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Dr. Bob is Robert Hsiung, MD,
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Posted by Dinah on January 20, 2005, at 6:47:55
In reply to boundaries, posted by just plain jane on January 19, 2005, at 21:41:53
It's just words, Jane. I happen to find therapy concepts interesting, and my therapists knows that. If your therapy concentrates on the therapeutic relationship at all, you probably discuss the same things but in different words. If your therapy doesn't "use" the therapeutic relationship, you probably don't. But that's ok, because there are all different sorts of therapies.
It's not as if we sat down to talk "boundaries". Well, ok we did today, but that was only because it was an extension of last session. Last session we sat down to discuss something else. And his thoughts were framed in terms of boundaries, because that's how he's trained. And he felt free to share those thoughts without reframing them in non-psych words because he's aware that I think in those terms as well.
And as it happens, it brought up some interesting and thought provoking observations on how I relate in general as well as on therapy and the therapeutic relationship. So it worked. Whatever works, right?
Posted by just plain jane on January 21, 2005, at 1:09:11
In reply to Re: boundaries » just plain jane, posted by Dinah on January 20, 2005, at 6:47:55
Posted by bimini on January 25, 2005, at 9:06:47
In reply to Re: oh my gosh, my boss did the same thing!, posted by gardenergirl on January 19, 2005, at 19:00:30
> "model good eye contact", but when I am the client, I am sure that I do not.
> ggWhen you talk to someone, eye contact is needed to assess response. When talked to, eye contact may be avoided. This maybe an attempt to not exhibit anything. I have wondered what I do myself, my family, my friends. Do we look into their eyes or away and when and why? Do I hold eye contact when I just babble and don't need to decode the response, is this mechanic and changes depending on how much input one wants or how much nonverbal information one wants to give?
OK, what do I want then, do I at least know that? (I'm just thinking loud here.) Cute, I mispelled one word and it *ed me, lol.
bimini
Posted by terrics on January 25, 2005, at 18:24:02
In reply to Re: boundaries » just plain jane, posted by Dinah on January 20, 2005, at 6:47:55
As most of you know, I have been doing DBT. Ms. ULTRA Boundary is my therapist. The first time I met her I said: you have very strict boundaries. She said yes and I am glad you see that and I expect you to respect them. I am on the verge of quitting as I would do just as well talking to my couch. Also I am beginning to think DBT is really just an overrated joke. I read stuff out loud to a friend and she also thought it was silly. It is SILLY. I am going to quit tomorrow. Se la vie. terrics
Posted by Dinah on January 25, 2005, at 18:54:44
In reply to Re: boundaries » Dinah, posted by terrics on January 25, 2005, at 18:24:02
I'll admit some of the DBT exercises seem silly. And strict adherence to any set of theories would probably annoy me to death. But I think you got an especially bad DBT teacher. lol. I think I'll let that stand. DBT does sound more like a learning experience than a therapy experience. But learning experiences can be helpful.
My therapist did a big boundary bender today. He let me use his computer to access this site and print out a post. And I did a big boundary bender by trusting him not to come back here. (He ostentatiously deleted his history file. He didn't need to. I had decided to trust him.)
Posted by gardenergirl on January 25, 2005, at 22:54:57
In reply to Re: model good eye contact » gardenergirl, posted by bimini on January 25, 2005, at 9:06:47
> > "model good eye contact", but when I am the client, I am sure that I do not.
> > gg
>
> When you talk to someone, eye contact is needed to assess response. When talked to, eye contact may be avoided. This maybe an attempt to not exhibit anything.Interesting...actually my supervisor was saying I model good eye contact as a listener as well as a speaker. I tend to have better eye contact when listening. Although I am convinced this is because I must rely in part on lip reading. I'm certain that when I take off my glasses I can't hear as well! :o
I have wondered what I do myself, my family, my friends. Do we look into their eyes or away and when and why? Do I hold eye contact when I just babble and don't need to decode the response, is this mechanic and changes depending on how much input one wants or how much nonverbal information one wants to give?
