feel pressured to act in a certain way or progress more in therapy. But right now I feel like I'm not heard and I don't have the space to fully express myself.

I acknowledge that I am uncomfortable with experiencing negative feelings. Suppressing them and my gift of hyperfocusing has allowed me to function somehow until this point, to the age of 32. However, I do not think when I come to therapy, I am trying to manipulate the session to go in a certain direction or avoid certain topics. I very much go with the flow. I often feel like I do not have the answers to the questions he asks, and maybe this makes him think I am withholding something or not trusting him enough to tell. He has actually asked me why I don't feel comfortable. At the time I didn't feel comfortable enough with him, I take a very long time to open up and only recently I've felt like I trust him a little bit. Now the reason is that I know something terrible has happened, I just don't have a memory of it. I have difficulties navigating emotions, and when he persists that I need to sit and listen to my vulnerable self, and I say I feel like crying. But when he says it is okay to cry, and asks me why am I too afraid to cry, I feel intimidated by the demand. I don't want to cry when told to.

I am definitely going to talk about this next time, but I just wanted to share this experience, write it out, and gain some clarity. And I cross my fingers that I am not going crazy or overreacting. Oh well, even if I am overreacting, that should be fine to talk about in therapy.

Whew. I apologize for the length, maybe this is why 45 minutes is not enough for me to share the important things in therapy. Thank you for reading! I'll be happy to hear if anyone has experienced a similar situation and how did you manage to clear the air or correct the misunderstandings?

Thanks,
Twilight

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Default Sep 18, 2020 at 09:46 AM
  #2
I'm sorry you're having this experience with your T. I do not think you are crazy. I think your perspective and reactions are reasonable. Dissociation is (most of the time) an involuntary response to being pushed out of your window of tolerance and/or not feeling safe in the room or in your body. It's your T's responsibility as well to ensure that you are not being pushed out of your window of tolerance in therapy and it's also his responsibility to help you learn grounding techniques that work for you. His stance seems rather blaming and like he's not meeting you where you are and is not assuming positive intent.

10 months is not a long time to build trust in a therapy relationship when one has experienced childhood neglect or trauma. It's especially not a long time when you're not feeling seen or heard at times.. Asking "why" questions like he is asking (e.g., why don't you trust me) is rarely fruitful. And it's normal for you to give him the answers you think he wants to hear when you don't feel safe--that is an engrained trauma response. He also sounds inconsistent--sometimes encouraging you to give yourself grace and then turning around and using that as evidence that you don't want to change.

He sounds out of his depth and rather than taking a look at how own role and contributions to your therapy (which is co-created), he is absolving himself and blaming you. I hope you feel safe enough to bring these things up to him--he ought to be receptive to hearing this and willing to work with you to find a path forward.
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Default Sep 18, 2020 at 12:09 PM
  #3
I am sorry you are having this experience. It sounds like to me, that he doesnt specialize in trauma. In my experience a therapist can be good with working with clients with trauma BUT it takes somebody who specializes in it to understand disassociation and distress tolerance. I had a great long term therapist whom I worked on my trauma with amongst many other issues.

When I started seeing my EMDR therapist I starting making very slow progress with my trauma. It has been three years and we are still moving slowly. Part of it has bern learning how far she could push me out of my comfort zone in order to expand my window of tolerance without me disassociation. Part if that process has been her figuring out the signs that she is pushing too hard so she can back up a bit and help ground me.

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Default Sep 18, 2020 at 01:25 PM
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I'm sorry you're going through this with your t. I agree with nottrustin that it sounds like he doesn't specialize in trauma. I don't think you're crazy or overreacting and I agree with Oliviab that 10 months isn't a long time at all for this kind of work. I hope you can talk with him about this and find some sort of resolution. You're doing the best you can and in my mind, this work has to be done at your pace. Not at the therapist's pace.

this statement especially "if you're not ready to do the work, then why are we even here?" would be extremely off-putting to me - I'd be like, "dude, I'm not even sure what 'the work' is at this point, I just know I don't feel good and that I want to feel better so I am asking for help. If I knew how to do this on my own I wouldn't BE here in the first place." (i've actually had to say that last part to my t more than once.)

