Do you think a more structured approach to therapy would help you? Like if your T broke out a workbook and went through it with you, or explained a step-by-step process he was going to use, would that be a relief?

Yes BLT I think it would be a relief to have a step-by-step plan although ideally it would be nice to have a flexible approach to the plan. I think there are times when I know what I want to talk about and if he insisted on a subject I would feel like he didn't care about my feelings. I know he feels like in the past when he suggested a topic and I didn't want to discuss it I shut down or was very unhappy afterwards but that was a long time ago when I felt unable to interrupt him and say, I want to talk about (fill in the blank). Whenever we have this discussion he reminds of those times in the past. Today he said when I've said I think think this topic is important it hasn't worked. I quickly told him that he doesn't say he thinks something is important at most he will start talking about a subject, he doesn't like to tell me what he thinks is important probably because that would help me to decide what to share (okay more likely it is because he doesn't want to dictate what is important to me but I'm angry and I want to stamp my feet).

Anyway, my T won't use a workbook or explain a process. He doesn't think that is organic and obviously deep down he thinks I do know what to talk about I just am afraid or confused or feel hopeless. For example, one of the things I struggle with is my weight and I feel like there is no point in talking about it because I know what to do to lose weight I just don't do it. It feels like my fault and I'm ashamed so I struggle to talk about it and usually shut down and just end up crying if I try to. So one day he asked if we could discuss who in my family from my grandparents down struggled with weight and eating issues. We didn't get very far because we were discussing something else but I spent a fair amount of time making a genogram with all my family members on it, showing their weight, addiction, mood disorders (from my point of view only) so I could show it to him and discuss it. I brought it to my next session he didn't ask me about it. I showed it to him he said we should talk about that next time. After a few weeks I stopped bringing it.

We actually spend more time talking about why I don't feel like talking or don't know what to talk about or what I am afraid of happening if I talk than actually talking about anything. At some point I think it was helping me to have those conversations but now after 5.5 years I think it has become a trap that neither of us can get out of. Or at least I feel like the only way out is to quit so at least I can stop feeling like such a failure.

I hear you saying that you often shut down or want to give up because you feel ashamed or like you're a failure. I guess one thing you could think about or discuss with him is how to structure therapy so that you can feel like a success some of the time.

thanks for the responses BLT. That is my problem. I think I could endure some of the pain and difficulty of therapy if I didn't feel so f****d up and like such a failure. I wish there was a way to have some successes in therapy but I don't know what I would call a success so I will think about that.

(((cogs)))

No words of wisdom but wanted to let you know I'm listening and hope things get a bit easier, it sounds very frustrating

Hey Cogs -

I was really struck by a couple of things in this post. One is that you're angry - and that's VERY cool. Ha ha, I sound like a T. I don't mean it's good that you're feeling something bad, it's not - more that it's good that you can FEEL the bad feeling you have. It seems like it's really crystalised and I think that's powerful. There's a lot of energy in anger, and I think that at some level that might be helping to power you along through some very difficult times and material (I'm really sorry to hear about the lung function troubles, as well as the job stress).

The next thing that struck me was how clear your first paragraph was about what is going on for you in your world. It seems like this paragraph lays out what you wanted to talk about. Is that right? And it's interesting that at the end of it you say "My T knows how I've been feeling." Straight after that you write about telling him you don't know what to talk about.

I'm wondering if that's the connection - or the disconnection. There are feelings you want to talk about, and T knows them - is it possible that what disconnects you from those feelings is the very fact that you feel T knows them, and so maybe part of you feels he should be the one to say them, take you to them, okay the process and lead the way?

Sorry if I'm either on the wrong track here or stating the obvious. I just wonder if this veil over your own self-knowledge - the knowledge to say 'I feel this, I want to talk about it' is getting ready to fall away here.

