Posted by fallsfall on October 2, 2004, at 15:20:15
In reply to Trust, Feeling Safe Other Things That Elude Me, posted by Poet on October 2, 2004, at 12:19:08
> If I hear *safe* and/or *trust* one more time I will scream.
>
> I know therapy is safe, I know I should trust my therapist, I know, I know, I know...but I just can't open up about certain things. In the last session she told me that I don't even trust her 50 percent. She's right.
>***Poet,
If I read between the lines here, I hear that you *do* want to feel better, you *do* know that you need help to do that. But you want those things without having to risk trusting anybody. Is that accurate? It is perfectly understandable - you have trusted people in the past and they have hurt you - why would you trust anyone again?. But the problem is that you want to feel better, and you know that you need help to do that.
> Things didn't go much better with pdoc this week, either. I was honest and told him that I'm more suicidal than I was a month ago. He launched into have I told my therapist, what are we doing in therapy, do I think she's helping me, etc. He said he was going to call her, but I talked him out of it. I promised to stay (SCREAM) safe.
>*** I'm really glad you were honest with your pdoc. That is an important step - a very important step.
I would have heard his "have I told my therapist, what are we doing in therapy, do I think she's helping me, etc." as primarily a criticism that I haven't done my job as the patient (but, then again, I hear everything as a criticism...). If I could get past that, then I would think that he was judging my therapist - thinking that she wasn't doing her job. Is this how you heard it?
Let me propose an alternative message. Perhaps he thinks that you need some help with your suicidal thoughts. Perhaps he is trying to figure out who might best be able to help you. Maybe the first person who comes into his mind is your therapist. So he needs to know if your therapist is *already* trying to help with this. "Have you told your therapist?" If the answer is "no", then his first suggestion might be to talk to her. Not that you are "bad" to not have already talked to her - just to find out if you have tried this yet. "What are you doing in therapy?" could be to get an idea about how you are doing therapy with your therapist - are you talking about the important things? are you talking about them in ways that are helpful? "Do you think that she is helping you?" if you are already trying your very hardest to talk to your therapist and you are getting increasingly suicidal, but you can't try any harder, then he might want to think of something else that will help you. Not that you are doing anything wrong, or that she is doing anything wrong - but if it isn't working, then it doesn't really matter how hard everybody is trying - it still isn't working. In that case, he might want to suggest something else.
Why would he want to talk to her? My first inclination would be to think that he wants to tell her secrets that I have wanted to keep from her. Or that he wants to get "the dirt" on me. Recently my therapist talked to my GP (and he will talk to my pdoc in the next couple of weeks). What he found out was a result of the fact that they are different people, see me in different contexts, have known me for different amounts of time, and see things through different viewpoints (MD vs. therapist). Based on what I have heard about the conversation, my GP was able to say things that helped my therapist think about things in a different way - my GP provided observations that helped my therapist to flesh out his view of me. So by talking together, each of them now has a deeper understanding of me. The other advantage is that now they are more likely to tell me things that aren't in conflict with what the other is telling me.
It is like the time I lost my keys. I had looked everywhere - twice - and couldn't find them. Finally my daughter came home and I asked her to look for them for me. She found them in 4 minutes - because she didn't have the same assumptions that I did, so she looked in places I hadn't looked.
When everyone is doing the best that they can, but it still isn't working, then it can really be helpful for people to share their thinking. This is one of the times when 2 plus 2 really is more than 4.
So, if you can believe that it is *likely* that both your pdoc and your therapist want you to feel better, then you *might* be able to let go of some of your mistrust, or fear of judgement, and let them collaborate on your behalf. This is the kind of decision where my head says "Of course, let them talk", but my heart says "That sounds dangerous". If I can't think of any other way to make progress, though, I will tend to go with my head at this point.
Staying safe is important - and I'm glad that you could make that promise to him. But just because you are *able* (with a scream, I might add) to make that promise doesn't mean that it is the best way to go. It doesn't mean that you shouldn't be doing other things at the same time. You might be able to stay safe - by useing all of your energy - but by doing that you won't have any energy to fix the *problem*. It is a temporary solution, but it really won't solve things in the long run. Using brute force and awkwardness on the *symptoms* is often not the best way to solve the *problem*.
> He said that I need to let someone help me. T says that I need to let her get close to me. I am fully aware that I can't get through this alone, but I need to be independent. I put up walls between me and anybody who tries to get inside.
>
*** Perhaps you will come to a point where you look at the situation that you are in now (in your words: SCREAM), and look at the situation that you would be in if you could consciously trust them a little more. This remind me of the pain that I was in with my previous therapist. I couldn't leave her because I knew that it would be painful to do so. But, when I was seriously considering suicide, I asked if the pain of leaving her would be GREATER than the pain I was in at that time. Even though I thought I wouldn't live without her, I *knew* I wouldn't live if things kept going the way they were. So there came a time when the slim chance of my surviving leaving her was actually greater than the chance of surviving if I stayed. Obviously, I did survive - and it was a good (but incredibly hard) decision.
> I don't want him talking to her as I feel compelled to protect her; the problem isn't her, it's me. Yes, I know this is transference, but I would have trouble opening up to anybody. I don't want to do therapy with pdoc (which is what he wants me to do.) I'm afraid that he's going to put me in the psych ward, but that would be a waste as I wouldn't talk to anybody there, either.*** Poet, you are assuming that if he talks to her that she will be "in trouble". If they are both competent professionals, they won't talk about her doing "the wrong thing". They might brainstorm some things that she could do that would be *more* helpful for you. You know how if you are doing a jigsaw puzzle, sometimes you get kind of stuck? Then a friend comes over and figures out the part that you couldn't get past? Your friend doesn't (I assume) think "Gee, Poet is so stupid for not figuring this out" - she probably thinks "Gee, I'm glad that I was able to help Poet so she can finish the puzzle".
Sometimes we can't take the next step until where we are is too, too painful to stay. The trick with therapy is to figure out that it is too painful to stay where we are before we do something drastic.
Believing that my doctors really do want to help me gives me the courage (over and over and over again) to take the next step before it is too late. You may need to believe this intellectually at first - you may not be able to *feel* enough trust, because that is one of the things that you are needing to learn in therapy. And you will only learn that by experiencing it. So if you *can* believe it intellectually, then try to steel yourself to the anxiety and take that next step.
>
> I can't get up the courage to write down all the painful stuff and let my T read it. Maybe if I made her promise to rip it up in front of me when she's done?
>
*** Do whatever you have to to get the information to her. This sounds like a fine technique to me...> Help.
>
> Poet
>
*** I wish you weren't in so much pain. Please keep trying to let them help you.
>
poster:fallsfall
thread:398271
URL: http://www.dr-bob.org/babble/psycho/20041002/msgs/398315.html