Therapeutic Supervision

[sun seeker]

In the past, he has shared too much of what was going on with him, and it affected you adversely.

He did? Do you mean when I said I wished he knew better what he was doing, or was there something else I said about this?

you may consider it useful to check in with her again, in terms of ways you may be able to get help for yourself while this process is ongoing - that seems to be the tough part for you, if I"m reading you right.

Well yes, because there truly is no one besides him who can help me in the same way, and his sudden withdrawal is really scaring me. He wants me to depend on some undefined other resources, but those don't seem to exist to anything near the degree I need them. This has been a problem since he planned his summer vacation and there was no other therapist to take over when I needed one, so I've been floundering since then. Also since I seem to have hit a nerve and he is now being defensive with me, I am afraid that I could fall into old patterns of taking responsibility for things I am not really responsible for. That would be pretty anti-therapeutic.

Trainees (?and practising therapists) are also required to undergo psychotherapy themselves

I'm not sure what the rules are here, but he did say he needed to do supervision soon anyway.

he needs to redraw boundaries which might feel like he's being defensive and uncommunicative

The supervision hasn't begun yet. The "defensive and uncommunicative" is about other matters entirely, which will hopefully be part of the supervision when it happens, but I just want to clarify the absence of cause and effect here. I'm being tactful and protecting his privacy, but I think I may have gone too far in this direction. The e-mail he last sent me was definitely defensive, and the new boundaries he drew effectively keep me from saying anything to him and getting prompt responses. So yes, also uncommunicative. This is why instead of just trying to sort this out with him, I started looking everywhere I could think of for people to help sort this situation out. Otherwise I would just feel helpless and sit here waiting in a highly activated state to see whether he is doing something about it or not. It's not my intention to take over the process, I just wanted to make sure the ball was rolling. Which it seems to be.

I think you're doing great at trying to find a collaborative way through it and to see things from your therapists point of view

Sigh. Yes, I'm good that way. Maybe too much so. Isn't he the one supposed to understand me?

Thank you for the good wishes, though!

 

[joeylittle]

Do you mean when I said I wished he knew better what he was doing, or was there something else I said about this?

I might be misremembering - it was part of him being gone this summer, there was (I thought) a time when he was explaining why he forgot a session, or why he was late, and you posted that you didn't want to have to worry about his reasons.

But truly, @sun seeker - I read an awful lot of posts. :) So I could be off. That's just what I recall.

 

[sun seeker]

Hmm. I don't remember that, but it's possible.

 

[sun seeker]

I just finished writing my version of what has been going on, in case he or the supervisor want to read it. It goes on and on. It drained me. Glad I got that out of the way.

 

[Suzetig]

He absolutely is the one that's supposed to understand you, but like any relationship if there are problems it's easier to find a way through if both parties try to have a sense of what might be happening for the other. That's not to say you accommodate that, or blame yourself, or take responsibility for trying to fix it or protect him but knowing where you think it's come unstuck can really help.

Well done on getting your stuff down on paper, I'd fully expect your therapist would want to read it and, if he can't talk to you about it with openness, he does need to take it to supervision and unpick his resistance there. Honestly, if you do both manage to find a way through it will hold so much learning for you both and will strengthen your relationship no end.

 

[sun seeker]

Well, that went off like a wet firecracker, or whatever the saying is (maybe I made that one up). The result of the supervision was that he focused on my response to a comment he made about how I should depend on him, and took it the wrong way, and how he can't be my only resource. There was no work on addressing the countertransference, and I can clearly see what dynamic from his own trauma he is playing out with his clients - I don't think just me. No admission of the extreme level the unreliability has reached or taking responsibility for it. No understanding of how much of an issue this is when working with vulnerable people. No, it all came back to me. And the supervisor apparently bought into it completely.

I'm not giving up easy. I told her she is not getting an accurate picture and I need to talk to her ASAP. I've been waiting a month for this to get sorted, and it's only gotten worse. I insisted until she agreed to talk to me tomorrow. Now I have to get clear enough on what I want to say so I'm not caught in the helplessness and just sob through the whole phone call.