((COGS)) You are in a tough situation, and it sure can be super frustrating, and I'm sorry. Looks like T is pushing you to get it out on your own because he knows its in there, but wants you to step forward with the information on your own, because he knows you can do this. Shame is so destructive and demeaning, I know this because I battle with this as well, and for myself, I know that shame gives me an empty, worthless, feeling where I feel like there is nothing inside of me, its all gone and I sit in my emptiness, all alone, and feel I have nothing to talk about, just emptiness, but its in there somewhere. Please know that because you feel you have nothing to talk about,this does not mean your a failure, your shutting down for self protection, and that isn't a failure. Not sure if this would help you, but I found that writing down a few topics of things the day before, and bringing them to the session helped me to start a discussion with T, then it went much easier. Again, please know you are not a failure, and that Therapy is not an easy process, so be gentle with yourself, and give yourself a lot of praise for going to Therapy and wanting to feel better.

((((COGS))))

I know you said your T wouldn't do a workbook BUT I just wanted to put in a plug for Kathy Steele, Suzette Boon and Onno van der Hart's book, "Coping With Trauma Related Dissociation". My T and I are working on it together. We talked about it yesterday and he couldn't say enough good things about it. He said they really wove together all different perspectives and made it very easy to understand. He also said that it was very comprehensive and that it was a "find". So, if you can order it and bring it in to show your T, maybe he would change his mind? Tell him you need more structure. Tell him you need permission to talk about what you want to talk about. It's okay to be upfront about what you need. It's YOUR therapy, Cogs.

Jones:

quote:

I'm wondering if that's the connection - or the disconnection. There are feelings you want to talk about, and T knows them - is it possible that what disconnects you from those feelings is the very fact that you feel T knows them, and so maybe part of you feels he should be the one to say them, take you to them, okay the process and lead the way?

i think that's actually pretty awesome insight. for me at least. maybe it's different for you, cogs ...

I'm sorry I didn't respond earlier. I've been doing a lot of thinking and rereading and thinking about my therapy. I had a second session last week and I was much clearer but my T didn't seem to think changing our approach would help. He thinks the same feelings of shame and failure will come up if we tried to do a workbook even though he doesn't think that is a bad or wrong thing to do. I felt like he didn't think we should do anything differently and I just had to feel terrible until I stopped. I am seeing him today and will be discussing my opinion of what he said some more.

Thanks for the hugs Armored Heart

Jones, your post made me think because actually I didn't want to talk about the things in my first paragraph. We've discussed them and they feel quite overwhelming. I'm not ready to look for a job yet. I want to discuss some relational things that we have started talking about but the conversations don't feel like they have gone far enough to me and I've often sent emails about them that we don't talk about. I think that is what I wish he would ask me about. However the quote that closed doors extracted led me to think quite a bit because it applies to the relational issues quite well. I do want him to okay the feelings and the conversation about my relationship to him, what he means to me, etc.

eme, thank you for your support. I am sorry you know that shameful empty feeling. It is so overwhelming it seems to block any memory I have of other feelings or connections or relationships.

Liese,

I have that book. consult T suggested it to me a couple of years ago. My T didn't ask to see it and I didn't bring it to him. How are you working on it? chapter by chapter? searching for a topic that you feel you need to process? Let me know how it goes.

closed doors, thank you for highlighting Jones quote because I think it is an awesome insight as well.

I am going to try and describe my session in detail without judging it or my reactions too much. I am hoping I will be able to see how I process things over time because right now I feel bereft and hopeless and I feel like I shouldn’t be feeling that way. If you get to the end and have any opinions or comments even if it is just that you understand how I feel and react I would like to hear them.

We spent the first few minutes discussing what has been happening with my family and health over the last few days then he asked me if I had any more thoughts about what we discussed last week. I told him that I felt like he didn’t feel like we should do anything different, that trying a something new like a workbook would result in the same feelings of shame and failure and hopelessness. I said I didn’t feel like I could just accept not knowing what to talk say and to speak as if I did know what to say (which was one of his suggestions). I said I felt like we weren’t making any progress but I realized he might not feel that way. He asked me what kind of progress. I said progress to me feeling safe and able to discuss things freely. I used to feel like after talking to him about what I was struggling with and what made it so difficult to talk that we understood each other better and we were making progress and this time I felt like we understood each other but there was nothing to do.

