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Negotiating with therapist

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Skywatcher

MyPTSD Pro
My T and I had a rupture close to 2 years ago. We worked through it. Went through a lot of developmental trauma exploration and my Big T’s. I even trust her now. I do believe she cares about me in and out of the therapy room. However, this rupture that changed our original email structure pops up every few months. The times we revisited it, I would ask for a change, she would get defensive and I would leave angry. We’d end up in a phone call with me crying and working it out. She had me do flash emdr on the original boundary placement last week. She wants me to process these feelings. Apparently, they welled up inside me yesterday in the form of extreme anger, followed by guilt. Oddly, I feel like I have processed a bunch more of it this time.

I started to write out my whole experience from this mess and was planning yet another negotiation and my reasons. In that process, I started to wonder if I even want the changes I am asking for. I’m not sure if I don’t trust myself or if I’m just afraid of being rejected yet again.

Has anyone ever asked your therapist to negotiate a boundary that they initially added to protect the relationship?
 
was planning yet another negotiation and my reasons
1. Why?

2. Since you’ve done this a few times now, you know the pattern(s). You ask, she says no, you lash out, you cry. (You ask again, are told no; you ask again, are told no)

- Are you doing something differently this time, so that you can accept being told no without lashing out or crying? <<< Doesn’t mean that you will be told no, but whenever we ask/are asked a question, no is an acceptable answer. Otherwise it’s not a question, it’s a demand or an order, ya know? Or are you hinging all your bets on being told ‘yes’, and being told no would be the same sort of catastrophic event it’s been for you the previous times?
- Do you follow either of these patterns when you’re told no, in other parts of your life? (Asking the same thing over and over again / not accepting no as an answer from someone; & flipping out when told no)
- IF this is a pattern in your life, and not just unique to these circumstances...
Is it something you’re interested in changing? I ask, because there’s no right answer. I have a couple of friends -and one acquaintance- who’ve built their lives on having to have their own way, full stop. No one is allowed to say no to them. Ever. Only one of them is an asshole about it, pretty much summed up by something I’ve heard her inform people on countless occasions “You might as well tell me, you will in the end, anyway. The only question is do you want to tell me now, or do you want to suffer first and then tell me?” The other 2 are far more charming about it, these days. But I knew them both when they were young and still found throwing tantrums and emotional blackmail as the fastest way to turn “no” into “yes”. Thank. Every. f*cking. Star. they both came to the conclusion that there are far more effective methods of persuasion/manipulation than making everyone miserable until they got what they wanted. ((I’m fairly certain all 3 of these people are actually in my life because I’ve been telling them no for years. Without any qualm. And almost never out of boredom/curiosity to see what lengths they’ll go to, to change my answer.))

Point being? Sure, rapists and used car salesmen and toddlers don’t take no for an answer; but neither do diplomats, lobbyists, and many other perfectly lovely people. Whether you use your powers for good or evil depends on you.
or if I’m just afraid of being rejected yet again.
^^^THIS^^^ Might be something to really
1 - Thrash out... IE Why is being told “no” scary?
2 - Possibly reframe. Sure, rejection meets the technical definition of “no”... but it’s also a hugely weighted word, even more so when you personalise it to YOU are being rejected, instead of the proposal simply being turned down.
Has anyone ever asked your therapist to negotiate a boundary that they initially added to protect the relationship?
For sure.

I have a solid rule in my own life to not ask questions I don’t want to know the answer to, & have zero problem with being told no in answer to a question; so I suspect we have different experiences to the same sort of situation.
 
Hi, my T and I had a similar situation about 10 years ago, which nearly led to us both terminating the therapy.

My T has a super strict policy of no emails and no phone calls outside of sessions (other than calls to re-schedule an appt).

At the time, I was having major issues that would only happen outside of the sessions and by the time the next session came around, I'd be emotionally far removed from those situations.

It was a really critical, core issue and not being able to work on it was making therapy impossible/ useless.

I wanted some kind of method to connect the situations that were happening outside of the sessions, with therapy.

I asked/ suggested emails, letters, phone calls to my T but he was adamant he had a "zero contact outside of sessions policy" for all his clients and wouldn't be budging on it.

We went round in heated, argumentative circles about this for a while and eventually it became clear that he thought I'd be calling "at all times, day and night" and "calling multiple/ countless times per week" or writing "very long, very frequent emails".

