My (former?) primary T wants to meet next week with me and a DBT T who has seen me on and off (but can’t continue to see me unless the primary T does or I find someone else to see me, which isn’t working out.) When I think about meeting with the primary T, I really feel ok with it… in a very reserved kind of way. I think any appointment where we can talk about what has happened and how to move forward would be great…

But any conversation that is about terminating or not having conversations (i.e. several appointments about what has happened and how to move forward in therapy) would just…

I would just scream and run out of the room. Seriously, I’m scared I’d leave and really freak out. I can’t even IMAGINE having that conversation and being ok.

So I’m thinking of not meeting with her at all.

The only problem is: any appointment where we can talk about what has happened and how to move forward would be so great to have.

I have no idea if we are going to meet and she is planning to tell me she is

A.) terminating and/or would not see me for a long time (which she might as well terminate if she deceides to not see me for a long time)

or

B.) if we are meeting to discuss what happened and how to move forward in some kind of fashion...


I kinda don’t want to know. Because I am so afraid of the answer. If she is planning on terminating and/or not seeing me for a long time, and she waited all this time, with all these threats to terminate something that never was going to happen anyhow, it would make the feeling of betrayal by this T just too much, it would make everything she has done so sickeningly real and so painful and so unfixable.

I don’t even know if it is good for me to see the primary T or not again on an on-going basis. I just want to option right now, IF ONLY to deal with what she has done, so that I can move on to another T easier.

But if I don't meet, then the whole matter can just be in the awful place it is right now, and something has to change. I just don't think I can take anymore - and if she says she is terminating anyhow... I just would be so deeply hurt.

I can’t figure out if I should go ahead and meet with her or not.
What would you do?

I dont know if this will be very helpful or not but this is honestly the way I would deal with it. I would freak out but still go to the appointment. I wouldnt be able to stop thinking about it and having the worse possible things going through my head. I would prepare for the very worst and decide exactly what I would say or do if the very worst actually did happen. And that way if the worst didnt happen I could just say what I feel at the time about it and be some what happy. But I always have to prepare for the worse so that I would be able to deal with it without completely breaking down and not know what to do. When I am in these hard situations (and my P threatens to terminate all the time)I go through the conversation and decide exactly what I would say when the worst happens, even if its just telling him to go screw himself and that I hate him.

That may not be the best idea of how to handle things but that is honestly how I deal with those things.

Hiya there Janedoe. I'm sorry things are so rough for you. I've thought a while about how to respond to you because i know that this isn't an easy situation, but I'm going to be really honest here and give my two cents. Please take this with a grain of salt, as I don't know the entire situation and I, indeed, am not you!

I DEFINITELY agree with pippi that you need to meet with your t, but I think you only need to see her in the presence of your dbt. He can shield you in some regard, and can at least be a witness so your primary t can't simply fault you for everything. Your primary t seems... unhealthy in the way she treats you. Your description of the relationship sounds abusive, and even if she offers to see you again, I think it would be wise to consider declining that offer. She seems dangerous, and needy, and I would NOT meet with her without the support of your dbt!

Further, I would go in with certain questions/comments prepared. Even if you can't verbalize them, maybe one of the t's can read them, or maybe you can read them. Based on your previous post, I would say things like

I've asked you not to text me or email me about XYZ, but you still do. Can you explain why do you not respect my boundaries when it comes to this?"
• Often, you don't respond to my comments in emails, but you continue to contact me, and do so abruptly at that. I really thrive on consistency, and your random ways of communicating with me are very difficult for me to cope with. Can you tell me why you do this?
• Can you please explain why you constantly threaten to terminate me? It's scary and I feel like I'm going to be abandoned at any moment. It doesn't make sense to me, and I'm always wondering what I have or haven't done that's going to make you react. Can you comment on that?

These are just a few examples, all of which I'm SURE are easy for me to suggest, but much harder to actually say. But i don't suggest these lightly Janedoe... not at all... because all of those things I mentioned, YOUR T SHOULD ALREADY KNOW!!! IMO, she is a wonderful example of how t's are NOT supposed to act. Your therapy has been on HER terms for WAY TOO LONG, and this is why I want your dbt to be there, maybe he will see some of the dysfunction and be able to help. If she has PROFESSIONAL accountability, things might change... things that might help you get around the troubles with the insurance company.