Interesting ideas here. I should try to pay attention to when my gaze shifts to see what is going on in the dialog.
gg
Posted by gardenergirl on January 25, 2005, at 22:57:52
In reply to Re: boundaries » Dinah, posted by terrics on January 25, 2005, at 18:24:02
> I read stuff out loud to a friend and she also thought it was silly. It is SILLY.
Oh, I am so curious as to what part you read...
I just started using some of the modules with a couple of my clients. I always worry that they will think it's juvenile.
I'm sorry it isn't working out for you.
gg
Posted by terrics on January 26, 2005, at 6:09:59
In reply to Re: boundaries » terrics, posted by gardenergirl on January 25, 2005, at 22:57:52
Hi GG, I will look later to see exactly what I said to her. Her comment was that we use the same stuff on our high function MR kids at work. When I thought about it I agreed with what she said. terrics
Posted by mair on January 26, 2005, at 21:47:26
In reply to Re: model good eye contact » bimini, posted by gardenergirl on January 25, 2005, at 22:54:57
GG - when you're with a client do you have trouble really listening?
As a client, I'm not always very good with eye contact, although I'm getting better. I do think I listen to my T better when I'm looking at her. Sometimes when I look away, I'm withdrawing and hearing but not listening. I think it makes feeling that connection harder.
I wonder about it from a T's perspective only because I find it hard to pay attention through whole session; (I mean during the time when my T is talking). I assume it must be hard for the T also.
My T takes alot of notes, because she says it helps her remember later on what was discussed, and I suppose, is a way for her to ensure that she doesn't miss anything. I never could figure out how Ts remember as much as they do without taking notes. HOWEVER - I'm starting to think there's a downside with notetaking. I think it's harder for me to make the connection that comes with eye contact if my T is looking down at a note pad. So I think she misses messages that I might convey by expressions, for instance. Sometimes I think the notetaking distracts to the point where she, too, is hearing but not really listening.
What do you think?
Mair
Posted by gardenergirl on January 26, 2005, at 22:47:22
In reply to Re: model good eye contact » gardenergirl, posted by mair on January 26, 2005, at 21:47:26
Good questions, Mair.
I haven't been aware of having trouble listening very often. I do distinctly remember one client who was an 82-year-old man I had been seeing for months. I was very very tired that day, and when he went into the usual recitation of all his bodily complaints, I found myself tuning out and going into a "zone" for a bit. It was hard to shake myself out of it. Ugh. But usually, I'm hooked by whatever the client is talking about.I don't take notes. I also find it distracting, and I rely on the non-verbal probably at least half as much as the verbal information from the client. The only time I take notes is during the first session when I am taking a history. Too much detail to remember then. And I always find myself stopping writing when things get really interesting, anyway.
gg
Posted by All Done on January 26, 2005, at 23:11:40
In reply to Re: model good eye contact » mair, posted by gardenergirl on January 26, 2005, at 22:47:22
Do you remember everything, gg? And if you do, how on earth do you do it?
I have a horrible memory - long-term, short-term, it doesn't matter. My T, on the other hand, seems to remember everything about me and everything I've said. Sometimes it surprises me when I can't, for the life of me, even remember telling him something.
He only (sort of) took notes on my first session, too.
Posted by terrics on January 27, 2005, at 6:35:48
In reply to Re: model good eye contact » gardenergirl, posted by mair on January 26, 2005, at 21:47:26
Just to add to this, my T. takes notes for 1/2 the session then puts her pad down and finishes without anymore notes. terrics
Posted by mair on January 27, 2005, at 7:05:33
In reply to Re: model good eye contact » mair, posted by terrics on January 27, 2005, at 6:35:48
I have other problems with note taking. Sometimes I find myself almost slowing down so my T can catch up with what I'm saying. It makes me feel like I'm dictating. Also, she has a tendency to write down some stuff I say verbatim, and I really dislike having it read back to me. I don't like the implication that what I say is of importance - not in the overall sense, but specific words or phrasing.
Should I tell her all this?
Mair
PS: She never used to take notes. She started when she decided I needed more intensive therapy and had me come twice a week. Now she loves it; she says she takes notes in her sessions with all of her other clients too. I think she really used to feel stressed between sessions trying to write things down about the session she just had, and probably like the rest of us, relieves her of having to try to remember things.
