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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by zenhussy on July 17, 2003, at 10:51:24
In reply to Well, I finally called my therapist, posted by judy1 on July 17, 2003, at 4:11:48
Judy1,
You haven't slipped up you are just continuing to heal. You have done an amazing job doing this on your own without the therapist and pdoc. I can certainly understand the need for breaks from such things. I admire that you called them both.
I wish the best for you and am proud of you for calling them.
Good luck. And no judgement about the SI. You've been doing so well this is just another step in your healing process.
zenhussy
> It's been several months since I have seen her and I've been doing really well but slipped and SIed tonight. I wonder if I'll ever stop that- I'm like an alcoholic counting days, I think I was up to 130. Another bizarre thing today-yesterday?- I called my old shrink and left a message and he called right back. Very strange, I haven't spoken to him in at least a year and it was a very superficial conversation but it must have triggered me. I wasn't emotional at all talking to him, almost detached, but every word is resonating in my brain now. I hate the thought that I still am so affected by him. Sorry for the rambling, I can't sleep despite 4mgs of klonopin.
> Take care all- judy
Posted by judy1 on July 17, 2003, at 14:50:02
In reply to Re: Well, I finally called my therapist, posted by Dinah on July 17, 2003, at 8:42:56
those were helpful suggestions- thank you. it is interesting being so much in denial, I can keep it up for months and then - bam. I'll let you know how things go.
take care, judy
Posted by judy1 on July 17, 2003, at 14:53:54
In reply to Re: Well, I finally called my therapist » judy1, posted by zenhussy on July 17, 2003, at 10:51:24
thank you. I guess it was healthy to call my therapist and I know she'll tell me not to beat myself up about the SI. As far as the ex-shrink, not so good since he was the one who crossed boundaries (I have another one now)- but obviously there are some unresolved issues there. I did a lot of work dealing with him, but apparently not enough.
take care, judy
Posted by zenhussy on July 17, 2003, at 17:18:32
In reply to Re: Well, I finally called my therapist » zenhussy, posted by judy1 on July 17, 2003, at 14:53:54
> thank you. I guess it was healthy to call my therapist and I know she'll tell me not to beat myself up about the SI.
>As far as the ex-shrink, not so good since he was the one who crossed boundaries (I have another one now)- but obviously there are some unresolved issues there. I did a lot of work dealing with him, but apparently not enough.
> take care, judySorry judy1! I did not know your former shrink was boundary crosser. I didn't mean to surface such an issue. Still am proud of you. I do hope you are not beating yourself up over the SI.
take care,
zh
Posted by noa on July 17, 2003, at 18:13:30
In reply to Well, I finally called my therapist, posted by judy1 on July 17, 2003, at 4:11:48
I'm glad you called your current therapist.
Do you know what was going on for you that you felt like calling the old shrink (the boundary crosser)?
This is an opportunity to do some more processing with your current therapist about that old trauma with the old shrink.
Will you see your current therapist soon?
Take care, Judy.
Posted by pinkeye on July 17, 2003, at 19:39:41
In reply to Re: Well, I finally called my therapist » judy1, posted by noa on July 17, 2003, at 18:13:30
hey Judy,
What happened with your ex therapist? Maybe it will help you if you share it with us.
Pinkeye
Posted by judy1 on July 17, 2003, at 23:59:41
In reply to Re: Well, I finally called my therapist » judy1, posted by zenhussy on July 17, 2003, at 17:18:32
Sorry judy1! I did not know your former shrink was boundary crosser. I didn't mean to surface such an issue
Please don't feel the need to apologize- I actually dealt this issue to death a couple of years ago on the board, and I'll briefly go over it later. I'm just disappointed with myself (re: the SI), I guess I was hoping I was done with that kind of behavior.
take care of yourself too, judy
Posted by judy1 on July 18, 2003, at 0:05:48
In reply to Re: Well, I finally called my therapist » judy1, posted by noa on July 17, 2003, at 18:13:30
Hi Noa,
No, my therapist hasn't called me yet, she may be out of town (does that a lot). As far as contacting the ex-shrink, he was always the comforter to me and I think I felt the need for that. When I talked to him it was very much like old patterns, the flirtations back and forth, his soothing voice and I guess he always knew exactly what to say to make me feel better (sounds like a drug). I will talk to my therp about it when we see each other, obviously my feelings towards him need some work.
thanks noa- judy
Posted by judy1 on July 18, 2003, at 0:17:44
In reply to Re: Well, I finally called my therapist, posted by pinkeye on July 17, 2003, at 19:39:41
Hi, I'll be brief because a lot of old-timers already know this. There was a mutual consent physical crossing of boundaries. He eventually tried to get me to see someone else, I made a suicide attempt, he dropped me. He and I had counseling with a third party- this is a big no-no for the APA, but I didn't file a complaint because I (still) had a great deal of feelings for him. Anyway it was a mess, and despite being over 3 years ago I guess I'm still having problems completely letting go. This is the main reason I tell people on the board to be careful with the 'slippery slope'- it doesn't start out physical, you get to be 'special'- took my phone calls even if he was in session, used to call me at home on week-ends for hours, etc. it turned out just awful. take care, judy
Posted by allisonf on July 18, 2003, at 1:07:35
In reply to Well, I finally called my therapist, posted by judy1 on July 17, 2003, at 4:11:48
I read your message this morning and have been thinking of you a lot today. For all of the silly fantasies I have had about my therapist recently, I am outraged every time I hear of a therapist who has actually crossed boundaries. It is such an incestuous-like betrayal of trust of someone already in a vulnerable state. Part of their job description is to be a safe harbor. I don't know the whole story of what you went thru, but I certainly hope your old therapist realizes how lucky he is that you didn't follow this thru with the APA.
