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Dr. Bob is Robert Hsiung, MD,
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Posted by noa on April 28, 2003, at 16:20:18
In reply to Re: Forever therapy » mair, posted by Dinah on April 27, 2003, at 13:58:52
Chiming in to this interesting thread....
Thank you Dinah, for seeing me as grounded. I think that I do owe whatever groundedness I have to all the therapy I've had, and (shall I also say?), to the work I have done in therapy.
I have had waves of depressive illness of varying severity, but my "baseline" before I ever started therapy also was problematic--I was a basket case of anxiety and lack of self esteem, and probably what is now termed "social phobia". OK, these are still "issues" but nowhere near what they were before therapy.
I do believe it helps but I also have at times felt like it was hard to see progress or that the progress was too slow, and feeling really frustrated with myself. But usually, those feelings were during depressed times. Or, when I was not quite ready to deal with some stuff that I was afraid would overwhelm me. Going to twice a week helped because it is easier to open up hard issues knowing that I don't have to close up for a whole week again. Overall, I most definitely see progress and how much therapy has helped me.
However, I think a good "fit" with a therapist is key. I think not only can progress not happen with a therapist who is a bad "fit", but it can make things worse. I saw this with a good friend of mine who got more and more depressed over time. What she had told me and another friend about her therapist had always kind of disturbed us, and when we saw her going way down hill fast, we just urged her as strongly as we could to get out of the therapy and find someone else. She did get out, and it has been taking a while to heal from that experience, but it was pretty clear that she was better off without therapy than with that particular therapist. She is just starting to look for a new therapist after taking a year and a half off from therapy.
Posted by Dinah on April 28, 2003, at 20:13:27
In reply to Re: Forever therapy » Dinah, posted by noa on April 28, 2003, at 16:20:18
You should definitely also say the work you've done in therapy. :) I'm sorry I didn't add that. I'm sure it's possible to go to therapy interminably and not improve at all if you don't use it wisely.
But that leads to the big questions. What does hard work in therapy really look like? How do you know if you're really doing it? My therapist usually congratulates me on my hard work when I've emoted all over the place or when he's pushed me to the point where I lose my temper. Is that really what hard work is?
And also, how do you know if your therapist is the right fit for you? I know that sounds like a silly question, but like with romance, when you're in a relationship it's hard to judge it objectively.
Is a good session where you feel better than when you came in? Or is it when you walk in feeling fine and leave sick and shaky? How about a reasonable mix of both of those?
Sometimes I think it would be nice if therapy wasn't quite so private. If maybe once a year or so you went in for an exam, where a third party evaluates what's going on. On the other hand, I'd rip the throat out of anyone who jeopardized my therapuetic relationship (metaphorically of course).
Posted by mair on April 29, 2003, at 21:20:07
In reply to Re: Forever therapy » noa, posted by Dinah on April 28, 2003, at 20:13:27
Dinah, those are all good questions. I'm frequently baffled by my inability to really quantify the benefits of therapy - other than the obvious benefit of having someone who sees that I'm slipping into a deeper depression far sooner than I do and who is there when I'm pretty much falling apart.
Most of the other benefits are those recognized in retrospect. Something routinely traumatic will happen and I'll realize that I haven't reacted as badly as I would before. We've spent alot of time hashing through work issues and while all of those issues are still there, I just seem to be able to distance myself from office turmoil better than I used to.
But of course the benefits are obscured by periodic episodes of depression, and by the difficulty I still have opening up to my therapist on all sorts of fronts. The relationship issues which seem to be interconnected to my very low self esteem are still troublesome, and since I'm so reluctant to really tackle these in therapy, I continually think it's just beyond my ability to progress as far as I need to.
I've also wondered about the "fit." I like my therapist alot and think she's very competent, but I'm rarely blown away by her insight or her intuitiveness. It's been a struggle for me to form a bond or connection to her. But I think all that says more about me than it does her, and more about why she wants me there twice a week. Lacking all that, what keeps me going, I guess, is her incredible patience and unending optimism that we can get where I want to go.