I know this all must be very daunting, scary, frustrating, awful, etc, and I'm sorry you're in this spot. But you are where you are, and if nothing else, you deserve to be in therapy with a competent therapist. It's okay to say you feel hurt and injured and confused, and it's possible to do all that without blaming. And even if you do want to run, you can acknowledge that in session and say things like "wow, this is really hard, and I want to run out the door, but I know that won't really get us anywhere." It's okay to WANT to freak and run... that is perfectly legit, i'd want to too! but like you said, running will only prolong this agony.

I hope this helps. Please let us know how it goes. Take good care of yourself and remember that you deserve more than ultimatums.

-CT

(((((janedoe)))))

Last August I was in a place very similar to where you are right now: After 8 months with my T, and one last session where he reacted much differently than I expected to something I told him, which he’d been encouraging me to talk about for months, I was facing a termination I didn’t want, where I had worked very hard and did not understand why the therapy was ending and I was not being listened to. I want you to know that I hear you and I really understand what an awful, painful place this is.

In my case, I made the choice to show up to the meeting. Like you, I was hoping for the best. Even though I knew I was being transferred against my wishes, I was at least expecting that we would talk about what happened in that last confusing session and there would be some good will in the transfer, that it would end on a positive note and there would be some explanation and some closure.

Well, the worst I could imagine DID happen. I was given only one session to “say goodbye” to my T, in front of the new T I had been assigned to. He was very cold and dismissive at the transfer meeting. I did not agree with his summary but was so upset I could hardly talk, let alone openly disagree, although I did my best to explain once again what I had thought we were doing in the therapy. He never smiled and clearly couldn’t wait to leave because he left after only half an hour with a brisk handshake with no eye contact. On top of that, the new T completely ignored that I started crying after he left and started drilling me with random questions, as if I had just walked in to the clinic that day. To say I was confused and deeply hurt, that I felt betrayed and sickened and wanted to crawl into a corner and whimper would be just a start on how it felt.

If it hadn’t been for the members of this board that I leaned VERY hard on during that time, I don’t think I would have made it. I posted at length on these boards through it all, and received so much insight and help in getting back out there and finding a new T. Thanks to them, I left that clinic and found the T I have today and the therapy is going in a very positive direction (see my other post about our session today). She is doing all the things I kept expecting and hoping my former T to do in the therapy.

Looking back now, I’m really glad I showed up to that transfer session, because I can look back now and know that I did my very best to make that therapy work. There is nothing I regret having done or having not done. There is nothing I could have or would have done any differently. For months I have micro-analyzed everything that was said in an effort to understand what happened. I’ve alternated between being angry at myself and being angry at him. But my current T is helping me work through that and I can finally say that it’s fading pretty quickly now, and being replaced by a little bit of progress in the areas I originally started going to therapy for. And it feels great!

I hope some of this is helpful, at the very least, to let you know that if the worst does happen, you are not alone, there are people on this board who can help you through it. I also hope it helps to know that some T-patient combinations just do not work and that it is not your fault. It is possible to find a better fit so that your efforts in therapy can go toward healing instead of disappearing into the abyss of repeatedly trying to fix the therapy relationship itself when you aren’t even doing anything wrong. Therapy is really not supposed to be like that.

Above all, as I have been told, don’t do this alone! Please let us know what you decide and how it goes.

More hugs (((((janedoe)))))
SG

P.S. I love CT’s suggested questions for you to take to the meeting. I had written down a similar set of questions with the same idea, but decided not to take them. I very much wish I would have now because once I got in there my mind went blank with fear. But they were very fair questions and I wish I would have had the chance to at least ask them.

Thanks

It helps so much to know I am not alone in this, and that there could be a better future down the road. I hope.

Pippi - I think your idea of preparing for the worst is wise.

