Rt,
Sorry, deleted what I wrote since I was approaching this as a philosophical discussion, but know you are grappling with ending with your T and this list is important to you in going forward. I am sorry if you saw the reply and found it insensitive. ~ AG

No worries, AG. I saw the first part of your post in my email notification. I thought about what you wrote - about being unregulated at the end of a session... needing a little more time... so the "rule" about starting sessions on time may be too restrictive.

I don't mind your challenge to that, because really what I'm trying to get at is that there are expectations. Some are absolute - like don't f*ck the client. Some need to be negotiated - like what happens when the therapist needs to run late with the person before me. I might get unregulated by the anxiety that waiting provokes, so it's important to have a way to manage that as well.

I know that some of this is really the *work* of therapy and certainly not all of it can be worked out in advance.

Really, what set me off writing this thread is hearing of yet another therapist who has abandoned their client. It makes me so, so angry. In what class do Ts learn that it is okay to send an email to someone and say it's over - I'm terminating you? Not. Acceptable.

quote:

In what class do Ts learn that it is okay to send an email to someone and say it's over - I'm terminating you? Not. Acceptable.

That made me cry because you are right RT. They are good tears. They are grief. Thank you for that. (((RT)))

I think my chief requirement is don't lie to me, preserve my best interests, work at the very least as hard as I do and don't surprise me if at all humanly possible.

I lose it when people are running late, it makes me so anxious and worried. I've thankfully gotten a lot of practice on it over the years lol. My T warned me in our first couple months in therapy that she's just... always late (or "exactly on time"). Her clock even runs a few minutes slow so that it looks on time to her... it's cute, but was really annoying at first. The most important thing is she is consistent she's on time for another time all the time.

I'm also not sure where the school of crappy e-mail terminations is, but my first P definitely graduated with honors.

Being able to identify what you want from and need in a T is really healthy I think. It took me a good few tries before I realised I could start a relationship with this stuff worked out before I went in. When I decided to see current T, we actually spent 4-5 sessions deciding on whether we were going to work together and how and that really worked for me. It's one of the most important and expensive investments you ever make. Over the years I've probably spent more on therapy than I have on cars. I definitely would research and test drive a car before taking the plunge.

I have a few non-negotiables and some nice to haves.

My non-negotiables are:

1. Ability to show warmth - not sentimentality, rather I don't want you tucked behind your blank screen. I tend to project coldness on to that and it has never ended well!

2. Respect for my boundaries - I get to say how slowly we take things. I don't mind you putting the brakes on if you think I'm ploughing ahead without thought for how I am going to contain the fallout.

3. A sense of humour. Humour is my favourite coping tool - I don't expect you to collude with it but if we're to form a decent working relationship, it would be good for you to be able to laugh at the ridiculous.

4. Knowledge and experience of working with disorganised attachment. I need you to get it - I don't want to have to teach you from scratch about how I conceptualise my issues. I don't mind a bit of negotiation and mutual education but if you don't know about attachment theory I don't want to know, sorry.

5. A decent structured ending. I'm probably going to spend a good few months pretending I don't care about you an awful lot, but shhhh, I probably will end up wanting to take up residence in your pocket.

6. Willingness to change appt days given enough notice.

7. Don't hang on to your pet hypothesis. If I repeatedly tell you it doesn't resonate then it's likely that you're off base, not that I am in denial. Imposing your own world view over mine is not cool. If I change my mind later, then great but you need to respect my autonomy.

That's about it.

We need to agree on a goal for therapy - not because we are doing short term, solve a specific narrow problem, but because T should have an idea of the core of my problems. Then,
T can explain how the situations that
I talk about tie back to our goal.

Don't know if I explained that well, but I've worked with a lot of Ts as I moved around the country, but we didn't accomplish much. We would put out the fires that were upsetting me that week. Then I started working with a group of people all trained the same way, a goal for me was introduced, and suddenly I'm getting so much more from therapy.

quote:

I'm also not sure where the school of crappy e-mail terminations is, but my first P definitely graduated with honors.

My oldT must have been in that same graduating class. Today is three years that we were supposed to meet after his 3 week vacation. Instead before he left for his nice vacation he sent me an email cancelling the session and taking me off his schedule forever. He went on vacation and I spent the next year in hell.

TN

thanks for your thoughtful list, Mallard.

Good lord, Hollow. When I hear things like that it makes me go

I'm sorry someone was unethical enough to say that to you. I cannot imagine how hurt I would be if a T had said that.

RT,
Thanks, glad I didn't get you upset. I definitely agree that there are expectations. I just know that it has been a lot of work, but very fruitful, for me to grapple with my expectations and have them run up against another person's boundaries. But I very much agree that there needs to be strong "frame" around therapy. I just think that frame can look different for different people.

My non-negotiables are being characterized by consistency (no one is perfect), non-defensiveness in the face of my feelings, no sexual involvement and no abandonment (I think there is a special ring of hell for Ts who abandon their patients and I very much place an email termination in that category). I also agree with Mallard that I would require a certain level of warmth and emotional accessibility. I just wouldn't think a T was wrong for not providing it, just as I wouldn't think a T was wrong for not providing outside contact, but it might send me searching for another therapist. And no matter where the boundaries fall, I need to feel comfortable that I can talk about my feelings about them.

AG

quote:

When I decided to see current T, we actually spent 4-5 sessions deciding on whether we were going to work together and how and that really worked for me.

Mallard - can you expand a bit on this? Thanks. RT

quote:

I just wouldn't think a T was wrong for not providing it, just as I wouldn't think a T was wrong for not providing outside contact, but it might send me searching for another therapist. And no matter where the boundaries fall, I need to feel comfortable that I can talk about my feelings about them.

*nods* Showing warmth for example while essential for me may actually be massively unhelpful in some cases. It is good that there are so many flavours of therapy and therapists.

RT, in answer to your question it wasn't anything particularly structured or even my idea but when I went to see my T around a year ago, I was not sure initially whether I wanted more open-ended counselling or Cognitive Analytic Therapy (CAT) which is more focussed, structured and time-limited. After one initial session I was not certain which would be most beneficial or whether I was sure about her, which I shared and she suggested we take a few more sessions to explore what form our work would take before making a final decision. We talked about all sorts, from 'what happens if I cry in here?' to 'how do you deal with a client having a negative reaction to your style?' to 'how flexible are you on appointment days?'. It wasn't one way - she asked stuff about me too.

It helped me because I'm naturally pretty cautious and I have also had some pretty traumatic stuff go down with ex-Ts. It allowed me to explore possibilities without feeling as if I was committing myself. After 5ish sessions I finally decided I didn't want CAT and T had a much clearer idea on how I prefer to be interacted with. It turned out to be absolutely the right decision because here I am a year later doing some pretty in depth work with someone I like enough to take some relational risks. The longest CAT goes for is 32 sessions and we are way past that!

For me it wasn't trying to eradicate bumping up against boundaries because I agree that it can be helpful to work through that and it's just impossible to control what will crop up in therapy. We are probably going to run into hurt and disappointment even with someone who meets a lot of the expectations we have. For me, the hope is that there is a decent enough fit to be able to weather it and grow when it happens.

Does that make sense?

thanks, mallard - that's helpful. -RT