![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 27 to 51 of 51. Go back in thread:
Posted by Dinah on December 26, 2004, at 21:31:12
In reply to Lifetime Therapy, posted by alexandra_k on December 26, 2004, at 18:25:05
I just like the sound of that better.
So maybe in a way it is rent-a-friend. Well, not really. Because it isn't a friendship. Not like any friendship I've ever had. It's not a mother/child relationship. It's not a lover or spousal relationship. It's a therapeutic relationship. And it's therapeutic.
It's rent a therapist. And no, they aren't interchangeable. My therapist stresses that with me, and I ask him occasionally in outrage if he thinks he's like a washer at a laundromat. "This one's out of service, please use the next one down." It's a personal therapeutic relationship.
I'm not always looking for insight. Not usually even. It's not very humble for me to admit, but deep insights usually come from me rather than him. He provides the setting for it, I suppose. I'm not really looking for coping skills, although he does reinforce the coping skills he's taught me over the years and helps me remember to use them when it might be easier to use less functional ones. But sometimes I use the bad ones anyway, and he is relatively (though not perfectly) nonjudgemental about helping me brainstorm to get out of whatever mess I get myself into.
I don't care easily. I don't attach easily. For some reason I've attached to him. And he's close enough to foster that attachment, but separate enough that he doesn't get mad at me like my husband does - he doesn't learn to hate me for my flaws. *Because* he cares enough but not too much. And yes, he does care about me as Dinah. But not so much as he cares about his family or close friends. And that's good in a way. He couldn't be what he is to me if he cared too much.
The attachment is, at this point anyway, a useful thing. The main reason I try not to SI is because I promised him not to. He's definitely a factor when I'm feeling suicidal. Or on the verge of doing something idiotic. His voice and words echo in my head a lot and moderate my reactions which tend to be a teensy bit extreme.
I don't handle stress well. I'll probably never handle stress well. I've been that way since pre-puberty. My body has hair trigger responses that manifest physically as well as mentally. My therapist is an ongoing way of dealing with an ongoing problem. By using him, I'm able to use fewer psych drugs and maintain the maximum functioning I'm capable of maintaining.
I feel safe in that office to feel the things I don't feel safe feeling elsewhere. And to tell the truth, I probably should keep a lid on those things elsewhere because I have responsibilities and things to do. But keeping the lid on makes the pressure build.
I am a better mom and wife and daughter and worker for seeing my therapist regularly. My husband is happy I see him. My migraine doctor said the other day that she was delighted I saw him twice a week.
It's not an addiction any more than my klonopin is an addiction, or my depakote. At most I'll consider it a what do they call it? medical dependence?
I know there's a possibility that it could turn out very badly. In fact it's bound to unless I'm lucky enough to die first. But I also know that he realizes just how badly it could turn out, and that he'll do his best not to hurt me.
Posted by Toph on December 27, 2004, at 7:15:56
In reply to Lifetime Therapy, posted by alexandra_k on December 26, 2004, at 18:25:05
Alexandra, I identify with much of what you posted. Sure, your T has to make a living, and let's hope (s)he is professional. But what Dinah alluded to is what I struggle with, does he really care about me, would he want to sit down over coffee for 50 minutes and talk with me for free? Or his he faking interest like a prostitute fakes whatever his/her client wants? I'd like to think that unlike a prostitute who survives through disassociation, your T develops a relationship with you as you work through various issues you bring into the room. It's a little one sided but dynamic all the same. You're smart enough to recognize if (s)he isn't there with you invested in your progress. That the part I also struggle with. Is a mechanic really invested in completely fixing your car or does he want you to come back? I hope our Ts have the same goal as us, to make them obsolete.
-Toph
Posted by Dinah on December 27, 2004, at 9:17:22
In reply to Lifetime Therapy, posted by alexandra_k on December 26, 2004, at 18:25:05
This probably isn't a topic I can discuss intellectually right now. With all the ties that bind me to this earth shattering over the last few years, I can't think of one of the last remaining ties objectively.
