When The 'therapeutic Relationship' Is The Big Trigger

[ghotiff]

So sorry that I couldn't help

 

[DharmaGirl]

it was kind of cautioning therapists that those of us with young trauma and attachment issues tend to want to recreate the trauma with our therapists, in order to get them to 'care' about us

I have done this. My therapist has 27 years of experience with trauma patients. I would get to a point where things were going well in therapy, then pick out something he said to me and turn it against him. I would quit therapy, then we would talk and I would go back. I was talking about this with a friend and I said that he was just like my mother. That's when I realized that it was transference. I couldn't wait to tell my therapist!

That was a big breakthrough for me. If he hadn't had experience with people like me, he might have refused to work with me any number of times and I wouldn't have healed. I still dissociate quite a bit in therapy. There is a clock high up on the wall in his hospital office that I look at when I dissociate.

 

[NovemberStar]

@Pencil Yes - that is the very hardest thing to do - trust her. I am doing my best to, and I am trusting her more than I have anyone else, but the wee girl in me is incredibly fearful. But - I am talking to my T about those fears now. I see her tomorrow morning, I am literally counting down the hours. It was a real risk bringing it up with her - some Ts really don't like to 'go there' and fee the therapeutic transference stuff. My last counselor didn't have much of a clue - she never 'got it' - or if she did, she pretended she didn't. Her not 'getting it' was incredibly painful and I stopped opening up to her in the end. I didn't' have the trust she could professionally support me through the painful process transference is.

@ghotiff Don't take it personally - I do really appreciate your responses and suggestions…

@DharmaGirl - Transference is in all therapy relationships - a good T will not only know it, accept it, but also be prepared to work through it, and face it head on. I feel a bit of excitement / hope that I have been able to recognize it AND be brave enough to bring it up with her. But I'm also really afraid she will reject me as a result.

As I said in my email to my T, i realize one reason why I don't want to talk about how I might feel towards her is because I really do believe she will find it REPULSIVE that I like her, that she will be repulsed ;(.

Transference sucks. I am afraid of what will happen next - If she triggers a lot of flashbacks and memories, and I can relate seeing her to what it was like with my mother, I am afraid of the feelings I might develop towards my T - I don't want to hate her, I don't want to fear her, I don't want to 'love' her either. It's so hard because the reality is, she will ALWAYS be more important to me, than I will ever be to her - and that is exactly how it was with my mother ;(

 

[ghotiff]

@ghotiff Don't take it personally - I do really appreciate your responses and suggestions…

Thanks for understanding that my intentions were well meaning.

 

[DharmaGirl]

Transference sucks

Yep, I say that a lot. I know transference is in every therapeutic relationship, I just meant that I had an "a-ha" moment when I realized I was playing my trauma out on my T. Can you slow things down a bit until you feel safer discussing things. I'm almost at the 3 year mark and I am still scared, but not enough to stop me or for me to run away.

I also went through the stages of not knowing how I should feel about my T, and not being able to look at him or his shoes. Until, of course, he wore Keens. which is my favorite brand, and I looked at him and said - I like your Keens. He had the kindest eyes. In another six months I could actually have intentional eye contact.

I keep an art journal on therapy, and on one page I put, "Sometimes I hate you" and on the facing page I put, "Sometimes I love you". I drew a picture of him in the center of each page, then put quotes in the appropriate sides. I also drew devil horns on the bad side and things like that. For me, journaling and scrapbooking allow me to work out feelings. Having that has really helped me. I was really mad at him once, and ripped up the first journal. I try not to do that so I can see how far I've come.

My T kept telling me, "Just keep coming back. Even if you have nothing to say, or are afraid, or angry, the way to heal is to just keep coming back". He's right. The way out of this pain is to keep moving. I'm sorry for the long post. I just feel for you and the place you are, it is not a pleasant place to be.

 

[NovemberStar]

I met with her today, and we did talk about some of my Big Fears. The issue of what feelings I might have gong to see her, and doing the therapy work is presently overshadowed by bigger fears that I have to be able to work through with her before we go onto the other stuff.

It all stems back to my previous experiences twenty years ago, when I first ended up in the psych system and was diagnosed ( I believe, incorrectly) 'BPD' - that diagnosis and the subsequent 'treatment' I received has left me greatly affected and I have so many intense and very deep seated fears surrounding that. Talking to her about it today was so damn hard :(.

Growing up in a very abusive environment, I know it is very normal to have a deep seated fear you are a 'bad seed' - inherently flawed, pathologically repulsive and awful - and when I was diagnosed 'BPD' and treated in the way people with that diagnosis were 20 years ago, it only served to absolutely CONFIRM my deep seated fear that I am inherently flawed, awful, and a very very 'bad seed' - one that can never be 'fixed' :cry:.