Posted by terrics on January 27, 2005, at 15:00:44
In reply to Re: boundaries » gardenergirl, posted by terrics on January 26, 2005, at 6:09:59
Hi gg, Here are a few examples of what I think are very foolish teachings: Core : teflon mind, watch your thoughts coming and going, the guard at the palace gate. Some good core mindfulness skills: non-judgmentally, letting go of vengeance etc., focus on what works. I think SURFING the URGE is useless. It focuses on the urge and keeps reminding you of the urge and therefore being who I am I complete the urge..Some of the interpersonal skills have been useful. You have to pick and choose. DEAR MAN GIVE has some usefulness; again pick and choose. Acting your way into feeling differently seems impossible to me. Have you ever been in a rage and then just tried an opposite action?
This is none of my business so you can berate these comments if you like. I think you should go through DBT from beginning to end with a skillfull therapist. You will also need somone to talk with if you decide to use it on borderlines because they act strongly both physically and verbally and can cause a lot of hurt and burnout to a young therapist. Also, if you go through it first, you can pick and choose whatever you find pertinent rather then using the 'silly stuff'. terrics
Posted by Annierose on January 27, 2005, at 15:32:43
In reply to Re: boundaries/ GG, posted by terrics on January 27, 2005, at 15:00:44
Posted by gardenergirl on January 27, 2005, at 19:37:15
In reply to Re: model good eye contact » gardenergirl, posted by All Done on January 26, 2005, at 23:11:40
Oh heavens no, I don't remember everything. I am always referring to my notes when my supervisor or one of the docs asks me a detail question. I'm much more of a big picture, flavor of the session kind of gal.
gg
Posted by gardenergirl on January 27, 2005, at 19:59:28
In reply to Note taking, posted by mair on January 27, 2005, at 7:05:33
> Also, she has a tendency to write down some stuff I say verbatim, and I really dislike having it read back to me. I don't like the implication that what I say is of importance - not in the overall sense, but specific words or phrasing.
Ewww, I would not like this. I think that how you say it today is what's important today. It's okay to note discrepancies or changes. But ick, it almost sounds like reading the transcript back in court. Yuck.
Okay, obviously I have a reaction to that. If it makes you uncomfortable, certainly tell her.
gg
Posted by gardenergirl on January 27, 2005, at 20:30:28
In reply to Re: boundaries/ GG, posted by terrics on January 27, 2005, at 15:00:44
I think this is valuable feedback. I really appreciate you letting me know. You are right, it's important for me to be very familiar with these skills in order to use them effectively. Especially because my supervisor is not familiar with them.
Thanks again,
gg
Posted by mair on January 27, 2005, at 21:23:46
In reply to Re: Note taking » mair, posted by gardenergirl on January 27, 2005, at 19:59:28
Actually I did talk to her about this today - how I don't like having my words repeated back to me and about how equivocal I am about the notetaking. She said she had been trying to cut down on taking notes because she thought maybe it was inhibiting my ability to feel connected with her. (I had noticed the last couple of times that she didn't seem to be as distracted by taking notes) I think she feels that it's a pretty valuable tool for her but certainly one she can pare back on. And I don't mind the notetaking; just the volume of it. She feels less rushed in between sessions if she doesn't have to devote that time to taking notes, although she said that it's not so much of an issue with me because I'm pretty good at making sure I don't run over my time.
And she also said she needs to be more sensitive about my discomfort having my words read back to me. (I have told her I don't like it before; I think she just forgets.) She's not so much reading them to me as reading them to herself - out loud.
So I'm sure she felt like today's session was a positive - she got me to ask for something I needed and to give her feedback on what I like and don't like about the way she conducts sessions, and she was able to respond in a way that showed me it was ok to do that.
It would just be nice if it wasn't all so excruciating.
Mair
Posted by Dinah on January 27, 2005, at 22:27:47
In reply to Re: boundaries/ GG » terrics, posted by gardenergirl on January 27, 2005, at 20:30:28
I think the advice to admit to the silly parts was excellent. As you may know, my main problem right now has to do with work, and since my therapist also has coaching experience, I had asked him if he could call on that to help me.
