Email fallout with T - need advice please

[No More]

I’m interpreting the most recent email the same way as @Sideways.

To me it sounds like quite a kind email to say he’s very proud of all the work you’ve done together, and that he’s available should you wish to continue - but he’s giving you space to easily step back and pickup in the future should you wish.

His training is in humanistic psychotherapy and he's clear he doesn't agree with diagnoses (gets visibly defensive in session if diagnosis is discussed to the point i don't feel comfortable owning my own diagnosis in session). He's made it clear he doesn't agree there's enough evidence for dissociative disorders.

That said, for some people (me included) the non-diagnostic approach works really well. This is totally aligned with how I feel and think. And there are a lot of very experienced/qualified/learned therapists that do work and think along the same lines as him in regards to dissociative disorders.
If this approach really doesn’t work for you, and you need someone that’s highly affirming of the diagnosis rather than just taking it symptom by symptom, perhaps his school of thought is not quite the right one for you at this point in your journey. That’s not to say he doesn’t have some excellent help and advice on various points, but if this is the specific area you wish to focus overall, perhaps you’d be better to persue the over avenue you mentioned re the nhs referral (I believe?)

I really think if you are going to continue with him a discussion re this referral needs to be had sooner rather than later, out of respect & fairness for all parties involved - and the fact that a lot of the time it’s unethical for multiple therapists to be working totally independently of each other with no collaboration between them. Perhaps he might be really interested on splitting the work together with the other centre focussing on the dissociative element, while he focus’s on the more humanistic element?

 

[beaneeboo]

I’m interpreting the most recent email the same way as @Sideways.

Thanks @No More

To me it sounds like quite a kind email to say he’s very proud of all the work you’ve done together, and that he’s available should you wish to continue - but he’s giving you space to easily step back and pickup in the future should you wish.

Good to hear from this perspective too

That said, for some people (me included) the non-diagnostic approach works really well. This is totally aligned with how I feel and think. And there are a lot of very experienced/qualified/learned therapists that do work and think along the same lines as him in regards to dissociative disorders.

I agree. It's not that this approach doesn't work for me. I see the value in it for sure. And totally respect it. It allows for less assumptions and isn't hinged on expected sypmtoms and patterns of thinking etc based on a group of people experiencing the same things. So I get it.

For me the issue is that there have been things I've presented in the therapy room which I don't think he's had experience of (not inherently problematic) but then in some instances he's not been able to come up with a solution (or not listened to me for a very long time about a possible solution) because he's not willing to do the reading around some common sypmtoms of the diagnosis. Because he disagrees with the medical approach.

For example, initially I don't think he took my parts seriously. But he quickly realised I was being serious. He didn't really know about communication with parts which is something I said I wanted to be able to do. Or about how to communicate the issues I'm dealing with brought up by one of my parts or more between sessions (I found i was dealing with alot of issues outside of session by parts that wouldn't be present during sessions and it was over whelming). He didn't really seem to get the concept of how difficult that was (doing therapy with only a part of me whilst carrying everything else on my own between sessions and not being allowed to email between sessions).

So in many ways its been a bit of a slog for me.

If this approach really doesn’t work for you, and you need someone that’s highly affirming of the diagnosis rather than just taking it symptom by symptom, perhaps his school of thought is not quite the right one for you at this point in your journey. That’s not to say he doesn’t have some excellent help and advice on various points, but if this is the specific area you wish to focus overall, perhaps you’d be better to persue the over avenue you mentioned re the nhs referral (I believe?)

Again I don't think the approach doesn't work. It does but it's limited. And without his willingness to learn more about the symptoms I experience and the strategies which can be used to help these (which is why I was initially coming to session with the videos made by the DD centre) I guess it means we can only make it so far as a team. I don't expect him to have to learn about DDs and sypmtoms if he doesn't want. I can tell him its useful for me. But that's not where he's at, I have to meet him at where he puts his boundaries.

I guess I'm struggling with that because we've done a lot of good work and I depend on him for so much. I don't want to have to break that. But there things he can't help me with unless he does his own learning...

I don't think he can tackle the amnesia I experience which has been getting worse and worse and I don't think he can help with more practical issues like return to work (these are all this the DD Centre claim to be able to help with). These are things we've touched on in session but it's not part of his skill set.

I really think if you are going to continue with him a discussion re this referral needs to be had sooner rather than later, out of respect & fairness for all parties involved - and the fact that a lot of the time it’s unethical for multiple therapists to be working totally independently of each other with no collaboration between them.

Thanks for bringing this up. It's an interesting perspective to me. I think you mentioned before that me not telling him could be hurtful to him also.