He said that had been thinking about my idea of doing a workbook and wondering if I had an idea of what workbook I would want to work through. I mentioned I had a few, The ACT workbook on Depression/Anxiety, Coping with Trauma Related Dissociation, and some book on Weight and Eating. He suggested the ACT book in the first year I was seeing him. He asked me how I felt about doing a workbook that was focused solely on Weight (if we could find a good one because he thought a lot of them were too simple) for a few months as opposed to a more general workbook on psychological suffering. He asked if any workbook had a lot of resonance for me. I said no and then I was quiet and thinking. I told him I was surprised that he was considering it. I didn’t tell him I was feeling uncomfortable.
Then he asked me if I was thinking about trying a new therapist because one of the things I said last week was I felt we had fallen into a rut and if I started with someone new then I would do things differently from the start. I said I wasn’t seriously considering a new therapist right now maybe in the future. I said that my husband was considering for me (my husband asked his T if he would see me for weight loss which is one of his specialties and he said no). My T said why wait to see a T. I started to cry and had trouble speaking. He said you seem very upset. I said talking or thinking about quitting therapy was very difficult and upsetting to me. I told him that I felt like I should be working on losing weight of the implications for my health and breathing so I needed to work on that but the things that had come up between us I wouldn’t be trying to work on with another T anytime soon (relational, dependence, was he asking. He said he was trying to figure out what I was trying to get a break from. I said I was trying to get a break from failing all the time and being ashamed of that failure. He said that the feeling of failure was very pervasive and damaging ffor me. Then he said he didn’t think of me as someone who failed all the time, he thought of me of someone who struggled a lot but not failed.
I said that wasn’t how I felt and cried a lot. Then he asked me if I was feeling like he was talking about a new therapist because he was suggesting that quitting was a good idea. I started to say yes and explain why and then I couldn’t talk from the crying. He said he could understand why I thought that but that wasn’t what he meant. I said it feels like you don’t think changing things is going to help and that nothing will work. He said I started the session talking about changing things. I’m addressing the issue of quitting therapy because you brought it up and I didn’t want to ignore it. In the past you have asked me to help you quit (true) so I thought we should discuss it. I was losing control because I couldn’t stop crying and I felt completely shaken up. I kept thinking he is giving up on me but I couldn’t say anything. He said does it feel like this is the end game that I am working up to quitting and I said yes. That was near the end of the session and he leaned forward and said I understand you feel like it is hopeless but I’m going to look at workbooks I have and you look at yours and I’ll see you Wednesday night.

I left but felt completely confused and upset. I waited outside and when he left I told him I didn’t know what to do and he said to do about what and I said the feeling we’ve reached the end and workbooks, am I supposed to just try and ignore it for two days or am I supposed just wait with it. He said he didn’t think I should quit therapy and he didn’t think it was the end of therapy. I walked away and drove home and called and left him a message telling him I appreciated that he was addressing my concerns but I felt like he was switching his position on workbooks and therapy which made me feel scared like he didn’t know what to do. I said I knew I should be happy he was willing to try something I suggested but I was scared. Then I admitted that I did want his help to quit in the past but I realized that he couldn’t help me quit any more than he could help talk or help me feel like I wasn’t failing. I said I kept looking for his approval and looking for him to say how he felt and I knew he wouldn’t.

I may be wayyyy off base here - but reading your posts in this thread I'm picking up some feelings of fear and/or trust.
I wonder if you trust yourself or if your feelings cause you fear.
a few:

quote:

I don't know what to talk about, or I don't know if I'm allowed to talk about what I want to talk about, or I don't know if it would help to talk about a subject.

quote:

Jones, your post made me think because actually I didn't want to talk about the things in my first paragraph. We've discussed them and they feel quite overwhelming.

quote:

I said I didn’t feel like I could just accept not knowing what to talk say and to speak as if I did know what to say (which was one of his suggestions).

quote:

I said I knew I should be happy he was willing to try something I suggested but I was scared.

