Therapist Terminated Due To Trust Issues

[GMW]

Hi guys

I just wanted a sounding board really. no questions, just a place to vent my pain.

Yesterday my therapist terminated our sessions without prior warning (though i could tell it was coming). She said there's no trust in our relationship anymore (she could have meant from both sides but specifically due to my behaviour... she was talking from her perspective - she doesn't trust me). I don't blame her. I don't really want to get into what I did, it's my fault, end of.

I'm just struggling now. Hubby is unemployed so we can't afford a new therapist and the NHS won't treat me beyond 6 weeks of CBT or a psychiatrist. I have to wait till he gets a new job.

I am in constant emotional pain today. constant dull ache in my chest. I did a lot of crying yesterday evening but today it's just settled into an ache. I hate myself.

During the termination session yesterday I emotionally dissociated and totally blanked out for a bit. I was expecting it but the rejection and abandonment (though it was my fault) crushed me and I didnt ask her any questions or say much at all. I think she said what she needed to, asked me what I'd take away from it, told me what she hoped for me and the rest of the time we sat in silence till it really got too much and i apologised and then asked if she could let me out 20 minutes before the end of the session (we met at her house and she always locked her front door in session). As I'd not said anything and just fled the scene I wrote her a sorry/thank you/goodbye letter last night, explaining why I did it and asking for recommendations for a new therapist who could handle BPD, PTSD and depression. I really hope she responds kindly, I think it would break me if she said she knew of nobody qualified enough to take me on, or didn't want to pass me on to anyone she knew or just didn't respond at all. My guess is she will respond in professional talk, very little emotion or will just text me. The most likely thing is she will just text "hi J, thank you for your letter. I know of xyz who might be able to help. Best Wishes J" and that will be it. Even though I'm desperate for her to tell me she forgives me and doesn't hate me I very much doubt she will.

I can't stop thinking about how much I miss her. For 4 months she gave me hope and insight. Without her I'd never have come to a place of acceptance with the BPD. I've encountered all the crappy stigma around BPD and she was the only one who said "that's not how i see you" but in typical me style, i made it how she saw me in the end.

I just want to cry but I can't. I just ache.

 

[Bloomy]

I feel you. Been through some of the same. Its crap and it really hurts. Dont have so much more to say then to send you warm thoughts and hope it will work out. Take well care.

 

[lostforgottensoul]

I'm not quite understanding why a therapist would terminate sessions because they don't trust you. My therapist does have a 2 way trust with me. I learned that only recently when his sister died and he felt safe enough to tear up. Before he did he said "well you've been coming long enough..." (8 years) which is what he says before he tells me more personal stuff.

But he hasn't always had that 2 way trust and he tells me of examples of past patients or current ones and leaves out names and details and some of his patients really seem to use him or try to set him up and he says he just calmly places boundries. And advises me how. We are talking about boundries or something specific to bring it up. He has talked about enough past patients to know some have done some really shitty stuff and there is my therapist hanging on but just saying "nope, we aren't going to do things this way".

Anyway, sorry, I know you didn't want to focus on what you did. I just fear it will serve as a way to beat the hell out of yourself when there are real reasons of why we do what we do, even if what we do is wrong in the end. I've been through many of those things with my therapist still hanging in there. There was a large period of time where it was all frustration for him as I was huffing duster which meant I couldn't go anywhere in therapy and he could have said he would stop sessions until I got clean, and that would have been very justified, but didn't and eventually I did ended up getting clean.

Please don't beat yourself up. I understand it was wrong (whatever it was) but I am sure there are reasons you did it and I am sure BPD and/or PTSD was at play and I am also sure there are others here that could relate to it too.

:hug:s

 

[EveHarrington]

:hug:

 

[Deleted member 29920]

Doesn't really matter what you done, termination is f*cking hard, I've been there. Until you get another therapist, is there a general counselling service you could go to? And of course, this forum may be of great use to you :hug::hug::hug:

 

[Justmehere]

It happens sometimes that clients with BPD act out in a way that some therapists don't have the skills to handle or treat. It sucks. It doesn't make you or her a bad person.