Posted by gardenergirl on December 27, 2004, at 15:47:05
In reply to To tell the truth, posted by Dinah on December 27, 2004, at 9:17:22
Dinah,
Your response above was a lovely description of the therapeutic relationship as it should be. I think I'll keep it to remind myself of why I went into this field.Thank you for posting it. I'm glad you have such a special and helpful relationship with your T.
gg
Posted by alexandra_k on December 27, 2004, at 15:50:47
In reply to Re: Lifetime Therapy » alexandra_k, posted by daisym on December 26, 2004, at 19:42:12
> disagree strongly with your comparisons.
Ah. Okay, perhaps I should say that I probably take a much more liberal line on drug pushing and prostitution than most. I mean, if I hadn't gone to varsity they pretty much were the sum total of my viable career options :-) I used to push drugs (at school mostly) and at the risk of people reading more into this... well... some of my best friends were pro's. What I mean is that I was not trying to degrade or demean (either therapists, drug pushers, or pros) when I made those comparisons. I was just trying to convey the points of similarity that I noted. Drugs are addictive - therapy may be similarly addictive for some. Prostitutes are paid to listen sympathetically (well, if you want regular customers and its nicer to be paid to listen than it is to be paid for sex acts).
>But I can see why it would be valuable with regards to ongoing support. There is something important about being able to explore your feelings about things without always having to be careful.
But why can't we achieve this with real world relationships? Perhaps going to therapy actually PREVENTS us from doing this because the need is met in therapy.
>Those occupations are about making money>Something that always occurs to me is that people seek out therapy and therapists...it isn't like they go trolling for clients. They aren't enticing folks into therapy, nor are they coercing them into staying.
One would need a certain amount of business smarts to succeed in private practice, I would have thought. Everyone has to eat. All occupations are about making enough money to at least meet ones fairly basic needs. Thats why it is an occupation. It is a job. Work. Surely the idea would be to build up enough 'regulars' to eat and meet ones basic needs. Unless one has a constant flow of new clients, of course...
>and they are illegal if not immoral.
>Would you compare a doctor
Prostitution is legal in NZ. If we wanted to talk about legal drug pushing I could get started on doctors working in pain clinics, morphene and benzo's and so on - but I won't go there. I suppose that I was attempting to convey that there may be something ethically / morally questionable about a therapists encouraging dependance...
>we want someone who genuinely likes kids and grows fond of OUR kids. That connection makes for a relationship, above and beyond the money. I don't want my kids to just be interchangeable with any old kid...
Now my point here is that sure we want someone who genuinely likes kids! And being fond of kids just means being fond of many particular kids. But if the teacher wanted to keep a kid in her class forever and perhaps even purposely (though maybe unconsciously) held the kid back so that they wouldn't move on to a new class with a new teacher, well then there would be something wrong. They are interchangable to the extent that kids move on and each year you get more kids. They come, they go and while you may miss them you get reattached to the new lot.
> I do hear the concern about encouraging dependency. But what if we reframe it as attachment, mutual respect and interdependency, instead of something prejorative?
I think that some of each may go on in therapy. I am just worried about the former. I don't think interdependency is good though, given the (ideal) nature of the theraputic relationship.
>I think like most things in life, one-size does NOT fit all.
Sure, and some therapists may be better suited to some clients and not others.
> I hope you find what you are looking for.
Yes. I hope we all find what we are looking for.
Posted by alexandra_k on December 27, 2004, at 15:57:24
In reply to Re: Forever Therapy » alexandra_k, posted by Dinah on December 26, 2004, at 21:31:12
>he is relatively (though not perfectly) nonjudgemental about helping me brainstorm to get out of whatever mess I get myself into.
Don't you think that you could find this in the real world?
>He couldn't be what he is to me if he cared too much.
Do you really think that? Do you think that everyone who is close to you will 'hate you for your flaws?' - I think you deserve better.
I reckon that all those things... all those things you mention could be found in the real world without your having to pay for them. All those things and more - because it could be mutual. The only thing you would lose out on is the inequal power balance and the one sided nature of it all. And you are not a selfish person so I don't believe you would miss that.Maybe I am just hopelessly optimistic...