None of that was the case, and I finally managed to get the following compromise from my T: I could leave 1 - 2 messages on his answerphone (which cut out after about 2 minutes) per month, write 1 - 2 emails per month no longer than an A4 page. If needed, my T would read the emails *during the session* so that he wouldn't be using upaid time outside of the sessions to be working on my emails/ phone messages.

This ended up working incredibly well and I think I made maybe 3 - 4 phone calls per year, and wrote maybe 3 - 4 brief emails per year during that therapy phase and it was incredibly helpful, we managed to work through the issue successfully and my T was very happy that I never even came close to crossing any of those boundaries that we negotiated.

It was incredibly confronting to be arguing with my T, to feel completely rejected at first and to not understand why he was so adamant, and to have the threat of therapy being terminated hanging over the whole argument.

In the end, what helped us was that we both genuinely liked each other and did have basic trust in each other to not f*ck the situation up unneccesarily. We both managed to stay solution-oriented and were both willing to look for "any solution that might work" without clinging to a "particular" solution and refusing other alternatives. We stayed focussed on the issue at hand (situations that were only happening outside of the therapy sessions and my inability to transport those issues into the therapy session just by talking about them).

We miscommunicated for quite a while, both of us making confused assumptions about what the other person was thinking and what their motivations were for making certain statements.

I think my T assumed that I was "using" the issue as a way of changing boundaries. I don't think he assumed that because of me/ my behaviour, but because he'd experienced other patients doing that in the past.

He communicated very weirdly about it (emotionally) so that it took me a long time to figure out what his concern/ motivation was.

All I was "hearing" was that he wouldn't budge an inch, or even half an inch, to help me work on an issue that was absolutely fundamental for my therapy working at all.

Today, so many years later, we still talk (and laugh!) about this big "crisis" in our therapy work together. (It was the only one of its kind in all those years.) And we laugh about how big of an issue it was at the time, and how easily it got resolved in the end and how well it worked and that it never posed a problem again.

(I have no idea if any of these ramblings have been of any help!!)
 
I feel as though I have changed. I see the problems that our first set up had caused for both of us. Our current set up works, but it still triggers me because I didn’t get any say in the planning. It became a new trigger of my childhood and traumas where I was either 1. Abandoned or 2. Didn’t have a choice. My negotiation isn’t even a big change. It’s quite small. It’s funny that @Friday mentions age 3 because that was the age that my first trauma occurred. Maybe I’m seeking a corrective experience in that area. I’m not sure if I will act badly when/if she says no this time. I feel different. However, I felt so much pain and anger about it this go around. She wants me to explore my feelings on this. I did email her asking that she come to our appointment armed with compassion. Oddly, though, I also felt a strange sense of peace.
 
I had my appointment. It was interesting. I read her what I had written. I listed off all the reasons that it was good and necessary when she added the boundary. She calmly explained the reasons again and pointed out that there has been a positive evolution and hopes that I have noticed it. I have. I told her it still hurts when we work on it or the few times that I emailed her and just wanted an encouraging response (like she used to give). An example would be recently when a family member died. She doesn’t want to confuse our relationship and what it’s purpose is. —I’ll give her that. No changes occurred, but I do have a better look at how our boundaries have evolved. So maybe boundaries do that? And I’m calm. That’s new. The plan going forward is to work more on the past. The root of this mess. Age 3,6,9.
 
My T and I had a rupture close to 2 years ago. We worked through it. Went through a lot of developmental trauma exploration and my Big T’s. I even trust her now. I do believe she cares about me in and out of the therapy room. However, this rupture that changed our original email structure pops up every few months. The times we revisited it, I would ask for a change, she would get defensive and I would leave angry. We’d end up in a phone call with me crying and working it out. She had me do flash emdr on the original boundary placement last week. She wants me to process these feelings. Apparently, they welled up inside me yesterday in the form of extreme anger, followed by guilt. Oddly, I feel like I have processed a bunch more of it this time.

I started to write out my whole experience from this mess and was planning yet another negotiation and my reasons. In that process, I started to wonder if I even want the changes I am asking for. I’m not sure if I don’t trust myself or if I’m just afraid of being rejected yet again.

Has anyone ever asked your therapist to negotiate a boundary that they initially added to protect the relationship?


