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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by daisym on December 31, 2004, at 2:46:02
I've been in therapy for 18 months and today was the first time I've ever had two sessions in one day. I'd call it a double session, except that there was an hour in between. I went for my usual appointment and there was so much to tell and two really big issues to sort out. I've had pieces of a new memory intruding since last night and I was frightened by it. But there was another pressing issue that my therapist wanted to talk about too. After spending about 20 minutes on "his" topic, I started to get really upset. I told him I just didn't have enough time today and I didn't know how to prioritize things. Everything felt urgent so I wanted to bounce around. He was quiet for a minute and then told me he had a cancellation this afternoon and I could have that spot, if I wanted it. My initial response was, "is this sinking even deeper into neediness?" But ultimately we decided that we could spend the remaining time on the first issue and give the next hour over to the memory.
The hard thing was that when I came back, I kept thinking, "this isn't a big enough deal to need an extra session for. I'm being stupid." He knew I was feeling insecure and pushy so he helped me just move right into the memory. It was good that we had set up what the agenda would be, it would have been easy to go back to the earlier conversation. I really struggled with the need to talk, however. It felt like, "OK, I said this felt so urgent...I better get to it!" I think because I felt so much pressure, I "made" myself go very deep into this memory and try and piece it together. My 8-year-old self strongly emerged and told most of the story and her fears were so huge. I kept trying to pull myself back into the room but I couldn't get myself back. After a half hour, my therapist intervened. He had been talking the whole time, asking questions, providing safety for the story. But I think I was struggling so hard and squirming so much that he just knew it was too much. I think this is one of the few times I've heard him say, "OK, I think that's enough for now. Let's rest..." It took a while to put that 8 year old away because when I stopped forcing the words there were still tears.
I don't think I'd do too many doubles. It was exhausting. Maybe because there was an hour in-between, so it felt like 3 hours of therapy. Or maybe because I felt like I needed to make it worth his while, so there was more pressure. I know some people do this routinely - have 75 minute sessions and they like having that much time. I'm actually surprised that I didn't like it more. But I am glad that I didn't have to hold onto everything for the weekend, thought I'd bet dollars to donuts that I'm going to get womped with the guilt monster soon.
I'm quickly moving into the "worst client" ever realm. I feel like the guy in the movie the mask, "somebody STOP ME!"
Posted by mair on December 31, 2004, at 10:12:57
In reply to My first double session day, posted by daisym on December 31, 2004, at 2:46:02
I had one of those once several years ago with a different therapist. It wasn't so much that we were going to run out of time to talk about things, as it was his strong on-the-spot insistence that I start to involve my husband in my treatment - it was right before Christmas; I was pretty depressed and very isolated; and I think it really bothered my T that my husband didn't have a clue as to what kind of shape I was in, or how serious my depression was. It felt strange to leave his office, go home, announce to my husband that my T wanted to see both of us that afternoon, and go pretty much right back there. My T then was in a fairly large practice and I felt embarrassed to be reporting to the receptionist for the second time in the same afternoon. I didn't want anyone there noticing that I was back again, since his office was right in the middle of my very small town, I even worried about whether people would notice how long my car was parked right outside that building. The 2 of us spent probably close to another 2 hours with him so it really was like a triple session day. It was exhausting and I took it in a very self-judgmental way as evidence as to how far I had sunk.
I, too, am generally pretty happy with the 50 minute hour. My T gave me my December bill yesterday and I was a taken aback when I saw that we had twice this month run way over so I had been charged on those days for a session and a half. I just had forgotten about those sessions and it's pretty rare that I'm not the one who's really watching the clock and who is most anxious to have a session be over. Even those slightly longer sessions are mentally draining.
I read your posts alot and I'm always very impressed, and frankly a little jealous of the depth with which you're able to communicate with your T. I think the important thing to hold onto is not that this means you're getting needier, or that your T thinks you are on shakier mental ground - I think you need to view this as an isolated instance where, on that day, having an extra session was the most expeditious way to progress with the work that you and he needed to do. That extra session may not have seemed as fruitful to you because you struggled so much, but I'm sure it layed the groundwork for the next session.
Mair
Posted by fallsfall on December 31, 2004, at 10:14:16
In reply to My first double session day, posted by daisym on December 31, 2004, at 2:46:02
He suggested the double session because you needed it. "Your" topic was getting in the way of discussing "his" topic. So by giving you the extra hour he made it so that "your" topic wouldn't be in the way. That both topics could be discussed.
Your feeling that you had to prove that "your" topic was urgent is interesting. You certainly weren't putting him out. He had planned to work that hour. He was in a position where he was not going to be paid for the hour. So you taking the session was not a hardship for him. Did he have a patient after your "2nd" session? It's not even like you asked him to stay late. He could listen to you whine or he could listen to someone else whine - but you didn't even whine! It sounds like you were working very hard. You are not a cross that he has to bear. He likes you. He has told you that and shown you, too.
I think it was a pretty creative way to get past your resistance to "his" topic. It worked, didn't it?
Posted by Shortelise on December 31, 2004, at 12:26:53
In reply to My first double session day, posted by daisym on December 31, 2004, at 2:46:02
Daisy,
To me it sounds like you are not a bad client, sooner your T is a good T. It's his job to be there for you, to feel out what you are going through and try to help. He did that, didn't he?