And it doesn't take away the very real pain of termination. I don't have BPD, but I've had a therapist suddenly (but somewhat expectedly) terminate me - we mutually triggered each other in one horrible moment. Oh it was hell. I can't even describe it... This forum helped me get through.

She should provide you referrals and I'm hoping she is already aware of your financial situation and the NHS crappiness. It may feel crappy and weird to get referrals in a professionally distant tone.

This might be a setback, but use it as chance to grow beyond what she could do with you.

It was awful when my old therapist terminated and it took me time before I found a new one I could afford... but the interim time was actually good for my growth. It required me to find other supports.

Look into DBT resources all you can. There are many free resources online. ACT is an offshoot of DBT and there are some great ACT workbooks too.

Connect with safe people in healthy ways as much as you can. If there are not any or many, use this time to begin to look for safe friends and relationships. Even if it's a simple book or knitting club - these kinds of connections helped me get through and help me now. It's not therapy, but it's still therapeutic connection and relationship and living life.

Most of all, don't lose hope.

Many people with BPD get better - with or without treatment, many no longer qualify for the diagnosis within 10 years.

From Borderline Personality Disorder: Fact and Fiction | Here to Help -

"First and foremost, studies have found that rates of recovery from BPD are much higher than previously thought. In one of the longest studies on BPD, Dr. Mary Zanarini and colleagues found that, over 10 years following hospitalization:

86% of people with BPD stopped meeting criteria for BPD for at least four years. 50% of people recovered completely (as shown by no longer meeting BPD criteria and having good social and work functioning)3 Many of these people were receiving some kind of treatment, but some were not. Although many people with BPD clearly struggle for a long time, BPD is not a hopeless diagnosis, and many people recover."

:hug:s to you.

 

[GMW]

Thanks guys,

I can't see who it was (on my phone at the mo) but someone said that those with BPD often act out. Yes, that's exactly what happened. I felt the horrible fear of abandonment with her then acted out in an attempt to manipulate her into staying. Unfortunately she now feels she cannot trust me anymore and i cannot say i blame her. If she felt that she can't trust me and therefore cannot put my best interests first she did exactly the right thing by both of us - it would have been unethical for her to continue working with me. She's the best therapist I've ever had (and I have been to about 14 now and never completed a course of therapy successfully... something always derails it) and she's definitely not a bad person or inexperienced. I let her down, end of story. This is on me, not her. I think maybe she should have expected BPD act out and maybe she was, just not what I did.

Deep down I am beginning to believe nobody can help me. I know BPD can be recovered from (not cured) but I need help and I either find therapists aren't experienced enough, don't want to treat me OR (and this is more common) I push them away and they don't realise what I'm doing. This is probably due to the fact that while I had my diagnosis in 2009, it wasn't done officially (the psychiatrist gave me the choice as to whether I wanted it to be official and wanred me about the stigma attached to such a diagnosis) so I have lived in denial for the last 7 years till I met my latest therapist. Then she gave me space to explore it and gradually I have come to terms with it and seen patterns of my behaviour which fit. Thanks to her I am now able to access the right help because I'm no longer in denial with it. So I'm going to have to tell the next one what I did with my latest therapist so I can't do it again.

I have looked on the BACP website (British Association of Counselling and Psychotherapy) where I originally found her. I saw her pic and profile again and burst into tears. I've contacted some possibles and been honest about my issues so they'll know before I even meet them what they would be taking on. I'm filled with regret. Unfortunately DBT isn't readily available in the UK (kind of makes me want to train as a therapist to fill the gap LOL) and my nearest DBT therapist is in London (about 2 hours drive away as I'm in the Midlands). I've seen online courses in DBT and will get myself the DBT skills workbook but I really do need a therapist too - even if she can't do DBT I need someone to talk everything through with and to learn how to relate to people appropriately. I also just need that feeling of being held, contained, accepted and validated. I need that emotional hug (not a physical one - never hugged a therapist in my life!!) but sometimes you get that sense of being warm with them that feels much like you do after a tender hug with someone you trust, if you know what I mean?

