Have I destroyed the therapeutic relationship?

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D

Deleted member 50877

Hi there,

I‘m new to this forum. And new to PTSD. Habe been in therapy for about a year and a half and my therapist is great. We never discussed diagnoses much, I didn’t care. Three months ago I was mad and challenging him, I told him I thought I hae a personality disorder. He said he actuaöly thought I had PTSD. I habe been crying every day since then and struggling. The whole therapy is so helpful but so difficult.

we discussed my resistance around the diagnosis and things calmed down a bit. But last session I asked something and he did the bridge to ptsd amd I felt so betrayed. Cancelled the next session - my first cancellarion since we started and then I send an email sharing about how betrayed and humiliated I felt and how I was thinking of quitting.

he replied in what i (and neutral observers) thought was pretty harsh - he set a boundary, said he did not wish to discuss this via email and that we had pur session and that he hoped I would keep it so that we could sort it out. He also said that for the second time now I asked something directly and became undone by the answer. That scared me.

We have had ruptures before, but overall a good relationship and in the past he told me he would not quit me but would help me through it even if it’s difficult. Now I believe I must have pissed me off and he will surely scold me and that next session will be the last one. Either he will quit or me. I always have paralyzing anxiety around sessions, but now it’s so bad I can’t cope. I see myself only sitting there and staring into space. And most of all I am so scared I made him angry... 😢

I am considering quitting - it’s almost as if I went too far. It’s also like since I started the therapy I am a mess 4 days out of 7, working myself from session to session. But my therapist is so good, I really like him and have made a lot of progress.. I‘m just so scared. I believe even if we fix this, he will surely start to set stronger boundaries (maybe forbidding me to send emails?) or just become mean..
 
D

Deleted member 50877

I have a few other things I’ll come back to, if someone else doesn’t hit them first... but my biggest Q is:

What did you want to achieve by sending the email?
I wanted to communicate my feelings and negotiate my boundaries. Let him know how the session was for me. And I was expecting reassurance or no reply at all.

I send an email very often - before sessions, after sessions, providing material to be discussed and sharing thoughts. So the act of sending wasn’t new.
 

mylunareclipse

MyPTSD Pro
Why does it make you so mad if the therapist thinks you have PTSD? I have almost forbidden my therapist from using the word trauma in session.
I don’t think at all that he will quit or be mad. This stuff you wrote here and what will happen next is therapy “gold”. I know it’s hard but I am hopefully that you’ll get through the discomfort and into growth.
 

whiteraven

MyPTSD Pro
he replied in what i (and neutral observers) thought was pretty harsh - he set a boundary, said he did not wish to discuss this via email and that we had pur session and that he hoped I would keep it so that we could sort it out. He also said that for the second time now I asked something directly and became undone by the answer. That scared me.
I'm not sure why you viewed this as harsh. Can you say a little more?

It sounds more to me like he doesn't want anything to be misinterpreted in email, that he wants you to be able to talk freely about what happened. It's really hard to address stuff like this in an email - I think email is great and serves an important purpose, but it's also a way to avoid really talking about things that need to be worked through.

Now I believe I must have pissed me off and he will surely scold me and that next session will be the last one. Either he will quit or me. I always have paralyzing anxiety around sessions, but now it’s so bad I can’t cope. I see myself only sitting there and staring into space. And most of all I am so scared I made him angry..
Well, if you quit, it *will* be your last one. I understand how very hard and scary it can be to go to a session, but that's how it is sometimes. And the more you go, esp. after times like this, the more you'll come to realize that he's a professional, and your fear and anger don't make him angry. It's different, getting mad and challenging a therapist, as opposed to someone who isn't. I sometimes get terrified that I've made mine mad, but I realize that that's how other people have reacted to me in the past when I expressed my frustration and anger. Part of a therapist's job is to help you work through any feelings you have, including anger.
am considering quitting - it’s almost as if I went too far. It’s also like since I started the therapy I am a mess 4 days out of 7, working myself from session to session. But my therapist is so good, I really like him and have made a lot of progress.. I‘m just so scared. I believe even if we fix this, he will surely start to set stronger boundaries (maybe forbidding me to send emails?) or just become mean..
You are viewing this very differently than he will, I think. It sounds like you have a good, working relationship. Having been in this position many times, I can say that I *always* overreact to it and always worry my T will be mad and stop seeing me. But I recognize more and more that he is actually happy that we are beginning to work through the really hard stuff. And the more it has happened, the more I have begun to develop trust, in my own feelings, my expression of them, and his ability to handle them.