Posted by alexandra_k on December 27, 2004, at 16:07:38
In reply to Re: Lifetime Therapy » alexandra_k, posted by Toph on December 27, 2004, at 7:15:56
> Alexandra, I identify with much of what you posted. Sure, your T has to make a living, and let's hope (s)he is professional. But what Dinah alluded to is what I struggle with, does he really care about me, would he want to sit down over coffee for 50 minutes and talk with me for free? Or his he faking interest like a prostitute fakes whatever his/her client wants? I'd like to think that unlike a prostitute who survives through disassociation, your T develops a relationship with you as you work through various issues you bring into the room. It's a little one sided but dynamic all the same. You're smart enough to recognize if (s)he isn't there with you invested in your progress. That the part I also struggle with. Is a mechanic really invested in completely fixing your car or does he want you to come back? I hope our Ts have the same goal as us, to make them obsolete.
> -TophI tutor at varsity. I am paid for the time I spend with the students. I get an office hour so they can come and talk with me and I get paid something towards email contact and phonecalls etc etc. I had a guy send me an email saying that he had been thinking about some stuff (the meaning of life etc etc) and he would really like me to read over it... I agreed. It came in the post to the department.. About 10 pages of tiny handwritten scrawl. He is a pleasant guy, achieves fairly average grades - this will take me a lot of (unpaid) time...
But I said I'd do it.
(And next time I am asked I will ask them to estimate how long it will take me)
I do care about them.
Even the ones who aren't likely to continue through.
Is he interchangable?
Well, there will be a new lot next year.
But you do remember individuals with kindness.About the coffee... Whats the bet that if you didn't meet as therapist - client he would probably enjoy that very much. But things being what they are it probably never occurs to him.
I like to think that I can tell whether they are genuinely interested or not. Some are none to subtle either... I think you can pick up on this. Their level of emotional engagement, awakeness, etc. I am sure we are to them how our responsibilities are to us much of the time: Sometimes you like them, sometimes they bore you to tears, and sometimes they just about drive you crazy. I don't think a complete pretense could go unnoticed. (People don't really care about how the pro feels about what she is doing so I guess that one is a little different there).
Posted by alexandra_k on December 27, 2004, at 16:17:27
In reply to To tell the truth, posted by Dinah on December 27, 2004, at 9:17:22
To tell the truth this may be a topic that none of us can discuss very objectively...
For those who don't know much about my situation I cannot let myself get very attached to my current t until I can figure out whether he is committed to working with me or not (I am not convinced that he is even capable of this).
So I hold back and devalue theraputic attachment...
But if I had someone who was committed to working with me no doubt I would melt and hold on to them so tight and be terrified that something would happen to them.
Would that be good for me?
Who knows. Really. It is hard to operationalise and data interpretation is horrid...I do believe that such things are possible of real world relationships. But they are hard to find / engineer and so if one cannot... well... therapy may well be the best there is.
That makes me feel sad.
But then it is a sad situation to start with.I am really sorry if I hurt anyone with my rambellings. not my intention.
Posted by annierose on December 27, 2004, at 16:48:53
In reply to Re: To tell the truth » Dinah, posted by alexandra_k on December 27, 2004, at 16:17:27
Not trying to beat a dead horse on this topic, but I'm believe we view the theraputic relationship differently, and that is okay. You keep mentioning the "real world". Well, my therapy does take place in the real world. It isn't a dream, or a fantasy. Yes, it is a "controlled" environment, but real conversations take place, real learning and self reflection. That, for me, is a good thing (not to steal that phrase from Martha Stewart). You asked if our T's should be helping us find these things in the real world so we won't need them anymore. Well, I do think even though I'm not in therapy for the short run, working out difficult issues with my T does help me with my relationships with my husband, daughter and son
(we don't think my relationship with my mom + dad is repairable at this point :) Most of my family and friends, although well meaning, are not able to objectively listen to my inner pain, or should they be subjective to it. Yes, I do look for my friends and husband for comfort and advice, but it is at a compeletly different level.
Okay, I am running on and on. That is just my 2 cents.
Posted by Camille Dumont on December 27, 2004, at 17:32:50
In reply to Re: To tell the truth » Dinah, posted by alexandra_k on December 27, 2004, at 16:17:27
This is so alien to me ... perhaps becuase she was the same gender as I, perhaps because of the PD I supposedly had but I never really felt any attachment to my T. She was great in that she gave me free sessions (talking to me for 2 hours and chargning only one), calling me and giving me all sorts of good references to health care people who were actually good ... but when I left ... when I stopped seeing her I felt nothing ... not really any pain, no lacking of any sorts ... perhaps a bit strange when she called me back to thank me for my x-mas card (my way of telling her this was kind of an official end to all this)... but thats it.
