Sex With Therapist

[Romup]

Just as you're miffed that I seem to be generalizing in your eyes, I get miffed when people take concepts out of context, dismiss all of Freud's work, and deem it outdated. I am not a Freudian, but we would still be clubbing patients over the heads if it weren't for his work, so, transference

I do understand transference and actually am not entirely dismissive of it as a therapeutic construct. I don't have an issue with Freud particularly and yes working through transference doesn't necessarily mean reenactment.

In saying that, there's a drive for people who have experienced relational trauma to seek to reenact that dynamic in an effort to resolve the trauma. Outside of therapeutic relationships, for example, you see it in women who experience domestic abuse and go on to have further abusive relationships - not a purposeful decision on their part so much as an unconscious drive. This means that in therapy the person is driven again to recreate the traumatic relationship dynamic and it takes a huge amount of skill to work with the transference and not inadvertently reenact the abusive dynamic. You'll see all over these boards where that process has gone badly wrong and the T relationship has become quite toxic at best and abusive at worst.

No one is partly to the full facts of this posters therapy but describing a situation where they find themselves doubting themselves and feeling therapy itself is crazy making strongly suggests something isn't working. I'm also very wary when clients say they can't make decisions about their therapy because they are too attached - it suggests the T isn't managing dependency in a way that supports client autonomy and agency.

So, I'd never say never re psychodynamic therapy and trauma, but I would exercise a huge degree of caution because the very processes that underpin psychodynamic therapy are the processes that are activated in relational trauma and while there's the potential to work through that towards healing, it's very very easy to get it wrong.

 

[Ruwap]

Just as you're miffed that I seem to be generalizing in your eyes, I get miffed when people take concepts out of context, dismiss all of Freud's work, and deem it outdated.

That's absolutely fair - you're right, I was incredibly insulting about Freud. Totally my bias, and totally not necessary.

The analysis of this transference would be my boyfriend and I discussing my fear reaction to him, wherein I can understand that not all men with green tshirts will do me harm. Ideally I would start losing my fear of guys in green tshirts. That is all transference analysis in psychotherapy entails.

Thanks - that's a great explanation of the usefulness (I mean that sincerely). Reading that, I understand better why I was struggling with seeing the usefulness. My trauma therapy has been a combination of PE, CBT, and EMDR techniques. My PTSD was late onset. I've only experienced transference with my therapist in a very small and specific way, and because that's not how we've been working, it (oddly) served very little purpose. But altogether, my 'now' issues are much broader than my trauma. It's been effective in very tangible ways to integrate these memories so they aren't stored on some separate reel in my head. They become infinitely less potent. And the hope is, turning the volume down on these memories with diminish the negative self-constructs that go along with them, which would then (in theory) allow me to build a sense of self that I can live with.

I grasp better how it would be applied, now. I'll be honest - it's hard for me to conceive of how talking about the event would be a bad idea for some people - but I don't doubt that you are right. It's likely because I was a non-talker. I told no-one at the time. So, after maintaining years of silence, I'm observing that the very act of telling it is intrinsically valuable. But I don't have years upon years of complex trauma, and I do know that the way I'm working would not work for them.

This means that in therapy the person is driven again to recreate the traumatic relationship dynamic and it takes a huge amount of skill to work with the transference and not inadvertently reenact the abusive dynamic. You'll see all over these boards where that process has gone badly wrong and the T relationship has become quite toxic at best and abusive at worst.

What @romup said :)

Seriously though - I want to echo it because it's definitely part of my bias against mixing the streams, as it were. To be a good psychoanalytic therapist is tough. I really think it is not altogether something that can be taught; one has an instinct for it, and a real ability, or one does not. After that, yes education matters - but it's not something everyone can do. I'm not sure what country you are from; I'm american, and here there are an awful lot of people who can go through a minimum of schooling, hang out a shingle, and say they treat trauma.

The "modalities" all feel safer, in a way, because they are templates. Now, it still makes a difference whether the person has skill as well as knowledge - but it's also a little easier to evaluate because of how it's all set up. I worked with a psychoanalytic therapist only once - and I felt pretty good about the recommendation. I went into it with an absolutely open mind. But after a while, part of me just started wondering if she was any good, really. I'm still not sure.