I feel really rubbish and tearful again so I'm gonna sign off for tonight I think. Thank you for your responses guys.

 

[lostforgottensoul]

if you know what I mean?

I do! My therapist gives me emotional hugs and I feel warm and comfortable there. I think he made extra sure I felt comfortable!

I have BPD too so I can sorta relate. I've never manipulated anyone on purpose but have been told I have manipulated whether on purpose or not.

I felt the horrible fear of abandonment with her

What made you feel abandonment orginally? If you don't mind me asking.

Whatever was done was done because of BPD so I hope that you at least see that and don't mentally beat yourself up.

Deep down I am beginning to believe nobody can help me.

And that is the problem with therapists ending sessions and leaving. It's one thing to say I don't have the training to best help you but I will refer you to someone that does. And it's another to just say "we're done. That's it."!

You are NOT beyond help! If I can be helped, so can you! I am my therapist's toughest case, I am positve of that. But I also have been helped. So can you! No one (or not many) are beyond help and those that are are folks that are like the criminally mentally ill. Or whatever the polically correct term is for that. You, my dear, aren't beyond help!

But, I get the thought process. I also think that several times inside of a month. So it is a common thought so i get it. But, it doesn't make it true.

and my nearest DBT therapist is in London (about 2 hours drive away as I'm in the Midlands).

Why not just a therapist. A "normal" therapist whom works with the traumatized. I would say a trauma therapist but even my own therapist doesn't advertize as a trauma therapist though he is. He advertizes as licenced mental health counselor; individual, couples, teen counselor. Though he is a trauma therapist whom has training and experience in my exact trauma.

And, as you said, buy the workbook. Id do that now as if you walk through it, it will be wonderous help while looking for a therapist.

But I agree, I would get a therapist ASAP and hopefully she refers you as that's the least she can do instead of just leaving you hanging. That isn't fair and even if it would be unethical for her to continue. She can at least refer you. But if she doesn't, you should start looking now.

Just take it easy. It will be ok! Sending warm :hug:s!

 

[GMW]

I've never manipulated anyone on purpose but have been told I have manipulated whether on purpose or not.

It wasn't consciously done by me either. I felt the abandonment and then *SNAP* without thought, I did something manipulative to her. I didn't consciously sit down and decide "if I do this, then she won't leave". I realise now as I reflected on why I'd done it that it is a pattern of behaviour dating back to when I was 14. I was afraid someone would leave and so I did it then too. THAT was consciously done, now it is just unconscious habit (I'm 32 - to give you an idea of how habitual this is!).

What made you feel abandonment orginally? If you don't mind me asking.

Not at all - basically what happened is that she couldn't see me for 2 weeks once. She actually told me (it's like it's burnt into my skull because when I felt that rush of anger and abandonment, it felt like she was TRYING to push me into these feelings... like she was game playing) "I'm actually going out of the county" My brain went "why tell me that?! WHY? Unless you want me to feel as removed from you as possible to trigger something?" Then I got angry with her for being a hypocrite (she'd questioned whether I was game playing that SAME week), then I realised I felt abandoned and that's why I was feeling angry.

Shortly after that I came across some awful therapist's take on BPD which sent me into a total spin. I was having transference issues like mad, imagining my therapist saw me in these awful ways and desperately needing to see her but she wasn't there. She wasn't anywhere nearby. So I felt abandoned again.

The next session was when I manipulated her I'm ashamed to say.

