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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Susan47 on July 25, 2004, at 11:05:47
I've been reading the posts about contact, including email, after termination.
I wonder; if a T has done a really good job, and his client is actually able to move on, whether personal contact of any kind is necessary. Wouldn't it be healthier to just pay for an hour of his/her time, recognizing that the relationship you always had was really a professional one, and it *was* based on you working out your deepest feelings?
I wonder if perhaps the hazards of keeping in touch after termination would be that the client is used to working with the therapist on a certain level, and may still be looking for more than friendship, whether s/he wants to admit that or not.
It's a difficult issue, because I'm also a person who wants to be trusted. It's hard to make the distinction between professional and personal and I think that's why T's have to be so careful. It's a profession fraught with hazards, isn't it?
As a client I think it's my job to find people in my *real* life to care about and want to be in touch with. Having said *that*, of course, I know how difficult it is.
People who go to T's in the first place seem to be more in touch with their feelings, and sometimes perhaps *project* a bit too much (I'm talking about myself here).
And of course, it's also the T's job to make sure his/her needs are taken care of outside the job.
How to be sensitive and caring and yet still do the best for everyone?
I'm curious; doesn't a T get trained in how to deal with termination effectively?
Posted by Dinah on July 25, 2004, at 11:22:46
In reply to Termination, posted by Susan47 on July 25, 2004, at 11:05:47
I'm sure therapists get training. I'm also sure their training only prepares them with the tools they need for each client, in the termination or any other phase. No two clients are alike, and no two therapies are alike, and no two terminations are alike. A therapist might specialize is a certain type of therapy, so that there is a great deal of uniformity in their work. But if they ever start churning out their therapies, I think they're past being a good therapist.
I think what a lot of people don't understand unless they've been in a long term therapy relationship is that you can't make a friend or lover out of your therapist, but you can't make a therapist out of your friends and lovers either.
So an ideal therapy wouldn't end in a client finding a substitute in other real life people for the therapist. It would be incorporating the therapist so that a person can act as their own therapist. I have a husband and family and friends and with them I have the relationship that is appropriate to have with a husband and family and friends. With my therapist I have a therapeutic relationship. My relationship with my therapist can't substitute for other relationships in my life. My relationship with others in my life can't substitute for my therapeutic relationship.
I once suggested to my mother that she seek therapy for a problem she was having. She said "I don't need a therapist. That's what family is for." and I looked back over my childhood and put it in context of that sentence and wished most fervently that she had had long term therapy for my entire childhood. Because she tried to have me fill the therapist's role.
Different people need different things from therapy. Because of that, terminations are different, therapies are different, and one size does *not* fit all.
What do *you* need from termination?
Posted by Susan47 on July 25, 2004, at 11:49:58
In reply to Re: Termination » Susan47, posted by Dinah on July 25, 2004, at 11:22:46
>> I once suggested to my mother that she seek therapy for a problem she was having. She said "I don't need a therapist. That's what family is for." and I looked back over my childhood and put it in context of that sentence and wished most fervently that she had had long term therapy for my entire childhood. Because she tried to have me fill the therapist's role.
>
Yes I agree with you that this is what happens. My relationships with my children have been much better since I've been seeing a therapist.> Different people need different things from therapy. Because of that, terminations are different, therapies are different, and one size does *not* fit all.
>
> What do *you* need from termination?I won't know what I need from termination until I'm ready to terminate! Wow! I guess that means I'm not ready.
I went into therapy having a real problem with boundary issues. I'm still working on that, and I hope my T isn't completely pissed with me for using his answering machine; he's told me it's okay but I still feel very needy on occasion.
On the Board I've seen both clients and T's who seem to have problems with boundaries (see Damiana at the top of this particular board).I never meant, in my original post on Termination, that I wanted my T to exit stage left while I piled all my fears and anxieties on everyone else in my life, I'm sorry, that isn't at all what I meant.
I was referring more to my feelings love, desire, etc. I'm sorry I wasn't more clear.
