Deciding when to call therapist between sessions

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deeplyloved

MyPTSD Pro
Good morning. I'm having trouble learning how to decide when to call my therapist between sessions and when not to. I know she doesn't want me to "muscle through" and she wants me to practice asking for what I need. But she is also expensive! Last week, I asked for an extra session via Vsee, but we ended up being able to resolve things by text and a 15 minute phone call. She will refer to my emails in our weekly sessions but doesn't usually respond to them. She wants me to text or call her. We had a communication issue this summer where she was traveling and missed my text and thought my call was an accidental pocket dial (by her). It was awful. We worked through it and now she calls or texts me back so quickly that I feel ashamed and guilty for bothering her! I logically know I am not responsible for her feelings or for managing her time. Feelings are not logical though, are they?

It feels physically painful to make the decision and follow through to call her on the phone. Why is that? I wonder which muscles I should be strengthening and how to discern? Is it better to practice my own distress coping skills even when it feels like they aren't working? Should I only call her if it's an emergency? Or should I practice reaching out for appropriate help and support.

Last week we joked a little out what it would be like for me to go 7 whole days without a meltdown (my words). I just don't know if pushing myself that way is a healthy goal or not. Is it reasonable to feel ashamed for needing more contact with my therapist? Thank you for letting me type that out. This is not something my very sweet and dear (but nonPTSD) spouse and friends can understand or process with me. It's so uncomfortable and embarrassing!
 
F

Fishouttawater

I think definitely talked to your therapist and make sure you both set healthy boundaries with it.
Most therapist say you can email them but they won't reply, but then discuss what you emailed them about in session. I think with texting or calling, it should be used only if your really struggling, but everyone is different and all therapist have different rules and boundaries, so I'd say defs mention and talk about it in your next therapy session.
 

deeplyloved

MyPTSD Pro
Maybe I'm not approaching the conversation with her as clearly as I need to. Whenever we talk about it, she simply says to call or text when I need her. My struggle is making that assessment of "need."
 

Crow

MyPTSD Pro
For years I didn't call even when things were horrible. When I started to call, the call usually stressed me out more than the issue. But I've gotten where I don't feel ashamed for asking for help. T has me very directly state if I want a call back. For a while we talked two or three times between sessions. These days I'm regulating better so I may call and leave a check in message with no call back. Sometimes we still talk for a while a couple of times a week.

Wasn't until we established clear parameters around when I call and what I expect in return did I start feeling comfortable taking her time. My own boundary is only calling during business hours. So weekends are off limits unless I am in dire straights. This helped me get over the taking her time guilt.
 
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Cannottakethis

MyPTSD Pro
I've had that same struggle for years. I went to 1 therapist for 8 years and the one time i needed to call she was on vacation, but the guy who subbed for her was great.
Now that I'm doing Dbt they offer phone coaching and my therapist has said call me many times, and I have. The first week I called him 3 times. The second week 3 times. He always answers or calls me back. He talks to me as long as I need and gives me a task/assignment to help me cope with the immediate situation and checks in with me later or the next day to see how I'm doing. I've called at night, on the weekend, he's always there for me. But it was a hard step for me to take and I'm so glad I took it.
 

deeplyloved

MyPTSD Pro
Thank you. I also keep all contact during business hours and try to be very clear and specific. My therapist assures me she is there for me, I don't need to manage her boundaries for her, and nothing we deal with together will be subtle. I see that this struggle is one I'm having with myself--being worthy of support and afraid of abandonment.

I started trying out Betterhelp so I would have more support and another outlet. The therapist is ok, but she doesn't reach out to me and her replies are quite succinct. I feel abandoned and dismissed...hmmm....I see a theme here! I struggle with asking for what I need and with recognizing and feeling the support I actually do receive.

I did briefly text my regular therapist to check in. She responded and one little text helped me so much--probably because she already knows me and the context of the triggers. I think I will be fine until our next session.
 

OliveJewel

MyPTSD Pro
Thank you for bringing this up. My old therapist encouraged me to text or call him whenever. He seemed very accommodating yet I ended up dropping him because of several reasons but partly because I wasn't challenging myself enough. With this new one I had a breakthrough in realizing my abuse. When I actually realized it I had to call her between sessions because I ran away and she called me back and I was grateful but I felt so much turmoil and pressure on myself to not cross that boundary. Last time I saw her I had the last time slot and she allowed it to go over by twenty minutes and I felt so guilty that I didn't stop it at the hour. I know she's in charge of her boundaries but when she did that I felt like a desperate fool. One thing I realized is that I feel totally dependent on my therapist right now and the fact that I feel dependent triggers feelings of anger, fear, and sadness. I tried to bring that up last time, but it was at the end of the session, in the parking lot(!) which also felt like it was crossing boundaries. I said, when I hear your voice in my head and I feel angry should I just ignore the anger? And she furrowed her brow and said, are you really angry or is it something else? Fear, I asked? She said anger is my go-to emotion. I said I would try to explore the issue. So I guess I'm afraid to feel dependent or reliant. Am I supposed to ignore that fear/anger/sadness? Tell myself it's okay?
 