Mair
PS: I too, have no clue what hard work is. I've told her before that I frequently feel that she is the only one of the 2 of us who is actually working. She seems mystified that I could feel this way since therapy is often just very difficult for me. But i don't equate hard work with being very uncomfortable. The fact that I spend an inordinate amount of time in many sessions staring at the clock or figuring out how I can get out of there as soon as possible, (a trapped animal comes to mind), doesn't mean I'm working hard but rather that I'm trying to avoid working.
Posted by Dinah on April 29, 2003, at 22:54:54
In reply to Re: Forever therapy- Noa Dinah, posted by mair on April 29, 2003, at 21:20:07
I'm trying to decide if I have ever stared at the clock. Except to see how much time I had left. It never seems like there is enough time. Whatever issue we are discussing takes up the full session, and I usually have things I want to ask from the previous session as well. I don't know how I did it at once a week.
He likes to leave me with at least one question to think about from one session to the next, although he isn't obvious enough to be irritating about it.
Posted by mair on April 30, 2003, at 7:39:21
In reply to Re: Forever therapy- Noa Dinah » mair, posted by Dinah on April 29, 2003, at 22:54:54
I guess "stare at the clock" isn't precisely accurate. Like you, I do have many sessions where I glance at it and see that there's far less time than I might want. But I also have sessions where I'll glance at the clock at a difficult moment and be horrified to see that there is too much time left. I won't then start at the clock, but I will continually glance at it and my therapist does notice this. I've also fended off difficult questions with a remark that there is not enough time to answer it.
When things are more difficult, I have a great deal of trouble maintaining eye contact. If I'm not staring at the clock, my eyes are locked into something else, like a point on the arm chair I sit in or a point in a picture on the wall. I definitely try to withdraw.
I'm amazed you can "chew" on things between sessions. It's horrifying to me how much I forget from one session to the next - I may remember how I felt when I left, but can't seem to put my finger on why. It's good that she takes notes.
My tendency to forget (and to avoid cogitating about what we talked about) is a liability to progress, and yet another thing I can criticize myself for.
Mair
Posted by Dinah on April 30, 2003, at 7:59:22
In reply to Re: Forever therapy- Noa Dinah » Dinah, posted by mair on April 30, 2003, at 7:39:21
Don't criticize yourself for that, Mair. "Forgetting" is a self protective measure and probably enables you to go to work and function ok, which I'm not always able to do if the subject matter is difficult. And I am fuzzy on a lot of details sometimes, again depending on what was discussed. I guess my mind just picks up on a question he asked that I wasn't able to answer and in true obsessive fashion, focusses on it.
As far as eye contact - I have only a rough idea of what my therapist looks like. But I can describe in detail his office, his rug, and most especially his shoes. (grin) His voice is what I focus on. I'm pretty sure it's not uncommon to have difficulty making eye contact.
Mair, don't be so hard on yourself. You've made a lot of progress, from what you've said. Not spinning as far out of control over things is a big improvement. Does your therapist think you're making progress?
Posted by fallsfall on April 30, 2003, at 9:56:46
In reply to Re: Forever therapy- Noa Dinah » mair, posted by Dinah on April 30, 2003, at 7:59:22
I saw my therapist yesterday and I am still alive to write about it. My homework was to make a list of the needs that she satisfies (describe the way in which I am dependent). I was terrified - terrified that I would be right and terrified that I would be wrong and she would think I was an idiot (she found that funny in an endearing kind of way - she hasn't thought me an idiot in 8 years, why would she start now?).
The needs go like this: I need her to verify my worth - my goodness. I used to define my worth by what I accomplished (work, kids, ice skating). But these days I don't accomplish anything, so I look to her for my worth. If she were gone, I would be neither good nor bad - I would be empty. I would have no self because my self is defined by her. I would have no goals or future because I had no self. I would be worthless because I would have no self, so I would be unable to do anything.