My thoughts on this are that I'm not responsible for my T's feelings and I should never be in a position where I'm worried about whether my decisions are hurting him or not. Obviously treating him with respect etc as I do any other person is necessary. And at some point when I can, out of respect, I'll tell him. But I don't think it's healthy for a client to have to bring something to session because they are worried about how it will make their T feel if they don't. To me that's boundary crossing and we get into guilt trip territory etc.

I'm also not sure that fairness is involved either. I did all i could to discuss with him the things in therapy i needed from him which were more than he was able to give at the time, and he had a big emotional reaction which caused a major major traumatic reaction in me. I think my actions since then have been what they have been. Not wrong, not right, not fair, not unfair. Just a natural consequence of what happened. I have a trauma history so I got as far as I could with the repair. I went back. We talked about it. I took a leap of faith. . But naturally I'm dealing with a system which doesn't see everything through the eyes of an adult within me. There are parts who can't manage what happened.

When the time feels right, I'll tell him about the assessment at the clinic- as has always been my intention. But as long as interactions, like have happened over the last week, continue, I don't much feel like telling him for fear of another reaction. I can't manage it on a day to day level. It's too destabilizing. Can you see the cyclical nature of the dynamic we're in?

Perhaps he might be really interested on splitting the work together with the other centre focussing on the dissociative element, while he focus’s on the more humanistic element?

This is a really great point. Thank you! When I do eventually tell him, I'm going to do so with a focus on this: 'are you interested in collaboration with this other team'? I guess that will help him feel like he can contribute (because he can alot) and it will also put the ball in his court as to whether he willing to continue working alongside another professional who comes from the diagnostic angle. I guess it will highlight what his work boundaries are.

 

[scout86]

I read his email the same way @Sideways and @No More did. It read to me like he gets that you're really upset by something but he may not actually know what that is. And that he thinks you might be deciding to quit therapy, which he acknowledges is your right to do. Doesn't sound like he really wants that to happen though.

I think you mentioned before that me not telling him could be hurtful to him also.

I'm not sure it's exactly a matter of being hurtful to him. It's more of a professional thing. I'm a farrier. If I had a client who was using me and someone else to work on the same problem and they didn't tell me, I'd probably fire them as a client when I found out. Partly because they clearly don't trust me and I think they should work with professionals they DO trust and partly because people can end up working at cross purposes in they aren't working together on a problem. Collaboration is fine, but it should happen out in the open. Does that make any sense? What would be the reason for not telling him?

There's a place where I know I run into problems communicating with people. Sometimes they say something, or do something, that flips a "PTSD switch" in my brain and my brain interprets it in light of the past, not the present. Now days, even if I don't know exactly what's going on, or the reasons for it, I notice the vibe and have the presence of mind to stop and think through other possible interpretations. It happened a lot with therapy, I imagine because that's the kind of thing you have to work on in therapy. Your PTSD brain is trying to protect you, but that doesn't mean it's always accurately assessing the situation. (I have a feeling I'm not doing a very good job of explaining what I'm trying to say!) If you spend a lot of time around people who try to gaslight you, it's gets to be second nature to question your own sanity. At the same time, if you've got PTSD, questioning your perceptions is reasonable, isn't it?

As an example. I have a "thing" about being lied to. Granted, no one likes being lied to, but being lied to by someone I should have been able to trust trips a switch and sends me beyond all reason. There was an occasion where I was REALLY sure my T had lied to me. I called him on it, thinking doing that was "progress" because I wasn't going to let him get away with it.... To this day, I honestly don't know if he was lying or merely wrong. I don't know if HE knows. I know I hurt his feelings when I called him a liar. But, here's what I learned. I overreacted. Reacting was fine, but my reaction was a PTSD fueled overreaction. People lie for different reasons. In this case, if he made something up, it was to make a point that was valuable, whether the story was actually true or not. I decided maybe I couldn't trust him to be totally accurate, but I COULD trust him to be coming from a place where he had my well being in mind. He wasn't actually going to hurt me, in other words. And he never did, even though there were some rough patches that were pretty upsetting. (Maybe for him too. LOL)

I hope you'll make another appointment and that the two of you can at least get to where you each know what the other is really thinking.

 

[No More]

Thanks for bringing this up. It's an interesting perspective to me. I think you mentioned before that me not telling him could be hurtful to him also.

My thoughts on this are that I'm not responsible for my T's feelings and I should never be in a position where I'm worried about whether my decisions are hurting him or not.

Sorry, I worded this really badly in my last post. I didn’t mean anything about his feelings being hurt, it was more the fact that there might be different perspectives from different therapists that are in conflict, it was about whether or not two therapists working independently would be giving *you* the best possible treatment, which I don’t think it would be. People working across each other can tend to get in a right old muddle.

