Therapist Causing Distress

[Bs3lht]

There's no real 'point' to this thread, except to vent some frustration.

My Therapist is fab, she really is. Except recently she's become flakey; not replying to my emails, rearranging my appointments & recently cancelling them.

Today, she cancelled with 2 hours notice. I have a baby who is 12 weeks old so venturing into therapy is no mean feat.

I understand circumstances crop up nor do I email her all the time & expect a reply but one minute she's lecturing about talking, not facing my problems, keeping things to myself & the next she's bailing on me & not giving me the space to do that.

She left me a voicemail this morning asking me to email her & that she'd be in touch later on today, but it's almost 8.30pm & I've not heard anything.

I'm sat in the bath crying. These cancellations always come after a shameful PTSD related 'cough up' as it were & I part wonder whether she's uncomfortable talking about it or whether I've messed up somewhere, adding to the intrusive thoughts I already feel.

And to be frank, I pay her lots of money, almost £100 an hour & I don't think I deserve to be treated this way.

Sorry.:unsure:

 

[twinkle30]

I don't think her cancelations have anything to do with your relapses or anything. I think she is just a flake. Sometimes therapist take on more patients than they can handle. I would start looking for someone else.

 

[Suzetig]

Honestly, unless you're in London, that's a very high fee for a therapist, I'd look for someone more consistent and cheaper if I were you.

 

[Scandinavgirl]

My therapist forgot my sessions once. It was of course a bit hurtful, but I learned that it was just a mistake - he forgot to put me in his calendar. It took a while for me to trust him again, though. And I guess trust is your issue here - do you feel like you can trust her now?
It has definitely nothing to do with you, that she is flaky. Ask your self how important it is to you to keep working with her - is it ok with you to find somebody else?
Remember you pay her to give you her services - you are the one to decide whether to move on to someone else if therapy is not working.

 

[Eagle3]

Discuss it with her. My T almost NEVER responds to my emails and i've learned to accept that fact about him. It makes the times he DOES respond mean that much more. But when it became evident that moving my schedule around was causing distress, he stopped doing that and kept me at the same time/day until i say I need a change (or a true emergency pops up for him).

 

[joeylittle]

Make a boundary - tell her you understand emergencies, of course, but your therapeutic alliance with her gets f*cked up when she doesn't give you advance notice and/or doesn't follow through on basic things that might seem like no big deal, but can tip your symptoms over on a bad day. I eventually told my therapist that if he knew it was likely he'd not get back to me about something until his next day off, or whatever - don't tell me you'll send it to me right after the session. I'd rather be realistic and wait than have him over promise and under deliver.

Sometimes we do check ins by phone, and he has a fairly predictable evening time for that; but it's contingent on he and his wife getting their two toddlers fed and into bed without many problems...and even knowing that, I'd get more and more anxious. So now, if he realizes it's going to be more than a ½ hour late, he just emails me with his new target time zone.

He was more flakey than I think he realized, and I was sucking it up so long, that when I finally talked about it, I was very very upset. And we had to evolve our 'policies' over a few months of real-world testing.

It's worth investing in getting the communication and expectations working - especially if you otherwise are benefitting from working with her (which it sounds like you are).

If you are on the fence about her, still do the talk but also start looking for a new one. You will know if she's trying to adjust pretty quickly, and if she doesn't, hopefully you've got leads for a new one and you can fire her.

 

[GardenGirl0214]

Definitely speak with her about it. This sounds unprofessional, and if she has something personal going on, you should be told about that.

 

[barefoot]

As others have said, definitely bring this up with her. It may be that a) she doesn't realise how flaky she is being and/or b) she doesn't realise the impact her flakiness has on you.

It's a big deal, especially if trust is something we find difficult in the first place.

My therapist is great - I really like her and she has gone above and beyond for me on numerous occasions. However, a while back I was in a total tailspin about the fact that she hadn't called when she said she would. I was in a bad way, she had offered me a phone call the next day, after much agonising, I said yes please (very difficult for me to know/ask for what I need so this was a big deal for me). Then, having said yes please, I got radio silence. No call. But, more importantly for me, no contact to let me know that a call wasn't going to be possible. I get that things crop up, so she might not then be able to call. But not taking a few seconds to text me to let me know was the thing that really got my goat.

I was really upset about it and ruminated about it for days and experienced a lot of anxiety - it was partly feeling upset with and let down by her and partly feeling ashamed of myself for asking in the first place and then getting so bothered about it when she didn't get in touch. We talked about it next session and I'm glad that we did. She clearly had no idea until I told her that that kind of thing would have such a major impact.

Sounds like you really like her and that this flakiness is a new, recent thing, so perhaps she has stuff going on in her personal life. If that's the case, she may well think she is managing it and that it isn't affecting her work/clients. So, again, talking to her about the impact of her last minute cancellations and flakiness around not doing what she says she'll do will make her aware that she is dropping the ball and it is having a negative impact on you.

I really feel for you - I very clearly remember how distressed I was in the above situation. I hope you can bring this up with her, that she will own her part in the situation and that the pair of you can agree a way to move forwards together.

 

[sun seeker]

It seems like situations like this come up pretty often here and cause a lot of distress. Here are a few thoughts.

Many of us have PTSD coming from childhood trauma. I'd be interested in how a person with single-incident later trauma feels in situations like this. Are they triggered as others are? Do these situations even cross the person's radar as something to be upset about? If anyone has experiences with this I'd be really interested. My sense of this is that in a therapeutic relationship some of us are exploring self worth and trust issues and figuring out stuff about healthy boundaries, perhaps for the first time. We may also be so symptomatic and in need of help that what to a person without PTSD would be just a change in plan, for us registers as a major disaster. And then it can be hard to figure out whether it's even "legitimate" to be upset over it. Thoughts go around in circles: "She said she'd call. She hasn't called. That must mean she doesn't care. Do I deserve for people to care about me? Maybe I don't. But she just told me I did in our last session. What does that even mean? Maybe she's just busy. People have a right to be busy. But she said she'd call. I can't trust anyone. People are always too busy for me. That must mean I'm not worth their time. But didn't she say... but... but... but..."

Meanwhile, the tiny amount of energy left in the prefrontal cortex is trying to convince us that it's all right, while the brain stem is reacting to danger.

All the while, the most likely thing is the therapist is just busy, bad at returning phone calls, and doesn't really understand the effect unfulfilled promises can have on a person with childhood trauma. Someone pointed out on a similar thread that the kinds of people who make good therapists tend to live in the moment, which makes them really good at therapeutic presence but bad at administrative skills like keeping track of when they said they were going to do things.

I have an excellent therapist, I can't say enough good things about him. He is extremely generous with his time, tells me to call if I need him and will put in the time to help me way above and beyond the call of duty. However, he is slow at returning phone calls. If I need someone in the moment of crisis, it's not usually going to be him. He is authentically very busy. He also knows, at least to some degree, how affected I am if he's not available when he says he's going to be. He gets, at those times, that it's the frightened child he's talking to and not the reasoning adult who can understand, "Oh, he's probably busy and forgot, I'll try again later."

So I think in these "my therapist isn't available when they said they'd be" cases, it can be an opportunity to work through all kinds of issues that probably come up in other parts of our lives but haven't been safe to work on. Yes, some therapists I've heard about get defensive, unfortunately. Those that don't can really help use these opportunities to explore deeper issues than the presenting issue at the moment.

I know this is a little bit off track from the therapist who keeps changing appointments when you have a new baby. I'd find that really frustrating. I've veered off a bit because I know so many others can relate with similar issues.