Stummergirl - I have read your posts about what happened and it has given me strength to just keep taking this one step at a time and know it could end up better than it was. Maybe. I know your heartache so well and I am so encouraged you have a better fit now.

quote:

by CT: Further, I would go in with certain questions/comments prepared. Even if you can't verbalize them, maybe one of the t's can read them, or maybe you can read them

good idea CT! I can write questions that are in repsonse to the worst I can imagine, and about everything else, and then if I can't even say them, then I can just hand them to the T.
_____________________________________________________________

Questions, questions, questions... I have way more questions than can fit into an hour session. I'm trying to think through what would be the most important to ask about first.

If she says:

A.) she is terminating (and/or not going to see me for a long time)

just imagining, picturing, being there with her and her saying that… my reaction is so visceral. I have no words to ask any questions about all that has happened. It would be such a final blow. Here is the best questions I can come up to ask in that case. None of which would really help me have closure or answers… but it’s all I can think of to say in response to that.

- Why did you threaten to terminate when you were going to do that anyhow?
- How the heck could you do this to me? After I have trusted you?
- What am I supposed to do now? How and where am I supposed to get therapy?
- How am I supposed to trust again and believe a therapist again? How am I supposed to get past this?
- How could I have trusted you and let you screw me like this? How could I have believed you?
- ...?

None of these seem like good questions. What else would there be to say if she says she is terminating and/or won’t see me for a long time?

B.) she would see me again, for a couple of sessions

I would go ahead and have the sessions and tape record them. (Something she has suggested I do in the past – so I think it would be fine with her.) Then I think I could ask more useful questions, about what happened and why. I’d want to avoid an argument. I would just ask, sit back and listen. Not challenge, at least not right away, but just try to listen and see what she says. Then consider it… I mean I could totally be missing the boat on everything...

- Consistency is very important. What can be done so that you do therapy in a manner that is consistent and predictable for me?
- Why did you suspend all therapy in December just a few days after suggesting I needed to come in more often? That feels like a mixed message – what was the intended message that I missed?
- How am I supposed to stop fearing abandonment when you threaten to terminate all the time?
- What about my boundaries? How do those fit into the therapeutic relationship? Can you show me that you respect me having boundaries?
- ...?
_____________________________________________________________

As I try to write out what I would ask, all I really want to ask is: “what the heck are you thinking?!” Probably not the most helpful question.

Deep down, I think what I really want to do is just say, "You hurt me. Do you even see how? Do you even care? Please tell me you do. Please help me work through this. Please make this pain go away. Please show me I didn't trust you for nothing. Please..."

It already feels like my heart is being ripped apart just figuring out how to get through this. I'm concerned I'm going to be slammed with so much pain leaving this meeting no matter what I do. I trusted her. I still want to trust her!

I'm looking over emails and texts with this therapist for the past 6 months. I feel physically sick. It was a great relationship. But now, I feel like I am going to get sucked back into something really icky.

I trusted her. She wasn't this way for the first 8 months of therapy. I just don't understand why she turned into being so pushy and domineering.

I feel physically sick reading this stuff. I miss her and I am hopeful, yet I feel so invaded and betrayed by her. The more I read what she wrote, the more I am baffled. The more I don't want to meet with her again. I think my hope will just be stirred up, and my longing to make this work, to know I trusted in someone worth trusting, that she is not really doing this...

She is a good therapist. She teaches therapy at a local colege for goodness sakes. I just can't stop thinking, why would she do this? Why am I so deeply affected by it so much?

JaneDoe,

I know this is really painful and I am so so sorry you are going through it. You've done a really good job describing to us what's been going on. From the details you gave, it sounds like she changed when you started putting up what were healthy and reasonable boundaries. You asserted yourself in a kind and respectful way, and I'm guessing she felt threatened and tried to reestablish some kind of power over you, and now it's gotten unhealthy and out of control.

I know what it's like to circle over and over and over again trying to figure out why, why, why things are going wrong. What I was really doing (and I'm guessing you probably are, too, if you have a background of abuse or neglect from your parents) is that I was absolutely certain I had done something wrong in the therapy, and if I could just figure that out, then it would fix everything...just like we did when we were children, thinking that we were being hurt or neglected because there must be something wrong with us. It's an impossible situation because we're really not doing anything wrong, but we have to stay close or we'll die, as AG has explained so many times. So we feel that we must find a reason to blame ourselves so we can stay close.