It’s just not really a professionally -done- thing. When I said fairness and respect I meant for their professional skill, and in regards to the fact the therapeutic relationship is supposed to be a very open one built without either party with holding from the other.

However that’s only my opinion - as you say you absolutely have every right to do what you feel is best & will get you the best results.

 

[beaneeboo]

Thanks both @scout86 and @No More ... really appreciate the time everyone is taking to help me work through this... it's quite astounding the community here...

I'll get back in more detail tomorrow ... just about to sleep as I'm exhausted...

But I just wanted to make clear there has never been any intention on my side for me to have 2 x Ts running at the same time... I know that's not a cool thing to do for anyone involved and actually as someone with a DD, it's a potentially damaging thing for me to do...If I get the clinic T, I would have to go on a long break from existing T (something he has said he does with clients) and then see if it's necessary to start up with him after. If there is possibility for collaboration in whatever way that looks like, then that would be something we'd all have to look into.. but that's going too far ahead!

Until last week I had no idea whether I'd be accepted for an assessment at the DD clinic. If theyd have said no, I likely wouldn't have told T about trying to get an assessment there ... I would have accepted that T can help with some areas and not others and just wouldn't go into certain issues with him where its been highlighted he can't help... what's the point telling him if no action can be taken on either side?

Now I have the assessment, it doesn't mean I'll defo get funded therapy there after. I may. I may not. But this has actually been the only point in our relationship where I've felt its possibly necessary to tell him in case I do get the funding. And even then I'm in 2 minds. If I don't get the funding, but tell him before I'm going for the assessment, I then go back to him with us both knowing i feel I need more out of therapy but he can't give it. But I don't have other options for therapy at this point. So .....

These things are never simple. And I'm also trying to protect his feelings in this in my own way. There is alot of juggling to do.

But yes I am fully aware that trying to have 2 Ts without them knowing about each other is not ok. And I'd never do that.

 

[Ecdysis]

Hi @beaneeboo

I was listening to Pete Walker's C-PTSD audiobook today and came across the section called "Collaborative Rapport Repair" which is about therapy ruptures and repairing them.

If you don't have a copy of his book, you can find a copy of that section here:

In-Depth Articles | Psychotherapy.net

Explore articles by leading psychotherapy professionals—engaging 60,000+ readers monthly worldwide with fresh insights into mental health care

www.psychotherapy.net

There it's called "4. Collaborative Relationship Repair"

(Click on "show more" and then scroll down almost to the end)

I think it could be a helpful guide for when you second-guess or doubt yourself.

Also, it explains well how valuable investing in this work can be.

 

[beaneeboo]

This is so incredibly thoughtful of you @Ecdysis - and really helpful. Thank you.
It's a very straight to the point article simply written and touches on alot of important things to reflect on.

I took this from it immediately (stood out to me):

**"Finally, I believe one of the most common reasons that clients terminate prematurely is the gradual accumulation of dissatisfactions that they do not feel safe enough to bring up or talk about. How sad it is that all kinds of promising relationships wither and die from an individual or couple’s inability to safely work through differences and conflict.**"

This is me. I don't feel safe enough. I never have done. I've had people my whole life tell me my perception on interpersonal matters is wrong. For example my dad - and this was coupled with then making me feel I was too blame for how awful he felt in life and for the break down of the relationship. Not just him but also his abusive partner. And this feeling that my perspective is often labelled as wrong carried out through my marriage and is something I struggle with in different interpersonal relationships today. For fear of being told I'm wrong. For fear of not having a voice. And that theme has also come up in therapy lots of times in relation to the sexual abuse. I didn't have a voice. No didn't even exist initially. Wasn't even a concept. Then it turned into 'if you stop me from doing it, I'll shame you by telling everyone how bad you've been'. So that feeling of safety around voicing something which isn't ok for me (my boundaries) hasn't been safe from an early age.

I also took from the article the following:

**"Earned Secure Attachment
In therapy, clients get the most out of their session by learning to stay in interpersonal contact while they communicate from their emotional pain. This gradually shows them that they are acceptable and worthwhile no matter what they are feeling and experiencing.**"

I think this gets to the crux of my personal challenge. I feel so unsafe telling my perspective and voicing what I think and feel, it feels almost an impossibility.

Thank you so much for bringing this to me because, along with this thread, it's helped me clarify where my challenge is how it's impacting my interpersonal relationships and that I need to confront it.

This is the hard bit. How.

Not asking anyone for answers, just speaking out loud...