But - none of that means that the whole thing is irrelevant and a waste of time. How does one find a good freudian-based but I think more interactive than the classic model? (I don't totally know what I'm talking about here). Can you tell based on who they studied with? Where they studied? I'm suddenly very interested in this :)

And I appreciate you taking the time to re-engage with me, very much.

 

[Zikewi]

OP,
I can only imagine how hard this is for you. All of it. The therapy and this issue with your t and possible cessation of your work with him. Even the debates on here. I find this thread upsetting as I don't have a clear idea of what you should do and I hope you most importantly make the decision that is going to help you heal the most.

You get to decide what is the right thing with this t. Not anyone here. That is another example of boundaries. Getting input from others and then making your own mind up is OK. Especially when those others aren't privy to all the info,

(A quick point to Arturer is that from the OP's description a female t is unlikely to save her from all the projection and transference issues she has with sex. )

You sound very overwhelmed and I just wanted to say to you that regardless of what you decide many good things can come from your present dilemma. You have come from a place of being sure sex with your t (and therefore a lot of situations) is perfectly right and normal to having a lot of insight into how sex plays out in your life. It would have been good if your therapist had led you to that place than those on here but regardless your therapy with him has been part of it and you are there now. Knowing and feeling are two different things of course and thats where the hard work comes in.

I asked a way back what type of therapy he practices and if he has any specialities. I think it would be helpful to know this. What is "normal" in therapy will vary depending on these as will the t's beliefs. Separate to what is "normal" for a particular approach is if it is good for you and is working for you. A lot of t's use a combination of approaches. Therapy will feel different depending on the t's personality but also their school of therapy. Most important is looking at what is going to help you the most i= not just whether this t has boundary issues. It would be good to know what the second opinion t uses too.

I won't rehash t approaches here as people have already done that. Although I personally do think discussing what comes up in transference can be truly healing (when dealt with the right way), and have found aspects of psychodynamic therapy helpful for me. I think when they are practiced poorly they can cause a lot of harm. When it comes to professionals agreeing when it comes to this stuff? Or sufferers. Forget it. There are no absolutes when it comes to the human brain. There are therapies that have higher proof of performance for certain conditions, others that have less proof, and still others that have strong proof of harm. As a clarification I wouldn't do pure psychoanalyses to treat my trauma ever again. As an addition or added backdrop whilst doing trauma focused therapy? Yes that would be fine and helpful for me. But different people have different needs,

The way I see it transference happens all the time regardless of whether someone discusses it or not. I think most t's would accept that. Wether they believe in making it a main focus in therapy is another thing entirely. It usually happens more if we trust a therapist or make a connection. Or potentially if something harmful happens and hooks us in. Someone can probably manipulate that into happening but I don't believe any reputable t would ever do that. They would just use the information that comes up naturally in t to help the person understand themselves better and potentially their trauma. If transference is recognised and a different conclusion is come to than in the original trauma that is healing. If it isn't recognised as transference or concludes in the same way it intensifies and reinforces the previous harm. If the t is caught up in the ride themselves and goes with it you end up in a bad situation. I personally have had that happen although not re sex.

If you have generally been getting better then thats a good sign. It sounds like you might be reliving too much and are not contained enough and what is relevant here is if he is a trauma therapist. A specialist. If you were becoming sicker then that would very obviously mean something was wrong. That the relationship wasn't working for you, maybe he was not containing you enough; maybe he was doing the things you fear he was doing - messing with your head; maybe you are going too quickly in therapy and need to slow down and focus on coping skills more. . Lots of possibilities. You improving doesn't mean therapy needs to be like this in the future though. I wonder if this is why you have been feeling you should resort to sex. Because you are so overwhelmed.

Yes I think its normal to start seeing the therapist as doing or being like an abuser when one is processing trauma. Re living. That's what is so different about PTSD. If you are back there too much then you need to slow down. The hard thing is separating when feelings are coming from reliving and when from real unhealthy behaviour on the part of the t. If I had this one down I would probably be back in therapy now. I don't trust myself to know the difference.