Now I know I don't know you, but from the fact that you're motivated enough to be here, and from what you've said so far, I'm going to go out on what appears to be a pretty sturdy limb and say that this is not your fault! Her behavior is her responsibility. And whatever the reasons might be, it is not healthy. Even if you were the most challenging patient on the planet, it wouldn't call for the measures she's taken. This is not your fault, janedoe.

You are so affected by this because you took a huge risk to open up to someone and she is letting you down. And it's probably triggering the pain of having been let down long ago by your parents, so as painful as it would be by itself, it's also multiplied many times over. You are in an incredibly painful place right now and I hope you keep coming here and talking about it so that you can get support as you go through it.

I can't advise you whether or not to meet with her, but something that might take the pressure off is to remember that you ALWAYS have the choice. You really do not have to meet with her if you don't want to! She seems like she's trying to take away your choices, and that bothers me a great deal. I wish for you that there was another T outside of this situation you could talk to. Is there any possibility of that?

SG

thanks for the feedback, understanding, and amazingly kind words. I’m pretty sad tonight. I think this stuff with this T is stirring up a lot for me. But I'm encouraged by your posts. I will respond soon. Thanks again.

monte - Thank you so much for your kind words!

quote:

No matter how skilled they are in their field, they're still human and as vulnerable to illness as we are. Sometimes they stuff up...they let they're stuff get in the way and they stuff us up. It's not fair.

Yeah, this primary T is just human. I fear that I did trigger her own stuff. I think she felt like she failed me when she found out I got upset with a nurse and ran out of the room. The hospital and another agency that heard of what happened contacted her and told her she wasn’t doing enough. That’s when she started getting really controlling, and I set up boundaries, boundaries I had been trying to set up before I got emotional with the nurse, and then 6 weeks later after breaking down the nurse, I had a session in which I was most vulnerable, and then 3 days later she suddenly stopped care. I have been thinking about this for awhile and a couple of days ago I called her and left her a voicemail message saying that she didn't fail me, the therapy was working...

quote:

Imagine if you were hearing your story as someone else's...I'll bet you'd be a whole lot more gentle and sympathetic.

Yeah, I probably I would be.

I am discovering how much this echoes and is stirring up my deepest original pain. It is so visceral and so deep that sometimes it is hard to think straight, let alone with perspective.

Thank you for your kind words and understanding and prayers. It helped me to have some perspective in the midst of a really tough week with this.



Strummergirl – Thanks for your encouragement and feedback. Your words really helped me see this differently.

quote:

What I was really doing (and I'm guessing you probably are, too, if you have a background of abuse or neglect from your parents) is that I was absolutely certain I had done something wrong in the therapy, and if I could just figure that out, then it would fix everything...just like we did when we were children, thinking that we were being hurt or neglected because there must be something wrong with us. It's an impossible situation because we're really not doing anything wrong, but we have to stay close or we'll die, as AG has explained so many times. So we feel that we must find a reason to blame ourselves so we can stay close.

I think this is exactly what I am doing! I really want an easy way out. A solution. If it’s all my fault, then that’[s easy to deal with. I can just fix me. The reality is that it is likely her brokenness and my brokenness that is interacting in this horribly painful way. I want to stay close, but I can’t just fix me and make it all ok. It’s hard to accept that this is somewhat out of my control.

quote:

you ALWAYS have the choice.

Yes! Choice is what I feel like was gone. She sought to control, maybe out of her own sense of failure (I had a setback, the rest of the therapy was helping so much, and my decline since stopping therapy is evidence of it!). In her desire to make everything ok, it feels like she took away my choices – but she really didn’t. I can still choose how I respond…
The hardest thing is that I feel like my voice is gone. I want to control and fight back to get my voice back. I want to make things ok and not be broken and betrayed by this. I trusted her and I want that to be ok.

