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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by raisinb on March 27, 2008, at 18:38:20
My T and I have had sessions exactly like this before, and it feels like a horrible repetition.
Usually, I can believe that she cares, but I have to get this from her tone of voice, things that she does and says, because she has never directly said "I care about you."
But occasionally, I go in there and she seems cold and distant, which is what happened today. Then she told me that my insurance called, and that they want her to justify treatment further, or something. She gave me a consent form to sign so that she could discuss my treatment with them. I asked her if she thought they'd cut me off. She said, no, and if they did she'd raise "holy havoc," and that the worst they'd do was to cut me down to once a week, she thought. (This is a big deal to me, and it was upsetting. I don't want to go back to once a week--it was too hard).
I got upset and withdrew, and didn't talk any more. She kept asking me questions, but they felt halfhearted. Eventually I said that she seemed cold and distant, and I couldn't understand why she seemed so warm and involved and caring sometimes (like last session) and now like this.
She said that she felt as if I was trying to figure out if she cared, and that I put too much weight on that. This was horrible to hear, because I needed to hear that she cared, and not only was she refusing to say it, but also that she was telling me that I was too needy to want it, and that I should simply go in there for analysis of my problems. It made me feel as if all the caring I'd felt for her in the past I'd made up in my head, that it was my fantasy, that she really didn't care that much, and that I had been living in a dream world the whole time.
I was very upset and couldn't talk, and broke down a little. Throughout this whole time, she felt very distant--she just sat there and occasionally asked questions about how I felt. I couldn't tell her, of course, because how can you open up and tell someone how you feel when they don't seem to care about you? It was horrible, to feel her just sitting there doing and feeling nothing, while I was in pieces. It was like she was a brick wall.
We've gone around and around about this before. I feel she's inconsistent--emotionally warm, caring, and we have this intense connection--one day, and then like this the next. The last time, it culminated in me writing her a letter telling her that I needed to know that she cared about me, would miss me if I left, and that I was important to her. She never said any of those things; she just said that she wanted me to stay and that we would work through it. She also said that she thought I needed something she couldn't provide--reassurance that I was good, worth it, okay, lovable, and that some of that she could provide, but the rest I had to do for myself. I nearly left that time, but she sucked me back in with a voice mail message in which she said she was upset about the way the session had ended and how much she wanted me to stay.
I feel caring from her so often, but then sessions like this make me doubt the whole thing. I *knew* today that she was just doing her job and that it didn't mean that much to her. It felt like the most horrible slap in the face and now I want to quit.
Sometimes I read threads on here, where people's Ts say directly "I care about you," or "you're special to me," and I feel that if she felt that, she'd say it, and that she is just hedging because she really doesn't feel that much.
I feel like I need a T who does care deeply for me, that I can't open up and be completely vulnerable to one who doesn't, and I feel like I am repeating a terrible pattern--trying to get love or recognition, acceptance, from somebody who just doesn't feel it.
She's calling me tomorrow to talk about it more, since the session ended badly, but I don't know what to say. To me, the whole thing is simple; there are people in my life who care and who love me, and with them, I feel like I can open up and talk because I am secure in that. I feel like there's no way I can ever be vulnerable with her.
Maybe the whole therapy setup is wrong for me. Maybe this is just the wrong T for me and I've refused to see it for three years. Three years is a really long time to feel alone and uncared for, and I feel like maybe I have just refused to face it all this time.
Posted by rskontos on March 27, 2008, at 19:28:37
In reply to had a really horrible session today *long*, posted by raisinb on March 27, 2008, at 18:38:20
Wow raisinb,
I feel the need to answer you because I feel your pain, but due to the nature of your post, I feel I need more time to digest it. I have two strong thoughts and feelings about it and they are at war with one another so I need to think about it before I post either of them.
So, I wanted to tell you, this is a strong feeling you are having and a difficult one so I wanted to say I care and I will post more.
There is much in your thread that reminds me of my struggles and I need to separate that.
It sounds like the connection between the two of you wanes from session to session and this is the crux of the struggle. And with the connection there should be a consistent sense of caring. And you don't always come away with that. And that is tough and furthermore it hurts.
