Struggling To Regain Trust With My Therapist

[erigby]

@joeylittle thank you for your helpful reply and insight. Thank you for reminding me it is a working relationship.
There have been some stumbling blocks (for me) in building the 'therapeutic alliance.'
Primarily in that...we have a dual relationship.
I serve in a capacity in our community that puts us in another and different relationship.

When I first sought him out as a therapist...PTSD and MDD were not issues on the table. I was simply someone dealing with a difficult situation and needed a therapist...someone I trust. It was only after months of time together I lost it and began talking about my own deeply personal feelings of emptiness.
He referred me to a psychiatrist..with whom I was very open and honest and then...complex PTSD becomes an issue and Major Depressive Disorder is a real thing.

It has been incredibly distressing...child abuse and suicidal ideation were never a part of my vocabulary but that's another conversation.

I had already developed a relationship with this therapist and thought to continue.
I was very up front with him in the beginning about how I wasn't sure if moving forward with him, and me with so much baggage, was a good idea.
I checked in on ethics etc. (there are differing opinions and ideally dual relationships are not a good thing but it is recognized that considering my profession...which I will not disclose here...it is not uncommon).
He said he was ok with it.
The truth is...I trust him...but value our other relationship too (which is a professional relationship in a completely different capacity).
I often hold back from being completely open.
I have been honest with him about it.
The truth is...it is excruciating thinking of having to start over with someone else...but...the more comfortable I get with this whole PTSD thing..the less scary that is.
I am so grateful for this Forum!
In many ways...I feel his reaction was defensive because he wants me to trust him so badly...and my suggesting seeing another therapist made him upset.
But... I'm not his therapist...and I need a therapist!
Someone who isn't going to get frustrated with me no matter how difficult I am.
The good news is...I feel confident I can bring it up when we meet again. And then I will know.
I can't thank you and @Gia1019 and @NightSky enough for your feedback.
He needs to be able to go where I need to go and if talking about how he 'abandoned' me over and over again is what I need to do...then either he is ok with it or not.
Stay tuned though...because if he drops me again...I'm really going to need some love and support.

I appreciate you very much.

 

[Suzetig]

As much as you value your other relationship with him, you need to accept that one will be impacted by the other and at the moment it's impacting your therapy because you can't be open with him. You're still very early in building a therapeutic relationship - 3.5 months is nothing really in terms of constructive work, I wouldn't have expected you to be doing difficult stuff particularly at this point. The work is truly about building the relationship.

If you think about the relationship as the vehicle for everything else that happens in therapy. You need a car that has four wheels, a strong engine and decent brakes and that's what you're putting together - repairing the disagreement you both have had is like checking the engine has everything it needs and kicking the tyres. If you're feeling that you need to look after him in some way because he doesn't like the idea of you going to someone else, that's like having a wheel come loose, you can't drive til it's sorted.

You need to talk this through with him, given the dual relationship he has a responsibility to make sure it doesn't have an adverse impact on you and if he can't do that, to refer you to someone else. That's because dual relationships are impossibly tricky to manage in therapy and kick up all sorts of boundary issues. It's ok to not "just get over it" if you've had a rupture.

I do think you also need to consider what you were trying to do in saying you wanted to move therapist given thstvshen he said ok, go then, you were upset and pleading with his answerphone. It's not unusual for clients to try and test the relationship in therapy and if that's what was happening (e.g. What will it take for him to quit on me) that's ok but it's part of the work in therapy to bring that honestly too.

The last thing, you said this touched a younger part of you - is it possible the dynamic in your T relationship is similar to a dynamic in relationships when you were younger? Again, not unusual and all part of the work but one of the reasons for working through ruptures is because they often tell us a lot about ourselves in relationship.

 

[erigby]

Dear @Suzetig thank you for your thoughtful reply. All of you have been so helpful. I feel empowered by your empathy and advice. It is helpful to me to hear you all talk about the "therapeutic alliance" and "ruptures" in that relationship. This is all very new language for me.

I feel confident I can approach my therapist openly and honestly with this new found knowledge and assurance. Having had the chance to share with you all and get such helpful feedback...I even know what I would like to say. This forum has given me so much clarity of thought and words.

In some ways...it might be best if he and I agree to just start over. Start over with PTSD and MDD as to why I am there.
I know it will be immensely helpful for him to know...I'm not ok with just "getting over it." I trust (at the very least am optimistically hopeful) he will be ok with me telling him this.
It is incredibly helpful for me to hear that 3.5 months isn't that long for the sorts of things we are headed toward. He seems very patient with "the process." I guess now I know why.

He is out of my insurance network...so I pay more than twice as much as I would for a psychologist in my insurance network. I suppose if I am willing to pay that much...I must believe on some level...he in particular is worth it.

In terms of testing him...it had crossed my mind...but my initial plea was out of my own frustration for not being able to open up, as I knew I needed to, because of our dual relationship. I even expressed to him how I had hoped rather than "fine good bye," he and I would work together on closure and finding a good match.

The truth is...he has made himself very available when I need it. Unlike some others I have read here...he is always open to texts and voice messages. He almost always replies to texts with some acknowledgment and he will call if I am specific that I need him to.
The most difficult challenge for both of us I believe...is my suicidal ideation. It is tough...and grueling...and surprising...and unpredictable...and while we wait for a medication that will hopefully help alleviate some of that pressure...it is an enormous hurdle for us both...and it is exhausting.