I've posted examples of the 'treatment' for 'BPD' I had - namely to ignore any distress I said I was experiencing (because it was only for attention, and to manipulate those around me); if I shared I felt suicidal I was told 'well what do you expect us to do about it - if you want to kill yourself, that's your choice'. I was perceived - and treated - like I was a pathological liar, whose sole purple was to create drama, attention, and manipulate those around me to 'care for me'. That was the standard treatment for BPD 20 years ago - to basically not 'encourage' any 'attention seeking behaviors'. Reporting you felt suicidal was definitely seen as the ultimate 'attention seeking' behavior - so it was ignored. If you had the label BPD attached to you, any distress you had was ignored for fear of 'encouraging' it. ;(

None of it was true. When I self harmed, it was never for 'attention' - on the few times I ended up in the accent and emergency room due to self harming (overdosing, cutting, burning myself) I would be MORTIFIED and have so much shame. I definitely did NOT want to turn up and have ANYONE know I had done those things to myself. Even when I had flashbacks, dissociation, and classic PTSD symptoms, no-one told me what was happening. I was involved with several different mental health professionals at the time, and I was terrified, alone, confused and bewildered - I didn't know what was happening to me was PTSD and that I was experiencing flashbacks and severe dissociation symptoms. I didn't get any help for it either - bcd then I would have just been happy for someone to take me aside and explain what was happening to me. I felt no one believed me - that I was making it all up for 'attention'.

There's other stuff I can't talk about - not yet anyway. I was able to tell my T this today though. There is more I told her and more to the background story as to why I am so afraid of what my T thinks about me but I have to stop for now as it's too much.

I'm so incredibly afraid that the more I share with her, the more she will come to believe I might have BPD. A small part of me knows there are some major flaws in the logic to say BPD explains what is wrong with me (i.e. - it all went away for 12 years and the 'symptoms' were NOT consistent over time or context - that is a big clue that hey, not too likely I have it). But the fears that my T will a) think that is what is wrong with me, b) treat me like I was treated before - right when I really really need her help - are so overwhelming I really cannot put it into words (if I try to think about it, I have very strong physical symptoms where I can't talk or move; have to lie down on the ground - panic attacks and dissociation).

I hate that it is a whole week before I can talk to her again about it - not that it's something I 'want' to do, but I know I HAVE to, if I ever want to move past this :(

 

[DharmaGirl]

Oh, @NovemberStar, I am so sorry. That is just like being punished for your abuse. I was a nurse before my breakdown, and the stigma of Borderline Behavior Disorder still lives on. PTSD has so much in common with BPD, that when I first started therapy, I called all my nursing friends, crying, telling them I had BPD. They would tell me I didn't have it but I still believed I did. BPD = PIA (pain in the ass).

You are very strong, and very brave to have talked to your therapist (T) about it. I am so glad you are able to tell yourself that BPD doesn't make sense, and PTSD does. You are strong for having dealt with all that Bullsh*t for years! It may not seem so now, but it is true. Now you can get the help you need.

 

[NovemberStar]

Thank you @DharmaGirl. It was reading the new criteria in the latest DSM V that gave me hope - the 'consistent across time and context' part - because as I've said before - if what was 'wrong with me' all those years ago was 'BPD', how come it completely went away for 12 years, only to return when further trauma (earthquakes) and the flashbacks from my childhood abuse started again? Why do I only have the 'symptoms' in a therapeutic context (and not in my professional life)?

The thing I wasn't able to post last night is this: nearly 3 years ago when I was trying to get treatment for my PTSD and severe eating disorder, I was caught between two systems of health care - the eating disorder team didn't want to treat me because I had trauma and they 'didn't deal with trauma'. The general psych team didn't want to treat me because they 'didn't deal with sting disorders'. Both teams wanted a quick fix and so I had an assessment by two psychologists - a full comprehensive assessment, the full personality questionnaire as well as a 1.5 hour long interview with the two psychologists. They were the experts on the local program designed specifically for those with BPD - I was assessed just in case I met the criteria and would qualify for the ONLY daily therapy program in my city. It was thought that if I somehow met the criteria, I'd be able to access more help than if I didn't.

One of the psychologists is the one I see now. It's coincidence it was her I ended up seeing 2 years later, in a private context. I had no idea it was HER, until I turned up, but she remembered me. She was the only one in all the many people I saw then who LISTENED and had the time for me. I'd phone her when I was upset and she never refused my calls. She was always kind, and sympathetic. I couldn't be happier with the 'coincidence' of seeing her privately now, because I never forgot her kindness!

