So Confused And Sad By Therapist's Response

[Philippa]

Didn't leave anything important out. After I read, she stood up turn to walk to her desk, and with her back to me she said,'you sound like you blamed yourself.' Then she sat down and asked 'so, when do you want to schedule your next appt?' It was instantly a different atmosphere. I was a bit shocked and had just used my voice for the first time so I was emotional. I just got up and left. No more discussion, no feedback, nothing.

That does sound weird.:cautious:

Even if it did sound like you had blamed yourself...how is that being manipulative or controlling?

I would have thought a good therapist would have, at that stage taken some time to at least try and convince you that it wasn't your fault or that blaming yourself isn't helpful...wouldn't you?

Sorry that was your experience. It would have been nice if she had shown some appreciation for how difficult that would have been to share with her, and to speak your voice for the first time ever.

 

[Sterre]

Secondly, my 'drug' of choice is avoidance. Some of my avoidance symptoms are outside of my control, but I do have to actively confront the traumas and the fact I have PTSD. I may not be able to control some of my dissociation, but I have to choose to be open about my experiences in a safe place to begin recovery.

I've also realized that I am a very concrete person, so therapist comments like "you need to get in touch with you're feelings" really doesn't make any sense to me-too abstact. While acknowledging that how and what I share is up to me, I respond better to concrete strategies and examples of possible ways to approach things.

A major hindrance with my therapist is that when I would ask her how to approach an issue, she would always tell me that it was up to me and there was no perfect way. She never seemed to understand that I wasn't asking her to tell me what to do, but was hoping for her to offer some practical guidance as a counselor and offer me some strategies that had worked for others.

For me, trying to really look at my trauma for the first time, seemed like looking the inside of my own dissected body, with a huge tumor growing and interwoven with my vital organ. I don't want my therapist to cut it out for me, but in the overwhelming state of looking at the tumor, it would be helpful to be told, 'some people find it best to start cutting here,' or 'these are some of the instruments typically used.' Also helpful would be, 'I know it looks messy, but you're on the right track.'

It makes a lot of sense to me.
I have encountered some of the same probems as you have during therapy. My T would say the same "abstract" things, wich left me more confused than I was before.
I completely get what you are writing about.

Good luck on your way to recovery!

 

[mamachick]

After re-reading posts and additions, I have a few other thoughts about this.
I do not know if your therapist is in private practice, at a clinic, if its self pay, insurance coverage, your insurance limitations, etc.

From your initial post, you described about 2 years that she was very supportive during this time of crisis and getting you through that crisis period with compassion and empathy and helping you with boundary issues. Following that, the two of you decided to work on childhood trauma issues, and you have a very difficult time coming forth with these issues. And it sounds like she has not been pushing you-and maybe letting you take the lead in this. That sounds reasonable as her first obligation to you is to cause you no harm.

This last session seems to have changed dramatically after reading your journal entry to her.
Now I hate to bring this fact of reality into the picture-but wonder if the agency or insurance plays any role in her belief that you need to limit sessions to one month as well.

All therapists are accountable to someone. In an agency setting, staff meetings require updates on the therapists case load, and their charts are often scrutenized. The treatment plan includes goals and objectives, and if she is unable to document progress, her supervisor may be coming down on her that further progress is not being made and that there may be indications that the client is becoming dependent on the therapist-which is a big no-no.

Also, insurances hold the therapist accountable and may allow weekly visits but not indefinately. There is an expectancy that this will not continue, even with a diagosis such as ptsd. For example, it is not unusual for depression to be allowed 6 visits by insurance and then need further pre-approval. Unrealistic as it is-they are calling the shots many times.

Sometimes clients need a break from therapy to put into practice what they have learned (boundaries, assertiveness, etc) and practice this before delving into deeper issues. Sometimes when someone is unable to talk freely in therapy (dissociating), it may be an indicator that they are just not quite ready.

Someone mentioned that dissociation has nothing to do with borderline. She said she thought you were being controlling, manipulative, and borderline-ish. She did not say you have BPD. What are your feelings about her limiting therapy sessions? Are you feeling a bit abandon? If you are, that may be what she is meaning. Is it possible that you are afraid to terminate therapy ?as you are saying that you are not able to share well. I think many of us without BPD have a B moment at times or in certain circumstances. I think of it as a panic to hang on to someone or thing due to fear of abandonment. The best thing we can do about that is work through it.

It is normal and understandable that when a T has been there for you for all these years and helped you through a crisis such as you have been through-in some ways they feel like your friend and confidant. I would miss this attention horribly as it becomes almost routine. It feels good to be cared about and your issues focused on. She has been someone you can rely on and trust. Yet if you are not benefitting in progress and are at a standing point, it may be time for a break.