I am so sorry.
I will post more after some thought. But my thoughts are with you. Please take care,
rsk
Posted by TherapyGirl on March 27, 2008, at 20:24:07
In reply to Re: had a really horrible session today *long* » raisinb, posted by rskontos on March 27, 2008, at 19:28:37
I agree with RSK. This is a loaded post and will take some time to digest. I will tell you that I've been in the same place many, many times over the 23 years I've been in therapy (that's not a typo). It's hard to imagine how sometimes I feel more connected to my T than anybody else on the planet and sometimes we are both going through the motions. I think it has a lot to do with where I am that day and where she is. I also think part of it is the natural ebb and flow of any relationship. I've learned over the years to (mostly) trust that she cares about me even when I don't feel it. Because she does.
Your T seems a little hung up on not saying it, but it seems that you feel she does express it, right? So I think you have to get to a place where you trust that. I wish I knew how to tell you to get there, but I don't. It's going to take some time. I don't think that she is necessarily the wrong T for you since you believe she cares about you sometimes and you seem connected to her. Maybe you can try to work through this yet again?
(((((((((((raisinb)))))))))))
Posted by raisinb on March 27, 2008, at 21:24:15
In reply to had a really horrible session today *long*, posted by raisinb on March 27, 2008, at 18:38:20
Posted by Dinah on March 27, 2008, at 21:43:42
In reply to had a really horrible session today *long*, posted by raisinb on March 27, 2008, at 18:38:20
Even now I get those mixed messages. And my therapist has been really clear that he cares about me, and that I'm special to him.
Yet there are sessions where he draws his boundaries up, or asks stupid and insensitive questions to question why it's important to me that he care about me. Or waxes eloquent on why boundaries are so important to protect therapists.
I try to keep context in mind. And that might come into play here. The context was discussing an insurance problem. She's likely to slip into a more businesslike mode at times like that, for reasons that might have nothing to do with you. My therapist gets a bit uncomfortable with talk of money. Maybe she does too. Or maybe she's angry with the fact that insurance people are dictating what's best for you, when she feels she's in the best place to make that decision.
I wouldn't worry too much about words. My therapist had always, until fairly recently really, been very careful to use words that could mean anything, and thus meant nothing. He didn't want to say anything that could be misleading, so he settled for confusing. What she does is more important than what she says. (Although hearing it is admittedly very nice.)
Posted by seldomseen on March 28, 2008, at 7:27:10
In reply to had a really horrible session today *long*, posted by raisinb on March 27, 2008, at 18:38:20
It has been my experience that not every session is a home run. In fact, some just are outright bad.
Sometimes my therapist is off, sometimes I am off and there really isn't anything that either of us can abou it. It happens.
I completely understand your desire to hear her say that she cares for you. I think we all want to hear that from our therapists. However, it sounds as though your T has set a boundary regarding telling patients that.
I can also understand that. She may not trust herself to know which patients will be able to benefit from it versus which ones would actually be harmed.
But she evidentally has no problem showing patients that she cares for them. My therapist doesn't even deal with insurance (I have to file), much less say that he would throw a holy tantrum if they tried to cut me off. What a wonderful thing to say!
On the whole, I would rather have my therapist show me that he cares about me than tell me, sometimes words are hollow you know?
Seldom
Posted by raisinb on March 28, 2008, at 8:48:49
In reply to had a really horrible session today *long*, posted by raisinb on March 27, 2008, at 18:38:20
You've given me some much-needed perspective. I can see the point about actions speaking louder than words, but when the emotional presence AND the words are rejecting, it's difficult to deal with. And I just came off a serious bout of depression (triggered by last week's bad session and a visit from my family), which my T knows. It seems like she has a tendency to kick me when I'm down, which makes it hard to feel safe.
I still can't fathom what to say to her later. I can't figure out how you talk to someone about how you feel when they've already rejected you so badly. I really have nothing to say. Guess it'll be a short conversation :)
Posted by crushedout on March 28, 2008, at 11:57:17
In reply to had a really horrible session today *long*, posted by raisinb on March 27, 2008, at 18:38:20
Gosh raisinb I can relate to a lot of this post. I don't have time to write more right now but will try to later.
