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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by floatingbridge on August 15, 2011, at 14:31:03
As I read along here, the majority (it seems) have been in longer term therapeutic alliances.
Why would, when something starts out o.k., it go so horribly wrong? Enough that there is no repair. Even with good intentions.
I have seen this mentioned. Toxic therapy was mentioned.
This just happens? I can see, pretty well I think, considering I was the patient, how things fed into my fear loop and I
exited as re-traumatized.But from a therapist's view, how does this happen? It was not this fellows intent to re-traumatize me. He doesn't have devil horns. But why does someone really stop listening?
I am extricating myself from self-blame. Breaking with this therapist was good for me. I actually don't think he ever really saw just me. Plain old me.
Therapists are just people. Why did I think he was different than he was, as in more capable? Like I wanted to believe
the alter-self that he saw as me, and that I finally had to reject...?I admire some of you for how you work it out with your therapists so directly. The first and only time I ever shouted
at this (or any) therapist to shut the f*ck up you are driving me nuts! I was mortified. I have never shouted at a doctor before. Much less anyone with such a statement.I see here some of you have said similar things to your therapists.....
I don't think I could ever engage like that again. But as I read along, I also see some of you able to swing back to a baseline of being o.k. I suppose like a 'real life' relationship with resiliency.....
Posted by emmanuel98 on August 15, 2011, at 20:08:24
In reply to Transference and why some alliances go bad?, posted by floatingbridge on August 15, 2011, at 14:31:03
My relationship with my p-doc is becoming unhealthy in some ways I think. I saw him today. I have been feeling depressed again and am fighting this hard with DBT. He is no longer my primary therapist. He has told me he doesn't know what to do if I bottom out again. He is out of ideas and thinks the DBT is the only hope for me. I tend to agree.
But today, I felt really bad and felt he didn't care and didn't want to deal with another round of this. This is no longer his problem. He has already told me he can't help me, doesn't know what else to do besides encourage me with the DBT.
Maybe I should stop seeing him. I only see him every other week. But it still pains me to imagine a life without him. But it pained me today to realize that he doesn't really see himself as taking care of me anymore. He just sees me because I want to see him, not because he wants to see me and feels he can help.
I have never gotten angry with him. Even if he is wrong, I feel hurt rather than angry. I wish I could get angry with him and feel that he would not just be dismissive and contemptuous. I don't understand how people can fight with their therapists. Maybe I would be less sensitive to him if I could get mad at him.
I hate this transference stuff. It's been unimaginably painful for me and it doesn't seem to end. Will it ever end? I don't feel this way about my DBT therapist. Just him.
Posted by Dinah on August 15, 2011, at 20:21:30
In reply to Re: Transference and why some alliances go bad?, posted by emmanuel98 on August 15, 2011, at 20:08:24
It's hard. It really is.
Posted by Dinah on August 15, 2011, at 20:33:17
In reply to Transference and why some alliances go bad?, posted by floatingbridge on August 15, 2011, at 14:31:03
I think that swing to ok has always been the thing that has taught me the most in therapy. To value someone warts and all, and recognize that they can be valuable in your life even when they are jerks.
I think my therapeutic relationship has been deepened by fighting to relationship. There's more than one way to fight. The kind that hurts the relationship is when one or both parties hurl accusations then shut themselves off. The kind that helps is when both parties open themselves up instead of shutting themselves off. And are open and vulnerable about how they feel. "When you... I feel..." or "When you... what I hear is ... Is this what you mean to say?" "Maintaining a relationship with you is very important to me, but right now I'm furious with you."
I think my therapist is particularly skilled at this (thank heavens) and has taught me a lot. I just wish he didn't have to exhibit this skill so often.
My guess is that it's all related to finding balance in life. Things aren't all rah rah, or all doom and gloom. My therapist is an idiot at times, and he's helpful at times. Sometimes he seems all idiot, and sometimes he seems all helpful. I'm a good client some of the time, and a difficult and annoying client some of the time. And while he might get sick of me sometimes, he is usually also able to hold the other image of me at the same time.
I don't know if I can explain it well. And it's got to be a two way street. Some therapists have no skill or inclination to fighting to relationship.
Posted by floatingbridge on August 15, 2011, at 22:17:49
In reply to Re: Transference and why some alliances go bad?, posted by emmanuel98 on August 15, 2011, at 20:08:24
emmanuel,
So your dbt therapist is now considered your primary?