I think I am trying to hold on and let go at the same time. My heart just aches. So much fear and grief, mixed in with hope and deep longings.

Hi Janedoe...I, too, have been following your plight and even though I can't offer anything in the way of additional advice, I would like to send you many hugs and support...
(((((Janedoe))))) very sincerely, mlc

thanks mlc

So I’ve confirmed that I’m meeting with this (former?) primary T and the DBT T this Friday.
Every time I think of it, I turn bright red, as if I am embarrassed or ashamed, even if I am alone at home, like right now. And my hands shake.

Thinking of meeting with this T is pulling up deep hurts that have nothing to do with her – an apparently a lot of shame.

The shame part is a little surprising. I would have expected to feel loss, grief, abandonment and even betrayal. But shame?

A couple of months ago I read in a book called "Wounded Heart" that shame and self contempt are a way that we try to have control over pain and hurt done to us. Ironically, the last session I had with the primary T in December, we talked about this very idea…

In fact, in the book, it suggests making a collage of words about how abuse made me feel. I actually did it! I had done the collage as a way to cope, to express what I was feeling in the process of remembering trauma and talking about it. I was kinda proud that I expressed what I was feeling that way instead of worse ways of falling apart or stuffing it all.

Just doing the collage felt like a release. I struggled to find words to express what I felt. Something about looking through words in magazines and searching for words that fit with how I felt was… settling. I wanted to show the T. I wanted to show someone, and I was so scared to show anyone. I decided to show her anyhow. I went into the session and handed it to her. It was rolled up, she couldn't see it unless she unrolled it. She sensed my fear and didn’t open it. Instead, she questioned if I really wanted her to see it – I told her yes. She still hesitated, asking if I was sure. I was confused about why she hesitated – I was so busy trying to manage my fear in asking her to see it, that I wasn’t sure how to communicate that I was afraid for her to see it, but I wanted her to see it anyhow. I became ashamed that I had asked her to see it and said “nevermind…” and took it back. I just put it aside and we talked about shame and self contempt. (But not specific to the collage, just in general, as I had read about in the book.

As we talked, I built up confidence again. About 5 minutes before the session was up, I asked her to see it. She did, with much hesitation. She said “hmm, you think about yourself pretty negatively. This is very concrete.”

Sadly, it was actually rather symbolic for me, not very concrete. I didn’t have the courage to explain that. I lost all my words. It might seem silly, but the collage of words and pictures I had cut out of magazines felt like the most vulnerable thing I have shared with her. It was a reflection of the hurt in my heart. I felt ashamed and deeply embarassed that I wanted someone to know how I felt… I felt ashamed that I even wanted her to see it. Why did I want that and yet was so afraid of it? I hid the mixed feelings I had as best I could… She said she was glad I shared it, and we ended the session. She said I did a good job, and walked out.

That was the last time I saw the primary T, on December 10. Three days later she called and canceled all the rest of my appointments. Now I am going to see her again on Friday. I have no idea what to expect.

But the shame and icky feelings are running away with me already. I just think of seeing her, and I turn bright red. It’s not even verbal… (does this make any sense?)

4 days until I meet with her (yes, I am counting the days.) Right now, I don’t know what I feel about her. I do know what I feel about me.

ick.

why did I want to show her that stupid collage?! I still have it. I should throw it away with all the ick feelings!!!

Hi JaneDoe,

Yes yes yes yes yes!!! So much of this makes total sense to me. When therapy ended with my previous T I felt this very deeply at first, for several days, and then it seemed to come in surges...kind of like electrical shocks and aches combined...I also had the shakes and the turning bright red symptoms. I started to get periods of relief, and it came less and less, and now I don't have it at all. I didn't know what to call it at the time, I thought it was shock, but I think you are right, that it's shame. Like there must have been something deeply wrong with me if he got rid of me...but there were no words, it was a visceral thing.

This is an awful feeling, and I am so sorry, more than I can say, that you are experiencing it right now. I wish so much I could take it away for you! Because you do not deserve to feel this way. It really must be coming from somewhere in your past (where you didn't deserve to feel that way either but you didn't know that).