Posted by Dinah on July 25, 2004, at 11:54:12
In reply to Re: Termination, posted by Susan47 on July 25, 2004, at 11:49:58
I didn't mean to suggest that you were saying that. I was just emphasizing that, to me, the therapeutic relationship is a valid relationship in its own right. Different from any other possible relationship.
If you're looking for love or reciprocal desire from your therapist, then it would be very healthy to turn those feelings towards someone else. I just have a hard time even understanding those feelings. :) Not love of course, I love my husband and son dearly. But the sort of feelings you're talking about.
Posted by Susan47 on July 25, 2004, at 12:29:55
In reply to Re: Termination » Susan47, posted by Dinah on July 25, 2004, at 11:54:12
What feelings specifically, Dinah, are you referring to?
Of course, our issues are different, and that has everything to do with it.My T has been wonderful, and thank God he realizes what I needed. He just told me to get someone else; basically, the lovey fired me.
That's okay, it's exactly what I need. He triggers some intense stuff and I can't stand up to it, I just sort of crumble and fall.
And I want to be a whole person.
Thanks for reading.
Posted by Dinah on July 25, 2004, at 12:52:54
In reply to Re: Termination, posted by Susan47 on July 25, 2004, at 12:29:55
I think I mean passion. Posts about passion are like a foreign language to me.
Your therapist fired you? I hadn't caught that from your posts. I'm sorry. :(
But if the transference was that intense, perhaps it will work out for the best. Maybe you'll be able to process it better with another therapist. What sort of things will you look for in a new therapist? Or are you going to try to go without therapy?
Posted by Susan47 on July 25, 2004, at 14:51:58
In reply to Re: Termination, posted by Dinah on July 25, 2004, at 12:52:54
I asked him to fire me last week.
That may sound strange to some, but the fact is that I was feeling crazy going to him.
Not only did he attract me too intensely physically, but I began to feel like I was playing into his expectations. I really felt more more and unbalanced, and responsible for being that way too.
He just *fired* me today.
He made a special effort to talk to me on his time off, and I appreciated that, felt bad about it, but knew it was about time he told me what I needed to hear... for my sake, not his.
I think he's really a wonderful person. Now, though, I have to say that I question the value of therapy past a certain point.
Posted by gardenergirl on July 25, 2004, at 15:45:23
In reply to Re: Termination: Dinah, posted by Susan47 on July 25, 2004, at 14:51:58
Interesting discussion here. I especially liked Dinah's thoughts about internalizing the therapist. I think my former client has done that to some extent because in her email she repeated soemthing I had said to her once and said she reminds herself of that all the time. That made me grin ear to ear! And I know that I use phrases my T has said to me before. I've even noticed another Babbler using one particular phrase! (I love it!)
Regarding training for termination...we do learn about the stages of therapy, and the issues that come up during termination. In our CBT-oriented classes, we are trained to reinforce what has been learned and to use booster sessions as needed to help the person maintain their gains. In psychodynamically-oriented classes, we talk about how termination can trigger past losses, can lead to an increase in dependence and some backsliding as a way to try to hang on, etc. And they stress that it is different for all. In cases of long term therapy, we were told to start talking about termination early, to allow enough time to process it. In some cases, termination can take a year to process in long established therapeutic relationships. I can think of one client with whom the transference (maternal) was the strongest issue to work on, and I think the termination was the most powerful thing for him. We talked about term. for at least five months, maybe longer. I've had other clients who just kind of said "goodbye and thanks" and were out the door without significant distress.
I think the main thing they teach us speaks to how therapy can be more of an art than a series of techniques...every client and every situation is different, and the therapist has to be prepared enough to be able to work from what that client needs. Racer said this very eloquently in another thread. In some cases, therapist-client pairings are not a good match. I know I tried to do CBT with that client I mentioned above (maternal transference issue), and I got nowhere. I had to switch to a more dynamic therapy in order to see any changes. If I were a strict CBT therapist, I'm sure I would have referred him to someone else or terminated (actually in this setting there was no one else...).