I think your therapist sounds very competent and professional. I agree with Anthony that this may be overdue. If you are coming away without remembering sessions and feel you might be dissociating, you can also ask her to tape your sessions so that you may go back and listen to them. You are obviously very bright, insightful, and couragous. It might help you to discover what is blocking you from talking or keeping you from remembering. That painful stuff can be hard to recall. (((hugs)))

 

[onmyway76]

Thanks for all the thoughts Brat. I sincerely appreciate you taking the time to consider my situation. I am always open to feedback and love the outsider's perspective.

My T went into private practice a few months ago from an agency and I decided to terminate services through the agency and continue to see her. I've always been private pay, as she offers a sliding scale. Also, she's been known to see clients for very long times. I haven't seen her weekly for 4 years. Some times I went a month or more without going. Up until a few months ago, I was seeing her twice a month. I'd only gone to back to weekly once I decided to do some trauma work. She works with another counselor who she staffs certain cases with. Maybe that is irrelevant, but felt worth mentioning.

Its interesting, but after the strange session where I shared, I had actually considered bringing up to her the possibility of taking a break from therapy and trying to come back to the work, because it was proving so difficult for me. Of course, I was never given the opportunity to bring up that conversation; it was brought up for me.

Honestly, I wasn't so hurt by spreading out sessions, taking time off etc. It was the "how" and "why" that bothered me. The 'how' was so cold and abrupt with no opportunity for any 2-way dialogue. The 'why' is still a bit shady to me. When I asked her to explain the "why" and if she would give me some examples, she would not tell me. She just said "see, this is what I'm talking about." (inferring I was playing games, manipulative, controlling etc.)

Its interesting that you mentioned the feeling of abandonment and BPD. I've definitely considered this. Yes, I did feel abandoned after she told me I may not get better, only hope was to take a break, etc. I attributed that to the fact that I was actually abandoned by my mother as a child and assumed that this situation had triggered feelings about that because it had happened in such a abrupt and insensitive way.

Especially, given my sensitivity from exposing some of my traumatic experiences. I figured all of this played a role in my upset. Still though, after processing and trying to see myself under a magnifying glass, I don't feel that I was controlling or manipulative. I have plenty of challenges and those are not them.:D Its been a bit healing to consider that my T has been both helpful and imperfect in the relationship and she just happened to miss the mark on this.

 

[SimplyComplex]

wow- emailing traumas to T- what a great idea! I may do that because I am unable to talk about traumas. Wow, thank you!

Check with your therapist...it has really helped me be able to break the ice. Once I know she knows, it is much easier to discuss them. However, I have often wanted to ignore it and go "but I already told you". So a plan to discuss emails is important too.

 

[Srain]

Onmyway, there is a lot of great feedback and information here, you certainly seem to have a handle on where you are and which direction you want to go, you are doing really quite well, and I'd like to welcome to the forum.

It's unfortunate when something like this happens in therapy especially after having had so many good experiences, I've had own moment of "what just happened" with a long term therapist so I somewhat relate to what you are must be going through. One thing I have surely felt empowering, as well as useful to me since I have a tendency to guess at what people are thinking or trying to interpret what certain actions or words mean, has been to simply be completely straight-forward and ask or state my feelings about what happened until I feel I've been heard. In this case I might suggest that when you shared from your journal the reaction you got was not the supportive or direct therapeutic guidance that you had received in the past, why? Or maybe not even why, maybe just that's what you experienced and you left feeling "confused and sad".

Not everyone feels the need to (for lack of other wording) put closure or resolve a situation such as this but I've found for myself it has helped me in my avoidance and helps stopped those endless conversations/obsessive thoughts due to a situation I had not finished dealing with. Sometimes, it's not necessary for anyone but me, sometimes I feel it's necessary to let the therapist understand what transpired in case they are not aware of what I felt their part was, sometimes it's me just needing to get my power back. For childhood abuse survivors this can mean a lot.

I think the word "games" is off-putting and can sound intentional. There is no doubt anyone with PTSD or Complex Trauma issues is going to use avoidance in the therapeutic setting at some point whether they are aware of it or not and it takes both the therapist and the client to work on these behaviours together. I think it's counterproductive to use terminology that sounds accusatory, that's not to say there isn't room for confrontation but not everyone needs somebody in their face treating them like they are doing this on purpose, this is where a professional with experience is very much required.

I hope you are able to find a therapist that can take it from here and hear you out. Great job!
Peace,
Rain

 

[Daisygirl]

onmyway76,

I agree that your T's reaction sounds very strange and not supportive. Regardless, of her reasons, I like that you are taking the road to take care of yourself. I like that you are finding the positives - being more proactive, feeling more confident and capable.