Maybe anger isn't appropriate at this moment. I don't know. The loss you write about is very moving to me. Maybe that could be something to discuss or just say.
I'm not real pleased to have gotten so angry. Anger is powerful, but only part of my experience. Behind the anger
was and is a well of pain that I will likely never express to this man.Very best wishes, e.
Posted by Daisym on August 15, 2011, at 23:36:13
In reply to Re: Transference and why some alliances go bad? » emmanuel98, posted by floatingbridge on August 15, 2011, at 22:17:49
This is one of those subjects that we might win the noble prize for if we could find the answer. I think "fit" is really, really important and internal resilience. More on the therapist than on the patient. In long term therapy, I think the relationship goes through a "teen-age" stage. Once a safe base is established, exploration becomes necessary. But exploring alone is scary and painful. We lash out at the safe base, who takes it and takes it, and then can't anymore. No one wants to feel like a failure and long term clients provide a unique opportunity for therapists to feel frustrated and like failures.
But - and a really big but here - there are so many opportunities for growing and skill building. Teens usually grow into really nice people. And the foundation on which the relationship was started, provides a lovely, life-long anchor in this world. The rewards can be enormous - and make a therapist feel so very proud of themselves and the patient.
Human. We are all so human. And we really don't want our therapists to be...or our parents.
But for sure, long term therapy is not for the feint of heart. On either side.
Posted by floatingbridge on August 16, 2011, at 0:01:11
In reply to Re: Transference and why some alliances go bad? » floatingbridge, posted by Dinah on August 15, 2011, at 20:33:17
>And while he might get sick of me sometimes, he is usually also able to hold the other image of me at the same time.
Well that right there says quite a bit.
I guess as you say, it takes two. I told my husband I can stay home and get counter transference for free. He
laughed. He likes that sort of humor. Thank goodness.I can think of seeing this new therapist as another opportunity to have a real conversation rather than give into only the apprehension I feel about dragging the old stuff with me. I did learn skills and a new sense of strength. Even if it was by dissension and ultimately saying no to someone else's perceptions of me. It's not denial, as I was repeatedly told as I resisted. It was self-discovery and affirmation. It took awhile to parse out, denial and simply not agreeing. It'll be on-going.....
Posted by floatingbridge on August 16, 2011, at 0:30:45
In reply to Re: Transference and why some alliances go bad? » floatingbridge, posted by Daisym on August 15, 2011, at 23:36:13
Thanks Daisy. I did want him to be perfect. Jeez. I wanted to be perfect. But then I didn't anymore. Well, more realized as you said, perfection is not the human condition. And after years of struggling against being 'medicated' I came to a testy embrace of medication as a part of my life. But as a pdoc/t, he began 'withholding' medication, now that I think about it, along with his approval. That was dangerous.
Speaking of the feint of heart, I have invoked what I call my version of the separation of church and state. Henceforth, the prescriber shall not be the therapist.
I hope the base that was created when the old therapy was working is what I take to the new.
I like the idea of a Nobel prize for the members of babble :-)
Posted by lucielu2 on August 16, 2011, at 16:58:03
In reply to Transference and why some alliances go bad?, posted by floatingbridge on August 15, 2011, at 14:31:03
FB, I wish I knew the answer to your question. Long term relationships, whether between T and client or peers, can go terribly wrong. Literature is full of these because they are so tragic. It is all the worse with a T, because the relationship is not equal and the stakes are so very high.
As for expressing anger, I have shouted at my T, even cursed at him on a few occasions. And he took it. But that was in the early days, when I was still a "wild child." But as my therapy progressed, I learned to fight with him more maturely, i.e. to have open and honest disagreements with him. And even so, sometimes we simply have to agree to disagree. I think this was one of the more valuable things I've gotten out of therapy. I do think that my getting very angry with him and working it out with him would be something he would take a lot of pride in, and I should too.
I don't know what it would take to completely poison this relationship. But we are both humans, so the possibility always exists.
Posted by mellow on August 17, 2011, at 2:56:52
In reply to Transference and why some alliances go bad?, posted by floatingbridge on August 15, 2011, at 14:31:03
I have had some therapeutic relationships breakdown over time. In one case I had a very controlling therapist who was really not well herself. In other instances I went into the hospital and never went back to continue the relationship. I have been seeing my current pdoc for 4 years and my current T for 2.5. They are in the same practice.