Hope this helps. Your situation is unique as well. I hope you are able to either work through your pain with this with him, on your own, or with anothe therapist.
Take care,
gg
Posted by NVDeb on July 25, 2004, at 15:47:51
In reply to Termination, posted by Susan47 on July 25, 2004, at 11:05:47
I can't even imagine termination. I have barely started so it's a long ways away, but right now my T. is the best thing in my life. I'm one of those people that would like to remain friends with their T's afterwards (and I would treat them as friends, not as therapists... I'm comfortable with that).
Termination... ::shudder::
Posted by Dinah on July 25, 2004, at 16:08:24
In reply to Re: Termination: Dinah, posted by Susan47 on July 25, 2004, at 14:51:58
> Now, though, I have to say that I question the value of therapy past a certain point.
That certainly may be true for you. But it's hard to generalize from personal experience. I certainly would never say that I would question the value of therapy that is less than five years in length. :) But it took me that long to get past the first phase of therapy and begin to get any serious benefits from it. In therapy as in medication, your mileage may vary.
Posted by Susan47 on July 25, 2004, at 16:58:57
In reply to Re: Termination: Dinah, posted by Dinah on July 25, 2004, at 16:08:24
I will try a new therapist. I've been pointed in that direction by my ex-T. He's right and although I find therapy very slow (for myself, it's a frustrating process because I've never been a very patient person anyway) I probably need to continue.
The fact that I was so nuts with my present ex-T tells me a lot.
I will look for compassion in my next T, as well as a very clear setting of limits from the outset; my last T wasn't very good at communicating his personal limits and I do believe I frustrated him.
Sometimes I just get so frustrated, myself -- I find communication and understanding very difficult. I just don't know. Therapy is so difficult, I do have to ask whether it's worth it *for me.* Having said that, I remind myself of my improved personal relationships in the last few months; due almost totally, I think, to seeing a therapist. I'm still very rigid in my thinking (can you *imagine* what I was like before therapy?) and I'd like to work on that too.
There's nothing more important in *my* life than my relationships.
Why did I treat my therapist so badly?
Posted by Dinah on July 25, 2004, at 17:13:05
In reply to Re: Termination: Dinah, posted by Susan47 on July 25, 2004, at 16:58:57
Don't feel too bad about it. I never had a romantic or erotic transference with my therapist but I tested him from here till next Friday for five years before I started to trust him. By that time it also took a while for him to trust me. :)
I'm glad you can see benefits in your personal relationships. Do you think having a woman therapist would help?
Posted by Susan47 on July 25, 2004, at 18:19:55
In reply to Re: Termination: Dinah » Susan47, posted by Dinah on July 25, 2004, at 17:13:05
Everyone's asked me that. I had a female therapist in the past and it was effective as well. I believe a female therapist will be very helpful for me in the future, and I do intend to find one.
As my last therapist said, sometimes you can only go so far with one therapist, and it can be helpful to switch. In my case, switching sexes at this point is going to be beneficial as well. I just love men .. and feel manipulated by them. It's a real dilemma for me.
Posted by shortelise on July 26, 2004, at 1:24:55
In reply to Termination, posted by Susan47 on July 25, 2004, at 11:05:47
Thirty years ago I saw a psychiatrist several times a week for about a year and a half. I quit therapy and moved on (Alas! Would that I'd had the ability to work things out at that young age. How different my life would have been.)
Anyway, a couple of years later when I was living abroad, I wrote to him. We've been exchanging letters from time to time ever since and we've never met again, nor are our letters ever very personal. I am not an important person in his life, nor is he in mine, but there is a continuity I find comforting.
He is a man I could not "be friends" with, nor do I think I'd ever see him as a therapist. But this contact is beneficial in some way. It's ... nice.
Shorte
Posted by bell_75 on July 26, 2004, at 8:50:34
In reply to Termination, posted by Susan47 on July 25, 2004, at 11:05:47
Hi Susan
As you know from my above post, I'm going through the termination process too...ick!