You know something? If this had happened this time last year, I probably would have been suicidal. Wanting to kill myself because I felt like an awful person. Now... because I've come to accept the BPD... is it really wrong to admit that I DO feel ashamed, regret my actions, wish I could turn back the clock, sad that I hurt someone who cares for me BUT I don't feel the need to punish myself for it? That doesn't make me a narcissist does it? I am blaming the BPD... is that a terrible thing to admit? Somehow to me it feels like beating myself up is the RIGHT thing to be doing? I deserve and should be in a mad spin of self-harm and chaos... but I'm not and I feel kind of guilty about that.... weird... I feel guilty about not feeling overly guilty (oh boy I'm messed up!!). I feel guilty that I'm not self-flagellating!! Yikes, I'm nuts!

It's one thing to say I don't have the training to best help you but I will refer you to someone that does. And it's another to just say "we're done. That's it."!

Ahh, again, not her fault. I actually told her in our last session that I was not going into therapy again. She asked what I'd take from this and my (rather petulant) reply was words to the effect of "well I don't think I'll be trying therapy again so it won't make a difference". I didn't mean it to sound "you bitch, you hurt me now I'm gonna hurt you by telling you that basically you have destroyed my trust in therapists TOTALLY" but I think that's how it came across! I meant "I only want you and if I can't have you, nobody else will do". After I said that, of course she would be unlikely to offer to refer me on or recommend someone for me. She wasn't going to push me to do something I wasn't ready for.

I've always wondered what last sessions are supposed to be used for - whenever a therapist has ended with me, I can never find any words. It feels like "what's the point?" "there's no point in telling you how I feel when I only have 10 mins left with you EVER" "All I feel is rejection but it feels manipulative to tell you that and like I'm pressuring you" "All I want to do is beg you not to leave but again; manipulation and pressure" "I want to tell you I'll miss you... I want to tell you.... I feel.... but there is absolutely no point anymore and that makes me feel lost, hopeless and paralysed" I managed "there's no point in my being here, is there?" She said "it's your 50 mins" *silence for like 5 minutes* "I think I want to go" "OK" (neither one of us moved, I was torn... I didn't want to leave her, but the silence was killing me. I wanted to beg her to say something... anything to help me talk but then I thought she hated me so she wouldn't want to hear it anyway) *silence for another 5 minutes* I went to pick up my coat, held it in my lap, frozen between getting up and leaning back in the chair "I am so sorry" "Thank you" "None of it was about you" "I never thought it was" I was again frozen. This time with an odd sense of "I'm being real, there's no acting here, I genuinely am totally torn, I cannot lean back in the chair or get up to go... this is horrible" I felt trapped so I said "can you let me out please?" "Yes, of course" and that was that. She got up to leave, went to open the front door, I glanced quickly around in a sort of weird "I'll never be in this room again" way then left. I managed eye contact with her on the way out and she (quite frankly) looked as unhappy as I felt. It can't be easy, she must understand what she would be putting me through and I bet she had to weigh up what was in my best interests, what carried the most risk; continuing to work with a therapist who no longer trusts me or being rejected and being on my own. So she probably realises that I will be suffering for a while. I got the distinct impression that if this is not the first time she has prematurely terminated therapy with a client, it is certainly the first time it's happened under these circumstances. Simply because she seemed genuinely unsure how to proceed the week before, she was in shock (obvious) and then this week she admitted she'd spent a long time reflecting alone and in supervision over this. She might have just said that because it would make me feel better if I thought it wasn't a snap decision (and it could have been an easy decision actually) but to me it felt like she could have almost added "because I didn't know what to do" to the end of that sentence. It is nice to know that we don't leave our therapist's minds as soon as we leave the building, that just as we think of them, they think of us. It gave me a little comfort to know she hadn't just on a whim decided anything that she'd considered it from all angles. It hurts to know that even with careful consideration, she'd still decided she couldn't forgive me or learn to trust me in time... the feeling of dislike must have been intense. I just hope I haven't caused any counter-transference issues for her. :-( - now I feel guilty again :-( Not only have I upset my therapist, I have also possibly damaged her ability to work with others. :-(

Why not just a therapist. A "normal" therapist whom works with the traumatized.