Take care of yourself. You can use the SI in your current therapy (one step bk, two steps forward...) Good luck with everything.
Posted by judy1 on July 18, 2003, at 1:42:20
In reply to Re: Well, I finally called my therapist » judy1, posted by allisonf on July 18, 2003, at 1:07:35
I had to answer you Allison before calling it a night. I think fantasies are all part of the transference process, but you are absolutely right it is the therapist's job to keep you safe. I don't know if I would equate it to incest, but the tremendous guilt I felt (and still feel) is very much like the feelings I have as an abuse survivor. I keep thinking I give off some kind of signals that say 'hey use me, I have no self-respect.' The therp who helped me through this right after was completely enraged and felt I was caused great harm. I of course thought I deserved it. I know, wrong thinking, but it's still there. Thanks for the words of encouragement. take care, judy
Posted by Dinah on July 18, 2003, at 8:21:02
In reply to Re: Well, I finally called my therapist » allisonf, posted by judy1 on July 18, 2003, at 1:42:20
I'm glad you know that it wasn't your fault and you have nothing to feel guilty about. I'm glad you know that you deserve better. But sometimes knowing isn't feeling, unfortunately. There may be some deeper levels at which this hasn't been resolved.
In light of what you said about the former therapist providing soothing, perhaps you should concentrate on that need more than the self injury itself. Maybe it's all connected, and that will let you be gentler and more nurturing with yourself.
I hope your therapist calls back soon. In the meantime, can you contact your pdoc?
Posted by pinkeye on July 18, 2003, at 15:38:27
In reply to Re: Well, I finally called my therapist » pinkeye, posted by judy1 on July 18, 2003, at 0:17:44
Hi Judy,
Why did you call it quits? What is wrong in having a relationship with your therapist?
Posted by judy1 on July 18, 2003, at 20:52:39
In reply to Re: Well, I finally called my therapist » judy1, posted by Dinah on July 18, 2003, at 8:21:02
she called this afternoon Dinah- I'm seeing her on wednesday. thanks for the encouragement- judy
Posted by judy1 on July 18, 2003, at 20:55:22
In reply to Re: Well, I finally called my therapist, posted by pinkeye on July 18, 2003, at 15:38:27
it's unethical- they can lose their license- to have a relationship with your pdoc or therapist and usually is very harmful to the client (it certainly was for me).
take care, judy
Posted by pinkeye on July 18, 2003, at 21:13:03
In reply to Re: Well, I finally called my therapist » pinkeye, posted by judy1 on July 18, 2003, at 20:55:22
hmm.. I don't understand why it is unethical, and I don't see why it would be harmful to the client also. If both of them are adults and like to have a relationship, what is wrong and unethical about it?
Posted by noa on July 18, 2003, at 22:24:46
In reply to Re: Well, I finally called my therapist, posted by pinkeye on July 18, 2003, at 21:13:03
First of all, it would affect the objectivity of the therapist. Second of all, a doctor-patient relationship, especially for psychological treatment is inherently not balanced in terms of power. The patient could be subject to being exploited by the therapist if their relationship goes beyond the therapeutic relationship. Being in an intimate relationship can cause undue influence on the patient. The therapist is supposed to work for the needs of the patient and leave his or her own needs out of it.
I found this from the APA code of ethics (http://www.apa.org/ethics/code2002.html):
3.04 Avoiding Harm
Psychologists take reasonable steps to avoid harming their clients/patients, students, supervisees, research participants, organizational clients, and others with whom they work, and to minimize harm where it is foreseeable and unavoidable.3.05 Multiple Relationships
(a) A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person.A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.
10.05 Sexual Intimacies With Current Therapy Clients/Patients
Psychologists do not engage in sexual intimacies with current therapy clients/patients.10.06 Sexual Intimacies With Relatives or Significant Others of Current Therapy Clients/Patients
Psychologists do not engage in sexual intimacies with individuals they know to be close relatives, guardians, or significant others of current clients/patients. Psychologists do not terminate therapy to circumvent this standard.10.07 Therapy With Former Sexual Partners
Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies.10.08 Sexual Intimacies With Former Therapy Clients/Patients
(a) Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.(b) Psychologists do not engage in sexual intimacies with former clients/patients even after a two-year interval except in the most unusual circumstances. Psychologists who engage in such activity after the two years following cessation or termination of therapy and of having no sexual contact with the former client/patient bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors, including (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a posttermination sexual or romantic relationship with the client/patient. (See also Standard 3.05, Multiple Relationships.)