Well trained, experienced T's with a strong value system, I think believe boundary setting is important, and most have realistic boundaries and keep them. Poorly trained or poor T's allow for much more flexibility in boundaries...and then things get iffy. It is the responsibility for any T to set and keep clear boundaries for a plethora of reasons....mainly integrity and ethics, and a few keep them because they need their down time.....and therapy is during therapy time.

Curious? Is your request a "need" or a "want?" In other words, will their be negative consequence to the therapeutic alliance if you don't get this boundary changed? My guess is if the T sees it more like a want, she will stand firm on the boundary.......but if changing the boundary will help to enhance the therapeutic outcome.....she might consider changing the boundary.

Sounds like you push for a boundary change...she says no....you push back by getting pissed off....you didn't get your way. How might the change impact you....how might it impact your therapist (both positively and negatively)?
 
Well trained, experienced T's with a strong value system, I think believe boundary setting is important, and most have realistic boundaries and keep them. Poorly trained or poor T's allow for much more flexibility in boundaries...and then things get iffy. It is the responsibility for any T to set and keep clear boundaries for a plethora of reasons....mainly integrity and ethics, and a few keep them because they need their down time.....and therapy is during therapy time.

Curious? Is your request a "need" or a "want?" In other words, will their be negative consequence to the therapeutic alliance if you don't get this boundary changed? My guess is if the T sees it more like a want, she will stand firm on the boundary.......but if changing the boundary will help to enhance the therapeutic outcome.....she might consider changing the boundary.

Sounds like you push for a boundary change...she says no....you push back by getting pissed off....you didn't get your way. How might the change impact you....how might it impact your therapist (both positively and negatively)?
The change would be a small bit of what our original set up was. I think, for me, it would improve the alliance. She believes it has too many anxiety risks for me. Want or need? It’s gray. We don’t fuss and fight the way you all are imagining from my original post. She’s a relational therapist. I describe the situation as: it’s like a kid just got her license and wants to take the car out with a friend and the parent says, “you aren’t ready.” That is how this feels. Maybe the kid isn’t ready, maybe it will cause new problems, but she just wants the opportunity to try her new skills.

Like I said, though. Even when I brought it up this time, I told her the reasons it may be a bad idea, but why I wish to try it. She pointed out how much of my request is already happening. The hurt I feel from the original issue, that wells up, is trauma related. That is what we will be working on.
 
I dont know if this helps, but I put together a safety plan and contract that covers every maladaptive behavior and pattern (me instead of others doing it and forcing it on me), to make it work it has real harsh consequences that make me think twice Before breaking it. And it really works, it has on many occasions made me think before acting out or self-harming and instead go for help which often was hospitalization. Because I put it together knowing my own behaviors, and setting the expectations, and some potential consequences, I know what is expected of me, and it’s not from some boundary someone else is setting and forcing upon me.

Point is, the contract is designed with potential harsh consequences that are enforced, it holds me accountable for my thoughts and behaviors. If I am unsafe it requires I get to a safe place and tell someone (safe presence), if I want to self harm it requires I tell someone I want to self harm, or get to a crisis intervention contact or go to the ER.

It also requires me to not stop eating, or attend groups, especially in the hospital, these are considered self harm.

The responsibility is on me to get help and not act out. If I want to stay being trusted, I must follow the contract, if I don’t then it’s back to the harsh approach where mental health professions error on the side of caution and safety, and I lose having choices.

Here is an example, over the course of the last week I had a major crisis, I was on a trend leading to hospitalization. I self harmed by breaking 9 year’s sobriety from alcohol abuse, in my contract it says if I do this, I may be put back on naltrexone, or vivitrol. In the immediate they are not allowing me to drive until I earn back that trust I lost by this self harming. The contract is all about being trusted and having choices and some control when interventions are required. One you lose trust by others its harder to get it back, and you never get it back 100%.

You might say I negotiated with me self. Besides it working to curb my harmful maladaptive behaviors and putting my Own safety in my hands, it has freyed my therapist so we are not spending session time on my behaviors on a daily basis, instead were working on deep trauma, In 2 years a lot has been accomplished, some of my maladaptive behaviors had been changed, and some of my core values and beliefs and cognitive distortions have been changed. For the first time ever I have some hope.