The last thing...that it "touched a younger part of me" is so true and has opened up a whole new dialogue with myself about relationships.
After some processing I realized I have, in the past, found myself in a pleasing and fawn mode with particular individuals who in some way or another not only have authority over me but also exhibit affection (appropriately of course), endearment, acceptance and appreciation for me.
When this has happened (there are only two other instances I can remember clearly) I have become overly concerned with pleasing them and not disappointing them. If there is any hint I might have failed in those areas...I become an emotional and apologetic wreck. I become increasingly worried about making them angry or frustrated and again...disappointing them. So I fawn and mask and pretend and hide all of the gnarly feelings and details.

This has been very helpful to process here.
My therapist and I have an appointment tomorrow.
I will talk about these things.
Thank you all for your help.
Stay tuned.
I appreciate you all very much.

 

[Muted]

If the intermittent suicidial ideation has been one of the challenges, would signing some type of contract be helpful?

I'm not sure if this has been mentioned or not, but maybe he didn't call you back right away because he needed time to get in the right mindset to deal with the situation?

I think it's very courageous of you to go back and discuss this with him. We will be anxious to hear how everything goes. Good job, @erigby !

 

[mrsmegan]

Wow, I'm so sorry that happened. I hope it goes well tomorrow.

 

[erigby]

If the intermittent suicidial ideation has been one of the challenges, would signing some type of contr...

@Gia1019 I appreciate your thoughtfulness. During this very difficult time I have thought about a some type of contract...I will bring it up...I do think it would be helpful for me...and I hope for my therapist.

Maybe even to help me in the mean time...I will type one up...this is good idea...thank you.
As I have mentioned previously...all of this is so new to me.
It is difficult.
I am grateful for this avenue to express concerns and to ask questions among other sufferers and survivors.
You all are amazing.
I hope you know how much you have helped me.
I know you have helped countless others.
This is a difficult journey we are all on.
We need each other.
Please never give up.
I say this as much for myself as I do to you all of you.
You have given me a community who "gets it."
I can't thank you enough.

Also, there is no edit button on this thing...so please forgive grammatical errors and incoherent sentences :).

 

[Robo]

I would start again with someone new. In my opinion, therapy is a bit like dating, it shouldn't be this hard this early on in to the relationship. If problems like this are all ready arising, where you are self editing what you share with him because you are worried how he will react, and trying to not upset him...the dynamic is already wrong.

Plus the dual relationship in another setting just adds another layer of complication tha doesn't need to be there.

You deserve total safety, someone who is ok to work with younger dissociated aspects of you (I have these and wow can they feel weird and overwhelming when we are high functioning in the rest of our lives). This is the stuff that needs to be worked on, these shame filled locked away aspects of ourselves. These elements need a safe therapist who will welcome their shame and pain and fear and respond with gentleness and love rather than "aren't you over it yet" type responses.

I'm new to all this, just realising I have locked away trauma and issues with younger frozen pain I haven't dealt with but I think we need to be so kind to ourselves in these situations and pick therapists who treat us with endless levels of empathy so our frozen pain can feel safe to come forth and finally be acknowledged.

Sending lots of positive thoughts your way

 

[Muted]

What do you mean dual relationship?

 

[Robo]

Erigby mentioned they have a dual relationship out in the community in another professional capacity.

 

[Muted]

Oh, I must have missed that. All the more reason to try and work it out. It's natural that that will complicate things to a certain degree , but if both are invested it would probably be worthwhile to work through if possible. That's just my opinion.

 

[erigby]

Dear all, thank you so much for your insight and encouragement. I met with my therapist today. I feel confident we are in a good place. In fact...it might be the best I have felt about progress in any session thus far. It can be a very freeing thing to take a leap and trust someone else will be able to handle it. While I was unsure...I am glad I risked it...and really glad he was ok with it. In fact it opened up some really good conversation and mutual understanding.

As I continue to work through this process...I am realizing more and more how important the therapeutic relationship is...not only in offering a safe space to work through the trauma and depression but also...demonstrating how to develop and maintain healthy relationships.
Healthy relationships aren't perfect.
They have challenges, there are disagreements.
Being able to be open and honest and respectful is a necessary part of those relationships.

Yes the dual relationship is a challenge. For me... in the end...that relationship was how I was able to risk being honest.
It has also helped me to realize what I am projecting onto our therapeutic relationship...I hope he is being as honest with himself about any transference he may be having...I think he is experienced enough (close to 40 years of practice) to do so.
We will see if the whole thing continues to urge me forward or to hold me back.

I am very grateful for all of you and this forum. I can't begin to explain how helpful it is to have this outlet and community.

As I process my session with my T today...I move towards..."what are my dreams telling me?"
So... I'm headed over to the dreams and nightmares forum.

 

[erigby]

I would start again with someone new. In my opinion, therapy is a bit like dating, it shouldn't be this hard this early o...

Dear Robo,

Thank you for your thoughtful reply. The disassociation thing is a very new concept to me as well. I agree it can be so weird. I am glad you are talking about it though. It took me months to get to a place where I even recognized it might be happening. Just recognizing it has helped me tremendously. Today for instance I was sharing the shame that came up when my therapist told me to "just let it go" and I immediately felt myself slip into childlike state and felt myself beginning to disconnect. This time though, I recognized what was happening and I was able to talk about it. It opened up a whole new level of conversation we had yet to have.

Keep talking about it here and with your therapist. Keep trusting someone will "get it."
I am realizing more and more just how difficult this work is.

I am grateful for you.
Thank you for the positive thoughts.