I know I at times (*ahem*) block progress in therapy because I don't trust myself and negative feelings terrify me.

((((cogs)))) first I want to say how sorry I am about all the difficulties you’re going through right now. you're dealing with an awful lot all at once, so i’m just sending big, safe, warm hugs your way

i kind of feel like i know what you're trying to say. i'm reading all over your posts that you want to discuss things that have come up between your T and you in regards to the relationship. is that right? but you feel like you don't know if it's important enough material, or like you're not sure if you should because of the permission thing? like "i'd really like to talk about some of this relational stuff between us, but since you (T) don't acknowledge it then i'm not sure if it's okay to go there". is that what you're trying to get at?

quote:

“I want to discuss some relational things that we have started talking about but the conversations don't feel like they have gone far enough to me and I've often sent emails about them that we don't talk about. I think that is what I wish he would ask me about. However the quote that closed doors extracted led me to think quite a bit because it applies to the relational issues quite well. I do want him to okay the feelings and the conversation about my relationship to him, what he means to me, etc”

quote:

I said progress to me feeling safe and able to discuss things freely

After discussing the workbooks you mentioned that you were feeling uncomfortable, but you didn’t disclose that to him. I was wondering what the discomfort was? Was it shame again? or perhaps frustration that things were turning in a totally different direction than you really want and need to go right now in the relationship? and you got frustrated and confused and didn't know how to turn that around?

quote:

He said does it feel like this is the end game that I am working up to quitting and I said yes.

When he mentioned seeing a new T you got very upset. I would have gotten upset, too, thinking that he was trying to get rid of me. cogs, i'm so sorry! this sounds so painful. you are desiring to step closer to your T to talk about the relationship, but then the communication gets all gunked up and you get the message that he's trying to close up shop. i know you talked about it, too, but when a T says it, it's bound to bring up alot of old pain. i'm so sorry!

you want to work on the weight, but you’ve created a relationship with this T where relational things have surfaced and it sounds like you really are longing to address these issues, and that these are the issues that you want to talk about but don’t feel safe or feel like you have the permission to talk about them, or you’re concerned that your T won’t think they’re important enough to talk about.

quote:

I said I kept looking for his approval and looking for him to say how he felt and I knew he wouldn’t.

i hope i'm not out of line, but what it sounds like to me is that you are really wanting/needing to talk about some deep feelings that have come up out of your relationship with your T. it sounds like they've kind of been skirted around, but not talked about to the depth that you need. and it sounds like although the weight stuff is also stuff you want to work on, that it is kind of getting in the way of your more immediate needs in talking about the relationship. if i'm way off base i hope you will forgive me. it just really sounds alot like what i'm going through with my T ... i want to talk to him about us and our relationship, but we're talking about my drinking, which definitely needs to be addressed, but i also really desire talking to him about us but don't feel like i have the permission, or like he knows it but won't lead me there and make it okay to go there.

I know my response isn’t very organized, but again if I’m hearing you correctly, then I’m going through many of the same feelings and it sounds like our dynamics are similar, and it’s really difficult stuff, especially if you were raised like me and were taught to not talk about the difficult stuff.

I came across this thread on PsychCentral that might speak to you (it does me):
Therapy without talking Transference and Relationship

one of the quotes that really spoke to me on this subject:

quote:

it seems like not talking about the relationship becomes avoiding talking about what is likely to be a very significant part of your life. How you feel about therapy, how you react to your therapist, how much trust you have in her --all those things are important because they give you a lot of information about how you are in relationships in general. Your ability to point out vulnerabilities and misattunements is key to the success of your therapy, otherwise how can your therapist be optimally helpful? And how can you do that without talking about the relationship?
For me, the relationship itself, the calm and accepting demeanour of my T, have been at least as important to my healing as any of the topics we've addressed.

If the T is ignoring those elements or not facilitating that discussion what is the client supposed to make of that silence? It could be awkward after awhile, no? I think the T checking in about that gives you permission to explore your feelings about them, about the therapeutic process and about your feelings in general. Without that element, IMHO, you're missing out on the depth and richness of the experience.