I used to be a mess between therapy sessions. We were going too fast, so once we discussed how I felt and how I had trouble functioning, we slowed down and it got much better. Maybe you could talk about the pace of your sessions with him?

And I was expecting reassurance or no reply at all.
Sorry. I forgot to reply to this.

Sometimes, when we expect one thing and get another, it throws us. It will probably be uncomfortable, but I think it will be really helpful to discuss this with him.
 

Sideways

Moderator
If you can put to one side for a moment what you think your T is currently thinking:


he set a boundary, said he did not wish to discuss this via email and that we had pur session and that he hoped I would keep it so that we could sort it out.
People setting boundaries with you in the past has probably often led to some pretty traumatic outcomes. If that's the case, it would make sense to me that him setting a clear boundary with you would scare you. So, be gentle with yourself - boundaries are scary. This situation feels frightening.

Even though it's frightening, one of the reeeally useful things Ts can do for us is give us practice and lived experience with healthy relationships and communication.

Your T has set a boundary: this is a topic for therapy, not email.

T has encouraged you to go to that session so you can have the conversation. I reckon give the conversation a chance.

But more importantly, give your T a chance to model healthy boundaries for you for once, and yourself the opportunity to experience that. He set a boundary, your respect it (okay, so we talk this through in session, not by email).

By far the most important part comes after that though. When you walk out of that session. And you've just had the experience of someone setting a boundary, and the relationship, and your ability to trust them, actually being strengthened by that, rather than ending in something traumatic.

Learning to trust your T takes time. But boundary setting and healthy communication is easily some of the most important stuff we can get out of therapy, and that's exactly what your T is offering here.

Even though it's scary.
in the past he told me he would not quit me but would help me through it even if it’s difficult.
It's brilliant that you remember this and have written it down.

Feelings are important. Right now, you're freaked out, and it's valid to feel that way.

But your T has told you in the past that you can trust him with situations just like this one. As scary as that might be? I reckon you should give him a chance. If he comes good, and does talk it through with you? How good would that be, right? More evidence that this is someone who will tell you where the boundaries are, and you can actually trust them.
 

Movingforward10

MyPTSD Pro
Hi @DodoBird ,sorry it is so tough right now.
.I agree with the other responses.

I totally and utterly get why the email response has made you feel like that. I freak the f out over email with my T. And digest every single thing my T says in therapy. What she says. How she says it. Why she says it. And then I am highly skilled at making it all into trauma responses and *absolute proof* that she doesn't care about me, she is lying, she is telling me off, she will be laughing at me etc etc etc. Essentially: that she will treat me in an abusive way and replicate what I have previously known. But: that is in my head! (And a symptom of PTSD?).

So, whilst the email feels harsh: it doesn't mean it is.

I would totally and utterly recommend you talk all this through with your T. This issue, and his response in the email, has triggered something big for you. Hence all your feelings. I think that is what your T was trying to point out when he says in his email that this is the second time you have asked something and the response has made you feel all these emotions. That isn't telling you off. That is trying to help you make connections and meaning: to heal.
However, when my T tries that with me when I am overwhelmed with emotions, it also makes me feel my T doesn't get me and is trivialising my feelings.

I think you can absolutely work this through with your T. And that you will feel a million times better when you do.
And this is said from someone who has done that. The stress just evaporates and the relationship with T is all Rosey again. (until the next rupture....!)

If it helps, reading up about the cycle of 'rupture and repair' in the therapeutic relationship might help?
 

scout86

MyPTSD Pro
From his point of view, I doubt that evens counts as "a rupture". It's probably more accurate to think of it as "part of the process". (Even though it's nearly impossible to be that objective when you're going through it.)

Wanting to have the conversation during a session isn't much of a boundary. Some therapists don't even do emails. (Although I'm glad mine does.) Some stuff is best sorted out in person.
He also said that for the second time now I asked something directly and became undone by the answer.
Seems like he pointed that out in a pretty non-judgemental way. I guess I have two thoughts (and neither of them is that he was harsh.) First, I think I was pretty young when I figured out you shouldn't ask questions you don't want to hear the answer to. Which means, to me, once you ask a question, you're kind of obligated to listen to the answer. Second, it might be worth wondering why you reacted to his reply as strongly as you did. That's a point for starting a conversation, nothing more or less.