Scarlet13

MyPTSD Pro
It is so hard with an attachment. They feel good and at the same time horrible. My attachment can feel like I have a gift, like something so special. But my attachment then operates like a portal through which I project so much insecurity and fears. It is so hard to gain clarity.
I have a difficult time asking for help too. It once took me 3 hours to compose an email to my psychiatrist because I was so paralyzed with fear. With her it is due to the fact that she is a good psychiatrist and I did not want to lose her and be harmed again by a bad psychiatrist. I feel so scared like I am bugging my t and my psych. They are both caring and supportive.
To answer your question, I think both reaching out for help and using skills and managing symptoms on your own can be goals at the same time. I try to use skills first and then when I need to, I contact my t, I inform her of the skills I am using. I sometimes contact her just to know she is there and I tell her that.
 

OliveJewel

MyPTSD Pro
I can't even imagine that my therapist would have a goal for me of reaching out for help, although one time she said that was good when I asked for help when I was sick so maybe it is a goal. I think her goal for me would be for me to not need to reach out to her for help between sessions but now that I think about it, that doesn't really make sense. However, I wish I could just call her to know she is there and to tell her that, like you said, Scarlet13. What would it feel like for me to make that request of her? Loaded with fear of rejection. I'm afraid to do that because of my csa messing with my boundaries. Someone told me that if my therapist lets me know that she can't respond that means she thinks I'm strong enough to handle without her. My feelings of trust are so big and scary and powerful. I would love to check in with my therapist just to check in but I don't feel like I can do it in a non-desperate way so I won't allow myself to.
 

Scarlet13

MyPTSD Pro
I don't ever feel that creepy, gross boundary issue that I think I know what you mean from csa. I hate some times showing affection or having to say that I need someone. It can all feel so terrible and I just want to avoid and yes there is the fear of rejection. I hate needing my therapist. But, I feel so ok with expressing feelings of love and need for her to her. I sometimes get this feeling that I want her to exist inside of me like a presence or her spirit to just be inside if me. I will tell her that someday. I don't mean it sexually, I mean it more like I want all the health and beauty of her to exist inside if me. I know it is a good thing, but it does sound intense and a little creepy.
As far as emailing her just to know she is there that was her idea to do that.
I will be talking to her again about what I can and cannot do in between sessions in terms of what I can ask for like a phone session. Yes, boundaries are so important. But it can feel good to get intimacy in a safe, theraputic relationship. I think that us healing for csa.
 

OliveJewel

MyPTSD Pro
I had to read your words over and over again because they really resonated with me. When you said, "I feel so okay with expressing feelings of love and need for her to her," it impacted me. I'm not there but I wonder what it would be like to express those things. I'm so used to saying it to people and expecting them to say it back to me but a therapist can't love or need me, so there is some fear at what her response would be. I wonder how long it would take me to have the courage to say something like that. Also when you said, "I want her to exist inside of me like a presence or her spirit to just be inside of me," I could really identify with that feeling. I told my therapist that I hear her voice in my head and it feels soothing, but then I started to resent that I had that feeling that you described--the feeling that I want her spirit inside me triggered feelings of fear and rejection so I felt angry toward that presence. Maybe I have to face that fear and accept her presence as something good?
 

Scarlet13

MyPTSD Pro
I struggle with this too. I really don't like intimacy because I was object raped and mollested from 4 to 5 ages by two women and there was a sort of maternal intimacy there that was profoundly disgusting and in my perception turned me into an alien. Then my mother has NPD and she turned me into her scapegoat even blaming me for the molestations because I was different and brought it upon myself and I participated in it and could have said no and run away (that is victim blaming). She would also force me to say I love you to her and would expect adoration.
So with my therapist, I feel love and greatfulness and I tell her because it feels right but I constantly fear rejection which leads to thoughts of self harm. So we had a good session in which she told me that it is risky to have an attachment, but that it is necc to do the work. That I have to be willing to accept and tolerate those feelings with courage. Courage is doing something in the face of fear. So, you can throw that you love your t out there as an act of courage.
After reading your post, it seems that needing her and reaching out is a good goal.
Honestly, t's hear all the time that patients love them and have an attachment. They are going for that.
 
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