 

[Ecdysis]

Finally, I believe one of the most common reasons that clients terminate prematurely is the gradual accumulation of dissatisfactions that they do not feel safe enough to bring up or talk about. How sad it is that all kinds of promising relationships wither and die from an individual or couple’s inability to safely work through differences and conflict

Yes!! I thought of you as I heard that passage of the audiobook and figured it might resonate!

So, I hope you also noted the bits of the article that said HOW VALUABLE working through those kind of ruptures is...?

Oops, hit "send" before I meant to...

Especially the story about his son and his friends and how the frienship was better after the fight and the repair?

 

[Ecdysis]

I worked through a rupture like that with my T once, many, many moons ago. He also brough his issues into the situation and abruptly "offered" for me to terminate therapy "if I was so disatisfied with his work".... Huh...??? Sigh....

We ended up working through it and truly resolving it... It took so much courage and trusting where there was no trust in the room.... But it was totally worth it.

That reminds me of a quote actually: The mind creates the abyss and the heart crosses it.

Deeply true.

So... as to:

How.

How about printing out/ screenshotting the section of that Pete Walker article and handing/ emailing it to him and saying "This is what I want to do and this is what we need to do if we want to fix the problem."

Or, how about making a synopsis of this thread? Take the most salient points you wrote, the ones that you feel juuuust enough courage to share and write brief summaries of other people's most important feedback and print our your summary and hand it to him in the session or read it out loud to him, if you feel up to it?

(I know there's a website policy here that doesn't allow you to just print content and show it to other people, especially stuff that's in member's only areas and/ or stuff written by other members... And it's obviously right to protect people's privacy and you probly don't want your T knowing where you write private stuff (including your gripes about your T, haha) so making a summary that is free of all identifying elements and just summises the most salient and relevant points is probably your best bet and (I assume) should be within the site's policies.)

 

[beaneeboo]

So, I hope you also noted the bits of the article that said HOW VALUABLE working through those kind of ruptures is...?

Oops, hit "send" before I meant to...

Especially the story about his son and his friends and how the frienship was better after the fight and the repair?

This is something that many people here have really highlighted, and hearing it again and again really helps hit home... I know in my heart that I can't walk away from this therapy relationship even though everything inside me is shouting to do just that... Thank you for making this point so conscious

 

[beaneeboo]

I worked through a rupture like that with my T once, many, many moons ago. He also brough his issues into the situation and abruptly "offered" for me to terminate therapy "if I was so disatisfied with his work".... Huh...??? Sigh....

The fact you have first hand experience makes sense. You, like so many here, have many wise words on the matter...

We ended up working through it and truly resolving it... It took so much courage and trusting where there was no trust in the room.... But it was totally worth it.

This is so good to hear.
. For you..... and for me that someone has done it before me

That reminds me of a quote actually: The mind creates the abyss and the heart crosses it.

Deeply true

I like this

How about printing out/ screenshotting the section of that Pete Walker article and handing/ emailing it to him and saying "This is what I want to do and this is what we need to do if we want to fix the problem."

I like this idea... although the last major therapeutic rupture was as a result of me bringing ideas into session... but this time the material isn't so personal ti him..at least that's what I think but to be fair I don't know... but yes I could give it a go... and actually it will be a good gauge as to how much of his own stuff he's bringing in the relationship..I don't think he could find that article difficult in any way...

Or, how about making a synopsis of this thread? Take the most salient points you wrote, the ones that you feel juuuust enough courage to share and write brief summaries of other people's most important feedback and print our your summary and hand it to him in the session or read it out loud to him, if you feel up to it?

Yep. Maybe this could work.

(I know there's a website policy here that doesn't allow you to just print content and show it to other people, especially stuff that's in member's only areas and/ or stuff written by other members... And it's obviously right to protect people's privacy and you probly don't want your T knowing where you write private stuff (including your gripes about your T, haha) so making a summary that is free of all identifying elements and just summises the most salient and relevant points is probably your best bet and (I assume) should be within the site's policies.)

Ok, noted.

Defo won't be screen shotting anything!

 

[Friday]

For me it seems he's using the apparent compassion and care as a veil for his own frustration that, in his head, I've crossed a line with him in the email (he's irked - clear from his first 'off' email response) and that I haven't replied to that email. It puts me in the position to say 'No you're wrong i really do want to continue therapy!' When these issues never had ANYTHING to do with me finishing therapy (he alone made it that).

Not only reading between the lines, but full on voodoo zombie mode.

To my way of thinking?

Either take him at his word, or don’t. Reading 17 levels of conspiracy theory between the lines? Says you don’t. Might be an interesting experimemt to do so, however.

As a “him” test, rather than a “people” test.