And, from WWLIA--from an article by an attorney (http://wwlia.org/us-prosx.htm)
Why Are There Prohibitions on Professional-Client Sexual Contact?
There are special characteristics of professional-client relationships which place the professional in a position of greater power and authority than the client and, in essence, render it "unfair" for the professional to gain any benefit at the client's expense. Legally, many professionals--therapists, physicians, attorneys, professors--are said to stand in a "fiduciary" relationship with respect to their patients, clients, or students. "Fiduciary" is a legal term describing the relationship that exists when one party reposes trust and confidence in the other, more powerful party. In a fiduciary relationship, the more powerful party has a duty to act only in the trusting party's best interest. Sexual contact may harm patients, clients, and students and therefore is a violation of the fiduciary's duty. Because of the fiduciary nature of professional-client relationships, professional-client sexual contact is prohibited.
In therapist-patient dyads in particular, specific attributes of the relationship may lead to a sexualization of the relationship. One of these attributes is transference. "Transference" describes the phenomenon in which the patient ascribes both positive and negative feelings the patient has about others in the patient's past and present life to the therapist. One court noted the difficulty this presents for the treating therapist:"The therapist must encourage the patient to express her transferred feelings, while rejecting her erotic advances; at the same time, he must explain to the patient that her feelings are not really for him, but that she is using him in a symbolic role to react to some other significant person in her life. In short, the therapist must both encourage transference and discourage certain aspects of it. This may be difficult to do and presents an occupational risk. The therapeutic alliance in this situation gives rise to a duty, imposed by professional standards of care as well as ethical standards of behavior, to refrain from a personal relationship with the patient, whether during or outside therapy sessions. This is because the personal relationship infects the therapy treatment, rendering it ineffective and even harmful."
The intimacy present in the therapeutic relationship also lends itself to sexual acting out. The American Psychiatric Association has warned: "[T]he necessary intensity of the therapeutic relationship may tend to activate sexual and other needs and fantasies on the part of both patient and therapist, while weakening the objectivity necessary for control."The likelihood of sexual contact, the harm caused patients, and the fiduciary nature of the therapist-patient relationship lead to the prohibitions on sex between therapist and patient. Other professions, such as medicine and law, note many similarities between physician-patient/attorney-client sex and therapist-patient sex, and have adopted ethical rules prohibiting such contact. Courts are following this trend and holding physicians and lawyers liable for harm caused by their sexual contact with patients.
Posted by allisonf on July 18, 2003, at 22:41:14
In reply to Re: Well, I finally called my therapist » pinkeye, posted by noa on July 18, 2003, at 22:24:46
Well said, noa! It was really interesting to see what the code of ethics actually says about it. Thanks for putting that together.
Judy, best of luck with your therapy on Wed.
Take care--Allison
Posted by Dinah on July 19, 2003, at 9:32:49
In reply to Re: Well, I finally called my therapist » pinkeye, posted by noa on July 18, 2003, at 22:24:46
Posted by judy1 on July 20, 2003, at 1:24:52
In reply to Re: Well, I finally called my therapist » pinkeye, posted by noa on July 18, 2003, at 22:24:46
Thanks for printing that out noa. I did find out about the 2 year rule for psychologists; psychiatrists (and mine was one) rules have no time limit attached- it's never considered ethical to have a relationship with an ex-patient. You are exactly right about the power imbalance, and more critically for me was the transference going on so that it essentially was a repeat of what happened to me as a child. I think that was easily the most harmful aspect of the relationship. I truly worry about people who see no problem with this.
take care, judy
Posted by judy1 on July 23, 2003, at 23:28:24
In reply to Re: Well, I finally called my therapist » noa, posted by judy1 on July 20, 2003, at 1:24:52
saw my therp and she had me work on finding a safe place vs. the 'place' I dissociate to. This place (I picked a cave with a lot of pillows and stuffed animals:-), is so I can still remain present around other people yet withdraw enough so I don't feel threatened. It seemed to work, I was very anxious when I went to see her and we did some hypnosis and I talked about what made me feel safe and we designed it together. I like her practical approach to problems. I'll be going back to weekly sessions for a while- at least until I have a handle on the SI. take care, judy
Posted by noa on July 24, 2003, at 6:09:25
In reply to just a follow-up..., posted by judy1 on July 23, 2003, at 23:28:24
: - )
That sounds great. I love the idea of actually creating a safe space for yourself. Your therapist sounds wonderful and just right for you.
Posted by Dinah on July 24, 2003, at 7:38:06
In reply to just a follow-up..., posted by judy1 on July 23, 2003, at 23:28:24
That sounds great. I'm glad you feel safer.
Posted by allisonf on July 27, 2003, at 15:51:11
In reply to just a follow-up..., posted by judy1 on July 23, 2003, at 23:28:24
Sorry I didn't post sooner--we were gone for the week. Glad to hear things went well with your therapist. She sounds like she uses a lot of great techniques. Good luck--A
Posted by judy1 on July 27, 2003, at 20:03:54
In reply to Re: just a follow-up... » judy1, posted by allisonf on July 27, 2003, at 15:51:11
This is the end of the thread.
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