What I thought that was interesting is how you spoke about client's wanting more than friendship with therapist etc and a therapist being trained in dealing with termination as this reminded me of an experience in my most reccent session.
As I said in my post, I got upset at the mere talk of termination and cried and couldn't control it. I didn't sob hysterically but i found that as soon as i settled my tears and thought I could finally open my mouth again and say something..i'd say one thing and start crying quietly again while i said it.
My point here is that he noticed i was upset and wanted to get to the bottom of these tears, the real truth. Through the dizziness of my tears i could hear him saying things such as "you've been coming here for over a year now and we have formed a relationship and maybe you're sad to see that end." First I thought "is this flattery that he thinks im crying because i dont want to stop seeing him once a week?" then i realised he just geniunely cares and as a therapist wants to sort out my upset.
Anywho, i told him the tears were more about fear of after therapy but in my mind i still thought that he probably doesnt buy that 100% and might still think I'm sad about not seeing him.
He truely is a nice person but I've kept closely to mind the professional nature of our knowing each other and tried to keep myself distance to avoid any dettachment saddness.
Its also true that we need to have a *real life* with people who care about us in that life because when it comes to the crunch therapy isnt our life its a temporary part of it that will come and go. The rest of our life and the people in it will remain there.
Also you mentioned the "hazards of keeping in touch after termination" and I truely agree that there is a degree of hazard in post-therapy contact if it isnt completely neccessary.
I reccently thought about this contact when my T last session gave me his new business card which has an email address on it that i didnt know before. I took it home then wondered if i could contact him on that address after therapy has terminated. *Then* I thought maybe thats just me wanting to hold onto the security of having a therapist available, even if i dont need one and thats potentially harmful in itsself.I hope I havent made this reply too long. I could truely talk about the weird and wonderful of termination for alot longer but eventually it'd just be a whole lot of me speaking my every thought.
Thanks for sharing your thoughts with us, Susan.
I hope my 2 cents helped somehow. Lets keep in touch with how our 'termination triumphs' are going :)I like that one.
-Bell
Posted by Susan47 on July 27, 2004, at 0:36:52
In reply to Re: Termination » Susan47, posted by bell_75 on July 26, 2004, at 8:50:34
Thanks for your message. Feel free to go on and on, as far as I'm concerned. It's lovely reading what you have to say.
I feel really good about my therapist telling me I couldn't see him anymore. The first day or so was difficult, but in spite of anything negative that my mind tries to tell me, my abiding feeling is that this is really good for me. I feel stronger than I have in many months. I actually got a glimpse of who *me* really *is*, since he let me go.
Isn't that weird phraseology?
Ew.
Posted by gardenergirl on July 27, 2004, at 8:47:47
In reply to Re: Termination: bell_75, posted by Susan47 on July 27, 2004, at 0:36:52
> I actually got a glimpse of who *me* really *is*, since he let me go.
> Isn't that weird phraseology?Actually, I think that is wonderful. That's the goal, afterall, isn't it?
Glad you are feeling strong.
Take care,
gg
Posted by Susan47 on July 27, 2004, at 10:23:01
In reply to Re: Termination: bell_75 » Susan47, posted by gardenergirl on July 27, 2004, at 8:47:47
Thanks.
I have to be honest, though. I did write my therapist a letter. I don't need any reply, and I said that, I just need for him to read it.
Even if he doesn't read it, the idea that it was read is big for me. It matters.
Posted by AuntieMel on July 27, 2004, at 11:19:47
In reply to 30 years of contact, posted by shortelise on July 26, 2004, at 1:24:55
Wow, that would be nice.