As I said before I am 30% of the opinion he was trying to do the right thing (psychodynamically) and just not doing a good enough job. I think its off he accepted the £1000. Although his replies to your direct no mess around questions could at a push be seen as along an investigative trend it strikes me that speaking about your patterns in life before with sex werent part of this; that asking open ended questions about possible harm it did to you werent; that probing more directly at the role it plays for you wasn't either. Stopping at the oddity of what you would get from it and him getting much more seems like he is totally missing the point in someone highly sexualised and traumatised. And yes, when it comes to PTSD and someone highly traumatised and sexualised I think any psyhodynamic t would or should eventually be very clear that this route brings with it retraumtisation. There are times for getting someone else to do the thinking and there are certain situations that need to be approached directly,

I think some people need a t with especially strong boundaries and I think you are one of those people.

You may be able to resolve this. If you leave and you have processed a whole lot of trauma then you have accomplished a lot. You won't loose that regardless. You can take the good and keep it. If you stay you have a template to move forward and deal with this stuff more directly. And you are safer as you will be more aware in any therapy you have. Don;t jump to thinking it was all a waste and a bad thing. Take a step back. Try to ground yourself and then think this through as clearly as you are able. Let us know what happens in the next session. You are also allowed to direct what happens here and say if the thread is heading off too much in directions that aren't helping you. If you leave then there will be other t's and maybe someone else will be really helpful.

 

[Ginan]

OP,
I can only imagine how hard this is for you. All of it. The therapy and this issue with your t and possible cessati...

OP here. Thank you so much for your thoughtful response. I don't have any clarity really except I will see my therapist Tuesday and then no matter what happens I'm forcing myself to take a month away from him and try a new therapist. I think I need to see what it's like to break the attachment with him because from what everyone has said, it doesn't have to be this hard.
My therapist does not specialize in PTSD and trauma. He says he works with people that have PTSD though. He's a psychodynamic and CBT and eclectic therapist, whatever that means.

The new therapist is a trauma therapist so I am curious how that will go. I have a hunch that I will come back to this current therapist since he pulls this sickness right out of me into the air to see and so much of my problem has been with traumatic amnesia. I wonder if the new T coddles
and supports me more if nothing will come of it.

Sorry if this is TMI, but since this upheaval began last week and this thread got me so pissed off at my T for not handling this well, my intrusive fantasies about him have gotten so dominant and nearly violent. Previously if I ever had BDSM fantasies, or when I did it in real life, I've always been extremely submissive. I recreate my past completely. The last few days my mind has flipped that switch 180 degrees which it's so bizarre to me. I have never ever thought like this before. I've definitely had a major mental shift. I probably need that psychiatrist that's posting to medicate me as I'm now officially nuts wanting to flog my therapist. I'll start a new thread asking if it's normal to want to tie up and flog your T. LOL

Anyways, I need to say thank you for the last 10 posts or so because I have loved the intellectual discussion. Definitely out of my league and I love reading it.

Moreover, this bizarre mental crisis I'm going through with my T has been eased by all the responses on here. I am really struck by all the support from people interested or wanting to give their two cents. I feel humbled by the rallying of support. Not sure anyone will care in a week, but I'll post an update just in case anyone does.

 

[Udegip]

I've definitely had a major mental shift.

This, this is GREAT! Some call it a "lightbulb moment", I call it self awareness. So that is AWESOME! Go you!

I agree the break to see another therapist is good. First, it is good to have another therapist's opinion, most especially a trauma therapist, and it is my opinion that you would be better served by a trauma therapist as their experience is trauma. But I want you to go with your gut descion and what you feel is good for you.

And keep posting here when you aren't sure. Those "lightbulb moments" is what I most love about this site!

 

[Ihag]

OP: Stick with this "I recreate my past completely. The last few days my mind has flipped that switch 180 degrees which it's so bizarre to me. I have never ever thought like this before. I've definitely had a major mental shift." instead maybe of this: "I probably need that psychiatrist that's posting to medicate me as I'm now officially nuts wanting to flog my therapist."

I am another one who's sat on the fence about whether or not your T was contributing to your dynamic. I agree with poster in #111 who says, "I think some people need a t with especially strong boundaries and I think you are one of those people."

Personally I hope that you'll continue to explore your mindset on this topic as it's clearly important for your progress. So far as anger, I know in my own case it won't come forward unless I feel I'm in a safe enough environment to feel or think it.