I only write this because sometimes taking the control and benefiting from a path of recovery is better when its in our own hands and not some therapists hands. Set your own path in therapy, don’t let it me a negotian in the first place.
 
I dont know if this helps, but I put together a safety plan and contract that covers every maladaptive behavior and pattern (me instead of others doing it and forcing it on me), to make it work it has real harsh consequences that make me think twice Before breaking it. And it really works, it has on many occasions made me think before acting out or self-harming and instead go for help which often was hospitalization. Because I put it together knowing my own behaviors, and setting the expectations, and some potential consequences, I know what is expected of me, and it’s not from some boundary someone else is setting and forcing upon me.

Point is, the contract is designed with potential harsh consequences that are enforced, it holds me accountable for my thoughts and behaviors. If I am unsafe it requires I get to a safe place and tell someone (safe presence), if I want to self harm it requires I tell someone I want to self harm, or get to a crisis intervention contact or go to the ER.

It also requires me to not stop eating, or attend groups, especially in the hospital, these are considered self harm.

The responsibility is on me to get help and not act out. If I want to stay being trusted, I must follow the contract, if I don’t then it’s back to the harsh approach where mental health professions error on the side of caution and safety, and I lose having choices.

Here is an example, over the course of the last week I had a major crisis, I was on a trend leading to hospitalization. I self harmed by breaking 9 year’s sobriety from alcohol abuse, in my contract it says if I do this, I may be put back on naltrexone, or vivitrol. In the immediate they are not allowing me to drive until I earn back that trust I lost by this self harming. The contract is all about being trusted and having choices and some control when interventions are required. One you lose trust by others its harder to get it back, and you never get it back 100%.

You might say I negotiated with me self. Besides it working to curb my harmful maladaptive behaviors and putting my Own safety in my hands, it has freyed my therapist so we are not spending session time on my behaviors on a daily basis, instead were working on deep trauma, In 2 years a lot has been accomplished, some of my maladaptive behaviors had been changed, and some of my core values and beliefs and cognitive distortions have been changed. For the first time ever I have some hope.

I only write this because sometimes taking the control and benefiting from a path of recovery is better when its in our own hands and not some therapists hands. Set your own path in therapy, don’t let it me a negotian in the first place.

I like your approach because the plan is self-created/self-negotiated. You have your negative consequences, and positive outcomes........you recognize having other people's trust is huge.....and the loss of trust a huge issue....but you are right, you are more likely to follow it if you create it....and it is more likely to be successful. So glad you have found hope!
 
I dont know if this helps, but I put together a safety plan and contract that covers every maladaptive behavior and pattern (me instead of others doing it and forcing it on me), to make it work it has real harsh consequences that make me think twice Before breaking it. And it really works, it has on many occasions made me think before acting out or self-harming and instead go for help which often was hospitalization. Because I put it together knowing my own behaviors, and setting the expectations, and some potential consequences, I know what is expected of me, and it’s not from some boundary someone else is setting and forcing upon me.

Point is, the contract is designed with potential harsh consequences that are enforced, it holds me accountable for my thoughts and behaviors. If I am unsafe it requires I get to a safe place and tell someone (safe presence), if I want to self harm it requires I tell someone I want to self harm, or get to a crisis intervention contact or go to the ER.

It also requires me to not stop eating, or attend groups, especially in the hospital, these are considered self harm.

The responsibility is on me to get help and not act out. If I want to stay being trusted, I must follow the contract, if I don’t then it’s back to the harsh approach where mental health professions error on the side of caution and safety, and I lose having choices.

Here is an example, over the course of the last week I had a major crisis, I was on a trend leading to hospitalization. I self harmed by breaking 9 year’s sobriety from alcohol abuse, in my contract it says if I do this, I may be put back on naltrexone, or vivitrol. In the immediate they are not allowing me to drive until I earn back that trust I lost by this self harming. The contract is all about being trusted and having choices and some control when interventions are required. One you lose trust by others its harder to get it back, and you never get it back 100%.

You might say I negotiated with me self. Besides it working to curb my harmful maladaptive behaviors and putting my Own safety in my hands, it has freyed my therapist so we are not spending session time on my behaviors on a daily basis, instead were working on deep trauma, In 2 years a lot has been accomplished, some of my maladaptive behaviors had been changed, and some of my core values and beliefs and cognitive distortions have been changed. For the first time ever I have some hope.