I am wishing you all the best.
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Default Sep 18, 2020 at 01:51 PM
  #5
@Oliviab
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Thank you so much for the responses! I appreciate the validation very much. This whole therapy thing is so new to me, all these years I read about it, what to look for and how to know you're with the right therapist. I've had the feeling that my therapist is good, but I have felt a few times that he has been wondering why am I not trusting him, and it feels really uncomfortable. I definitely need to talk to him about all this next time, writing about it and talking about it with my boyfriend will likely help me remember what I have been thinking and feeling!

@nottrustin and @ArtieTheSequal mentioned that it doesn't sound like my therapist is specialized in trauma. Thing is, by working on the eating disorder and discovering the dissociative symptoms, he shared that he has treated people with trauma and even dissociative disorders. We have worked quite a bit on learning about distress tolerance, and me finding where my boundaries are. So we are getting started.

I do feel like I can talk to him about this, and I have gained some courage to talk about the things that bother me. It's just difficult when things happen, you don't feel anything or don't think anything in particular, once you sit down at home or something, you start figuring out "Hey, this actually upsets me somewhat".

Again, thank you for the responses and reading my rambly rant! It is a relief to know these feelings are understandable and more or less appropriate.

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Default Sep 18, 2020 at 03:13 PM
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Have you told him straight up that you struggle with trust and need to go slower so that it can develop. I had to do this with T. She was asking questions I was not ready or able to answer. I took a deep breath and told her that I needed to slow down to build more trust. I explained that while I trusted her to a certain degree, we were going to deep. I also explained that was not something she did or didn't do just that trust is really hard.

Also, just because he has worked with people with trauma and disassociation doesnt mean he specializes in it.

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Default Sep 19, 2020 at 04:45 AM
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Quote:
Originally Posted by nottrustin View Post
Have you told him straight up that you struggle with trust and need to go slower so that it can develop. I had to do this with T. She was asking questions I was not ready or able to answer. I took a deep breath and told her that I needed to slow down to build more trust. I explained that while I trusted her to a certain degree, we were going to deep. I also explained that was not something she did or didn't do just that trust is really hard.

Also, just because he has worked with people with trauma and disassociation doesnt mean he specializes in it.
That time when he asked me why don't I feel comfortable sharing some things (I forget which), I said that it takes a very long time for me to open up and really trust someone. It took me 3 years to trust my boyfriend and I see him every day. Anyway, I had good vibes about my therapist and told him that I think we'll get there eventually. He respected that and didn't push further until a time when we did an exercise on tolerating some difficult emotion, where I thought if I was sad, I'd probably want to cry. He kept asking about what makes me not able to cry and in the end I did want to cry, not because I had to, but because I felt pressured to. After grounding, he said I can stop any time things become too much, which had not even occurred to me.

The complex nature of a therapeutic relationship makes it even more challenging than let's say, a friendship or a romantic relationship. A therapeutic relationship is a mix of uncomfortable elements: you work with someone you hardly know, but you're supposed to open up to.

You raise a good point in your last sentence. I don't know *how* many people he has worked with, maybe 10, maybe 5. I don't know if the therapy was successful for those people and it's not my business. Either way, it seems he has more knowledge of dissociative disorders and trauma work than most therapists, psychiatrists and nurses I've met. So, I am looking forward to having this conversation and setting things straight. If he is receptive, great but if not, I suppose I'm going to have to freeze this process for now and look for a new therapist.

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Default Nov 06, 2020 at 07:15 AM
  #8
Hey everyone,

I meant to come back here to let you know how my next session went. Well, it's been a while now so the details are blurry but in general, he was receptive and wanted to hear about my thoughts. He did not comment on them, nor validate whether I was wrong or right when I asked him if he feels I'm not doing "enough" in therapy and getting frustrated. I know some therapists avoid divulging any type of personal information or opinion, so I guess that is his method. The situation began to resolve little by little when he kept asking what made me think those things and just talking about it. That time, he did reveal that sometimes he has been thinking if I would benefit more from a more trauma-focused therapy, with a trauma therapist. I thought about it for a month, researching information here and asking friends who had gone to trauma therapy/tried EMDR, and decided I want to go for it. Thing is, I had started feeling a lot more secure with my therapist after that incident so it was a difficult decision. But the potential therapists I have contacted are very knowledgeable about trauma and dissociation, so I think it'll be worth it in the end.

Best of luck to everyone on this journey. We all deserve a therapist who respects us and our unique situations.

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