 

[Ginan]

OP: Stick with this "I recreate my past completely. The last few days my mind has flipped that switch 180 degrees which...

Regarding anger, yes very true for me as well. I've only felt anger since I've been with this therapist. I had made the decision years back that my perpetrator was not human - my dissociation with him actually made him seem robotic many times so I was oddly convinced he's wasn't human. Hard to be angry with a robot so anger was never part of my recovery. Now with this T I've been so angry with him for a year. What's more frustrating is that he keeps wanting to bring this transference shit back to my mother - I just want to scream at him for not acknowledging how horrific my actual trauma was - wtf does my mother have to do with this? He infuriates me when he does this. Him ignoring my actual trauma IS like my mother so how funny is that. Just wanted to say, yes, he gives me a reason to be angry but also a safe place to be angry with him which has been helpful.

I clearly need a break and some perspective.

 

[Vuwoj]

It took me a long time to learn that anger used rightly is "motivation to change". I'd definitely bring up in session what you share about "Him ignoring my actual trauma IS like my mother".

I used to get really ticked off and angry at my shrink because he'd wear a pretty standard expression of what I thought/decided was "amusement". He'd sit scribbling notes or doodling (no telling) and have a slight smile or grin on his face and only occasionally gave me feedback verbally, mostly he'd nod. One time I got so pissed off I told him, dropping my voice low and it came out like a growl "... and you have no idea how badly I'd like to stand up, cross this room and slap that f'ing grin right off your face." He nodded and leaned forward and said something like... "okay let's free flow" (stream of consciousness where you just say words as they pop into your head - basically teaching me how to attend and slow down and identify my thoughts) and he scribbled some more but kept that grin. It took me a while to change my perception about that. He was right though cuz I had a solid breakthrough not too long afterwards.

 

[Zikewi]

Oh my psychodynamic t did that to me too to an extent. Except I was in denial about my trauma and only mentioned very little of it. But she was obsessed with my mother who I thought was perfect at the time. In truth in the longer term she was right in many ways., She was not a trauma t and caused harm in that department but she was really good when it came to the dysfunctional dynamics of my family, and particularly mother, that at the age of +- 40 I still could not see. Accepting that and seeing it has changed a lot for me.

In psyhodynamics(PD) there is an internal mother which people misunderstand and think of in a literal sense. We internalise a mother function which we get from the person that fills that role in our lives. This gives us the ability to fulfill those functions for ourselves longer term. If that mothering hasn't been there in some sense then until we can see it clearly, separate from it, and start working on internalising a better example of it and process the loss or anger related to it then we remain stuck in certain senses when it comes to relationships with others and oneself. Other trauma definitely messes and distorts those internal abilities to look after ourselves on a huge way but regardless I have come around to accepting that the mother role is still important. When the mother is not the primary abuser dysfunction can sometimes leave us open to abuse from other people.

Not saying this judgmentally but I think you have poor boundaries and usually this comes from our primary environment to at least some extent. The thing that PD t is best at in my opinion is showing up patterns of behaviour in life and giving us an opportunity to change them. Those patterns will almost always end up playing out in the relationship we have with the t. If they are a good t they will not let that happen in a negative way. If they drop the ball then it can. Even if it does it can still remove blinds and make us see new truths.

What I think PD t is really poor with is allowing the real big t trauma to have its place center stage and help take away shame and blame. There is so much focus on personal responsibility and the role of self (which of course has huge validity and benefits) but really in the bigger scheme of things when it comes to real severe trauma it can feel shaming and blaming if not balanced enough by someone who understands these things,

As for your shift from submissive to the other with your fantasies about him - I can't really see that as a breakthrough personally. I think you have had a lot of breakthroughs on here but that to me just sounds like more of the same. Your mind still using sex to try to solve your relationship problems and you still expressing yourself relative to your trauma. Your trauma intruding into this which is only natural.

 

[Ilub]

There need to be strict boundaries. The T should be called account.

 

[Azufi]

So much I liked about post #117 but I did really well with the personal responsibility aspect of it after having been so helpless/victimized/abused by my child and young adulthood.

 

[Gadulu]

I felt uncomfortable having my therapist hug me, I can't imagine having any type of physical intimacy with one. I would...

I had a panic attack when my therapist hugged me to try to comfort me.