She was clearly impressed by the work that I had done. She seemed to be in agreement. She said that to create/find (?) myself that I need to get out in the world. That messages from the world would help me define who I am. It seems strange that something so simple (getting a life) could fix something so fundamental.
She had also presented my case to her peer supervision group - I guess I'm her problem child. They suggested reducing to every other week in September. They also said that if I am still this distressed in September that I should switch therapists (I agree with that).
For now, I am keeping my mind busy so I can't think. I read Psychology books that I get at the University library. If I let my mind think, I cry.
Somehow I don't think I'll get my forever therapy.
Thanks for listening
Posted by Dinah on April 30, 2003, at 10:21:47
In reply to Re: Forever therapy, posted by fallsfall on April 30, 2003, at 9:56:46
I am so sorry. I can't quite imagine what her supervisory group is thinking. This sounds more like her problem than yours. But I guess it's right in that if she can't professionally handle your dependency needs, you should find another therapist who can, for your own sake.
I need to be even more appreciative of my therapist now. (Is that even possible?)
Posted by fallsfall on April 30, 2003, at 10:51:28
In reply to Re: Forever therapy » fallsfall, posted by Dinah on April 30, 2003, at 10:21:47
They are saying that if I am still miserable in September that she is not helping me. I have been miserable for 2 months now, if I am still miserable in 4 months, I think that is enough. This pain level is extremely high. I don't want more than 6 months of it.
It is getting better (slowly) so I don't think that will be an issue. I'm feeling like she understands a little better - that she is listening better.
So I take a deep breath and try to decide if I will think too much if I take my dogs for a walk.
Thank you, Dinah.
Posted by allisonf on May 1, 2003, at 16:21:15
In reply to Re: Forever therapy » allisonf, posted by Dinah on April 28, 2003, at 12:22:41
Thanks, Dinah, for seeing this crazy stuff with my therapist in a positive way. This is why I haven't tried to switch therapists. I'm convinced that this is some mechanism to deal with my hypomanic energy (even tho the obsessive thinking that goes on isn't very pleasant)and that I will just end up in love with the next therapist the same way. That's why, fallsfall, it just seems unfair that your therapist wants to go to every other week or to terminate in Sept. if you're not feeling better about the dependency thing. And you've been with her 8 years! The fact that *she* (or her supervision group) is instigating it makes it seem like she's the one with the issue to work out there. I think it's marvelous that you were able to be so honest with yourself about your self definition/self worth and then be so open with her about it. That's what I think is good work in therapy. I have an optomistic view that stuff like that really helps you function better outside of therapy in the long run.
I am so sensitive to this issue b/c I've been going thru something sort of similar with my therapist, tho my dependency on her is packaged in a romantic infatuation rather than the more honest way yours is. I was inspired by you and Dinah and this week, and I did talk to her about the transference issues in therapy. I didn't end up discussing the bracelet tho I did talk about the self-disclosure piece which she already knew anyway. BTW, Dinah, it was really interesting to me that self-disclosure doesn't really affect you the same way. I swear, we need more books like In Session. Therapy is too private an experience (like you said in an earlier post) and I am always wondering if other clients go thru what I do. Like not being able to make eye contact. Until you all were posting about it, I thought I was the only one.
Anyway, therapy was kind of a bummer, b/c even tho our rapport was good, I got the impression that she was uncomfortable with the topic. Like she ended the session 5 minutes early. She has *never* in all the years I've known her, ended early & she routinely keeps me about 10-15 minutes late. I ended up having a 1/2 phone session yesterday to clear things up. That went really well. She assured me that I can discuss my feelings for her in therapy, and that I shouldn't worry about making her uncomfortable b/c she has other people to go to if she needs support. And no, I didn't bring up the ending early b/c she ended up keeping me a lot later than 1/2 of a session on the phone. (And I chickened out). The whole thing made me really want to work thru this tho...and my plan was exactly what you have been talking about, fallsfall: getting a life. I'm hoping there's something to that. That if I was in school or had a job (I'm home with my kids now), and had less time to obsess about therapy & less time to write about my therapist, that I would get past this dependency thing quicker. Oh, I don't know...