Continuity....gives a warm fuzzy safe feeling, doesn't it. Puuuurrrrrr
Posted by LG04 on July 30, 2004, at 15:50:15
In reply to Re: 30 years of contact » shortelise, posted by AuntieMel on July 27, 2004, at 11:19:47
I'm also going thru termination with my therapist. (right now, over the phone b/c we are living in two different countries...but i will return for two weeks at end of august when we will do it more officially).
however we are going to stay in touch somehow. my relationship with her has become as important to me as the therapy itself. i actually read something recently about transference that discussed this as a common thing that happens in therapy. and that it's hard for a patient to get better if they know it will mean the end of a relationship that has become so important, in and of itself. and that it's hard to get out of the transference mode if the therapist never becomes "real." it was an interesting viewpoint. this article said that freud and jung used to have "post-therapy clubs" where they still interacted with their clients, in order to keep the relationship going for them.
i don't think i could have made the decision to return to the States if i thought it meant the total loss of my relationship with my therapist. i still need her and want her in my life. knowing she will still be there gave me the security and confidence to make this move.
we already discussed that the first year will be a "transition" year. basically that the boundaries will be the same, and we will figure out how often i will call her. after a year, we will re-evaluate our relationship and see if we (actually, if I) want to make any changes. she has basically given me control over what i want from our relationship post-therapy. she says it's totally up to me and my needs.
i know this is unusual. she personally has never done this with another client in her 15 years of practice. we are extremely close, on a soul level. i also know that it might get confusing or difficult, at which time i might decide that it's not good for me. it will also probably be influenced by what happens with a new therapist...i.e., my therapist has said that it might be difficult for me to form a new therapeutic alliance if she and i are still in close touch. she might be right. but maybe not. maybe it will help me to make the transition.
we are able to talk about our relationship very openly and i think that is what will enable us to figure out how to do this, one little step at a time. she does things at my pace, and that feels very safe to me.
as i said, i know this is an unorthodox approach. but every therapeutic relationship is different, every relationship is different, and perhaps for our relationship -- more importantly, for me -- this is what i need. if it goes well, i intend to write a book about it. it could be a new paradigm for therapeutic relationships, though i know it would always be a small minority of therapists and clients that would do it.
as for me, i am incredibly grateful and feel blessed that she is willing to do this with me. it might not be easy, but i believe it would be far more difficult for me to cut off from her after i move back here. also, it probably makes a difference that we are living across the world from each other, rather than terminating but in the same city. also it's a VERY premature termination, it's being done not becuase i am ready but because i have determined that i need to move back to my home community. if i were staying where i was, i'd probably be in therapy with her for years and years. as it is, it was only two years.
anyway just adding a different, unusual perspective to the whole concept of termination. it could be that our relationship will fade once we are no longer seeing each other on a regular basis. i just don't know. but that we are pacing it and moving very slowly, and not cutting off my relationship with her is so important to me. i am in a very difficult transition right now, even a crisis (very depressed), and if she were just gone, i'd be over the edge.
LG
Posted by shortelise on August 3, 2004, at 1:14:53
In reply to Re: 30 years of contact, posted by LG04 on July 30, 2004, at 15:50:15
Yes, LG, I remember you. Last time I read you, which was a while ago, you were moving back to the states for a while.
I'm glad to hear it's working, so far. You are surely putting a lot of energy into doing well. I admire you a lot, frankly. That has to be a hard transition.
I would not want to have a "real" relationship with my therapist as I would lose the other relationship. That is not meant to criticise you or influence or anything. But it made me think - and my need for him as a therapist is strongest.
Shorte
Posted by terrics on August 4, 2004, at 15:24:40
In reply to Re: 30 years of contact, posted by LG04 on July 30, 2004, at 15:50:15
hi, has the format changed? Just want to add a little observation from new T. [With Whom I initially had a very difficult time] This new T has VERY strict boundries, which i HAVE LEARNED TO APPRECIATE. I loved my old T. too much. She has now invited me for coffee, said i could stay over night if I need to, and has invited me out. i truly think the attraction is mutual and dangerous. new t said old t. is giving me double messages. I really feel safe with new T. I now think strong boundries are important. Allowing the old relationship to die with patient and T. on good terms is also important. terrics
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