I find there can be a great deal of emotions transferred in my case. Usually when I can't pin point what is bugging me I get sort of angry with my treatment team. I really don't have anyone in my life I can talk to like my therapist. We actually made a real breakthrough this afternoon. I told her some darker stuff that goes through my head and she didn't even blink. I had been holding onto it for months feeling like she could hold hospitalization over my head if I disclosed too much.
My wife is my best friend and we can talk about just about anything, but my relationship with my T is situated in a way that I don't feel like a burden so I can be totally open. I can bitch for an hour if I want to. Sometimes I can be an jerk. I've even gotten passive aggressive with her and accused her and her practice of benefiting financially from so many people's misery rather than being good hearted. I felt bad about that, but she didn't judge me for it. She knew I was in a bad place that day.
I think for many reasons the relationship can get messed up. By giving someone emotional power or seeking their approval you can get pretty twisted when you aren't feeling well. If I'm not doing well I start to think I need to move on or that she isn't doing a good job. I question her methods etc. Then I have a lot of guilt and feel like I'm putting up an emotional wall for thinking about "leaving".
I have anticipation for our sessions all week and when I don't find a lot of resolve in our session I sometimes transfer that disappointment or fear as anger at her. I do the same thing with my pdoc. For these and so many other reasons the relationship can get weird and I don't even do Freudian stuff. It's not very deep. She does patient center therapy. She studied Karl Rogers a lot. There is CBT woven in as well, but for the most part it's about having a place to clear my mind. She's not big on the subconscious. If she was I'd be locked up lol... I can't imagine what it would be like if I were working with a true analyst.
All I can say is when I feel angry or disappointed with my T it usually has more to do with me needing a target for my frustration and nothing to do with her abilities. I can imagine it would be hard for her to watch me grow and then digress at times when I am not doing well, but overall I have made more progress than failure and she tells me I am a fun client.
Sorry for the long post. I hope it works out floating.
mellow
Posted by lucielu2 on August 17, 2011, at 3:42:12
In reply to Re: Transference and why some alliances go bad? » Daisym, posted by floatingbridge on August 16, 2011, at 0:30:45
> But as a pdoc/t, he began 'withholding' medication, now that I think about it, along
>with his approval. That was dangerous.>Speaking of the feint of heart, I have invoked what I call my version of the separation of church and state. Henceforth, the prescriber shall not be the therapist.
This sounds to me like a really good policy. My T and pdoc are not in the same practice and don't even agree with each other. My T has been treating me for trauma and depression for years and my pdoc has been medicating me for mood disorder. He is convinced it is biological. I don't see that they are mutually exclusive, and I can see both. It is good to have two different perspectives.
Posted by pegasus on August 18, 2011, at 12:05:57
In reply to Re: Transference and why some alliances go bad?, posted by lucielu2 on August 17, 2011, at 3:42:12
>My T has been treating me for trauma and depression for years and my pdoc has been medicating me for mood disorder. He is convinced it is biological. I don't see that they are mutually exclusive, and I can see both.
There is significant evidence these days that trauma and depression lead to biological changes. So, they could both be right. I think it makes sense that their different approaches can be helpful in different ways.
- P
Posted by floatingbridge on August 19, 2011, at 10:22:47
In reply to Re: Transference and why some alliances go bad? » lucielu2, posted by pegasus on August 18, 2011, at 12:05:57
> >My T has been treating me for trauma and depression for years and my pdoc has been medicating me for mood disorder. He is convinced it is biological. I don't see that they are mutually exclusive, and I can see both.
>
> There is significant evidence these days that trauma and depression lead to biological changes. So, they could both be right. I think it makes sense that their different approaches can be helpful in different ways.
>I believe this model. (I am this model?)
My new therapist, second visit, had an interesting observation as to why bad things happen between good people. She suggested that the majority of those drawn to medicine have
a considerable fix-it drive. When encountering conditions they cannot fix, they can turn their anger/whatever on the patient. She says she sees this often in her practice.She has a few other patients with, not only psychological issues, but the mystery illnesses, like CFS, fibromyalgia, migraines, IBS, and finds a part of her counseling time is counseling the fallout her clients experience seeking treatment (like doctors saying it's depression and giving up w/o attempting to address symptoms) and needing to live
with symptoms.I am still liking her. Though what I really need to talk about is painful. But, then, carrying it around is painful, too. We discussed EMDR again. She wants to go at my speed, I get to say stop, she will ask if we should slow down, but says she hasn't encountered untoward or destabilizing effects. She'd thinks clearing the top layer of the traumatic associations will help me see deeper issues underneath, whatever they may be. It's true that I have surface triggers. They are very concious, but loop w/o resolve, very unorganized, and like rogue waves when they hit hard.