Posted by Phillipa on March 28, 2008, at 12:03:09
In reply to Re: had a really horrible session today *long* » raisinb, posted by crushedout on March 28, 2008, at 11:57:17
I feel actions and words are intertwined and wonder seriously if theraphy is good or bad for me since I tend to focus on the negative. Phillipa
Posted by raisinb on March 28, 2008, at 16:40:24
In reply to had a really horrible session today *long*, posted by raisinb on March 27, 2008, at 18:38:20
Near the end of that session, she kept urging me to call her if I needed to. I said that if she wanted to talk to me she could pick up a phone like anyone else. She said, okay, let's set up a time and I'll call you.
So, as the time neared for that call today, I started having a panic attack and by the time she called I was too upset to pick up the phone.
I have to say, I'm a peach to work with :)
Posted by seldomseen on March 28, 2008, at 18:36:12
In reply to well, posted by raisinb on March 28, 2008, at 16:40:24
sometimes in therapy you have to take a leap of faith when you don't feel safe.
It's really hard, but my biggest advances in therapy occurred when I was willing to stretch myself into unknown and very scary territory.
They were always a huge risk on my part, but I took them.
It was more than worth it for me.
Posted by Phillipa on March 28, 2008, at 20:35:10
In reply to Re: well, posted by seldomseen on March 28, 2008, at 18:36:12
Excellent advise I also needed to hear it thanks Phillipa
Posted by Daisym on March 28, 2008, at 21:06:08
In reply to well, posted by raisinb on March 28, 2008, at 16:40:24
**But occasionally, I go in there and she seems cold and distant, which is what happened today.
**I feel she's inconsistent--emotionally warm, caring, and we have this intense connection--one day, and then like this the next
**I feel caring from her so often, but then sessions like this make me doubt the whole thing. I *knew* today that she was just doing her job and that it didn't mean that much to her.
**It seems like she has a tendency to kick me when I'm down, which makes it hard to feel safe.
**Near the end of that session, she kept urging me to call her if I needed to. I said that if she wanted to talk to me she could pick up a phone like anyone else. She said, okay, let's set up a time and I'll call you.
Raisinb,
I'm noticing from what you've written that there are times when you really feel connected to her and you can feel her caring and then something interrupts that feeling - like an insurance deal or maybe she is less effusive with her warmth - and you want to chuck the whole thing. I often have to remind myself that therapy can't be all warm and fuzzy all the time - it is painful work and most of it I have to do on my own. Sometimes I feel like my therapist has withdrawn into a corner and is asking questions that he knows hurt - but later I can see that these are the things that I have to deal with. I know this might sound harsh but believe me I do understand a lot of this - I'm someone who struggles a great deal with the connection and caring thing around therapy. I've found, for myself, that certain subjects or certain things that are happening in my life always bring on this reaction from me. Usually it is mother stuff - I have a hard time dealing with my feelings about my mother because some how my therapist gets all mixed up in them and I end up feeling like he has pulled away, that he can't stand working with me and that he thinks I'm a whiny brat. Since we've identified this pattern (it took a long time) he will now say, "I'm not your mother!" - That usually calls it out and breaks through. I noticed that you wrote, "it seems like she has a tendency to kick me when I'm down" -- is it possible that when you are down it tends to feel like she is kicking you because you feel ultra vulnerable and she hasn't realized this yet? The same from coming off a rough visit from your family...you needed her and she didn't meet that need - perhaps she didn't know what you needed, yet? But if she figures it out, do you then get it?
I really doubt that a therapist who didn't care would urge the phone call today and want to talk about it more. They would let you stew and/or figure it out on your own. And she did remember the phone appointment, even if you weren't in any shape to keep it.