That's exactly what my last one was (though she was studying for her PhD in Counselling Psychology so she was set to become a Psychologist in a year or two). She never advertised as having experience with BPD, she told me that on like the 2nd or 3rd time I met her. Her profile ticked every BPD issue though; abuse, trauma, identity, sexual issues, anger, addiction, mental health etc etc etc. And that was why I picked her. She probably wasn't given the option to select "Borderline Personality Disorder" when choosing what to select as areas of expertise! I've done the same thing again; deliberately only contacted those who have those issues listed (or as close as I can get to those) AND have at least a BSc in Psychology or BA in Counselling AND significant experience - if it's working with abuse or childhood trauma survivors, even better (because that increases the chance they've encountered BPD). In the UK you can be accredited to the BACP with just a foundation degree (1 year) in counselling. However, I don't think someone fresh out of their basic training with only a handful of certified 2 week courses under their belts and a few years experience could ever handle what I am likely to throw at them.

Anyway, this has become really long winded and a total mind dump, so I will leave it there. Sorry for the boredom folks!

 

[Suzetig]

In the UK you can be accredited to the BACP with just a foundation degree (1 year) in counselling. However, I don't think someone fresh out of their basic training with only a handful of certified 2 week courses under their belts and a few years experience could ever handle what I am likely to throw at them.

What a horrible thing to have happened, regardless of the reason for termination it's awful that you're feeling so badly.

I did want to explore the bit above though - BACP Accreditation means that someone has completed an approved training course with a set number of classroom hours, a clear number of practice hours and a supervision requirement. They also need to have been in practice for at least 3 years and have a minimum number of supervised hours of practice post qualification.

An accredited therapist should have a reasonable level of experience and their training is much more intense than a few 2 week courses and will most likely have included extensive personal therapy. It doesn't mean every counsellor is great, or that they have particular experience with BPD but they aren't beginners either.

You can be registered with the BACP with just the training mentioned above and most people will do that while working towards accreditation.

I'm surprised you can't find a suitable therapist in the midlands as some of the best counselling courses run out of Nottingham and Warwick universities. It can be difficult to find someone new, but try not to give up hope.

 

[GMW]

Sorry that's what I meant - registered not accredited. I didn't mean to imply they would be "beginners" but I just feel that I am exceptionally challenging and because I have been through this many times now, I feel I need a very experienced, robust, well educated, extremely compassionate therapist. I had her too... then I went and messed it up :(

When I say there are no therapists in the Midlands - I was referring to ones who can carry out DBT (or advertise they do). I'm aware that just because a counsellor is training in say... psychodynamic therapy, that doesn't stop them from knowing how to use DBT methods. I just can't find one close to home (Leicestershire) who has DBT listed as a skill. There's a definite gap in the market that needs to be filled here!

There are plenty of good therapists (I've emailed 3 so far who fit the bill) but for the moment, I am looking at them going "but you're not J" and feeling a bit resigned to the situation rather than happy to find someone else. Sort of "I really want J back but I know that's not happening so I guess I HAVE TO look at your profile *sad face*" Maybe till I can stop doing that, till in my heart I have accepted it's over, I am not ready to find someone else? But then it's not like a friendship or romantic relationship so in theory a new therapist should be able to help me get over the old one, correct? It's silly that I'm sat here thinking " won't they be offended if I'm still upset about my old therapist?" LOL

I am feeling better today about this than I did yesterday or even this morning. Just having somewhere to off load and "talk" to people about it who understand (never having been in therapy - my husband cannot understand my attachment, feelings of loss, sense of rejection and hopelessness) has been really helpful. Thank you for listening. I feel that perhaps I will be ready to start again quicker than I thought with your support.

 

[qwyoey]

Can you find a used copy of this book?
Effective Psychotherapy with Borderline Patients: Case Studies
by John G. Gunderson, Johng Gunderson

It was really helpful for me to read case studies of BPD in therapy