Perhaps its a sign that it didn't really work ... I don't know ... but it wouldn,t be the first time I find myself at odds with what others feel.
Posted by alexandra_k on December 27, 2004, at 18:06:17
In reply to Therapist Attachment, posted by Camille Dumont on December 27, 2004, at 17:32:50
Maybe you never really got to the point where you were able to tell her stuff that was really private to you. Sometimes it is fairly hard to think of anything to say. Othertimes I find myself thinking of stuff that I think I could never bring myself to say. But if you can bring yourself to say it and they respond appropriately, well, then I guess that is what makes me feel attached more than anything.
Maybe it was about that.
It could have been a lot of things.A p-doc was looking at diagnosing me with schizo-affective. I have a mood disorder (well, emotionally unstable kinda mood disorder really) - everyone agrees, but the episodes of psychosis (well 'episodes' - I continually hear voices) and social withdrawal didn't really fit in with my dx of Borderline Personality Disorder.
I have felt the same way as you about therapists before. But then I have also gotten pretty attached. Sometimes it can depend on the therapist client fit.
Posted by Dinah on December 27, 2004, at 19:55:11
In reply to Re: Lifetime Therapy » daisym, posted by alexandra_k on December 27, 2004, at 15:50:47
I think what we're trying to say is that the needs we get met in therapy are *different* needs than the ones we get met in real life.
I don't expect my friends or relatives to be my therapist. I hope they don't expect me to be theirs. Well, my parents did so perhaps I'm extra special cautious about doing the same to others. It was wrong of them.
My time in therapy doesn't prevent me from looking to meet those needs elsewhere because I'm meeting them in therapy. On the contrary, I managed to go most of my life without getting many of my needs met at all in real life. My therapist teaches me how to get needs met appropriately in real life for the first time. Well, we're working on it anyway. I wouldn't be at Babble if it weren't for therapy, for example.
And it is very definitely not my therapist's practice to ensnare clients for a steady income stream. With the exception of me, his clients are mainly six session to one year short term CBT clients. He gets extra supervision and consultation on my case because he doesn't generally do long term - definitely not this long term. So I don't think he chose this one person - me - to try to addict them to therapy. On the contrary, I fought long and hard to get the relationship we have. It is totally unfair to that good man to blame him for the length of our association. I can be enormously strong willed. He *has* come to see the many ways I am better off for ongoing therapy, though. He'd be equally happy were I to need to see him less.
I don't expect you to understand my position, so I won't bore you further by trying to explain. We just have different ideas about therapy, that's all. You seem to see it more as a teaching experience?
Posted by Dinah on December 27, 2004, at 19:57:04
In reply to Re: To tell the truth » Dinah, posted by gardenergirl on December 27, 2004, at 15:47:05
Thanks gg. I do tend to be a bit defensive of the length and frequency of my therapy, so it helps to get some positive reinforcement now and again.
I can't tell you how delighted I was that my migraine neurologist thought it was terrific that I saw my therapist twice a week.
Posted by alexandra_k on December 27, 2004, at 20:09:39
In reply to Re: Lifetime Therapy » alexandra_k, posted by Dinah on December 27, 2004, at 19:55:11
> I think what we're trying to say is that the needs we get met in therapy are *different* needs than the ones we get met in real life.
ok.
I guess I was just thinking of the stuff you mentioned.
> And it is very definitely not my therapist's practice to ensnare clients for a steady income stream. With the exception of me, his clients are mainly six session to one year short term CBT clients. He gets extra supervision and consultation on my case because he doesn't generally do long term - definitely not this long term. So I don't think he chose this one person - me - to try to addict them to therapy. On the contrary, I fought long and hard to get the relationship we have. It is totally unfair to that good man to blame him for the length of our association. I can be enormously strong willed. He *has* come to see the many ways I am better off for ongoing therapy, though. He'd be equally happy were I to need to see him less.Oh, hey I never intended to imply that that was what was going on for you. Just that that could happen. And that that is something that I think about.