I only write this because sometimes taking the control and benefiting from a path of recovery is better when its in our own hands and not some therapists hands. Set your own path in therapy, don’t let it me a negotian in the first place.
. Thank you for Sharing this with me. I saw my T again last Wednesday and she helped me realize that I was still a bit stuck in little parts transference. We then did emdr on where these feelings originated. We work a lot on trying to channel my adult self and when I get back in control, things do go much smoother. The thing that you wrote is something that I’m trying so hard to implement. Taking charge of my own healing. I think I was steady at 60-70 percent prior to the pandemic. I’ve sort of slipped into a place of 30-40 percent. I also realized that I’m smack in the middle of trauma anniversaries. Not sure why I’m just now realizing that. My T leaves on a trip soon. I’m going to work really hard to take care of myself. I guess this will be a chance to see how I do.
 
Hi, my T and I had a similar situation about 10 years ago, which nearly led to us both terminating the therapy.

My T has a super strict policy of no emails and no phone calls outside of sessions (other than calls to re-schedule an appt).

At the time, I was having major issues that would only happen outside of the sessions and by the time the next session came around, I'd be emotionally far removed from those situations.

It was a really critical, core issue and not being able to work on it was making therapy impossible/ useless.

I wanted some kind of method to connect the situations that were happening outside of the sessions, with therapy.

I asked/ suggested emails, letters, phone calls to my T but he was adamant he had a "zero contact outside of sessions policy" for all his clients and wouldn't be budging on it.

We went round in heated, argumentative circles about this for a while and eventually it became clear that he thought I'd be calling "at all times, day and night" and "calling multiple/ countless times per week" or writing "very long, very frequent emails".

None of that was the case, and I finally managed to get the following compromise from my T: I could leave 1 - 2 messages on his answerphone (which cut out after about 2 minutes) per month, write 1 - 2 emails per month no longer than an A4 page. If needed, my T would read the emails *during the session* so that he wouldn't be using upaid time outside of the sessions to be working on my emails/ phone messages.

This ended up working incredibly well and I think I made maybe 3 - 4 phone calls per year, and wrote maybe 3 - 4 brief emails per year during that therapy phase and it was incredibly helpful, we managed to work through the issue successfully and my T was very happy that I never even came close to crossing any of those boundaries that we negotiated.

It was incredibly confronting to be arguing with my T, to feel completely rejected at first and to not understand why he was so adamant, and to have the threat of therapy being terminated hanging over the whole argument.

In the end, what helped us was that we both genuinely liked each other and did have basic trust in each other to not f*ck the situation up unneccesarily. We both managed to stay solution-oriented and were both willing to look for "any solution that might work" without clinging to a "particular" solution and refusing other alternatives. We stayed focussed on the issue at hand (situations that were only happening outside of the therapy sessions and my inability to transport those issues into the therapy session just by talking about them).

We miscommunicated for quite a while, both of us making confused assumptions about what the other person was thinking and what their motivations were for making certain statements.

I think my T assumed that I was "using" the issue as a way of changing boundaries. I don't think he assumed that because of me/ my behaviour, but because he'd experienced other patients doing that in the past.

He communicated very weirdly about it (emotionally) so that it took me a long time to figure out what his concern/ motivation was.

All I was "hearing" was that he wouldn't budge an inch, or even half an inch, to help me work on an issue that was absolutely fundamental for my therapy working at all.

Today, so many years later, we still talk (and laugh!) about this big "crisis" in our therapy work together. (It was the only one of its kind in all those years.) And we laugh about how big of an issue it was at the time, and how easily it got resolved in the end and how well it worked and that it never posed a problem again.

(I have no idea if any of these ramblings have been of any help!!)
This seems unusually harsh and demeaning. We have had similar issues, my therapist and me but we always work it out. He is good with e-mails in between sessions, but with the understanding that he may not be able to reply before the session. We do have a system in place for crisis mode, which is putting exclamation points "!!!" in the subject line, which triggers a 24-hour reply from him. Maybe you could do something similar? But also, if it has been a tough session, he will offer a follow-up (15 minutes) phone call a few days after. As a future therapist myself (about 6 months out), I will be trying to gain a middle ground. It is never a great idea to do actual therapy outside of a session, but in some cases that reassurance of connection is needed between sessions.
 
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