Posted by mair on May 1, 2003, at 21:03:07
In reply to Re: Forever therapy, posted by allisonf on May 1, 2003, at 16:21:15
You surely aren't unique. Dinah recommended "In Session" to me a while ago, and my reaction to it was that I was just so astounded at what people could discuss with their therapists. My therapist says she's trying to get me to a place where I feel that I can say anything to her with the knowledge that she won't reject me because of it. Her notion is to give me what she calls Corrective emotional experiences, the thought being that if I can get close to her without experiencing rejection I'll be more willing to get closer to others. I really admire the extent to which you and Dinah and others are able to be pretty candid in therapy.
Obviously to many therapists there is real value in having a patient develop some dependency - I think you're right that fallsfall's therapist's supervisory group likely sees a problem with the therapist and not with fallsfall.
Mair
PS: year's ago when I first started being treated for a second episode of major depression, my husband went to a couple of my sessions with my then - psychiatrist who was also my therapist. The main reason for bringing him in was to make him more aware of what was going on with me. I remember him saying something to my doc about how he was fine with all of this, but he just didn't want me to get really dependent on therapy. (pretty laughable now after about 5 or 6 years of therapy) Anyway my pdoc made a statement that a little dependency would be a really good thing for me. We never discussed it more but I've come to understand how right he really was and how very difficult that is for me.
Posted by Pfinstegg on May 1, 2003, at 23:05:34
In reply to Re: Forever therapy » allisonf, posted by mair on May 1, 2003, at 21:03:07
These are just the most moving, honest and intelligent posts; the therapists are fortunate to have patients like you, who are aware of all the emotional complexities, and the pain, fear, hope and longing which we all bring to each session. If anyone continually feels that their therapist is not fully accepting of who they are, and of all the feelings they are bringing to their sessions, including dependency, really consider changing therapists. The fault is not in you- you are doing the only thing you can- being your authentic self. But not all therapists can really accept and contain all the feelings of every patient they encounter. Sometimes the therapist has emotional blind spots, insufficient or inappropriate training, or the "fit" just isn't good. Intelligent, insightful, emotionally complex and complete people like you deserve only excellent therapists who feel right to you!
Pfinstegg
Posted by Dinah on May 2, 2003, at 9:05:22
In reply to Re: Forever therapy, posted by allisonf on May 1, 2003, at 16:21:15
I'm glad you were able to work it out, Allison. I always feel just awful when I think my therapist and I are out of charity with one another, and I usually call him to check it out.
Congratulations on having the courage to talk to her about it. And congratulations to her for recognizing that whatever discomfort she has is her own issue to deal with. Sounds like you've got a winner.
Posted by fallsfall on May 2, 2003, at 17:23:39
In reply to Re: Forever therapy » allisonf, posted by Dinah on May 2, 2003, at 9:05:22
Hi Dinah,
This is in response to your question on Psycho-Social-Babble (Lost my Therapist).
Yeah, I saw my old group therapist once in March. She was very helpful. She saw me without my regular therapist knowing. She said that she would be happy to see me again and/or do a consult if I wanted (but that if she was going to see me more than that one time she wanted my regular therapist to be notified.)
My regular therapist told me later that I should feel free to see her, or my Pdoc if I need to. I've seen my Pdoc twice when he's wanted to "talk about it". The problem is that he says too much and talks too long and by the time I get out of there I'm really upset. I will either have to control the sessions or see him only about meds.