((((cogs)))) let me know if i'm off base and i'll take this down. i do hope things get better for you soon

Please don't take it down closed doors. I am very tired and will probably write more tomorrow but I think you are absolutely right in that I want to talk about what he means to me but I don't know if it is allowed or if it is helpful.

Also I usually don't think of myself in parts but tonight I have been feeling like my T is talking to the adult me (talking about workbooks, and explaining that he isn't suggesting I quit) but he isn't reaching the child part of me. That part of me is just hearing we can try something different if you want and other T's and feeling like I am about to get dumped. A quick statement of I'm not suggesting you quit therapy isn't reaching that child part of me at all.

quote:

Also I usually don't think of myself in parts but tonight I have been feeling like my T is talking to the adult me (talking about workbooks, and explaining that he isn't suggesting I quit) but he isn't reaching the child part of me. That part of me is just hearing we can try something different if you want and other T's and feeling like I am about to get dumped. A quick statement of I'm not suggesting you quit therapy isn't reaching that child part of me at all.

This is a major point and likely to be one of the biggest stumbling blocks in your path. When healing from an attachment injury or trying to reach a secure attachment status, the healing is ALL about the relationship. That is where the focus should be and even when the focus moves to other areas the relationship stuff is always humming in the background. Having a therapist be your attachment figure allows the opportunity to examine the relationship live as it plays out. You should feel free to point out issues or ask questions about the relationship or any disruptions that happen along the way. No matter what T and I are working on it seems that we always end up in a discussion about our relationship.

In addition, we are doing some inner child work. I have fought with him tooth and nail and have kicked and screamed over this. I have been so angry at him and we have had our share of disruptions but T is right. There is that little kid inside that is carrying a lot of wounded stuff and she is usually very scared. When that happens she sabotages things for me and also in my T relationship. Her development was stunted at a young age so she needes T's and my help to grow up and to be integrated into adult me.

This is a large part of not having emotional regulation. Kids learn to regulate emotions from an adult attachment figure who is steady, consistent and who models this for them. So when T goes away on vacation or moves an appointment or changes things in the office, it's this kid who freaks out even when adult me realizes and accepts that T needs a vacation or that painting the office will not end our relationship. And when the adult is sitting with T having a perfectly reasonable conversation about some issue, I end up dissociating because the kid is inside screaming to be heard or gets scared about something. I can't hear what T is saying because of all the noise she is making about wanting to be heard or to ask a question.

Would you be able to talk to your T about addressing the child inside who needs to be heard? What does he know about this kind of work? I think that before you proceed to workbooks and more structure, you may need to have a discussion about integrating the child who has needs and whose development has gone awry into the adult. I think the child needs support and comforting and a good parent to care for her. I think she needs to feel secure before you can process deeper trauma.

I also believe that when the emotions, fears and anxiety that are mostly contained with the child are addressed, then your eating patterns can change and you will begin to lose weight. I am overweight and have begun to lose a little bit of it because I have not had the need lately to stuff my feelings down with food. I am not using food to either punish myself or to numb myself. I'm not "dieting" but I am more aware of what I eat and why. I think some of this is due to having the ability to better regulate my feelings by having my attachment to T grow stronger and more loving. I am beginning to let a tiny speck of his care in. I still have a long ways to go and I still take one step forward and two steps back at times but there is some tiny movement lately. I can sometimes acknowledge there is a child and I can even tell T what she wants to say at times. Not always. But it's a start.

Not sure if this is helpful but maybe it's worth considering. I know it is important to know how your T feels about you. You may just have to outright ask him. He seems very caring and committed to you from my POV. But if you don't ask him then can you look at what he has DONE for you and the experience of working with him and how that has played out? Even if you ask and he tells you, will you believe him? You have to experience the care to be able to believe it. You have to pay attention to your experience. and if you FEEL care from him, then it is real.

Sorry this has turned into a ramble. I hope there is something here that helps.

TN