> I don't expect you to understand my position, so I won't bore you further by trying to explain. We just have different ideas about therapy, that's all. You seem to see it more as a teaching experience?You aren't boring me at all.
I feel very privaleged that you have been sharing on a topic that is clearly hard for you. Well, it is hard for me too - but in a different way and I suppose I started this...I really don't know much about what therapy is supposed to be about. About the scope of things one can choose to work on etc. I have only had DBT / CBT offered to me properly and that was solely about treating the symptoms of my diagnosis.
But there are more options than that, right (please god)?
I would love to hear about why people go and what they get out of it.
Yes I am a sceptic and a bit of a cynic by nature - I don't claim that they are my nicest personal qualities.
Maybe I can't understand. But I'd like to try.
Posted by Pfinstegg on December 27, 2004, at 22:10:24
In reply to Re: Lifetime Therapy » Dinah, posted by alexandra_k on December 27, 2004, at 20:09:39
I know you'll tell me if I am wrong, but from past posts of yours, I've gotten the idea that you have complex PTSD, with a disorder on the dissociative spectrum, such as an ego state disorder. I guess I got this idea because of the traumatic background you have mentioned- and because I have it myself.
I think the very best kind of therapy for this is intensive psychotherapy- the kind that daisym and I are having, where you have a chance to both explore the different parts of yourself, as well as the chance to form a really strong attachment to a therapist who will stick with you. With DBT, you can't really do either one of those things. Is this available for you- for example in the in-patient situation you are exploring? If it isn't, you could obtain it if you come to the US for graduate studies. It might mean becoming a patient of a psychoanalyst in training(those people would already have had very good psychotherapy training, but would be able to see you frequently at a very low fee).Frequency and the strength of attachment seem to be very important in allowing the different ego states to become conscious and more integrated.
This may not meet your needs for psychotherapy- I was just replying to your hope that there was something out there for you besides what you've already had.
Posted by alexandra_k on December 27, 2004, at 22:37:18
In reply to Re: Lifetime Therapy » alexandra_k, posted by Pfinstegg on December 27, 2004, at 22:10:24
> I know you'll tell me if I am wrong, but from past posts of yours, I've gotten the idea that you have complex PTSD, with a disorder on the dissociative spectrum, such as an ego state disorder.
You nailed it.
> I think the very best kind of therapy for this is intensive psychotherapy- the kind that daisym and I are having, where you have a chance to both explore the different parts of yourself, as well as the chance to form a really strong attachment to a therapist who will stick with you. With DBT, you can't really do either one of those things. Is this available for you- for example in the in-patient situation you are exploring? If it isn't, you could obtain it if you come to the US for graduate studies. It might mean becoming a patient of a psychoanalyst in training(those people would already have had very good psychotherapy training, but would be able to see you frequently at a very low fee).Frequency and the strength of attachment seem to be very important in allowing the different ego states to become conscious and more integrated.Yeah, I guess now that you mention it that is what I want. But it is something I have never been able to have. I was hoping it would be available at Ashburn, that was the whole point in going.
> This may not meet your needs for psychotherapy- I was just replying to your hope that there was something out there for you besides what you've already had.Thankyou.
I am so sorry everyone that I have been such a terror on this thread.
I am just sour and jealous.
I am really sorry.
You can argue most anything with reason
But what seems intuitive to defend
Can be very f*cked up indeed.
Posted by alexandra_k on December 28, 2004, at 2:56:53
In reply to Re: Lifetime Therapy, posted by alexandra_k on December 27, 2004, at 22:37:18
Actually, forget about it.
It is too terrifying for me to bear thinking about.
Really
Posted by Dinah on December 28, 2004, at 3:57:14
In reply to Re: Lifetime Therapy, posted by alexandra_k on December 27, 2004, at 22:37:18
Alexandra, you did nothing wrong. Yours is the majority view, you know. :)
I'm a bit more defensive right now even than usual, and I'm sorry if that came across. I'm just tired, is all.