Three and half years is a very big investment of time. I don't get a sense from your post if you feel caring from her most of the time or half the time or not very often. I ask because perhaps this is one of your therapy tasks - to trust that someone cares about you even when they aren't overtly saying it or showing it or even when they themselves are having a bad day or hard time. I know it is one of mine - to believe that caring exists even if it goes invisible sometimes and that relationships can survive anger, hurt feelings, mis-attunement and unmet needs.
But I hate, hate, hate having to work through it over and over again. So I do understand your angst, and if I had a better answer than keep talking about it, I swear I'd give it to you.
I hope you can read this hearing a gentle voice - as I intended it.
Daisy
Posted by seldomseen on March 29, 2008, at 5:58:47
In reply to Re: well » raisinb, posted by Daisym on March 28, 2008, at 21:06:08
" I ask because perhaps this is one of your therapy tasks - to trust that someone cares about you even when they aren't overtly saying it or showing it or even when they themselves are having a bad day or hard time. I know it is one of mine - to believe that caring exists even if it goes invisible sometimes and that relationships can survive anger, hurt feelings, mis-attunement and unmet needs."
Very well said.
This was one of my therapy tasks as well - to be able to absorb hurt and disappointment and still value the relationship.
Specifically, I had two related pathologies regarding relationships. One, when I perceived danger in a relationship, I would start piling ALL the perceived problems in the relationship into one big mass of reasons why I should hate that person (regardless of how much they meant to me previously). The second was, I would use those big reasons to get out the relationship.
It took a lot of introspection and a good deal of pain to realize that the way I handled relationships wasn't helping me at all, but was a vestigal defense mechansim.
It took even more work to consciously extend myself to my therapist and to keep stretching into and not away from the relationship.
He's let me down plenty of times, some of them I was sure were deal breakers, but a couple of disappointments here and there are part and parcel of any relationship. It took a lot of practice to develop the confidence that I could handle it.Please don't get me wrong, I'm not saying that I am perfect at this - I'm clearly not. It took me years and years to hone my defenses, and it will take years and years to disable them. It maybe something I struggle with for the rest of my life I don't know. But therapy has definately helped.
Seldom.
Posted by raisinb on March 29, 2008, at 11:30:57
In reply to Re: well » raisinb, posted by Daisym on March 28, 2008, at 21:06:08
Daisy, thank you for all your wisdom. I've been thinking about what you said this morning.
"I'm noticing from what you've written that there are times when you really feel connected to her and you can feel her caring and then something interrupts that feeling - like an insurance deal or maybe she is less effusive with her warmth - and you want to chuck the whole thing. I often have to remind myself that therapy can't be all warm and fuzzy all the time - it is painful work and most of it I have to do on my own. Sometimes I feel like my therapist has withdrawn into a corner and is asking questions that he knows hurt - but later I can see that these are the things that I have to deal with."
Yes, I guess the difference is so *extreme* sometimes--and it often seems that it's when I need her most that she withdraws emotionally. And that's very difficult for me. Though intellectually I may know that relationships ebb and flow, in the moment, I feel as if she's stoppd caring about me. Therefore, I can't talk. We waste so much time this way. It seems like there's only one session every few weeks, sometimes, that is truly helpful.
I just can't figure out when and if it's okay to need her, and which needs are okay and which aren't. She's always asking me, "what do you need from me right now? I would like to be able to provide it." In those moments, I can't say what I need, because of sessions like the last one in which I clearly needed something from her so badly and she not only didn't provide it, but made me feel wrong and pathological for needing it in the first place. It's a difficult cycle.
I noticed that you wrote, "it seems like she has a tendency to kick me when I'm down" -- is it possible that when you are down it tends to feel like she is kicking you because you feel ultra vulnerable and she hasn't realized this yet? The same from coming off a rough visit from your family...you needed her and she didn't meet that need - perhaps she didn't know what you needed, yet? But if she figures it out, do you then get it?"
I guess sometimes yes, sometimes no, and I don't know when it'll it work and when it won't, and I don't know if it's really just miscommunication (she doesn't know what I need in the moment) or if there really is this part of me that is so needy that it will repulse her and she'll confirm that I'm unlovable. Sometimes her responses seem to say one thing, sometimes another. And it's a pretty big deal not to know.