This is so, so not right. I don't deserve this. At least I know that, which would not always have been true. If he's doing one thing for me, it's giving me an opportunity to exercise assertiveness. Even if it's with him.

Why do people kick vulnerable people when they're down? I don't believe it's on purpose, but the dynamic behind it is so clear. Trauma therapy is not supposed to be retraumatizing. Where the hell am I in this mess as the experts sort out their stuff (or don't)? Still struggling to survive from one minute to the next.

I wish I could recover enough to be a really good trauma therapist. The world needs more of them.

 

[Suzetig]

No admission of the extreme level the unreliability has reached or taking responsibility for it.

I'm so sorry this isn't working out - is it the supervisor you're going to be talking to? Can you give clear examples of the unreliability eg sessions consistently start x minutes late, are short, he answers his phone in sessions, doesn't seem to remember x when we talk about it. Try to avoid giving your interpretation of what's going on with your T. Counter transference is a concept in psychodynamic therapy but there are lots of things that could be happening with your T and a hundred different ways to explain them. It may be better for you to explain what's wrong and the impact on you than try to explain what you think is happening with your T (even though you may be spot on, naming behaviours is harder to deny).

In that same vein try not to get into what might be happening with his other clients, his behaviour is impacting on you, you know this for fact - it's much harder to deny clear, individual examples than "I can see this would be happening with all his clients). It's also easier to hear "you've screwed up with me" than "you're screwing up your whole job with all your clients". Besides you're the important person here, so be brave and hold your ground.

I'd also say that some level of dependence is ok in therapy, some would say it's needed - you wouldn't be the first person for whom therapy is their main/sole source of support for a long time. Your Ts job is to hold that and help you build a support system outside of therapy, while not fostering a greater level of dependence. It's a tricky balance to strike and different for everyone but even if you were very dependent (and I'm not saying you are) I'd expect your T to work with that in a non-shaming way.

If things don't work out in the phone call, can you ask for a joint meeting with him and his supervisor?

 

[sun seeker]

is it the supervisor you're going to be talking to?

Yes. Tomorrow.

Can you give clear examples of the unreliability

You bet. I have the long version if she's up to reading it, but have also written out a synopsis to read from if I get tongue-tied and can't think while on the phone. And there are lots of examples.

(even though you may be spot on, naming behaviours is harder to deny)

Kind of like going to a doctor and saying what symptoms you have but not "I want to see if I have XYZ?"

What is going on is so obvious to me, because of things he has told me about his own traumas. I might mention to her that I can see what is happening but leave it to her whether we go there or not.

Besides you're the important person here, so be brave and hold your ground.

Right. I have a sense of being on a crusade to protect others, but I may do that best by being more focused. Though I already did say to him that he will damage a lot of people if he doesn't get it together.

I'd also say that some level of dependence is ok in therapy, some would say it's needed - you wouldn't be the first person for whom therapy is their main/sole source of support for a long time.

Thank you. Until a few weeks ago, I would have thought he agreed with that from a lot of comments he made. He's changing what he meant to suit present circumstances with no regard for what the sudden change is doing to me. I mean, I can see him needing perhaps to make some changes around how much he is available. That happens. But not to blame it on me, and also not when almost all the times I have called him for help have been because the session was so mismanaged that it ended with me in a crisis state I couldn't get myself out of.

Your Ts job is to hold that and help you build a support system outside of therapy, while not fostering a greater level of dependence.

When he said I would have to be dependent on him for a while, it was actually in a context where I was asking for help with a social situation that had gone wrong, and I said to him that I needed more people to talk to than just him. I was the one asking for help gaining more independence, and his response was to encourage me to depend on him still more. Now he's claiming I misinterpreted the whole thing and he only meant to depend on him in the context of the sessions. WTF??

It's a tricky balance to strike and different for everyone but even if you were very dependent (and I'm not saying you are) I'd expect your T to work with that in a non-shaming way.

Yes, that would have been nice.

If things don't work out in the phone call, can you ask for a joint meeting with him and his supervisor?