Posted by floatingbridge on August 19, 2011, at 10:39:07
In reply to Re: Transference and why some alliances go bad? » floatingbridge, posted by mellow on August 17, 2011, at 2:56:52
Thanks for explaining some of your experience, mellow. Sounds like you do have a good therapeutic alliance with your therapist. She sounds upbeat herself, I don't know. I'm glad you were able to share some of that darker stuff with her. I find it's a great feeling when the other person doesn't flinch. I spend a lot of energy protecting my familymfrom the flotsam and jettison in my head.
In my old (the broken) alliance, there was a lot of tortture I endured, self inflicted because I wanted things resolved that session and would be disappointed. I was, I think, a very,very *needy* client in the first two years. It's wicked painful, and I did throw all sorts of stuff at my pdoc/t, though being who I am, it was internalized mostly. Things might have worked out better had I actually said more. Though we used to laugh about how I did tell him once I didn't think he could be my therapist because he drove a Lexus (do I have class issues?).
As time passes, I am tending to see that in some ways, this pdoc was controlling and maybe not so well himself, as you commented about an experience of your own. I am slowly movingmout of the shame place. My new therapist is already helping by just validating. She let me know that if I wanted to talk about my experience with this last doctor, she wouldn't consider me someone who walks around blaming other people and talking trash. So I did end up talking about him, and I did feel better. Because it really was so confusing.
Thanks mellow.
Posted by pegasus on August 19, 2011, at 11:01:14
In reply to Re: Transference and why some alliances go bad? » pegasus, posted by floatingbridge on August 19, 2011, at 10:22:47
I hear you on the triggers and waves. It sounds like you are pretty aware of what's going on with that, at least. I find that as my understanding of the phenomenon increases, it's incrementally easier to bear. I hope the same is true for you.
Interesting observation about docs. I agree that it seems not uncommon, at least among the folks who come here, to have experienced some level of hostility (unconscious or not) in doctors, when our symptoms aren't easily treated, or at least pigeonholed into a neat diagnosis. I think/hope one of the best things about working with a good T is that they are more used to that, and can help us cope with the experience better than an MD. Although, surely some Ts are better than others around clients who don't improve, as well.
- P
Posted by Solstice on August 19, 2011, at 17:19:40
In reply to Re: Transference and why some alliances go bad? » pegasus, posted by floatingbridge on August 19, 2011, at 10:22:47
Floating -
When I started therapy with my current therapist, I had No intention of saying one word about my previous failed therapeutic relationship. It was such a source of pain and shame, that I did not want to talk about it. I blamed myself. Some two or three months into therapy with my new therapist, though, I made a statement of fact about my being unable to sustain relationships. By that time, this therapist had learned enough about me to go down the list and bring up relationships that I had been (and was currently) successful at sustaining. Then came the *big* question: "So Solstice - what relationship is it that left you feeling so incompetent in relationships? There is something going on here that you aren't telling me.. and unless you tell me, I won't be able to help you." It was like a big ole light shined on my secret shame. But by then, a series of things that had taken place with this therapist had left me feeling like I was safe. So... I said it. I revealed that failed therapeutic relationship... and it ended up consuming a considerable amount of time from that point forward as I worked through the pain. That failed relationship had such a toxic effect on me, I thought I would never, ever heal. I was drowning in unbearable pain. but... my new therapist provided a therapeutic relationship that 'held' me throughout the process. It's been 3.5 years now.. and heal I did. It's probably been almost two years since I even mentioned my toxic therapist's name in therapy :-) And believe me - at times I thought the pain would kill me.
I would probably still be wrestling with that pain if I had not been confronted by my therapist about the secret pain I was holding onto.. where it could brought out into the open and worked through within a safe therapeutic relationship.
Solstice
Posted by floatingbridge on August 19, 2011, at 18:50:09
In reply to Re: Transference and why some alliances go bad? » floatingbridge, posted by Solstice on August 19, 2011, at 17:19:40
Solstice, thanks. I am very sorry you have experienced this. I can only say thanks for speaking about this. Because I really do go in and out of very painful places about this. That you, too, would generalize about that toxic relationship, well, I do that too. I said something not as concise to this new therapist, but, yeah, like this failure is all mine and runs a dart line through every unhappy relationship straight to childhood. Then I interpret it as an inability to maintain relationships....
I am glad you have healed. That's true encouragement :-)
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