As far as quitting goes..... my own philosophy on that is that the more wanting to quit is a reaction to something that comes up in therapy the more that suggests it's the wrong time to quit. You can quit anytime. But quitting isn't likely to solve any problems if it comes from a place of wanting to not hear a message. If your therapist is good at their job, it makes more sense to ride things out and see where it takes you, (I usually end up looking at this as "an experiment" because my usual go to tactic is to leave and I KNOW how THAT works.)

One other thought. Some people use the threat of leaving or quitting as a way to manipulate other people. In a variety of relationships this can happen. Not saying that's what you're doing, but I can see where a therapist would want to be pretty careful not to go down that road. You're free to quit, but you're also free to work through stuff and that's probably going to be the plan that benefits you most in the long run.
 
D

Deleted member 50877

Thank you very much for all your answers. It blows my mind how many kind people are here and how many answers came in. You helped me to get grounded for a while and stop catastrophizing. I am also glad that nobody here seems to believe that this is something that cannot be worked on.

Why does it make you so mad if the therapist thinks you have PTSD? I have almost forbidden my therapist from using the word trauma in session.
I don’t think at all that he will quit or be mad. This stuff you wrote here and what will happen next is therapy “gold”. I know it’s hard but I am hopefully that you’ll get through the discomfort and into growth.

Thank you for your kind words. I liked the idea of therapy "gold". What made me so mad? I don't know. I am not denying I had trauma and I am not denying it had consequences, but something about him giving me the diagnoses after such a long time of work triggered me. We have been talking few times about it and it took more than a month until I stopped fighting it and fighting my T. It was the worst crisis I ever had during our work. And that's what triggered me in the last session - after having had this huge conflict, I asked about hypervigilance. Just wanted to know whether it's more of a cognitive thing or whether anxiety is a part of the construct. And without any invitation from my side, he brought up that it was one of the core symptoms of ptsd. And I felt just super betrayed that he brought the diagnosis in again and the rest of the session felt like I was pressed into saying yes T., I agree and I accept having ptsd. I was just sitting there defeated, giving shoulder shrugs as answer to anything and staring on the floor and counting minutes until the session ends. I also hated how he was talking to me at that session, it just created a bigger gap and wasn't what I was used to.
Wanting to have the conversation during a session isn't much of a boundary. Some therapists don't even do emails. (Although I'm glad mine does.) Some stuff is best sorted out in person.

Seems like he pointed that out in a pretty non-judgemental way. I guess I have two thoughts (and neither of them is that he was harsh.) First, I think I was pretty young when I figured out you shouldn't ask questions you don't want to hear the answer to. Which means, to me, once you ask a question, you're kind of obligated to listen to the answer. Second, it might be worth wondering why you reacted to his reply as strongly as you did. That's a point for starting a conversation, nothing more or less.

As far as quitting goes..... my own philosophy on that is that the more wanting to quit is a reaction to something that comes up in therapy the more that suggests it's the wrong time to quit. You can quit anytime. But quitting isn't likely to solve any problems if it comes from a place of wanting to not hear a message. If your therapist is good at their job, it makes more sense to ride things out and see where it takes you, (I usually end up looking at this as "an experiment" because my usual go to tactic is to leave and I KNOW how THAT works.)

One other thought. Some people use the threat of leaving or quitting as a way to manipulate other people. In a variety of relationships this can happen. Not saying that's what you're doing, but I can see where a therapist would want to be pretty careful not to go down that road. You're free to quit, but you're also free to work through stuff and that's probably going to be the plan that benefits you most in the long run.

You brought up few good points. We always did emails, at least he always was tolerating my writing it. So getting a boundary in this sense was very new and out of how he usually communicates. That's what made it scary. Then, the part with me asking a question. First time, months ago, yes, I asked what he thought I had and he answered and that's my responsibility. As you say, don't ask if you don't want the answer. But last time I didn't ask about ptsd and didn't invite him to discuss it. I only asked about hypervigilance and it was a straight forward question. The ptsd element is what he brought up. Thinking about it, my asking about hypervigilance was either my pushing myself into slowly opening to the idea of the diagnosis and check one symptom, gaining information about whether it fits my subjective experience, my way of taking it one step at a time, but his bringing it up destroyed my willingness to go there again. Second assumption is that it may have been and unconscious testing - bringing it up and see whether he stays within what I ask for or will grab the topic he knows has potential to upset me. In both cases, the outcome wasn't good. I just feel humiliated and stupid and have loss of trust.