I certainly intend to. I'm not letting this go on if there is any way I can possibly help it. If there is one thing I am sure of, it's that this is not my fault. And I guess that's progress right there. But I hate how this is taking over my whole life, and has for the past month. I'm being a squeaky wheel until I get oiled, whatever it takes.

(I know you haven't said this, but in case anyone wants to suggest I just find a different therapist... there are none in the area who even come close to having expertise in the area I need to work on. He comes closest, even with all these problems. I'd have to pack up and move, and that just isn't feasible right now.)

 

[Suzetig]

If he's told you about his traumas I would tell his supervisor that and tell her in a level of detail that only he could give you. That one thing (that you know he's experienced trauma and what that trauma is) could in and of itself indicate a blurred boundary. I say could because, depending on what the trauma was it may be a helpful use of self.

To give you an example, my T will talk about her having been disciplined in a particular non-physical way which means being in a particular setting makes her feel uncomfortable, and the strategies she's used to overcome this. Not lots of detail and not lots of her feelings. I had a different therapist who talked in great detail about a recent bereavement, issues with the doctor wanting her to use medication etc and her not being comfortable with this - a good example of over sharing that made me anxious not to stress her further, meaning therapy was hopeless.

In any even your Ts supervisor does need to know about his use of self disclosure. It sounds like your T is scared he's done something wrong (which he may well have done), that's for his supervisor to work with. The reason therapeutic supervision is non-hierarchical is so that Ts can be open about what's gone wrong but it's still very hard to think you've messed up.

 

[sun seeker]

I'm finally, finally realizing what the issue here is. He's been trying to tell me, and acting it out, and I haven't understood what the heck he's talking about.

He has a problem with people needing him, but at the same time, he wants to rescue people. This creates a very confusing environment and lots of mixed messages. He wants not to be my only resource because he wants me not to be so upset when he cancels sessions - which would be reasonable if it were once in a while, but it's become more often than not, and it triggers extreme reactions because of the nature of my trauma.

It's also blaming me for the stage I am at and the fact that I do need weekly sessions (which he earlier happily agreed to).

Which means he has no business saying he can work with people with serious trauma.

 

[sun seeker]

Not lots of detail and not lots of her feelings. I had a different therapist who talked in great detail about a recent bereavement, issues with the doctor wanting her to use medication etc and her not being comfortable with this - a good example of over sharing that made me anxious not to stress her further, meaning therapy was Hopeless.

Right. I know (I think) exactly where this conflict in him comes from and why he is playing it out with clients. Which makes me reluctant to go into the depth of the pain I am in because I know it affects him and makes him dissociate to be around people in a lot of pain. Which would be why he is blaming me for needing him so much, which in turn exacerbates my shame and the feeling of being too hurt for anyone to handle.

I did tell him during our last session that it doesn't work for him to bring his own issues to the session and that I can listen to him at other times, not when I am needing him to be there for me. He sounded resigned, like "oh yes, there's this again."

 

[sun seeker]

Now, hold on just one minute. (Not you guys. It's my therapist I'm talking to in my mind here, because he isn't available to say this to in person.)

Putting the pieces of this together here. His comment that I should depend on him came up precisely when I was asking for help putting back together some connections that had fallen apart BECAUSE I shared too much of what was really going on for me (with a group that, until they knew just how bad it was, urged me repeatedly to do just that). I was telling him how sad I was about losing those connections, and he was offering to help but stated that I would have to depend on him for a while. Later, same topic, he had changed that to warning me that other people might not be able to hear what it's like for me and I should save that for him.

So, he himself tells me he is the only person I should try to talk to about the extent of the trauma and how it affects me... and THEN goes on to complain that I need him too much and should rely on "other resources?" So that's saying I should talk only to him, but it's wrong to be so traumatized that I need to talk to him on a regular basis?

This is definitely not my issue. It's a conflict between wanting to rescue people vs. not wanting to be needed. You can't have both, not as a trauma therapist.

So glad I worked this out before talking to the supervisor.

ETA: Actually, you shouldn't have either as a trauma therapist. Rescuing doesn't benefit the client in the end, though it's near impossible not to take it when it's offered. Being there consistently, though... that's the happy medium that is missing. It's that consistency that he's fighting tooth and nail.