What you did to try to show your T how you feel on the inside is EXACTLY what I did with the former T (only with a different picture - I wasn't as creative as you, but very much understand using symbols to communicate when it's so hard to find the words), and I got the same feeling afterward: He didn't "get" it.

And it feels so disappointing because it's not something we normally tell people! You took a risk, and by not getting it, she also didn't get what an effort it was for you to show her that. There was nothing wrong with you in wanting to show her. She just didn't understand, which provoked more shame in you. I really understand how much it hurts to risk opening up like that and still to not be seen. I know it might make you feel like never opening up again, but please believe me that there are people out there, and T's out there, who do "get it"! You just had the really bad luck to get someone who happens not to get it.

JaneDoe, there is more I'd like to write but I have to go right now (I'm at work and break was over 5 minutes ago - and I'm the teacher so I have to show up ) but I just want to tell you with everything in me, please, keep talking to us and hang on to the truth which is that you have done nothing wrong here! These feelings will pass, they don't totally belong to the present day. They are symptoms of the injuries you went to therapy to heal, and instead you are being retraumatized through no fault of your own.

(((((JaneDoe))))) lots of cyberhugs to you - hang in there
SG

p.s. As much as this absolutely sucked going through...if sharing my experience with you helps you get through this...then I'm GLAD it happened to me.

quote:

A couple of months ago I read in a book called "Wounded Heart" that shame and self contempt are a way that we try to have control over pain and hurt done to us.

Hi Janedoe,
I just wanted to talk about the whole struggle with shame. (Wounded Heart is a GREAT book by the way, it had a huge impact on my recovery, especially in the area of forgiveness.)

Shame is an attempt on our part to protect us from further injury. It's an incredibly strong emotion and since humans are intrinsically social, is a very strong deterrent to behavior. Shaming is a way of ostracizing someone from a group and being driven from the group would mean death. So there is a strong biological, visceral (as SG pointed out) component to shame. It bypasses your frontal cortex and reasoning abilities and goes right to where you live.

If our needs are not met when we're children, if even expressing those needs gets us into trouble, we decide that our needs are the problems. That the way to avoid getting hurt is to NOT have the needs,, or at least to NOT express them. But our needs are extremely imperative and closely related to our drive towards life. Getting our needs met, especially when very young was a matter of life and death. That's seriously hard to turn off or ignore.

Your limbic system is what builds up the record of what's dangerous. You know how you touch a hot burner and get burnt once, you have a strong feeling to NOT do that again. That's your amygdala. It's whole purpose is to respond to fear. Here's the thing, get scared when you don't need to be, no big deal. Fail to be scared when you should be, you can be dead. So our nervous system is heavily geared towards safety above all. So if something is dangerous, it will produce any feelings necessary to keep you away from it. Shame is the strongest weapon in its arsenal, set against the desperation of getting your needs met.

Part of the very difficult part of the work in therapy, especially when healing from attachment injuries, is repeatedly doing what terrifies us until we can build up enough experience of moving towards a caring other being a good thing, to offset the old beliefs about how dangerous it was.

You did exactly what you were supposed do (it was an incredibly courageous of you actually) and moved towards another. Her failure in attunement hurt you which has completely fired up the networks in your brain which hold those implicit memories of how dangerous it is to move towards your attachment figure. So to try and keep you safe, you're getting hit with all the shame.

It's really strong, and almost overwhelming, but it's totally undeserved! You did nothing wrong. But that misattunement triggered a lot of old stuff, the very stuff you're trying to change by experiencing something different.

I'm really glad that SG was able to share her experience with you, she really understands what you're going through.

AG

Hi again,

Okay I've got a few more minutes...I also wanted to say how creative and courageous you were to make that collage. And I totally get how it made you feel "settled" and "kinda proud" when you were done...how it was a "release"...it feels so satisfying when you finally find a way to express what has been inexpressible for so long, doesn't it? Like, yes, that's IT. That's what I feel like inside. What that looks like, that's how it feels when I'm in that place.

Anyway I am really hoping for a turnaround with your T on Friday.

SG