And what is a bad client, anyway? We are all supposed to move through various stages, and one of them is dependance.
I felt so badly because I was awfully nasty with my T for a long time. After I'd come out of that phase, maybe a year later, he said something that made it clear that he didn't hold it against me, that it had been an acceptable part of the proces. I started to cry, and told him what a relief it was to hear that.
On the one hand, I want to care about him, be sensitive to him, and make our relationship pleasant for him. On the other hand, I want what I need, I want to get through the process, get from him everything he has to give me. That's his job. All those people helping skills.You are brave Daisy. Looking into the abyss of memory is so frightening.
Hugs to you.
ShortE
Posted by Daisym on December 31, 2004, at 17:23:17
In reply to Re: My first double session day » daisym, posted by mair on December 31, 2004, at 10:12:57
Thank you for sharing your experience. I can't imagine going and getting my husband but that is a different thread, I think. I sometimes wonder too, what the other therapists in his building think. We switch off offices so I'm not always at the same place every day. But since I've been going for a long time, one of the other therapists says hi to me now.
Emotionally draining is a good way to describe how I felt. I'm like you, I watch the clock. I tried to give this up but I haven't been able to yet. I saw the bill for the month of December. It was two pages. He asked me if that made me feel bad. I said it is like seeing the intensity of my neediness on paper. He said next time he would write small and keep it on one page. :)
Thanks for saying that I'm not getting needier. In my more rational moments I know it is just another phase but right now it feels so bad. I was really angry at him about 2am this morning for letting me have another session yesterday and allowing me to open up this memory. I told him that on the phone today and he said he could see why I might feel that way. So we talked about how everything is all mixed up right now. He did say it was OK for me to be mad at him and still he wouldn't pull back from me. Good thing. I need him right now.
Grieving is such a long process.
Posted by Daisym on December 31, 2004, at 17:37:15
In reply to Re: My first double session day » daisym, posted by fallsfall on December 31, 2004, at 10:14:16
Yes, it worked. It probably would have been OK if I hadn't watched that movie too. Guilt I can handle. Complete melt downs I can't. And you are also right that I don't need to take care of him or make it better for him.
On the phone today I said I wanted to end this conversation by saying, "don't worry, I'll be OK" or something cheerful but I just didn't have it in me. He said that was fine, he could take care of himself. He suggested we not say good-bye but instead he said -"OK. I'm here. Call me later or over the weekend if you need me. I'm around." It was easier that way to hang up. Because he says "OK" in a way that conveys: "I understand, it's OK and we have to stop" all in one very gentle word. So all I have to say is "OK" back. That I could make myself do.
Posted by Daisym on December 31, 2004, at 17:46:22
In reply to Re: My first double session day » daisym, posted by Shortelise on December 31, 2004, at 12:26:53
Thanks, ShortE.
I don't know what a bad client is. My self-definition is different than my more global definition. I just don't want to see my file some day and see written in it..."she came or called - AGAIN."
I'm glad your therapist accepted your nastiness as part of the process. I've heard so many of them don't know how to handle that part. I told mine today that I was mad at him...he fully accepted this and we talked about how it made me feel (scared) to be mad at him. You stated it so well: I want to be sensitive to him but I also want what I need. It is a hard balance.
I don't feel brave right now, ShortE. I want to stay in bed and hide under the covers from these memories. I didn't know I had so many tears in me. Thanks for the hug.
Daisy
Posted by Dinah on December 31, 2004, at 20:11:21
In reply to My first double session day, posted by daisym on December 31, 2004, at 2:46:02
I did a session and a half once. I was afraid to really explore one topic because there was another topic that was important to me. So my therapist offered me as much of the next hour as I wanted, since he was available. A half hour did it.
I think it would be really hard to leave then come back. It would break the momentum.
Once I really hinted that I wanted to come back the same day, because of an event that happened after therapy. He later told me that he could have seen me but that I needed to ask for what I wanted, since it hadn't occurred to him that I'd want to see him twice in a day.
I always figure he wouldn't offer (or agree) if he weren't willing.
I think you handled it very well, actually. I'd have probably taken a temper tantrum and told him that he could discuss his topic during a session he was paying for, but that since this was my therapy my topic was going to have to take precedence. lol. Now *I'm* a difficult client.
I'm sorry this whole thing is so difficult for you, Daisy. You've got so much stress in your life right now.
Posted by Aphrodite on January 1, 2005, at 7:33:17
In reply to Re: My first double session day » daisym, posted by fallsfall on December 31, 2004, at 10:14:16
You just get right to the point with a wonderfully gentle but certain logic. I am vicariously comforted:)
Posted by Aphrodite on January 1, 2005, at 7:35:52
In reply to My first double session day, posted by daisym on December 31, 2004, at 2:46:02
Just chiming in a little late that it sounds like it was an ideal handling of a unique situation. I wouldn't worry too much -- it's not like this will become a habit or come up all the time. As a chronic clock watcher, I like having long sessions. It gives me time to warm up, get logistical things out of the way, and pull myself together before I leave. All great things. I wouldn't like my 70 min. sessions if they were 100% topic intense. I'd burn out.
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