I don't know if I will see the group therapist again. My regular therapist and I are starting to get to the point where things are getting a little clearer and more concrete. I'm most likely to see the group therapist if I disagree strongly with my regular therapist (How can I? She's perfect.), or I'm having trouble understanding what is going on.
My Pdoc really spooked me about how hard it is to break a dependency like mine. Sometimes I wonder if it wouldn't be easier to terminate with my regular therapist and start with someone else. I don't want to do that, but I am very afraid of the pain. I'm trying to give my regular therapist a chance to clear things up.
Thanks for caring.
Posted by Dinah on May 2, 2003, at 19:50:08
In reply to Re: Forever therapy » Dinah, posted by fallsfall on May 2, 2003, at 17:23:39
It sounds like you're doing everything you can and should do. I do hope it works out for you.
If it's any comfort to you, I eventually worked through the painful part of my dependency feelings. Every once in a while something will stir up abandonment fears, but for the most part I'm quite happily and comfortably dependent. (I mean that as a good thing, although it didn't come out that way.)
Posted by allisonf on May 2, 2003, at 23:24:16
In reply to Re: Forever therapy » allisonf, posted by mair on May 1, 2003, at 21:03:07
Thanks for your support. Sometimes I feel like I'm not quite honest enough with my therapist (like not telling her that I was upset she ended early) but then I also think there are times when things are better left unsaid, as long as the issue can be resolved somewhat (like my main concern about her ending early was that she was upset, and she told me she wasn't, so...).
Also, I think the fact that you have so much insight about what's going on with your therapist re: the trust issue, is most of the battle. My therapist speaks of the same corrective emotional experiences concept as your therapist, calling it reparenting. I don't know how many times I have reacted to something she says, and she has replied, "Just to remind you, I'm not your mother".
Best of luck with your therapy--
Allison
Posted by allisonf on May 2, 2003, at 23:36:03
In reply to Re: Forever therapy » allisonf, posted by Dinah on May 2, 2003, at 9:05:22
Thanks. Last week I was reading some of "To those with therapists..." above, and I was thinking about how you called your therapist when you thought he was upset about his mother's death (was that right?)...and it made me think that calling to ck in with my therapist was the right option for me this week.
Also, I will pass along your compliments to her! :)
Allison
Posted by allisonf on May 2, 2003, at 23:39:14
In reply to Re: Forever therapy » allisonf, posted by Dinah on May 2, 2003, at 9:05:22
Oops. I apologize about th wording of my previous message. Obviously, your therapist was upset by the situation...you just wanted to make sure he was doing ok.
Posted by fallsfall on May 4, 2003, at 21:30:15
In reply to Re: Forever therapy » Dinah, posted by allisonf on May 2, 2003, at 23:39:14
I am very dependent on my therapist, but I'm trying to "behave" and do the normal thing. I had a dream this morning - very detailed, long, and clear. It was about my therapist and me. It clearly says a lot about the way I see her, the way I see our relationship, the hopes/fears I have for therapy. I have a strong urge to drop a copy off at her office Monday. I see her on Wednesday. But I'm afraid that it will be seen as the equivalent of calling between sessions, i.e. being dependent. The last thing I want to do is make her mad.
Why do I want her to have it before the session? I'm not expecting her to call me. I want her to have some time to think about it before I see her. In some sense, I want her to have to do some work (it does feel to me that I'm doing all the work these days). Otherwise, she/I will read it and she'll ask me what I think and I'll tell her and I won't find out what she thinks. (that's unfair, if I asked her she would tell me)
Also we only got through about half of what we wanted to talk about last week. If I drop it off then we won't spend session time reading it.
I never dream, so this is an event - I'm excited, won't she be excited?
So is dropping it off "dependent"?
Posted by Dinah on May 4, 2003, at 21:43:33
In reply to Between Forever Therapy Sessions, posted by fallsfall on May 4, 2003, at 21:30:15
I get those urges too, sometimes. But the one time I've been moved to contact him between sessions with my truly stunning insight, it ended up not being all that satisfying.