In your T's office you faced your fears twice - first when you told part of your trauma story and second, when you talked to her about dissociation. You are working hard. I am glad that you see that.

Like Philippa said, I am sorry too that you had this experience. I also liked what Junebug said about taking baby steps.

 

[mamachick]

onmyway76,

As rain said, there are so many good responses here.
After your last post and hearing the time frame of therapy and she is in private practice, I retract my thoughts about insurance and agency policy. I think its unfortunate that we ever have to consider the care or lack of care we get is based on insurance, but it is and its here to stay I think. However, given the further information, I dont think that is the case.

It is very disheartening that she did this at this particular time. It just sounds that up until this time, she was very professional and ethical. Again, I am so very impressed with your calm and reasonable approach and accepting the variety of input in response to this. You sound very grounded and should be proud as it sounds like you have come a very long way in these years. It does sound like it is an issue with her, possibly her own history or just being over her head or uncertain. (her first obligation is to do no harm). As others have said, she is human and imperfect. Whatever the case, it does not sound as though she handled this very well.


If I understand right (without re-reading), you do have another appointment. While there are so many good responses and so many possibilities, the only way to be certain of what she is saying is to address that in your session. You have every right to ask and receive a response to all the questions that you have. Maybe she is thinking something that the rest of us are missing-I sure can't see any excuse for turning her back at this time and then using words such as (control, manipulation, b-linish, games, etc) without some further explaination.

I mentioned the feeling of abandonment related to BPD only because the reaction to abandonment is a primary symptom of BPD (real or imagined abandonment). Please know, I am in no way suggesting that with you. IMHO, not feeling abandon in that situation would not be normal for anyone. Actually, its a stretch for me to think of any good reason for any therapist to use the term borderlinish. I was just reflecting on my own stuff, and although I am not bpd, I can certainly think of moments I have had in response to something significant in life, particularly when most symptomatic. (I can use humor and say Im having a b-ish moment, just dont act on it).

I hope you get clarity with her. I think it would be most helpful for you but also for her, as she may not even know the impact of what she has done/said. Even if you decide to change therapists or discontinue with her, I think it is so important to not carry miscommunications into your future. For myself, I have enough unreasonable people in my life that I know I need clarity with those who are capable.

 

[Hashi]

onmyway76,
I have had both types of therapists - one who specializes in trauma and one who didn't. I found the experience very different. For instance, a trauma specialist would be able to ask you questions that could help you understand why you are dissociating in therapy. He/she could also help you with grounding techniques to help you during your sessions. I don't see how this is telling the patient what to do or steering them in their healing. This is teaching you a skill and helping you learn awareness so that you can find your path to healing.

I feel exactly the same. I started with a specialist trauma therapist, and felt safe, supported and validated. We spent time talking about safety, how it felt to talk, how it felt after I'd talked. She never once pushed me to say anything, but because I knew she would listen without judgement and she could handle what I said, I was able to. I mostly read out of my journal or took art I'd done, and her response included acknowledging the achievement of opening up and sharing something so difficult and private.

I had to stop seeing her and found someone else who was not a specialist but had particular skills I thought would help. She was a good therapist for those skills, but not for trauma work. She meant well, but didn't establish safety properly or create/hold a space for me to be able to talk - so instead she had to push and I pushed back. I've stopped seeing her now.

Something I noticed in your description was how much therapy-speak there was - "playing games", "manipulation" etc, alongside the lack of examples other than "You're doing it now". IMHO, if there are valid issues for a therapist to raise they should be able to do this without hiding behind labels - at best this is lazy and poor communication. In my view, they should be able to explain what they mean and say things like, "When you say/do X, what are you feeling? Do you think you could try Y? What do you think would happen if you did?" etc.

When I've been directly challenged in therapy, I've been asked first if it's OK for the therapist to give me feedback. Then they've said something like, "I'm wondering if what's going on is..... What do you think?" They didn't throw out psychobabble at me then leave me, like a child being punished, to think about what I did.

We're all different, and maybe the "tough" approach with psychological terms suits some clients. It didn't suit me, and I know I've been able to talk in therapy not because someone pushed and challenged me, but because they didn't.

 

[mamachick]

Something I noticed in your description was how much therapy-speak there was - "playing games", "manipulation" etc, alongside the lack of examples other than "You're doing it now". IMHO, if there are valid issues for a therapist to raise they should be able to do this without hiding behind labels - at best this is lazy and poor communication. In my view, they should be able to explain what they mean and say things like, "When you say/do X, what are you feeling? Do you think you could try Y? What do you think would happen if you did?" etc.

I so agree. A reasonable dialogue is to say-for ex; I have noticed that when...., or, I am seeing a pattern of... Then to follow up with examples so the client has the opportunity to understand and gain insight