About quitting, I have always been open when I noticed fantasies about quitting. I would bring it up in a session and we would talk about it, but it was always clear that it was only a fantasy. This was the first time ever that I indicated feeling like never coming back and it was the first session after more than 1,5 years of work that I cancelled. I never threatened to leave and I wouldn't have written it if I haven't meant it. I am getting a sense of him not believing how bad this really is, maybe seeing it as empty threats. I am still not sure what will happen tomorrow. Maybe he underestimates my composure, but things are getting so difficult we definitely either have to change the course or make a break or quit.
I'm not sure why you viewed this as harsh. Can you say a little more?

I used to be a mess between therapy sessions. We were going too fast, so once we discussed how I felt and how I had trouble functioning, we slowed down and it got much better. Maybe you could talk about the pace of your sessions with him?

Thank you very much for this. Exactly this is happening, we seem to go too fast, I just can't take this pace. I am so relieved to read that I'm not the only one that is a mess between the sessions..

I viewed the reply as harsh because there was zero compassion or validation, not even a simple thank you for sharing that, whatever. And the very first sentence was that thing that this was not the second time I asked a question and became undone by the answer. And the next sentence was about him not wishing to discuss this any further via email. It was just so weirdly written and I just thought "ok, so now I got him to his limit". I was also disagreeing with this being the second time - as I said, I didn't ask and in my email there were other things I was unhappy with. A difficult position for me - feeling I was treated unfairly in the session, but my T disagreeing, claiming it's me and it's an old story. Not very encouraging. But as you all mention, yeah, discussing it through is the way. If I will be able to talk at all tomorrow. I see myself staring into space for the whole session.
Hi @DodoBird ,sorry it is so tough right now.
.I agree with the other responses.

I totally and utterly get why the email response has made you feel like that. I freak the f out over email with my T. And digest every single thing my T says in therapy. What she says. How she says it. Why she says it. And then I am highly skilled at making it all into trauma responses and *absolute proof* that she doesn't care about me, she is lying, she is telling me off, she will be laughing at me etc etc etc. Essentially: that she will treat me in an abusive way and replicate what I have previously known. But: that is in my head! (And a symptom of PTSD?).
Thank you so much! Yes, this totally fits to what I'm doing. It's very encouraging to read that you have been there too and that things will be fine.
People setting boundaries with you in the past has probably often led to some pretty traumatic outcomes. If that's the case, it would make sense to me that him setting a clear boundary with you would scare you. So, be gentle with yourself - boundaries are scary. This situation feels frightening.

Even though it's frightening, one of the reeeally useful things Ts can do for us is give us practice and lived experience with healthy relationships and communication.

But your T has told you in the past that you can trust him with situations just like this one. As scary as that might be? I reckon you should give him a chance. If he comes good, and does talk it through with you? How good would that be, right? More evidence that this is someone who will tell you where the boundaries are, and you can actually trust them.
That first paragraph was an eye-opener, thank you. Never thought of it this way, but you are right, this is why it is so scary. I am so afraid of people getting cross with me, it's paralyzing. Thank you for the validation. You are right. My T tried to tell me in the past that anger is normal and that we can have a relationship even when we get upset sometimes. I never realized that the interpersonal component in this is so huge and can make things so difficult.

Thank you again for your kind support.
 
D

Deleted member 50877

I guess I also will have to figure out what was not ok with my email. Some time ago I would just go with whatever unfairness I perceived and just let it go. Learning to take care of my boundaries is one of the therapy goals and I was proud to say / write what I didn't like. I wasn't rude, but very clear and I made sure to point out that I also was very happy with our work. Receiving that answer then triggered because I feel even more like not being taken seriously. So far I seem to do something wrong every time I pluck up the courage and say what I didn't like. But this time the situation doesn't even seem welcoming enough for me to open up in any way. That's the silly circle and I'm just wondering how am I supposed to be honest again. Rambling now. 22 hours to the session and I have no plan other than showing up and trying not to get a panic attack. Being able to speak would be great, but not even sure about that. Arghhhh.
 
It's possible (and likely) you did nothing wrong by sending that email. Your therapist can probably see how much this matters to you, and knows that meeting with you to talk about it may feel much warmer and more meaningful in the end, even if it is scary at first to talk about it together.

If your therapist had emailed you back, there might be more painful misunderstandings, especially because tone is hard to convey over email. In person, your therapist is probably much more able to read nonverbal cues and help you process these feelings. So, I imagine your therapist heard your feelings, and wants you to come talk about them so that he can help.
 
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