So based on my own less than wonderful experience, I'd wait to give it to her. And perhaps it will be extra special unwrapping the gift together, so to speak.
I do understand the not wanting to fill up the session though. I have got so extra much to tell him tomorrow, because so much happened when he was out of town, that I wish he had a two hour stretch to give me. It's going to feel like forever until Friday when I see him next. It's going to take all I have to resist scheduling an extra appointment. Unfortunately, I know he'd be willing enough to do that.
That fifty minute hour is just not long enough.
Posted by Eggy on May 4, 2003, at 22:40:19
In reply to Re: Forever therapy » Dinah, posted by fallsfall on April 21, 2003, at 10:22:03
Posted by fallsfall on May 4, 2003, at 23:33:05
In reply to Re: Between Forever Therapy Sessions » fallsfall, posted by Dinah on May 4, 2003, at 21:43:33
Some times in the past I have left her journalling. She always acknowledged getting it, and didn't seem to have a problem with it. She would call me if I didn't say she didn't need to.
But, you are right, it is probably better to err on the side of caution. I will control myself and keep it until Wednesday.
My therapist has reduced her sessions to 45 minutes, and I only get one per week. Enjoy your 100 minutes!
Thanks for your voice of reason.
Posted by fallsfall on May 4, 2003, at 23:37:25
In reply to Go here...LINK, posted by Eggy on May 4, 2003, at 22:40:19
WOW
Very sobering.
Posted by Dinah on May 5, 2003, at 3:29:05
In reply to Re: Between Forever Therapy Sessions » Dinah, posted by fallsfall on May 4, 2003, at 23:33:05
Well, I do hate to be a voice of reason. :) Really.
It sounds like her attitude is different. Mine has no particular problem scheduling extra sessions or moving them up (except that one time I was so excited about my insight - I'm assuming my timing was genuinely bad). But asking him to read something outside session or talking ot him on the phone between sessions isn't all that useful. He's just not good on the phone and never has been. And he's forgetful to the extreme, Or draws really good boundaries, something like that.
So my suggestion was based on my therapist, and yours might have different strenghts and weaknesses.
I know I'm pretty lucky having the time I do have with him a week. I also feel pretty self indulgent about it. I'm sorry your therapist has cut you to 45 minutes, was that from 50 minutes? Was it a sort of fee increase, or was it based on the perception of your dependency? I'm sorry if you've told me that already. My brain has been whirling this past week.
Posted by fallsfall on May 5, 2003, at 9:32:13
In reply to Re: Between Forever Therapy Sessions » fallsfall, posted by Dinah on May 5, 2003, at 3:29:05
I wasn't singled out, the 45 minute sessions are for all of her clients. It was in the last 6 months, I think. She didn't tell me, it was in an agreement I signed in January - so maybe that was when it happened. Someday I'll ask her about it.
She has seen me for extra sessions in the past. I remember the first time I was suicidal she saw me at 5 - that is when she goes home, so she stayed late for me. I've only done extra sessions when it is really an emergency, and she hasn't had a problem with my definition of "emergency". But I know she would not want to see me now unless I needed to go into the hospital (and we've done that over the phone in the past - she was on her cell phone driving back from 6 hours away on a Sunday). She would say that I need to be more independent and handle things on my own rather than depending on her. It still feels like I am doing the hardest therapy work yet by myself (guess that is why she says I'm dependent). I don't know. I am starting to feel a little better, I've been taking the dogs for a walk, blowing last fall's leaves, maybe I'll do some laundry or go grocery shopping today. So she'll take that as a sign of improvement and think that what she's doing is good, sigh.
I think that 6 months ago my description of her wouldn't be all that different from your description of your therapist.
I really appreciate your insight, I'm not objective, and my friends aren't really objective either (they see my pain up close and personal).
8^)
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