"Three and half years is a very big investment of time. I don't get a sense from your post if you feel caring from her most of the time or half the time or not very often."It varies. Sometimes we have four or five great sessions, sometimes we'll go a few weeks without a really good one. Half, maybe?
I don't know if you remember this, but Skinner did a bunch of experiments with rats in a maze. One group of rats got cheese every time they ran through the maze. One group never got it (I may be remembering this wrong). One group got it occasionally and the schedule was completely random. I feel like one of those rats. Occasionally I get cheese and I can never figure out what behavior gives it to me and that very unpredictability keeps me running the same maze.
"I ask because perhaps this is one of your therapy tasks - to trust that someone cares about you even when they aren't overtly saying it or showing it or even when they themselves are having a bad day or hard time. I know it is one of mine - to believe that caring exists even if it goes invisible sometimes and that relationships can survive anger, hurt feelings, mis-attunement and unmet needs."
Yes, I know. It is. I worry not about whether that's my task, but whether or not the level of caring and consistency she can provide is going to be just enough to push me over that level, or whether it's going to fall just a little too short.
"But I hate, hate, hate having to work through it over and over again. So I do understand your angst, and if I had a better answer than keep talking about it, I swear I'd give it to you.
I hope you can read this hearing a gentle voice - as I intended it."
DaisyI did :) Thank you so much for your response.
Posted by raisinb on March 29, 2008, at 11:36:43
In reply to Re: well, posted by seldomseen on March 28, 2008, at 18:36:12
I know. I wish now I'd picked up. I thought it would be safer not to, but I don't think I predicted how I would feel afterwards.
My fear of rejection is very intense. Sometimes it precipitates a little attack where I get dizzy, see spots in front of my eyes, and occasionally faint (last year I fainted when a boyfriend broke up with me unexpectedly. Very Victorian of me :) )
You are right, though. Taking risks is difficult for me, but I know I won't grow unless I do it.
Posted by raisinb on March 29, 2008, at 11:39:36
In reply to Wise wise words » Daisym, posted by seldomseen on March 29, 2008, at 5:58:47
Seldom, I do exactly the same things.
I guess I'm still in the place where I believe they are helping me--if this T is not right for me, or is messing up, or is simply unable to provide what I really need, or doesn't care--then I'm doing the right thing by keeping my defenses strong. I'm setting boundaries and taking care of myself.
Or...I'm just too scared of real intimacy to take the risk.
If I could decide one way or the other, then I'd really have something :)
Posted by raisinb on March 29, 2008, at 11:44:50
In reply to Re: well » seldomseen, posted by Phillipa on March 28, 2008, at 20:35:10
Thank you so, so much for all the support and wisdom. I have really been struggling this weekend, and this board saved me from feeling alone with the struggle :)
Posted by seldomseen on March 29, 2008, at 14:44:32
In reply to Re: Wise wise words » seldomseen, posted by raisinb on March 29, 2008, at 11:39:36
It's okay raisin. If it were easy then everyone would do it right?
What really sucked about my whole mess was that I couldn't trust myself to know what was safe and what wasn't.
I was just so accustomed to nothing being safe that the slightest hurt would set me on guard and shortly thereafter I was out of there.
For me it took a conscious decision to say "This may end up in the cr*pp*r and with me in the hospital, but I am going to trust this guy"
Needless to say, we didn't exactly ride off in the sunset together and the road has been bumpy.
But somedays he feels like this old pair of slippers that fits my feet perfectly.I talked so much about the same things over and over again, but finally I was able to internalize the relationship somewhat. It takes a long time.
FWIW, my T didn't say he cared about me until just a few years ago. Most of the work on this matter had to come from my end. Now it's just so obvious that we both care that we don't need to say it very much.
My thoughts are with you as you struggle with this. It is a long long road, but ultimately I think it leads to a very good place.