From the assessment, they said I didn't not meet the criteria for their program. The program designed for those with BPD. They said I needed help fro PTSD and my eating disorder. BUT - because of my previous awful, damaging experience of being labeled 'BPD' I had made it VERY clear, that to imply I did have it, would be extremely devastating to me, and damaging.

SO - as I told my T, my concern is I gave them 'no choice' but to say I 'didn't' have BPD. My deep fear is maybe they did conclude I have it, and just told me I didn't, in order to 'protect' me from further harm. I am so afraid (!!!!!) of hearing true possible truth (i.e. my T does think I have it) that I have made it clear to her, I cannot know the answer right now. I am still SO incredibly fearful of her answer, I'm not in a place anywhere close to accepting what that answer might be. If she says I do have it, that would trigger me and I would struggle to cope - I think it would seriously destabilize me (due to the past experience of having all my distress ignored). Yet on the other hand - if she said no, they did tell me the truth and I DON'T have BPD, I'd not believe her - I'd still think she is protecting me from further harm :(.

I also worry that they never said I don't have BPD - only that I 'didn't met the criteria for the program'. I never clarified this, because I was so fearful of having those words associated with me - and I was in far too vulnerable a place to cope with the idea of being not treated again.

As hard as it is, I am kinda glad I have bought it up with her, because in all the 8 months of seeing her, it's always been in the back of my mind.

I feel afraid to share certain things with her - things that I need to talk about in order to heal - for fear she will conclude I have that awful diagnosis - and change her treatment of me (i.e., ignore my distress, think I'm attention seeing, being manipulative).

Yesterday she spent a lot of time reassuring me that she does not see BPD in the stigmatized way it was seen 10 plus years ago. If anything, it seems she is a huge proponent of changing the stigma associated with BPD and PROVING those assumptions are anything but true. She does not believe those with BPD manipulate, she believes their distress is real. She has been active in the research behind this, and was (and still is) actively involved in treating those with BPD in the much better, less rejecting kind of way people with it have always been treated up until recently. I guess it makes her a 'fighter for the cause' so to speak.

And of course, I sit here thinking 'is she telling me this BECAUSE I have BPD', or is she telling me this as an example of how she perceives those with it, to help me feel that IF my fears were confirmed, I'd have nothing to worry about? :eek:

I try to remind myself - a personality disorder is a personality - it's either there or it isn't, it can't 'come and go' - it is consistent across time and context. but I am still so afraid :(

 

[Pencil]

@NovemberStar I see now why you wrote about destigmatizing the disorder on that other thread. I read this post and I really FEEL in response to it.

I'm really sorry you went through this, and it reminds me that I had a really crap experience with a psychiatrist about 15 years ago when I was in the middle of a crisis. She diagnosed me with BPD (she was the only professional to do so) within 10 minutes and really, really treated me like crap, and actually insulted me.

I had forgotten about the incident but reading your post brought it up. And the memory stirs up awful feelings. The funny thing is that when I think about it I become angry and I want to react to the stupid woman - and this means of course 'acting in BPD fashion' - with which I mean that ANYBODY who is in a crisis and is treated that way would 'act like someone who has BPD' (whatever that means). Sorry, the whole thing is so convoluted that I can't express it without getting tangled up in my own sentences. Don't know if I'm eporessing it clearly.

How could anybody think that kind of treatment could have any positive effect?

 

[NovemberStar]

@Pencil the CPTSD thread? I've posted about it before on different threads.

Really struggling today - have wanted to self harm pretty damn bad - which as you mention @Pencil - would not be good to do, in terms of overcoming my fear of having that label put to my name again :(. Struggling with almost flashbacks - flashes too brief to know exactly what they are OF, but enough to feel like I'm BACK THERE, and desperate to get away from being triggered 'back there'.

Taking extra quetiapine and it's left me feeling out of it - which has made the derealization pretty bad. I was half asleep on the couch and feeling so disorientated - between the flashes and the derealization and being only half awake, it was like being in a waking nightmare. I would keep my eyes closed and try to get ALL the way to sleep to escape; but couldn't.

I feel so disconnected. Life is feeling like a continual mix of de je vu and flashbacks and I don't recognize my life anymore. I don't have anyone to phone or talk to. I feel so alone, yet am too afraid to leave the house anyway. I'm off work for the weekend (I'm usually on call) and this has probably made my disconnect worse, because I feel so far away form my working life and working self - the only thing that makes me connect to my life and the world.

I'd love to be ale to cry and cry and cry - but am frozen stuck in a pain I can't release ;(

 

[ghotiff]

I feel so alone

I am here. Is there something I can say to help you?

 

[Pencil]

Have you tried a sharp pencil? It is painful enough but does not break the skin.