Posted by Joslynn on December 28, 2004, at 9:04:06
In reply to Therapist Attachment, posted by Camille Dumont on December 27, 2004, at 17:32:50
Also, some therapists do not believe in creating or using attachment in the psychological sense of the word. My therapist came out and told me something like "oh I don't believe in attachment as a technique, I think you have to be careful with that, if the client just attaches to me then they set up a new dependency." Something like that. This may sound cold, but she really is a very empowering therapist and is especially good at seeing how family-learned dynamics play out and how I can change them both in my family of origin and in my personal life.
But I also want to tell her, um, just because you don't beieve in attachment doesn't mean it won't happen.
That said, I never felt that emotional, tender attachment to her that I felt for my male pdoc. I attribtued that to the fact that he is male and I have father issues, while my relationships with female friends and my Mom are good. But now I wonder if it is just her style, and the pdoc has more of a tradtional style, regarding attachment.
I guess my point is, if the T doesn't try to create that attachment, but has more of a "coach" or "advocate" style, that could explain why the attachment isn't that deep...not necessarily because of the client, but because of the therapist style.
Posted by alexandra_k on December 28, 2004, at 14:07:59
In reply to Re: Lifetime Therapy » alexandra_k, posted by Dinah on December 28, 2004, at 3:57:14
> Alexandra, you did nothing wrong. Yours is the majority view, you know. :)
Well, I am not sure that I buy it. It is just something that I think about, that is all.
> I'm a bit more defensive right now even than usual, and I'm sorry if that came across. I'm just tired, is all.Thats okay. It is a hard time of year for everyone. Truth be told I think I may have been a little bored and typically when that happens I can be even more antagonistic than usual.
The way I chose to express myself probably didn't help. I really am sorry.
Posted by Dinah on December 28, 2004, at 16:50:38
In reply to Re: Lifetime Therapy » Dinah, posted by alexandra_k on December 28, 2004, at 14:07:59
No, no Alexandra. You were just asking questions.
I'm starting to hurt from the losses now. Therapy today was like opening a door that had been tightly shut, but I know it was leaking out before today. I'll try to write more about it later. Right now I need to calm down some.
But what I'm saying is that I'm in so much abject terror at the thought of further losses right now that I'm straining to cling to whatever I can cling to. Babble, my therapist. I'm trying desparately hard *not* to cling to my son, because that's not his job.
I'm just starting to slide towards trouble, and I'm afraid you might have caught some of that.
I just need to need my therapist right now.
Posted by alexandra_k on December 28, 2004, at 17:08:42
In reply to Re: Lifetime Therapy » alexandra_k, posted by Dinah on December 28, 2004, at 16:50:38
> I just need to need my therapist right now.
Thats ok. I guess I just need to not need mine, and that is because... well, you know the situation.
Yes I was 'just asking questions', but I also kinda knew it was likely someone would get upset. I just didn't realise the full impact of that untill... well, you know.
Back to support mode :-)
Posted by judy1 on December 28, 2004, at 17:41:15
In reply to Lifetime Therapy, posted by alexandra_k on December 26, 2004, at 18:25:05
I truly related to a great deal of what you wrote. I don't know your background since I've been absent from this board for months at a time, but I'll hazard a guess that we have both been terminated by pdocs/therps on more? than one occasion. Having been the recipient of that action (plus having boundary issues), I can't help but think that shapes our views of our therps. Personally I fear any deep work with a therp because I am certain I will be disappointed. If this is the emotion that taints my relationship with a therp, then it is most certainly doomed from the start. I think? I agree with you, the true progress we make must come in the 'real world' and the time spent away from that is cheating any real progress in our emotional growth. I most certainly have gained insight into the triggers that harm me through work with therps, but in retrospect they have often been the source of those triggers. Your post definitely resonated with me.
take care, judy
Posted by judy1 on December 28, 2004, at 18:02:12
In reply to wow » alexandra_k, posted by judy1 on December 28, 2004, at 17:41:15
Posted by left_hangin on December 29, 2004, at 23:10:50
In reply to wow » alexandra_k, posted by judy1 on December 28, 2004, at 17:41:15
I completely understand and agree with you Alexandra about the relationships with a T.
I am much the same as Judy1.
So many are blessed and others can be cheated!
Take care.
This is the end of the thread.
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.