Posted by Daisym on March 29, 2008, at 22:50:10
In reply to Re: Wise wise words » raisinb, posted by seldomseen on March 29, 2008, at 14:44:32
I think the inconsistency would drive me crazy too. There are times when I think my therapist has withdrawn or is distracted and I will usually ask if he is OK. More often, I'll bring it up the next session - "you seemed distant yesterday" or something like that. Often he reflects on it and will tell me if he agrees or doesn't - but I'd say more than half the time we trace it back to either me or the subject. I'm not saying it is all you here - but the combination of both you obviously goes astray at times.
The only other thing I'll add is about good sessions - I bet many people here would agree with what you said about maybe one really good session every couple of weeks. I think therapy is a cycle of climbing to the top of mountains - fighting your way up an overgrown path or even cutting the D@mn path yourself! Sometimes you slide down, further than you were before and you begin again. And then there are those sessions when you get to the top - and man does that feel good! And for a few sessions it is downhill - easier, but downhill picks up speed and might get out of control and then you have to climb all over again.
One of the things I've actually learned is that when something is super important to me I will ask my therapist directly to tell me how he feels about it. It is sometimes easier to accept disappointment when you understand more about someone's thought process or reasoning. Can you ask her, "why is it so hard for you to tell me that you care but you seem to be able to show it?"
I just hope you get to a less painful place soon.
Posted by Dinah on March 29, 2008, at 22:59:56
In reply to Re: Wise wise words, posted by Daisym on March 29, 2008, at 22:50:10
I agree completely with Daisy. One of the greatest advantages to therapy is being able to make what is usually unspoken, spoken. I've often found my best experiences come from the sort of question Daisy describes.
Posted by raisinb on March 30, 2008, at 21:35:14
In reply to Re: Wise wise words, posted by Daisym on March 29, 2008, at 22:50:10
Daisy, I can't imagine asking her that, which tells me that it might be something I should think about.
I've internalized a lot of her caring--or what I've interpreted as caring--over the course of the therapy, to where I feel it's a part of me. Yet I've never asked her directly whether she does or not, and I am terrified that I was wrong. Then I'd lose something huge.
In theory, nothing should be unspoken; in practice, her answer, if it's evasive or unsatisfactory, might just undo a lot of stuff I need to rely on. Sucks.
Posted by raisinb on March 30, 2008, at 21:59:16
In reply to Re: Wise wise words, posted by Dinah on March 29, 2008, at 22:59:56
Dinah, I love that idea, and I am quite an outspoken person in general.
There is something about my T's tight boundaries, her emotional withholding, though, that creates areas of "unspoken"-ness. She does not express her emotions directly, and it seems like this makes the air in the room very...like the expression of emotion is wrong or disallowed. I know she thinks that her lack of expression makes room for my expression, but that isn't the case for me, which I've tried to tell her. I'm not sure how much is my discomfort with my own vulnerability and how much is her.
There are so many things I end up talking around, and she ends up talking around, and all the while the emotional climate doesn't seem to match the words on the table. It is much more intense than the things we say. (I don't know if I'm expressing this at all clearly in this post, either, which is ironic :)).
I have a tendency, though, to become very tight-lipped when I care about a relationship, and so I know I am contributing to the dynamic.
My T has said she often is silent with me because she feels that her words don't express what she feels--"that I want to be here with you," or that "my words aren't getting through."
I think that ends up being the case (with lots of different emotions--intense anger, dislike, love, etc.) with many of our sessions. It is like we have a big well that both of us step carefully around.
Anyway, that is rambling, and probably nonsensical, but I am struggling so much with this because of this feeling I am describing. It is hard when I'm in there to even talk at all sometimes, much less say things that entail big risks.
Posted by Dinah on March 30, 2008, at 22:20:00
In reply to Re: Wise wise words » Dinah, posted by raisinb on March 30, 2008, at 21:59:16
I thought that was very articulate. Can you bring in your post (cut and paste in word, if you don't want her to know about Babble)?
I did that a lot for quite a long time. Even now, when I'm afraid that what I want to express is too complex for me to say coherently out loud, I might bring in something in writing.
It's just an idea. You know the dynamic between the two of you better than I do. Certainly my attempts at openness with biofeedback guy did not go at all well. I feel very fortunate that my therapist is inordinately open to that.
This is the end of the thread.
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