The other day he did that, but he admitted that parts of what he said would sound silly. And they did. But it didn't matter as much, and I didn't get as angry because he had admitted that. Instead of rolling my eyes and sighing, I smiled at him when I felt patronized, and instead of getting defensive, he smiled back and told me the part of the silly stuff he thought was actually helpful.
It took what has always been a huge problem to me with those one size fits all models and made it into something positive.
Posted by Dinah on January 27, 2005, at 22:36:16
In reply to Re: Note taking » gardenergirl, posted by mair on January 27, 2005, at 21:23:46
>
>
> It would just be nice if it wasn't all so excruciating.
>
> MairAin't it the truth!!
I get a bit paranoid about my therapists notes sometimes and ask him to read them back to me. He always picks apart my request enough that I'm discouraged from doing it often. Fortunately he appears to hate notes as much as I do. They're always something very generic, no matter how intense what we discussed was. "Patient discussed family stressors, and we identified possible coping strategies." or something similarly bland and often oddly off the mark. And usually one line per session. I suspect that even when he takes a lot of notes when he thinks he needs to for self protection, they're probably along the same generic lines.
Oddly, he now remembers things I barely even remember telling him. Quite a change from the early days when he barely remembered my name. It was the change from once a week to twice a week therapy that did it.
I think you are showing an immense amount of trust in your therapist - more than you give yourself credit for. It's hard enough to say things out loud. If I knew they were going to be written down verbatim, they'd never leave my mouth. :(
Posted by Annierose on January 28, 2005, at 12:59:15
In reply to Re: Note taking, posted by Dinah on January 27, 2005, at 22:36:16
All -
My T only takes notes when I lie down, vs. sitting. And I imagine that are not too detailed, although I don't know for sure. Along the same lines as GG, my T is a more "flavor of the session" type person, than specific details. Sometimes I do find that irritating, as I will have to recall information to her, but usually once I start the "story" she'll remember what I as referring to and I can stop the retelling.
And often times, she misunderstands the story completely (a "language" barrier ... I speak quickly). But I am getting better at speaking slower and I think she is getting better at remembering :)
Posted by mair on January 28, 2005, at 22:38:16
In reply to Re: Note taking, posted by Dinah on January 27, 2005, at 22:36:16
It's not like she makes reading these things back as part of a regular session. Mostly it's when neither one of us can remember something from a recent session and she looks back at her notes and just reads aloud what she had written.
I was a little disconcerted when she first started taking notes, but I guess I don't see the difference between taking them in session or right afterwards so long as it doesn't disrupt the rhythm of the session. I guess she does get stuff in more detail. I know they're not always in super detail. She told me recently that she wrote the word "miss" is large writing after a particularly bad session recently to signify that we just weren't on the same wavelength. That doesn't sound too detailed.
As to the there for posterity part, I guess I do have to trust her. I know with all of these notes, my file is two pretty thick folders. I've never had any desire to read my file, and it doesn't sound as if my file has alot of editorial comment to it anyway. So I figure I can't win either way - I don't like reading my own words, and I don't like seeing myself referred to in clinical terms.
Periodically, I do worry about what happens to my file if she's suddenly killed in an accident. Anyone know the protocol for this?
Mair
Posted by terrics on January 29, 2005, at 7:42:11
In reply to Re: Note taking » Dinah, posted by mair on January 28, 2005, at 22:38:16
Hi Mair, What a good question. What DOES happen to our files if T. dies? I do worry what info is in mine, but what can you do..terrics
Posted by shrinking violet on January 29, 2005, at 10:03:04
In reply to Re: Note taking » Dinah, posted by Annierose on January 28, 2005, at 12:59:15
My T never takes notes. I think she did during the first session or two, but after that she stopped. And she remembers everything, even little details of our conversations or details about me, even things I don't remember! I'm glad, though, b/c it makes me feel like she's more invested and paying attention. I'm sure she writes things in my chart after our sessions, but I've never seen them so I'm not sure how detailed they are.
I'm not sure if I'd rather have a T who took notes and remembered everything, or a T who didn't and couldn't remember much. I'm glad my T doesn't fall into either category. :-)
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